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The Weekender — Friday, March 15, 2013

Health & Fitness Ask the Doctor

Men can also get urinary tract infections BY PAUL G. DONOHUE, M.D. CONTRIBUTING WRITER

DEAR DR. DONOHUE: Everything I read about urinary tract infections deals with women, including what you write. I am a 35-year-old man, and I just had a week of antibiotics for a urinary tract infection. Why is there this bias in dealing with female urinary infections over male infections? -- J.F. ANSWER: The urinary tract infection we're talking about is bladder infection, cystitis (sisTIE-tiss). Both men and women come down with bladder infections, but the number of women who develop such an infection is far, far larger than is the number of

men -- 30 times the number of men. The main reason for this is an anatomical one. The female urethra, the tube that empties the bladder, is much shorter than the male urethra. That allows bacteria to make their way into the female bladder with relative ease. Furthermore, sexual relations force bacteria into the female urethra, something that doesn't happen in men. People describe cystitis as a burning pain when passing urine. The infection makes a person

want to empty the bladder frequently, and it's a task that has to be taken care of quickly. At older ages, men develop almost as many bladder infections as do women. That's because of prostate enlargement. An enlarged prostate gland makes complete emptying of the bladder impossible. Urine stagnates there and sets up an environment that favors bacterial growth. Don't feel left out because you have had only one bladder infection. Recurrent bladder infections are truly unusual for men. If a man were to develop one bladder infection after another, then his doctor would have to look for

conditions that lead to repeated infections. Diabetes is one. So is Crohn's disease, an inflammation of the digestive tract. The inflammation fosters the development of a tunnel between the bladder and the inflamed area of the tract. Bacteria have free access to the bladder. These are only two examples of why cystitis recurs in few men. The booklet on urinary tract infections explains this common malady in detail and its treatment. Readers can obtain a copy by writing: Dr. Donohue -- No. 1204W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6

Let’s Talk Mental Health

Juvenile injustice: a societal crisis BY OSCAR WRIGHT, PH.D. CONTRIBUTING WRITER

The crisis is devastating and undeniable: An invisible population of youth lingering between the juvenile justice and mental health systems with unprecedented unmet needs. Current studies increasingly validate the fact that 65 percent to 70 percent of youth in the juvenile justice system meet criteria for a diagnosable mental health disorder. According to recent studies, the majority of these youth have multiple diagnoses. Many families and children who seek our help and guidance embrace the principles of the Coalition for Juvenile Justice: • Community-based and culturally-sensitive mental health services should be accessible to all youth and families in need. • Young offenders with mental health problems should receive appropriate and adequate services in the juvenile court system. • Families should never have to surrender innocent children to the juvenile court system just to get mental health treatment. As the mental health crisis escalates in communities across California, fundamental questions are being asked such as: • How many mentally ill children are in the juvenile justice system? • How many entered that system because they could not get

help earlier? • What kind of mental health care do they get once in the system? • How many of them would have ended up in juvenile justice despite receiving adequate attention from other agencies? As the answers to these questions begin to trickle in, we are informed by recent studies made available through the Coalition that: • 36 percent of respondents to a national survey said their children were in the juvenile court system because mental health services outside of the system were unavailable to them. • 23 percent of respondents to a national survey were told that they would have to relinquish custody of their children to get needed mental health services. • 20 percent of respondents to a national survey said that they relinquished custody of their children to get needed mental health services. • Among youth that receive structured, meaningful, and sensitive mental health treatment, recidivism rates are 25 percent lower than those among untreated control groups. • The most successful mental health programs—those that treat

young offenders in their families and communities—reduce recidivism up to 80 percent. • Roughly two-thirds of all dollars spent on the juvenile court system go to housing delinquent and mentally ill youth in costly lockups that provide little more than warehousing. While at different times, a single agency may have primary responsibility, these youths are the community’s responsibility and all responses developed for them should be collaborative in nature, reflecting the input and involvement of the mental health, juvenile justice and other systems. United Advocates for Children and Families was awarded funds by the Zellerbach Family Foundation to develop a training course specifically for families and youth to provide information allowing them to navigate the two systems. Best practices and greater collaboration between the two systems and the community-at-large must be established with a sense of urgency. To do anything less would be ‘juvenile injustice’ at its worse. I'd like to hear from readers. Send your comments to talkback@uacf4hope.org. OSCAR WRIGHT, PH.D, is the CEO of United Advocates for Children and Families (UACF), a statewide nonprofit that provides support to parent, families, children and youth experiencing mental illness.

Canada with the recipient's printed name and address. Please allow four weeks for delivery. DEAR DR. DONOHUE: I take Coumadin because of atrial fibrillation. I've taken it for 13 years. Never in all those years has anyone, doctor or nurse, told me not to eat lettuce or other salad greens. My cousin just did. She wasn't sure why, but she said those foods mess up Coumadin. I have regular blood tests. None has shown that my Coumadin level needs adjusting. What is this green vegetable taboo? -- M.O. ANSWER: Coumadin thins blood (prevents clots from forming) by decreasing the production of vitamin K. Green,

leafy vegetables -spinach, lettuce, Brussels sprouts -- are a rich source of vitamin K. If a person on Coumadin splurges on these vegetables, he or she could block the action of Coumadin. You have gone 13 years taking it. Your blood tests have shown that your diet is not affecting Coumadin's action. You can eat whatever you wish. DR. DONOHUE regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. © 2013 North America Synd., Inc. All Rights Reserved

Diabetes and Eyes: Your vision is talking to you Diabetes is a serious disease that can affect many aspects of the body -- the heart and kidneys, blood circulation and even the eyes. In fact, diabetic eye disease increased in prevalence by 89 percent between 2000 and 2010 and is a leading cause of blindness among American adults. Despite this, vision care is often overlooked by people with diabetes as they work to manage the many other health problems the disease can cause. According to a survey by the American Optometric Association, 55 percent of people are unaware that diabetic eye disease often has no visual signs or symptoms. Additionally, 44 percent of Americans don't know that a person with diabetes should have a comprehensive eye exam once a year, including a retina (dilated) eye exam. Yet, these exams are the only way to diagnose serious eye diseases associated with diabetes at its early stage. Regular retina eye exams are critical for early detection and treatment of these progressive eye diseases that often begin without warning. The longer a person has diabetes, the higher their

risk for eye disease. Over time, diabetes may cause damage to the blood vessels in the back of the eye, known as diabetic retinopathy, which can lead to diabetic macular edema (DME). DME occurs when the damaged blood vessels leak fluid and cause swelling. Although symptoms are not always present, this swelling can cause blurred vision, double vision and patches in vision, which may appear as small black dots or lines "floating" across the front of the eye. Approximately 26 million Americans have diabetes and may be at risk for DME. More than 560,000 Americans have DME. Yet, approximately 55 percent are unaware that they have the disease. African Americans and Hispanics over the age of 40 are also at a higher risk for DME. Prevent Vision Loss • Getting an annual retina eye exam is the best way to help detect changes in vision • Don't wait -- make an appointment with a retina specialist today • For more information about DME and tips for healthy vision, visit www.DiabetesEyeCheck.org. Source: NEWSUSA

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