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Smart medicine is better health.

Welcome to Knowledge of Medicine –your internet resource for everything medicine. We provide the best health/medical resources available on the internet for both the professional and patient communities. Our comprehensive searches and selection of those medical internet sites with extraordinary content are provided as educational and informational tools. Medical care delivery must be educational,participatory and collaborative with all health partners. Take charge of your medical knowledge –only you can do it!

Harlan R. Weinberg,MD,FCCP

Educate –Participate –Communicate

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Youth Fitness 101:A Kid-Focused Workout Video

bruceandladonna

When I first enrolled my nephew,Bruce,into the HealthWorks! program,my expectations were that it would help him learn healthy eating habits and how to become more physically fit.

Because five of his close relatives have or have had diabetes,I felt like these were necessary,proactive skills for him to acquire to hopefully ward off the disease.

Since he started the program last year,I have seen marked changes in him. Most notably,his awareness. He’s watching what he eats and drinks. He reads food labels at …


Cincinnati Children’s Blog

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Mortality rates increase due to extreme heat and cold

When temperatures are extremely high or low,there is a significant increase in the number of deaths caused by heart failure or stroke.
Public Health News From Medical News Today

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The Influence of the Metaparadigm of Nursing on Professional Identity Development Among RN-BSN Students

Rebecca C. Lee,Jacqueline Fawcett
Jan 1,2013;26:96-98
Essays on Nursing Science
Nurs Sci Q:Most-Read Full-Text Articles

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Why I chose MD Anderson for breast cancer treatment

helenvollmer723.jpgBy Helen Vollmer

When I was diagnosed with stage I breast cancer almost a year ago,I went through all the standard emotions:disbelief,anger,fear and utter confusion.

As someone in perfect health,according to my charts,I was suddenly confronted with something beyond my control. No matter what I did,I still had cancer,and there were no guarantees that I would be cured.

Deciding where to go for breast cancer treatment
After the initial shock of the diagnosis lifted,I knew that I needed to act. Where to start? An oncologist? A surgeon? Was it more important where they had studied,what hospital they were associated with,how many patients they treated or the personal connection between us? I,like others who go down this path,had a dizzying array of choices to make with,frankly,only limited guidance.

My gynecologist had given me the name of three Houston oncologists to choose from for breast cancer treatment,but it was up to me to check them out. I started calling friends and colleagues who either had personal or professional connections to the Texas Medical Center.
I began making appointments and talking to surgeons and oncologists alike. I had more MRIs. Pretty much all the doctors I spoke to recommended the same breast cancer treatment plan: surgery,radiation and chemotherapy. And at that point I realized that what mattered most to me was a connection with the physicians who would treat me,an open and caring environment and staff,and a definitive plan moving forward. 

My breast cancer treatment in MD Anderson’s Multi Team Clinic 
About that time,a friend suggested a new multidisciplinary approach at MD Anderson and called on my behalf to set an appointment. All I knew was that,over the course of a day,I would undergo additional tests and meet with a dedicated team of MD Anderson physicians assigned to treat me in the Nellie B. Connally Breast Center’s Multi Team Clinic. As a Houston resident,I felt like this was incredibly convenient. So why not try it?

After a morning of tests and a round of questions by a very competent physician’s assistant,my husband and I patiently waited in an exam room. Suddenly,the door flew open,and there were three animated doctors swarming around me:a surgeon,a radiologist and an oncologist.

Each asked me questions,and I did the same as they examined me. We covered everything from what my day-to-day routine was like,did I have any pain or other symptoms as well as my fears and concerns (will I lose all my hair,will I be able to work during treatment,etc.)

In addition to my physical condition,they also asked about my personal and professional life. What did I do for a living? Did I travel? What kind of exercise did I enjoy? All of us,including my husband,were part of the conversation.  

They left to confer,and shortly thereafter the surgeon returned. To my amazement and joy,she said,“OK,here’s the plan.” She outlined surgery that was scheduled for the following week,the option to have in-cavity radiation and then timing on chemo based on what the pathology from my tumor showed following surgery.  

What? A plan of action and a timetable? And it was all confined to one,incredibly caring place with a team who talked to each other and,more importantly,to me? Done deal.

The rest,as they say,is history. Thanks to a loving support system of family,friends and colleagues,I was able to continue working throughout my breast cancer treatment. My doctors and technicians made a difficult time easier because I always felt that I was more than a statistic and I could (and still do) ask any question I wanted.  

And today? I appear to be cancer free,and feel strong and sassy as I happily watch my hair grow back.  

To schedule an appointment in MD Anderson’s Breast Center,please call 1-877-632-6789 or request an appointment online.

Cancerwise | Cancer blog from MD Anderson Cancer Center

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Favorite foods can cause serious choking accidents in kids

UCLA expert offers tips to prevent young children from choking on food

(Note to broadcast editors:A high-definition package,b-roll and SOT’s are available for download. Please contact Amy Albin,UCLA Health Sciences Media Relations,aalbin@mednet.ucla.edu,(310) 794-8672.)

Most parents never dream that their children’s favorite foods can pose choking hazards. 

It happened to Landon Jones when he was 15 months old. He was walking around eating a handful of nuts when a cashew became lodged in his bronchi (wind passage to his lung) causing wheezing and coughing.

“At the time,Landon had a cold so it was not obvious if the coughing was related to his illness or choking,”recalled his mother,Ula Jones. 

Eventually,the nut in his bronchi was detected by his doctor and had to be removed in a delicate surgery under anesthesia. Thankfully,the toddler made a full recovery.

“Landon’s situation is surprisingly common,”explained Landon’s surgeon,Dr. Nina Shapiro,a professor of head and neck surgery at the David Geffen School of Medicine at UCLA. “In many kids,the food object passes down to their bronchi where it gets lodged and they present with coughing,wheezing,or even what might appear to be pneumonia. At first,it is not always clear that the child has had a choking incident.”

In fact,it is food-not toys-that is the most common culprit of choking accidents in kids under 5 years of age. More than 10,000 children visit emergency rooms each year due to choking on food. While most of these events are not fatal,one child dies every five days from a food-choking accident. The reasons have a lot to do with a child’s anatomy.

“Young children have underdeveloped swallowing mechanisms,immature teeth and narrow airways which put them at a higher risk for choking on food,”said Shapiro who is also the director of pediatric ear,nose and throat at Mattel Children’s Hospital UCLA. “Plus,the diameter of a child’s airway is about the size of their pinky,so high-risk foods can easily block their tiny airways and prevent their ability to breathe.”

The list of high-risk foods for children under age 5 years includes many of kids’favorites:

  • Cheese sticks
  • Chewing gum
  • Chunks of meat or cheese
  • Chunks of peanut butter
  • Chunks of raw vegetables
  • Dried fruit
  • Grapes
  • Hard or sticky candy and lollipops
  • Hot dogs
  • Nuts
  • Popcorn
  • Seeds such as pumpkin seeds and sunflower seeds

“The good news is that not all high-risk foods should be completely avoided. Many are healthy for young children –as long as they are served in the right form,”added Shapiro.

Here are some tips:

  • Vegetables should be cooked and cut into small pieces.
  • Hot dogs and cheese sticks should be cut lengthwise,then widthwise,and then into the shape of small moons.
  • Grapes should be peeled and cut in half or quarters.
  • Nut butters should be spread thinly onto crackers or bread.
  • Young children should always be attended to by an adult when they eat and only eat developmentally appropriate foods.
  • Children should sit up straight and not play or run while eating.

“We cut all the foods and we are a lot more cautious,”said Landon’s mother. “We don’t feed him in the car and he is not going to have nuts for a really long time.”

If a child does choke and is unable to breathe,call 9-1-1 and perform the Heimlich maneuver.

Even if the child seems to choke but then coughs and appears fine,the object may have become lodged and the child should see a doctor.

To learn more,watch a video and download a free educational brochure,please visit www.uclahealth.org/preventchoking.

UCLAhealth.org Health News

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Our patients’ stories:treating Matt’s vesicoureteral reflux

Matt-1

Preschoolers are drawn to play. Summertime sprinkler fun,snow-bound sledding and endless forms of indoor,outdoor horseplay are part of a youngster’s childhood fabric.

But for Matthew Dolan,carefree play was absent from much of his early years.

As a toddler and young boy,Matthew didn’t feel well and was much smaller than his active peers. He often experienced great pain—to the point of tears—when lying down,had numerous urinary tract infections (UTIs),ear infections and bouts of strep throat.

“I was sick all the time and stayed home from school frequently,” says Matthew,now 19. “I was tiny and not as active as other kids my age. They were larger,faster and more skilled at games we played.”

Matthew’s mother,Martha,knew her son was fighting a much larger medical issue. But Matthew’s pediatrician could not pinpoint the source of the problem.

“I felt very helpless since I knew something was wrong but didn’t know what was causing his pain,” says Martha.

At 6 years old,Matthew’s medical journey took a life-saving turn. He was referred to Boston Children’s Urology Department.

Here,physicians ordered a series of urological tests including renal ultrasounds and a voiding cystourethrogram (VCUG),a minimally invasive test that uses a special x-ray technology to visualize a child’s urinary tract and bladder.

The test results indicated that Matthew had duplex kidney (two kidneys) on his left side with severe vesicoureteral reflux (VUR)—the condition where urine flows backwards from the bladder up toward the kidneys—in the left lower kidney and a milder version of reflux in the left upper kidney. Thankfully,the right kidney was fully functional and damage-free.

RetikAlan“This explained the pain,fevers and so many sleepless nights,” Martha says.

At this point,surgery was required,and Alan Retik,MD,Boston Children’s Hospital Chief of Urology at the time was called upon for care.

He and his expert urology team successfully removed the upper and lower left kidney. Throughout the surgery,Dr. Retik kindly updated Mom and family detailing Matthew’s progress.

“I remember how grateful I was when Dr. Retik periodically sent me an update from the operating room,” recalls Martha.

Though Matthew doesn’t remember much of his days recovering,he does remember the many acts of kindness that followed.

“I remember getting get well cards from my kindergarten classmates. One card had a picture of me on the front,and the girl who made the drawing cut a whole in the middle of it,” Matthew recalls.

Soon after the surgery,Matthew experienced a growth surge. He quickly grew in height and weight eventually outgrowing many of his classmates.

“Physically,I quickly went from being the smallest in my class to the biggest,” Matthew says.

Today,he is a sophomore at the University of Massachusetts Lowell,weighs in at 200 pounds,is 6 feet 4 inches tall and on the UMass Lowell crew team.

“My care at Boston Children’s was fantastic,and it definitely changed my life for the better,” he says.

Matt-4More than a decade after his surgery,Boston Children’s Urology Department,ranked #1 by U.S. News &World Report 2014-2015,continues to provide best-in-class care to children worldwide.

Mom is truly grateful for the care her son received.

“Being on the crew team and seeing Matthew fly over the waters with so much physical power is a true gift,” she says.


Thriving

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Summer first aid tips for parents

Meaghan_OKeeffe_1Meaghan O’Keeffe,RN,BSN,is a mother,writer and nurse. She worked at Boston Children’s Hospital for nearly a decade,in both the Cardiac Intensive Care Unit and the Pre-op Clinic.  She is a regular contributor to Thriving.

Summer provides ample opportunity for enjoying nature,playing outside and gazing at skies full of stars. But some of the side effects of all that outside time—scrapes,stings and other minor injuries—can take some of the fun out of summer. Here’s a quick refresher on some basic first aid every parent should know this time of year.

Insect stings and bites

When it comes to insects,staying vigilant and familiarizing yourself with a few preventative and comfort measures will help in the event of a sting or bite.

Mosquitoes and ticks

  • Use insect repellent and protective clothing.
  • Perform regular skin checks to look for any ticks or unusual bites.
  • If you do come across a tick on your child’s skin,follow the Center for Disease Control’s guidelines for removal.
  • Avoid scratching and picking.
  • Review signs and symptoms of mosquito-borne illnesses,such as West Nile Virus and Chikungunya,which has recently been reported in the United States.

sad kidBee stings

  • Keep the area clean.
  • Apply cold compresses to help reduce swelling.
  • Apply wet baking soda or calamine lotion to the skin to alleviate discomfort.
  • If the stinger is still in the skin,gently brush the stinger and venom sac from the skin.
  • Keep in mind that 2 million people in the United States are allergic to bee stings,and some 3 percent of children will have an allergic reaction. Signs to look for include hives,excessive itching or swelling.
  • A more severe allergic reaction,known as anaphylaxis,includes airway swelling,difficulty breathing and low blood pressure. Anaphylaxis is a serious medical condition that requires emergency care. Call your pediatrician if your child appears to be having an allergic reaction,even a mild one. If your child reports difficulty swallowing or breathing,call 911 immediately.

 

Scraped knees and elbows

Abrasions (scrapes) from minor falls will send your child running to you in tears. In addition to a reassuring hug,you can take the following steps:

  • Use pressure to stop any bleeding.
  • Gently rinse the wound with clean water,gingerly cleaning around the wound with a mild soap.
  • Apply an antiseptic lotion.
  • Cover with a bandage or dry gauze.
  • Keep the area dry and change the dressing often.
  • Some signs that you need to contact your pediatrician include continuous bleeding for more than 5 to 10 minutes after applying pressure,a deep cut or one longer than an inch,or if symptoms of infection appear,including warmth,swelling,redness or drainage.

Head injury

Photo:Ben Grey

Bike helmets are a safety must for the prevention of bike-related head injuries. Even small children on little tricycles need head protection. Starting them early will help make wearing a helmet more of a habit than a chore. Helmets should meet the safety requirements of the U.S. Consumer Product Safety Commission (CPSC). If your child does hit their head from a fall,monitor them closely. Signs that your child may have a more serious head injury include:

  • increased sleepiness
  • vomiting
  • headache
  • behavioral changes

Notify your child’s physician immediately if you suspect a fall may have resulted in a head injury. Read this mom’s story of a seemingly typical childhood fall and how her fast action saved her son’s life.

Sunburn

Protect your child’s skin by practicing good sunburn prevention,including frequent application (at least every two hours) of a broad-spectrum sunscreen,with an SPF of at least 15 (and up to 50),avoiding direct exposure to midday sun and wearing protective clothing.

Sun safety

If your child does suffer from sunburn,you should:

  • Keep them well-hydrated to replace any lost fluids.
  • Apply cool water for comfort.
  • Give acetaminophen or ibuprofen according to your health care provider’s recommendation.
  • Limit your child’s sun exposure until the burn heals.
  • Avoid any medicated lotions until you’ve consulted your child’s physician.

As with any health concern,never hesitate to call your child’s health care provider. They can ask the right questions to get to the bottom of what’s going on,reassure you,instruct you on ways to care for your child at home,or have you bring your child in if it’s required.


Thriving

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Cancer Clusters

A fact sheet that describes what constitutes a cancer cluster,the process for reporting and investigating suspected clusters,and the challenges in investigating suspected clusters.
NCI Fact Sheets

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Effects of creative and social activity on the health and well-being of socially isolated older people:outcomes from a multi-method observational study

Colin J Greaves,Lou Farbus
May 1,2006;126:134-142
Article
Perspect Public Health:Most-Cited Full-Text Articles

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Vegetable Spotlight:Summer Squash

Squash

Summer squash are a subset of squashes that are harvested when immature,while the rind is still tender and edible. Nearly all summer squash are varieties of Cucurbita pepo,though not all Cucurbita pepo are considered summer squashes. The subset includes yellow summer squash (pictured above),yellow crookneck squash,zucchini,pattypan or scallop squash and cousa squash. The name “summer squash”refers to the short storage life of these squashes,unlike that of winter squashes.

Summer squash is an excellent source of copper and manganese. It is a very good source …


Cincinnati Children’s Blog

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