Jack Roush in Serious, but Stable Condition: What does that mean?

Often in news reports we hear of patients being in “serious” or “critical” condition, such as today’s report that NASCAR team owner Jack Roush, who was involved in a plane accident in Wisconsin, is in “serious but stable condition.” Terms used to describe medical conditions are often done so to describe two aspects of a patient’s state – condition and prognosis.
The terms used to describe a patient’s medical condition is not meant to be a diagnosis, but a general guide to the patient’s status as determined by several factors. The American Hospital Association guidelines advise US doctors and hospital spokespersons to use one of the following one-word conditions to describe a patient’s condition.
• Undetermined – this usually means that the patient is still being assessed by health professionals, who do not currently have enough information to formally declare a patient’s medical state.
• Good – A patient’s vital signs are stable and within normal limits. Vital signs are a measure of some of the most basic body functions, such as body temperature, pulse rate (heart rate), blood pressure, and respiratory rate. The patient is conscious and comfortable, and indicators for a good outcome are excellent.
• Fair – A patient’s vital signs are again stable and within normal limits and he or she is conscious, but possibly uncomfortable, such as when pain is uncontrolled. Indicators for a positive outcome are favorable.
• Serious – A patient is serious conditions does not have vital signs that are stable or within normal limits. The patient himself is acutely ill and indicators are questionable.
• Critical – a patient in critical condition is not usually conscious and is gravely ill. Vital signs are unstable and not within normal limits. Overall, the indicators for a good outcome are uncertain but often unfavorable.
A patient may also be given a prognosis of short-term prognosis. The AHA guidelines stresses that “stable” should not be used solely as a description of a patient’s medical state, but it is often used to mean that no immediate change is expected.
Another term that is often used in news reports Is “treated and released”. This means that a patient was brought into a hospital, received treatment, and then released without an in-patient stay.
These general, often vague terms are mostly used as an effort to provide information while protecting a patient’s privacy when being treated medically. The HIPAA Privacy Rule provides federal protections for personal health information and only permits disclosure only to authorized persons for important purposes, such as patient care.
Sacred Heart Children’s Hospital spokesman Mike Burke says, "Someone's medical condition is a complex matter. It's really unrealistic to give a one-word description of how they're doing, but because of restrictions we're under, that's what we do."

Residue from cigarette smoke may pose health hazard, study says

The scent of cigarette smoke is stubborn, clinging to clothes, walls and hair. Now scientists are beginning to explore the health threats of “third-hand smoke,” or the residue left behind after the smoke clears.
In a study published Monday, Lawrence Berkeley National Laboratory scientists showed how tobacco smoke lingering on surfaces chemically reacts with air, releasing potentially harmful substances.
Much has been made of the perils of secondhand smoke. The U.S. Surgeon General estimated in 2006 that it causes 50,000 deaths a year. But the idea of third-hand smoke is relatively new. The phrase was coined last year in the journal Pediatrics.
“Many people think that after the smoke is gone things are clean, but that is probably not the case,” said Hugo Destaillats, the study’s co- author.
Destaillats and his colleagues exposed cellulose, a material present in many household objects, to cigarette smoke and then nitrous acid, a molecule found in the air.
After several hours of exposure, they found the cellulose had 10 times the amount of tobacco-specific carcinogens than it did originally. The scientists also found high levels of a particle that is not present in freshly emitted tobacco smoke.
Destaillats said toxicologists will have to look into whether this new particle is harmful to humans.
Kent Pinkerton, an inhalation toxicologist at UC Davis Medical School, said it is, noting that cigarette smoke has 4,000 components, with toxic particles that end up on surfaces that can release them through simple touch.
Third-hand smoke is most harmful for children, he said.
“It’s not only because of what children breathe in, but because the smoke deposits itself,” he said. “Children are very oral and they put things in their mouths, so they would expose themselves to toxic particles by ingestion as well.”
California’s smoking rates are below the national average: 13.3 percent of adults smoke, compared to the national average of 21 percent.
California also has been at the forefront of secondhand smoke policies, outlawing, for example, smoking in a car with a child passenger. Monday, Gov. Arnold Schwarzenegger announced $4.7 million in American Recovery and Reinvestment Act funds for health and fitness initiatives, including expanding programs to decrease tobacco use and second-hand smoke exposure.
Much needs to be done in other areas of tobacco control, said Paul Knepprath from the American Lung Association. He would like to see smoking banned in all apartment buildings, which could have third-hand smoke implications.
The Berkeley study was published in the Proceedings of the National Academy of Sciences, and was funded by the University of California Tobacco-Related Diseases Research Program.

Turning Clocks Back Not Good for Your Health

It’s time once again for turning clocks back, and some say they relish the extra time to sleep. But an expert at Policy Studies Institute, as well as Saga research results, say that turning clocks back is not good for your health.

Turning clocks back impacts physical and mental health

According to Mayer Hillman, senior fellow emeritus at the Policy Studies Institute, putting clocks forward in the spring is a simple way to improve health because it increases the number of daylight hours and thus encourages people to be outside and participate in outdoor activities. Turning clocks back, however, has the opposite effect.
Given the growing problem of overweight and obesity among both children and adults, as well as weight-associated health challenges such as heart disease, diabetes, high blood pressure, and certain cancers, efforts to encourage physical activity are critically important.
Mayer notes in a “Personal View” section of the recent British Medical Journal that putting the clock ahead in the spring but not turning it back in the fall “would considerably increase opportunities for outdoor leisure activities—about 300 additional hours of daylight for adults each year and 200 more for children.”
Research indicates that individuals tend to be happier and have more energy when there is more daylight and to be more sad and lethargic when there is less daylight. In fact, a type of depression known as SAD—Seasonal Affective Disorder—is associated with a decline in sunlight during the winter months.
In a recent article in the UK Telegraph, it is also reported that Saga’s monthly poll of more than 13,000 people older than 50, two-thirds are in favor of not turning back clocks in the fall to avoid the isolation they feel during the longer days without sunlight.
According to Ros Altmann, Saga’s director-general, “Taking away the extra hour of daylight robs many of their independence. By staying indoors to avoid driving they are being isolated from friends and family.” Saga’s research has shown that two-thirds of people older than 50 are less likely to go out on dark evenings, 40 percent said they were more depressed by dark evenings, nearly 25 percent were “grumpier,” and they exercised less.
For many people, the approach of winter is also the time for turning clocks back. Some argue that it may be time to forego this tradition because it is not beneficial for our health. Officials will have an extra hour or so to sleep on that question.