By LAURA JOHANNES in the Wall Street Journal

There’s a new twist in the winter ritual of stocking up on cold and flu medicine–—products designed to protect you from getting sick in the first place. (See full story) 

BY LAURA JOHANNES in the Wall Street Journal

Copper and silver are making a comeback as germ-fighting agents. The metals have been known for their anti-microbial powers for more than a century, but they were eclipsed by antibiotics in the modern era. Now, due in part to technology that allows them to be woven into fabrics, copper and silver are showing up in consumer products. (See full story) 

Kids who are endangered by everyday foods need to learn how to fend for themselves in the real world

By SANDRA BEASLEY, Wall Street Journal

At a recent dinner with friends, I was determined to enjoy a night without any allergic reactions. I had asked for the dairy-free menu, but when the waiter brought our drink orders, I eyed my martini glass with alarm: It was garnished at the bottom with a pearl of milky liquid.

“What’s in that?” I asked.

He proudly described a liqueur containing essence of pine nut. I groaned.

“You didn’t ask for the nut-free menu!” he said.

I looked at him. “The nut-free menu for cocktails?” (Read full story)

By Melinda Beck, Wall Street Journal

As many as 20% of adults at some point suffer from a painful digestive disorder that is difficult to diagnose and has no cure. Treatment is hit or miss, and many sufferers never seek help because they find the symptoms hard to discuss. (Read full story)

Pediatric

Adult Forms

Oversensitivity diseases, or allergies, now affect 25 per cent of the population of Denmark. The figure has been on the increase in recent decades and now researchers at the Dansk BørneAstma Center [COPSAC, Copenhagen Prospective Studies on Asthma in Childhood], University of Copenhagen, are at last able to partly explain the reasons.

“In our study of over 400 children we observed a direct link between the number of different bacteria in their rectums and the risk of development of allergic disease later in life,” says Professor Hans Bisgaard, consultant at Gentofte Hospital, head of the Copenhagen Prospective Studies on Asthma in Childhood, and professor of children’s diseases at the Faculty of Health Sciences, University of Copenhagen.

“Reduced diversity of the intestinal microbiota during infancy was associated with increased risk of allergic disease at school age, he continues. But if there was considerable diversity, the risk was reduced, and the greater the variation, the lower the risk.

“So it makes a difference if the baby is born vaginally, encountering the first bacteria from its mother’s rectum, or by caesarean section, which exposes the new-born baby to a completely different, reduced variety of bacteria. This may be why far more children born by caesarean section develop allergies.”

There is no allergy-causing bacteria 

In the womb and during the first six months of life, the mother’s immune defences protect the infant. Bacteria flora in infants are therefore probably affected by any antibiotics the mother has taken and any artificial substances she has been exposed to.

“I must emphasise that there is not one single allergy bacteria,” Professor Bisgaard points out.
“We have studied staphylococci and coli bacteria thoroughly, and there is no relation. What matters is to encounter a large number of different bacteria early in life when the immune system is developing and ‘learning’. The window during which the infant is immunologically immature and can be influenced by bacteria is brief, and closes a few months after birth.
“Our new findings match the large number of discoveries we have also made in the fields ofasthma and hay fever,” Professor Bisgaard explains. Like allergies, they are triggered by various factors early in life.

The researchers gathered their data from a unique material consisting of 411 children whose mothers have asthma. This cohort was monitored, interviewed and tested continually from when the children were born 12 years ago, and the COPSAC group has published articles at regular intervals with new knowledge about allergy and asthma ever since. 

These findings could be relevant for other modern diseases
Professor Bisgaard acknowledges the irony of something that used to be perceived as a threat to public health, namely bacteria, now turning out to be a fundamental part of a healthy life. He also points out that there may be other couplings, such as between intestinal flora and diabetes orobesity and other lifestyle diseases affecting modern man in the West.

“I think that a mechanism that affects the immune system will affect more than just allergies, he concludes. It would surprise me if diseases such as obesity and diabetes are not also laid down very early in life and depend on how our immune defences are primed by encountering the bacterial cultures surrounding us.”

University of Copenhagen. “Bacterial Protection From Allergy.” Medical News Today. MediLexicon, Intl., 3 Nov. 2011. Web.
3 Nov. 2011. <http://www.medicalnewstoday.com/releases/237070.php>

WASHINGTON—A Salinas, Calif., farm is recalling bagged salads after a sample of lettuce tested positive for listeria, according to the producer.

River Ranch Fresh Foods LLC said it was recalling 2,154 cases of the salad, some of which was distributed to Giant Eagle Inc., a Pittsburgh-based grocery store chain, which also announced a recall.

Giant Eagle said it was recalling eight-ounce bags of “Farmer’s Market” shredded iceberg lettuce that it sold in Ohio and Pennsylvania stores.

River Ranch Fresh Foods said it distributed the recalled bags of salad in Ohio, Pennsylvania and Iowa and they all carry a use-by-date of Oct. 14 and are sold under the brands “Farmer’s Market” and “Hy-Vee.”

Also included in the recall are bags of Parisian blend, leafy romaine, romaine garden, American blend and garden supreme salads.

The listeria was found through routine testing by the Ohio Department of Agriculture, according to River Ranch Fresh Foods and there have been no illnesses associated with the recall.

But listeria can be a particularly dangerous bacteria.

An ongoing outbreak of listeriosis connected to tainted cantaloupes has infected more than 100 people and killed 23, making it the deadliest food-borne outbreak since 1985 when listeria-contaminated cheese killed 48 people.

Some of the lettuce being recalled by Giant Eagle was used as ingredients in Giant Eagle sandwiches.

Giant Eagle said it had “removed all potentially affected products from its store shelves” and is calling customers who purchased the products “with instructions to dispose of the product or return it to the store for a refund.”

The most common symptoms of listeriosis are fever, muscle aches and diarrhea or other gastrointestinal problems. Infection can be especially dangerous “for older adults, persons with weakened immune systems, and pregnant women,” according to the Centers for Disease Control and Prevention.

Today, hospitals and doctors use a system of about 18,000 codes to describe medical services in bills they send to insurers. Apparently, that doesn’t allow for quite enough nuance.

Search for diagnoses codes from the International Classification of Diseases, 10th Revision, by typing in a keyword. We’ve provided a few to get you started.

 

 

And see the full table of codes at the Centers for Medicare and Medicaid Services site. Click 2011 Code Descriptions — Long Format, Table Format and README files.

A new federally mandated version will expand the number to around 140,000—adding codes that describe precisely what bone was broken, or which artery is receiving a stent.

It will also have a code for recording that a patient’s injury occurred in a chicken coop. (See code.)

Indeed, health plans may never again wonder where a patient got hurt. There are codes for injuries in opera houses (see code), art galleries (see code), squash courts (see code) and nine locations in and around a mobile home (see codes), from the bathroom to the

bedroom.

 

Health insurers, doctors and hospitals are bracing for chaos as they prepare to adopt a new federally mandated format for medical billing. Anna Wilde Mathews has details on Lunch Break.

Some doctors aren’t sure they need quite that much detail. “Really? Bathroom versus bedroom?” says Brian Bachelder, a family physician in Akron, Ohio. “What difference does it make?”

The federal agencies that developed the system—generally known as ICD-10, for International Classification of Diseases, 10th Revision—say the codes will provide a more exact and up-to-date accounting of diagnoses and hospital inpatient procedures, which could improve payment strategies and care guidelines. “It’s for accuracy of data and quality of care,” says Pat Brooks, senior technical adviser at the Centers for Medicare and Medicaid Services.

Billing experts who translate doctors’ work into codes are gearing up to start using the new system in two years. They say the new detail is welcome in many cases. But a few aspects are also causing some head scratching.

Some codes could seem downright insulting: R46.1 is “bizarre personal appearance (see code),” while R46.0 is “very low level of personal hygiene (see code).”

It’s not clear how many klutzes want to notify their insurers that a doctor visit was a W22.02XA, “walked into lamppost, initial encounter” (or, for that matter, a W22.02XD, “walked into lamppost, subsequent encounter”).

Why are there codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not while shopping, wonders Rhonda Buckholtz, who does ICD-10 training for the American Academy of Professional Coders, a credentialing organization.

Code V91.07XA, which involves a “burn due to water-skis on fire (see codes),” is another mystery she ponders: “Is it work-related?” she asks. “Is it a trick skier jumping through hoops of fire? How does it happen?”

Much of the new system is based on a World Health Organization code set in use in many countries for more than a decade. Still, the American version, developed by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services, is considerably more fine-grained.

The WHO, for instance, didn’t see the need for 72 codes about injuries tied to birds. But American doctors whose patients run afoul of a duck (see codes), macaw (see codes), parrot (see codes), goose (see codes), turkey (see codes) or chicken (see codes) will be able to select from nine codes for each animal, notes George Alex, an official at the Advisory Board Co., a health-care research firm.

There are 312 animal codes in all, he says, compared to nine in the international version. There are separate codes for “bitten by turtle” and “struck by turtle.” (See codes.)

U.S. hospitals and insurers are bracing for possible hiccups when the move to ICD-10 happens on Oct. 1, 2013, even though they’ve known it was coming since early 2009.

“You have millions of transactions flowing in the health-care system and this is an opportunity to mess them all up,” says Jeremy Delinsky, chief technology officer for athenahealth Inc., which provides billing services to doctors.

Medicare officials say they believe many big insurers and hospital systems are making preparations, but there may be some issues with smaller ones that won’t be ready.

With the move to ICD-10, the one code for suturing an artery will become 195 codes, designating every single artery, among other variables, according to OptumInsight, a unit of UnitedHealth Group Inc. A single code for a badly healed fracture could now translate to 2,595 different codes, the firm calculates. Each signals information including what bone was broken, as well as which side of the body it was on.

Some companies hope to grab business from the shift. One medical-coding website operator, Find A Code LLC, has created a series of YouTube videos with the tagline, “Yeah, there’s a code for that.” Snow White biting the poisoned apple, the firm says, may be a case of T78.04, “anaphylactic shock due to fruits and vegetables (see codes).” On April 1, the company posted a document with the secret “X-codes” to describe medical conditions stemming from encounters with aliens.

Other coding cognoscenti spot possible hidden messages in the real codes. The abbreviation some use for the new system itself, I10, is also a code for high blood pressure. Several codes involving drainage devices end in “00Z.” Then there are two of the codes describing sex-change operations that end in N0K1 and M0J0. “You could see it ripple through the room as people said, ‘nookie and mojo!’” says Kathryn DeVault, who has been teaching ICD-10 classes for the American Health Information Management Association. “Was it purposeful? We don’t know.”

No, it wasn’t, says the Medicare agency’s Ms. Brooks, who says the codes are built according to a consistent pattern in which each digit has a meaning.

“I couldn’t if I wanted to insert a cute message,” says Ms. Brooks, who admits that she could be described by Z73.1, “Type A behavior pattern (see code).”

Medicare and CDC officials say codes were selected based on years of input from medical experts in various fields. Codes describing the circumstances of injuries are important for public-health researchers to track how people get hurt and try to prevent injuries, they say.

Being able to tabulate risks tied to locations such as chicken coops could be “important as far as surveillance activities” for public health research, says Donna Pickett, a medical systems administrator at the CDC. She says the current code for a badly healed fracture is so vague it isn’t useful.

Another CMS official, Denise M. Buenning, compares ICD-10 to a phone book. “All the numbers are in there,” she says. “Are you going to call all of the numbers? No. But the numbers you need are in there.”

Getty Images In a study of people 18 to 91 years old, those who played an instrument since 16 were better at tasks involving auditory processing than non-musicians.

A lifetime of playing and practicing a musical instrument protects the brain’s ability to detect and process sound, resulting in better hearing as people age, according to a study in Psychology and Aging.

Moderate hearing loss affects 30% of people by the age of 60, but a growing body of research suggests cognitively demanding activities can delay the effects of aging. Using a soundproof room, Toronto researchers tested 74 musicians and 89 non-musicians on their ability to detect brief gaps in sound, speech in a noisy background, different sound frequencies and increasingly quieter tones called pure-tone thresholds. Subjects ranged from 18 to 91 years old. Musicians had played an instrument since the age of 16. Non-musicians had no more than two years of music lessons and didn’t play an instrument.

Musicians were significantly better than non-musicians at distinguishing sound frequencies, sound gaps and speech amid noise, tasks associated with auditory processing in the brain. Detection of pure-tone thresholds, commonly used to assess hearing loss, was similar in both groups, reflecting normal age-related changes to the inner ear, researchers said. Playing a musical instrument may have long-lasting neural benefits, the study suggests.

Caveat: Musicians may have inborn abilities that endow them with enhanced auditory-processing abilities, researchers said. Distinguishing levels of musical experience is an inexact process, they said. The study was small.

Dr. Denninghoff’s notes:

There are 2 reactors within 30 miles of Columbia (Callaway and University of Missouri). Potassium iodide is available over the counter and is not expensive. I keep it at home just in case.