Marion County Medical Center

Health Shorts

February 2007

Tell Your Family If You Wish
To Donate Your Organs
If you haven’t signed a Uniform Donor Card to donate your organs after your death, you may want to consider it. Organs for transplantation are in short supply, and 17 Americans die every day while waiting for a transplant of a vital organ.

But even if you’ve signed such a form, you should also talk to your family about your wishes. Regardless of what you’ve signed, your next-of-kin will also be asked to sign a consent form. And in 35 percent of cases, this final consent is not given.
[SOURCE: National Kidney Foundation, “25 Facts about Organ Donation and Transplantation,” 2007]

Transplantation Can Affect Sexuality
Organ transplantation generally has a positive effect on overall health and quality of life. A recent study, however, found that 28 percent of women getting kidney or pancreas transplants reported negative effects on sexual function. One third of the women had only positive effects and 29 percent reported no effect.
[SOURCE: Rebecca J. Muehrer, Mary L. Keller, Arpaporn Powwattana and Atittaya Pornchaikate, “Sexuality among Women Recipients of a Pancreas and Kidney Transplant,” Western Journal of Nursing Research, March, 2006]

Smoking Endangers Transplant
Smoking can be a major contributor to heart disease. In fact, one study found that 98 percent of patients requiring a heart transplant had previously been smokers.

More alarming, 26 percent of these transplant recipients continued to smoke, despite warnings of the damage it could do. Another study found that 11.5 years after a transplant procedure, none of the smokers were alive compared to 80 percent of non-smokers.
[SOURCE: Andrea DiMartini, “Beyond Assessment: Psychiatry’s Role in Organ Transplantation,” Psychiatric Times, December 1, 2005]

If You Break a Toe...
A broken toe is not necessarily disabling, but if you suffer a painful injury that you think might be a fracture, it’s important to see a doctor right away. In the meantime, apply ice to reduce the swelling, take antiinflammatory pain killers, wear a wide shoe with a stiff sole and try to keep your weight off the affected foot.

About 75 percent of fractures occur in the smaller four toes, and these rarely require a cast. Proper treatment is needed, however, to prevent deformities in the bony structure of the foot and recurring arthritic pain.
[SOURCE: American Academy of Orthopaedic Surgeons, “Toe and Forefoot Structures,” December, 2001]

Young Women and Bunions
Adolescent females frequently develop bunions, and although the deformities are usually not as severe as they are with adults, they can lead to considerable distress.

The best way to relieve pain is to wear wide-toed shoes with low heels–an approach that many resist. Surgery is not recommended for cosmetic purposes alone, however, because the recurrence rate is considerably higher in young patients than in adults.
[SOURCE: Schmuel Tsurel and George H. Thompson, “Recognizing and Correcting Toe Problems in Children,” the Journal of Musculoskeletal Medicine, April, 1999]

Big Toe Carries Heavy Load
The big toe withstands 40 to 60 percent of body weight with each step–about twice the load of the other toes. During vigorous running or jumping, this load can increase to as much as eight times body weight, putting football, soccer and basketball athletes at risk of injuries such as turf toe.

Turf toe involves damage to the capsule in which the toe joint is housed. The risk is highest when athletes compete on hard, artificial surfaces in light, flexible shoes, such as those used for soccer. Turf toe may require several weeks’ rest. According to one study, about half of persons with turf toe injuries were still feeling symptoms five years later.
[SOURCE: Blake Ohlson, “Turf Toe,” emedicine from WebMD CME, last updated March 21, 2005]

Blood Test Predicts Heart Risk
A test measuring blood levels of the protein NT-proBNP was highly effective in predicting heart attack risk in a study of about a thousand heart disease patients. Subjects with the highest levels of this protein were eight times as likely as those with the lowest levels to suffer a heart attack, stroke or heart failure, according the study published in the Journal of the American Medical Association [January 10, 2007].

The test has been used for some time by emergency physicians to help identify heart failure in patients with shortness of breath and other symptoms.

The blood test is believed to have more value at this time for patients with established heart disease rather than for the general public.
[SOURCE: Salynn Boyles, “Blood Test Predicts Heart Attack Risk,” WebMD Health News 2007 from K. Bibbins-Domingo, JAMA, January 10, 2007]

CRP Test Adds Little, Study Says
Inflammation is a major factor in the development of plaque in blood vessels, and some authorities have recommended a blood test for CRP (C-reactive protein) as a way of detecting inflammation and identifying individuals at risk for heart disease. A recent study, published in
Archives of Internal Medicine [July 10, 2006] concluded, however, that widespread use of CRP screening is not advised.

Based on data from about 16,000 Americans from 1987 to 1989, the study found that traditional risk factors such as age, cholesterol, blood pressure, smoking and diabetes were good indicators of heart disease. Adding CRP to any or all of these risk factors did not improve the ability to predict a heart attack, stroke or heart failure.
[SOURCE: Daniel DeNoon, “CRP Test: Identify Heart Risk?” WebMD Health News, 2006 from A.J. Folsom, Archives of Internal Medicine, July 10, 2006]

Walking Test Predicts Risk of Death
Individuals who remain physically active in their 70s stand a better chance of remaining healthy in their 80s and beyond. In fact, a study of 2,680 persons aged 70 to 79 found that those who finished a quarter-mile hallway walking test had a significantly lower risk of disability and death.
[SOURCE: Miranda Hitti, “Walking Test May Predict Elders’ Death,” WebMD Health News, 2006, from A. Newman, JAMA, May 3, 2006]

Coronary Calcium Scans Found Effective
A painless, non-invasive scan that can be performed in less than 10 minutes has been found to be an effective way of evaluating the health of coronary arteries. A coronary calcium scan (also known as electron beam CT or multidetector CT scanning) measures the amount of calcium in coronary arteries. Calcium is a component of plaques but is not present in healthy arteries.

A study of 4,613 men and women in their 50s and 60s found that those with higher calcium scores were more likely to have a heart attack, stroke, surgery or angioplasty in the next four years. The predictive value of the test was found to be better than that of the commonly used Framingham risk score.
[SOURCE: “Coronary Calcium Scans Predict Heart Attacks,” Johns Hopkins White Papers: Coronary Heart Disease, 2006; from Journal of the American College of Cardiology, July 5, 2005]

Choosing a Yoga, Tai Chi Class
Yoga and tai chi have strong philosophical components and are best learned from an experienced teacher rather than a book or video. To find a teacher who is right for you:

•Visit a class, at least two or three times, even if that means paying a minimal charge.
• Educate yourself by reading.
• Talk to the teacher about his or her experience with the discipline. What attracted you to yoga (or tai chi)? How long have you been practicing? How long have you taught? Who was your teacher?
• Talk to other students about their experience with the class.
• Try a class to make sure you’re comfortable with the teacher and his or her style. If you don’t enjoy the class, you’re less likely to stick with it.
[SOURCE: Heather Hatfield, “Beyond Om: The Many Styles of Yoga,” WebMD Feature, medically updated May 18, 2006; Barbara Russi Sarnatoro, “Tai Chi Exercises Both Mind and Body,” June 23, 2006]

Yoga Improves Strength, Flexibility
A Vermont yoga teacher recruited 16 older women with an average age of 78 and enrolled them in a one-hour yoga class meeting either once or twice a week for 12 weeks. Based on tests conducted by an independent physical therapist both before and after the study, she found that students meeting twice a week registered a 25 percent increase in strength, a 22 percent improvement in function and a 4 percent increase in flexibility. The once-a-week group had smaller but significant gains in each area.
[SOURCE: Shirley Archer, “IDEA Member’s Study Shows Yoga Benefits Older Adults,” IDEA Fitness Journal, November-December, 2005]

Tai Chi: A Slow But Steady Burn
Tai chi involves slow, gentle movements that place almost no impact on the joints. Nevertheless, it burns 400 calories an hour–more than surfing and about the same as downhill skiing or brisk walking.

Workouts: Mind, Body or Music?
Do you work out to the sound of music from your iPod? Or are you the old-fashioned type of runner who listens to your body so that you can tell by the end of mile two how you’re going to be feeling when you reach mile eight?

Headphones and TV sets have become a standard part of any health club, and there are advantages. One British study found that subjects on stationary bikes pumped 13 percent harder to up-tempo music compared to those pumping in silence. If you have to force yourself to exercise, music or TV watching is a pleasant distraction that can keep you motivated.

On the other hand, studies have found that serious athletes, reaching for the maximum performance, do better without any distractions. And mind-body exercises such as yoga and tai chi require intense concentration on the movement itself.
[SOURCE: Michael Hill, AP Health, January 23, 2007]