HEALTHNET NEWS VOL. XV, NO. 2 SUMMER  2000
Lyman Maynard Stowe Library
University of Connecticut Health Center

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TABLE OF CONTENTS
           UPDATE
            -Incorrect volume number for our Spring issue
            -Medical reference workshop scheduled for September 26th
            -Why not link to our list of Internet resources
          PROFESSIONAL  READING
             Diabetes information and new consumer health books in Library Journal
          NETNEWS
            -Guidance on good eating
            -New features of MEDLINEplus
            -Online medical dictionary
            -Are you at risk for cancer?
            -Gray's anatomy online
            - More info on medical tests
            -An ounce of prevention . . . safety education for children
            - Dangerous food
         FOR YOUR CONSIDERATION
            Recommended consumer health books:
             -Children with spina bifida
             -Living with hepatitis C
             -The scleroderma book
            -The savy mom's guide to medical care.
 
 


              UPDATE 

INCORRECT  VOLUME  NUMBER  FOR  OUR  SPRING  ISSUE

The volume number for the Spring 2000 issue of Healthnet News is incorrect.  The correct volume number is XV, not XIV.  Please correct your copy.

MEDICAL   REFERENCE  WORKSHOP  SCHEDULED  FOR  SEPTEMBER 26th

Healthnet will be offering a medical reference workshop for public librarians on Tuesday, September 26th.  The workshop will be held at the Wallingford Public Library from 9 a.m. – Noon. We’ll be sending out an announcement in early August so watch for details.

WHY  NOT  LINK  TO  OUR  LIST  OF  INTERNET  RESOURCES?

Many public libraries have a homepage that includes  recommended Internet resources for different subject areas.  If you have a health section, why not link to Healthnet’s list of recommended web sites instead of spending a lot of time developing your own list of sites.  Our list is updated regularly and is highly selective, so you can be assured that only quality sites are included.  We recently added a section on Connecticut health resources. You can link directly to our recommended health and medical resources on our  library homepage.
 

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PROFESSIONAL  READING

The supplement to the May 1, 2000 issue of Library Journal is devoted to new consumer health books.  Over 500 titles of recent or forthcoming books are organizaed into 41 categories, such as  aging alternative medicine, cosmetic surgery, infectious diseases, menopause, skin diseases, health insurance, and nutrition.

A separate article on diabetes includes recommended books, videos, and Internet resources.  General guides are included as well as titles in specific subject areas such as diet and nutrition, emotional issues, personal narratives, alternative therapies, and children and diabetes.   Each title is briefly described and essential titles for diabetes collections are indicated.

Subject listings – consumer health.  Library Journal 2000 May 1;125(8 – supplement):19-45.

Schneider JM. Make life sweet : diabetes resources.  Library Journal 2000 May 1;125(8- supplement):3-16.

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NETNEWS

GUIDANCE  ON GOOD  EATING

With all the daily claims being made regarding what’s good and not good to eat, it’s easy to get confused when planning a sound  personal nutrition program  – one in which you can be sure you’re getting  the necessary requirements for good health.  The new Dietary Guidelines may be just the thing to get you on the right track.

On May 27, the US Department of Agriculture (USDA) and Department of Health and Human Services (HHS) released the fifth edition of The Dietary Guidelines for Americans.  The guidelines are designed to provide  scientifically based easy-to-understand, suggestions for diets that promote good health. This edition has been redesigned to be more consumer-friendly. For the first time, the guidelines  also contain recommendations for  safe food handling and there is a  stronger emphasis on physical activity, not just for wweight management, but as a key to healthy living in general. The complete report numbers 40 pages, but numerous summaries throughout the document make it easy for readers to sift through the important details.  A complete copy of the guidelines is at the  USDA site . You'll need Adobe Acrobat reader to view the document.

NEW   FEATURES  ON  MEDLINEPLUS

The National Library of Medicine recently added the adam.com medical encyclopedia to  MEDLINEplus    its  consumer health resource.  The encyclopedia, easily accessed via the Medical Encyclopedia tab on the left side of  every MEDLINEplus page or by going directly to medlineplus.adam.com,  contains over 4,000 articles and medical images organized in eight sections:  Disease, Injury, Nutrition, Poison, Special Topics, Surgery, Symptoms, and Tests. Users can browse the encyclopedia entries alphabetically within each of the eight areas or use the alphabetic list of the entries.

Many entries are one or two paragraphs in length; some are one or two sentence definitions.   Most  entries are accompanied by attractive  full-color illustrations.  This is a handy resource for easy to understand descriptions of medical terms and concepts.

MEDLINEplus has also added extensive information on more than 9,000 brand name and generic prescription and over-the-counter drugs.  The information gives the side effects, dosing, drug interactions, precautions, and storage requirements for each drug.  The information is from the USP DI, Volume II Advice for the patient, one of the most authoritative sources for drug information. Advice for the patient is also known as The Complete Drug Reference, which is published by Consumer Reports Books.  Each online drug monograph is identical to the monograph in the print edition.  The drug database may be accessed via the Drug Information tab on the left side of every MEDLINEplus page or by going directly to www.nlm.nih.gov/medlineplus/druginformation.html .

ONLINE  MEDICAL  DICTIONARY

 MedicineNet  is an interactive web site of health information for consumers and is produced by board certified physicians and scientists.  MedicineNet claims that all of the information on their site is peer reviewed to insure that it is accurate, readable, and comprehensive.  A feature recently added to the site is a medical dictionary  that includes classical and contemporary medical terms as well as pertinent scientific terms, abbreviations, acronyms, jargon institutions, projects, symptoms, syndromes, and eponyms.

Entries range from one to two sentence definitions to mini-medical essays.  Jargon is held to a minimum – this is one medical dictionary where you won’t need another dictionary to understand the terms used in the definition.  One main advantage to an online dictionary is its ease in updating, which the site developers claim they do on a regular basis.  There is some overlap between this dictonary and the MEDLINEplus Medical Encyclopedia mentioned above.  Both are useful resources and deserve to be bookmarked.

ARE  YOU  AT  RISK  FOR  CANCER?

The Harvard Center for Cancer Prevention is a research and education center based at the Harvard University School of Public Health. The Center provides leadership in promoting prevention as the primary approach to cancer control. It conducts and coordinates  research to identify modifiable causes of cancer and translates the findings into effective prevention strategies at the individual  and community level. Through the use of reports, publications, seminars and web sites, it makes information on cancer  prevention available to the public.

The Center has developed Your Cancer Risk -  a personalized tool to help individuals estimate their risks for certain types of cancer.  YourCancerRisk also provides helpful tips on prevention. The information in YourCancerRisk is based on established science and proven risk factors. A risk factor is proven if the evidence is strong enough to show a link to the disease.  The risk assessment is most accurate for people over the age of 40 who have never  had any type of cancer.  Currently, risk assessments are included for breast, lung, colon, and prostate cancer.  Eight more cancers will be added at a later date.

Each assessment takes a few minutes to complete.  The resulting risk profile displays your risk on a scale of low to high. An explanation  of what makes up your risk is provided and tips are offered on how to lower your risk.  Users are cautioned that some risks cannot be modified, for example  your age or your family ancestry. You can easily see how your risk profile can be affected by  making one or more of the recommended changes.  For instance, if you have an above average risk for colon cancer, you can lower your risk to average by eating less than 2-3 servings of red meat each week and by eating 3 or more servings of vegetables each day.  You can lower your risk even more by taking a daily multivitamin.

The site also includes a  description of the diagnosis and treatment of each  cancer inlcuded in the assessments.  There is also a link back to the Harvard Center for  Cancer Prevention which includes links to online cancer resources.

 GRAY’S  ANATOMY  ONLINE

Gray’s Anatomy, the classic illustrated text of human anatomy,  is now available online at www.bartleby.com  This is the 20th edition published in 1918.  The text is fully searchable by keyword, table of contents, or by a subject index of over 13,000 entries.  There are over 1200 engravings, many of which are in color.   A smaller image is provided with the text and users have the option of enlarging the image to full screen.

MORE  INFO  ON  MEDICAL  TESTS

We reported in the Winter 1999 issue of Healthnet News about the availability of information on medical tests and diagnostics on  Healthgate's web site .  Recently, Lycos Health with WebMD added the complete text of the Yale University School of Medicine Patient’s Guide to Medical Tests to their  web site.  The online edition is an exact reproduction of the popular print edition.

This authoritative and comprehensive guide explains how to prepare for a test, what to expect during the test, and how you may feel afterward.  The guide also includes information on your rights as a patient, your doctor’s responsibility in disclosing possible risks and complications, and the differences between screening and diagnostic tests.  Sections include diagnositic imaging tests, laboratory tests, tests related to different organs and structures of the body, such as the digestive system and the heart, and tests for different conditions, such as allergies, hypertension, and diabetes.

AN  OUNCE  OF  PREVENTION . . . SAFETY  EDUCATION  FOR  CHILDREN

Unintentional childhood injury is the number one killer of children ages 14 and under, accounting for more deaths than all of the childhood diseases combined. In 1997, more than 6,000 children in this age group died from unintentional injuries.   In addition, each year nearly 120,000 children are permanently disabled and 14 million children sustain injuries that are serious enough to require medical attention.  These injuries have enormous financial, emotional and social effects not only for the child and the family, but the community and society as a whole.

The  Injury Prevention web site  from the Children’s Hospital of Pittsburg offers information for children, teens, parents and guardians, and health professionals on safety issues and injury prevention.  Special features include an online safety handbook for parents and guardians that describes how to make homes safe for children.  Topics in the handbook cover buying a crib and an infant car seat, how to buy and use baby safe toys, furniture, and equipment, poison prevention,  handling emergencies, gun safety, and many other important  topics.  There are separate sections for young children, teens, parents and guardians, and professionals.  Animated sound cartoons instruct children on bicycle, playground, street, and sledding safety.  Topics covered in all of the sections include safety precautions during thunder storms, safe use of in-line skates and skate boards, importance of life jacket use for water activities, helmut use when bicycling, smoke alarms, lawnmower safety,  auto restraints for children, and other safety issues and concerns.

The mission of the  National Safe Kids Campaign  is to prevent the number one killer of children – unintentional injury.  The sponsors of Safe Kids include Johnson and Johnson, Nestle Corporation, Children’s National Medical  Center in Washington DC,  FedEx, General Motors, U.S. Department of Housing and Urban Development, and other governmental and private agencies and organizations.

The Safe Kids web site includes announcements of child and household product recalls,  fact sheets on over 20 child safety related topics such as scald burn injury, playground safety,  fire safety,  poisoning, and falls.   A FAQ page answers questions on buying infant car seats, what to look for when buying a crib, the dangers of baby walkers, poisonous household plants, small parts testers, use of carbon monoxide detectors, and other similar concerns. Information on the Safe Kids Buckle Up program, a national campaign to encourage the proper use of auto seat restraints for children, includes guidelines for the proper restraint of children and  a link to the American Academy of Pediatrics car seat buying guide.  A state by  state schedule of car seat check-up events sponsored by state Safe Kids programs is also provided.  Health and safety links to organizations concerned with all aspects of child safety are also featured.

The Connecticut Safe Kids Campaign  is sponsored by the Connecticut Children’s Medical Center in Hartford.  Their web site includes many of the features of the national site as well as some state specific information such as how to purchase a Safe Kids license plate.

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DANGEROUS   FOOD 

 Do You Know What You're Eating?  is an analysis of data comparing the relative amounts and toxicity of pesticide residues in different foods.  The report is from data collected by the U.S. Department of Agriculture’s Data Program from 1994-1997 and published February 1999 by the Consumers Union (CU),  the publishers of Consumer Reports. The full report of CU’s analysis of pesticide residues in food may be downloaded in PDF format.  If you’re concerned about pesticides in food, particularly food eaten by young children, this is a “must” read.

Consumers Union obtained pesticide residue data on over 27,000 food samples then weighted the amounts of residues present to account for differences in the toxicity of individual pesticide chemicals.  They then computed a Toxicity Index (TI) for each food.  Foods with high TI scores have greater amounts of pesticide residues, residues that are more toxic, or both, compared to food with low TI scores.  The majority of foods tested have TI values between 10 and 300, and some have values between 300 and 600.  CU states that values greater than 100 show comparatively high pesticide contamination, and values less than 10 indicate that those foods are comparatively “clean”. The highest T1 score was over 5,000.

Six foods had very low TI’s (10 or less) each time they were tested.  These were frozen/canned corn, milk. U.S. orange juice, U.S. broccoli, bananas, and canned peaches.  Others with relatively low scores include frozen/canned sweet peas, U.S. and imported apple juice, frozen winter squash from Mexico, tomatoes from Canada, Brazilian orange juice, and U.S. wheat. Seven foods had consistently high or very high TI scores: domestic and imported fresh peaches, frozen and fresh winter squash grown in the U.S., domestic and imported apples, grapes, spinach and pears, and U.S. grown green beans.

Although CU voices concerns about the level of pesticide residues found in many fruits and vegetables, they do not recommend eating less of these foods since  the benefits of these foods outweigh the risks from pesticides.  Advice is offered to help concerned consumers reduce their exposure to pesticides in foods.

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                       FOR YOUR CONSIDERATION 

The following books may be of interest to public and health sciences libraries.  They are not part of the UCHC Library collection.

Children with spina bifida : a parent's guide.   Marlene Lutkenhoff, ed.  Woodbine House (Special Needs Collection), 1999.  404 p.  (ISBN 0-933149-60-3),  $16.95.

Every year in the United States about 3,000 babies are born with a neural tube defect, more commonly known as spina bifida.  Spina bifida is a defect in which the spinal cord of the developing human embryo does not completely close.  There are several different forms of spina bifida, but the most serious and most common is myelomeningocele, or meningomyelocele,  when the spinal cord and its surrounding membranes protrude through an opening on the back into a sac.  Spina bifida can have varying degrees of severity depending on the size and the location of the lesion on the spine.  Some children may have complete paralysis and be unable to walk; others may eventually be trained to walk with the assistance of leg braces and crutches.

Editor Lutkenhoff, a nurse who is the Service Coordinator for the Myelomeningocele Clinic at the Cincinnati Center for Developmental Disorders, has brought together an experienced team of doctors, nurses, parents, therapists, and teachers to offer comprehensive information, guidance and support for parents of children with spina bifida.  Topics  include a discussion of the causes and symptoms of spina bifida and how it may be diagnosed prenatally,  associated orthopedic and urologic problems and how they are managed, child development concerns and issues, and why neurosurgery may be indicated for some children.
Emotional issues, family and parenting concerns, educational considerations, and legal rights for disabled children are all covered in separate chapters.  At the end of each chapter are quotes on specific chapter topics by parents of children who have spina bifida.  One chapter, written by a young woman who was born with spina bifida, describes what it is like to live with this disability, her experiences with clinics and doctors, her education, and her feelings about what the future holds. A glossary, chapter references, and a resource directory for further information are included.  A helpful and valuable guide.

Living with hepatitis C : a survivor’s guide. Rev. ed.  Gregory T. Everson and Hedy Weinberg.  Hatherleigh Press (WW Norton), 1999.  255 p.  (ISBN 1-57826-034-5), $14.95.

Hepatitis C is a viral infection that causes inflammation and eventual scarring of the liver.  A serious and potentially deadly disease, it currently affects almost 4 million people in the United States. Each year 8,000 – 10,000 people die from liver failure due to hepatitis C.  Although the disease can be life threatening, most people learn to live with and survive hepatitis C.

Both authors bring their unique knowledge and experience to this fact-filled, thoughtful book which offers guidance and answers for those infected with the deadly virus and for their husbands, wives, families, and friends. Gregory Everson is Professor of Medicine and Director of Hepatology at the University of Colorado School of Medicine and a nationally recognized expert on the treatment of hepatitis C.  Hedy Weinberg, diagnosed with hepatitis C in 1993, is an award winning writer and essayist. Throughout the authors maintain a positive tone without offering false hope to patients.
The authors begin with a description of hepatits C – what it is, how it’s transmitted, and what it means to have the disease.  They describe the functions of the liver, how the disease is diagnosed, the specifics about the tests used for diagnosis, and the possible confusing and  conflicting results of the tests.  Emotional concerns are addressed and as is proper nutrition for patients with liver disease.   Treatments, which include interferon and ribavirin and liver transplants for those with end stage liver disease, are thoroughly discussed in separate chapters.   Other chapters discuss hildren with hepatitis C, financial concerns, and research trends.

Chapter references are provided and a list of resources is offered for those who want further information.  If you have the older edition in your collection, it should be replaced with this up to date edition.

The scleroderma book: a guide for patients and familiesMaureen D. Mayes.  Oxford University Press, 1999.  182 p. (ISBN 0-19-511507-4), $23.00.

Scleroderma is an autoimmune disease that  affects hundreds of thousands of people in the United States and in its different forms can occur in  children as well as the elderly.  The disease involves the blood vessels and collagen, the natural protein that makes human skin firm and the major component of connective tissue such as tendons, joints, and skin.  Collagen is what forms as scar tissue over an injury such as a cut in the skin or damage to the lungs from an infection.  In scleroderma, cells in the body start making collagen as if some injury needs to be repaired.  This excess collagen gets in the way of normal functioning.  In some instances, when the heart or lungs are affected, scleroderma can be life-threatening.
The author of this up-to-date, readable guide is a Professor of Internal Medicine, Division of Rheumatology, at Wayne State University School of Medicine.  Dr. Mayes is also a past president and director of the national Board of Directors of the United Scleroderma  Foundation. She provides basic practical information with a supportive and encouraging tone.  Basic facts about scleroderma are discussed including the different types of the disease and how each is manifested.  The genetic features of the disease are also described as are occupational and environmental links.

A detailed description is given on how scleroderma affects different organs of the body and the treatments available to minimize these complications.  Advice is given on strategies to manage the symptoms of the disease (there currently is no cure) and suggestions are offered on how patients can improve their quality of life.  Although scleroderma occurs as a separate entity, it often coexists with other autoimmune diseases such as rheumatoid arthritis, lupus, polymyositis, and dermatomyositis.  These “overlap” syndromes are described in a separate chapter.

A short directory of patient support groups and resource materials is included along with a glossary.  A practical, encouraging guide for scleroderma patients and their families.

The savvy mom’s guide to medical care. Pamela Gallin. and Kathy Matthews.     St. Martin’s Press, 1999.  259 p.  (ISBN 1-58238-049-X),  $24.95.

This book claims “…to teach moms the key to children’s health that other medical guides leave out – how to get top quality care.”  The lead author, Dr. Gallin, is Director of Pediatric Ophthalmology at  the Edward Harkness Eye Institute and at the Babies and Children’s Hospital of the Columbia Presbyterian Medical Center.  As a doctor and a parent, Dr. Gallin understands that nothing makes  parents feel more frightened or vulnerable than a sick child.  She believes that parents don’t need to practice medical care,  they need to know how to arrange it. Therefore, this guide does not include descriptions of the care and treatment of childhood illnesses and conditions, but rather advice about how parents can effectively use the health care system to get the care their child needs.

In a warm, reassuring manner, Dr. Gallin offers practical advice for parents on questioning doctors about diagnosis and treatments, how to find a top-notch pediatrician or specialist, when to get a second opinion, and when and why to call a doctor about a sick child.  For parents who are unsatisfied with the care their child is receiving, she provides helpful suggestions on when and how to change pediatricians.  Special chapters include how to handle an emergency room visit,  what to do when a child needs hospitalization and surgery, and coping with a diagnosis of a serious illness.  A resource guide of clearinghouses, toll-free numbers,  and organizations to contact for further information is included in an appendix along with information on the American Board of Medical Specialties Member Boards and the certificates they issue.

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 Healthnet News is written by Alberta L. Richetelle with the assistance of Judith Kronick.
     If you have questions about anything in the newsletter or about Healthnet services for Connecticut public libraries,please call 860/679-4055; e-mail address:  richetelle@nso.uchc.edu

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