Health notes

Doctor gives tips on falling asleep

"Coping with Insomnia" will be the next topic in the Waveny Care Center and Norwalk Hospital lecture series at 4 p.m. Tuesday, March 1. The featured speaker is Ian Weir, associate director of the Sleep Disorders Center and director of the Insomnia Center at Norwalk Hospital.

The talk is at Waveny Care Center, 3 Farm Road, New Canaan. Weir will talk about symptoms of the disorder and offer tips on how people can become more successful at falling asleep. Weir has written about pulmonary medicine topics and sleep disorders, with his work appearing in medical journals. Call 203-594-5334.

MS walks planned to raise awareness

On April 10, there will be nine sites across the state at which people will gather to raise awareness about multiple sclerosis and raise funds for research. Westport will host a walk on Sunday, April 3. The insurance company Travelers is back for the fifth year as the title sponsor for the walks, which are run by the Connecticut Chapter of the National MS Society. Last year, the walk attracted nearly 9,000 participants and raised more than $1.3 million. The chapter hopes to raise $1.4 million.

Walks will take place in Stamford at Cove Island Park, in Westport at Sherwood Island State Park, and at West Haven High School. Check-in begins at 8 and the walk kicks off at 9 a.m. at Stamford and West Haven. Check-in in Westport begins at 9. and the walk begins at 10 a.m. To learn more or to register, visit www.ctfightsMS.org or call 860-913-2550 or 860-913-2550.

Panel on heart disorder, club on respiratory disease

A panel of Bridgeport Hospital physicians will discuss the causes and treatment of atrial fibrillation during a free lecture, "Heart All A-Flutter? Get Your Rhythm Back!" at 7 p.m. Thursday, Feb. 24, at the Trumbull Marriott, 180 Hawley Lane. Doors open at 6:30 p.m. Speakers include cardiac electrophysiologist Dr. Murali Chiravuri, director of cardiac electrophysiology Dr. Craig McPherson, and chief of cardiothoracic surgery Dr. M. Clive Robinson.

At 1:30 p.m. Feb. 25, the Better Breathing Club will meet at Bridgeport Hospital, duPont Board Room, 267 Grant St. The support group for those with chronic respiratory disease. For more information, call 888-357-2396.

Source http://www.ctpost.com/health/article/Health-notes-1024027.php

Three tips to save health care firms big bucks

Health care providers don’t anticipate the reimbursement rates they get from insurance companies or the federal government to take a giant leap any time soon.

So they’re looking to collect every dollar they’re entitled to under current contracts.

And Bob Stevens, CEO of Crescent Springs-based Bottom Line Systems, is helping them. His company looks for cases where providers have been underpaid.

Bottom Line Systems collected more than $70 million in additional reimbursement for clients over the last year.

The 14-year-old company has 200 employees and serves clients, including hospitals, physician practices and infusion companies, in 20 states. It’s recently been growing revenue by 10 percent to 20 percent per year.

Stevens, who also is a partner in the Crestview Hills-based law firm Dressman Benzinger LaVelle, offers several tips for providers seeking to maximize their revenue in the new year:

• Review contracts carefully. Nearly every dollar that passes through a hospital is covered by a contract or a regulatory system. Knowing the fine print in every agreement is the only way providers can know whether they’re being reimbursed properly.

• Test every payment. Nowadays, periodic audits and sampling are not enough, Stevens said. “There’s so much complexity and opportunity that when you go ahead and review all the claims, the payoff is more than worth the effort.”

• Don’t be afraid to seek outside help. Stevens’ firm operates almost entirely on a contingency basis. “We’re at risk, so I wouldn’t be doing the review if I didn’t think it was worth it,” he said.

A typical hospital, Stevens said, can increase its net revenue between 1 percent and 3 percent by implementing such a review process.

Source http://www.bizjournals.com/cincinnati/blog/2010/12/three-tips-to-save-health-care.html

15 health tips for the new year

Year after year we make resolutions to exercise regularly, eat well, and give up smoking and other bad habits. Following such basic rules can cut heart disease risk by 80 percent, diabetes risk by 90 percent and cancer risk by 50 percent, according to the Harvard Nurses’ Health Study. But most of us fail to keep our promises to ourselves. Some American experts have given the following tips for practical ways to get – and stay – healthy.

1 .Wear a pedometer. New research suggests that routinely wearing a pedometer encourages people to walk about an extra mile each day, lose weight, and lower their blood pressure. Aim for at least 30 minutes of brisk walking and a total of 10,000 steps per day.

2. Don’t forget strength training, involving both the upper and lower body. Too many people neglect resistance exercise, particularly women for whom it’s crucial for preventing muscle and bone loss with age. Lift weights for at least 20 minutes, two- to three-times per week.

3. Don’t pop too many vitamins. Enthusiasm for vitamin pills is high, but evidence for their benefits is low. Try to get vitamins from foods and consider a multivitamin for insurance. Any woman thinking about getting pregnant should make sure to take a folic acid supplement. Women should get at least 1,000 mgs of calcium per day (1,200 mgs/day if you’re past menopause) from food and/or supplements. Everyone should also get 800 international units of Vitamin D per day.

4. Eat at least two fish meals per week. The evidence is strong that the oils in darker types of fish, such as salmon, tuna, mackerel and herring, are beneficial for the heart and brain and may even lower risk of cancer.

5. Talk to your doctor about taking aspirin for heart protection but don’t assume that it’s right for you. A recent clinical trial suggested that healthy women younger than age 65 don’t get heart protection from aspirin. Women who are the best candidates for long-term aspirin are age 65 or older or have a history of cardiovascular disease or diabetes. And be aware that aspirin has some serious risks, including gastrointestinal bleeding.

6. Drink water. No matter where you are, water should always be the first thing you reach for when you’re thirsty. Water truly is essential.

7. Sleep eight hours a night. A number of recent studies have confirmed that you really do need at least eight hours a night. Among the many benefits: Adequate sleep makes you feel better, decreases risk for cardiovascular disease, boosts memory and reduces the likelihood of being in a car accident.

8. Keep sugar and caffeine – the “legal evils” – to a minimum. It’s hard to believe, but decreasing sugar actually increases people’s energy, by minimising the highs and lows that sweet foods triggers. Different people react differently to caffeine, but most of us are probably overstimulated already – adding a stimulant just adds to things like road rage.

9. Consider acupuncture and massage as valid therapies for chronic problems, such as back pain and neuropathy. Seeing a good massage therapist for neck strain may work better than taking extra strength Tylenol and/or Advil regularly.

10. If you smoke, quit. There is nothing good about it. If you’re having trouble quitting, start smoking less today – smoke only half a cigarette, and skip as many of your usual smokes as you can – and get help right away. Get some guidance about why it is you smoke to figure out how best to stop doing it. Smoking cessation groups can be extremely helpful and supportive, and medications like a nicotine patch can help decrease the cravings. Acupuncture may also be useful.

11. Don’t focus on dieting. Focus on eating. If you’re hungry, you’re more likely to overeat, especially in the evening. Instead, of sacrificing all day and gorging later, it’s better to eat enough during the day to avoid hunger pangs and uncontrolled eating at night. Eat every four hours or so, and make sure to eat a “second lunch” – think of it as another meal rather than a snack – in the mid-afternoon to keep your energy up and make you less hungry in the evening.

12. Budget your food as you do your money. A rough guideline for daily caloric intake: Multiply your ideal body weight by ten (ie, 1,200 calories if you want to weigh 120 pounds) and then add another 600 calories if you’re moderately active, a few hundred more if you’re very active. Divide those calories out across the day to keep yourself well fed.

13. Eat three different foods at every meal. Don’t eat a scoop of tuna for lunch – eat tuna on a roll with a salad.

14. Eating won’t solve emotional problems. Many people eat to make themselves feel better when they’re upset. It works in the short run; certain foods can temporarily boost mood. But in the long run, you’ll have the same emotional problems – plus the extra weight.

15. Don’t drink too many calories. It’s easy to drink calories without noticing: that latte may have nearly as many calories as a cheeseburger. It’s okay to have one as an occasional treat, but consider it a meal, not a drink.

Source  http://www.newsday.co.tt/features/0,133519.html

LUNG CANCER SCREENING ENDORSED BY ACS

The updated guidelines on lung cancer screening released by the American Cancer Society (ACS) conclude that there is sufficient evidence for screening with low-dose computed tomography (LDCT) in certain high-risk individuals.

The guidelines were published online January 11 in CA: A Cancer Journal for Clinicians. They are an update of interim guidelines issued in 2010, and are based on a systematic review published last year (JAMA. 2012; 307:2418-2429).

The ACS supports screening for lung cancer for people 55 to 74 years with a history of smoking (at least a 30-pack-year history), in those who currently smoke, and in those who quit smoking in the previous 15 years. The ACS also supports an individual's decision not to be screened, even if they fall in this high-risk category.

The LCDT screen is performed annually, and the ACS emphasizes that people should be encouraged to join an organized screening program with expertise in lung cancer and multidisciplinary teams "wherever possible."

"The adoption of lung cancer screening could save many lives," Richard Wender, MD, from Thomas Jefferson University Medical College in Philadelphia, Pennsylvania, and colleagues state in the guidelines, citing evidence from the National Lung Cancer Screening Trial (NLST).

"At this time, there is sufficient evidence to support screening provided that the patient has undergone a thorough discussion of the benefits, limitations, and risks, and can be screened in a setting with experience in lung cancer screening," they add.

The National Comprehensive Cancer Network was the first to recommend annual screening with LCDT for certain populations (in 2011); the American Lung Association followed in 2012.

The American College of Radiology has announced that it is preparing its own set of guidelines to ensure that CT lung cancer screening is performed using "proper personnel, equipment, protocols, and follow-up."

Issues of Concern

Despite the official guidelines and enthusiasm from some medical centers, there has been reticencefrom some lung cancer experts, who are concerned that many details need to be resolved before national screening programs are implemented.

The ACS acknowledges some of these concerns in its guidelines, and notes that high-quality lung cancer screening in the United States "poses many challenges." Whether or not the benefit from screening observed in the NLST will be seen in community-based screening for lung cancer "could be influenced by many factors, and the answer awaits the results of further observations and research," Dr. Wender and colleagues write.

On the positive side, screening could detect lung cancer at an earlier stage and therefore save lives; on the negative side are limitations and potential harms, including the "relatively high" level of false-positive findings and the resultant anxiety and need for additional invasive tests (such as lung biopsy). In the NSTL, 96.4% of the postive screening results in the LDCT group and 94.5% in the radiography (control) group were false-positive results.

In addition, there is "a legitimate concern" that some smokers will view the chance to undergo screening as an excuse to continue smoking, Dr. Wender and colleagues note. They emphasize that "vigorous smoking cessation efforts must accompany LDCT screening for adults who are current smokers."

Another issue concerns payment. Currently, very few government or private insurance programs provide coverage for the initial LDCT for lung cancer screening.

Advice to Clinicians

The ACS guidelines outline specific recommendations for clinicians.

They advise that clinicians review the smoking history of all patients 55 to 74 years of age to identify those who are in relatively good health but who have a history of smoking (at least 30-pack-year) and currently smoke or have quit smoking in the previous 15 years.

Having identified these individuals, clinicians who have access to high-volume, high-quality lung cancer screening and treatment centers should initiate a discussion about lung cancer screening. This should include a discussion about potential benefits and harms, limitations, and for current smokers should include counseling on smoking cessation.

The guidelines emphasize that clinicians should not discuss lung cancer screening with individuals who do not meet the above requirements.

"Wherever possible, individuals who choose to undergo lung screening should enter an organized screening program at an institution with expertise in LCDT screening, with access to a multidisciplinary team skilled in evaluation, diagnosis, and treatment of abnormal lung lesions, " the guidelines advise.

They recommend that "if an organized, experienced screening program is not accessible, but the patient strongly wishes to be screened, they should be referred to a center that performs a reasonably high volume of lung CT scans, diagnostic tests, and lung cancer surgeries."

"If such a setting is not available, and the patient is not willing or able to travel to such a setting, the risks of cancer screening may be substantially higher than the observed risks associated with screening in the NSTL, and screening is not recommended," according to the guidelines.