Monday, June 23, 2014

Charlotte doctor offers alternative to PediaSure

Charlotte pediatrician Sheila Kilbane has a keen interest in good nutrition and helping children who have developed allergies or aversions to particular foods.

As an integrative medicine practitioner, trained by Dr. Andrew Weil at the Univesity of Arizona, Kilbane was asked by "100 Days of Real Food" to write a recipe for a natural alternative to PediaSure, advertised as a "nutritional drink for children."

Her report, including a recipe for Dr. Kilbane's Liquid Vitality, starts by describing her own experience with Pediasure. On a road trip years ago, she stopped at a gas station and bought a bottle of PediaSure instead of indulging in chips or candy bars. She began drinking as she finished pumping my gas, and she described what happened next as a "scene from a Jim Carrey movie."

She gagged and nearly spit the contents all over her car. THEN she read the ingredient list. After water and sugar, the list was rife with items such as short-chain fructooligosaccharides, carrageenan, calcium pantothenate, phylloquinone and cyanocobalamin.

She realized she should have followed the advice she has given parents for years: “If you can’t pronounce the product ingredients, put it back on the shelf.”

Friday, June 13, 2014

Chikungunya virus strikes North Carolina resident

North Carolina’s first case of chikungunya, a viral infection that can be transmitted to humans by infected mosquitos, was confirmed in a resident who recently traveled to the Caribbean.

The virus has been spreading rapidly through the Caribbean, but for now, no cases of the disease are known to have been acquired in North Carolina or in the continental United States.

Still, state health officials say the Asian Tiger mosquito that is commonly found in North Carolina could effectively transmit this virus.

Prior to its introduction in the Caribbean, chikungunya was established in East Africa, India, the Indian Ocean and the Western Pacific regions. It was introduced in the Caribbean in 2013 through travelers returning from affected areas. As of June 6, chikungunya has caused illness in over 130,000 persons in the Caribbean, state health officials said.

Symptoms of chikungunya usually begin three to seven days after being bitten by an infected mosquito. They typically include sudden onset of fever and severe, often disabling, joint pains in the hands and feet. Many patients feel better within a week, but joint pain may persist for months in some people. Newborns exposed during delivery, adults over 65 years and people with chronic medical conditions have a greater risk for a severe form of the disease.

State health officials advise people traveling to countries where chikungunya transmission is occurring to take precautions to prevent mosquito bites and immediately consult a doctor if they develop fever in the two weeks after their return.

“With North Carolina residents traveling to and from the Caribbean and other affected areas, we have been monitoring for possible imported cases,” said Dr. Megan Davies, state epidemiologist for the Department of Health and Human Services. “Travelers who visit countries where chikungunya is widespread should take extra precaution against mosquito bites.”

Precautions include wearing light-colored long pants and long-sleeved shirts, reducing time outdoors during early morning and early evening hours when mosquitoes are most active, and applying mosquito repellents such as DEET, picardin, oil of lemon eucalyptus or IR3535 to exposed skin areas.

Also, residents should take steps to decrease possible breeding grounds for the Asian Tiger mosquito. That means removing containers that hold water, changing water in bird baths and pet bowls, keeping gutters in good repair, using screens for doors and windows.

Tuesday, April 29, 2014

See how Charlotte hospitals rated in safety survey

Charlotte's two major hospitals did not make the "A" list Tuesday when the nonprofit Leapfrog Group issued its annual safety scores.

The scores are developed from a survey based on 28 safety measures such as hand hygiene, antibiotic selection and catheter removal.

Carolinas Medical Center got a B, and Novant Health Presbyterian Medical Center got a C.

Charlotte-area hospitals that received "A" grades were: Carolinas Medical Center-University and CMC-Mercy in Charlotte, CMC-Pineville, CMC-Union in Monroe, Cleveland Regional Medical Center in Shelby, Kings Mountain Hospital, Stanly Regional Medical Center in Albemarle. Both Piedmont Medical Center in Rock Hill, and Springs Memorial Hospital in Lancaster also got A grades.

Other "B" grades went to: CMC-NorthEast in Concord, CaroMont Regional Medical Center in Gastonia, Iredell Memorial Hospital in Statesville, Novant Health Huntersville Medical Center, Novant Health Matthews Medical Center, Novant Health Rowan Medical Center in Salisbury.

Other "C" grades went to: CMC-Lincoln in Lincolnton, and Lake Norman Regional Medical Center in Mooresville.

The Leapfrog group's survey is intended to address the more than 180,000 deaths and accidents from hospital errors and injuries that occur each year. Scores are based on federal data from the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services as well as an annual survey by the American Hospital Association.

Nationwide, 32 percent of hospitals got A grades, 26 percent got B’s and 35 percent got C’s. Six percent got Ds and less than 1 percent got an F.

Tom Zweng takes over as Novant Health's chief medical officer

Dr. Tom Zweng, a longtime Charlotte surgeon, has assumed the role of chief medical officer for Novant Health, replacing Dr. Stephen Wallenhaupt, who moved to a part-time role after seven years as chief medical officer and more than 20 years with Novant.



Zweng, 58, served as senior vice president of medical affairs for Novant Health’s Greater Charlotte market for the past seven years. A graduate of the University of California at Davis and UCLA medical school, did his surgery residency at the University of Michigan.

From 1990 to 1995, he was assistant professor of surgery at University of Kentucky Medical School where he developed the laparoscopic program for general surgery. He then moved to Charlotte, where he practiced with Surgical Specialists of Charlotte for 11 years and also served as chief of general surgery for Novant Health Presbyterian Medical Center.

Wallenhaupt, 62, will focus his efforts on roll-out of electronic medical records across the hospital system.

Winston-Salem-based Novant operates four hospitals in Mecklenburg County -- Presbyterian Medical Center, Charlotte Orthopaedic Hospital,  Huntersville Medical Center and Matthews Medical Center.

Friday, April 25, 2014

After patient notices expired drink, Charlotte hospital changes protocol

Carolinas HealthCare System has instituted a new tracking system at its doctors’ offices after a Waxhaw patient recently noticed the liquid she had been asked to drink as part of a glucose tolerance test had an expiration date from October.

“We’re grateful for the patient’s having observed this situation,” said spokesman Scott White. “Because it was past the expiration date, the glucose drink should have been rotated out and it was not. That was an error.”

The pregnant patient from Waxhaw will be retested. Her husband, Abhishek Sinha, told the Observer she was given an oral glucose tolerance test at Carolinas Medical Center-Waxhaw to see if she has gestational diabetes.

He said his wife had consumed about 80 percent of the sugary drink used for the oral glucose tolerance test before she noticed the label and its expiration date. When she pointed it out, the test was stopped, and Sinha said the doctor told him to watch his wife for 24-48 hours to make sure she didn’t have a bad reaction.

“I’m so surprised because this is happening in America. We are not in a Third-World county,” said Sinha, who moved to the United States from India seven years ago. “This is negligence.”

Sinha said his main concern was to make sure other patients who may have had a similar test at that center know they could have received an outdated product. Sinha said he tried to contact a laboratory supervisor with Carolinas HealthCare System, but she did not return his calls.

White said there were six bottles in the expired lot of glucose drinks. He said two were left in the laboratory refrigerator and were disposed of. The other three had been used but cannot be traced because the lot number was not recorded in the patients’ records.

“Our laboratory personnel have been inspecting other centers where glucose tolerance testing is done and have found no additional outdated stock,” White said. “We have changed the protocol for such testing and will now require that the lot number and expiration date be listed on the order before providing it to a patient.”

Wednesday, April 23, 2014

High turnover not unusual in individual health insurance market

Last October, as enrollment for the Affordable Care Act got underway, I wrote about some Charlotte-area consumers who were surprised to learn their individual health insurance policies were being cancelled because they did not meet the minimum requirements under the new federal law.

A political firestorm erupted as others across the country experienced similar problems and complained that President Barack Obama lied when he had promised Americans could keep their insurance policies if they liked them.

A new study in the journal Health Affairs reviewed that phenomenon and provides more context about patterns in the individual insurance market.

First, the study found this market has been characterized by high turnover before the Affordable Care Act took effect in January 2014. It found that only 42 percent of Americans who have non-group coverage retain that coverage after a year.

Another finding: 80 percent of those who leave non-group coverage end up with different health insurance within 12 months, most commonly through employer-provided coverage. 

The author concluded: "Given estimates from 2012 that 10.8 million people were covered in this market, these results suggest that 6.2 million people leave non-group coverage annually. This suggests that the non-group market was characterized by frequent disruptions in coverage before the ACA and that the effects of the recent cancellations are not necessarily out of the norm."

Tuesday, April 15, 2014

Who decides what procedures are unnecessary?

Americans love lists. But we should pay attention to who's making the list.
As Kaiser Health News reported, when America’s joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly affected their incomes.
The American Academy of Orthopaedic Surgeons discouraged patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery. The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline. 
Kaiser Health News reported: "They could have chosen many surgical procedures that are commonly done, where evidence has shown over the years that they don't work or where they're being done with no evidence," said Dr. James Rickert, an assistant professor of orthopedic surgery at Indiana University. "They chose stuff of no material consequence that nobody really does."
Read the entire story here.