In Brief

Boy's death heightens awareness of dry drowning

Respiration

June 19, 2008

Though water has always been a hazard to be wary of, the idea that someone could drown hours after visiting a swimming pool may seem new to many. On June 1, 10-year-old Johnny Jackson of Charleston, S.C., died while napping more than an hour after returning home from the pool with his mother. The incident has drawn new attention to the phenomenon of dry drowning, a danger long recognized by other names by emergency department physicians.

Medical examiners have found that as many as 15 percent of drowning fatalities are dry drowning victims - those whose respiratory distress comes after an incident in the water. But it comes in different forms and from different causes.

In one form, a muscle spasm of the larynx causes the victim to suffocate. Hitting the water after a long, fast slide or from a high diving board appear to be the most common swimming-related causes of such a spasm, which can happen minutes or hours after the impact. Johnny's dry drowning, however, appeared to have been caused by a delayed reaction to aspirating a large amount of water while swimming - the other common form of dry drowning. In cases where a near-drowning has occurred during swimming, the lungs can be damaged, allowing them to fill with fluid. In such cases, called "post-immersion syndrome," the reduced airflow can cause organs to begin to fail in the hours or days after a near-drowning.

Los Angeles Times

Plastic surgery

More minorities choose to go under the knife

The face of plastic surgery patients is changing. And that's even before the bandages come off.

The American Society of Plastic Surgeons recently reported that 2.6 million cosmetic plastic surgery procedures were performed in 2007 on patients of African, Asian and Hispanic descent.

That's almost a quarter of all procedures and a 13 percent increase over the year before. (And since 2000, cosmetic plastic surgery procedures have increased 173 percent among Hispanics, 129 percent among blacks and 246 percent among Asian Americans.)

There are several reasons for the trend, including the growing economic power of these groups and a willingness to go beyond traditional boundaries. According to the ASPS, the most commonly requested surgical procedures were nose reshaping, liposuction and breast reduction for blacks; nose reshaping, breast augmentation and eyelid surgery for Asian Americans; and breast augmentation, nose reshaping and liposuction for Hispanics.

Chicago Tribune

Health care

25 million people in U.S. classified as underinsured

A study in this month's Health Affairs journal found that 25 million people ages 19 to 64 were underinsured in 2007, up from 16 million in 2003. The study's authors define "underinsured" as those families earning more than $40,000 who have health insurance but still spend 10 percent or more of their income on out-of-pocket medical expenses (or 5 percent of their income if they make less than $40,000).

Nearly 50 million additional people have no health insurance at all. In all, "You end up with about 75 million adults who were either underinsured or uninsured at some time during the year," says study co-author Sara Collins, an assistant vice president of the Commonwealth Fund, a foundation that supports independent health care research.

Those with inadequate insurance coverage were almost as likely as those with no insurance to avoid getting needed care or to have medically related financial problems. Some 53 percent of the underinsured went without needed care, compared with 68 percent of the uninsured. And 45 percent of underinsured people had trouble paying medical bills, compared with 51 percent of uninsured people.

"You can have health insurance and still go bankrupt if you get sick," the authors wrote.

Los Angeles Times

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