Fw: [Healthlink Newsletter] MCW HealthLink -- vol. 8 no. 17

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MCW HealthLink

Medical College of Wisconsin

Milwaukee, Wisconsin

http://healthlink.mcw.edu/

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1 September 2003

Vol. 8 No. 17

In this issue:

(1) Study Follow-Up Shows Big Increase in Preschooler

Vaccinations

(2) Sneezing, Wheezing, Coughing, Swelling... Is it an Allergy?

(3) Women Should Adjust Nutrition after Menopause

(4) What's New on MCW HealthLink

(5) Subscriber Information

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(1) Study Follow-Up Shows Big Increase in Preschooler

Vaccinations

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After a Medical College of Wisconsin study showed that nearly half

of inner city preschool children who visited two Milwaukee health

clinics were not given timely immunizations, proactive

interventions by the research team cut the rate of “missed

vaccination opportunities” at one of the clinics from 49% all the

way down to 13%.

The initial study, first presented in 1996, focused on children

under three years of age at the Downtown Health Center and the

16th St. Community Health Center. The follow-up efforts to reduce

the rate of missed opportunities took place at the 16th St.

clinic.

“We were looking at little children because those are the children

at higher risk (for not receiving immunizations),” said Svapna S.

Sabnis, MD. “The kids who are in school are less likely to be

missed because the schools are required to see that vaccinations

get done.”

Dr. Sabnis pointed to several barriers to vaccine delivery

identified by the National Vaccine Advisory Committee and reported

in the follow-up study. In addition to missed vaccination

opportunities, these include long waiting periods, appointment-

only services and pre-vaccination physical examination

requirements.

According to the follow-up study, “Missed opportunities are

usually provider-related, and are minimally influenced by parent

education or case management.” In other words, Dr. Sabnis agreed,

it is often the practitioner’s responsibility to see that children

receive timely immunizations, regardless of the role parents may

play in the process.

The results of the original study were significant: Of 352 pre-

school children in the earlier study, 173 (49%) with vaccine

opportunities were not vaccinated, and of those 42% did not

receive immunizations in the following six months. During the

three-month period after the follow-up interventions, missed

vaccination opportunities decreased to just 13%.

“If you look at immunization rates you’ll see they are steadily

creeping up,” said Dr. Sabnis. “But when you look at inner cities

and rural areas in relation to the suburbs, they tend to have

lower rates. So there are still pockets where the rates are lower.

Overall the trend has generally been heading in the right

direction, including in those areas. There are a lot of different

programs out there that are really working on it. Still, there’s

lots of work to be done.”

For the full story, go to:

>> http://healthlink.mcw.edu/content/article/newsletter/1031002284.html

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(2) Sneezing, Wheezing, Coughing, Swelling... Is it an Allergy?

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Allergies are the sixth leading cause of chronic disease in the

US, with more than 50 million people suffering from allergic

disease each year. But how do we know if we have allergies instead

of something like a cold or flu? Jordan Fink, MD, MCW Professor of

Pediatrics and Medicine, explains, “Symptoms of seasonal allergies

are like a long cold, with itching, sneezing, coughing, and

tearing of the nose, eyes and throat.” The big difference is that

allergic reactions have much more itching and produce clear

secretions, says Dr. Fink, and symptoms may last up to several

months.

Asthma can be one of the many types of allergic reaction. “Asthma

can occur as a result of an allergic reaction to something in a

person’s environment – a dog or cat, mites, ragweed, etc. – or can

be associated with a respiratory infection,” Dr. Fink says. The

allergic type of asthmatic reaction has a genetic basis, Dr. Fink

explains, but asthma itself does not seem to be inherited.

There are many types of allergy treatments, depending upon the

source of the allergen. Overall, says Dr. Fink, “The most

effective treatment for allergic disease is avoidance of the

offending agent. And if an allergic reaction to pollen does occur,

drugs are available for treatment.

“Allergic diseases are chronic illnesses and need to be treated

chronically and aggressively,” Dr. Fink concludes.“ If you are

suffering from seasonal or food allergies, see your health care

provider for proper treatment. And if you suspect you are having

an allergic reaction to a particular food, chemical or other

irritant, don’t wait to get medical attention. Appropriate

lifestyle changes and treatments are usually enough to prevent

your sneezes, wheezes and coughs.

For the full story, go to:

>> http://healthlink.mcw.edu/content/article/newsletter/1031002285.html

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(3) Women Should Adjust Nutrition after Menopause

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Poor nutrition is implicated as a contributing factor in 5 of the

10 leading causes of death in women – coronary heart disease,

cancer, stroke, diabetes, and diseases of the liver and kidneys.

It’s also a key factor in osteoporosis, putting women especially

at risk for fractures of the hip, wrist, back and other bones.

As female “baby boomers” enter midlife in record numbers, more of

them are becoming aware of the link between what they eat and

their health and longevity, says Joan Pleuss, RD, MS, CDE, CD.

“Women, especially as they reach menopause, need to reassess their

nutrition,” she says. “As we age, a number of issues emerge that

require changes in the nutrients we need.”

Pleuss realizes that few Americans fulfill all the recommended

nutrition guidelines, since the typical American diet is too high

in fat and sugar and too low in fiber, fruit and vegetables.

Still, she says, “Women of all ages should strive to get the

nutrients they need the old-fashioned way – by eating a healthy

diet with servings from all food groups.”

In addition to altering their diets, women often need to increase

their physical activity level and add supplementary vitamins and

minerals. “I think a multivitamin is a good idea for all women,”

she says. “Older women have increased need for calcium, vitamin D

and vitamin B-12. Taking a multivitamin together with good food

choices helps women meet dietary recommendations.”

“Compare food labels,” Pleuss recommends. “Remember whole grains,

fruits, vegetables, legumes and dairy products provide health

benefits.” Make sure to carefully evaluate vitamin labels, too,

she cautions. Some supplements might not be appropriate for older

adults.

As for herbal remedies, Pleuss says there are no general

recommendations. But since some herbs can interfere with or

intensify the action of blood thinners and others drugs, patients

should always ask a health practitioner before taking them.

The bottom line for women’s nutritional requirements? “Eating a

variety of foods, supplemented by a multivitamin, is the best way

to get the nutrients we need,” Pleuss says.

For the full story, go to:

>> http://healthlink.mcw.edu/content/article/newsletter/1031002286.html

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(4) What's New on MCW HealthLink

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* Where Are You Going?

The more often you provide children with reliable and

accurate information about seemingly small things, says Dr.

on, the more likely it is that they’ll look

to you for guidance on the larger issues they face later in

life.

http://healthlink.mcw.edu/content/article/newsletter/1031002287.html

* Medications Can Impair Senses

Many older people taste and smell only stronger flavors and

odors, but medications can also be responsible for

diminished senses.

http://healthlink.mcw.edu/content/article/newsletter/1031002288.html

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(5) Subscriber Information

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Medical College Physicians

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HealthLink home page: http://healthlink.mcw.edu/

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Copyright © 2003, Medical College of Wisconsin.

ALL RIGHTS RESERVED.

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