More and more people are going abroad for medical care.

Before you or a loved one, make this choice, please read what the Centers for Disease Control (CDC) has to say on the subject.

“Medical tourism” refers to traveling to another country for medical care. It’s estimated that up to 750,000 US residents travel abroad for care each year. Many people who travel for care do so because treatment is much cheaper in another country. In addition, a large number of medical tourists are immigrants to the United States returning to their home country for care. The most common procedures that people undergo on medical tourism trips include cosmetic surgery, dentistry, and heart surgery.

Risks of Medical Tourism

The specific risks of medical tourism depend on the area being visited and the procedures performed, but some general issues have been identified:

• Communication may be a problem. Receiving care at a facility where you do not speak the language fluently increases the chance that misunderstandings will arise about the care.
• Doctors may reuse needles between patients or have other unsafe injection practices, which can transmit diseases such as hepatitis and HIV.
• Medication may be counterfeit or of poor quality in some countries.
• Antibiotic resistance is a global problem, and resistant bacteria may be more common in other countries than in the United States.
• The blood supply in some countries comes primarily from paid donors and may not be screened, which puts patients at risk of HIV and other infections spread through blood.
• Flying after surgery increases the risk for blood clots.

What You Can Do

• If you are planning to travel to another country for medical care, see a travel medicine practitioner at least 4–6 weeks before the trip to discuss general information for healthy travel and specific risks related to the procedure and travel before and after the procedure.

• Check for the qualifications of the health care providers who will be doing the procedure and the credentials of the facility where the procedure will be done.
• Make sure that you have a written agreement with the health care facility or the group arranging the trip, defining what treatments, supplies, and care are covered by the costs of the trip.
• Determine what legal actions you can take if anything goes wrong with the procedure.
• If you go to a country where you do not speak the language, determine ahead of time how you will communicate with your doctor and other people who are caring for you.
• Obtain copies of your medical records, which should describe any allergies you may have.
• Prepare copies of all your prescriptions and a list of all the medicines you take, including their brand names, their generic names, manufacturers, and dosages.
• Arrange for follow-up care with your local health care provider before you leave.
• Before planning “vacation” activities, such as sunbathing, drinking alcohol, swimming, or taking long tours, find out if those activities are permitted after surgery.
• Get copies of all your medical records before you return home.

Guidance from Professional Organizations

• Organization for Safety, Asepsis, & Prevention’s Travelers Guide to Safe Dental Care
• The International Society of Aesthetic Plastic Surgery Guidelines for Travelers
• CDC Yellow Book 2014 information on Medical Tourism

It seems that the nightly news carries coverage of at least one home fire a week during the winter months.

It may be a good time to share this fire safety message from the US Fire Safety Administration with your family members.

Bedroom Fires

Each year, fire claims the lives of 3,400 Americans and injures approximately 17,500. Bedrooms are a common area of fire origin. Nearly 600 lives are lost to fires that start in bedrooms.

Many of these fires are caused by misuse or poor maintenance of electrical devices, such as overloading extension cords or using portable space heaters too close to combustibles. Many other bedroom fires are caused by children who play with matches and lighters, careless smoking among adults, and arson.

The United States Fire Administration (USFA) and the Sleep Products Safety Council (SPSC) would like you to know that there are simple steps you can take to prevent the loss of life and property resulting from bedroom fires.

Kids and Fire: A Bad Match

Children are one of the highest risk groups for deaths in residential fires. At home, children usually play with fire – lighters, matches and other ignitables – in bedrooms, in closets, and under beds. These are “secret” places where there are a lot of things that catch fire easily.

• Children of all ages set over 35,000 fires annually.
• Every year over 400 children nine years and younger die in home fires.
• Keep matches and lighters locked up and away from children. Check under beds and in closets for burnt matches, evidence your child may be playing with matches.
• Teach your child that fire is a tool, not a toy.

Appliances Need Special Attention

Bedrooms are the most common room in the home where electrical fires start. Electrical fires are a special concern during winter months which call for more indoor activities and increases in lighting, heating, and appliance use.

• Do not trap electric cords against walls where heat can build up.
• Take extra care when using portable heaters. Keep bedding, clothes, curtains and other combustible items at least three feet away from space heaters.
• Only use lab-approved electric blankets and warmers. Check to make sure the cords are not frayed.

Tuck Yourself In For A Safe Sleep

• Never smoke in bed.
• Replace mattresses made before the 2007 Federal Mattress Flammability Standard. Mattresses made since then are required by law to be safer.

Finally, having working smoke alarms dramatically increases your chances of surviving a fire. Place at least one smoke alarm on each level of your home and in halls outside bedrooms. And remember to practice a home escape plan frequently with your family.

 Kids are not the only ones who have to practice bicycle safety. According to a press release from the Governors Highway Safety Association, adult bike fatalities are on the rise.

Press Release: Bicyclist Fatalities a Growing Problem for Key Groups

WASHINGTON, D.C. – The number of bicyclists killed on U.S. roadways is trending upward, particularly for certain subsets of the population, according to a recent report released by the Governors Highway Safety Association (GHSA). GHSA’s notes that yearly bicyclist deaths increased 16 percent between 2010 and 2012, while overall motor vehicle fatalities increased just one percent during the same time period.

The report’s author, former Insurance Institute for Highway Safety Chief Scientist Dr. Allan Williams, analyzed current and historical fatality data to uncover bicyclist crash patterns. There have been some remarkable changes. For example, adults 20 and older represented 84 percent of bicyclist fatalities in 2012, compared to only 21 percent in 1975. Adult males comprised 74 percent of the total number of bicyclists killed in 2012.

Bicycle fatalities are increasingly an urban phenomenon, accounting for 69 percent of all bicycle fatalities in 2012, compared with 50 percent in 1975. These changes correlate with an increase in bicycling commuters – a 62 percent jump since 2000, according to 2013 Census Bureau data.

While bicyclists killed in motor vehicle crashes increased in 22 states between 2010 and 2012, six states – California, Florida, Illinois, New York, Michigan and Texas – represented 54 percent of all fatalities.

“These are high population states with many urban centers,” pointed out Williams, “and likely reflect a high level of bicycle exposure and interaction with motor vehicles.”

There are some bicycle fatality data that remain unchanged over the decades. Bicyclists killed are predominantly males (88 percent in 2012), and lack of helmet use and alcohol impairment continue to contribute to bicyclist deaths. In 2012, two-thirds or more of fatally injured bicyclists were not wearing helmets, and 28 percent of riders age 16 and older had blood alcohol concentrations (BAC) of .08 percent or higher, compared with 33 percent of fatally injured passenger vehicle drivers.

“What’s notable here,” said Dr. Williams, “is that the percentage of fatally injured bicyclists with high BACs has remained relatively constant since the early 1980s and did not mirror the sharp drop in alcohol-impaired driving that happened among passenger vehicle drivers in the 1980s and early 1990s.”

State Highway Safety Offices are giving bicyclist safety considerable attention, despite bicyclists representing two percent of overall motor vehicle-related fatalities, a proportion that has remained constant since 1975.

“Many states are dedicating resources to ensuring the safety of all roadway users, including bicyclists, by investing in educating bicyclists and motorists, promoting helmet use, enforcing motor vehicle laws and implementing infrastructure changes,” said Jonathan Adkins, GHSA Executive Director.

As an example, the New York Governor’s Traffic Safety Committee promotes helmet use by funding bicycle helmet distribution programs and proper fit training. In Florida, police officers are stopping bicyclists who ride without lights at night, providing lights to those who are less able to afford them and helping to affix them to bikes.

Adkins stressed that helmet laws are an effective countermeasure particularly with so many inexperienced riders expected to choose bicycling in the coming years. Twenty-one states have helmet laws for younger riders, but no state has a universal helmet law and twenty-nine states do not have any kind of bicycle helmet law.

On the engineering side, several states are adopting Complete Streets policies, which take into consideration all travel modes when building and/or improving existing roadway systems. They are also stepping up efforts to collect information on bicycle crash patterns and locations, which is critical for making informed decisions about countermeasures and resource allocation.

Adkins noted that while bicyclist fatalities are a problem in some states, unlike many highway safety challenges, this is not necessarily a national issue. Twenty-three states averaged five or fewer deaths per year between 2010 and 2012. This suggests a need to focus resources on those states and locations where bicyclist fatalities most often occur.

About GHSA
The Governors Highway Safety Association (GHSA) is a nonprofit association representing the highway safety offices of states, territories, the District of Columbia and Puerto Rico. GHSA provides leadership and representation for the states and territories to improve traffic safety, influence national policy, enhance program management and promote best practices. Its members are appointed by their Governors to administer federal and state highway safety funds and implement state highway safety plans. Contact GHSA at 202-789-0942 or visit www.ghsa.org. Find us on Facebook at www.facebook.com/GHSAhq or follow us on Twitter at @GHSAHQ.

Many of us have vowed to lose weight in 2015. We all would like to find a quick fix, an easier path than dieting and exercising. We may be tempted to try one of those miracle weight loss supplements or foods. Before you do, please read what the FDA has to say about weight loss products.

Many so-called “miracle” weight loss supplements and foods (including teas and coffees) don’t live up to their claims. Worse, they can cause serious harm, say FDA regulators. The agency has found hundreds of products that are marketed as dietary supplements but actually contain hidden active ingredients (components that make a medicine effective against a specific illness) contained in prescription drugs, unsafe ingredients that were in drugs that have been removed from the market, or compounds that have not been adequately studied in humans.

“When the product contains a drug or other ingredient which is not listed as an ingredient we become especially concerned about the safety of the product,” says James P. Smith, M.D., an acting deputy director in FDA’s Office of Drug Evaluation.

Tainted Products

For example, FDA has found weight loss products tainted with the prescription drug ingredient sibutramine. This ingredient was in an FDA-approved drug called Meridia, which was removed from the market in October 2010 because it caused heart problems and strokes.

“We’ve also found weight-loss products marketed as supplements that contain dangerous concoctions of hidden ingredients including active ingredients contained in approved seizure medications, blood pressure medications, and antidepressants,” says Jason Humbert, a senior regulatory manager at FDA. Most recently, FDA has found a number of products marketed as dietary supplements containing fluoxetine, the active ingredient found in Prozac, a prescription drug marketed for the treatment of depression and other conditions. Another product contained triamterene, a powerful diuretic (sometimes known as “water pills”) that can have serious side-effects and should only be used under the supervision of a health care professional.

Many of these tainted products are imported, sold online, and heavily promoted on social media sites. Some can also be found on store shelves.

And if you’re about to take what you think of as “natural” dietary supplements, such as bee pollen or Garcinia cambogia, you should be aware that FDA has found some of these products also contain hidden active ingredients contained in prescription drugs.

“The only natural way to lose weight is to burn more calories than you take in,” says James P. Smith, M.D. That means a combination of healthful eating and physical activity.

Dietary Supplements are not FDA-Approved

Under the Federal Food, Drug and Cosmetics Act (as amended by the Dietary Supplement Health and Education Act of 1994), dietary supplement firms do not need FDA approval prior to marketing their products. It is the company’s responsibility to make sure its products are safe and that any claims made about such products are true.

But just because you see a supplement product on a store shelf does not mean it is safe, Humbert says. FDA has received numerous reports of harm associated with the use of weight loss products, including increased blood pressure, heart palpitations (a pounding or racing heart), stroke, seizure and death. When safety issues are suspected, FDA must investigate and, when warranted, take steps to have these products removed from the market.

FDA has issued over 30 public notifications and recalled 7 tainted weight loss products in 2014. The agency also has issued warning letters, seized products, and criminally prosecuted people responsible for marketing these illegal diet products. In addition, FDA maintains an online list of tainted weight-loss products.

To help people with long-term weight management, FDA has approved prescription drugs such as Belviq, Qysmia, and Contrave, but these products are intended for people at least 18 years of age who:

• have a body mass index (BMI, a standard measure of body fat) of 30 or greater (considered obese); or
• have a BMI of 27 or greater (considered overweight) and have at least one other weight-related health condition.

Moreover, if you are going to embark on any type of weight control campaign, you should talk to your health care professional about it first, Welch says.

Know the Warning Signs

Look for potential warning signs of tainted products, such as:

• promises of a quick fix, for example, “lose 10 pounds in one week.”
• use of the words “guaranteed” or “scientific breakthrough.”
• products marketed in a foreign language.
• products marketed through mass e-mails.
• products marketed as herbal alternatives to an FDA-approved drug or as having effects similar to prescription drugs.

Advice for Consumers

Generally, if you are using or considering using any product marketed as a dietary supplement, FDA suggests that you:

• check with your health care professional or a registered dietitian about any nutrients you may need in addition to your regular diet.
• ask yourself if it sounds too good to be true.
• be cautious if the claims for the product seem exaggerated or unrealistic.
• watch out for extreme claims such as “quick and effective” or “totally safe.”
• be skeptical about anecdotal information from personal “testimonials” about incredible benefits or results from using a product.

If you suspect a product marketed as a dietary supplement sold online may be tainted, FDA urges you to report that information online. You or your health care professional can also report an illness or injury you believe to be related to the use of a dietary supplement by calling 1-800-FDA-1088 or visiting FDA online.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Updated January 5, 2015