Ways to stop pain, limitations from hand arthritis

When arthritis affects the hands, a range of treatments may reduce pain and preserve joint mobility. The August issue of Mayo Clinic Health Letter provides an overview.

Osteoarthritis, also called degenerative arthritis, is related to aging. In the hands, it occurs when the stress of everyday motions or an injury wears down the smooth cartilage surfaces required for pain-free movement. The result can be swollen, tender finger joints and pain, which limit activity. Treatment options include:

Topical anti-inflammatory drugs: Of particular value for relief is the prescription gel diclofenac (Voltaren). It’s rubbed on the skin around the affected joints. Because the medication is applied directly to the affected location, side-effects are of less concern than with oral medications.

Nonsteroidal anti-inflammatory drugs (NSAIDS): Nonprescription aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve, others) or prescription-strength medications may help reduce inflammation, swelling and pain. Ongoing use can cause ulcers, stomach bleeding and other side-effects.

Splints: Splints reduce pain two ways — by supporting the joint in an optimal position for function or by providing a stable resting position, which allows for better function when the splint is removed.

Corticosteroid injections: These injections provide short-term pain relief but generally aren’t given in the same spot more than once or twice a year.

When conservative measures don’t control pain, surgery can be performed to fuse or replace joints.

Source: Mayo Clinic


Jacksonville University’s Online RN to BSN Program Provides Flexibility for Nurses

U.S. Labor Department analysts predict that by 2012 the country will need 1 million nurses to care for the more than 60 million aging baby boomers population. By 2016, it is estimated that 587,000 new nursing jobs will be created nationwide – the largest number of new jobs created in any industry.

Institutions of higher learning, such as Jacksonville University (JU), are developing nursing degree programs to not only meet the needs of the healthcare industry but also the needs of those seeking the degrees. JU’s online RN to BSN program is run in conjunction with the University Alliance (UA), the largest facilitator of e-learning in the country.

The challenge for registered nurses who are working but want to earn their bachelor of science in nursing (BSN) degree is how to schedule courses around their work schedules and other commitments. This is particularly true for traveling nurses, who typically work 13-week shifts then move on to another assignment, often in another locale.

Jacksonville University’s administrators understand that traveling nurses do not want to put their education and careers on hold. JU’s online BSN program is designed to overcome scheduling obstacles, and its administrators cite the following reasons why traveling nurses are choosing online programs like theirs:

1. A bachelor’s of science in nursing (BSN) degree makes a traveling nurse more marketable. Additional fields open up, including medical-surgical, obstetrics/gynecology, pediatrics, psychiatry and many others.

2. Traveling nurses usually earn a higher hourly rate and can earn even more with a BSN. Pay scales range from $21 to $42 per hour, plus benefits.

3. An online program allows nurses to study while they travel. E-learning systems such as JU’s provide the same information, material and degree as offered in a traditional classroom setting. In fact, a recent Department of Education study showed that, for adults, online learning is more effective than face-to-face learning, on several measures.

4. Online BSN programs are as flexible as the lifestyles of its students. “I am able to continue to work full-time and go to school part-time,” said Candice Jewett of Massachusetts. “I have been able to work full-time and maintain a 4.0 in my online classes.”

5. An online BSN program allows the flexibility to take sessions off. There are six 8-week sessions in a year, so students can tailor the program to match their own schedules. Students can opt to attend part-time and take off a session or two if needed.

6. Students can complete their BSN at their own pace. Most students complete the online BSN course in about two years.

7. Practice projects (clinicals) can be completed wherever there is a BSN-trained nurse. No travel is required to complete practice projects. At JU, two courses require projects, which are self-directed and allow students to work one-on-one with mentors.

8. Money is available to pay for nursing school. The American Association of Colleges of Nursing’s “Scholarships and Financial Aid Resources for Nursing Students” is a good place to start. Also, the U.S. Department of Health and Human Services offers the Nursing Education Loan Repayment Program. Individual states also may offer grants and loans. JU offers a helpful resource on how to pay for nursing school.

9. Many traveling nurse agencies offer tuition benefits. American Mobile Healthcare, NursesRx, Medical Express, RN Demand, Platinum Select, Nurse Choice and Preferred Healthcare Staffing have partnered with the University Alliance. A 10 percent tuition discount from JU and UA is available to traveling nurses who work for these agencies.

10. An Internet connection is all that’s needed to get started. “The JU website is easy to access at any computer – whether I’m at home, at a friend’s house or at the hospital,” said Susan Cardona of Massachusetts.

For more information about JU’s online RN to BSN program, visit http://www.jacksonvilleu.com/.


With the Centers for Disease Control and Prevention (CDC) announcing the potential for an unusual number of serious illnesses in school-age children (ages 5-24) and pregnant women from the H1N1 virus (swine flu)(i,ii), washing hands with soap that can kill the virus immediately and continue to kill it for up to six hours could mean the difference between getting swine flu or avoiding it, especially before a vaccine is expected to be available in mid-October.

As with other flu viruses, the swine flu is spread via contact with infected droplets or surfaces followed by contact with a person’s eyes, nose or mouth.(iii) Frequent hand washing with soap or the use of alcohol-based hand sanitizers (when no sink is available) will kill or remove the virus. However, the challenge is washing consistently after touching any surface such as a door handle, chair or desk or any person that could have been exposed to the virus. Cleansers that contain 4 percent chlorhexidine gluconate (CHG) bond to the skin and continue to actively kill germs for up to six hours.(iv) That’s almost an entire school or work day.

CHG offers better protection between washings, even if you are able to wash your hands frequently. Two over-the-counter brands that contain 4 percent CHG are Hibiclens skin cleanser and Hibistat individual wipes. Hibiclens and Hibistat have specifically been tested against a strain of the swine flu virus similar to the one that is currently causing illness in the community.(v) Since these strains are of the same virus family, these products will effectively kill both types of flu virus for up to six hours.

For moms, the swine flu is a major concern since both children and pregnant women are part of the high-risk groups. CDC says pregnant women have higher rates of hospitalization and a greater risk of death compared to the general population and recommends that antiviral treatment be started within 48 hours after symptoms begin.(vi)

“I’m very concerned,” said Jeanne Fuller, mother of Adam, 5, and Sam, 3, and 30 weeks pregnant with her third child. “I admit when I heard that pregnant women were at higher risk, especially late in pregnancy, I panicked. I ran to the store to get antibacterial everything. That’s when I learned about Hibiclens and have been using it ever since. My oldest son starts kindergarten this year and who knows what kind of new bugs he will encounter. If he gets sick, I will be the one caring for him and I have to protect the baby, too,” she said.

To help moms like Fuller, physicians are recommending long-lasting, germ-killing products, such as Hibiclens.

Doug Smith, M.D., an emergency department (ED) physician in Miami, Fla., knows what it’s like to see a bad flu season take its toll. “I tell all of my patients to be sure to wash their hands – they just can’t do it enough. And for those who might be at high-risk or need longer protection than just a few minutes, I recommend using washes with 4 percent CHG since it kills germs for hours. That’s what we have been using in our facility for years and we continue to use it to protect us,” said Smith.

Molnlycke Health Care provides the following tips for staying healthy this swine flu season.

– Wash your hands frequently with soap and water or an alcohol-based sanitizer (if a sink is not available).(vii)
– Wash hands after touching anything that might not have been washed with soap or a disinfectant recently.
– Wash hands with cleansers that contain 4 percent chlorhexidine gluconate (CHG) in order to kill the virus for a long period of time.
– Keep hands away from eyes, nose and mouth.
– Cough or sneeze into your elbow rather than hand to reduce the risk of transfer.
– Avoid crowds (or at least try to keep your distance from others).
– Get plenty of sleep and exercise.
– Stay home if you are experiencing flu symptoms (fatigue, fever, nausea, etc).
– Isolate individuals that are ill or have flu like symptoms, especially in a family.
– Use the hottest water possible in your washing machine, especially for sports and school uniforms, and dry everything completely.

i) Steenhuysen J, Fox M. (2009, July 17). www.reuters.com. “CDC fears more swine flu cases in fall.” Retrieved August 3, 2009, from http://www.reuters.com/article/healthNews/idUSTRE56G5DD20090717

ii) Stobbe, M. (2009, July 26). www.usatoday.com. “Swine flu could hit up to 40% in U.S. this year and next without vaccine.” Retrieved August 3, 2009, from http://www.usatoday.com/news/health/2009-07-26-swineflu27_N.htm

iii) Erin M. Sorrell, Hongquan Wan, Yonas Araya, Haichen Song, and Daniel R. Perez, “Minimal molecular constraints for respiratory droplet transmission of an avian-human H9N2 influenza A virus.” http://www.pnas.org/content/106/18/7565. Last accessed July 10, 2009.

iv) Regent Medical Study #030917-150.

v) Independent lab test time-kill for Swine Flu virus (H1N1 Virus strain A/Swine/Iowa/15/30).

vi) Dooren, JC. (2009, July 29). www.wsj.com. “CDC Says Pregnant Women With Flu Symptoms Should Receive Anti-Viral Drugs.” Retrieved August 4, 2009, from http://online.wsj.com/article/SB124885469827889531.html.

vii) “Novel H1N1 Flu Situation Update.” http://www.cdc.gov/h1n1 flu/update.htm. Last accessed July 10, 2009

Source: Molnlycke Health Care


Cancer mortality rates experience steady decline

  • Author: Health Informer
  • Filed under: Health News
  • Date: Aug 13,2009

VARI scientist finds conventional method underreports declining death rate for all age groups

The number of cancer deaths has declined steadily in the last three decades. Although younger people have experienced the steepest declines, all age groups have shown some improvement, according to a recent report in Cancer Research, a journal of the American Association for Cancer Research.

“Our efforts against cancer, including prevention, early detection and better treatment, have resulted in profound gains, but these gains are often unappreciated by the public due to the way the data are usually reported,” said Eric Kort, M.D., who completed the study while employed as a research scientist at Van Andel Research Institute (VARI) in Grand Rapids, Mich.

Cancer mortality rates are usually reported as composite age-adjusted rates. These rates have been declining modestly since the 1990′s. However, these statistics heavily emphasize the experience of the oldest Americans for whom mortality rates are the highest. As a result, trends emerging in younger Americans can be concealed.

As an alternative to age-adjustment, Kort examined cancer mortality rates stratified by age and found that for individuals born since 1925, every age group has experienced a decline in cancer mortality. The youngest age groups have experienced the steepest decline at 25.9 percent per decade, but even the oldest groups have experienced a 6.8 percent per decade decline.

The public often hears about incidence rates, which continue to rise across many cancer types, or mortality proportions, with the World Health Organization’s assertion that death from cancer will surpass death from heart disease by 2010. Both these calculations are accurate, Kort said, but they ask the wrong question. In particular, the often-quoted WHO statistic can be misleading.

Richard Severson, Ph.D., a cancer epidemiologist and associate chair of the Department of Family Medicine and Public Health Sciences at Wayne State University, said proportional mortality is calculated in groups of 100.

“When calculating proportional mortality, we start with the assumption that everyone dies of something eventually, so you take 100 deaths and calculate, based on death certificates, what those people have died from,” said Severson, who reviewed the report for Cancer Research.

Cancer will surpass heart disease as a cause of death in 2010 because, while both heart disease and cancer have been declining, heart disease mortality rates have been declining much more rapidly. And while it’s true that cancer incidence rates continue to grow, the decreased mortality across all age groups shows the effect of improved screening and treatment.

“In childhood cancer particularly, we’re able to do amazing things with leukemia and lymphoma that used to be a death sentence but now we are curing many of these cancers,” Severson said.

“This study focuses on an aspect that has been overlooked in determining whether we’ve had a significant impact on cancer mortality,” said George Vande Woude, Ph.D., head of VARI’s Laboratory of Molecular Oncology. Vande Woude helped conceive of the project and is one of the study’s authors.

Vande Woude and Kort, currently a medical resident at Helen DeVos Children’s Hospital in Grand Rapids, worked in collaboration on the project with Nigel Paneth, M.D., of Michigan State University’s College of Human Medicine, departments of Epidemiology and Pediatrics and Human Development. The project was funded by a grant from the National Institute of Child Health and Human Development and Van Andel Institute.

Source: Van Andel Institute


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