Passing kidney stones can be an extremely painful process that no one wants to repeat. But patients who have experienced kidney stones have a 50 percent chance of recurrence within 10 years.

Kidney stones are made up of crystal-forming minerals in the urine. Normal urine contains substances that inhibit crystal formation. However, if urine is too concentrated or if the crystal-preventing compounds aren’t working properly, crystals may gradually accumulate and grow to form one or more kidney stones.

Most kidney stones pass naturally through the ureters (tubes that connect the kidney to the bladder), through the bladder and then out in the urine. Passing a kidney stone may take hours or weeks. Most often, the process takes seven to 14 days. Small stones may not be a big bother. Larger ones can cause extreme pain, typically on the side and the back, just below the rib cage and radiating to the lower abdomen and groin. There are a variety of treatment options, from pain management to surgical removal of the stone.

Once the stone has passed, the focus switches to prevention. Prevention strategies depend somewhat on the composition of kidney stones. About 70 percent are formed primarily of calcium oxalate. Others are formed mainly from calcium phosphate, uric acid or struvite stones. Recommendations for prevention of kidney stones in most people may include:

Drink enough fluid: Drinking at least 12 cups of fluid — preferably water — a day is the most basic way to prevent kidney stones. The fluid dilutes the urine and decreases the risk of crystal formation.

Limit meat intake: Consuming more than 6 to 8 ounces of meat daily can increase calcium and uric acid in the urine, increasing the acidity of urine and reducing the chemicals that inhibit crystal formation.

Get adequate calcium: Meeting daily calcium intake recommendations based on age reduces the risk of kidney stone development, probably because calcium binds to oxalate in the gut, reducing oxalate levels in the urine.

Avoid excess vitamin D: Often consumed with calcium to help absorption, vitamin D may raise the risk of developing calcium-based stones. Vitamin D has many health benefits, but for those at risk of kidney stones, limiting vitamin D consumption to age-specific recommended daily limits may be advised.

Consider food choices: Limiting intake of oxalate-containing foods — such as spinach, beets, chocolate, peanuts, potatoes and many other foods — is an important preventive strategy for those with calcium oxalate stones who also have conditions that affect the small bowel, such as Crohn’s disease. For those who don’t have digestive conditions or high urine oxalate levels, the benefits of diet changes are unclear. Because the diet is very difficult to follow, Mayo Clinic experts don’t emphasize this strategy.

Source: Mayo Clinic


As economic, social and political factors change the face of substance abuse in Illinois, the state’s leading provider of addiction treatment services is expanding its efforts to help the growing number of people who can’t afford expensive clinics but also fail to qualify for government-funded treatment programs.

Gateway Foundation Inc., a 41-year-old non-profit organization, serves more than 29,000 patients in Illinois each year, historically through publicly funded treatment programs. But as the overall need for treatment grows at the same time government funding is increasingly in jeopardy, Chicago-based Gateway is sharpening its focus on middle-income patients who must pay for treatment out of pocket or through private insurance.

At its four Chicago-area facilities – on the city’s Westside, near Humboldt Park, and in suburban Aurora and Lake Villa – and at five other locations across the state, Gateway is offering a variety of customized, flexible and fully integrated treatment programs based on nationally recognized clinical criteria from the American Society of Addiction Medicine.

“The current economic situation has created a ‘perfect storm’ of factors that threatens those suffering the consequences of an untreated substance abuse problem,” said Gateway President & CEO Michael Darcy. “People who have been laid off or closed their business are less able to afford treatment due to loss of salary and benefits, yet their emotional state may make them more likely to seek comfort or escape in drugs or alcohol.

“At the same time,” Darcy added, “shrinking tax revenue is forcing governments to cut programs, which is a major concern because public funding covers approximately 80 percent of all spending on substance abuse treatment in the U.S.”

In fact, affordability has long been a major obstacle for substance abuse patients in need of treatment. For instance, according to the Substance Abuse & Mental Health Services Administration (SAMHSA), in 2007 more than 868,000 Americans felt they needed treatment for alcoholism but failed to pursue such treatment; 35% of them cited cost or insurance barriers as the reason they didn’t get the help they needed.

Sally Thoren, community director for Gateway in Chicago, says the organization is committed to helping people of all income levels to structure a program that not only meets their treatment needs, but fits within their long-term financial picture as well.

“There is considerable data that shows the economic benefits of treating substance abuse,” said Thoren. “One study showed people were three times as likely to be employed after completing treatment than those who don’t seek help. Other research points to the increased earnings, improved health and lower medical costs of those who get treatment. So the question isn’t what’s the cost of treatment, but rather, what’s the cost of not treating substance abuse.”


Experts to review quality improvement programs to prevent preterm birth

  • Author: Health Informer
  • Filed under: Health News
  • Date: Sep 19,2009

March of Dimes Supports Screening, Education and Intervention Tools

Journalists are invited to attend a gathering of the nation’s leading maternal-child and quality assurance health care experts who will review and develop programs that may help lower the nation’s costly preterm birth rate.

The symposium, which will be held Oct. 8 and 9 in Arlington, Virginia, is a collaborative project of the March of Dimes, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, American College of Nurse-Midwives, and the Association of Women’s Health, Obstetric and Neonatal Nurses. Attendees will review existing programs developed by state officials, health systems, health insurers, hospitals and clinicians, that successfully lower cesarean section and induction rates and improve care and services for pregnant women and babies.

Some of the highlighted programs will be:

– Intermountain Health Program, Salt Lake City, Utah, which reduced its elective c-sections to less than 5 percent from more than 30 percent.
– Hospital Corporation of America, Nashville, Tenn., which delivers about 5 percent of all U.S. births, implemented an integrated quality improvement program in the 21 states it serves, and reduced the primary c-section rate, lowered maternal and fetal injuries and reduced the cost of obstetric malpractice claims 500 percent.
– Geisinger Health System, Danville, Pa., developed an electronic health record to ensure pregnant women are screened for chronic conditions and risk factors that can be treated proactively, lowering the risk of preterm birth and other complications.

Preterm birth is a serious and costly health problem, and is the leading cause of death in the first month of life in this country. More than 540,000 babies — one out of every eight — are born too soon each year in the United States, and the rate has increased more than 20 percent in nearly 20 years. Babies who survive an early birth face serious risks of lifelong health problems, including learning disabilities, cerebral palsy, blindness, hearing loss, and other chronic conditions including asthma. Even infants born just a few weeks too soon have a greater risk of respiratory distress syndrome (RDS), feeding difficulties, temperature instability (hypothermia), jaundice and delayed brain development.

“There are tools out there that can successfully prevent preterm birth — whether by ensuring that a c-section is medically necessary, or by screening pregnant women for diabetes, or by offering them access to smoking cessation programs,” said Alan R. Fleischman, MD, medical director for the March of Dimes. “At this meeting, OB-GYNs, pediatricians, nurses, hospital administrators, health insurers and policy makers will share their best practices and create a plan that will outline education and intervention opportunities and begin to reverse the serious increase in our nation’s preterm birth rate.”

Among the nationally-known experts who will present at the meeting are:
– Carolyn M. Clancy, MD, director, Agency for Healthcare Research and Quality
– Mark R. Chassin, MD, FACP, MPP, MPH, president, The Joint Commission
– Tina D. Groat, MD, MBA, UnitedHealthcare National Medical Director, Women’s Health Line of Service
– Hal C. Lawrence, III, MD, FACOG, vice president, Practice Activities, ACOG
– Melissa Avery, PhD, CNM, FACNM, FAAN, President, American College of Nurse-Midwives (ACNM)
– Jose F. Cordero, MD, MPH, dean, Graduate School of Public Health, University of Puerto Rico and founding director of the National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention
– Helen Darling, president, National Business Group on Health
– Kim Armour, NP-BC, APN, MSN, RDMS, 2009 President of the Association of Women’s Health, Obstetric and Neonatal Nurses


Government-run Health Care and Increased Taxes Top List of Concerns

On the heels of the new $856 billion health care bill proposed yesterday by Senate Finance Committee Chairman Max Baucus, doubt over health care reform passing this year still looms across the American public. Fifty-four percent of U.S. adults surveyed believe health care reform will not pass this year compared to 41 percent who do, according to the results of a new Deloitte Center for Health Solutions study.

While many doubt legislation will pass, those surveyed who watched President Barack Obama’s address last week (44 percent versus 55 percent who did not watch) were inclined to agree (68 percent) versus disagree (30 percent) with the components of the President’s reform plan.

“Consumers are at a crossroads and while the majority of Americans surveyed (84 percent) believe some form of change is needed, many are confused by the complexity of the system and often default to their own personal experience with the system rather than look at the functionality of the entire system,” said Paul Keckley, Ph.D. and executive director of the Deloitte Center for Health Solutions. “Interestingly, respondents said they trust physicians and health care providers (37 percent) the most when it comes to reforming the health care system, followed by the White House (21 percent), Congress (13 percent), employers (11 percent) and health insurance companies (7 percent).”

Concern over the government running health care was a common theme throughout the survey results. Sixty-one percent of respondents believe that Congress is likely to make the health care situation worse than better, and 55 percent thought government solutions to health care will ultimately cost more and deliver less compared to private sector solutions. Additionally, while the economy is still a major concern, 51 percent believe that health reform should not wait until the economy is better compared to 47 percent who thought it should wait.

Top concerns regarding health care reform expressed by consumers surveyed include:

– Thirty-seven percent do not want the government to run health care.
– Twenty percent did not want their taxes to increase to cover health care for others.
– Thirteen percent were concerned that they did not understand the proposals.
– Twelve percent thought they might have to wait too long to see a doctor if the public option is passed.
– Only five percent were concerned about issues related to end of life care.

“Given consumer concerns regarding the public option and government-run health care, the current bill appears to be more in line with what consumers we surveyed may be more comfortable with,” added Keckley. “Our survey results indicate that while the majority believe the health care system needs to change, 48 percent want improvements, but not a major overhaul of the system. This supports the idea that a more moderate, incremental approach may be the answer.”

Additional findings from the survey include:
– Seventy-three percent of respondents believe it is important for every American to have health insurance.
– The uninsured (60 percent) and underinsured (55 percent) respondents were more likely to believe a major overhaul of the U.S. health care system is needed.
– Fifty-seven percent of respondents believe Town Hall meetings have been an effective forum for gaining feedback from the public compared to 35 percent who did not think they were.
– Respondents were split when it came to ranking the U.S. health care system, with approximately half (48 percent) agreeing that the U.S. health care system was the best system in the world compared to nearly half (48 percent) who disagreed.
– Fifty-five percent of those surveyed do not believe coverage for the uninsured should be the sole focus of the debate.
– Respondents were most familiar with terms such as the public option (46 percent), health care co-ops (34 percent) and health insurance exchanges (28 percent), compared with terms such as comparative effectiveness research (20 percent) and the medical home (19 percent).

Methodology:

The Deloitte Center for Health Solutions commissioned Harris Interactive to conduct a nationally representative telephone survey of 1,010 U.S. adults 18 years-old and older from Sept. 10 -13 to gauge consumers’ opinions of health care reform following the President’s address to the nation on Wednesday, Sept. 9th. Data were weighted to be representative of the total U.S. adult population on the basis of age, sex, geographic region and race. The survey has a sampling error of + or – 3.1 percent at the 95 percent confidence level.

Source: Deloitte


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