Keeping the kids home from daycare when there's a bug going around won't necessarily stave off sickness, according to an article on Health Day. Guidelines from AAP and APHA say it's safe for children to go to daycare despite minor illnesses.

Kids share everything, including germs. When there’s something going around at daycare, the temptation to kids home can be too much. Daycare providers often choose to send mildly ill children home so they don’t spread it to others, but their extra efforts may be useless.

“By the time (children) start showing symptoms, the cat’s already out of the bag,” study author Dr. Andrew Hashikawa of the Medical College of Wisconsin told Health Day. By then, chances are the bug has already spread.

The survey included responses of 305 directors of metro daycare facilities in Milwaukee, Wisconsin. Surveyors from the American Academy of Pediatrics (AAP) and the American Public Health Association (APHA) briefly described five different illnesses—a cold, conjunctivitis (pink eye), stomachache, fever, and a scalp infection—to directors of childcare facilities to test their knowledge of excluding sick children from daycare.

Based on AAP/APHA guidelines, none of these situations should result in exclusion from daycare, but directors would send as many as 4 out of 5 children home. Although the state has promoted exclusion guidelines to childcare facilities since the nineties, only 38 percent of these directors were aware of the AAP/APHA’s exclusion guidelines.

“If the directors of child care facilities and centers are well-educated and understand the recommended guidelines, then it’s fairly clear which children should stay and which should go home,” Hashikawa said. “This study highlights the need for ongoing training.”

Read the original story on Health Day, or check out AAP/APHA’s book of guidelines on managing ill children in a daycare or school setting.

Ten years ago, soy products were recommended to postmenopausal women to reduce LDL (bad) cholesterol levels. New research indicates that soy may not help as much as previously thought, and a re-evaluation by the FDA may challenge soy producers’ claims about their products as heart healthy.

Many women experience sharp increases in LDL levels during menopause when their bodies no longer produce estrogen. More women also see a hardening of the arteries (atherosclerosis) and an increased risk of heart disease.

Soy products contain isoflavens, natural compounds that mimic estrogen.  These are supposed to increase estrogen levels, and thus improve cholesterol. Keeping cholesterol in check can help coronary artery disease, the leading cause of death in American women.

For the study, 62 women under age 65 with moderate-high cholesterol were asked to increase either soy or casein (milk protein), intake for one year. While HDL (good) cholesterol levels increased slightly for women consuming soy, they experienced little or no change in LDL levels.

“The aim of this study was to examine the effects of soy protein consumption on heart disease risk in postmenopausal women,” authors of the study wrote. “These findings, as well as those from other studies, lend credence to the decision of the Food and Drug Administration to reevaluate the soy protein health claim issued a decade ago.”

Learn more about heart health, or read the study's abstract in Menopause.

Glucose intolerance during pregnancy may put women at greater risk for heart disease. According to Baiju Shah, MD, PhD, FRCP, of the Institute for Clinical and Evaluative Sciences in Toronto, co-author of a recent study on women with gestational diabetes, even mild glucose intolerance—below the threshold for gestational diabetes—increases the chances of later cardiovascular disease. 
Gestational diabetes had been connected to cardiovascular disease prior to this study, but little was known of the links between minor glucose intolerance and heart disease. Type 2 diabetes and cardiovascular disease share several characteristics including obesity, insulin resistance and cholesterol problems. Oftentimes, individuals with one condition will develop the other. Women with gestational diabetes may experience similar metabolic complications as soon as 3 months after giving birth.

Researchers analyzed the medical records of all Ontario women between the ages of 20 and 49 who had given birth between April 1994 and March 1998.  Participants were divided into three groups: those who were diagnosed with gestational diabetes, those who received an oral glucose tolerance test, and those who were not screened using oral glucose testing. One birth was selected at random for women with multiple deliveries; the median ages were between 29.2 and 31.1.

Women are tested for gestational diabetes (a type of diabetes that develops when women experience unusually high glucose levels during pregnancy) during the second trimester of pregnancy (13-27 weeks). The first step is a glucose challenge test, taken by measuring glucose levels one hour after ingesting a sugary substance such as glucola. If results are abnormal (≥7.8 mmol/L), a second oral glucose tolerance test (OGGT) is taken.

Participants in the study were followed up until March 31, 2008, providing information reflecting cardiovascular disease development for a median of 12.3 years after childbirth. “If you followed 10,000 people for one year, 4.2 of them would have an event,” Dr. Shah explains. “If you followed those 10,000 people for 10 years, 42 of them would have an event…In other words, these are extremely rare events.”

Although the differences were minor—absolute risk was 0.16% and 0.05% for women with gestational diabetes and women who received an OGGT, respectively—the results indicate a need for further research. "We shouldn't be ignoring these mild abnormalities during pregnancy,” Dr. Shah says. “(They) may benefit from extra surveillance and/or cardiovascular disease screening.”

More information is needed to establish the exact relationship between glucose intolerance and cardiovascular disease. In the meantime, proper nutrition and exercise may reduce your risk for both gestational diabetes and cardiovascular disease.

Read more about gestational diabetes and cardiovascular disease.

You may not realize that you’re taking too much of a popular pain reliever. The most widely used medication in the United States, acetaminophen (Tylenol), is effective in relieving mild to moderate pain and reducing fever—when used at the recommended dosage. When more than 4,000 milligrams of acetaminophen are used a day, however, it can harm the liver. Acetaminophen overdosage causes an estimated 56,000 visits to emergency facilities each year and is the most frequent cause of liver failure.

Although the problems have been recognized for years, they recently gained more scrutiny. The Federal Drug Administration has taken a closer look at the safety of over-the-counter and prescription medication containing acetaminophen. Last week, an FDA joint advisory committee gathered to discuss safety questions surrounding acetaminophen. They made several recommendations, such as lowering the maximum daily dosage and strengthening the labeling.

And, manufacturers may be asked to play a bigger role in helping prevent overdoses. One issue: many remedies contain acetaminophen along with other medications. Consumers may not be aware they are swallowing acetaminophen along with both prescription and over-the-counter remedies. A majority of acetaminophen-related deaths have involved opioid/acetaminophen combination products, such as acetaminophen/oxycodone (Percocet) and acetaminophen/hydrocodone (Vicodin). Typically, the package warning labels concentrate on the more potent opioid drug.

Although the FDA is not required to accept the recommendations of its advisory committees, it usually does so.

To help protect yourself from overdosing on acetaminophen, Daniel A. Hussar, PhD, Remington Professor of Pharmacy at the Philadelphia College of Pharmacy at the University of the Sciences in Philadelphia, offers these tips:

• Know that APAP is the abbreviation for the chemical name of acetaminophen and, if found on the list of ingredients, means the product contains acetaminophen.
• For occasional, modest pain, consider starting with a dose of 500 mg (rather than 1000 mg).
• Be aware there are two concentrations of nonprescription acetaminophen for children. The infant formulation is more concentrated than the formulation for older children. Make sure you understand the concentration level before giving medication to a child.
• Check the dose of acetaminophen that is included in any combination medication. Ask your pharmacist if you are uncertain.
• For over-the-counter cold and flu remedies, seek products that treat just the symptoms you have. For sneezing and a runny nose, for example, a product containing an antihistamine and a decongestant would be sufficient.

For more information on acetaminophen, see the Pharmacist Activist Newsletter. For information and support on relieving back pain, a very common pain complaint, see the Healia Back Pain Guide. And talk to others about treatment and relief at the back pain online health community and support group.

A little bee venom may be a good thing. Some people are so allergic to bee stings and other insect bites that they are in danger of potentially lethal anaphylactic shock. Such shock can be fatal if obstruction of the airway occurs, blood pressure drops, or heart rate or heart rhythms are interrupted. One method of treatment involves injecting small, periodic doses of venom from bees and other stinging insects to help the patient build up immunity. Venom therapy was developed in the 1970s at Johns Hopkins.

In a recent study by Johns Hopkins and published in the June 2009 Journal of Allergy and Clinical Immunology, the same venom shots can help treat non-fatal but serious allergic reactions to insect stings. While not dangerous, large local allergic reactions can be painful and inconvenient. People who have jobs or hobbies such as landscaping, gardening and golfing are likely to be adversely affected by painful reactions that may cause severe swelling that lasts for days. Until now, if the reaction was not life-threatening, they were typically denied venom therapy.

“We just didn’t know if venom therapy would work or cause problems for these patients,” says David Golden, M.D., an associate professor of medicine at the Johns Hopkins University School of Medicine.
To find out, he and his colleagues recruited volunteers who were subject to unavoidable frequent stings owing to outdoor jobs or hobbies. From that group, Golden selected those whose reactions were marked by extremely large swellings of at least 16 cm—about the size of a football.

Golden’s team subjected the subjects to an initial sting to rigorously measure their response, then separated them into two groups: 19 who would get venom shots once a week for seven to 11 weeks over a summer, and 10 who would get no shots. While the control group members’ responses to stings stayed the same, those in the treatment group showed 50 percent less swelling on average.

After the first summer, both groups received venom therapy for up to four years. Following two or more years of treatment, both groups had swellings about 60 percent smaller on average than initial measurements, though the response to treatment varied.

Golden and his team plan to investigate why some patients experienced almost complete elimination of their allergic reaction whiler others still experienced moderate swelling. Click to read more about the study.

Post your questions about allergies and chat with other allergy sufferers at Healia Allergy Online Health Community and Support Group.

If pollen and other outdoor allergens—rather than stinging insects—cause your allergic reactions, find out more about how to treat them in the Healia Outdoor Allergies Guide.

Healia and the American Medical Student Association (AMSA), the nation’s oldest and largest independent association for more than 67,000 physicians-in-training, announced this morning that AMSA medical students and interns/residents are answering the public's online health questions for free on Healia Communities. Trained medical students will answer common health questions anytime and at no cost to consumers.

According to the Pew Internet&American Life Project, between 75% and 80% of American Internet users have looked for health information online.

There are many online Q&A websites but very few of them are appropriate for answering health questions because their members are seldom qualified health professionals. In contrast, the health Q&A service on Healia Communities shows the profiles of those who have posted answers to questions; all medical students or interns/residents have been verified by AMSA.

The free online health Q&A service is available immediately. Sign up and submit your health questions at Healia Communities.

See the full press release about this new health Q&A service.

As budgets continue to shrink as a result of the economic downturn, so does the amount of produce eaten by American families. An annual survey of moms, released Tuesday by the Produce for Better Health Foundation, found that although 60 percent of mothers believe their families don’t eat enough fruits and vegetables, they are serving less produce with meals and as snacks.

Even though 87 percent of moms still value the importance of vegetable- and fruit-heavy diets, 90 percent of Americans eat less than the recommended amount (between 2 and 6 ½ cups daily). In the past year alone, reported fruit consumption decreased 12 percent and reported veggie consumption dropped six percent. Moms listed factors such as high cost and discrepancies in family members’ produce preferences as contributing to the menu change.

“It is important to continue to eat healthy, even in tough economic times. Fruits and veggies are an inexpensive part of a healthy lifestyle,” says Elizabeth Pivonka, Ph.D., R.D., Produce for Better Health Foundation President and CEO.

The Produce for Better Health Foundation recommends moms extend their food budgets by serving produce prepared in a variety of ways. Fresh, frozen, canned, juiced, and dried fruits and vegetables all contribute to dietary requirements.

OnSurvey, an online quantitative research consultant, conducted the survey of moms between January 16 and January 22, 2009. The 1,000 respondents were a nationally representative sample of 24 – 41 year-old women who had at least one child living in their household.

For more information on healthy eating, visit the Healia Diet and Nutrition Health Community and Support Group or check out the Healia Diet and Nutrition Health Guide.


Source: The Produce for Better Health Foundation, Generation X Mom Survey. Press Release 3/31/2009. http://www.pbhfoundation.org/pulse/press/releases/pressrelease.php?recordid=268.

^{Photo: Joyosity, Flickr, Creative Commons}

More than 50 new Healia Health Information Guides have just been launched. The Health Guides are original, consumer-friendly health information guides that provide trusted information about common health topics. Each Health Guide, written by a medical writer and reviewed by a physician, provides essential information about symptoms, causes, diagnosis, treatment, and risk factors and prevention.

Available Health Information Guides include the following topics:

• Acid Reflux
• Alcoholism
• Allergies
• Alzheimer's Disease
• Anemia
• Anxiety
• Asthma
• Attention Deficit Hyperactivity Disorder (ADHD)
• Autoimmune Diseases
• Back Pain
• Breast Cancer
• Carpal Tunnel Syndrome
• Celiac Disease
• Chickenpox
• Childhood Vaccines
• Chlamydia
• Dementia
• Depression
• Ear Infection
• Excessive Sleepiness
• Fibromyalgia
• Genital Herpes
• Genital Warts
• Graves' Disease
• Heart Disease
• Heart Palpitations
• Hepatitis B
• High Blood Pressure
• High Cholesterol
• Human Papillomavirus (HPV)
• Irritable Bowel Syndrome (IBS)
• Lupus
• Lyme Disease
• Menopause
• Menstruation
• Migraine
• Mono
• Obesity / Overweight
• Osteoarthritis
• Osteoporosis
• Pink Eye
• Post-Traumatic Stress Disorder (PTSD)
• Pregnancy
• Rheumatoid Arthritis
• Ringworm
• Salmonella
• Sinusitis
• Stress Management
• Tuberculosis
• Type 2 Diabetes
• Uncontrolled Asthma
• Vaccines
• Weight Management

We are delighted to announce that the American Diabetes Association (ADA) and Healia are working together to improve access to high quality and personalized diabetes information through our online health community Healia Communities. The ADA is the nation’s premier voluntary health organization supporting diabetes research, information, and advocacy.

Through this new collaboration, members of Healia Communities will now be able to ask questions of two prominent diabetes experts from the ADA, Dr. Sue Kirkman and Stephanie Dunbar. The ADA will also have a presence on Healia’s diabetes-related communities and have opportunities to communicate directly with Healia Communities members.

Through this exciting relationship with the ADA, we hope that Healia Communities will become an essential resource for information and support for people with diabetes or those taking care of someone with diabetes.

Healia Communities is a free online health community that enables people to get personal support for their health decisions from peers and experienced health professionals. Healia Communities helps you make better health decisions by allowing you to:

• Share your health knowledge, experiences, and favorite resources.
• Connect with people like yourself who’ve experienced your situation.
• Ask questions of the community, your peers, and health professionals

About the New Diabetes Experts on Healia Communities, Dr. Kirkman and Ms. Dunbar:

Sue Kirkman, MD is the Vice President of Clinical Affairs for the American Diabetes Association. Dr. Kirkman has primary responsibility for the work of ADA’s Clinical Affairs area, including oversight of the Professional Practice Committee and its clinical practice recommendations and consensus statements, which provide guidance and direction to health care professionals around the world.

Stephanie Dunbar, MPH, RD is the Director of Nutrition and Clinical Affairs at the American Diabetes Association. Stephanie has been with the ADA since August of 2001 and is currently responsible for managing nutrition-related activities and projects for the Association as well as assisting with development of ADA Clinical Practice Recommendations.

Join the Healia / American Diabetes Association Diabetes Community.

View the press release about the Healia / American Diabetes Association collaboration.

American Diabetes Association diabetes online health community

Today, Healia kicks off the Healia Points Program to recognize and reward Healia Communities members who are active contributors and who are helpful to other Community members. The goal of the Healia Points Program is to encourage Healia Communities members to help each other make the best health decisions.

Members receive Healia Points when they are active and contribute positively to the community. Additional points are awarded if a member's comments/answers are rated highly among other members. Each week, members who have earned the highest number of Healia Points for the previous week are recognized on the site as Top Contributors.

Points are awarded for certain activities including filling out your profile, posting a journal, and asking and answering questions. The number of points varies by the activity. The cumulative number of Healia Points is shown in the upper right corner when logged in and is also shown in conjunction with the member profile.

The Healia Points Program is launching with a special offer from Meredith Corporation, Healia’s parent company. Beginning May 11, 2008, the week’s five “Top Contributors” who have earned the most points during the previous week will receive a free annual subscription of their choice of either Ladies Home Journal, MORE, or Fitness Magazine. Winners may also give their free subscription to someone else as a gift. 

Healia Points Healia Communities online health community