Marion County Medical Center

Health Shorts

October 2005

ACE Inhibitors for Diabetics:
Medicare Coverage Is Cost Effective
Although most diabetes patients on Medicare would benefit from treatment with ACE inhibitors, only 40 percent take them, at least in part because of the lack of insurance coverage. With the cost of treatment with generic ACE inhibitors averaging $233 a year, a recent study found that Medicare would save money as well as lives by paying the full cost of ACE inhibitor treatment for diabetic beneficiaries.

Approved as blood pressure medications, ACE inhibitors have been found effective in slowing the progression of kidney disease and lowering the risk of heart attack and stroke in diabetics–even those who do not have high blood pressure.

[SOURCE: “The Cost-Effectiveness of Full Medicare Coverage of Angiotensin-Converting Enzyme Inhibitors for Patients with Diabetes,” Annals of Internal Medicine, July, 2005]

Hand Washing Becomes Contagious
When squatter settlements in Karachi, Pakistan were given soap and educational materials about hand washing, the incidence of diarrheal illness fell by 53 percent and the incidence of pneumonia by 50 percent. Regular soap was as effective as antibacterial soap, even though the water available for hand washing was contaminated with fecal organisms.

The researchers noted, however, that the reduction of disease did not come immediately but became apparent after several months. They theorized that the change in habits took several months to become established among family members.

[SOURCE: Stephen P. Luby, et al, “Effect of Handwashing on Child Health: A Randomised, Controlled Trial,” The Lancet, July, 2005]

Interrupting the Hand/Mouth Path
During the cold and flu season, infectious organisms may lurk on at least 60 percent of household surfaces. An organism may survive for several hours on a computer keyboard, for example, so the best way to protect yourself is to wash your hands frequently...before you inadvertently bring them in contact with your mouth, nose or eyes.

[SOURCE: “Clean Your Keyboard–and Wash Your Hands,” Indiana Business Journal, July, 2005]

From Athlete’s Foot to Jock Itch
Men with athlete’s foot frequently develop jock itch, a fungal infection in the groin area. One important way of interrupting this cycle is through frequent hand washing.

[SOURCE: Carol Luangsawasdi, “Tinea, Tinea, Everywhere!” Clinician Reviews, January, 2005]

Cold Prevention: It’s in Your Hands
Numerous strategies have been advanced for preventing the common cold: echinacea, zinc, vitamin C and other antioxidants. The evidence for their effectiveness is slim.

The best proven way to protect yourself from colds, flu and other infectious illnesses is to wash your hands frequently, particularly after interacting with others or spending time in crowded public places.

[SOURCE: Joan Hamilton, “Combating Colds: Everyone Swears by a Different Remedy,” Town & Country, January, 2004]

ACE Inhibitors--Not Equally Effective
Studies have found that ACE inhibitors, when taken by persons who have survived a heart attack, reduce the risk of a second attack. One recent study, however, found that not all of these medications had the same level of effectiveness when prescribed for this purpose.

Among 7,512 patients 65 years and older, those taking ramipril, lisnopril and perindopril were less likely to die during the first year than subjects taking enalapril, fosinopril, captopril or quinapril.

[SOURCE: L. Pilote, et al, “Mortality Rates in Elderly Patients Who Take Different Angiotensin-Converting Enzyme Inhibitors after Acute Myocardial Infarction: A Class Effect?” Annals of Internal Medicine,” July 20, 2004]

Atherosclerosis Linked to Pollution
Exposure to air pollution has long been known to cause lung damage, but a new study suggests a connection between air pollution and atherosclerosis or hardening of the arteries. Results, reported by the National Institute of Environmental Health Sciences (NIEHS), showed that the more a subject was exposed to air pollution, the thicker the inner layers of the person’s carotid arteries.

Of the subjects, those most exposed to air pollution experienced approximately eight percent more artery thickening than those least exposed. The NIEHS study also showed that the rate of artery thickening among women over age 60 was nearly four times higher than in the overall population.

[Source: “New Study Links Cardiovascular Disease to Particulate Matter,” Mobile Emissions Today, Feb. 2, 2005]

Reduce Stress, Reduce Risk
If you’re at high risk for atherosclerosis, you may want to try reducing stress levels in your daily life. Researchers from Germany recently found a direct connection between psychological strain and hardening of coronary arteries.

The human brain responds to stress by releasing neuropeptides, which both mediate stress and initiate an inflammatory response. According to Robert A. Anderson, repeated episodes of acute stress can produce chronic inflammatory changes in the arteries, which may result in atherosclerosis.

Some researchers now think that the final event in rupture of arterial plaque is related to an acute inflammatory response related to increased stress levels.

[Source: Robert A. Anderson, “Inflammation and Stress,” Townsend Letter for Doctors and Patients, May 2005; “Being under Strain Increases Risk of Carotid Plaques.” Nursing Standard, May 18, 2005]

Vegetable Alternatives for Omega-3
Omega-3 fatty acids are a heart-healthy nutrient known to dramatically reduce the risk of atherosclerosis. Though fish is the richest known source of omega-3 fats, a recent study found that persons eating foods rich in a plant omega-3, alpha-lineolic acid (ALA), slashed early measures of atherosclerosis by 75 percent.

Food sources of ALA include flaxseed, canola and walnut oil, as well as ground flaxseed, walnuts, cooked soybeans and tofu.

[Source: Gloria McVeigh, “Smart Alternatives to Fish,” Prevention, April, 2005]

Tips for Managing Atherosclerosis
Atherosclerosis, or hardening of the arteries, is the major cause of heart disease which in turn is the leading cause of death for both men and women. There’s no cure for atherosclerosis but you can prevent it or slow its progression.

•Stop smoking. It damages blood vessels and hastens the progression of disease.

• Control your blood pressure. Even blood pressure slightly over 120/80 doubles a person’s risk for heart disease and is a risk factor for stroke, congestive heart failure and kidney failure.

• Lower your LDL and increase your HDL cholesterol by following a heart-healthy diet, getting at least 30 minutes a day of moderate intensity exercise and maintaining a normal weight.

• Reduce your homocysteine level by eating foods rich in folic acid (citrus fruits; dark green, leafy vegetables and whole grain bread and cereal), vitamins B6 and B12 (beef, poultry, fish, vegetables, milk and other dairy products).

[SOURCE: “Atherosclerosis: Prevention,” NWHRC Health Center,” 2005]

Warnings on Safe Toys Dilute Message
After pushing for and obtaining appropriate warnings on toys that constitute a choke hazard, the Public Interest Research Group is now concerned that some manufacturers are “over-labeling toys,” placing the hazard warning even on toys that do not contain small parts. PIRG warns that this “could dilute the meaning of the warning labels, making them less useful to parents.”

[SOURCE: Public Interest Research Group, “Trouble in Toyland,” November, 2004]

Keep Your Tree Baby-Safe
If you have an under-three child in your home or coming to visit for the holidays, be sure to child proof your decorations as well as your house. Any ornaments within the child’s reach–or that might fall to the floor–should not be breakable or small enough to fit inside the child’s mouth. Generally speaking, that means less than one and one-quarter inches in diameter and two and one quarter inches in length.
It’s also a good idea to secure your tree well so there is no danger that it will tip.

[SOURCE: “Baby’s First Holidays: Here’s How To Make Them Fun–and Safe,” American Baby, December, 1997]

Not So Loud, Kids!
More than 15 percent of American children and adolescents have signs of hearing loss, according to a report in the Journal of the American Medical Association [November, 1998], and at least some of this may be attributed to loud toys or music.

The loudness threshold for handheld toys was recently set at 90 decibels by the American Society for Testing and Materials. In the work place, the Occupational Safety and Health Administration (OSHA) has determined that 85 decibels of chronic exposure is hazardous to hearing. This is approximately the loudness level of a hair dryer.

[SOURCE: Public Interest Research Group, “Trouble in Toyland,” November, 2004]

Wash Hands Rather than Disinfect Toys
Toys can transmit viruses and bacteria, just as any surface of your home can. If other children visit, you may want to put washable toys and vinyl books in the washing machine once a week or so. Soap and water is every bit as good as antibacterial products in cleaning them. The easiest and best way to prevent the spread of germs is through frequent hand washing.

[SOURCE: Donald Middleton and Sharon Dickinson, “Why Buying Toys, Aim for Safe & Stimulating,” Newsweek, September 29, 1997]

Health Shorts

October 2005

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