Nine breast cancer programs get total of $360,000 from Komen

Nine programs in Central and Eastern Kentucky will share $360,000 for breast cancer screening, treatment, education and patient navigation.

The grants go to breast cancer-specific projects of the Lexington-Fayette County Health Department; the Kentucky Pink Connection; Central Baptist Hospital; St. Joseph Breast Center; King's Daughters Medical Center; Mountain Comprehensive Health Corp.; Our Lady of Bellefonte Hospital; Dayspring Family Health Center; and North Central Area Health Education Center. Programs chosen were determined to have the greatest impact on underserved women in a 58-county service area, the Lexington Herald-Leader reports.

The grants were awarded by the Lexington affiliate of Susan G. Komen for the Cure. Another $100,000 raised in Kentucky went to the Susan G. Komen for the Cure National Grants Program to fund research. (Read more)

Heartburn on the rise, driven by overeating; avoid minty antacids

As overeating has become more common, Americans have been suffering from a lot more heartburn, the American Gastroenterology Association has found. About 25 million people say they experience daily symptoms of acid reflux, up from 15 million a decade ago, with another 60 million saying they have heartburn once a month.

"Blame stress and an aging population — and above all, experts say, blame Americans' habit of eating too much," reports The Courier-Journal's Anita Creamer.

Though it can occur at any age, acid reflux is most common in middle age. It is caused when acid backwashes into the esophagus while a person is digesting, the result of the sphincter muscle at the top of the stomach being weak. Acid reflux, which can cause heartburn, nausea, coughing and hiccups, can be especially common at night if a person goes to bed with a full stomach. "Anything that increases stomach pressure increases reflux," said Dr. Ronald Hsu, a gastroenterologist at Sutter Roseville (Calif.) Medical Center. "People who are more obese have more symptoms. Pregnant women can have more reflux."

To get relief, avoid mint-flavored antacids. Mint relaxes the valve between the stomach and esophagus, compounding the problem. Losing weight can help. So can avoiding chocolate, citrus fruits, alcohol, caffeine or spicy foods. Over-the-counter medications like Prilosec and Prevacid can block the release of stomach acid and provide relief.

People who regularly have acid reflux are more prone to developing esophageal cancer, which has been relatively rare but is difficult to treat and is quickly becoming more common. Most at risk are middle-age and elderly men who have long suffered from acid reflux and often are obese. (Read more)

EPA says DEET is safe for fighting off skeeters when used correctly; some natural alternatives are also effective

Though April showers did bring May flowers, May's seemingly constant rain also grew something else in Kentucky: mosquitoes — and lots of them. To protect oneself from the irritating suckers (Getty Images), there is a host of products from which to choose.

The most obvious are products containing DEET, a synthetic compound that was approved for the general public in 1957, reports Amanda Leigh Mascarelli of the Los Angeles Times. DEET is used by 30 percent of Americans each year, the Environmental Protection Agency reports. A 2009 market survey showed products containing the compound accounted for 90 percent of the insect repellent market.

(LAT photo Kirk McKoy) Though popular, DEET has its drawbacks. It can dissolve some plastics, such as soldier's goggles, watchbands and computer keyboards. It can pollute soil and water, is sticky on skin, is not effective against all insects, and is smelly. Is it unsafe? That is a common conception, but EPA insists it is safe when used properly. "There really is no chemical out there that works better than DEET," said Donald Roberts, a retired professor of tropical public health at the Uniformed Services University of the Health Sciences. (Read more)

There are more natural alternatives on the market. Oil of lemon eucalyptus (LA Times photo by Hatley Mason), which is sold under the name Citriodiol, has been proven effective for six or more hours and is found in brands like Repel, Cutter and Coleman Botanicals. Though more natural than DEET, it is still considered a hybrid natural/synthetic product.

A pine oil derivative called isolongifolenone also shows great promise, though testing is still ongoing. "It does look as if this organic repellent functions pretty much at an equal level with DEET, maybe even better," Roberts said. "Until we have a lot more test data, it would be hard to give a definitive statement on that, but I would say that it shows real promise." It is hoped the product will be on the market within 18 months.

Unlike compounds such as DEET, natural repellents are characterized as "minimum-risk pesticides" by EPA, making them "exempt from safety testing because their active and inert ingredients have been deemed safe for intended use," Mascarelli reports. But the manufacturers do not have to prove how well these natural repellents work. For the most part, they do work, but generally not for very long. The lemon-eucalyptus and pine oil alternatives seem to be the exception. (Read more)

Kentucky and other states slow to adopt health-law mandates

Though it's one of the centerpieces of the new health care law, most states have not taken steps to establish a health insurance exchange, and that incluides Kentucky. The exchanges are meant to make it easier and less expensive for people who buy their own coverage to compare health plans.

"So much of this stuff is speculation," state Rep. Tom Burch (D-Louisville) told The Washington Post when asked why the state has not moved to set up an exchange. He said his party was "simply waiting for the Obama administration to issue regulations spelling out federal requirements in more detail." Burch is chairman of the House Health and Welfare Committee.

Despite a deadline of January 2013 to prove to the federal government they are getting ready to establish the exchanges, just seven states have adopted laws that outline the details of them. Two others, Virginia and North Dakota, have adopted legislation showing intent to form an exchange. Seven more states have not passed any legislation that pertains to an exchange, but have accepted grants meant to prepare for them. More than 10 states have defeated or haven't acted on proposed bills to establish exchanges. About 13 other states haven't even broached the matter on their committee floors.

States also seem to be grappling with an impending Medicaid deadline. Because the new health-care law expanded the income guidelines for Medicaid eligibility, states will have to provide care for a broader range of Americans starting in 2014. But a report by the National Governors Association and the National Association of State Budget Officers shows that states are struggling to pay for the program as it is now.

The report shows 43 states have passed laws to contain Medicaid costs, and nearly half of the states have reduced payments to physicians, hospitals and other health-care providers. More than 20 have agreed to lower spending on prescription drugs, and 20 have restricted some services. For the coming year, "45 governors proposed further cuts, the report says, without specifying which reductions were adopted by legislators," Goldstein and Aisenman report. (Read more)

Kentucky legislators grappled in a special session to fill a $166 million gap in Medicaid funding this year, and the state is turning to managed-care organizations to run the program.

On 30th anniversary of AIDS detection, it is no longer a death sentence, but Kentuckians die because they delay testing

Though life expectancy for people living with AIDS has improved, the disease "remains a serious health threat, with Kentucky's minorities and poor being affected in disproportionate numbers," reports the Lexington Herald-Leader's Mary Meehan.

Part of the problem is the stigma associated with the disease, which was first reported by the Centers for Disease Control and Prevention 30 years ago yesterday. It is especially problematic in rural parts of the state. "We have clients in rural areas of Kentucky who hide their medication so if something happens to them, their family members won't find out," said Mark Royse, executive director of AVOL, an education- and support-based organization for people living with AIDS.

The stigma is associated with the perception of the disease, which in turn prompts people to avoid being tested. "AIDS was marginalized early on as a 'gay' disease," said Dr. Robert Crosby, an AIDS researcher and chairman of the department of health behavior in the University of Kentucky's College of Public Health. "Later, it was associated with drug users, promiscuous heterosexuals or people who live in other countries, such as Africa. "The point to drive home is that a lot of people think of Africa or China or India when they think of AIDS," Royse said. "This issue is still very real here at home."

Kentucky ranks 19th in the country for the number of people who have the HIV infection that leads to AIDS, according to the Kaiser Family Foundation. "Health officials say that at least one new HIV infection is discovered each day in Kentucky," Meehan reports. Nationally, about 20 percent of people who have HIV don't know they are infected.

The earlier people discover they have HIV, the better the treatment works, but early detection is not commonplace in Kentucky. By the time they are tested for HIV, 30 percent of Kentuckians already have full-blown AIDS. Still, that diagnosis is no longer a death sentence. Though at one time 100 percent of Kentuckians infected with HIV died within five years, now 82 percent are alive after the same time period. However, there has been a spike in infection among 18- to 24-year olds, despite early education to avoid unprotected sex. "They say, 'That person doesn't look like they have AIDS'," so decide to have unprotected sex with that person, said Jessica DuMaurier, in charge of the HIV program at the Lexington-Fayette County Health Department. (Read more)

Ten counties getting $5,400 each for farm-to-school programs

More than $50,000 in grants were awarded to Kentucky school districts this week to start or expand farm-to-school programs, an effort meant to support local farmers and get healthier meals in school cafeterias. Funding was given to Calloway, Carlisle, Daviess, Fayette, Madison, Marshall, Mercer, Owsley, Perry and Woodford counties. Each county got $5,400.

County health departments will form teams of school food-service directors, teachers, farmers and community advocates. "These teams will implement activities in local schools that include three program areas — cafeteria, classroom and community — as a way of educating children about what they eat; what they learn about food; and what they observe in their communities," said a press release from the Kentucky Department for Public Health.

Funding was awarded by the department's Obesity Prevention Program. For more information about farm-to-school programs in Kentucky, click here.

Teens don't need sports drinks unless they are playing sports, and shouldn't consume energy drinks, experts say

Though teens are increasingly consuming sports and energy drinks, the beverages don't offer them any benefits, a report contends. In fact, teens should only consume sports drinks like Gatorade if they're actually playing sports and avoid caffeinated energy drinks like Red Bull entirely, reports Alice Park of Time magazine's Healthland. "Water, not sports drinks, should be the major source of hydration for adolescents," said Dr. Marcie Schneider said.

The report was compiled by the American Academy of Pediatrics' Committee on Nutrition and its Council on Sports Medicine and Fitness. It found many teens consume sports drinks (Getty Images photo) in the school cafeteria, in part because sodas are increasingly being taken out of school vending machines. Sports drinks have extra carbohydrates and electrolytes, which can be beneficial after intense workout sessions. "But outside that setting — and honestly most of our teens and children are way outside that setting — they don't need sports drinks," Schneider said. The extra carbs are just extra calories. They also can erode enamel from teeth and cause dental problems.

Energy drinks are similar to sports drinks, but have the added ingredient of caffeine, which kids also don't need. "We know that caffeine raises heart rate, blood pressure, speech rates and motor activity, and affects how much acid your stomach secretes, your body temperature and how much you sleep or don't sleep" Schneider said. These drinks can make children who are already anxious have more anxiety and rev up kids with attention deficity hyperactivity disorder even more. "Do these kids really need caffeine as part of their lives? The answer is no." (Read more)

Plate is replacing food pyramid as guide to a balanced diet

A segmented plate is the U.S. Department of Agriculture's new icon for what to eat. It will replace the long-used food pyramid, which critics say is confusing. It makes clear a general consensus of nutrition experts about what amounts of what types of foods should make up a balanced diet.

MyPlate dedicates the most space to vegetables and grains, with fruits and protein each getting less than a fourth of the plate. Looking like a glass or cup on the side of the plate, a circle for dairy products gets a bit less. The graphic makes a clear point: "Make half your plate fruits and vegetables," Robert Post, an official at USDA's Center for Nutrition Policy and Promotion, told told Brian Vastag of The Washington Post.

The new graphic was unveiled Thursday at USDA headquarters. First Lady Michelle Obama, who is a strong advocate for improving child nutrition, attended and said, "Kids can learn to use this tool now and use it for the rest of their lives. It's an image that can be reinforced at breakfast, lunch and dinner." Indeed, children will be exposed to the image, as they were the food pyramid, through USDA's school-food programs. The new graphic was designed to combat obesity, Agriculture Secretary Tom Vilsack said. (Read more)

Retiring Boyle County health director has played important roles in the community; many of his counterparts do likewise

The man behind Danville's smoke-free ordinance is stepping down from his position as Boyle County's public health director. "I've got a 100-acre farm and I plan to pursue those interests and do some extensive traveling," Roger Trent told The Advocate-Messenger's Mandy Simpson. (Advocate-Messenger photo)

Trent has been at the helm of the health department for 12 years. During his tenure, he "successfully lobbied the Danville City Commission to pass an ordinance banning smoking in all enclosed public places of employment," Simpson reports. He also started smoking cessation classes at the health department, collected food for families in need, and headed efforts during the 2009 ice storm. "He will certainly be missed, and I hope we can find somebody equivalent," said David C. Liebschutz, chairman of the Boyle County Board of Health.

Al Cross, director of the Institute for Rural Journalism and Community Issues and publisher of Kentucky Health News, commented on Trent's impact on his community: "County health directors rarely get noticed except when they create controversy or retire," he said. "They play, or should play, a more important role in the community than local news media might suggest." (Read more)

Pediatrics academy tells parents to monitor kids' online activities

A report from the American Academy of Pediatrics stresses children's physicians can play a vital role in educating parents about setting limits for kids when it comes to technology like texting and Facebook.

"Pediatricians are in a unique position to help families understand these sites and to encourage healthy use," the report says. The academy recommends that parents communicate often with their kids about time spent on computers, both to make sure it is not harmful to them and it doesn't conflict with family time. "I think even in the tween years, this has to be happening because ... more and more, pop culture is percolating down to tweens," Dr. Kathleen Clarke-Pearson, a North Carolina pediatrician and co-author of the report, told The Courier-Journal's Darla Carter.

Parents should look for signs of sleep deprivation and "Facebook depression," which can happen when children spend a lot of time on social media sites. Parents should also have a plan regarding when electronics should be allowed to be used at home, during dinner or at bedtime, for example. Parents should also talk to their children about how to be a "responsible digital citizen," Clarke-Pearson said, which involves talking about subjects like sexting, cyberbullying or posting inappropriate matter or comments.

Kids and teens can be influenced by social media and other websites to try risky behavior, such inhaling chemicals or trying the choking game, experts say. "The mantra basically is it's not going to happen to me, so they will do these things because everybody else is," Dr. Hatim Omar, a pediatrics professor at the University of Kentucky, told Carter.

Earlier this year, the academy reported about one in five teens log onto their favorite social media site more than 10 times a day, and more than half log on more than once a day. "It also notes that 75 percent of teens own cell phones and 25 percent use them for social media while 54 percent use them for texting and 24 perfect use them for instant messaging," Carter notes. (Read more)

Louisville doctors help woman with extremely rare condition

Louisville doctors have helped a woman with an extremely rare type of dwarfism deal with the deterioration caused by her disorder. Monica Zaring, who is one of just two women in the world who has osteodysplastic microcephalic dysplasia, has had her shoulder joint replaced using custom-made implants and instruments, The Courier-Journal's Laura Ungar reports.

The 3-foot-6 Bellarmine University student (C-J photo by Matt Stone) started having problems when she woke up one morning last year and couldn't move her right arm. Over time, she was able to move it again, but not without severe pain. Doctors found arthritis had caused the cartilage to deteriorate, causing the joint's bony surfaces to rub on each other. "We needed to do something," said Dr. Ryan Krupp of Norton Orthpaedic Specialists, who was the lead surgeon.

So began months of preparation, part of which involved designing a custom-made shoulder stem, head and socket. Custom instruments were also needed to install the implants. "Krupp even flew to a company lab in New Jersey to try the instruments on a cadaver to make sure they would work," Ungar reports.

The Dec. 7 operation took 90 minutes and Zaring spent four days in the hospital, resulting in a $85,000 hospital bill; she is covered through her mother's insurance. Norton Healthcare officials would not say how much the procedure cost, but the custom implant was 47 percent more expensive than a standard one. However, the operation was considered necessary. Zaring, who plans to graduate in December with a degree in communications, does not dwell on future health problems that will likely be caused by her condition. "I have challenges," she said. "But if if I let them get me down, I'd always be sad." (Read more)

E-cig, hookah ban takes effect Monday in Madison County

Electronic cigarettes and water pipes known as hookahs will be banned in enclosed public places in Madison County beginning Monday under an amendment to the county's existing smoking ban.

The ban, which has been in effect since 2007, was amended in April by the Madison County Board of Health. In addition to adding the e-cig and hookah regulations, the amendment also prohibits smoking in retail tobacco stores, reports the Lexington Herald-Leader's Greg Kocher.

Madison County is not the first jurisdiction to ban e-cigs and hookahs. Bardstown and Glasgow prohibit the use of e-cigarettes in their smoking bans. The Bullitt County Board of Health also approved a ban, which takes effects in September, that prohibits them. Effective July 1, a campus-wide tobacco-free policy that includes e-cigarettes and hookahs takes effect at St. Catharine College in Washington County. Lexington's smoking ban does not include e-cigarettes. (Read more)