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Mayo Clinic Roche ter nd
Mayo Clinic J ck onville, Fla.,
Ho Line to take Men's
nutrition question
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Significant change in the
role of men and women in the
'80 contlnue to present new
challenge in the '90a, especial­
ly in the areas of health and
nutrition. Men who traditional­
ly have not thought much about
what they eat are now realizing
that food choice can impact
productivity, perform nee nd
overall health.
To help them learn more, the
National Center for Nutrition
and Dietetics, the public educa­
tion initiative of The American
Dietetic As ociation (ADA) and
its foundation, will spon or a
toll free national hot line, e pe­
cially for men, June Sand 6 in
advance of Father's Day. Men
who call 800-366-1655 betwee
make better food choice ."
he reque ted that how 45 of 49
tate in noncompliance with
Feder I law requiring tate
Medicaid agencies to make
private in urer pay for the
he I th care co t of Medicaid
recipient for which they are in­
sured.
"Thi noncompliance could
result in 10 e of over S900 mil­
lion to the Medicaid program if
it rem in uncorrected," Con­
yers pointed out .
Federal law require, private
in urance companie to pay
health care claims for Medicaid
recipient when they are
covered by private plans, the 0-
called third-party requirement.
The state ,which admini ter the
Medicaid program, are man­
dated to ensure compliance with
this requirement.
"This b ically comes down
to a m Iti-million dollar mug­
ging of the Medicaid program by
the tates an.d insurance' com­
panies," Conyers asserted.
"The report includes a close
examination of the problem in
Mtchigan and California: These
two states alone currently have
backlogged claim with poten­
tial insurer liability totaling
more than $175 million," Con­
yers continued. "The states paid
the doctor and hospital bills of
Medicaid recipients for which
Blue Cros /Blue Shiel4 is liable.
WASHINOTON, D.c.-Rep.
John Conyers, Jr. (D-MI), Chair­
m n of the Hou e Committee on
Government Operation.
released on May 7 a General Ac­
counting Office (GAO) report
•
million dollar game of 'pay and
cha e ' wi th BI ue Cross/BI ue
Shield and other in urers; Ior 26
percent of Medicaid recipients
with insurance, the tate
Medicaid agency i first paying
the provider and only later
seeking recovery from insurer .
A significant amount of the
money owed to the two rates
may not be collectable because
many of the insurance planes re­
quire that claim be submitted
within 12 to 18 month.
"While the state drag their
fe�t, the insurance companies
make out like bandits and
Medicaid is looted. This non­
payment represent a corporate
ubsidy, which is n outrage to
the ta yers tbi
gram nd to the poor who
depend on it.
"Those state that continue
their wasteful ways allowing in-
urers to not pay what they owe
should end up paying for their
weak compliance efforts," Con­
gress said. I strongly support
the GAO recommendation to
withhold Federal Health Care
, matching funds to the states if
they do not comply with the law.
Congre should enact legis­
lation requiring private in­
surance companies who refu e
to pay these claims on time to
pay double damage , as is now
the case under Medicare, Con­
yers said.
REGISTERED dietitians are
skilled in epar ting nutritional
facts from fad and translating
the laste t scientific data into
pracUcal food choice. During .
the hot line, RD vol unteers wlll
be on hand to n wer questions
about eating for maximum ener-
. gy, 10 ing or maintaining
weight, enhancing ports perfor­
mances through diet, the
diet/disease connection, re -
taurant and travel eating, and
more. Callers al 0 will be able
to request a free Nutrition Info­
Kit containing information on.
healthy eating and a recom­
mended reading list.
The National Center for
��"h'����III� •• �.'�����.���H. 1-
tabUshed to distribute. tI ely,
objective food and nutrition in­
formation to the public. AJ a
nation 1 resource center on
nu tri tion, the Center offers
several consumer education
programs.
For referral to a registered
dietitian in your area, contact
your physlcian, local dietetic as­
sociation, or write to the Nation­
al Center for Nutrition and
Dietetics, 216 West Jack on
Boulevard, Suite 800, Chicago,
l1tinois 60606-6995
U-M Conference
examine trend
Black denti t'ry
in
ANN ARBOR-The Univer­
si ty of Michigan School of Den­
tistry will bost the nation's first
conference on Black dentists and
dental care in the Black com-'
munity June 27-28.
The conference, "Black Den­
tistry in the 21st Century," will
include a keynote speech by
Audrey F. Manley, deputy assis­
tant secretary for health, U.S.
Department of Health and
Human Services, In 1988, Man­
ley wa tbe first Black woman to
achieve the rank of assistant sur­
geon general in the U.S. Public
Heal th Service.
"Black denti ts encounter
qui te di fferent experiences than
whi te dentists do," say con­
ference co-chairs Emerson
Robins, U-M professor of den­
tistry and of dental public health,
and Michael E. Razzoog, U-M
a sociate professor of dentistry.
"FOR INSTANCE, there are
fewer Black dentists tban white
dentists in tbe United States, and
the practices of Black dentists
tendto be confined to the public
sector or to the Black com-
munity.
These problems need to be ac­
knowledged and addres ed.
"We also are concerned tbat­
due' to a decline in public
programs-Blacks do not have
adequate access to dental care.
There also has not been enough
attention paid to educating the
Black community about the im­
portance of regular dental care.
These issues must be dealt wi th
as we move into the 21st cen­
tury," ay Robinson and Raz­
zoog.
THE PROCEEDINGS of the
conference will be published as
a reference source on Black den­
tistry.
The conference w ill take
place from8 a.m. to 5 p.m. June
26 and 8:30 a.m.-3:30 p.m. June
27 in the University's Rackham
Auditorium,
The fee, which includes lunch
on both days, is $75 for health.
care professional and $25 for
students. To register or for more
information, call (313) 763-
5070. On-site registrauons will
be accepted if space is available.
time) either day can ask a
registered dieti tian their nutri­
tion-related que tion ..
More than 75 percent of men
today are concerned about how
diet affect their health, accord­
ing to a 1990 Gallup Poll co-
ponsored by ADA. Yet only 23
percent of those surveyed could
name the major food groups.
"Most have hunche about
what constitutes a healthy diet,"
says ADA President Mary Ab­
bott Hess, MS, RD (registered
dietitian). "but many need to im­
prove their actual knowledge to .
YET, BOTH STATES bave
failed to make Blue Cross/Blue
Shield pay up.
"The Blues haven't reim­
bursed Michigan for a single
Medicaid claim since 1988.
California is playing-a multi-
Bad breath and burning mouth
may be due to Diabetes
the tongue and other mouth ti�-
ues i often seen in people with
diabetes. Sometime the
symptoms result directly from
changes in the tissue of the
mouth caused by the disease, but
the coating and mouth soreness
can.al 0 result from a thrush in­
fection that often accompanies
diabetes.
These infections--caused by
the fungu Candida albicans­
produce the film and bad t ste
you describe along with white
patche on the .inside of the
cheek. When the e patche -
that look like "cottage
chee e"-are scraped off, the
skin underneath is red, irritated
and tender. Obviously, acid
foods would cause discomfort to
a person with this condition.
A deficiency in any of the B
vitamin can al 0 cause
symptom like yours. While
most vitamin deficiencies are
due to eating a poor diet, they
can result bom an inability to
absorb vitamins from food be­
cau e of previou intestinal
urgery, or from alcohol abuse.
I encourage you to return to
see your doctor. There are many
thing that need to be considered
as pos ible cause of your
ymptoms.
THE FACTS
ABOUT ENDOMETRIAL CANCER
Question: I have' an old,
sticky, nasty-tasting film cover­
ing �y mouth. It is worse in the
morning. I've gargled with all
the mouthwashes without relief.
Acid foods burn my mouth, and I
feel sick all the time. I've seen
several doctors=none helped.
Any ideas?
tiee unusual bleedina or any bleedina
after menopause, )IOU should see your
doctor riaht away.
To diaanose endometrial cancer,
the doctor usually perform a pelvic
exam and a biopsy, or dilation and
curettaee (D & C) when a laraer tissue
sample is needed. A biopsy' a test
in'YOlvina SWJica1 removal of a small
sample of tissue for examination.
Dilation and curettaae i a procedure
in which the cervix i tretcbed and
tissue is aently scraped or auctioned
from the linina of the uterus. A Pap
test' not a reliable test for uterine
cancer.
. 1reatment for endometrial cancer
depends on a number of facton in­
cludina the s-= of the disease, how
fast the cancer is powina, and the
and aeneral health of the woman.
Suraecy, radiation, hormone therapy
and drua treatment (chemotherlPY)
may be used, sometimes in combina­
tion.
The outlook for patients with uter­
ine cancer is aood, especially if dis­
covered in its early . That why
it i important to have a reauJar
aynccolOlic check-up and report any
unusual bleedina to your doctor.
Thi year, about 33 000 women in
the United States will d�lop endo­
metrial cancer - cancer of the linina
of the uterus. An estimated S,SOO
women will die of this disease in 1991.
Fortunately, the death rate from endo­
metrial cancer has. been declinina
steadily inee the 19SOs, a sian that
earlier detection and better treatment
are payina oft: .
Endometrial cancer (sometimes
simply called uterine cancer) occurs
most often in women between the
of 55 and 70. Althouah we don't
know for sure what causes thi dis­
ease, a variety of facton are known to .
increase a woman's ri of deYelopina
it. Amona these factors are obesity, a
history ofinfertility, a history ofirrea­
War periods, diabetes, and late meno­
pause: Althouah estroaen replace­
ment therapy to rdi� the symptom •
of menopause is also a known risk
factor, addina the hormone proaestin
to most formulation appean to re­
duce thi risk.
Oral contracepti on the other
hand, seem to protect apinst endo­
mettial cancer. Studi have shown
that women who use combination
birth control pills containi estrosen
and progesterone are half likely to
develop endometrial cancer those
who tuM � used the combination
pill.
The first symptom of endometrial
cancer i usually abnormal vaainal
bleedina. Bleedina may beain
, sliahtly bloody disc and
later contain more blood. If you no-
.Medical Arts
Pharmacy
13700 Woodward
869-1800
Ans�er: A filmy, nasty-ta t­
ing coating in the mouth can be
caused by a variety of condi­
tions. Normal mouth bacteria
can produce this effect in a heal­
thy' person-as the manufac­
turers of mouthwash gladly
remind us in TV commercials.
Their products do help rinse
away the bad taste and the com­
mon, "garden-variety" bad
breath which goes along with it.
Whether or not you eat or
drink after using the mouth­
wash, in a relatively short period
of time the bad-tasting film will
return as the normal mouth bac­
teria accumulate in sufficient
numbers again. Perhap thi i
why you feel that the mouth­
washes have been ineffective.
I get the feeling from your
letter, though, that the problem
you are experiencing are orne­
what greater than the simple,
everyday bad breath I've been
discussing. Therefore, I'll tell
you about a few of ' the other
more serious potential cause .
Antibiotics: EtTective Infection Fighters
• Because oftbeir ability to interfere with or stop the growth of infection­
em_ bacteria, antibiotics are among the most valuable of all the pre­
lCJiptioo medicines. Antibiotics commonly prescribed include tetracy­
ciiM, the pellicillillS (includes ampicillin and amoxicillin) , the
amiItoglyconMs, erythromycin, and the cepltalosporins. A relatively new
poop fA tibiotics, rd'emd to as the qllinoloraes, are gaining in popular­
ity because of their ability to treat some infections that previously required
inlravenous itibiOlic administration.
Anyone or sevaal of many bacteria may be responsible for a particu­
.. infection. SiDce all bacteria do not rapond to the same antibiotic, the
bacteria sbouJd be identified. The identification of bacteria in the
body' detennined through test known a culture. Ofcen antibiotic
mediclDes are not SIar1ed until the results of the culture are known. If the
orpnism identified· a virus, antibiocics may not be prescribed at all. ,
V' b thole that cause the commoo cold do not respond to anti­
biotic tbenIpy. AlllDlibiocics �d be &&ken as prescribed by the physi­
cian in order to receive the maximum therapeutic benefit and to prevent the
emaaeoce of cxpnisms.
"FAMILY MEDICINE" is a
weekly column. To submit ques­
tions, write to John C. Wolf,
D.O., Ohio University College
of Osteopathic Medicine, Gros­
venor Hall, Athens, Ohio 45701.
Next wmc: Hbki. Up 1b Morn;.
Sickness
FIRST, COATING of the
mouth along with serene s of