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Healthy individuals who gain weight, even to a weight still considered normal, are at risk for developing chronic kidney disease (CKD), as per a research studyappearing in the September 2008 issue of the Journal of the American Society Nephrology (JASN). The study suggests that CKD should be added to the list of conditions that are linked to weight gain, including diabetes and hypertension.

Research has shown that obesity is associated with an increased risk of CKD, but no studies have looked at the effects of weight gain within the "normal" range of an individual's body mass index. To investigate, Drs. Seungho Ryu and Yoosoo Chang of the Kangbuk Samsung Hospital in Seoul, Korea, and their colleagues conducted a prospective study of individuals who were of a healthy weight and had no known risk factors for chronic kidney disease.

In Korea, all workers participate in either annual or biennial health exams, as mandatory by Korea's Industrial Safety and Health Law. As a result, the researchers had access to clinical data from thousands of individuals. For this study, they included 8,792 healthy men who participated in the health exams in 2002.

The scientists discovered a U-shaped association between weight change and development of CKD. Men who lost or gained a lot of weight (more than 0.75 kg per year) had the highest risk of developing CKD. Those whose weight changed minimally (within a range of -0.25 to

Women who gain more or less than recommended amounts of weight during pregnancy are likely to increase the risk of problems for both themselves and their child, as per a new report by the RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center.

The report, which was supported by the U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) in partnership with the American Dietetic Association, is based on a systematic review of 150 studies that assessed the short- and long-term effects of maternal weight gain on pregnancy, mothers, fetuses, and children. The studies were published in English between January 1990 and October 2007.

Among the reports key findings is a strong association between high maternal weight gain and increased fetal growth and infant birth weight, which can contribute to complications during labor if a baby is too big, and can lead to long term health effects for the child. High maternal weight gain also is linked to cesarean delivery and weight retention by mothers after childbirth.

The review also confirmed that gaining too little weight during pregnancy can be a problem. Low maternal weight gain is linked to poor fetal growth, lower birth weight, and the chance of a baby being born prematurely.

The report was prompted by several trends, including an increase in the number of American women who are overweight and obese, as well as the number who gain more weight during pregnancy than amounts laid out in the Institute of Medicines 1990 recommendations for maternal weight gain. Public health officials also are concerned about an increase in pregnancy complications such as diabetes and cesarean delivery.

The Institute of Medicine is currently reviewing its pregnancy weight guidelines to see if they need to be revised; it expects to issue a report next summer.

Unfortunately, the existing body of research on maternal weight gain is inadequate to permit a more comprehensive assessment, said Meera Viswanathan, Ph.D., the study director and a senior research analyst at RTI International. Most beneficial would be an analysis that considers the risks and potential benefits of various maternal weight-gain scenarios to all women irrespective of age, race or ethnicity, or their body mass index before they became pregnant. But such an analysis is not possible at this time.

Her research colleague at UNC, Anna Maria Siega-Riz, Ph.D., agreed.

Despite the large body of research, clear clinical recommendations based on this systematic review will be challenging to formulate because of major shortcomings in this research, said Siega-Riz, an associate professor in the UNC School of Public Healths epidemiology and nutrition departments. To fully understand the effects of maternal weight gain on short- and long-term health outcomes for both women and infants, future studies will need to adopt standard measures and consistent definitions of exposures and outcomes.

The scientists said future studies will need to examine multiple outcomes within the same study population to explore fully the trade-offs between the risks and benefits to the mother and to the child.


Posted by: Evelyn    Source

The Board of Directors of the Greater New Bedford Community Health Center have recognized six outstanding employees in 2008. The winners were selected from a group nominated by Health Center personnel. Recommendations were based on several reasons including dedication, commitment to the community, and service well beyond what is required. In the Annual Employee Recognition Ceremony held at the Whaling Museum, Rose Yates, Board Chair, thanked everyone who makes the Health Center as great as it is and referred to all the employees as special people. Those recognized this year include the friendly and assuring voice you hear at the other end of the telephone line, the nurse who willingly helps wherever needed, the secretary who makes sure the patients are cared for in a timely manner, the maintenance person who makes sure the campus is safe for all, the Doctor whose unfailing first priority is the patientxs care, and the clerk who generously volunteers in the various efforts that benefit the community. These everyday heroes that were recognized are:
Viviana Abreu, Billing ClerkKerry Chavez, Pediatric Unit SecretaryRoy Filkins, MaintenanceJames Hayes, NP, Infectious DiseaseDianne Lowe, Switchboard SupervisorDonald Middleton, MD, Director of Urgent Care

The Greater New Bedford Community Health Center has been invited to present its experience in establishing an Occupational Medicine Program for the underserved Greater New Bedford community at the National Summit of Clinicians for Health Care Justice. The program is under the direction Ismail Nabeel, MD, MPH who will present the abstract entitled Changing Healthcare Practice: Building a healthy work force in a resource poor setting is no longer a broken promise. He will be able to showcase the pioneering work of the program at GNBCHC and the novel tracking system for surveillance of occupational related injuries in a medically underserved population.

The conference will be held October 23-25, 2008 in Washington, DC. It is expected to provide an opportunity for clinicians to explore cutting edge solutions and to be a part of the vital efforts to make quality health care for the underserved a reality.

The Greater New Bedford Community Health Center has been selected as one of two Health Centers in Massachusetts to participate in the Occupational Health Surveillance program. By combining Public Health and Health Center objectives, individuals subjected to work related injuries and exposures can receive treatment for those conditions as well as receive primary care and a whole range of services.

The surveillance program involves collecting information on work-related injuries and illnesses, using the information to develop intervention and preventive programs, and educating workers, employers, and health care providers in occupational health problems in medically underserved communities. Workplace health conditions include asthma, needlesticks, musculoskeletal injuries, lead poisoning, burns, carbon monoxide poisoning, and occupational cancer.

The Greater New Bedford Community Health Center continues to explore funding sources to support these efforts.

The surveillance program at GNBCHC is under the direction of Ismail Nabeel, MD who is a member of the Infectious Disease team. Dr. Nabeel is Board certified in Internal Medicine and Occupational Medicine. He not only lectures on occupational health conditions at the Health Center but has also trained Park Service Rangers and volunteers in hazard communication during Summerfest. and has provided training for fishermen. He is a visiting scholar at Harvard School of Public Health. He has presented lectures to judges in Massachusetts and Rhode Island on work related issues in HIV positive patients. Dr. Nabeel is a member of the Department of Public Health Advisory Board for Occupational Health Surveillance.