Marion County Medical Center

Health Shorts

August 2006

Bed Sharing–The Other Side
About half of all SIDS death occur while the child is sleeping with the parents, and the American Academy of Pediatrics’ (AAP) 2005 guidelines for the prevention of Sudden Infant Death Syndrome include a recommendation against bed sharing. Not all medical groups agree.

In Alaska the incidence of SIDS has declined by 50 to 70 percent since 1993 while the percentage of mothers sleeping with their infants increased from 16 to 40 percent. As a result, the Alaska Division of Public Health and the Alaska chapter of AAP called on the AAP “to revise their recommendations to reflect the scientifically defensible position that bed sharing is only a risk if the parent is impaired or the sleeping surface is inappropriate.”

The AAP’s Section on Breastfeeding stated that “bed sharing under safe conditions may prove to be an important factor in the success of breast feeding.” Exclusive breast feeding for six months, according to this group, is an important preventive practice.
[SOURCE: Bradford D. Gessner, et al, “Bed Sharing with Unimpaired Parents Is Not an Important Risk for Sudden Infant Death Syndrome,” (Letters to the Editor) Pediatrics, March, 2006]

Heading Off Head Deformity
With more parents putting their babies to sleep on their back rather than their stomach or side, the incidence of positional head deformity (a flattened back of the head) has increased dramatically since 1992 and now affects 1 of every 60 live-birth infants.

Prevention involves giving the child plenty of supervised play time on his stomach and avoiding prolonged use of a swing or car seat. For feeding, doctors recommend approaching the child from the side opposite the flattened area.

Positional head deformity can be treated with physical therapy and a helmet orthosis.
[SOURCE: Wendy S. Biggs, “Diagnosis and Management of Positional Head Deformity,” American Family Physician, May 1, 2003]

Blacks Have Increased SIDS Risk
A dramatic reduction of SIDS deaths among all groups has occurred since 1992, but a disparity between white and black infants remains. African-American infants have sudden infant death syndrome (SIDS) at double the rate of white children.
[SOURCE: Duane Alexander, “Reducing the Risk of SIDS Through Community Partnerships,” American Family Physician, July 15, 2005]

SIDS Risk in Child Care High
Studies show that children in child care environments are no more likely than other children to be placed in an unsafe sleeping position or on an unsafe sleeping surface. Yet the percentage of SIDS deaths in child care settings is still relatively high at 16.5 percent. That percentage is about double what could be expected but is down from 20.4 percent in 1995-1997.

SOURCE: Rachel Y. Moon, Bruce M. Sprague and Kantilal M. Patel, “Stable Prevalence But Changing Risk Factors for Sudden Infant Death Syndrome in Child Care Settings in 2001,” Pediatrics, October, 2005]

Watch Out for Vision Problems
A headache of a kind you’ve never had before, scalp tenderness and sudden changes in vision can be signs of temporal arteritis, a major cause of permanent vision loss in persons age 50 and over. With prompt treatment, this disease can be successfully treated and visual problems reversed.

Women are twice as likely as men to get temporal arteritis, an inflammatory disease of the arteries. Individuals of Northern European descent are particularly vulnerable.
[SOURCE: Ted D. Epperly, et al, “Polymyalgia Rheumatica and Temporal Arteritis,” American Family Physician, August 15, 2000]

Headache Is Chief Complaint
A sudden-onset headache–usually severe and predominantly in the temples–was the most common symptom reported for temporal arteritis, an inflammatory disease affecting the blood vessels of the head. About a third of patients had blurred vision, double vision or temporary loss of vision, and half of these patients eventually had permanent blindness. Prompt treatment with corticosteroids can, however, prevent loss of vision.
[SOURCE: Miguel A. Gay-Gonzalez, et al, “Giant Cell Arteritis: Disease Patterns of Clinical Presentation in a Series of 240 Patients,” Medicine, September, 2005]

Severe Headache: When To Worry
A severe headache is often a sign of a life-threatening or potentially disabling neurological disorder such as a central nervous system infection, temporal arteritis, a stroke or a brain tumor. Headaches that should raise a red flag include:

the worst headache or the first severe headache a patient has ever had,
a headache that gets worse over a period of days or weeks,
a headache accompanied by vomiting, fever or other unusual symptoms,
a headache that wakes you up or keeps you awake,
a headache brought on by bending, lifting or coughing,
a type of headache that appears for the first time after age 55.

[SOURCE: Casilda Balmaceda and Jennifer Rossi, “Is It a Minor Headache or a Dangerous Neurological Disorder? Temporal Arteritis and Infections Are High in the Differential,” the Journal of Critical Illness, February, 2003]

Work Out in High Heels? No
Workouts in skimpy outfits and high heeled shoes, featured recently at some health clubs, might feel and look sexy but they are not healthy for knee, ankle and feet joints.

A woman wearing narrow high heeled shoes either for work or play is putting herself at risk of bunions, hammer toes and other painful and unsightly foot problems. In addition, a high heeled shoe forces the foot into a position that takes away most of its usefulness in absorbing shock while adding little cushioning of its own. By forcing the calf and thigh muscles to contract, the shoe places extra stress on the knee joint.
[SOURCE: Marc Darrow, “The Functioning Knee,” WebMD Medical Reference from The Knee Sourcebook,” 2002.

The Right Shoe for the Right Sport
Athletic shoes today are designed for specific sports. Running shoes, for example, provide cushioning and motion control, but they lack the lateral stability that is needed for basketball or tennis. To avoid injury, wear the right shoe for the right sport.
[SOURCE: Jim Morelli, “Twist and Shout: How To Minimize Ankle Sprains,” WebMD feature, 2000]

Protecting Arthritic Joints
For arthritis patients, physical therapists offer some basic concepts of joint protection for exercise or daily activities:

Use stronger and larger joints–the elbow rather than the fingers, the whole body rather than the arm–whenever possible to ease the burden on the smaller, more vulnerable joints.
Distribute the load over several joints.
Learn good body mechanics: lift with your legs rather than your back, keep your joints in extended rather than flexed positions.
Avoid long periods of sitting or standing. Change positions frequently throughout the day. Make frequent stops when traveling by car.
Make sure your chair and work station are neither too high nor too low.

[SOURCE: Neal S. Birnbaum, Lynn H. Gerber and Richard S. Panush, “Self-Help for Arthritis Patients,” Patient Care, August 15, 1989]

Exercise Good for What Ails You
About 48 percent of Americans age 60 and over suffer from knee or back pain, according to one study. Although pain may put a damper on their physical activities, it’s important for them to stay active. Another study published in the Journal of the American Medical Association found that seniors who did either weight-bearing exercise or walking had less pain and more mobility than those given verbal instruction in arthritis care.
[SOURCE: Marc Darrow, “The Functioning Knee,” WebMD Medical Reference from The Knee Sourcebook,” 2002; Dr. Walter Ettinger, et al, JAMA, 1997]

Investing in AIDS Prevention?
An investment of $122 billion in global AIDS prevention programs targeting both sexual and IV drug transmission could avert 28 million new HIV infections over the next decade, according to one projection. The cost of preventing each new infection is estimated at $3,900, but the savings in treatment and care costs would be $4,700 per person.
[SOURCE: John Stover, et al, “The Global Impact of Scaling Up HIV/AIDS Prevention Programs in Low- and Middle-Income Countries,” Science, March 10, 2006]

Circumcision Reduces HIV Risk
A large randomized study in Africa found that men who were circumcised had a markedly lower risk of HIV infection. The inner mucosal surface of the foreskin may contain cells susceptible to infection, particularly in men with a history of sexually transmitted diseases.
[SOURCE: Jeffrey Laurence, “Suppressing HIV Transmission Through Behavior and Biology,” The AIDS Reader, May 1, 2006]

Women More Vulnerable to HIV
Twenty years ago, more than 90 percent of AIDS patients in the United States were males; today nearly 30 percent of new AIDS diagnoses are in women, with women under age 25 particularly vulnerable.

Biologically, women are more vulnerable to being infected with HIV, and they are more likely to suffer progression of the disease with lower levels of virus.
[SOURCE: Jeffrey Laurence, “Suppressing HIV Transmission Through Behavior and Biology,” The AIDS Reader, May 1, 2006]

Health Shorts

August 2006

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