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Access To Abortion Services In Kansas Hindered After Closure Of Tiller's Clinic
After the murder of abortion provider George Tiller and the closure of his Wichita, Kan., clinic, residents of the city face about a three-hour drive to the nearest abortion provider, a distance experts say is not uncommon for access to abortion services in southern and midwestern states, the Wichita Eagle reports. Jenny O"Donnell of the Abortion Access Project said that southern and midwestern states have the heaviest restrictions on abortion, adding that "substantial populations don"t have an abortion provider" in states such as Mississippi and Arkansas. According to 2005 statistics from the Guttmacher Institute, 87% of U.S. counties have no abortion provider; the figure rises to 94% of counties in the Midwest and 96% of counties in Kansas. The number of abortion providers in Kansas declined from 15 in 1992 to seven in 2005, while the number of providers nationwide dropped from 2,380 to 1,787 over the same time period, according to Guttmacher. Experts say the decline is the result of several factors, including public pressures, increased regulation that has driven up the cost and complexity of providing abortion and a general trend in the health care industry toward consolidated, more specialized practices.Vicki Saporta, president and CEO of the National Abortion Federation, said that the decrease in the number of abortion providers is misleading on some levels. The decline primarily has occurred among hospitals and small providers who perform a few procedures a year, while major clinics that specialize in abortion have remained essentially stable, Saporta said. Peter Brownie, executive director of Planned Parenthood of Kansas and Mid-Missouri, said that the group"s clinics have experienced an increase in contacts from women from south-central Kansas since Tiller"s clinic closed a little more than one week ago. He added, "At the present time, there"s no place between Denver and Kansas City where a woman can obtain abortion care. That"s a significant barrier for women throughout the state that have that need." NAF has established a national hotline to offer referrals for women who have to make new arrangements for abortion care because of the closure of Tiller"s clinic, Saporta said (Lefler, Wichita Eagle, 6/9).
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Uninsured Account For Nearly One-Fifth Of Emergency Room Visits
Health and Human Services Secretary Kathleen Sebelius released new data from the Nationwide Emergency Department Sample - the largest, all-payer emergency department database in the United States. The Nationwide Emergency Department Sample is designed to help public health experts, policymakers, health care administrators, researchers, journalists and others find the data they need to answer questions about care that occurs in U.S. hospital emergency departments.
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Nebraska Legislature Advances Ultrasound Viewing Bill
The Nebraska Legislature on Wednesday voted to advance a bill (L.B. 675) that would require abortion providers who perform ultrasounds on women seeking the procedure to tell women that a view of the fetus will be available and display the screen in a way that the image can be easily seen, the AP/Lincoln Journal Star reports. The bill also would require the state to compile a list of clinics that offer no-cost ultrasound services. State Sen. Brenda Council (D) criticized that particular provision, saying it would force the state Department of Health and Human Services to spend more taxpayer money.Lawmakers advanced the bill by voice vote after approving an amendment to clarify language surrounding the qualifications of health professionals performing ultrasounds. Advocates for the bill claim it would provide more information to women seeking abortion procedures, while opponents of the bill argue that it would allow the government to interfere in a private procedure. The bill faces a final vote before going to Gov. Dave Heineman (R). If the bill becomes law, Nebraska would join more than a dozen states that have similar laws, the AP/Journal Star reports (Ortiz, AP/Lincoln Journal Star, 5/27).
Diagnostics

What Is Diarrhea? What Causes Diarrhea?

Diarrhea is the frequent passing of loose or watery stools. Acute diarrhea, which is a common cause of death in developing countries, appears rapidly and may last from five to ten days. Chronic diarrhea lasts much longer and is the second cause of childhood death in the developing world. Diarrhea is sometimes accompanied by abdominal cramps or fever. It may be caused by infection, allergy, or could be a sign of a serious disorder, such as IBD (inflammatory bowel disease), or Crohn"s disease. According to the World Health Organization (WHO) approximately 3.5 million deaths each year are attributable to diarrhea. 80% of those deaths occur in children under the age of 5 years. Children are more susceptible to the complications of diarrhea because a smaller amount of fluid loss leads to dehydration, compared to adults. Interesting articles What is gastroenteritis? What is food poisoning? What are bacteria? What are antibiotics? How do antibiotics work? What is food poisoning? What is gastroenteritis? What is gluten intolerance? What is celiac disease? What are laxatives? How do laxatives work? What is constipation? What causes constipation? What is Crohn"s disease? What causes Crohn"s disease? What is typhoid? A bacterium called enteroaggregative E. coli, is responsible for 10 percent of cases of diarrhea in children, researchers at Cincinnati Children"s Hospital Medical Center, USA, found. According to Medilexicon"s medical dictionary, diarrhea is "An abnormally frequent discharge of semisolid or fluid fecal matter from the bowel." What are the five types of diarrhea? *Secretory diarrhea Either the gut is secreting more fluids than usual, or it cannot absorb fluids properly. In such cases structural damage is minimal. This is most commonly caused by a cholera toxin - a protein secreted by the bacterium Vibrio cholera. *Osmotic diarrhea Too much water is drawn into the bowels. This may be the result of celiac disease, pancreatic disease, or laxatives. Too much magnesium, vitamin C, undigested lactose, or undigested fructose can also trigger osmotic diarrhea. *Motility-related diarrhea Food moves too quickly through the intestines (hypermotility). If the food moves too quickly there is not enough time to absorb sufficient nutrients and water. Patients who had a vagotomy (removal or severing of the vagus nerve) as well as those with diabetic neuropathy are susceptible to this type of diarrhea. *Inflammatory diarrhea The lining of the gut becomes inflamed. This is usually caused by bacterial infections, viral infections, parasitic infections, or autoimmune problems such as IBS (inflammatory bowel disease). Tuberculosis, colon cancer and enteritis can also cause inflammatory diarrhea. *Dysentery The presence of blood in the stools is usually a sign of dysentery, rather than diarrhea. Dysentery is caused by a release of excess water caused by an antidiuretic hormone from the posterior pituitary gland. Dysentery is one of the symptoms of Shigella, Entamoeba histolytica, and Salmonella. When it occurs in people age 60 and older, there"s a good possibility bloody diarrhea indicates ischemic colitis, according to the Mayo Clinic, USA. What are the symptoms of diarrhea? Some sufferers may pass slightly watery stools and have brief episodes of stomachache, while others may pass very watery stools and have more severe stomach cramping. The most common symptoms include: *Abdominal cramps *Abdominal pain *An urge to go to the toilet, sometimes this may be sudden *Vomiting *Nausea *Temperature (fever) *Headache *Loss of appetite *Fatigue *Loose, watery stools *Bloating *Blood in stool Anybody who has had diarrhea for more than one week should see their doctor. The UK National Health Service advises parents to take their child to the doctor if: *The child is aged 3 months to 1 year and the diarrhea has lasted over two days *The child is over 1 year of age and the diarrhea has lasted more than five days You should also see your doctor if you experience or witness any of the following: *You have symptoms of dehydration - excessive thirst, very dry mouth, very little or no urination *Your abdominal pain is severe *You have severe rectal pain *There is blood in the stools, the stools are black *Your temperature is over 39C (102 F) *A baby has not wet the diaper (UK: nappy) in over three hours *A child/baby is very sleepy, irritable, or unresponsive *A child/baby has a sunken abdomen *A child/baby has sunken eyes and/or cheeks *The child"s/baby"s skin does not flatten after being pinched What causes diarrhea? Causes of acute diarrhea (short term diarrhea) This is usually caused by an infection, and is also a symptom of a bowel infection when the stomach and the intestines become inflamed (gastroenteritis). This may be caused by: *A virus - most commonly a norovirus or a rotavirus. It could also be caused by a hepatitis virus, or the herpes simplex virus. Viral diarrhea spreads easily. *A bacteria - if food or water is contaminated bacteria and parasites can be transmitted into the body. Parasites may include Giardia lamblia and cryptosporidium. Examples of bacteria are campylobacter, salmonella, shigella and Escherichia coli (E. coli). Traveler"s diarrhea is usually caused by bacteria or parasites. Researchers at Boston University School of Medicine identified the structure of bacteria responsible for traveler"s diarrhea. *An antibiotic - antibiotics can disturb the natural balance of bacteria in our intestines, which can lead to infection, commonly with a bacterium called Clostridium difficile. The following may also be causes of acute diarrhea: *Anxiety *Consuming too much alcohol *Consuming too much coffee *Some other medications, apart from antibiotics Causes of chronic diarrhea (persistent, longer term diarrhea) *Bacteria *A virus *Laxatives *Some dietary habits - long term regular alcohol, coffee consumption may cause persistent diarrhea. Regular eating of candy (sweets) can too. Many sugar-free chewing gums containing a sweetener called sorbitol can cause chronic diarrhea, The British Medical Journal reported. The following long-term conditions can cause chronic diarrhea *Celiac disease *Crohn"s disease *Diabetes *Irritable bowel syndrome (IBS) *Lactose intolerance *Pancreatitis *Ulcerative colitis How is diarrhea diagnosed? Most cases of acute diarrhea will resolve themselves within a week or so. If the diarrhea lasts longer, or if there is blood in the stools and there are other symptoms, such as dehydration, the GP (general practitioner, primary care physician) will take a stool sample to check for infection. A sigmoidoscopy may also be performed. This involves introducing a thin fiber-optic tube through the rectum to look into the intestine. The device has a viewing lens. The doctor will also ask the patient whether he/she is taking any medications, has traveled recently, and possibly some questions about what foods were consumed over the last couple of weeks. The GP may also examine the abdomen to determine where the pain is. What is the treatment for diarrhea? In the vast majority of cases the diarrhea will disappear within a week or so. Before it does, the following steps may help ease symptoms: *Drink plenty of fluids - diarrhea often carries a risk of dehydration, especially if it includes vomiting. It is important to make sure babies and children are getting plenty of fluids. Diarrhea may affect the balance of salts and electrolytes in the body. Special dehydration drinks can be bought in a pharmacy to restore their balance. A pharmacist can advise on which drinks to consume. *Eat as soon as you feel up to it - doctors used to tell people not to eat until the symptoms went away. They now recommend patients start with foods such as pasta, bread, rice or potatoes - foods high in carbohydrates, as soon as possible. Add a bit of salt to the food to replace salt loss. Avoid foods that are high in fat. *Medications - such medicines as loperamide may slow down bowel movements and may also increase the gut"s water absorption. Do not give anti-diarrhea medications to children without checking first with a doctor. Do not take anti-diarrhea medications if there is blood in the stools or if you have a fever. *Breastfeeding or bottle-feeding babies - doctors recommend that feeding continue as normal if the baby has diarrhea. If necessary, add rehydration drinks that are bought from a pharmacy. *Painkillers - for fever or headache doctors recommend Tylenol (paracetamol) or ibuprofen. If you have kidney, liver or long-term stomach problems do not take ibuprofen. Do not give aspirin if your child is under 16 years of age. *Probiotics - these are supposed to treat diarrhea, among other things. However, a study published in the British Medical Journal indicated that some of them don"t work, while others do. Doctors may prescribe specific medications, depending on the results of the stool test. How can you lower your risk of developing diarrhea? Hand washing - regular hand-washing with soap and warm water helps reduce the risk of catching or passing on germs. Especially after going to the toilet, playing with pets, gardening, and before touching food. An intensive program of handwashing education and promotion in Pakistan decreased the incidence of diarrhea by more than 50 percent among children, according to a study. Keeping the kitchen and toilets as clean as possible also reduces the risk. When handling raw meats wash your hands before touching other things, such as other foods, work surfaces, cutlery, etc. If you are travelling to a warm country remember that uncooked foods are more likely to have bacteria than hot food. Depending on where you are, it is sometimes advisable to avoid having ice in your drinks if you are not sure where the water to make the ice came from. Written by Christian Nordqvist Copyright: Medical News Today Not

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