Health Tip: Keeping Backyard Pools Safe

Summer is a time for fun, but not for carelessness, especially around pools and other water areas.

As the school year comes to a close, parents must be vigilant while their children swim.

Because more than 350 young children drown in pools each year nationwide, and more than half of these incidents occur in June, July and August, the American Red Cross is encouraging families with young children -- especially those with backyard pools -- to learn several safety tips for preventing accidental drownings:

• Never leave a child unattended near water. Because it only takes a second for a small child to fall into a pool and slip underwater, adult supervision is always required during pool usage.
• Keep basic lifesaving equipment near the pool, and learn how to use it: a reaching pole, a portable phone and U.S. Coast Guard-approved flotation devices such as life jackets and ring buoys. Many families with backyard pools also install pool alarms, which can offer an extra layer of protection when used correctly.
• Surround a backyard pool with a fence at least four feet high on all sides. To prevent a child from gaining access to the water, the fence should have a self-closing, self-latching gate that remains locked when the pool is not being used.
• Keep toys away from the pool area because toys can distract children.
• Learn cardiopulmonary resuscitation (CPR). Families with backyard pools must insist that babysitters, grandparents and anyone else who cares for their children learn lifesaving CPR. Post clear CPR instructions and your local emergency number in a visible place near the pool in case of an emergency.
• Make an emergency plan. If a child is missing from the pool area, check the pool first. Make sure to go to the edge of the pool and scan the entire body of water, bottom and surface, as well as the surrounding pool area.

Health Tip: Conquering Celiac Disease

Celiac disease is a digestive illness that damages the small intestine and interferes with absorption of nutrients from food.

People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye and barley. When people with celiac disease eat foods containing gluten, their immune system responds by damaging the small intestine.

Symptoms of celiac disease may include one or more of the following: recurring abdominal bloating and pain; chronic diarrhea; weight loss; pale, foul-smelling stool; unexplained anemia (low count of red blood cells); gas; bone or joint pain; behavior changes; muscle cramps; fatigue; delayed growth; failure to thrive in infants; seizures; tingling numbness in the legs (from nerve damage); pale sores inside the mouth; painful skin rash; tooth discoloration or loss of enamel; and missed menstrual periods (often because of excessive weight loss).

According to the National Institute of Diabetes and Digestive and Kidney Diseases, the only treatment for celiac disease is to follow a gluten-free diet, which means avoiding all foods that contain gluten. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage.

A small percentage of people with celiac disease don't improve on the gluten-free diet. These people often have severely damaged intestines that can't heal even after they eliminate gluten from their diet.

Because their intestines are not absorbing enough nutrients, they may need to receive intravenous nutrition supplements. Drug treatments are being evaluated for unresponsive celiac disease. These patients may need to be evaluated for complications of the disease.

Depressed Heart Surgery Patients Face Higher Mortality Rates

Heart patients suffering from depression seem to be at a higher risk of death within five years of their surgery than non-depressed patients, a new study suggests.

The findings would indicate that, besides monitoring for cholesterol and blood pressure, doctors should pay more attention to the emotional well-being of heart patients both before and after surgery, according to Duke University researchers.

In a study of nearly 5,000 heart surgery patients treated at the university's medical center, the researchers found that those who were taking anti-depressants before their heart surgery had a 10 percent lower survival rate five years after the surgery, compared to patients not taking the medicine.

"That the outcomes of patients on anti-depressants are a lot worse over time is very concerning, and shows that we need, from a clinical aspect, to be much more aggressive in treating and monitoring depression in the same way that we monitor hypertension and high cholesterol in heart surgery patients," said Dr. Glen Xiong, a resident at Duke's internal medicine-psychiatry program, and lead author of the study.

The study results were presented Wednesday at the American Psychiatric Association's annual meeting in Atlanta.

Xiong said the initial reason for undertaking the study was to see if the family of antidepressants known as selective serotonin reuptake inhibitors (SSRIs) was linked to bleeding after heart surgery. The results were inconclusive.

But he and his colleagues were surprised to find that those patients taking SSRIs, the medicine of choice for 60 percent to 80 percent of people suffering from depression, had a higher risk of mortality, he said.

A month after surgery, the survival rates were the same for both patients taking SSRIs before their surgery and for those who did not. But five years later, the survival rate for those on SSRIs was 75.1 percent, compared to 84.9 percent for those not on the medications.

"We were expecting to find that depression would be less significant over time for people who were on SSRIs. But as time went on, the people on SSRIs were found to have a higher mortality rate," Xiong said.

Dr. Stephen Kimmel, associate professor of medicine and epidemiology at the University of Pennsylvania School of Medicine, said the similar survival rates for both groups of patients a month after surgery did not surprise him. Those early deaths were most likely due to complications from the surgery, not depression, he said.

"But this study does highlight what we have known for a while, which is that depression is associated with higher rates of morbidity and mortality in heart disease," Kimmel said.

In the analysis of 4,794 heart surgery patients, Xiong and his colleagues found that 246 patients (5.1 percent), were taking SSRIs before their operations. The group taking the antidepressants was more likely to be white, female, diabetic and suffering from hypertension than those not on the medications. However, all the patients shared the same rates of other cardiovascular risks, such as smoking or a family history of heart disease.

After adjusting the data to account for gender, ethnic background and health differences between the two groups, the researchers found that those who had taken the SSRIs still had a significantly lower survival rate.

Xiong said that, while it's clear more attention should be paid to depression in heart patients, the condition is tougher to diagnose than other risk factors, such as easily measured blood pressure readings and cholesterol levels.

"It's quite complicated. It's a lot trickier to identify and reimbursement is difficult. But we need to figure out better ways of incorporating currently available instruments that measure and treat depression and incorporate them into clinical practice," he said.

Kimmel agreed, adding that if research could show that treating depression would have an effect on lowering heart disease risks -- data that doesn't exist today -- screening for depression would likely become more widespread.

"Cholesterol testing took a long time to be established," he said, adding it took many studies showing that reducing cholesterol reduced risk for heart disease.

More information

The American Heart Association has more on the link between depression and heart disease.