P agi A 6
J uly 3, 1996 • I'm P ori land O bserver
Strep And Rheumatic Fever
A group streptococcal infection
in the throat is called streptococcal
pharyngitis or strep throat
Strep throat is not caused by vi
ruses. It is caused by streptococcus
bacteria.
Strep throat should be diagnosed
by a pediatrician or family physi
cian using a throat culture.
Strep throat should be treated
with penicillin, as recommended in
the June 1996 supplement o f PEDI
ATRICS and by the American Acad
emy o f Pediatrics, the World Health
Organization and American Heart
Association.
Penicillin is also available as a
single injection, which is preferable
when adherence to a ten-day regi
men o f oral penicillin might be dif
ficult.
Strep throat can be distinguished
from other sore throats by its sud
denness and trademark high fever
(over 101), redness and swelling at
the back o f the mouth, swollen, ten
der lymph nodes on the neck, and the
possible absence of a runny nose and
coughing.
Strep throat can lead to rheumatic
fever in as little as two weeks if the
strep is not properly diagnosed and
treated. Children between five and
15 are most commonly affected.
Symptoms include fever with pain,
inflammation and swelling in one or
more joints. Heart damage can de
velop slowly, often resulting in a
thickening and scarring o f the heart
valves that can eventually require
surgery.
Symptoms o f rheumatic fever in
clude continued fever, swollen wrists,
kneesorankles, a warm feeling in the
swollen joints, and swelling migrat
ing from joint to joint.
Treatment for rheumatic fever in
cludes penicillin and bed rest for
more than a month To avoid anoth
er attack, a child must receive pre
ventative treatment with penicillin
once every month until he or she is
18 years old or older.
Rheumatic fever and other com
plications of group A strep infec
tions are now more of a concern for
health care providers because seri
ous group A streptococcal infec
tions have reemerged during the
last ten years as a public health
problem.
Many current strains o f group A
strep may be virulent and result in a
higher risk o f mortally for both
children and adult.
Other complications o f group A
strep include streptococcal toxic
shock syndrome and tissue infec
tions such as necrotizing fascitis,
the flesh eating virus, both o f which
have a reported mortality rate o f 30
percent or higher.
Van Pelt Elected To Catholic
Health Association Board
Greg Van Pelt, Chief Executive,
Providence Health Plans—Sisters of
Providence, Portland, OR, has been
elected to serve a three-year term on
the Board of T rustees o f the Cathol ic
Health Association of the United
States (CHA).
He was installed during CH A ’s
yearly business meeting at the 8 1 st
Annual Catholic Health Assembly in
San Antonio.
Van Pelt has been with the Sisters
o f Providence since 1975 where he
has held numerous executive posi
tions. He is currently a member ofthe
American College o f Healthcare
Executives, Oregon Association of
Hospitals, Providence St. Vincent
Medical Center Foundation Council
o f Trustees, Good Health Plan o f
Oregon Board o f Directors, Jesuit
High School Board, Rotary Club of
Gregory Van Pelt
Portland, and Youth Employment/
Empowerment Coalition Board of
Directors.
Van Pelt received a bachelor’s
degree in economics from Villanova
University, Philadelphia, PA, where
he graduated magna cum laude. He
attended St Louis University and
received a master’s degree in health
care administration and was the re
cipient ofthe Rev. John J Flanagan,
S.J. Scholarship.
He also did post-graduate work at
Western Network Institute for Health
Care Executives, University o f Cal
ifornia, Berkeley, and Kennedy In
stitute o f Ethics-Intensive Bioethics
at Georgetown University, W ashing
ton, DC
Celebrating its 81st anniversary,
the Catholic Health Association of
the United States represents more
than 1,200 Catholic-sponsored facil
ities and organizations.
The members make up the na
tion’s largest group o f not-for-profit
healthcare facilities under a single
form o f sponsorship.
California Children Have More Cavities, Survey Finds
California children ages six to
eight are far more likely to have
cavities than youngsters in the rest o f
the nation, according to data from a
statewide survey.
Known as the “California Oral
Health Needs Assessment o f Chil
dren,” the survey found that 73 per
cent ofthe state’s children in this age
group examined during 1993-94 had
experienced cavities in their teeth.
This compares to 53 percent nation
wide in the same age range accord
ing to a National Institute o f Dental
Research survey in 1986-87.
Both figures are far from the goal
o f a prevalence rate o f no more than
35 percent for children o f this age
proposed by the U.S. Public Health
Service, says Howard Pollick, BDS,
MPH, Principal Investigator for the
California Assessment Survey and a
clinical professor in the Department
o f Dental Public Health and Hygiene
o f the UC-San Fransisco School o f
Dentistry.
The USPHS goal was published
in 1991 as part o f a special report
titled. Healthy People 2000.”
Pollick recently presented a pre
liminary summary o f some o f the
California data at the International
Association for Dental Research
annual meeting in San Francisco.
The full report is expected to be
published in the fall.
The C alifornia assessm ent in
volved 6,643 children in three age
groups: pre-school, elementary (K-
3), and high school (grade 10). It was
conducted by The Dental Health
Foundation, a private nonprofit
group, under contract with the Ma
ternal and Child Health Branch of
the California Department o f Health
Services with additional funding
from. The California Wellness Foun
dation.
Pollick says the high prevalence
oftooth decay in California children
is related to the state’s past lack of
commitment to fluoridating drinking
water. Until last year, Califomiacom-
munities could choose whether to
add fluoride to waterand m ostdidn’t.
However, recent legislation requires
the majority ofCalifornia communi
ties to fluoridate when funding be
comes available.
“Only 15.7 percent ofCalifornians
have access to fluoridated water
now,” says Pollick. “ We’re 47th out
o f all the states.”
The statewide assessment includ
ed data on 391 15-year-olds in 30
California public schools.
“Here, the figure was more com
parable to the national average,”
Pollick says. Seventy-one percent of
More Than 5,300 Immunizations
More than 5,300 young Orego
nian’s received immunizations at
over 120 Free clinic sites during
the week long statewide “ Immu
nize ’96 Campaign."
The “ Immunize ’96 Campaign’
was the third annual effort by the
Oregon Preschool Immunization
Consortium (OPIC) to help increase
immunization awareness and per
centages o f adequately immunized
infants and children.
All counties in Oregon offered
FREE clinics during April 21 - 27,
which was “National Infant Immu
nization Week.”
“We at OPIC are determined to
make sure all O regon’s children are
protected from vaccine-preventable
diseases, and this year we took an
other major step forw ard,” said
Megan Osborn, chairperson for the
Campaign. “ With each immuniza
tion campaign, we are getting closer
to our goal, which is to fully immu
nize 90 percent of Oregon’s two year
olds by the year 2000.”
About 27,000 ofOregon’s children
have not received adequate immuni
zations before their second birthday.
Age appropriate immunizations
protect against ten serious diseases:
measles, diphtheria, tetanus, pertussis
(whooping cough), polio, mumps.
rubella (German measles), hepati-
tis-B, hemophilus influenza type-b
(common cause o f meningitis) and
chickenpox.
This year’s campaign includes a
partnership with over 150 Mc
Donald’s restaurants throughout the
state. Each McDonald’s provided
in-store education materials on the
importance of immunizations and
local clinic information as well as
special immunization record cards
and bandaids to clinic sites.
“M cdonald’s have helped us get
our important message out to fam
ilies all over O regon,” added
Osborn.
Minority Medical Students Gain
Support To Fill Critical Healthcare Gap
Check the yellow pages under
“Physician" in most inner cities or
rural communities, and you'll quick
ly see why it’s dangerous to get sick
there. Your chances o f seeing a doc
tor are slim.
The critical shortage o f skilled
doctors in poor urban and outlying
rural areas—now reaching crisis pro
portions in the U .S .-has been the
subject o f recent articles in The Wall
Street Journal and USA Today. Both
papers noted one glimmer o f hope in
order to practice their life's work and
give something back to their commu
nities.
But this potential solution to the
urban/rural doctor shortage has an
inherent snag. Due to environmental
circumstances-such as personal fi
nances. fam i ly issues or lack o f expo
sure to accelerated exam methodolo
gy in their early schooling—minority
students are sometimes impeded in
their performance on the U.S. Medi
cal Licensing Boards. Although they
possess the keen medical and clinical
knowledge required to be fine doc
tors, these students need practice with
question types, answer patterns and
how to battle test fatigue, skills that
their peers from more affluent school
districts developed in high school.
That’s where ArcVentures Medical
Education Services steps in to help
level the playing field.
ArcVentures Medical Education
Services is a study assistance pro
gram affiliated with Rush-Presbyte-
rian-St. Luke’s Medical Center in
C hicago-one of the nation’s most
prestigious non-profit healthcare in
stitutions. It istheonly hospital-spon
sored study program in the nation.
By drilling these bright, accom
plished students in the art o f test
taking strategies, ArcVentures helps
to bridge the “testing gap” left from
their early schooling-and booststheir
confidence along with their test
scores.
A rcV en tu res’ com m itm ent to
helping remove one ofthe barriers to
minority doctors is heartily endorsed
by the Student National Medical
Association (SNMA), an organiza
tion founded 3 1 years ago to promote
timely matriculation for medical stu
dents o f color.
“The shortage o f minority doctors
is a critical piece o f the healthcare
puzzle that severely impacts care,"
says Jason Denny, immediate past
Chairman o fth e Board o f Directors
ofSNM A, and himself, a fourth-year
medical student at Mt. Sinai Medical
School in New York City. "W e are
more likely to go back to our own
communities to serve, where the need
is greatest. If you understand the
community where a patient came
from, you have more com passion-
you see them as your grandmother,
your brother, your aunt—and you
better understand how they view the
medical profession through the prism
o f their own culture.”
Founded in 1988 at the request of
students who wanted a hospital-spon
sored study course, ArcVentures has
grown in direct response to the short
age o f affordable healthcare profes
sionals in the U.S. The program cur
rently sponsors 38 medical review
courses at 20 medical schools year
round, located in the U.S., San Juan,
Puerto Rico, and Guadalajara, Mex
ico.
C o u rse s are also o ffe re d at
ArcVentures’ satellite locations in
Chicago, Houston, Los Angeles,
Miami, New York City, Washing
ton, D C. and Clifton, New Jersev.
Faculty members are professors from
major medical schools and practic
ing physicians, and are selected strict
ly for their teaching experience, en
thusiasm and reputation. To date,
ArcVentures has helped more than
14,000 American medical students
and foreign-trained physicians pre
pare for top scores on their Boards.
• **
What is the use o f running
w h en y o u are o n th e w ron g
road?
— Old saying
these teens had experienced cavities,
compared to 78 percent nationwide
in 1986-87. The Healthy People 2000
goal is no more than 60 percent.
The survey also found that dental
health varied widely depending on
the socio-economic and ethnic status
o f the children. Among the 6 to 8
year-olds, 86 percent o f children
whose parents had less than a high
school education had experienced
tooth decay, while 70 percent o f the
African-American, 84 percent of
Hispanic/Latino, 90 percent o f Asian
and 6 1 percent o f white children had
known cavities.
In addition, the survey looked at the
number of children whose teeth are
protected by dental sealants. Again,
Pollick draws a correlation between
fluoridation and dental health.
"Our study found that in the fluori
dated areas we went to in San Fran-
cisco, the East Bay and Long Beach, a
higher proportion of children received
sealants,” he says. “This is because
sealants are applied to healthy teeth
when a child gets hisor her first perma
nent molars around age 6. A sealant is
no, applied if a tooth has already de
veloped a cavity, as it is more likely in
an untluoridated area.”
"W e believe this isconsistentwith
the idea that you apply sealants to
protect the teeth,” he adds. "It’s a
preventive modality. I think fluori
dation will help us achieve our goals
for sealants.”
O fthe 776 8-year-olds in the Cal
ifornia survey in 1993-94,10 percent
had one or more sealants on their first
molars, compared to 11 percent na
tionwide in 1986-87. The Healthy
People 2000 goal is 50 percent.
The prevalence o f sealants in Cal
ifornia varied widely, Pollick notes.
ranging from a high o f 54.5 percent
for c h i I dren whose fam i I ies were not
poor and who lived in fluoridated
urban areas, to a low o f 0.6 percent
for Latino children from all income
groups living in rural areas.
Among California 15-year-olds,
the survey found a total o f 12.6 per
cent had sealants, with a range in
fluoridated urban areas from 37.8
percent for wh ite students, to a low of
zero for Asian students. The national
survey showed 8 percent o f 14-year-
olds had sealants in 1986-87.
Co-investigators ofthe assessment
project are Patricia Kipnis o f Kaiser-
Perm anente in O akland, Calif.,
Joanne Wellman and Robert Isman
o f the California Departm ent of
Health Services, James Ellisonofthe
UCSF School o f Dentistry, and Jared
Fine o f the Alameda County Health
Care Services Agency.
Hypertension-Complicated Pregnancies
African-American women suffer
ing from a common condition o f preg
nancy, maternal hypertension, expe
rience serious complications at a far
higher rate than women o f other
ethnicities. This was discovered in a
a five-year, nationwide retrospective
study by the Morehouse Treatment
Effectiveness Center (M TEC) at
M orehouse School o f M edicine
(MSM).
African-American women were
more than four times more likely
than other women with hypertension
to suffer inadequate fetal growth;
three times more likely to experience
serious bleeding before going into
labor; and twice as likely to deliver
early.
The study was published in the
April issue o f Obstetrics and Gyne
cology.
“The higher incidence o f maternal
hypertension and the increased risk
of pregnancy complications shown
by our research may explain why
African-American infants experience
a lower average birth weight, more
premature deliveries, and more in
fant illness and death than other
A merican babies,” said A ziz R
Samadi, M.D., M.P.H., lead investi
gator o f the study.
Providence Run For Good Health And Family Fitness Fair
One of Portland’s premier running
and walking events is set for Sunday,
July 14. Providence Health System is
sponsoring the Providence Run for
Good Health and Family Fitness Fair.
After crossing the finish line, peo-
pie can join in the fun in Pioneer
Courthouse Square. From 8 a m. until
noon. Providence will sponsor music,
clowns, bike safety and informational
booths focusing on good health, plus
an awards ceremony. Entry fees are $6
(without shirt) and $15 (with shirt)
beforeJuly 14. The fees will be $8 and
$ 17, respectively, the day ofthe race.
Maybe we can’t make Northeast Portland a
perfect place to live. But w e’re making
hundreds of improvements.
Frimds </ T ito '
SeeJtkeTuture
mu
Rvdaid Canal Ehrtric
Portland General Eleilric’s Employees Seed the Future.
“Seed the Future” is a five year partnership with Friends of Trees to
plant 144,000 trees and seedlings around Portland. Those trees will help
beautify neighborhoods and purify our air. At PGE, w e think a power
company can do more than make a profit. It can make a difference.
Portland General flectric