Good Health

Fighting Seasonal Affective Disorder Symptoms During Winter

2010-05-31T20:39:00.000-04:00

DANNY ROSE

For one in 300 Australians, June 1st marks not just the official start of gloomy weather.

The arrival of winter can also highlight the presence of a mild form of Seasonal Affective Disorder (SAD), when a person's mood takes a downturn along with the temperature and daylight hours.

Along with a gloomy outlook, the disorder could make a person feel lethargic and crave carbohydrate-rich fatty foods, Associate Professor Greg Murray from Swinburne University said.

"While winter SAD is most common in the northern hemisphere and appears to be rare in our temperate climate, research has shown that around one in 300 of the Australian adult population experiences SAD-like symptoms," said Dr Murray, who is convenor of clinical psychology programs at the Melbourne-based university.

"There is a trend for Australians to report lowered mood and energy levels in winter compared to the warmer months, but there are many ways to ease the symptoms."

Dr Murray said at its most extreme form, SAD was recognised as a type of recurrent depression.

People suffering a winter-time bout of depression should not put off seeking professional help, he said.

Otherwise, he offered some tips on battling SAD in its milder forms.

Dr Murray said sunlight was a natural mood enhancer, and people should aim for at least one hour of outdoor light each day, preferably in the morning.

Social activities tended to fall away during winter, affecting mood and energy levels, so a Winter Solstice or Christmas in July dinner party might provide some light relief.

Consider a gym membership during the colder months, Dr Murray said, and otherwise try to keep as active as possible.

The presence of colds and flu also made it harder to remain as productive as during the warmer months.

"For some people, acceptance of this natural rhythm is an important part of winter wellbeing," Dr Murray said.

"Although for most of us the mood and energy changes in winter can be addressed with these simple strategies, we should keep in mind that depression at any time of year can be difficult to shift and may require professional attention."

More on Seasonal Affective Disorder (SAD)

At least 44 cases of Hepatitis C linked to an Australian Abortion Clinic

2010-05-31T19:54:00.001-04:00

Patients of a late-term abortion clinic in Victoria may have been deliberately infected with hepatitis C after a further 32 women tested positive to the virus, bringing to 44 the total number of infections.

Health authorities and police are investigating allegations a cluster of patients of Melbourne's Croydon Day Surgery became infected with hepatitis C when James Latham Peters worked as an anaesthetist at the clinic over an 18 month period in 2008 and 2009.

The state's chief medical officer, John Carnie, said more than 1100 women who attended the clinic had been contacted for blood tests, with 44 so far testing positive to hepatitis C.

That contact was made after health authorities confirmed in April that 12 women who attended the Croydon Day Surgery became infected with hepatitis C, all of whom were linked directly to the clinic, and nine to the anaesthetist himself.

Since then, Dr Carnie said, 32 additional patients had tested positive to the virus and further genetic testing had linked 13 of those cases to the clinic.

"The more cases you find in this instance, it becomes more and more difficult to explain this by an accidental means," Dr Carnie said yesterday.

A spokesman for law firm Slater & Gordon said 30 patients of the Croydon Day Surgery had so far contacted the firm about compensation. It is understood letters of demand have been served on the clinic and Dr Peters. Slater & Gordon is yet to determine whether action will be taken against the Medical Practitioners Board of Victoria.

Health Minister Daniel Andrews yesterday described the hepatitis C outbreak as "a very serious matter", but he defended the effectiveness of the safety checks within the state's health system.

"I believe this is not about system failure; this is about, it would seem, the appalling, totally inappropriate behaviour of one particular person," Mr Andrews said.

"It is difficult to know what went on in that clinic."

Dr Peters has not worked at the Croydon Day Surgery since last December, and was suspended by the Medical Practitioners Board on February 15. The alleged infections occurred between 2006 and last year.

Victoria Police established a taskforce to investigate allegations that the hepatitis C infections were linked to the surgery, after it received a request from the Department of Health in April.

No charges have been laid but police yesterday said in a statement: "Detectives are working to discover whether any criminal activity led to the spread of hepatitis C to patients at the facility."

Victoria Police said it was working closely with government and private agencies, but the investigation was likely to be a "long and involved" one.

Dr James Latham Peters was given a six-month suspended jail term in August 1996 after pleading guilty to 20 charges over providing his wife with a two-year non-stop supply of pethidine the Herald Sun reported.

Dr Peters voluntarily surrendered his medical registration but succeeded in having it restored within the past five years.

The Medical Practitioners Board is refusing to release details of Dr Peters' history, saying it must protect doctors' privacy.

It had placed him on a program for substance-abusing doctors, made him submit to drug tests for a year, and restricted his practice when he re-applied for registration. But the conditions were later removed.

More on Hepatitis C

Swine Influenza aka H1N1

2009-10-31T08:13:00.001-04:00

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses. In the recent outbreak cases of human infection with swine influenza A (H1N1), viruses were first reported in Mexico. Ninety one (9!) cases of swine flu infection have now been reported in the United States and additional cases have been reported internationally.
The CDC has determined that the swine influenza virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people. In addition, it is unclear why the disease is mild in all locations except Mexico. To date, there have been no fatalities and few people requiring hospitalization outside of Mexico. The one current fatality is a Mexican citizen who was being treated in the U.S.
There is increasing concern that this virus will become easily transmissible from person to person, and that a pandemic will occur. The severity of such a pandemic depends upon the virulence of the virus, which is uncertain at this time. A pandemic is a global disease outbreak that affects an exceptionally high proportion of the population. The H1N1 virus is a likely candidate to cause the next pandemic, although no one can predict with certainty that a pandemic will occur.
Human vaccines for the virus that causes swine flu have not been developed. There is no evidence that the individuals who received the seasonal flu vaccine have immunity to swine flu. Two anti-viral medications, Tamiflu (oseltamivir) and Relenza (zanamivir), have been shown to be effective in treating swine flu.

Rheumatoid Arthritis Definition

2009-10-17T08:33:00.001-04:00

Rheumatoid arthritis (RA) is a chronic, autoimmune disorder that causes the immune system to attack the joints, resulting in substantial loss of mobility and joint destruction. The disease is also systemic, meaning it often affects many extra-articular tissues throughout the body, such as the skin, blood vessels, heart, lungs and muscles.

Signs and Symptoms of Rheumatoid Arthritis
One of the most common symptoms of RA is daily joint pain. Most patients also experience some degree of depression and anxiety, which can impact functional status and quality of life.

Other symptoms include:

* Morning stiffness in and around the joints
* 3 or more joint areas with simultaneous soft tissue swelling or fluid
* Swollen joint areas in the wrist, knuckle or middle joint of the finger
* Fatigue, which can be severe during a flare-up
* General sense of not feeling well (malaise)

Although RA is traditionally a chronic disease, it tends to vary in severity, alternating between flare-ups and remission.

Causes and Risk Factors of Rheumatoid Arthritis
Doctors do not know why people develop RA, but it is believed to be the body's immune system attacking the tissue that lines a person's joints. More than 2 million people in the U.S. have RA. It is two to three times more common in women than men and typically develops between the ages of 20 and 50.

While RA itself is not inherited, what can be inherited are the genes that may make someone more likely to develop the disease. Although scientists believe it is unlikely that genes alone bring about RA, research continues to study the role genes play in the development of the disease. In addition to genetics, recent research suggests that RA may also be caused by environmental and hormonal factors.

Other factors that increase the risk of RA include:

* Getting older, incidences of RA increase with age
* Being female
* Heredity, a predisposition to RA runs in some families
* Smoking cigarettes over a long period of time

Doctors also believe that certain infections or factors in the environment may cause the immune system to attack the body's own tissues, resulting in inflammation in various organs of the body such as the lungs or eyes.

Diagnosis and Treatment of Rheumatoid Arthritis
While your family doctor may be able to diagnose your symptoms, only a qualified physician can diagnose you with RA. If you think you have RA, have your doctor refer you to a rheumatologist, a doctor specializing in managing conditions involving joints, muscles and bones. It is important to diagnose RA early, and patients should start aggressive treatment as soon as possible. However, proper treatment can greatly improve the quality of a person's life.

The cure for RA still remains unknown, but the main goal of treatment is to relieve symptoms, especially pain, as well as slow progression of the disease and prevent disability. Doctors may suggest a variety of treatment options to improve symptoms, such as medicines, therapies, procedures and lifestyle changes.

If you have been experiencing daily joint pain or any other symptoms of RA, it is best to schedule an appointment with your doctor for a proper diagnosis.

Inhibiting TAK-1 Reverses Pancreatic cCncer Resistance to Chemotherapy

2009-09-27T05:12:00.004-04:00

Inhibiting the action of an enzyme called TAK-1 reverses pancreatic cancer resistance to chemotherapy
, a finding that could lead to the development of a new way to treat the disease, researchers say.

Pancreatic cancer is resistant to every currently available anti-cancer treatment.

"During the past few years we have been studying the role played by a cytokine or regulatory protein called transforming growth factor-beta [TGFbeta] in the development of pancreatic cancer. Recently we focused our attention on a unique enzyme activated by TGFbeta, TAK-1, as a mediator for this extreme drug resistance" in pancreatic cancer, study author Dr. Davide Melisi said in a news release from the European Cancer Organization.

He and his colleagues developed a TAK-1 inhibitor and tested it on its own and in combination with the anti-cancer drugs gemcitabine, oxaliplatin and SN-38 (a metabolite of the anti-cancer drug irinotecan) in pancreatic cancer cell lines. They also tested the TAK-1 inhibitor combined with gemcitabine against pancreatic cancer
in mice.

"The use of this TAK-1 inhibitor increased the sensitivity of pancreatic cells to all three chemotherapeutic drugs," Melisi said.

"By combining it with classic anti-cancer drugs, we were able to use doses of drugs up to 70 times lower in comparison with the control to kill the same number of cancer cells. In mice, we were able to reduce significantly the tumor volume, to prolong the mice survival, and to reduce the toxicity by combining the TAK-1 inhibitor with very low doses of a classic chemotherapeutic drug, gemcitabine, that would have been ineffective otherwise," Melisi added.

The study was scheduled for presentation Sept. 24 at the joint meeting of the European Cancer Organization and the European Society for Medical Oncology in Berlin.

"This is the first time that TAK-1 has been indicated as a relevant target for the treatment of a solid tumor and that it is a valid approach to reverting the intrinsic drug resistance of pancreatic cancer," Melisi stated. "The TAK-1 inhibitor used in this study is an exciting drug that warrants further development for the treatment of pancreatic cancer."

Face Masks and Hand-Washing May Stop Flu

2009-08-04T09:14:00.004-04:00

Amy Norton

Face masks and clean hands may be key to preventing the influenza virus from spreading among family members, a study published Monday suggests.

The study, of 259 Hong Kong households, found that when family members wore face masks and minded their hand hygiene, the odds of catching the flu from an ill relative dropped by two-thirds.

The key was to start taking the two measures within 36 hours of the stricken family member's first symptoms. Flu symptoms typically include fever, sore throat, body aches and headache that arise suddenly.

The findings point to simple, inexpensive ways to curb flu transmission during both regular influenza season and during pandemics like the current swine flu (H1N1) outbreak, the researchers report in the online edition of the Annals of Internal Medicine.

"Some people may have the misconception that flu is so infectious that very little can be done to prevent household transmission," lead researcher Dr. Benjamin J. Cowling, an assistant professor at the University of Hong Kong School of Public Health, told Reuters Health in an email. "Our study demonstrates that this is not the case."

For the study, Cowling and his colleagues followed 259 households in which one family member had a confirmed case of influenza. The researchers randomly assigned each household into one of three groups: one that received education on a healthy diet and lifestyle; one that was instructed on good hand hygiene; and one that was instructed on both hand hygiene and face mask use.

In both hand-hygiene groups, family members were given liquid soap and told to wash their hands whenever they used the bathroom, sneezed or coughed. They were also given alcohol-based hand rub, to be used whenever they first arrived home and immediately after touching any potentially virus-contaminated surface.

Families in the face mask group were given disposable surgical masks to wear whenever they were not eating or sleeping.

Over the next week, family members in 19 percent of the study households developed a confirmed case of the flu. That risk was two- thirds lower in households where the hand-washing/face mask intervention was begun within 36 hours of a family member's first flu symptoms.

The risk was also somewhat lower in the hand-hygiene group.

The fact that hand-washing appeared effective, Cowling said, shows that the flu can spread via direct contact and, more indirectly, by touching virus-contaminated household objects like door handles, light switches and TV remotes.

Brain Exercise Delays The Onset of Dementia

2009-08-04T09:08:00.002-04:00

Anne Harding

A new study in Bronx seniors provides yet more evidence that keeping your brain active for fun can keep dementia at bay.

Dr. Charles B. Hall of the Albert Einstein College of Medicine in Bronx, New York, and his colleagues found that every day per week that a person engaged in one of six mentally stimulating leisure activities delayed the onset of dementia by about two months.

Hall and his colleagues had previously shown that people with more years of education who developed dementia did so later than less educated individuals. In the current study, he said, "it was the cognitive activity that mattered, not the education."

In the current study, published in Neurology, Hall and his team looked at 101 people who developed dementia. All were participating in the Bronx Aging Study, which has been following 488 people since the early 1980s.

All of the study participants, who ranged in age from 75 to 85, had reported their years of formal education at the study's outset, as well as how often each week they read, wrote, did crossword puzzles, played board or card games, participated in group discussions, or played music. A person scored 1 for each day that they did each activity. The study participants, all of whom were dementia free at the beginning of the study, underwent cognitive testing every 12 to 18 months.

The higher a person's score on the activity scale, the later the onset of accelerated mental decline, Hall and his colleagues found. For example, a person in the top 25 percent based on their activity scale, who engaged in 11 "activity days" a week, started their accelerated decline 1.29 years later, on average, than a person in the bottom 25 percent, with four activity days a week.

But once that decline began, it happened faster in people with higher activity scores.

The findings back up the idea of "cognitive reserve," Hall noted, which is the theory that education and brain exercise build extra capacity into the brain so it can better handle the damage to neurons caused by Alzheimer's disease. But once that damage reaches a certain point, a person will develop dementia.

Being more mentally active "might keep you out of a nursing home for a year or two," Hall said. "But it's not going to prevent Alzheimer's disease unfortunately, at least that's the theory, and this is evidence toward that theory." Eventually, he said, the disease "would overwhelm whatever reserve you had."

Hall and his colleagues are now investigating which of the six activities in the current study might give the most brain-preserving "bang for the buck." Studies will need to tease out whether education and later-life mental activities have effects that are independent of one another.

With what we know now, he added, engaging in these activities could help-and it certainly won't hurt. "You might get depressed from not being able to do a crossword puzzle, but there's really very little of a downside here."

Michael Jackson's Health Problem History

2009-06-26T12:45:00.001-04:00

Pop icon Michael Jackson, 50, who died Thursday afternoon after being rushed to a Los Angeles hospital in cardiac arrest, had a long history of confirmed health problems, in addition to rumored conditions.

In 1984, Jackson was burned while singing for a Pepsi-Cola commercial in Los Angeles, when the special effects smoke bomb misfired. He had to have major surgery on his scalp, and said that because of the intense pain he developed an addiction to painkillers.

He also was reported to have a form of lupus in the 1980s, but it was later said to have gone into remission.

He has had numerous plastic surgeries, including rhinoplasty and a chin implant.

In 1993, Jackson's dermatologist, Dr. Arnold Klein, released a statement saying that Jackson had a rare skin disease called vitiligo. Vitiligo causes a person to lose melanin, the pigment that determines the color of skin, hair and eyes, in patches or all over the body. The condition affects 1 percent to 2 percent of the population, and no one knows what causes it.

He was also hospitalized with chest pains in 1990 and postponed a concert because of dehydration in August 1993. A concert tour was cut short in November 1993 because of an addiction to prescription painkillers amid allegations of child molestation.

During a rehearsal at the Beacon Theater in New York in December 1995, the entertainer collapsed onstage from apparent dehydration and low blood pressure and was hospitalized.

While jurors deliberated in a case in which he was accused of child molestation in June 2005, Jackson went to a hospital for treatment of what his spokeswoman said was recurring back pain. He had complained of back problems before.

Rumors circulated in December that Jackson was ill and in need of a lung transplant because of Alpha-1 antitrypsin deficiency, a rare genetic condition.

More rumors emerged in May that Jackson had skin cancer. But Randy Phillips, president and CEO of AEG Live, told CNN at the time, "He's as healthy as he can be -- no health problems whatsoever."

Jackson apparently collapsed in his home in Los Angeles on Thursday and was taken by ambulance to UCLA Medical Center.

Brian Oxman, Jackson family attorney, told CNN Thursday that Jackson's use of medications had gotten in the way of doing rehearsals.

"His injuries, which he had sustained performing, where he had broken a vertebra and he had broken his leg from a fall on the stage, were getting in the way. I do not know the extent of the medications that he was taking," he said.

The results of toxicology tests on the body of Michael Jackson may not be available for six to eight weeks, the Los Angeles coroner's office said Friday.

Ed Winter, assistant chief coroner, said the autopsy exam will be conducted Friday, but few results are expected Friday because of the extensive tests being performed.

"The likelihood is very slim that we will have any results to release today because of the extensive [tests] that we're going to be performing," he said.

The office will likely not determine a cause of death "until we get results of all the tests," he said.

Are you at risk for diabetes?

2009-06-21T23:26:00.002-04:00

Definition of Diabetes

Diabetes is a disorder of metabolism, the process by which the body uses digested food for energy and growth. Most of the foods we eat are broken down into glucose, a form of sugar in the bloodstream that is used as the body's main fuel source. Insulin, the hormone produced by the pancreas, works together with glucose to help it enter the body's cells to be burned for energy. When people have diabetes, the pancreas either produces too little insulin, or the insulin produced cannot be used by the body. This prevents glucose from entering the cells, which ultimately denies the body of its main source of fuel.
Two Main Types of Diabetes

Type 1 diabetes occurs because the pancreas produces little or no insulin, which prevents glucose from entering the cells and causes high blood sugar levels. Type 1 diabetes can develop at any age, but is most common among people younger than 20 years old and must be managed by taking daily injections of insulin.

Type 2 diabetes is caused by insulin resistance, a condition in which the body cannot use the insulin produced by the pancreas. Type 2 diabetes is most common in people over age 45 and is usually associated with obesity (approximately 80% of people with type 2 diabetes are overweight), a family history of diabetes, previous history of gestational diabetes, physical inactivity and ethnicity.

Signs and Symptoms

When the body isn't processing enough glucose, the buildup is secreted into the urine, which passes out of the body. As a result, a person with diabetes will experience the following symptoms:

* Excessive thirst and appetite
* Increased urination
* Dry mouth
* Unusual weight loss or gain
* Weak, tired feeling
* Frequent yeast infections
* Blurred vision
* Numbness or tingling of the hands or feet
* Irritability
* Nausea, perhaps vomiting
* Itchiness, especially around the groin
* Slow-healing sores or cuts

People with type 1 diabetes usually develop symptoms within days or weeks, while people with type 2 diabetes often don't experience symptoms for years. Signs of diabetes may seem harmless and are often overlooked, but studies show early detection and treatment can greatly reduce the chance of complications.
Risk Factors of Diabetes

Doctors do not know why people develop RA, but it is believed to be the body's immune system attacking the tissue that lines a person's joints. More than 2 million people in the U.S. have RA. It is two to three times more common in women than men and typically develops between the ages of 20 and 50.

The following factors increase a person's chance of developing diabetes:

* Family history of diabetes
* Smoking
* Age (older than 45)
* Race or ethnic background
* Poor diet
* Diabetes during a previous pregnancy
* Being overweight, especially around the waist
* Years of heavy alcohol abuse
* History of hypertension (high blood pressure)
* Low activity level
* Abnormal blood cholesterol or triglyceride levels
* Certain drugs (these might increase blood sugar)
* History of gestational diabetes
* Delivery of a baby weighing more than 9 pounds

Managing Diabetes

While the cure for diabetes is still unknown, the goal of treatment is to keep blood sugars at a relatively even level. The main treatment for people with type 1 diabetes is exercise, a diabetic diet and daily injections of insulin. Insulin injections need to be balanced with meals and exercise, and blood sugar levels must be frequently tested.

When treating type 2 diabetes, doctors will first suggest lifestyle changes such as losing weight, following a diabetic diet and getting regular exercise. Once these measures become less effective in controlling glucose levels, oral medications are often prescribed. If oral medications are still unsuccessful, doctors may recommend insulin treatments.

Glucose levels that are excessively high or low can be extremely dangerous, even life-threatening. When blood sugar levels drop too low, a condition called hypoglycemia can occur, which causes a person to become nervous, shaky and confused. In severe cases the person may eventually lose consciousness. However, this condition can be reversed by eating or drinking something sugary, like a candy bar or glass of orange juice.

If you or someone you know has diabetes, making healthy lifestyle choices about diet, exercise and other health-related habits can improve glycemic (blood sugar) control and help prevent or minimize complications of diabetes.

Induced Labor by means of Relaxation, Breathing, Orgasm ...

2009-03-18T07:29:00.001-04:00

The Lamaze Technique is a natural childbirth technique developed in the 1940s by French obstetrician Dr. Ferdinand Lamaze as an alternative to the use of general anesthesia during labor. Dr. Lamaze was influenced by Soviet childbirth practices, which involved breathing and relaxation techniques under the supervision of a "monitrice" or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book Thank You, Dr. Lamaze.

Modern Lamaze childbirth classes teach expectant mothers breathing techniques and often other ways to work with the labor process to reduce the pain often associated with childbirth, such as hot and cold packs, changing positions, the use of a "birthing ball" to remain in a supposedly more natural upright position, and even orgasm to induce or hasten labor. When you see laboring women on TV or in movies huffing and puffing through clenched teeth, they're practicing the Lamaze technique of childbirth.

Myths about Lamaze

Myth #1: Lamaze is all about breathing.

Reality: The goal of Lamaze classes is to increase women's confidence in their ability to give birth. Lamaze classes help women discover the inner wisdom they already have for giving birth. Women learn simple coping strategies for labor, including focused breathing. But breathing techniques are just one of many things that help women in labor. Movement and positioning, labor support, massage, relaxation, hydrotherapy, and the use of heat and cold are some others.

Myth #2: Lamaze promises painless childbirth.

Reality: Many women are afraid of the pain that is a normal part of childbirth. The pain of labor and birth, like other pain, protects us. Responding to the pain of contractions - by changing positions and moving, by massaging, by moaning - actually strengthens the contractions, helps the baby settle into the pelvis and move through the birth canal, and reduces pain perception. Some women find that experiencing and coping with the pain of labor and birth is similar to the hard work demanded by dancers and athletes. Lamaze classes help women understand the value of pain and learn how to respond to pain in ways that both facilitate labor and increase comfort.

Myth #3: Lamaze childbirth means you can't have an epidural.

Reality: Lamaze classes provide information about natural pain relief options as well as epidural anesthesia. Eliminating pain completely makes it difficult to respond to contractions in ways that facilitate labor and birth. Women who have epidural anesthesia are required to have IV fluids and continuous electronic fetal monitoring. They may be encouraged to stay in bed and may need medications to increase the strength of her contractions. The ability to use many of the comfort techniques learned in Lamaze classes, such as changing positions, walking, and hydrotherapy may be limited. Lamaze education will assist women in making personal decisions that are right for them.

Myth #4: Lamaze doesn't work.

Reality: Lamaze that "works" has nothing to do with feeling pain, taking or avoiding medication, or developing complications that necessitate medical interventions. Lamaze teaches women that nature has designed birth simply and close to perfectly and that women already know how to give birth. Lamaze is working if women trust the natural process of birth, have confidence in their ability to give birth, have the freedom to work with their bodies as labor progresses, and are supported by health care providers, family and friends who wait patiently for nature to do its incredible work. Lamaze "works" if birth is allowed to work.

Myth #5: Lamaze is not for everyone.

Reality: Women have always prepared for the birth of their babies. Until recent times, women learned about birth from their own mothers and sisters. Birth took place at home with family rituals and traditions to help them feel confident in their ability to give birth. Women were surrounded by family and wise women who provided comfort and encouragement through labor and in the days and weeks after birth. Today, Lamaze childbirth classes provide the knowledge, skills, and support that help women give birth with confidence and joy as they have done for centuries. Lamaze preparation is for everyone!

Lamaze Philosophy of Birth

1) Birth is normal, natural, and healthy.

2) The experience of birth profoundly affects women and their families.

3) Women's inner wisdom guides them through birth.

4) Women's confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.

5) Women have the right to give birth free from routine medical interventions.

6) Birth can safely take place in birth centers and homes.

7) Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

What To Ask Your Doctor During Your Visit

2009-01-26T06:03:00.003-05:00

Your relationship with your doctor greatly influences your ability to make wise health decisions. It can also affect the outcome of your care. Partner with your doctor in making decisions about your health care. Common goals, shared effort, and good communication are the basis of successful doctor-patient partnerships.

Questions to ask your doctor
Even if you don't have a plan for treating your condition, your doctor does! These important questions will help you and your doctor create a treatment plan that is right for you.
How should I treat my condition?

What problems could occur from my condition?

What will happen if I don't treat my condition?

What lifestyle changes can help me deal with my condition?

How will this condition affect my life in the long-term?

When should I set my next appointment?

Questions if you receive a prescription
Some conditions can be managed with diet, exercise or other lifestyle changes; but it may be necessary to take a prescription medication as well. If you receive a prescription from your health professional, here are some specific questions you should be asking:
What is the benefit of this medication over another?

How does my medication work?

How do I take my medication?

Is my medication available in generic?

What are the possible side effects of my medication and what should I do if I
experience any?

What should I do if I miss a dose?

What are the risks of not taking my medication as prescribed?

How long will I have to take my medication?

What Is Erectile Dysfunction?

2008-11-29T21:07:00.000-05:00

Erectile Dysfunction is a male sexual dysfunction that makes men incapable of triggering off erections or sustaining the erections long enough to have a satisfactory sexual intercourse. Male sexual health is often placed at risk on account of a whole range of sexual disorders and among all the sexual problems suffered by men; erectile dysfunction is a prominent one. The other sexual disorders that constantly afflict men are ejaculatory problems like premature or early ejaculation, delayed or retarded ejaculation, dry orgasm, peyronie`s disease, priapism, male infertility et al.

Erectile Dysfunction: Another Name For Male Impotence

In 1993, the NIH Consensus Development Panel on Impotence called impotence "an important public health problem." The panel proposed that the term "impotence" be replaced by the less pejorative and more precise "erectile dysfunction" (ED) to signify "the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance."

How Erectile Dysfunction Sterilizes The Sex Life Of Men?

All the sexual dysfunctions affect men one way or the other but when it comes to male impotence or erectile dysfunction, the impact is very strong for the reason that once a person falls in the grip of erectile dysfunction, adequate amount of blood fail to reach his penile section. When proper blood flow to the penis is restricted, the person fails to trigger off erections necessary for satisfactory sexual intercourse. Erectile dysfunction not only sterilizes a man's sex life but also becomes a cause for other diseases such as depression.

Other Consequences Of Erectile Dysfunction

After erectile dysfunction or male impotence makes a man incapable of achieving sexual fulfillment with his partner, a whole array of unwanted circumstances evolve as the ultimate end result:

* Erectile Dysfunction means more than just the sexual incapability of a man. The emotions and uncertainties that coincide with this condition often have a significant effect on a man's self-esteem, as well as, his relationship with his partner.
* In case of erectile dysfunction afflicted married men, relationship breakdown is an inevitable outcome.
* There are significant consequences of erectile dysfunction like looking down upon by friends and peers and most particularly the rejection from girls can be very painful for a man.
* Guys are increasingly at the risk of losing their girlfriends as soon as their erectile dysfunction secret is out.
* Erectile dysfunction, the premier male sexual disorder is generally accompanied by tension, stress and other mental setbacks. These mental disorders further accelerate disaster in a man's personal as well as social life.

The Side-Effects of Viagra

2008-11-29T21:02:00.000-05:00

Every drug is accompanied with some of its side effects too apart from its benefits and Viagra is also no exception to it. But the side effects of Viagra are very mild and do not last for a long time. Some of the side effects of Viagra occur only if you take large dosages so if you are taking Viagra for the first time then it is best to start with the lowest pill dosages.

The most common are

* Headache
* Flushing of the face
* Upset stomach.
* Stuffiness of the nose

Less common medicine effects that may occur are

* Temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them)
* Eyes becoming more sensitive to light or blurred vision
* Cloudy or bloody urine
* Increased frequency of urination
* Pain on urination
* Diarrhea

Some of the rarest side effects which have been noticed are as follows, though you must remember that these are some of the rarest side effects and does not necessarily mean to be experienced by everyone taking Viagra.

* Painful genital erection that lasts many hours.
* Convulsions or seizures
* Bleeding of the eye
* Decreased or double vision
* Prolonged and inappropriate erection of the penis.
* Anxiety

You should call a medical doctor immediately if you ever have an erection that lasts more than four hours.

The causes of Erectile Dysfunction

2008-11-29T21:00:00.001-05:00

The causes of erectile dysfunction can be broadly classified into two principal categories, physiological and psychological causes. From these two, physiological factors are found to be the primary cause of erectile dysfunction. However physicians state that approximately eighty-five percent of erectile dysfunction is attributed to physiological/organic conditions while only fifteen percent is due to psychological or mixed origin (both psychological and organic). Moreover, there are some lifestyle factors which are also found to cause erectile dysfunction to a substantial degree.

Physiological Causes Of Erectile Dysfunction

Some of the prominent physiological causes responsible for erectile dysfunction in men are detailed below:

* Vascular diseases like arteriosclerosis, hypertension, hypercholestremia,
* Diabetes
* PrescriptionMedications

(i)Antihypertensives such as beta-blockers, diuretic medications and calcium channel blockers.

(ii)Antidepressant/antipsychoticmedications

(iii)Antiandrogen medications used in the treatment of prostate cancer

(iv) Chemotherapy/radiation therapy used in the treatment of cancer
* Substance abuse like the chronic intake of marijuana, cocaine, alcohol e.t.c.
* Radical Pelvic Surgery
* Neurological Diseases
* Deficiencies in the Endocrine System
* Psychological Erectile Dysfunction
* Anatomical deviation of the penis

Psychological Causes Of Erectile Dysfunction

Even though physiological reasons account for most of the cases of erectile dysfunction, the role played by psychological causes in triggering off erectile dysfunction in men cannot be ruled out altogether. The effective functioning of a man's sexual life depends a lot on his mental well being and only when a man is mentally steady and fine, he is able to extract the maximum sexual satisfaction by physically uniting with his partner. There are a lot of factors that cause mental disturbance in a man and make him a victim of erectile dysfunction thereby ruining his sex life. The psychological causes that lead to erectile dysfunction are namely,

* anxiety with regard to one's sexual performance
* Indifference towards the existing sexual relationship between partners
* Stress caused by hectic lifestyle and other factors
* Serious depression on account of relationship failure, business loss and similar other setbacks
* low self esteem resulting from earlier episodes of unfulfilled sex

Lifestyle Causes of Erectile Dysfunction

A healthy lifestyle prevents the occurrence of erectile dysfunction or male impotence to a considerable extent but if men continue to indulge in harmful vices like smoking, drinking, drug usage et al, then sooner or later they are likely to become erectile dysfunction patients. Important facts concerning lifestyle causes and erectile dysfunction are placed below:

* Excessive alcohol intake may increase high blood pressure levels and induce erectile dysfunction.
* High levels of nicotine released in the blood on account of cigarette smoking and the smoking of other tobacco containing substances reduce blood flow to the penis and lead to erectile dysfunction.
* Apart from alcohol and tobacco containing products, the intake of marijuana, cocaine, ecstasy is also a primary cause of male impotence.
* Overweight men as well as people leading sedentary lifestyle are highly at risk of erectile dysfunction.

Viagra and Depression Induced Erectile Dysfunction

2008-11-29T20:55:00.001-05:00

The term 'Impotence' has been replaced with 'Erectile Dysfunction' by the National Institute Health, USA . The erectile dysfunction is one of the most common sexual problems regarding male sexual health.

Erectile dysfunction has a range of physiological and psychological causes behind its occurrence. The psychological causes take the maximum share amongst the percentage of the reasons responsible for erectile dysfunction. According to a survey for both men and women approximately 78% cases of erectile dysfunction or inhibited sexual desire are of mental or emotional origin. This shows that erectile dysfunction is often the consequence of either sexual guilt or disturbed and cold relationships between the spouses or the partners. It is very important for us to clearly understand the causes which are responsible for erectile dysfunction like fear of intimacy, sexual guilt or may be some recreational drugs.

Coming to an altogether different area of discussion, let us throw some light on depression too which is often found closely related to many cases of erectile dysfunction. Impotence and Depression are highly coexisting condition. Depression is one of the most common and the most serious mental health problems that men are facing today. According to a study published in American Journal of Psychiatry successful treatment of erectile dysfunction or impotence in depressed men can lead to marked improvement in depression. 60% of all men over the age of 40 showed some degree of impotency and 30% of Americans have a depressive disorder every year. Study found a correlation between change in Impotence and change in depressive symptoms - but it was not cleared whether the depression caused impotence erectile dysfunction (ED), or impotence erectile dysfunction (ED) caused the depression.

For millions who suffer from depression the sexual side effects of the medication can be a big turn off for them to continue their treatment with the anti depressants like the selective serotonin inhibitor drugs used for treating depression. In a study it has been proved that Viagra, the oral pill to treat erectile dysfunction, can ease a man in his condition of depression by having a positive impact. When a person knows that he can lead a normal sexual life with Viagra, in spite of the sexual side effects caused by the anti depressants, he will surely not hesitate to shy away from his treatment for depression. This way, a man suffering from anxiety no more has to worry about his sexual problem of erectile dysfunction which is an undesired side effect of taking anti depressants. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation. A Survey indicates that Viagra showed great improvement in Men in their Impotency as well as in their depression.

What is Benign Prostatic Hyperplasia a.k.a Enlarged Prostate?

2008-11-06T14:08:00.001-05:00

Benign prostatic hyperplasia (BPH), known as an enlarged prostate, is a non-cancerous growth of the prostate that commonly occurs in men over 50. The prostate, which is located below the bladder and surrounds the first inch of the urethra (the duct through which urine and sperm are discharged), is a walnut-sized gland that secretes fluid for semen. As a man ages and the prostate gland grows, it compresses the urethra and bladder, resulting in restricted urine flow.
Symptoms of an Enlarged Prostate

While most symptoms of BPH start gradually, the most common ones involve changes or problems with urination.

* Difficulty starting to urinate
* Hesitant, weak urination stream
* Blood in the urine
* Interruption of urination stream

However, the size of the prostate does not determine the severity of a man's symptoms. While some men with extremely swollen glands have little obstruction and few symptoms, others with less enlarged glands experience more blockage and greater problems.

As the urethra narrows and the bladder wall becomes thicker, the bladder itself becomes smaller causing the following symptoms:

* Bladder irritability
* Urge to urinate frequently, especially at night
* Incontinence (the inability to control urination)

Over time BPH can lead to other urinary problems, such as urinary tract infections, bladder or kidney damage and bladder stones. In some cases these symptoms could be a warning of a more serious disease and should be treated by a doctor.
Risk Factors and Preventative Measures

While age is the most common risk factor, ethnicity and genetics also play a role in the development of BPH.

* Age: BPH is rare before the age of 40, but more than half of men in their 60s and as many as 90% in their 70s and 80s have some symptoms of BPH.
* Ethnicity: While BPH is common in Europeans and Americans of European descent, it is rare in Asian men.
* Heredity: Having a family history of BPH greatly increases a man's chances of developing the condition.

Lifestyle changes can also help reduce the occurrence of BPH symptoms:

* Reduce the intake of coffee, tea and soda
* Eat an early dinner to eliminate drinking fluids later in the evening
* Cut down on fluids after 7pm
* Drink 8 glasses of water per day to help prevent accumulation of bacteria
* Avoid over-the-counter (OTC) cold remedies that contain pseudoephedrine and antihistamines
* Avoid spicy and salty foods
* Stay regular (constipation may aggravate the urinary tract)
* Ejaculate regularly
* Take hot baths
* Avoid prolonged sitting
* Drink cranberry juice to increase the acidity of the urinary tract

Treatment Methods

Treatment options vary from case to case depending on the severity of the symptoms. If a patient's symptoms are mild, the usual procedure is "watchful waiting" and no pharmaceutical or surgical treatment is recommended. For moderate symptoms doctors may prescribe alpha-receptor blockers to relax the prostatic-urethral muscle or 5-alpha-reductase inhibitors to help shrink the size of the prostate. In extreme cases surgery is considered the most effective treatment option after other methods have been exhausted. There are different types of surgical treatments used to improve urine flow, including transurethral resection of the prostate (TURP) and transurethral incision of the prostate (TUIP), as well as several newer minimally invasive procedures.

Could Your Child Be Suffering From Attention Deficit Hyperactivity Disorder (ADHD)

2008-11-02T16:45:00.003-05:00

Attention-deficit/hyperactivity disorder (ADHD), previously known as attention deficit disorder (ADD), is a common mental condition characterized by poor concentration, distractibility, hyperactivity and impulsiveness that are inappropriate for the child's age. It affects between 3 and 5% of American children and is usually diagnosed in childhood, although roughly 60% of the cases continue into the adult years.
Symptoms Of ADHD
The symptoms of ADHD can be broken down into 3 different subtypes: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype and a combined subtype.
Symptoms of the inattentive subtype of ADHD include the following:
* difficulty keeping the mind on any one thing
* skipping over details
* getting bored with a task before it’s completed
* making careless mistakes
* being easily distracted from a task, lesson, or conversation
* difficulty listening when directly addressed
* disorganization and forgetfulness
* difficulty following instructions or finishing tasks

Children experiencing the hyperactive/impulsive
form of ADHD may:

* have difficulty with quiet, sedentary activities
* fidget or have trouble staying in their seat
* talk excessively
* blurt out answers before questions are completed
* speak tactlessly or inappropriately
* exhibit difficulty waiting
* move around constantly, often running or climbing inappropriately
* interrupt or intrude on others

The combined subtype applies when a child shows symptoms of both the inattentive and hyperactivity/impulsivity type of ADHD. Children diagnosed with ADHD will exhibit persistent symptom in a variety of settings, including at home, in school and during extracurricular activities.

Causes of ADHD
While the cause of ADHD remains unknown, studies show that the brains of children with ADHD may function differently than those of other children, suggesting an imbalance of chemicals that help regulate behavior. Research also indicates that genetics play a significant role in the development of ADHD, contributing to about three quarters of the total ADHD population. However, roughly 1/5 of all ADHD cases are thought to be acquired after conception due to brain injury caused by substance abuse or physical trauma prenatally or postnatally.
Will my child outgrow ADHD?

While ADHD is considered a chronic disorder, symptoms often get better as children grow older and learn to adjust. Hyperactivity usually stops in the late teenage years, but about half the children diagnosed with ADHD will continue to be easily distracted, have mood swings, hot tempers and are unable to complete tasks. However, parenting plays an important role in helping a child with ADHD. Children with loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.

Treatment of ADHD
Although there is no cure for ADHD, a child’s symptoms can be controlled with a combination of behavioral management, counseling and medication.

Behavioral management can help you and your child identify unwanted behaviors and replace them with more positive ones.

Counseling may include psychotherapy, social skills training or parental training, and it can often help a child deal with low self-esteem, anxiety, depression and stubborn behaviors.

Medication is most effective when it is combined with behavioral management or counseling. While there are many different types of ADHD medication, stimulants are the most common. By affecting the brain’s chemistry, it can help reduce overactivity and increase a child’s attention span.

If you think your child may have ADHA, talk to your doctor to learn what you can do to help.

Breastfeeding Does NOT sag New Mother's Breast

2008-11-02T07:27:00.003-05:00

Breastfeeding won’t make a new mom’s breasts sag, but having more babies might, a new study indicates.
“A lot of times, if a woman comes in for a breast lift or a breast augmentation, she’ll say ‘I want to fix what breastfeeding did to my breasts’,” University of Kentucky plastic surgeon Brian Rinker told Livescience. So he decided to study any possible connection. Rinker and his colleagues interviewed 132 women who came in for breast lifts or augmentation between 1998 and 2006. On average, the women were 39 years old, and 93% had experienced at least one pregnancy. Among the mothers, 58% had breastfed at least one of their children. The average duration of breastfeeding was nine months.
The researchers evaluated the study particpants’ medical history, body mass index, pre-pregnancy bra cup size and smoking status.
The results of the study, presented this week at a conference of the American Society of Plastic Surgeons, showed no difference in the degree of breast ptosis (or sagging) between women who breastfed and those who didn’t. The main factors that did affect sagging were age, smoking status and the number of pregnancies.
Rinker noted that the smoking connection made sense because “smoking breaks down a protein in the skin called elastin, which gives youthful skin its elastic appearance and supports the breast”.
Pregnancy also “has a very strong contribution to breast ptosis (sagging)”, Rinker said. “In fact, our study showed that those negative effects increase with each pregnancy.”
Rinker says this finding should alleviate the fears of new mothers over what nursing their child might do to their breasts in the long run and will encourage them to breastfeed because of the health benefits to their infant. “Women may be reluctant to breastfeed because of this unfounded myth that doing so means the end of youthful breasts,” Rinker said. “Now, expectant mothers can relax knowing breastfeeding does not sacrifice the appearance of their breasts.”

Safe Handling Tips for Preventing Foodborne Illness From Pet Food and Pet Treats

2008-10-30T04:56:00.002-04:00

Consumers can take steps to help prevent foodborne illness, including Salmonella -related illness, when handling pet foods and treats. These products, like many other types of foods, can be susceptible to harmful bacterial contamination.

Salmonella in pet foods and treats can cause serious infections in dogs and cats, and in people too, especially children, older people, and those with compromised immune systems. Salmonella in pet foods and treats potentially can be transferred to people ingesting or handling the contaminated products.

FDA has stepped up its efforts to minimize the incidence of foodborne illness associated with pet foods and treats. Pet owners and consumers can also help reduce the likelihood of infection from contaminated pet foods and treats by following safe handling instructions:
Buying

* Purchase products in good condition, without signs of damage to the packaging such as dents or tears.

Preparation

* Wash your hands for 20 seconds with hot water and soap before and after handling pet foods and treats.
* Wash pet food bowls, dishes, and scooping utensils with soap and hot water after each use.
* Do not use the pet's feeding bowl as a scooping utensil—use a clean, dedicated scoop or spoon.
* Dispose of old or spoiled pet food products in a safe manner, such as in a securely tied plastic bag in a covered trash receptacle.

Storage

* Refrigerate promptly or discard any unused, leftover wet pet food. Refrigerators should be set at 40º F.
* Dry products should be stored in a cool, dry place—under 80º F.
* If possible, store dry pet food in its original bag inside a clean, dedicated plastic container with a lid, keeping the top of the bag folded closed.
* Keep pets away from food storage and preparation areas.
* Keep pets away from garbage and household trash.

Raw Food Diets

FDA does not advocate a raw meat, poultry, or seafood diet for pets, but is stepping up its efforts to minimize the risk such foods pose to animal and human health. The agency understands that some people prefer to feed these types of diets to their pets. For the protection of both you and your pet, the FDA recommends you follow these instructions when handling or using raw meat, poultry or seafood, for use in a pet’s diet:

* Keep raw meat and poultry products frozen until ready to use.
* Thaw in refrigerator or microwave.
* Keep raw food diets separate from other foods. Wash working surfaces, utensils (including cutting boards, preparation and feeding bowls), hands, and any other items that touch or contact raw meat, poultry or seafood with hot soapy water.
* Cover and refrigerate leftovers immediately or discard safely.

In addition:

* For added protection, kitchen sanitizers should be used on cutting boards and counter tops periodically. A sanitizing solution can be made by mixing one teaspoon of chlorine bleach to one quart of water.
* If you use plastic or other non-porous cutting boards, run them through the dishwasher after each use.

Why You must take the Flu Shot this Flu Season?

2008-10-25T18:16:00.001-04:00

Each winter, millions of people suffer from the flu. Flu—the short name for influenza—is caused by viruses. Viruses are very small germs. Some viruses can spread easily from one person to another. They cause illnesses or infections like the flu.

For some people, flu is a mild illness. For older people, especially those who have health problems like diabetes or heart disease, the flu can be very serious.

How Serious Is Flu?

Most people who get the flu feel much better in a week or two. But, some people can get very sick. For example, because your body is busy fighting off the flu, you might pick up a second infection. Older people are at great risk of these secondary infections, such as pneumonia.

How Does Flu Spread?

It was mid-November, and Ellen had not gotten a flu shot. One day she was out having lunch with a friend and noticed people sneezing and coughing at the next table. Two days later, Ellen woke up feeling achy and had a fever. She had the flu. Her husband Jack took care of her and was careful to wash his hands after touching Ellen’s dishes. But, a few days later he too was sick. Maybe he used the phone just after Ellen finished talking with their son. Or, maybe he touched a doorknob Ellen used after sneezing. Flu spreads easily from one person to another.

The flu is contagious—that means it spreads from person to person, often through the air. You can pass on the infection before you feel sick. You are contagious for several days after you get sick. You can catch the flu when someone near you coughs or sneezes. Or, if you touch something the virus is on, like Ellen and Jack’s phone or doorknob, and then touch your nose or mouth, you could catch the flu. The flu virus can live on a surface like a book or doorknob for a number of hours. Remember to wash your hands often when you are around someone who is sick. Make a point of washing them before eating and touching your eyes, nose, or mouth. If you can, stay away from sick people. That will help stop the flu from spreading.

Is It the Flu or a Cold?

It’s easy to confuse a common cold with the flu. A cold is milder than the flu, but since the flu can make older people very sick, you should know the difference. That way you will know when to call the doctor who might want to give you a prescription for medicines that can help you get over the flu.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza.

Why Do You Need A Flu Shot Every Year?

Flu viruses change often. Each year’s virus is just a little different than the year before. So every year the vaccine in the flu shot is changed. That’s one reason why you need a flu shot every fall.

Are There Side Effects?

Most people have no problem with a flu shot. In fact, for most people, the flu is more dangerous than the flu shot. When you get the flu shot, your arm might be sore, red, or swell a bit. These side effects may start shortly after getting the shot and can last up to 2 days. They should not get in the way of your daily activities. A few people do have a headache or a low-grade fever for about a day after they get the shot. The flu shot cannot cause you to get the flu. If you are allergic to eggs, you should not get the flu shot. Because eggs are used to make the flu vaccine, people who are allergic to eggs could have a serious reaction to the shot.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

Can Flu Be Prevented?

Getting a flu shot every year can help you stay healthy. A flu shot contains the flu vaccine, which could keep you from getting the flu. Medicare will pay for the shot, and so will many private health insurance plans. You can get a flu shot at your doctor’s office or from your local health department. Sometimes grocery or drug stores offer flu shots.

A flu shot won’t keep everyone healthy. But, getting the flu shot every year can mean that if you do get the flu, you might have only a mild case.

Who Should Get a Flu Shot?

The Centers for Disease Control and Prevention, part of the Federal Government, says that people age 50 and older should get a flu shot every year. Anyone who lives with or takes care of people age 50 or older should also have a flu shot every year.

When Should I Get My Flu Shot?

Most people get the flu between November and April. That’s why that time is called the flu season. It takes at least 2 weeks for your shot to start working, so try to get your flu shot in October or early November. Don’t worry if you can’t get your flu shot before the flu season starts. The shot can help keep you healthy no matter when you get it.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

It is important to check with your doctor when you first get the flu. Also, call your doctor if:

* your fever goes away and then comes back; you may have a more dangerous infection.
* you start having breathing or heart problems or other serious health problems.
* you feel sick and don’t seem to be getting better.
* you have a cough that begins to make thick mucus.

What About the “Bird” Flu?

Sometimes a new, different kind of flu virus appears. You may have heard about the avian or bird flu. This flu is an example of how changes in a flu virus might lead to serious illness. However, there is some good news about bird flu. It is rare in people. In most cases, the bird flu has not passed from one person to another, and so, it might not become widespread in humans. But this could change over time. Scientists are working on new vaccines that can help protect people from bird flu. Right now, the flu does not protect you against bird flu.

Things to Remember About the Flu

* The flu can be dangerous for older people.
* The flu can be prevented.
* Older people need a flu shot every year.
* Medicare pays for the flu shot.
* The flu shot is safe.

"Sunshine" Vitamin D Reduces Breast Cancer Risk

2008-10-25T18:14:00.001-04:00

Nidhi Sharma
Women who get an adequate amount of vitamin D through daily exposure to the Sun are less likely to develop breast cancer as compared to women who do not, new studies suggests.

The "sunshine vitamin," when taken in high doses may cut the risk of breast cancer by 70%. Vitamin D is synthesized naturally in human body after the skin is exposed to the ultraviolet (UV) rays and lack of UV exposure is linked to higher risk of breast cancer.

A new study led by Garland FC and colleagues from the University of California San Diego showed there is an association between low ultraviolet irradiance and higher breast cancer risk. The study, which is published in the March 17, 2008 issue of Breast Journal also found high levels of vitamin D translated to a 50% lower risk of breast cancer.

The researchers concluded that "there was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates."

A second study by Canadian researchers, found that women who spent time outdoors or got a lot of vitamin D from their diets or supplements. This holds true especially for teens who were 25% to 45% less likely to develop breast cancer than women with less vitamin D.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

The Safety and Risks of Acupuncture Treatment

2008-10-25T18:11:00.004-04:00

Most modern acupuncturists use disposable stainless steel needles of fine diameter (0.007" to 0.020", 0.18 mm to 0.51 mm), sterilized with ethylene oxide or by autoclave. These needles are far smaller in diameter (and therefore less painful) than the needles used to give shots, since they do not have to be hollow for purposes of injection. The upper third of these needles is wound with a thicker wire (typically bronze), or covered in plastic, to stiffen the needle and provide a handle for the acupuncturist to grasp while inserting. The size and type of needle used, and the depth of insertion, depend on the acupuncture style being practised.

Warming an acupuncture point, typically by moxibustion (the burning of a combination of herbs, primarily mugwort), is a different treatment than acupuncture itself and is often, but not exclusively, used as a supplemental treatment. The Chinese term zhen jiu (??), commonly used to refer to acupuncture, comes from zhen meaning "needle", and jiu meaning "moxibustion". Moxibustion is still used in the 21st century to varying degrees among the schools of oriental medicine. For example, one well known technique is to insert the needle at the desired acupuncture point, attach dried moxa to the external end of an acupuncture needle, and then ignite it. The moxa will then smolder for several minutes (depending on the amount adhered to the needle) and conduct heat through the needle to the tissue surrounding the needle in the patient's body. Another common technique is to hold a large glowing stick of moxa over the needles. Moxa is also sometimes burned at the skin surface, usually by applying an ointment to the skin to protect from burns, though burning of the skin is general practice in China.

An example of acupuncture treatment

In western medicine, vascular headaches (the kind that are accompanied by throbbing veins in the temples) are typically treated with analgesics such as aspirin and/or by the use of agents such as niacin that dilate the affected blood vessels in the scalp, but in acupuncture a common treatment for such headaches is to stimulate the sensitive points that are located roughly in the center of the webs between the thumbs and the palms of the patient, the hé gu points. These points are described by acupuncture theory as "targeting the face and head" and are considered to be the most important point when treating disorders affecting the face and head. The patient reclines, and the points on each hand are first sterilized with alcohol, and then thin, disposable needles are inserted to a depth of approximately 3-5 mm until a characteristic "twinge" is felt by the patient, often accompanied by a slight twitching of the area between the thumb and hand. Most patients report a pleasurable "tingling" sensation and feeling of relaxation while the needles are in place. The needles are retained for 15-20 minutes while the patient rests, and then are removed.

In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment, sensations that are stronger than those that would be felt by a patient not suffering from a vascular headache:

* Extreme sensitivity to pain at the points in the webs of the thumbs.
* In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
* Simultaneous relief of the headache.

Indications according to acupuncturists in the West

According to the American Academy of Medical Acupuncture (2004), acupuncture may be considered as a complementary therapy for the conditions in the list below. The conditions labeled with are also included in the World Health Organization list of acupuncture indications. These cases, however, are based on clinical experience, and not necessarily on controlled clinical research: furthermore, the inclusion of specific diseases are not meant to indicate the extent of acupuncture's efficacy in treating them.

* Abdominal distention/flatulence
* Acute and chronic pain control
* Allergic sinusitis
* Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
* Anorexia
* Anxiety, fright, panic
* Arthritis/arthrosis
* Atypical chest pain (negative workup)
* Bursitis, tendinitis, carpal tunnel syndrome
* Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel)
* Cervical and lumbar spine syndromes
* Constipation, diarrhea
* Cough with contraindications for narcotics
* Drug detoxification
* Dysmenorrhea, pelvic pain
* Frozen shoulder
* Headache (migraine and tension-type), vertigo (Meniere disease), tinnitus
* Idiopathic palpitations, sinus tachycardia
* In fractures, assisting in pain control, edema, and enhancing healing process
* Muscle spasms, tremors, tics, contractures
* Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
* Paresthesias
* Persistent hiccups
* Phantom pain
* Plantar fasciitis
* Post-traumatic and post-operative ileus
* Premenstrual syndrome
* Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
* Sequelae of stroke syndrome (aphasia, hemiplegia)
* Seventh nerve palsy
* Severe hyperthermia
* Sprains and contusions
* Temporo-mandibular joint derangement, bruxism
* Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)

Safety and risks

Because acupuncture needles penetrate the skin, many forms of acupuncture are invasive procedures, and therefore not without risk. Injuries are rare among patients treated by trained practitioners.

Certain forms of acupuncture such as the Japanese Toyohari and Shonishin often use non-invasive techniques, in which specially-designed needles are rubbed or pressed against the skin. These methods are common in Japanese pediatric use.

Common, minor adverse events

A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:

* Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
* Hematoma, seen in about 2% of patients, which manifests as bruises. These usually go away after a few days.
* Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce likelihood of fainting.

The survey concluded: "Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions, it is a safe treatment method."

Other injury

* Other risks of injury from the insertion of acupuncture needles include:
* Nerve injury, resulting from the accidental puncture of any nerve.
* Brain damage or stroke, which is possible with very deep needling at the base of the skull.
* Pneumothorax from deep needling into the lung.
* Kidney damage from deep needling in the low back.
* Haemopericardium, or puncture of the protective membrane surrounding the heart, which may occur with needling over a sternal foramen (an undetectable hole in the breastbone which can occur in up to 10% of people [citation needed]).
* Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin.

These risks are slight and can all be avoided through proper training of acupuncturists. For correct perspective, their risk should be compared to the level of side effects of common drugs and biomedical treatment - see below. Graduates of medical schools and (in the US) accreditated acupuncture schools receive thorough instruction in proper technique so as to avoid these events.

Risks from omitting orthodox medical care

Some doctors believe that receiving any form of alternative medical care without also receiving orthodox western medical care is inherently risky, since undiagnosed disease may go untreated and could worsen. For this reason many acupuncturists and doctors prefer to consider acupuncture a complementary therapy rather than an alternative therapy.

Critics also express concern that unethical or naive practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. However, many recent public health departments in modern countries have acknowledged the benefits of acupuncture by instituting regulations, ultimately raising the level of medicine practiced in these jurisdictions.

Safety compared to other treatments

Commenting on the relative safety of acupuncture compared to other treatments, the NIH consensus panel stated that "(a)dverse side effects of acupuncture are extremely low and often lower than conventional treatments." They also stated:

"the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments."

In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA). Two combined studies in the UK of 66,229 acupuncture treatments yielded only 134 minor adverse events. (British Medical Journal 2001 Sep 1). The total of 121,520 treatments with acupuncture therapy were given with no major adverse incidents (for comparison, a single such event would have indicated a 0.0008% incidence).

This is in comparison to 2,216,000 serious adverse drug reactions that occurred in hospitals 1994. (Lazarou J, Pomeranz BH, Corey PN., JAMA. 1998 Apr 15;279(15):1200-5.) So to compare indirectly, Acupuncture has a 0.2% chance of causing a minor adverse effect compared to prescription medications having a 6.7% chance of causing a serious adverse event in a hospital setting.

Gastroenteritis outbreak claims 120 lives in Northern Nigeria

2008-10-21T18:56:00.001-04:00

The Nigerian Ministry of Health is trying to determine what caused a gastroenteritis outbreak that has claimed 120 lives in northern Nigeria’s Sokoto state and dozens more in the northwest, according to national health statistics.

“Unfortunately, it is the environment,” said the Ministry of Health’s deputy director, Abdul Nasidi. “The environment is so dirty. We are trying to work with the Ministry of Environment to inculcate in Nigerians how to live in a better environment. We want to get to the bottom of these outbreaks.”

Not cholera

“It is a serious outbreak,” Sokoto state health commissioner, Jabbi Kilgori, said at the height of the outbreak on 10 October. “We have 23 local government areas and at least 10 are affected. We have between 2,000 and 3,000 people affected and 120 deaths.”

He said authorities had initially thought the illness was cholera.

“We have received reports from four, five states in the northwest in particular,” said the Ministry of Health’s Nasidi on 11 October. “From some of the samples taken, we tested for cholera and they were all negative.”

Similar to cholera, gastroenteritis causes diarrhoea, but beyond that, stomach and intestinal inflammation can also cause pain, nausea and vomiting. Parasite-laden faecal-contaminated drinking or cooking water cause both illnesses. If left untreated, both can quickly kill.

Response

Kilgori told IRIN officials are acting as quickly as possible, contrary to what some locals said was a sluggish start to control the spread: “We [local health officials] are taking measures, including the use of oral dehydration [and] antibiotics, disinfecting the affected areas and ensuring that sanitation is improved – especially where people defecate,” he said, adding that the source of drinking water must be protected.

Kilgori said Sokoto state is distributing gastroenteritis treatments worth US$200,000 in the north.

Rivers, ponds and open wells in northern Nigeria, which serve as the main sources of drinking water in the typically arid communities, have been contaminated by unusually heavy rains in recent months, the doctor told IRIN.

“We have to provide proper latrines to these communities,” said Kilgori. “We are also working to protect the source of drinking water and encourage people to avoid drinking water from open water sources.”

Underreporting

Northern residents said the death toll may be higher as most of the deaths were never reported and the victims were buried the same day, in line with Islamic custom.

“I can confirm 90 deaths in Dange Shunni [in the northern region] alone,” declared Sokoto-based primary health worker, Aminu Abdullahi, who visited the area in early October. “Most of [the people] died at home and were buried without the health authorities being informed.”

Irish Law Reform Commisssion To Consider Advance Medical Directive

2008-10-14T21:22:00.001-04:00

There is a need for legislation to cater for people who want to make advance care directives – in other words, who want to make their wishes known about what should happen to them in the event of an incapacitating accident or illness, the Law Reform Commission (LRC) has said.

An advance care directive sets out a person’s wishes about what should happen to them in the event of an incapacitating accident, such as a serious car crash, or illness, such as a stroke or Alzheimer’s disease, that makes it impossible for them to communicate their wishes directly.

Such a directive can be written or verbal and quite often, the person will also nominate another person to carry out their wishes. This other person is sometimes called a health care proxy.

At its annual conference today, the LRC is launching its Consultation Paper on Bioethics: Advance Care Directives, which forms part of its Third Programme of Law Reform 2008-2014.

The paper provisionally recommends that there is a need for legislation in this area and it makes 25 specific recommendations on the topic. Some of the main recommendations it makes are:

-The proposed legislation would not involve euthanasia or assisted suicide and it would not allow a person to refuse basic care.
-It would only deal with advance care directives involving refusal of treatment, e.g. ‘I do not wish to be resuscitated’. It would not deal with requests for treatment, e.g. ‘I want a liver transplant’.
-An advance care directive could be written or verbal, however one that refuses life sustaining treatment would have to be in writing.
-The proposed legislation could, in general, allow a person to refuse treatment on religious grounds.
-A person should be encouraged to seek medical advice when making an advance care directive, but this should only be mandatory in the case of directives involving the refusal of life sustaining treatment.
-A healthcare professional would not have any legal liability where they follow an advance care directive that they believe to be valid and applicable to the condition being treated.

The Law Reform Commission is an independent statutory body whose main role is to keep the law under review and to make proposals for reform. Today’s conference is taking place at Dublin Castle.

the effectiveness of computer-aided detection (CAD) for screening mammography

2008-10-02T20:41:00.001-04:00

When it comes to reading mammogram results, two heads aren’t always better than one.

A new study found that so-called computer-aided detection (CAD) for screening mammography has rates of cancer detection similar to mammograms read by two different radiologists.

“Reading mammograms by a single reader (radiologist) using CAD has been shown to be as clinically effective as having films read by two expert readers,” said the study’s lead author, Dr. Fiona Gilbert, a professor of radiology at the University of Aberdeen in the United Kingdom.

“Women should be reassured that the final decision on recall is made by the human reader using their knowledge and experience to decide if any areas of the mammogram marked by CAD merit further investigations,” she said.

In the United Kingdom and many European countries, the recommendation is that every mammogram be read by two independent radiologists. This practice isn’t common in the United States, according to Dr. Thomas Hall, director of breast imaging for Providence Hospital in Southfield, Mich. “Most mammograms are single-read in America, though most places now, when they get digital mammography, also get CAD,” he said.

Gilbert said, “We know that two readers will detect approximately 10 percent more cancers than a single reader.” But two readers aren’t always available. Sometimes, there might be seasonal shortages, as might occur during the holidays. Or, it may be that there aren’t enough resources to have multiple radiologists available to read mammography results, she said.

So, Gilbert and her colleagues wanted to know if the computer plus one reader would be similarly effective to two readers.

To assess this question, the researchers randomly assigned more than 31,000 women undergoing routine screening mammography to have their films read by two radiologists, by CAD and one radiologist, or using both measures.

Double reading found 87.7 percent of the cancers, while CAD plus a single reading was able to detect 87.2 percent. Recall rates, that is the number of women called back for further testing due to suspicious findings, were 3.4 percent for double reading and 3.9 percent for single reading with CAD.

The study findings were expected to be published in the Oct. 16 issue of the New England Journal of Medicine, but were posted online Oct. 1.

“CAD could increase the cancer detection rate of a single reader in breast screening centers currently using single reading alone,” said Gilbert, who added that, “in countries where double reading is standard practice, CAD could be used if there is a shortage of readers without compromising cancer detection rates.”

Hall said it’s likely that, if this study had been done with a digital mammography system, the results would have been even better. He said for this study, the researchers took mammography films and scanned them into the computer before the computer reading. That means the computer was essentially checking a copy, and when you copy something, information may be lost, he said.

“There are definite advantages to digital mammography with CAD. Digital helps you visualize the anatomy better, and the CAD helps keep you on your toes,” Hall said.

What You Need to Know About Seasonal Flu Vaccine

2008-09-26T17:53:00.000-04:00

The single best way to protect against the flu is to get vaccinated each year.

There are two types of vaccines:

* The "flu shot"— an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

* The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year.

About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.
When to Get Vaccinated

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

Who Should Get Vaccinated

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

1. Children aged 6 months up to their 19th birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain chronic medical conditions
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:
a. Health care workers
b. Household contacts of persons at high risk for complications from the flu
c. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy* people 2-49 years of age who are not pregnant.
Who Should Not Be Vaccinated

There are some people who should not be vaccinated without first consulting a physician. These include

* People who have a severe allergy to chicken eggs.
* People who have had a severe reaction to an influenza vaccination.
* People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
* Children less than 6 months of age (influenza vaccine is not approved for this age group), and
* People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Effectiveness

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.
Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are

* Soreness, redness, or swelling where the shot was given
* Fever (low grade)
* Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

LAIV (FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include

* runny nose
* wheezing
* headache
* vomiting
* muscle aches
* fever

In adults, side effects from LAIV (FluMist®) can include

* runny nose
* headache
* sore throat
* cough

What You Need to Know About Pinhole Glasses

2008-06-21T08:52:00.003-04:00

Sandy Williams

The technology of pinholes is not new. Neither was it invented by man. Use of principle of pinholes by nature can be seen in the eyes of the mollusk Nautilus found in the Indian and Pacific oceans. It uses its pinhole eyes effectively to scavenge for food.

The science behind pinholes has been known to man since 5th Century BC. Since then he has tried variously to use this knowledge to his benefit. The Ancient Chinese seem to be the first to observe the pinhole effect. They observed that rays from an object would cast an inverted image when passed through a pinhole. Using it, they cast pinhole images of a model 'Pagoda' (a type of tower in Oriental temples) on a screen inside the temple premises.

Later, in the 4th Century BC, Aristotle makes a mention in his book 'Problems', of the curious behavior of sunlight when viewed through a pinhole. It took 2000 years to find solutions for the questions concerning light raised by the philosopher in that book.

Arab mathematician and physicist, Ibn al-Haytham too experimented with the effect of pinholes on candle-light. His observations led to the discovery of linear behavior of light rays.

Ever since then, the principle of pinholes has been used for varied purposes like telling time(Cathedral of Florence, Paolo Toscanelli, 1475), by artists as an aid for drawing (Camera Obscura, Renaissance artists) and for making the Pinhole Camera.

Pinholes as an aid to vision

Eskimos seem to be the first in using the principle of pinholes for helping eyesight. They struggled from the glare of sunlight as it reflected from ice as they went about their daily life. Ingenuously, they used wooden spectacles with very narrow slits to overcome this problem.

Today, Ophthalmologists use instruments based on this principle in diagnosing vision related problems. They use these instruments typically on their patients to measure the sharpness of their vision.

They also use this principle in a piece of equipment called a Pinhole Occluder to check whether vision related problems in their patients are due to refractory errors or not. Patients with refractory errors are seen to have better vision when using this tool than when not using it.

Use of Pinhole Glasses

Even though nature attests the veracity of its effectiveness and modern medicine makes use of its principles, use of pinhole glasses is not as popular as it ought to be.

However, because of a wider spread of word about this tool and resolution of irrelevant problems associated with its use, more and more people are taking interest and availing of its benefits.

Most persistent amongst these problems is what is known as the “Honeycomb Effect”. It arises from a notion that viewing through pinhole glasses would be like viewing through a honeycomb; that you would not be able to see any images at all; that all you would get to see is a lot of plastic.

This has been seen to be untrue and is really a matter of adjustment. For instance, people new to wearing spectacles would testify to the fact that initially a large part of their field of vision is taken up by the frame of their glasses. But after some time, when the brain gets adjusted to the glasses, one no longer perceives the frame.

Similarly, when using pinhole glasses initially the glasses might be more prominent in your vision. But after your eyes get adjusted, you will enjoy nothing but clearer vision.

Diffraction

Another problem that deters people from buying pinhole glasses is reports by some users of occurrence of double images when using them. To understand this problem, it is necessary to know the science behind it.

It is a common phenomenon, and one that can easily be attested to, in daily life that light bends around the corner of objects. Closely observe a shadow formed from a single light source. You will observe a fringe on the edges of the image. This is an example of diffraction or the phenomenon of bending of light rays.

Diffraction happens when light rays pass through the edges of small holes like those in pinhole glasses. Since in these glasses light rays will be entering from multiple holes, you will see fringes bordering the image.

For people with low refractory errors i.e. with lens requirements of less than 6 diopters, this would be hardly noticeable and would pose no problems. But for higher ratings, the diffraction would be significant enough to prevent the user from seeing a clear image. This is the reason why pinhole glasses are not advised for people who have refractive errors greater than 6 diopters.

In fact, at such high ratings, the 'honeycomb effect' explained earlier too will prevent users from experiencing the benefits of wearing pinhole glasses.

READ MORE

When Blood Transfusion Translates To An Early Death

2008-05-19T22:34:00.004-04:00

Kat Piper

Mounting evidence that routinely giving blood transfusions to patients could actually increase their risk of death or other complications has prompted calls for medical staff to be more cautious about who they administer transfusions to.

Jehovah's Witnesses refuse blood transfusions based on a passage from the Bible, which forbids them to "eat blood," but many still successfully undergo operations including open-heart surgery. This, say some surgeons and anaesthetists, should be the way most operations are performed.

Higher death rates
The danger is not from infections such as HIV but from something to do with the blood itself. Many studies over the past ten years have shown that transfusions, particularly of those involving red blood cells, are linked to higher death rates in patients who have had a heart attack, heart surgery, or who are in critical care.

Although the exact nature of the link is not yet known, it seems likely that chemical changes in ageing blood, their impact on the immune system, and the blood's ability to deliver oxygen are key. "Probably 40 to 60 percent of blood transfusions are not good for the patients," said Bruce Spiess, a cardiac anaesthesiologist at Virginia Commonwealth University in Richmond, to New Scientist.

Transfusions first became part of medical procedure during World War One when they were used as a last resort to treat soldiers who had lost a lot of blood. Its usage is now no longer confined to cases of catastrophic bleeding, but is often employed as a routine treatment for patients undergoing surgery or intensive care.

Background
The rationale behind giving transfusions is that by giving patients red blood cells, oxygen is better transported around the body thereby increasing the chances of survival. A healthy person has 120 to 170 grams per liter of haemoglobin—the oxygen-carrying protein in red cells—in their blood, usually with 35 to 50 percent of their blood volume being composed of red cells. Doctors commonly decide to give patients a transfusion if the haemoglobin levels fall to between 70 and 100 grams per litre.

Less effective blood
A 1999 Canadian study of 838 critical care patients found that significantly fewer patients (22 versus 28 percent) died in hospital when treatment with transfusion was limited to patients with haemoglobin levels of less than 70 grams per litre. In 2004, a study published in the Journal of the American Medical Association showed that heart attack patients with red blood cell levels of over 25 percent were three times more likely to die or have another heart attack within 30 days of having a transfusion.

A U.K. study of almost 9,000 heart surgery patients between 1996 and 2003 supports this finding, and indicates a six-fold increase in the risk of death after 30 days with a three-fold increase in the risk within one year following surgery. Transfusions were also associated with more infections and higher incidences of stroke, heart attack, and kidney failure. These complications were usually linked to a lack of oxygen to body tissues.

Little benefit
"There is virtually no high-quality study in surgery, or in intensive or acute care—outside of when you are bleeding to death—that shows that blood transfusion is beneficial and many that show it is bad for you," said Gavin Murphy, a cardiac surgeon at the Bristol Heart Institute and leader of the U.K. study.

Recommendations ignored
Many experts are now worried that guidelines are being ignored. They suggest that transfusions should only be given as a last resort and that preventing blood loss in the first place whilst ensuring patients are not anaemic before they undergo surgery should be prioritised.

"Usually when there is any clinical uncertainty about a treatment you don't give it, but with transfusions we do," said James Isbister of the Royal North Shore Hospital in Sydney, Australia, who is an adviser to the Australian Red Cross Blood Service. But Mr. Isbister still encourages people to donate blood as it is used to treat other conditions as well as extreme blood loss.

The specific reasons why blood transfusions appear to be harmful to some patients are not yet fully understood and further research is being strongly encouraged by health authorities, including the U.S. National Institutes of Health.

6 Key Ways to Manage Social Anxiety

2008-04-03T21:53:00.000-04:00

Matthew Shulman

It is normal to feel nervous and awkward in some social situations. Going on a first date or giving a presentation may give you that uncomfortable feeling of having butterflies in your stomach, for instance.

For some people, though, common, everyday social situations cause extreme anxiety, fear and self-consciousness, and they may become impossible to engage in. You may go to great lengths and come up with many excuses to avoid dating or giving presentations. You may not even be able to eat with acquaintances or write a check at the grocery store, let alone go to a party with lots of strangers.

With anxiety this extreme, you may have social anxiety disorder. Social anxiety disorder is a chronic mental health condition that causes an irrational anxiety or fear of activities or situations in which you believe that others are watching you or judging you. You also fear that you'll embarrass or humiliate yourself.

If you or a loved one has social anxiety disorder, take heart. Effective treatment — often with cognitive behavior therapy, medication and positive coping skills — can improve your quality of life and open up new opportunities.

Social anxiety disorder can be far more crippling than normal shyness, even on the mild end of the disorder's spectrum. Experts offer these tips on how to overcome the symptoms.

1. Pay attention to your breathing. Hyperventilation can bring about a panic attack, so try to take deep, slow breaths.

2. If you're worried about embarrassing yourself at a party or on a date, prepare beforehand by reading the news, catching a broadcast, or seeing a movie. You'll have things to talk about with others.

3. Consider joining an organization like Toastmasters, where speaking to groups is encouraged in a friendly and constructive environment.

4. A lot of anxiety in public situations is normal, but when it becomes pervasive and debilitating, seek the help of a professional. Cognitive-behavior therapy, a form of talk therapy, can help identify unwanted thoughts and develop ways to modify irrational or unrealistic behavior.

5. Psychiatrists sometimes prescribe a combination of cognitive-behavior therapy and medication, which may include selective serotonin-reuptake inhibitors, or SSRIs, other antidepressants, beta blockers, or short-acting benzodiazepines that can help calm you down.

6. After several preparatory sessions, a psychotherapist may bring you into uncomfortable situations in order to engage your feelings head-on and challenge your negative thoughts and associations with those experiences.

Rheumatoid Arthritis, What Is It?

2008-03-29T08:47:00.002-04:00

What is rheumatoid Arthritis?

Rheumatoid arthritis (RA) is traditionally considered a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. It is a disabling and painful inflammatory condition, which can lead to substantial loss of mobility due to pain and joint destruction. The disease is also systemic in that it often also affects many extra-articular tissues throughout the body including the skin, blood vessels, heart, lungs, and muscles.

Signs & Symptoms
Daily joint pain is one of the most common symptoms for rheumatoid arthritis. Most patients also experience some degree of depression, anxiety, and feelings of helplessness. Some of the more common symptoms for rheumatoid arthritis include: morning stiffness in and around the joints, at least three joint areas with simultaneous soft tissue swelling or fluid, and at least one swollen joint area, in the wrist, knuckle, or middle joint of the finger. The disease often affects the wrist and finger joints closest to the hand.

Do you feel pain in at least one of your joints daily?
Yes No

Is your body stiff in the morning around your joints?
Yes No

If you answer yes to any of these questions, see your doctor please

Who gets RA?
More than two million people in the United States have rheumatoid arthritis. Generally, it affects more women than men. RA typically develops between the ages of 25 and 50. While RA itself is not inherited, what can be inherited are the genes that may make someone more likely to develop the disease. Although scientists believe it is unlikely that genes alone bring about RA, research continues to discover what role genes may play in the development of the condition.

How do you know if you have RA?
Only a qualified physician can determine whether or not you have RA. While your general practitioner may be able to diagnose your symptoms, it's a good idea to see a rheumatologist if you suspect you have RA or any other type of arthritis.

Rheumatologists specialize in treating arthritis and are trained to manage conditions involving joints, muscles and bones. They can work with, or as a consultant to, your physician.

The Neuromuscular Disease, Restless Leg Syndrome or RLS

2008-03-06T02:11:00.003-05:00

Restless Leg Syndrome (RLS), also known as Ekbom's Syndrome, is a neurological disorder that affects up to ten per cent of the population at some point in their life.

RLS affects about 15% of Americans, and incidence increases with age. Women have a higher incidence of RLS than men, especially during the last months of pregnancy. The syndrome also appears to run in families.

Although the symptoms are distinctive, many people dismiss the feelings as muscle aches or restlessness, and do not suspect that they have RLS. Thus, RLS is frequently misdiagnosed and often left untreated, resulting in restlessness, insomnia, and daytime sleepiness.

Those Who Have It

For some, RLS is a mild disorder with occasional symptoms. For others, it is much more serious, causing chronic insomnia resulting in daytime fatigue that interferes significantly with everyday life. Said one victim: “I feel as if worms are creeping and crawling in my legs. I need to wiggle my legs to make the feelings go away.”

RLS affects both sexes and is most common and more severe in older people. Most often it is diagnosed in people in their 50’s, though often the symptoms appear decades earlier. Sometimes symptoms can be traced back to childhood. Often, though, RLS goes unrecognized in children. Because they can’t sit still or are constantly fidgeting, young people with RLS are frequently labeled as “hyperactive.”

Though experts recognize RLS to be a neurological disorder, its cause is difficult to pinpoint. In most of those who have it, the cause is unknown. RLS has, however, been linked to certain factors. For example, RLS runs in families, passing genetically from parents to their children. Some pregnant women experience RLS symptoms, especially during the last months of pregnancy. After delivery, the disorder usually disappears. Sometimes medical disorders, such as low iron levels or a lack of certain vitamins, trigger RLS discomfort. Chronic disease may also cause RLS symptoms—particularly kidney failure, diabetes, rheumatoid arthritis, and peripheral neuropathy, damage to the nerves in the hands and the feet.

The Search for Relief

Sadly, there is no cure for RLS, and the symptoms often worsen over the years. However, the good news is that RLS can be treated effectively, often without drugs. There is no one solution; what works for one person may not work for another. Those who have it need to find what habits, activities, or medications either worsen the symptoms or improve them.

A first step in treatment is to decide if there is some correctable medical condition that is causing RLS symptoms. For those who have an iron or vitamin deficiency, supplementing the diet with iron or vitamin B12 may be all that is needed to relieve RLS symptoms. However, taking too many vitamins and minerals can endanger one’s health. Thus, a health-care provider should be involved in deciding whether a person should have iron or vitamin supplements.

In some people caffeine aggravates RLS symptoms. Coffee, tea, chocolate, and many soft drinks contain caffeine. Cutting back on caffeine or cutting it out may help to improve or eliminate RLS symptoms. Alcohol consumption too usually increases the span or intensity of symptoms. By reducing alcohol in the diet or eliminating it, some find relief.

Living With RLS

If you have RLS, life-style changes may help you. Since fatigue and drowsiness often make symptoms worse, a consistent sleep routine can be a real help. If possible, it’s best to have a sleeping environment that is quiet, cool, and comfortable. Going to bed at the same time every evening and waking up at the same time every morning also help.

A regular exercise program will help you get a good night’s sleep. However, vigorous exercise within the six hours before you go to bed may have the opposite effect. Some with RLS find that moderate exercise immediately before bedtime helps them sleep. Experiment with various exercises to discover what is best for you.

Don’t fight the urge to move. If you try to suppress movement, the symptoms usually worsen. Often the best solution is to get out of bed and move about. Some find a measure of relief in walking, stretching, bathing in hot or cold water, or massaging their legs. If you have to sit for a long time, such as when traveling, it may help if you keep your mind actively engaged in reading.

What about medication? The Restless Legs Syndrome Foundation, located in Raleigh, North Carolina, U.S.A., says that “the institution of pharmacologic [drug] therapy may become necessary.” Since there is no one medication that is effective for all who suffer from RLS, your health-care provider may need to find the one that works best for you. Some find that a combination of medications is most effective. Sometimes a medication that works for a while loses its effectiveness. Since taking drugs and especially combinations of drugs carries health risks, it is important to work closely with your health-care provider to determine what works best for you.

More Than Four Hours Daily On Cell Phone Lowers Sperm Count

2008-02-16T08:48:00.002-05:00

In a study of 361 men seen at their infertility clinic, researchers at the Cleveland Clinic found an association between the patients’ cell phone use and their sperm quality.

On average, the more hours the men spent on their cell phones each day, the lower their sperm count and the greater their percentage of abnormal sperm.

The findings, published in the journal Fertility and Sterility, add to questions about the potential health effects of cell phones and other wireless devices. Some studies, for example, have linked long-term cell phone use to a higher risk of brain tumors, though many other studies have found no such connection.

The concern is that, over time, the electromagnetic energy emitted from mobile phones could theoretically harm body tissue — by damaging DNA, for example.

However, the new findings do not prove that cell phones somehow damage sperm, according to the researchers.

“Our results show a strong association of cell phone use with decreased semen quality. However, they do not prove a cause-and- effect relationship,” lead researcher Dr. Ashok Agarwal told Reuters Health.

He and his colleagues based their findings on semen samples from 361 men who came to their infertility clinic over one year. All of the men were questioned about their cell phone habits.

In general, the researchers found, sperm count and sperm quality tended to decline as daily cell phone hours increased. Men who said they used their phones for more than four hours each day had the lowest average sperm count and the fewest normal, viable sperm.

“We infer from our results that heavy cell phone use ... is associated with a lower semen quality,” Agarwal said. But whether cell phones somehow directly affect men’s fertility is not clear.

Agarwal said he and his colleagues have two studies underway aiming to shed light on the issue. In one, they are exposing semen samples to electromagnetic radiation from cell phones to see what, if any, effects occur.

The second is a follow-up to the current study that is assessing a larger group of men. Agarwal said this study is more rigorously designed and will account for certain other factors like lifestyle habits and occupational exposures that might affect sperm quality.

Bloodless Surgery Tops Agenda Among Non-Jehovah's Witnesses

2008-02-05T06:03:00.000-05:00

JOSIE HUANG

Over the last five years, surgeons have replaced Iris Carr's knees, repaired a hip, removed a gall bladder. They have opened her chest to slice away a tumor from her heart.

Not one of those times was she given any blood.

A Jehovah's Witness, Carr is forbidden from getting blood transfusions. So she built up her blood level ahead of time by taking bioengineered drugs and intravenous iron supplements. During open-heart surgery, when blood loss is particularly heavy, Carr's doctors at Maine Medical Center in Portland suctioned off blood that had pooled around the incisions so it could be washed in a machine and returned to her body.

Carr returned home to Cape Elizabeth slightly anemic, but within a couple weeks her blood count was back to normal. And she did not develop any of the infections that can result from receiving someone else's blood: "I'm glad I went through with it," Carr, 89, said.

Bloodless medicine used to be geared toward people with concerns about transfusions. But studies showing that skipping transfusions results in faster recoveries -- and therefore lower hospital costs -- has more medical leaders saying the practice should be for everybody. Maine's largest hospitals are the latest to join a movement among medical facilities to turn no-transfusion medicine from an offering by some of its doctors into a standard of care.

Eastern Maine Medical Center in Bangor started a blood management program with a medical director more than a year ago, while Maine Med this year hired a medical director to lead theirs. A committee of doctors from different departments at Central Maine Medical Center in Lewiston has been meeting on the issue since last spring.

All three hospitals have spent the last several years on reducing transfusions in cardiac surgery, which historically has higher rates of transfusion. Today, both EMMC and Maine Med transfuse roughly a quarter of their patients. CMMC did not provide figures.

"Patients always ask, 'What are the chances of me getting a blood transfusion?'" said Dr. Robert Kramer, a cardiac surgeon who works on quality improvement projects at Maine Med. "We used to say 50/50. Now it's less, and we're hoping to get it even lower and lower."

There still is a need for transfusion in certain situations: the victim of a car crash, or a woman who keeps bleeding after giving birth, may have lost so much blood that a transfusion is the only option.

But even in emergencies, blood conservation techniques can be used so that transfusions can be kept to a minimum, according to the Society for the Advancement of Blood Management, which represents more than 120 blood management programs around the country.

Not only is bloodless medicine safer, it removes the need to buy blood, an increasingly expensive commodity, the group said.

Ten years ago, a unit of blood cost $75 but now it is about $300, said Dr. Jonathan Waters, society president and Chief of Anesthesia Services at Magee-Womens Hospital of the University of Pittsburgh Medical Center. "Those costs have gone through the roof," Waters said. Most of the cost is coming from rigorous testing to make sure blood doesn't contain pathogens and viruses such as HIV or hepatitis. As a result the blood supply is the safest it has ever been, Waters said.

COMPLICATIONS STILL OCCUR

But blood recipients still risk developing transfusion-related problems such as renal or respiratory failure or an infection because the donor's blood is suppressing the patient's immune system. There is also the chance the patient will receive the wrong blood type and develop a bad reaction. For much of the last half-century, the medical community saw the benefits of transfusions as outweighing the risks. The value of donated blood gained wide recognition during the world wars, when advancements in blood storage and distribution helped to save soldiers on the front lines.

After World War II, American Red Cross blood centers and independent blood banks began to crop up across the country.

Interest in finding alternatives to transfusions began to surface with the rise of AIDS during the 1980s. There was also a growth in the number of Jehovah's Witnesses, who believe the Bible prohibits transfusions. An oft-cited verse comes from Genesis: "Only flesh with its soul -- its blood -- you must not eat."

Doctors, on an individual basis, have offered bloodless medicine for decades. In Maine, there are 90 of these doctors, up from just one in the 1970s, according to the Jehovah's Witnesses.

It took longer for hospitals to recognize transfusion-free medicine. The first hospital programs debuted in the 1990s, and began to use multiple blood conservation methods on a large scale.

In the weeks leading up to surgery, a patient could take synthetic erythropoietin or EPO, which stimulates production of red blood cells in the bone marrow.

On the day of the surgery, doctors could remove blood from the patient -- so fewer red blood cells will be shed -- to be returned to the body later. To make up for the lost volume, patient are injected with donated plasma -- the yellowish liquid that blood cells float in -- and saline solution.

OTHER STRATEGIES

Another strategy is to use a "cell-salvage" machine that collects blood pooling during the surgery and filters out the impurities for reinfusion into the body. After the surgery, doctors would make sure to draw smaller amounts of blood for testing than was taken in the past.

At Englewood Hospital, which has one of the oldest and busiest bloodless medicine programs in the country, the transfusion rate among patients receiving coronary artery bypass grafting -- one of the most common surgeries -- is down to 8 percent, said the program's medical director Dr. Aryeh Shander.

Maine hospitals are hoping for similar outcomes by formalizing blood management programs. Dr. Irwin Gross, who runs the EMMC program, said his challenge is to work with a medical establishment -- including doctors, nurses and technicians -- who have been hard-wired to see transfusions only as a life-saving tool.

"There's a lot of work to do in terms of education, changing physician practices and changing hospitals systems so the care is uniform," Gross said. The American Red Cross said the rise of bloodless medicine has taken some of the pressure off the donor blood supply.

"If somebody uses a blood conservation method -- and not a unit of blood -- that makes the unit available to another patient who may need it," said Dr. Patricia Pisciotto, chief medical officer of the Northeast Division of the Red Cross.

But Pisciotto added that bloodless medicine is not commonplace enough to reduce the need for volunteer donors. The Red Cross in Maine said it typically has only several days' worth of blood at any given time.

Snorers More Likely To Develop Chronic Bronchitis

2008-01-28T17:55:00.000-05:00

People who snore regularly are more likely to develop chronic bronchitis, according to a study published today.

Researchers at Korea University Ansan Hospital studied 4270 people (52 per cent men and 48 per cent women) starting in 2001.

Why snoring might lead to bronchitis was not clear, said the team led by Inkyung Baik.

Participants provided information on demographics, health conditions, family disease history and lifestyle, as well as details about how often they snored. They were interviewed again every two years through 2006.

During the four years of follow-up, 314 people developed chronic bronchitis.

Those who snored six to seven times a week were 68 per cent more likely to develop bronchitis than those who never snored.

Those who snored five times a week or less were 25 per cent more likely to develop bronchitis.

The association was strongest in individuals who had never smoked, who worked in the home or who were overweight.

"It has been suggested that structural or functional changes in the airway due to inflammation may cause snoring and obstructive sleep apnea syndrome," the authors wrote.

"Conversely, repeated snoring vibrations may act as mechanical stresses, leading to increased inflammatory response in the upper airway."

Further study is needed to confirm the association as the "mechanisms underlying the association between snoring and chronic bronchitis are largely unknown," the authors concluded.

Finding And Feeling The G-Spot Made Easy

2008-01-06T07:42:00.000-05:00

For many women, the G-Spot is a highly sensitive, highly erotic area that provides hours of pleasure. For others it's a knobbly bit that, when touched too much, creates an overwhelming sensation of needing a wee.
Yet for some others they wonder What the G-Spot is? Where it is? What to do with it and how to feel it during intercourse? Playing this video might help.

Bloodless Surgery: Safer And Cost Saving For Patients

2008-01-03T08:47:00.000-05:00

ANI
The pioneer of transfusion-free bloodless surgery has revealed just why the technique is so beneficial, especially for patients wary of transfusions or those whose religion does not allow for it.

People such as Jehovah's Witness patients believe that accepting blood from a source other then themselves defies the scriptural teachings that their religion holds steadfast.

"Jehovah's Witness patients no longer have to die for want of blood," says Patricia Ford, MD, a hematologist/oncologist and Medical Director of the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital, part of the PENN Medicine hospital network.

Dr. Ford is one of the pioneers of bloodless surgery and has been teaching its technique to doctor's around the world.

One technique a bloodless surgery can employ is called "cell salvage" in which blood lost during surgery is siphoned from the body, passed through a filter for cleaning and returned to the body.

The physician can also use it during surgery to limit blood loss and to avoid the need for transfusion of blood from sources other than the patient.

Originally developed to meet the needs of the Jehovah's Witness community, bloodless surgery is transfusion-free and is acceptable to Jehovah Witness followers because they are being reinfused with their own blood.

Bloodless surgery and medicine is a viable and life-saving option for these patients and those wary of the safety of the blood supply, and it is safe for a growing number of surgical and medical conditions, except for acute leukaemia and traumatic injury.

"Bloodless procedures have proven to be safer than blood transfusion because they help eliminate complications resulting from transfusions such as immunosuppression, infection, diseases from emerging pathogens for which our blood supply is not yet tested," said Dr. Ford.

"The hospital stay is also shorter for our bloodless patients, a cost savings for the patient and the institution," she continues.

Pennsylvania Hospital in Philadelphia is one of the pioneering centres for bloodless medicine and surgery.

Dr. Ford likens the weeks-old blood often used for transfusions to "water from a dirty fish tank." Depleted of most of its oxygen-carrying capacity, the stored blood is not maximally beneficial to any patient.

Prior to surgery, Dr. Ford prepares patients carefully - using medicines to build red blood cells, and managing their haemoglobin count. A higher haemoglobin level lowers the risk of transfusion.

Dr. Ford has performed the largest number of successful stem cell transplants without blood transfusion of anyone in the world. Among the procedures for which Dr. Ford has prepared patients for bloodless medicine and surgery are cardiothoracic surgery; radical hysterectomies, prostatectomies, cystectomies, and repair of aneurysms, chemotherapy management, and total hip and knee surgery.

The bloodless team at Pennsylvania Hospital has saved the lives of many Jehovah's Witness patients who otherwise would not have received care.

"We see patients from all over the country who come to us for our expertise in bloodless medicine. The needs of the Jehovah's Witness community have helped us develop practices that can not only save their lives, but can also benefit the entire patient community," concluded Dr. Ford.

Angolan Men Hide Their HIV Status From Their Spouses

2007-12-07T16:37:00.001-05:00

Maria Antónia* began to wonder about her husband's frequent trips to neighbouring South Africa, especially when he was away for 15 days without contacting her on one occasion.

She decided to investigate whether he was going to South Africa to see another woman, but discovered that he was going to get antiretroviral (ARV) medication because he was HIV positive.

Miguel André's wife died in 2001, officially from typhoid fever, but before she died she told her child's godmother that she had AIDS. She never found the courage to tell her husband, but the news spread and soon everyone in Benguela, a coastal town in central Angola, was talking about it. André was the last to find out that his wife had been HIV positive.

Stories like these are repeated time and again in Angola, but fear of a partner's reaction, fear of being abandoned, fear of discrimination, even fear of shame, are just some of the reasons that prevent people living with HIV from telling those dear to them.

Many only discover the HIV status of their partners after they have died, and then learn that they are also infected, but it is often hard to know who infected whom, or how. An estimated 2.5 percent of Angola's 16 million people are living with HIV/AIDS.

To tell or not to tell?

The debate in Angola about the role of healthcare workers in disclosing the HIV status of their patients has been heated. On the one hand there are those who believe that health workers should do their utmost to find the spouses of patients living with HIV, as was once the case with syphilis, and there should be compulsory notification. Others say doctor-patient confidentiality should be preserved at all costs.

António Coelho, executive secretary of the Network of AIDS Service Organisations (known by the Portuguese acronym Anaso), feels there should not be mandatory notification of spouses, but rather awareness-raising to enable HIV-positive patients to tell their partners.

He stressed that by law "infected persons have the duty to inform those people with whom they have or intend to have sexual relations about their serological status."

But Catarina Saldanha, executive secretary of Mwenho, an association of HIV-positive women, believes that doctors should inform their patients' spouses.

Saldanha, who is HIV positive, told IRIN/PlusNews this was to protect the partners of people living with HIV, because the network of sexual relations is often not restricted to spouses, but extends to previous partners and extra-spousal relations.

She said some doctors in Angola were already doing this: they told patients that they could continue treatment only if their spouse or partner also came to the next appointment.

The country's network of people living with HIV/AIDS is calling for a compromise. "First, the doctor should exhaust every possibility of changing the infected person's behaviour. If this doesn't work, the doctor should make his position clear regarding intentional infection - that it is a crime punishable by law," said Noé Mateus, the network's executive secretary.

"But confidentiality can and should be discarded as soon as the physician realises that the infected person's behaviour places his or her spouse or others at risk of becoming infected."

The mysterious cassette tape

UNAIDS official Roberto Campos said confidentiality should be maintained in all instances, without exception. "People have to have the sovereignty to reveal their serological status to whomever they wish. They and they alone have this right, under any and all circumstances."

Campos stressed that because of the extremely high levels of stigma still associated with HIV/AIDS, doctors could place patients at risk of being publicly condemned by revealing their seropositivity. "Health professionals must be competent enough to give patients all the information they need to make the decision," he added.

António Feijó, the director of Hospital Esperança ("Hope" in Portuguese), a healthcare facility for HIV patients in the capital, Luanda, said doctors should encourage their patients to tell. "Notifying a patient's spouse about his or her serological status cannot be decided in an arbitrary manner ... It's immoral to treat one of them and leave the other's life at risk."

When she was 17, Suzana* married her first boyfriend. After 25 years of marriage her husband died in her arms, but she only learned that he had died of an AIDS-related illness when, during the funeral, she heard a cassette tape on which he confessed to being HIV-positive.

Her husband had given the cassette to a nephew, who thought it contained his wishes regarding his estate and it would therefore be appropriate to play the tape at the funeral.

With clearer rules covering confidentiality and HIV, the final message left by Suzana's husband could have been a message of love, or even about his estate, rather than a painful confession of his positive status.

* Not their real names

Drink to Stupor And Still Feel Good The Next Day

2007-12-01T08:37:00.000-05:00

The root cause of all hangovers is, of course, drinking alcohol. If you drink enough and end up with a hangover, it means you've ingested more alcohol than your body can metabolize efficiently. The toxins in alcohol build up in your body and make you feel sick. A chief culprit is a chemical called acetaldehyde. This is an alcohol by-product that research suggests may cause the worst of your hangover symptoms.

Admittedly, I binge drink two or three times per month (the version where one drinks 5+ drinks in one evening). I know this isn’t especially good for my physical well-being, but being a 28 year old male in New York City it’s a common or even conservative amount. I am not proud of this fact, but know I do it and admit that it’s not healthy. I try to drink in a way where it affects me the least. I try to not ruining the following day, by avoiding a hangover. Below are a few ways to help you do this if you don’t already have your own method.

Hangover1. My Method. An old colleague once gave me his method of hangover prevention. It always worked for him, so I tried it, and I’m a fan. You must do this before you go to sleep, but it’s easy to do. After you finish drinking alcohol, drink a sports drink or a liquid with mostly water and electrolytes. Any drink with glucose will do. My colleague always liked Gatorade. I like Glacéau Vitamin Water. Drink as much as you can without feeling too water logged. With this drink, take a pair of ibuprofen pills.

2. Eating. Eating before you drink will help slow the absorption of the alcohol. Starchy foods like bread and pasta are best for this. Drinking also causes loss of essential minerals like vitamins B & C. Eat foods to get these back. Fruit is a great solution.

3. Water. Drink lots of water before, during, and after drinking. This will prevent dehydration.

4. Know what to drink. Don’t drink drinks that hide the taste of alcohol too much. You will drink fast and too much. The exception here is fruit drinks have the vitamins you lose through alcohol. If you must drink hard liquor, get cranberry with it once to get those vitamins back.

Avoid beverages that have given you hangovers before. Pay attention to which alocohol triggers a hangover, as results vary from person to person. Red wine has a exceeding negative effect for many people.

Some says additives make a hangover worse. I’m not sure about this, but I would be willing to bet artificial added chemicals and ingredients don’t help the situation.

Side tip: Have any chemistry ambitions inside you? Start to brew your own beer! In college, I joined a beer brewing club. It’s a great way to meet people, have fun, and learn to make and drink great beer! You can save money this way too. But I bring this up because of another great reason to brew, the lower hangover effect. Homemade beer has most of the vitamins you lose when drinking! Yeast is filtered out in most macrobrews, but usually not in homebrews. This yeast is rich in B vitamins. I never had a hangover from our homebrews.Hangover

5. Pills and Medicine. Though I prefer eating because you also get the sugars and water you need from food, you can directly ingest the vitamins you are losing by drinking with supplements. Some companies also have cocktail type pills with everything you need supposedly. I tried Chasers a few times. They worked, but am not really sure if it was the pills or the fact I also took the measures I always take.

Another point worth mentioning is the choice of pain killers before or after going to bed. Although acetaminophen is one of the most popular pain killers, alcohol metabolism increases the toxic effect acetaminophen has on the liver. Go with Asprin.

I know this may sound like a public safety announcement, but I also have to mention it because of so many people I know have been affected by it in one way or another, including myself. Don’t drink and drive!

The Ugly Side Of Coffee

2007-11-29T22:01:00.000-05:00

There are hundreds, if not thousands, of books which discuss the wide-range of views concerning the mass use of caffeine in our culture.

From my own research, it does not seem to be much of a debate- nutritionists and scientists have repeatedly shown, in a myriad of ways, that the caffeine chemical is not very healthy for the human body.

In his book Caffeine Blues Stephen Cherniske, M.S goes so far to propose that if caffeine were introduced today as a new food additive, the FDA would never approve it.

He explains that any substance that causes such extreme reactions—heart palpitations, anxiety, panic, insomnia, and even birth defects—would be treated as a new drug and denied status as a food additive.

This is an interesting perspective, and if you are a big coffee drinker I urge you to consider the sentiment. The purpose of this article is to expound on Mr. Cherniske’s insights and explore some unique and interesting characteristics of caffeine that you may not have known.

Before I get to these points, let me say that although I will paint a pretty negative picture of coffee and caffeine, my goal is NOT to scold you and suggest that you stop drinking coffee immediately.

I hope some of the things I explain opens your eyes to the elemental effects of caffeine, but I also understand, and believe, there is a very real enjoyment for many people in a nice, hot cup of Java (for me too, sometimes)!

With that said, here are a few interesting things I bet you didn’t know about coffee and caffeine:

Its a Pesticide

By definition, caffeine is a naturally occurring compound found in the beans, leaves, and fruit of over 60 plants where it acts as a natural pesticide that paralyzes and kills certain insects feeding on the plants. If you drink a lot of coffee and caffeinated drinks, I urge you to read that sentence again and start seeing caffeine in this light—as a substance produced with the sole purpose to harm creatures that ingest it.

Its Highly Acidic

To date, over 700 volatile substances have been found in coffee, including more than 200 acids and an incredible array of alcohols, aromatic compounds and carbonyl compounds.

It Erodes Your Ability to Metabolize Blood Sugar

Caffeine stimulates the fight or flight stress response in humans and plays a major role in hypoglycemia (a condition where blood sugar levels fall below normal). As part of this response, the liver rapidly raises blood sugar levels. This is felt as a “lift” to the person consuming caffeine, but the body must then deal with the metabolic emergency of hyperglycemia, or elevated blood sugar.

This is accomplished by the pancreas, which secretes insulin, driving the blood sugar down. Over time, this “wear and tear” of our blood sugar metabolism causes the system to become ineffective and can result in hypoglycemia and even diabetes.

There is NO Positive Science

According to Mr. Cherniske: “No scientific study has ever shown that coffee is good for you. The discussion only concerns the degree to which it will harm you”. Interesting.

It Causes Chronic Digestive Problems

Caffeine lowers the stress threshold of our bodies so that the events we would normally handle suddenly become insurmountable. Because of this, coffee consumption is a major contributor to bloating, pain and gas that roughly 50% of Americans adults experience after they eat.

It Leads to “Caffeinism” Which Is Very Serious

In large amounts, and especially over extended periods of time, caffeine can lead to a condition known as caffeinism. Caffeinism is defined on Wikipedia as: “combining caffeine dependency with a wide range of unpleasant physical and mental conditions including nervousness, irritability, anxiety, tremulousness, muscle twitching, insomnia, headaches, respiratory alkalosis and heart palpitations”.

Furthermore, because caffeine increases the production of stomach acid, high usage over time can lead to peptic ulcers, erosive esophagitis, and gastroesophageal reflux disease.

With all this said, nearly 100 million American adults drink three or more cups of coffee a day. But does that make it right? Consider that sometimes we make decisions in our lives based NOT upon what is real, but upon habit, or upon what other people want us to think.

“If five million people do a foolish thing, it is still a foolish thing” –Ancient Chinese Proverb

Here are a few more myths about caffeine, effectively debunked:

Caffeine Gives You Energy

* Caffeine does not provide energy, only chemical stimulation. The perceived “energy” comes from the body’s struggle to adapt to increased blood levels to stress hormones.

Caffeine Gives You a Lift

* Using coffee for mood enhancement is a short-term blessing and a long-term curse. While the initial adrenal stimulation may provide a transient antifatigue “lift”, caffeine’s ultimate mood effect is a letdown, either subtle or profound.

Caffeine Sharpens Your Mind

* While caffeine users may feel more alert, the experience is simply one of increased sensory and motor activity (dilated pupils, increased heart rate, and higher blood pressure). The quality of thought and recall is improved no more than the quality of music is improved when played at a higher volume or speed!

In all, caffeine is substance that purports to give you energy by stimulating your nervous system. But it really isn’t giving you anything, and is in fact harming you! That’s because caffeine creates tension, and the ultimate result of tension is always fatigue.

So how can you start “getting off” caffeine? There are a million and one ways to do this, and I plan on writing a follow-up article on this subject within the next week. Here are some basic suggestions you can start with right away:

SUGGESTIONS

- Brew your coffee with 50% decaf

- Switch to an herbal tea, herbal coffee or another caffeine alternative

- Get a smaller coffee mug

- Spill half of your favorite Starbucks concoction out, before you start drinking it

- Make your coffee weaker by adding more milk

- If you must drink coffee, have it after eating a big meal (preferably after lunch)

- Start eating foods high in minerals

- Try Gingko Biloba

- Drink more water

- Do not drink coffee first thing in the morning

- Do not drink coffee before you go to bed

- Try coffee substitutes

- Drink less potent caffeinated drink

I hope this article was informative, and opened your eyes to some of the very real dangers of continuous caffeine consumption. Look for a second article next week which goes into some more detail about how to weed yourself off caffeine, or better yet, please share your thoughts and experiences in the comment field below!

Key Facts You Need To Know About Avian Influenza (Bird Flu) and Avian Influenza A (H5N1) Virus

2007-11-13T13:15:00.000-05:00

This is a fact sheet by Centers for Disease Control and Prevention, dated January 18, 2006, provided for general information about bird flu and information about one type of bird flu, called avian influenza A (H5N1) that is infecting birds in Asia and has infected some humans.

What is avian influenza (bird flu)?

Bird flu is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, bird flu is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them.

Infection with avian influenza viruses in domestic poultry causes two main forms of disease that are distinguished by low and high extremes of virulence. The “low pathogenic” form may go undetected and usually causes only mild symptoms (such as ruffled feathers and a drop in egg production). However, the “highly pathogenic” form spreads more rapidly through flocks of poultry. This form may cause disease that affects multiple internal organs and has a mortality rate that can reach 90-100%, often within 48 hours.

How does avian influenza spread among birds?

Infected birds shed influenza virus in their saliva, nasal secretions, and feces. Susceptible birds become infected when they have contact with contaminated excretions or with surfaces that are contaminated with excretions or secretions. Domesticated birds may become infected with avian influenza virus through direct contact with infected waterfowl or other infected poultry or through contact with surfaces (such as dirt or cages) or materials (such as water or feed) that have been contaminated with the virus.

Do bird flu viruses infect humans?

Bird flu viruses do not usually infect humans, but more than 100 confirmed cases of human infection with bird flu viruses have occurred since 1997. The World Health Organization (WHO) maintains situation updates and cumulative reports of human cases of avian influenza A (H5N1). Please visit these and previous WHO situation updates and cumulative reports for additional information.

How do people become infected with avian influenza viruses?

Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry (e.g., domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretions and excretions from infected birds. The spread of avian influenza viruses from an ill person to another person has been reported very rarely, and transmission has not been observed to continue beyond one person. During an outbreak of avian influenza among poultry, there is a possible risk to people who have direct or close contact with infected birds or with surfaces that have been contaminated with secretions and excretions from infected birds.

What are the symptoms of avian influenza in humans?

Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress syndrome), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection.

How is avian influenza detected in humans?

A laboratory test is needed to confirm avian influenza in humans.

What are the implications of avian influenza to human health?

Two main risks for human health from avian influenza are 1) the risk of direct infection when the virus passes from the infected bird to humans, sometimes resulting in severe disease; and 2) the risk that the virus – if given enough opportunities – will change into a form that is highly infectious for humans and spreads easily from person to person.

How is avian influenza in humans treated?

Studies done in laboratories suggest that the prescription medicines approved for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to determine the effectiveness of these medicines.

Does the current seasonal influenza vaccine protect me from avian influenza?

No. Influenza vaccine for the 2005-06 season does not provide protection against avian influenza.

Should I wear a surgical mask to prevent exposure to avian influenza?

Currently, wearing a mask is not recommended for routine use (e.g., in public) for preventing influenza exposure. In the United States, disposable surgical and procedure masks have been widely used in health-care settings to prevent exposure to respiratory infections, but the masks have not been used commonly in community settings, such as schools, businesses, and public gatherings.

Is there a risk for becoming infected with avian influenza by eating poultry?

There is no evidence that properly cooked poultry or eggs can be a source of infection for avian influenza viruses. For more information about avian influenza and food safety issues, visit the World Health Organization website .

The U.S. government carefully controls domestic and imported food products, and in 2004 issued a ban on importation of poultry from countries affected by avian influenza viruses, including the H5N1 strain. This ban still is in place. For more information, see Embargo of Birds, http://www.cdc.gov/flu/avian/outbreaks/embargo.htm .

We have a small flock of chickens. Is it safe to keep them?

Yes. In the United States there is no need at present to remove a flock of chickens because of concerns regarding avian influenza. The U.S. Department of Agriculture monitors potential infection of poultry and poultry products by avian influenza viruses and other infectious disease agents.

What precautions can be taken to reduce the risk for infection from wild birds in the United States?

As a general rule, the public should observe wildlife, including wild birds, from a distance. This protects you from possible exposure to pathogens and minimizes disturbance to the animal. Avoid touching wildlife. If there is contact with wildlife do not rub eyes, eat, drink, or smoke before washing hands with soap and water. Do not pick up diseased or dead wildlife. Contact your state, tribal, or federal natural resource agency if a sick or dead animal is found.

What precautions can hunters take to reduce the risk for infection when hunting birds in the United States?

Hunters should follow routine precautions when handling game, including wild birds. The National Wildlife Health Center recommends that hunters:

* Do not handle or eat sick game.
* Wear rubber or disposable latex gloves while handling and cleaning game, wash hands with soap and water (or with alcohol-based hand products if the hands are not visibly soiled), and thoroughly clean knives, equipment and surfaces that come in contact with game.
* Do not eat, drink, or smoke while handling animals.
* Cook all game thoroughly.

Avian Influenza A (H5N1)

What is the avian influenza A (H5N1) virus that has been reported in Asia and Europe?

Influenza A (H5N1) virus – also called “H5N1 virus” – is an influenza A virus subtype that occurs mainly in birds, is highly contagious among birds, and can be deadly to them.

Outbreaks of avian influenza H5N1 occurred among poultry in eight countries in Asia (Cambodia , China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam) during late 2003 and early 2004. At that time, more than 100 million birds in the affected countries either died from the disease or were killed in order to try to control the outbreaks. By March 2004, the outbreak was reported to be under control.

Since late June 2004, however, new outbreaks of influenza H5N1 among poultry have been reported by several countries in Asia (Cambodia, China [Tibet], Indonesia, Kazakhstan, Malaysia, Mongolia, Russia [Siberia], Thailand, and Vietnam). It is believed that these outbreaks are ongoing. Influenza H5N1 infection also has been reported among poultry in Turkey and Romania and among wild migratory birds in Croatia .

Human cases of influenza A (H5N1) infection have been reported in Cambodia, China, Indonesia, Thailand, Turkey, and Vietnam. For the most current information about avian influenza and cumulative case numbers, see the World Health Organization website at http://www.who.int/csr/disease/avian_influenza/en/.

What are the risks to humans from the current H5N1 outbreak in Asia and Europe?

H5N1 virus does not usually infect people, but more than 140 human cases have been reported. Most of these cases have occurred from direct or close contact with infected poultry or contaminated surfaces; however, a few cases of human-to-human spread of H5N1 virus have occurred.

So far, spread of H5N1 virus from person to person has been rare and has not continued beyond one person. Nonetheless, because all influenza viruses have the ability to change, scientists are concerned that H5N1 virus one day could be able to infect humans and spread easily from one person to another. Because these viruses do not commonly infect humans, there is little or no immune protection against them in the human population.

If H5N1 virus were to gain the capacity to spread easily from person to person, an influenza pandemic (worldwide outbreak of disease) could begin. No one can predict when a pandemic might occur. However, experts from around the world are watching the H5N1 situation in Asia and Europe very closely and are preparing for the possibility that the virus may begin to spread more easily from person to person.

How does H5N1 virus differ from seasonal influenza viruses that infect humans?

Of the few avian influenza viruses that have crossed the species barrier to infect humans, H5N1 virus has caused the largest number of reported cases of severe disease and death in humans. In the current situation in Asia, more than half of the people infected with the virus have died. Most cases have occurred in previously healthy children and young adults. However, it is possible that the only cases currently being reported are those in the most severely ill people and that the full range of illness caused by the H5N1 virus has not yet been defined.

Unlike seasonal influenza, in which infection usually causes only mild respiratory symptoms in most people, H5N1 infection may follow an unusually aggressive clinical course, with rapid deterioration and high fatality. Primary viral pneumonia and multi-organ failure have been common among people who have become ill with H5N1 influenza.

How is infection with H5N1 virus in humans treated?

Most H5N1 viruses that have caused human illness and death appear to be resistant to amantadine and rimantadine, two antiviral medications commonly used for treatment of patients with influenza. Two other antiviral medications, oseltamivir and zanamavir, would probably work to treat influenza caused by H5N1 virus, but additional studies are needed to demonstrate their current and ongoing effectiveness.

Is there a vaccine to protect humans from H5N1 virus?

There currently is no commercially available vaccine to protect humans against the H5N1 virus that is being detected in Asia and Europe. However, vaccine development efforts are taking place. Research studies to test a vaccine that will protect humans against H5N1 virus began in April 2005, and a series of clinical trials is under way. For more information about the H5N1 vaccine development process, visit the National Institutes of Health website .

What does CDC recommend regarding H5N1 virus?

In February 2004, CDC provided U.S. public health departments with recommendations for enhanced surveillance (“detection”) of H5N1 influenza in the country. Follow-up messages, distributed via the Health Alert Network, were sent to the health departments on August 12, 2004, and February 4, 2005; both alerts reminded public health departments about recommendations for detecting (domestic surveillance), diagnosing, and preventing the spread of H5N1 virus. The alerts also recommended measures for laboratory testing for H5N1 virus. To read the alerts, visit Health Updates on Avian Influenza .

Does CDC recommend travel restrictions to areas with known H5N1 outbreaks?

CDC does not recommend any travel restrictions to affected countries at this time. However, CDC currently advises that travelers to countries with known outbreaks of H5N1 influenza avoid poultry farms, contact with animals in live food markets, and any surfaces that appear to be contaminated with feces from poultry or other animals. For more information, visit Travelers' Health update.

Is there a risk in handling feather products that come from countries experiencing outbreaks of avian influenza A (H5N1)?

The U.S. government has determined that there is a risk to handling feather products from countries experiencing outbreaks of H5N1 influenza.

There is currently a ban on the importation of birds and bird products from H5N1-affected countries in Asia and Europe. The regulation states that no person may import or attempt to import any birds (Class Aves), whether dead or alive, or any products derived from birds (including hatching eggs), from the following countries: Cambodia, Indonesia, Japan, Laos, Kazakhstan, Malaysia, People's Republic of China, Romania, Russia, South Korea, Thailand, Turkey, Ukraine, and Vietnam (current as of December 29, 2005). This prohibition does not apply to any person who imports or attempts to import products derived from birds if, as determined by federal officials, such products have been properly processed to render them noninfectious so that they pose no risk of transmitting or carrying H5Nl and which comply with the U.S. Department of Agriculture (USDA) requirements. Therefore, feathers from these countries are banned unless they have been processed to render them noninfectious. Additional information about the import ban is available on the USDA website.

Is there a risk to importing pet birds that come from countries experiencing outbreaks of avian influenza A (H5N1)?

The U.S. government has determined that there is a risk to importing pet birds from countries experiencing outbreaks of H5N1 influenza. CDC and USDA have both taken action to ban the importation of birds from areas where H5N1 has been documented. There is currently a ban on the importation of birds and bird products from H5N1-affected countries in Asia. The regulation states that no person may import or attempt to import any birds (Class Aves), whether dead or alive, or any products derived from birds (including hatching eggs), from the following countries: Cambodia, Indonesia, Japan, Laos, Kazakhstan, Malaysia, Peoples' Republic of China, Romania, Russia, South Korea, Thailand, Turkey, Ukraine, and Vietnam. (current as of December 29, 2005) .

Can a person become infected with avian influenza A (H5N1) virus by cleaning a bird feeder?

There is no evidence of H5N1 having caused disease in birds or people in the United States . At the present time, the risk of becoming infected with H5N1 virus from bird feeders is low. Generally, perching birds (Passeriformes) are the predominate type of birds at feeders. While there are documented cases of H5N1 causing death in some Passeriformes (e.g., house sparrow, Eurasian tree-sparrow, house finch), in both free-ranging and experimental settings, most of the wild birds that are traditionally associated with avian influenza viruses are waterfowl and shore birds.

Influenza Pandemic Preparedness

What changes are needed for H5N1 or another avian influenza virus to cause a pandemic?

Three conditions must be met for a pandemic to start: 1) a new influenza virus subtype must emerge; 2) it must infect humans and causes serious illness; and 3) it must spread easily and sustainedly (continue without interruption) among humans. The H5N1 virus in Asia and Europe meets the first two conditions: it is a new virus for humans (H5N1 viruses have never circulated widely among people), and it has infected more than 100 humans, killing over half of them.

However, the third condition, the establishment of efficient and sustained human-to-human transmission of the virus, has not occurred. For this to take place, the H5N1 virus would need to improve its transmissibility among humans. This could occur either by “reassortment” or adaptive mutation.

Reassortment occurs when genetic material is exchanged between human and avian viruses during co-infection (infection with both viruses at the same time) of a human or pig. The result could be a fully transmissible pandemic virus—that is, a virus that can spread easily and directly to humans. A more gradual process is adaptive mutation, where the capability of a virus to bind to human cells increases during infections of humans.

What is CDC doing to prepare for a possible H5N1 flu pandemic?

CDC is taking part in a number of pandemic prevention and preparedness activities, including:

* Providing leadership to the National Pandemic Influenza Preparedness and Response Task Force, created in May 2005 by the Secretary of the U.S. Department of Health and Human Services.
* Working with the Association of Public Health Laboratories on training workshops for state laboratories on the use of special laboratory (molecular) techniques to identify H5 viruses.
* Working with the Council of State and Territorial Epidemiologists and others to help states with their pandemic planning efforts.
* Working with other agencies such as the Department of Defense and the Veterans Administration on antiviral stockpile issues.
* Working with the World Health Organization (WHO) and Vietnamese Ministry of Health to investigate influenza H5N1 in Vietnam and to provide help in laboratory diagnostics and training to local authorities.
* Performing laboratory testing of H5N1 viruses.
* Starting a $5.5 million initiative to improve influenza surveillance in Asia .
* Holding or taking part in training sessions to improve local capacities to conduct surveillance for possible human cases of H5N1 and to detect influenza A H5 viruses by using laboratory techniques.
* Developing and distributing reagents kits to detect the currently circulating influenza A H5N1 viruses.

CDC also is working closely with WHO and the National Institutes of Health on safety testing of vaccine candidates and development of additional vaccine virus seed candidates for influenza A (H5N1) and other subtypes of influenza A viruses.

Qualitative Alternatives To Blood Transfusion

2007-11-06T20:34:00.000-05:00

You might feel, 'Transfusions are hazardous, but are there any high-quality alternatives?' A good question, and note the word "quality."

Everyone, including Jehovah's Witnesses, wants effective medical care of high quality. Dr. Grant E. Steffen noted two key elements: "Quality medical care is the capacity of the elements of that care to achieve legitimate medical and nonmedical goals." (The Journal of the American Medical Association, July 1, 1988) "Nonmedical goals" would include not violating the ethics or Bible-based conscience of the patient. —Acts 15:28, 29.

Are there legitimate and effective ways to manage serious medical problems without using blood? Happily, the answer is yes.

Though most surgeons have claimed that they gave blood only when absolutely necessary, after the AIDS epidemic arose their use of blood dropped rapidly. An editorial in Mayo Clinic Proceedings (September 1988) said that "one of the few benefits of the epidemic" was that it "resulted in various strategies on the part of patients and physicians to avoid blood transfusion." A blood-bank official explains: "What has changed is the intensity of the message, the receptivity of clinicians to the message (because of an increased perception of risks), and the demand for consideration of alternatives." —Transfusion Medicine Reviews, October 1989.

Note, there are alternatives! This becomes understandable when we review why blood is transfused.

The hemoglobin in the red cells carries oxygen needed for good health and life. So if a person has lost a lot of blood, it might seem logical just to replace it. Normally you have about 14 or 15 grams of hemoglobin in every 100 cubic centimeters of blood. (Another measure of the concentration is hematocrit, which is commonly about 45 percent.) The accepted "rule" was to transfuse a patient before surgery if his hemoglobin was below 10 (or 30 percent hematocrit). The Swiss journal Vox Sanguinis (March 1987) reported that "65% of [anesthesiologists] required patients to have a preoperative hemoglobin of 10 gm/dl for elective surgery."

But at a 1988 conference on blood transfusion, Professor Howard L. Zauder asked, "How Did We Get a 'Magic Number'?" He stated clearly: "The etiology of the requirement that a patient have 10 grams of hemoglobin (Hgb) prior to receiving an anesthetic is cloaked in tradition, shrouded in obscurity, and unsubstantiated by clinical or experimental evidence." Imagine the many thousands of patients whose transfusions were triggered by an 'obscure, unsubstantiated' requirement!

Some might wonder, 'Why is a hemoglobin level of 14 normal if you can get by on much less?' Well, you thus have considerable reserve oxygen-carrying capacity so that you are ready for exercise or heavy work. Studies of anemic patients even reveal that "it is difficult to detect a deficit in work capacity with hemoglobin concentrations as low as 7 g/dl. Others have found evidence of only moderately impaired function." —Contemporary Transfusion Practice, 1987.

While adults accommodate a low hemoglobin level, what of children? Dr. James A. Stockman III says: "With few exceptions, infants born prematurely will experience a decline in hemoglobin in the first one to three months . . . The indications for transfusion in the nursery setting are not well defined. Indeed, many infants seem to tolerate remarkably low levels of hemoglobin concentration with no apparent clinical difficulties." —Pediatric Clinics of North America, February 1986.

Such information does not mean that nothing need be done when a person loses a lot of blood in an accident or during surgery. If the loss is rapid and great, a person's blood pressure drops, and he may go into shock. What is primarily needed is that the bleeding be stopped and the volume in his system be restored. That will serve to prevent shock and keep the remaining red cells and other components in circulation.

Volume replacement can be accomplished without using whole blood or blood plasma.* Various nonblood fluids are effective volume expanders. The simplest is saline (salt) solution, which is both inexpensive and compatible with our blood. There are also fluids with special properties, such as dextran, Haemaccel, and lactated Ringer's solution. Hetastarch (HES) is a newer volume expander, and "it can be safely recommended for those [burn] patients who object to blood products." (Journal of Burn Care & Rehabilitation, January/February 1989) Such fluids have definite advantages. "Crystalloid solutions [such as normal saline and lactated Ringer's solution], Dextran and HES are relatively nontoxic and inexpensive, readily available, can be stored at room temperature, require no compatibility testing and are free of the risk of transfusion-transmitted disease." —Blood Transfusion Therapy —A Physician's Handbook, 1989.

You may ask, though, 'Why do nonblood replacement fluids work well, since I need red cells to get oxygen throughout my body?' As mentioned, you have oxygen-carrying reserves. If you lose blood, marvelous compensatory mechanisms start up. Your heart pumps more blood with each beat. Since the lost blood was replaced with a suitable fluid, the now diluted blood flows more easily, even in the small vessels. As a result of chemical changes, more oxygen is released to the tissues. These adaptations are so effective that if only half of your red cells remain, oxygen delivery may be about 75 percent of normal. A patient at rest uses only 25 percent of the oxygen available in his blood. And most general anesthetics reduce the body's need for oxygen.

HOW CAN DOCTORS HELP?

Skilled physicians can help one who has lost blood and so has fewer red cells. Once volume is restored, doctors can administer oxygen at high concentration. This makes more of it available for the body and has often had remarkable results. British doctors used this with a woman who had lost so much blood that "her haemoglobin fell to 1.8 g/dlitre. She was successfully treated . . . [with] high inspired oxygen concentrations and transfusions of large volumes of gelatin solution [Haemaccel]." (Anaesthesia, January 1987) The report also says that others with acute blood loss have been successfully treated in hyperbaric oxygen chambers.

Physicians can also help their patients to form more red cells. How? By giving them iron-containing preparations (into muscles or veins), which can aid the body in making red cells three to four times faster than normal. Recently another help has become available. Your kidneys produce a hormone called erythropoietin (EPO), which stimulates bone marrow to form red cells. Now synthetic (recombinant) EPO is available. Doctors may give this to some anemic patients, thus helping them to form replacement red cells very quickly.

Even during surgery, skilled and conscientious surgeons and anesthesiologists can help by employing advanced blood-conservation methods. Meticulous operative technique, such as electrocautery to minimize bleeding, cannot be overstressed. Sometimes blood flowing into a wound can be aspirated, filtered, and directed back into circulation.#

Patients on a heart-lung machine primed with a nonblood fluid may benefit from the resulting hemodilution, fewer red cells being lost.

And there are other ways to help. Cooling a patient to lessen his oxygen needs during surgery. Hypotensive anesthesia. Therapy to improve coagulation. Desmopressin (DDAVP) to shorten bleeding time. Laser "scalpels." You will see the list grow as physicians and concerned patients seek to avoid blood transfusions. We hope that you never lose a great amount of blood. But if you did, it is very likely that skilled doctors could manage your care without using blood transfusions, which have so many risks.

SURGERY, YES —BUT WITHOUT TRANSFUSIONS

Many people today will not accept blood. For health reasons, they are requesting what Witnesses seek primarily on religious grounds: quality medical care employing alternative nonblood management. As we have noted, major surgery is still possible. If you have any lingering doubts, some other evidence from medical literature may dispel them.

The article "Quadruple Major Joint Replacement in Member of Jehovah's Witnesses" (Orthopaedic Review, August 1986) told of an anemic patient with "advanced destruction in both knees and hips." Iron dextran was employed before and after the staged surgery, which was successful. The British Journal of Anaesthesia (1982) reported on a 52-year-old Witness with a hemoglobin level under 10. With the use of hypotensive anesthesia to minimize blood loss, she had a total hip and shoulder replacement. A surgical team at the University of Arkansas (U.S.A.) also used this method in a hundred hip replacements on Witnesses, and all the patients recovered. The professor heading the department comments: "What we have learned from those (Witness) patients, we now apply to all our patients that we do total hips on."

The conscience of some Witnesses permits them to accept organ transplants if done without blood. A report of 13 kidney transplants concluded: "The overall results suggest that renal transplantation can be safely and efficaciously applied to most Jehovah's Witnesses." (Transplantation, June 1988) Likewise, refusal of blood has not stood in the way even of successful heart transplants.

'What about bloodless surgery of other types?' you may wonder. Medical Hotline (April/May 1983) told of surgery on "Jehovah's Witnesses who underwent major gynecological and obstetric operations [at Wayne State University, U.S.A.] without blood transfusions." The newsletter reported: "There were no more deaths and complications than in women who had undergone similar operations with blood transfusions." The newsletter then commented: "The results of this study may warrant a fresh look at the use of blood for all women undergoing obstetric and gynecological operations."

At the hospital of Göttingen University (Germany), 30 patients who declined blood underwent general surgery. "No complications arose that could not also have arisen with patients who accept blood transfusions. . . . That recourse to a transfusion is not possible should not be overrated, and thus should not lead to refraining from an operation that is necessary and surgically justifiable." —Risiko in der Chirurgie, 1987.

Even brain surgery without using blood has been done on numerous adults and children, for instance, at New York University Medical Center. In 1989 Dr. Joseph Ransohoff, head of neurosurgery, wrote: "It is very clear that in most instances avoidance of blood products can be achieved with minimal risk in patients who have religious tenets against the use of these products, particularly if surgery can be carried out expeditiously and with a relatively short operative period. Of considerable interest is the fact that I often forget that the patient is a Witness until at the time of discharge when they thank me for having respected their religious beliefs."

Finally, can intricate heart and vascular surgery without blood be performed on adults and children? Dr. Denton A. Cooley was a pioneer in doing just that. As you can see in the medical article reprinted in the Appendix, on pages 27-9, based on an earlier analysis, Dr. Cooley's conclusion was "that the risk of surgery in patients of the Jehovah's Witness group has not been substantially higher than for others." Now, after performing 1,106 of these operations, he writes: "In every instance my agreement or contract with the patient is maintained," that is, to use no blood.

Surgeons have observed that good attitude is another factor with Jehovah's Witnesses. "The attitude of these patients has been exemplary," wrote Dr. Cooley in October 1989. "They do not have the fear of complications or even death that most patients have. They have a deep and abiding faith in their belief and in their God."

This does not mean that they assert a right to die. They actively pursue quality care because they want to get well. They are convinced that obeying God's law on blood is wise, which view has a positive influence in nonblood surgery.

Professor Dr. V. Schlosser, of the surgical hospital at the University of Freiburg (Germany), noted: "Among this group of patients, the incidence of bleeding during the perioperative period was not higher; the complications were, if anything, fewer. The special view of illness, typical of Jehovah's Witnesses, had a positive influence in the perioperative process." —Herz Kreislauf, August 1987.

Doripenem Injection (Doribax) Gets FDA Approval For Treating Complicated Urinary Tract and Intra-Abdominal Infections

2007-10-18T08:07:00.000-04:00

The U.S. Food and Drug Administration has approved doripenem injection, 500 mg intravenous infusion, for the treatment of complicated urinary tract and intra-abdominal infections. Doripenem injection, sold under the trade name Doribax, has been shown to be active against several strains of bacteria.

“This is a significant new drug in the treatment of hospitalized patients with serious bacterial infections,” said Janet Woodcock, M.D., FDA’s deputy commissioner for scientific and medical programs, chief medical officer and acting director, Center for Drug Evaluation and Research.

In several multi-center, multinational studies, doripenem was shown to have a cure rate comparable to the currently prescribed medications levofloxacin, for complicated urinary tract infections, and meropenem, for complicated intra-abdominal infections.

The most common adverse reactions reported were headache, nausea, diarrhea, rash, and phlebitis. In addition, allergic reactions have occurred and some may require immediate treatment.

The safety and effectiveness of doripenem injection in pediatric patients have not been established. Doripenem has not been studied in pregnant women, and the drug should be used during pregnancy only if clearly needed.

Doripenem injection is manufactured by Johnson and Johnson Pharmaceutical Research and Development, LLC, Raritan, N.J.

However it is beneficial to know symptoms of Urinary Tract infections before they become complicated or if one has a clean slate prevent it.

UTI-bladder-Urinary tract infection symptoms:

* Burning sensation when urinating
* Persistent strong urge to urinate
* Going frequently on bathroom passing small amounts of urine
* Strong smelling urine , blood in the urine or cloudy
Prevention of urinary tract infection:
You can take action to prevent urinary tract infection:

* Drink a lot of liquid Cranberry juice(not if you are taking the blood-thinning medication warfarin) and especially water. Cranberry juice is known as good natural remedy for urinary tract infection.
* Urinate promptly, when urge arises. Don't retain urine for a long time after you feel urge to urinate.
* Wipe from front to back after urinating and after bowel movement. It helps bacteria in the anal region from spreading to the vagina and urethra.
* Clean your genital area before sex intercourse
* Empty your bladder as soon as possible after sex intercourse
* Avoid using feminine products that could be potentially irritable, such as deodorant sprays for genital areas.
* Take showers instead of tub baths

FDA,s Approved Source Of Puffer Fish

2007-10-18T08:05:00.000-04:00

The Food and Drug Administration (FDA) is advising consumers only to eat puffer fish (also known as fugu, bok, blowfish, globefish, swellfish, balloonfish, or sea squab) from two known safe sources. The safe sources are 1) imported puffer fish that have been processed and prepared by specially trained and certified fish cutters in the city of Shimonoseki, Japan, and 2) puffer fish caught in the mid-Atlantic coastal waters of the United States, typically between Virginia and New York. Puffer fish from all other sources potentially contain deadly toxins and therefore are not considered safe.

The liver, gonads (ovaries and testes), intestines, and skin of some puffer fish contain the toxins tetrodotoxin and/or saxitoxin. These toxins are 1,200 times more deadly than the poison cyanide and can affect a person's central nervous system. There are no known antidotes for these toxins. Puffer fish must be cleaned and prepared properly so the organs containing the toxins are carefully removed and do not cross-contaminate the flesh of the fish. These toxins cannot be destroyed by cooking or freezing.

Symptoms resulting from ingesting either of the toxins include tingling of the lips and mouth, followed by dizziness, tingling in the extremities, problems with speaking, balance, muscle weakness and paralysis, vomiting, and diarrhea. These symptoms can begin anywhere from 20 minutes to 2 hours after eating the toxic fish. In extreme cases death can result from respiratory paralysis.

The Japanese government licenses specially trained fish cutters to process and prepare puffer fish. These fish are imported into the United States two to three times per year for special occasions, by only one approved New York importer, Wako International, under an FDA/Japanese government agreement. This is the only acceptable source of imported puffer fish. They are sold only to restaurants and dishes containing the fish are often very expensive, sometimes costing hundreds of dollars for a full meal.

Puffer fish caught from the mid-Atlantic coastal waters of the United States do not contain these deadly toxins and are considered safe to eat. They are less expensive than imported puffer fish and may be found in markets or restaurants. However, puffer fish caught off the east coast of Florida should not be eaten because the entire fish is potentially toxic.

Before ordering or buying puffer fish, consumers should ask where it came from to ensure it is from a known safe source. Consumers who are unsure of the source should not eat puffer fish.

To Spanish Readers

Coma pez globo sólo de fuentes seguras conocidas

La Administración de Medicamentos y Alimentos (FDA, Food and Drug Administration) recomienda a los consumidores que coman pez globo (también conocido como, fugu, bok, botete diana, pez inflado o pez rechoncho) sólo de fuentes seguras conocidas. Las fuentes seguras son: 1) pez globo importado que se ha procesado y preparado por cortadores de pescado certificados y especialmente capacitados en la ciudad de Shimonoseki, Japón, y 2) pez globo que se pesca en las aguas costeras del Atlántico medio de los Estados Unidos, normalmente entre Virginia y Nueva York. Los peces globo de todas las demás fuentes pueden contener toxinas mortales, por lo que no se consideran seguros.

El hígado, las gónadas (ovarios y testículos), los intestinos y la piel de algunos peces globo contienen las toxinas tetrodotoxina o saxitoxina. Estas toxinas son 1,200 veces más mortales que el cianuro y pueden afectar el sistema nervioso central de una persona. No se conocen antídotos para estas toxinas. El pez globo se debe limpiar y preparar de manera adecuada para que los órganos que contienen las toxinas se retiren cuidadosamente y no se produzca la contaminación cruzada de la carne del pescado. Estas toxinas no se pueden destruir con la cocción o congelación.

Los síntomas que aparecen al ingerir cualquiera de las toxinas incluyen hormigueo en los labios y la boca, seguido de mareos, hormigueo en las extremidades, problemas para hablar, con el equilibrio, debilidad muscular y parálisis, vómitos y diarrea. Estos síntomas pueden comenzar desde 20 minutos hasta 2 horas después de comer el pescado tóxico. En casos extremos, se puede producir la muerte debido a una parálisis respiratoria.

El gobierno japonés autoriza a cortadores de pescado especialmente capacitados para procesar y preparar pez globo. Estados Unidos importa estos pescados dos a tres veces al año para ocasiones especiales, y lo hace a través de un sólo importador aprobado de Nueva York, Wako International, en virtud de un acuerdo entre la FDA y el gobierno japonés. Ésta es la única fuente aceptable de pez globo importado. Se vende sólo a restaurantes y los platos que contienen el pescado a menudo son muy costosos, en ocasiones llegando a costar cientos de dólares una comida completa.

El pez globo que se pesca en las aguas costeras del Atlántico medio de los Estados Unidos no contiene estas toxinas mortales y se considera seguro para comer. Cuesta menos que el importado y se puede encontrar en mercados o restaurantes. Sin embargo, el pez globo que se pesca en la costa este de Florida no se debe comer porque el pescado completo puede ser tóxico.

Antes de pedir o comprar pez globo, los consumidores deben preguntar por su origen para asegurarse de que proviene de una fuente segura conocida. Los consumidores que no están seguros de la fuente no deben comer pez globo.

The U.S. FDA Approves Raltegravir Tablets As New HIV Drug

2007-10-16T18:34:00.000-04:00

The U.S. Food and Drug Administration (FDA) has approved raltegravir tablets for treatment of Human Immunodeficiency Virus (HIV)-1 infection in combination with other antiretroviral agents in treatment-experienced adult patients who have evidence of viral replication and HIV-1 strains resistant to multiple antiretroviral agents.

Raltegravir is the first agent of the pharmacological class known as HIV integrase strand transfer inhibitors, designed to interfere with the enzyme that HIV-1 needs to multiply. Raltegravir, sold under the trade name Isentress, received a priority review by the FDA.

“This is an important new product for many HIV-infected patients whose infections are not being controlled by currently available medications,” said Janet Woodcock, M.D., FDA’s deputy commissioner for scientific and medical programs, chief medical officer and acting director, Center for Drug Evaluation and Research.

When used with other anti-HIV medicines, raltegravir may reduce the amount of HIV in the blood and may increase white blood cells, called CD4+ (T) cells, that help fight off other infections.

FDA’s approval of raltegravir is based on data from two double-blind, placebo-controlled studies in 699 HIV-1 infected adult patients with histories of extensive antiretroviral use. A greater proportion of the patients who received raltegravir in combination with other anti-HIV drugs experienced reductions in the amount of HIV in the blood, compared with patients who received placebo in combination with other anti-HIV drugs.

The most common adverse events reported with raltegravir were diarrhea, nausea, and headache. Blood tests also showed abnormal elevated levels of a muscle enzyme in some patients receiving raltegravir. Caution is advised when using raltegravir in patients at increased risk for certain types of muscle problems, including those who use other medications that can cause muscle problems.

Patients taking raltegravir may still develop infections, including opportunistic infections or other conditions that may develop in patients living with HIV-1 infection. The long-term effects of raltegravir are not known, and its safety and effectiveness in children less than 16 years of age has not been studied.

Raltegravir also has not been studied in pregnant women. Women who are taking HIV medications when they get pregnant are advised to talk with their physician or other health care professional about use of this drug during pregnancy, and about registering with the Antiviral Pregnancy Registry if they use raltegravir.

Raltegravir is distributed by New Jersey-based Merck & Co., Inc.

OTC Cough and Cold Oral infant Medicines Voluntarily Withdrawn Due To Abuse

2007-10-11T11:53:00.000-04:00

The Consumer Healthcare Products Association (CHPA) on behalf of the leading makers of over-the-counter cough and cold medicines today announced voluntary market withdrawals of oral cough and cold medicines that refer to "infants." The voluntary withdrawal affects only these "infant" oral medicines, not those intended and labeled for use in children age two and older.

"It’s important to point out that these medicines are safe and effective when used as directed, and most parents are using them appropriately," said Linda A. Suydam, D.P.A, president of CHPA. "The reason the makers of over-the-counter, oral cough and cold medicines for infants are voluntarily withdrawing these medicines is that there have been rare patterns of misuse leading to overdose recently identified, particularly in infants, and safety is our top priority."

The branded cough and cold medicines that are being voluntarily withdrawn are:

* Dimetapp® Decongestant Plus Cough Infant Drops
* Dimetapp® Decongestant Infant Drops
* Little Colds® Decongestant Plus Cough
* Little Colds® Multi-Symptom Cold Formula
* PEDIACARE® Infant Drops Decongestant (containing pseudoephedrine)
* PEDIACARE® Infant Drops Decongestant & Cough (containing pseudoephedrine)
* PEDIACARE® Infant Dropper Decongestant (containing phenylephrine)
* PEDIACARE® Infant Dropper Long-Acting Cough
* PEDIACARE® Infant Dropper Decongestant & Cough (containing phenylephrine)
* Robitussin® Infant Cough DM Drops
* Triaminic® Infant & Toddler Thin Strips® Decongestant
* Triaminic® Infant & Toddler Thin Strips® Decongestant Plus Cough
* TYLENOL® Concentrated Infants' Drops Plus Cold
* TYLENOL® Concentrated Infants' Drops Plus Cold & Cough

This voluntary withdrawal does not affect medicines intended for children age two and older. CHPA and its member companies have put forth recommendations to the U.S. Food and Drug Administration (FDA) to strengthen the labels on all oral OTC children’s cough and cold medicines from "ask a doctor" before using to "do not use" in children under two years.

CHPA made these recommendations to the FDA in preparation for a joint FDA advisory committee meeting on October 18 and 19. These recommendations, as well as several additional recommendations, including those proposed by FDA review staff, will be explored further at this meeting.

"These medicines are—and always have been—safe at recommended doses," Suydam said.

"These voluntary actions are being taken out of an abundance of caution. The vast majority of parents and caregivers safely use these medicines to help relieve their children’s symptoms. But as with all medicines, it’s important that parents read over-the-counter medicine labels carefully, use these medicines only as directed, and store them safely out of the reach of children."

CHPA will be launching a major, multi-year national campaign to educate parents and healthcare providers about the safe use of over-the-counter medicines in children, partnering with major physician, nurse, and pharmacist organizations.

Controversial Vaccine Drops Cases Of Meningococcal B In Rotorua And Taupo In News Zealand

2007-10-10T10:59:00.000-04:00

Alison Brown

A drop in the number of cases of meningococcal B in Rotorua and Taupo is proof a controversial vaccine is working, health experts say.

There have been no cases of meningococcal B in Rotorua or Taupo this year. Nationally, 76 people have contracted the potentially deadly illness.

The figures are well down on the hundreds of cases reported at the height of the epidemic, which has swept the country for 16 years.

Bay of Plenty medical officer of health Phil Shoemack says there's no doubt the immunisation campaign has been effective.

"The vaccine has accelerated the natural decrease in the epidemic. When you look at how much of an impact it's had, we wish we could have had it earlier so fewer kids would have got the disease."

Since 1991 about 6000 New Zealanders - half of them under 6 - have been struck down by the disease and 245 people have died. At the height of the epidemic, Bay of Plenty was among the worst regions affected, recording double the rate of cases as the rest of the country.

In the two years before the vaccine became available in the Bay of Plenty, 107 cases were reported - 29 in 2004 and 78 in 2003. Two people died.

Meningococcal B is an infection of the fluid of the spinal cord and fluid surrounding the brain. It is caused by bacterium and can kill within 24 hours. Other strains of the disease are caused by a virus. Symptoms can be mistaken for influenza and include fever, severe headaches, vomiting, drowsiness, muscular aches and a stiff neck.

In an attempt to control the epidemic, the Ministry of Health launched a massive $220 million vaccination programme targeting babies and teenagers in 2004. Free but not mandatory, it became available in Rotorua and Taupo in February 2005. About 32,100 people under 20 in the Lakes district have been eligible for the vaccine - 82 per cent or 26,400 have completed the programme.

The figures are slightly less for Maori, with 78 per cent of eligible Maori receiving all their doses.

About 5800 out of 7629 preschoolers (76 per cent) have been immunised. Of the 4139 Maori under fives eligible for the vaccine, 2730 (66 per cent) have completed the programme.

Vaccination rates for school-aged children are higher. Of the 24,540 eligible for the vaccine, about 20,600 (84 per cent) have completed the programme. About 9600 out of 11,740 Maori school children and teenagers (82 per cent) have received their three doses.

The school-age immunisation campaign has finished but the health ministry has indicated vaccinations will continue to be available for under-5s until 2009.

Health Rotorua chief executive and Maori health manager Eugene Berryman-Kamp said Lakes has had more success reaching Maori in all age groups than other regions.

Massage Hurts, But Hurts So Good

2007-10-08T17:48:00.000-04:00

Jo McCarroll

I am a bit of sadist when it comes to having a massage, which might sound like a non-sequitur but it isn't really. Because while there is a wide variety of massages on offer, in the end there are only really two - hard massage and soft massage.

Some people like those fluffy soft massages, all tinkling music and feathery stroking.

Me, I'd rather chew glass. If I'm having a massage, I like a bruising deep tissue massage right on that edge of pain.

I am already a fan of Thai massage, which is usually, in my experience, quite exquisitely agonising (don't be fooled by the often tiny therapist - they often have superhuman upper body strength). However, I had never tried a Thai herbal hot compress ($200 for 90 minutes), an ancient form of massage and one of the signature treatments at Senses Spa at the Westin Hotel.

It uses a "massage ball", a poultice stuffed with lemon grass, plai, soap pod, turmeric and kaffir lime (among other things), soaked in hot oil and then rubbed onto your skin, followed by a full body massage.

The massage ball looks exactly like a larger version of one of those money balls you get as part of a mixed entree platter at a Thai restaurant - in fact, the waft of lemon grass that pervades the room is quite reminiscent of Thai restaurants as well (in the most pleasant way, I hasten to add).

Lemongrass, apparently, helps you relax - and the herbs that make up the compress all have healing or soothing properties. Plai, which is from the same plant family as ginger, combats joint and muscle problems; soap pod, a Thai herb similar to tamarind, improves the texture of the skin; turmeric is good for skin problems; and Kaffir lime works on skin tone.

The essential oils in the plants are released into the heated massage oil - devotees of this treatment claim it has a number of health benefits, in particular relieving muscle sprains and joint stiffness.

But the health benefits, for me, are not the point of having a massage, what I want is to de-stress and relax. And, my God, after an hour-and-a-half of being rubbed with this hot massage ball (and be warned it is hot, almost to the point where it's uncomfortable) I felt like I was practically liquid.

Having (rather swaggeringly) told the therapist I liked my massages fairly hard, she more than took me at my word: ow, ow, ow, ooo, ooo, ooo God yes.

At the end my arms barely had the strength to lift my cleansing ginger tea. Those of you who like your light ticklings and barely-there back rub, steer clear.

But for the rest of us it's best summed up in just three words: hurts so good.

Gordon McEwen, A Veteran Chef Allergic To Fish

2007-10-06T20:36:00.000-04:00

Julie Jacobson

Gordon McEwen could be forgiven for wanting to cry into his kilt at times. The veteran chef, who has cooked for some of the diplomatic community's most powerful members, is acutely allergic to fish.

But the former Wellington restaurateur hasn't let what many would consider to be a major handicap get in the way of a stellar 40-year career in the kitchen.

Now at the Tauranga Club in the Bay of Plenty, McEwen spent the past 19 years as chef to five US ambassadors. During that time he catered for several world leaders and dozens of visiting dignitaries.

It was while working at the ambassador's Lower Hutt residence he had his first reaction to seafood.

"I'd been cooking fish for 25 years. I'd just had a meal when my eyes started falling out of my head and my lips began swelling up. It was not very pleasant."

Since then, he has used gloves to prepare the fish and shellfish meals for which he has become renowned.

At the same time, he "cooks" in his head - "I imagine the dish and the taste in my mind".

McEwen's wife, Elizabeth, and other kitchen staff are called on to check seasoning and taste any new dish he develops.

He says the allergy has had unexpected results - he believes his kitchen has some of the highest hygiene standards in the business.

"I take huge care in the kitchen not to cross-contaminate anything. I've had to become very aware of the implements I use, which means everyone else in the kitchen picks up on that."

While it doesn't hamper what goes on the menu - calamari in a soy-lime dressing; chilli, garlic and ginger prawns; and fresh fish with an Asian mustard sauce and balsamic vinegar drizzle are some of his dishes - it has occasionally put a dampener on McEwen's social life.

He has learned not to kiss his wife immediately after she has eaten seafood, and there have been several times when he's especially chosen steak at a restaurant only to suffer a reaction. "I've known straight away that whoever cooked that steak had been handling fish."

Despite that, McEwen still loves fish. He waxes lyrical when describing the preparation that goes into his dishes, and says he remembers distinctly what fish tastes like; "the texture on my tongue, Akaroa smoked salmon ... it sometimes drives me insane that I can't taste it".

He admits to being so tempted by a nice piece of fresh fish that he ate several small pieces "just in case I'd got over it.

"Unfortunately, I learned the hard way that I hadn't."

Ironically, Thai fish sauce, tinned salmon and tuna, and marinated mussels, are four things that don't trigger a reaction.

Nor does smelling seafood. "Like any- one else, I can tell what's fresh and what isn't," he laughs.

Tattoo Removal Surgeries Now Gaining Grounds

2007-09-25T19:22:00.000-04:00

Diamonds, cockroaches, and tattoos are forever. But wait a minute - that's no longer true of the latter. These days, a tattoo can be here today and gone over the course of several painful tomorrows.

For many regretful men and women, what used to be a permanent reminder of a passing fad is now written in erasable ink. Tattoo removal surgeries, involving multiple laser treatments that destroy the pigments beneath the skin, have become increasingly common.

Over the past twenty years, tattoos have exploded in popularity. The explosion is thanks to better health and safety standards, including single-use needles, protective gloves, and sterilisation, as well as a surge of ink in popular culture. Together, these factors have encouraged a generation who otherwise could have lived without the Chinese symbol for Mouthwash etched in its skin. A newly tattooed tribe was born, and it thrives to this day.

While the techniques had become safer and more common, the classic dangerous appeal of the tattoo remained. Regardless of their relative safety, tattoos were no less painful or permanent. Somehow, even the promise of individuality persevered. But with more and more skin going under the needle, more and more people began to realise that forever is a long, long time.

The most comment argument against the tattoo is regret, and that regret falls into three basic categories. One, your sensibilities may change: You may eventually decide that you do not feel as strongly about Megadeth, or the Tasmanian Devil, or Jason, Sharon or Steve. Two, your circumstances may change: You may find it difficult to acquire gainful employment with exposed tattoos, even if they include WORD and EXCL across the knuckles.

All the more common is reason three: you, physically, will change. Thousands of years ago, before the first tattoo was performed on an early Eurasian ancestor, his ancient Eurasian mother asked him how it was going to look when he was old and wrinkly. This, however, is the easiest argument to refute. After all, nobody's modelling swimsuits when they're old and wrinkly.

The common theme of these arguments is time. Time passes, things change, yet (with occasional retouching) tattoos stay the same. For many, committing to a tattoo used to mean coming to terms with and accepting your regret. That, strangely, was yet another part of the appeal.

But today, for a few thousand dollars and a few weeks of appointments, that permanence and regret is no more.

Soon, a new type of tattoo ink will be available that is designed for laser surgery. Only one treatment will be necessary to remove the ink from the skin, making this the tattoo equivalent of non-alcoholic beer.

Meanwhile, the fringe will continue to get - and keep - their tattoos, even while the tribe who sought their tattooed individuality together seeks removal together as well. Like any other youthful fad, ink is now readily tossed aside for family, career, and adulthood.

Tattoos aren't forever, but some things never change.

Some One Million Crib Recall Underway In The United States

2007-09-21T18:42:00.000-04:00

The largest crib recall in history is underway following findings showing that a couple of kids have been killed by their cribs. Some one million cribs with older drop-side hardware were recalled following an announcement by the Consumer Product Safety Commission (CPSC) and Simplicity for Children Inc., asking consumers with such cribs to return them.

The agency and the company are concerned with failure in the "drop-side" of the crib when it is incorrectly assembled. According to the CPSC, the drop-side failures result from both the hardware and crib design. These two faulty elements all too easily trick consumers into unintentionally installing the drop-side upside down. Thus installed, the hardware can weaken and cause the drop-side to detach from the crib, creating a gap in which infants can become entrapped and, there, suffocate. Thus far this failure has led to three infant deaths.

"According to First Candle, a leading promoter of infant health, infants who sleep in an adult bed with their parents are up to 40 times more likely to die through suffocation or other means than infants who sleep in a crib. Parents need to know that babies are
safest in a separate sleeping space designed for them," said Simplicity President Ken Waldman.

This is the largest recall of cribs in United States history. The cribs were made in China.

All of the cribs in question were manufactured by the first part of 2006, and none of the cribs that Simplicity is presently distributing to stores have this design problem.

Once again, a controversy is surrounding products made in China and sold for children in the United States.

However, the last time such a thing happened, which was with the recent recall of supposedly lead paint toxic toys made in China for the giant Mattell toy manufacturer, it ended up being a red herring. Today, Mattell issued a company apology to the entire nation of China when it became clear that the amounts of lead paint that were in the recalled toys did not exceed CPSC limits. Instead, the problem lay tiny magnets in the toys that children could swallow and get sick from - which was a design problem on Mattell's end, not China's.

Critics are concerned that the real motive behind at least a lot of the "China bashing" lies in the frustration that many American consumers feel over the outsourcing of so many formerly American jobs to the Asian nation, where the workers demand only a fraction of the salary that their American counterparts would, as well as with the United States' steep trade deficit with China which American officials blame largely on China's artificially depreciated currency.

E. Coli Found In US Lettuce Brand, Triggers Dole Lettuce Recall

2007-09-18T12:15:00.000-04:00

A bag of Dole's Hearts Delight salad mix sold at a store in Canada, tested positive for E. coli triggering a recall in at least nine states. Neither Canadian health officials nor Dole Food Co. have received reports of anyone getting sick from the product, despite speculations that the product, which is suspected of being contaminated with E. coli O157:H7 has been distributed all over Canada.

The affected packages contain romaine and green leaf lettuce and butter lettuce hearts.

“Don’t play Russian roulette,” said Rene Cardinal, national manager of the fresh fruit and vegetable program at the Canadian Food Inspection Agency. “If you have it in your home, destroy it.”

Cardinal added that not all bags are necessarily contaminated, “but don’t take any chances.”

The food safety agency discovered that a sample of Dole’s Hearts Delight mixed lettuce salad was tainted with bacteria as part of random testing completed over the weekend. It’s possible the recall could be expanded as the agency begins an investigation to determine the origin of the bagged salad and where it was distributed.

However, he noted it will take time for the government to determine where the produce was grown because it is a blend of different lettuce types.

“If it had been one single type of lettuce it would be easier,” he said. “It’s too premature at this point in time (to say) what caused the contamination.”

Last year, E. coli-tainted spinach was linked to the deaths of several people in the U.S. Hundreds more were made ill. The spinach scare, as well as subsequent recalls involving items such as carrot juice and lettuce, prompted governments and the food industry to find new ways to improve produce safety.

But this most recent recall shows there is still a long way to go before problems involving food safety are eliminated, said Mansel Griffiths, director of the Canadian Research Institute for Food Safety at the University of Guelph, Ont.

“Hopefully as we identify these issues and put things in place — the correct production practices for the fruit and vegetable industry — then we can reduce the problems that we have.”

The traceability of food, which refers to the ability of authorities to determine where food came from and how it was distributed, is a major factor affecting how quickly possible sources of contamination can be pinpointed and dangerous foods pulled off shelves, Griffiths said.

“Certainly it would help if you could trace the sources of this lettuce as quickly as possible so remedial measures could be taken,” he said.

Despite these latest safety scares, the industry has been making major gains to improve the safety and quality of food, said Heather Holland, senior technical manager of food safety and government relations at the Canadian Produce Marketing Association.

“In actual fact, we’ve been working on food safety for a number of years,” she said.

The fact that this week’s recall is focused on a specific type of Dole brand lettuce shows that the industry’s focus on improving safety and production is working, Holland said.

“What we’re seeing here is the benefits of good practices,” she said. “We’re able here to have the scope of the product narrowed down to a lot number and a best-before date.”

The affected Dole brand lettuce blend is sold in 227-gram packages, coded UPC 0 71430 01038 9 and lot code A24924B, with a best-before date of Sept. 19. It may have been distributed nationally.

Long-Term Breastfeeding Does Not Reduce Children's Risk Of Suffering Asthma

2007-09-17T12:25:00.000-04:00

Long-term breastfeeding, while famously rich in nutrients for baby, does nothing to reduce the risk of developing childhood asthma and allergies, a new study suggests.

Canadian and Belarusian doctors recruited 17,046 breastfeeding women who were attending maternity clinics in Belarus in the late 1990s.

The volunteers were split into two groups.

In one group, the women (and the healthworkers at the maternity clinics) carried out their normal practices and policies of breastfeeding.

In the other, breastfeeding was promoted and supported, with the result that more infants of women in this group were breastfed exclusively for their first three months of life, and for longer periods, at up to 12 months.

When the children reached the age of six and a half, they were tested for any symptoms of asthma and their parents were asked to detail any symptoms of wheezing, chest tightness, hay fever and eczema.

In addition, the children were given allergy pricks to test for any response to house dust mites, cats, birch pollen, mould and grass pollen.

A total of 13,889 youngsters were followed up this way.

There was no difference between the groups on the questions of asthma, hay fever or eczema - and the results from the allergy pricks showed that in the "pro-breastfeeding" group, the youngsters were more sensitive to dust mites and grass pollen than their counterparts.

"These results do not support a protective effect of prolonged and exclusive breastfeeding on asthma or allergy," say the investigators, led by Michael Kramer of The Montreal Children's Hospital, Canada.

They note that asthma and allergies have surged in incidence in the past few decades while breastfeeding has enjoyed a renaissance.

This "strong suggests that breast feeding does not have a potent protective effect (against these disease) at population level."

In 2002, a smaller study, conducted among 1,037 New Zealand infants, found that babies who had been breastfed for more than four weeks rank almost double the risk of contracting asthma and allergies in their childhood compared with counterparts who had been fed on infant formula.

Oesophagus Cancer Linked To Obesity In Australia

2007-09-09T03:10:00.000-04:00

A rapid rise in cases of a deadly oesophagus cancer has been linked to Australia's obesity crisis, with doctors investigating whether fat tissue is feeding the tumours.

The incidence of adenocarcinoma of the oesophagus — one of the most lethal cancers — has increased fivefold in the past 25 years in Australia, according to David Whiteman, senior research fellow at the Queensland Institute of Medical Research.

"It's a real increase in cancer which you just don't see in epidemiological lifetimes," he said. "It's unprecedented to see a cancer come up so quickly."

Those at greatest risk appear to be obese people, especially men, who suffer from reflux and have smoked at some time.

Dr Whiteman has recently completed a study aiming to identify factors that might affect a person's risk of oesophageal cancer, with a particular focus on whether fat may be feeding certain cancers.

"There really is no question that this is an obesity-related cancer but the question is how and why?" he said.

"Could it be that the fat tissue itself is acting like a fertiliser? Is it producing an environment where if you have an early change that could turn into a cancer in someone with more body fat, that it is more likely to flourish, take root and grow than it would in a lean person who doesn't have the same amount of proteins flitting around the body?"

Dr Whiteman's study has been accepted for publication in the medical journal Gut, published by the British Medical Journal publishing group. His research team compared more than 1000 Australians diagnosed with oesophagus cancers with healthy people.

The participants were asked a number of questions including the nature of their symptoms prior to diagnosis.

"People often don't realise they have any problem until they get their food stuck when they swallow and when that happens usually the cancer is of a large size, which means it's resistant to treatment," Dr Whiteman said.

"It has a survival rate that's as bad as any of the bad cancers like pancreatic cancer."

According to Cancer Council Victoria, there were an average of 133 new cases of the cancer per year in Victorian men and women in 2002-04. Men are five to eight times more likely to get it than women.

One of the big risk factors associated with the cancer is reflux (heartburn) from the stomach, a condition more often suffered by overweight people.

Smoking is also a risk factor, even for people who have only smoked for a short time.

The director of Cancer Council Victoria, Professor David Hill, said the rise in adenocarcinoma of the oesophagus was concerning.

The Cancer Council has conducted a 20-year study of more than 40,000 Victorians, which looked at how lifestyle factors, including diet and exercise, affected a person's risk of developing certain cancers.

It was estimated that obesity contributed to 500 cancer deaths in Victoria each year.

The study, developed by Professor Graham Giles, found men and women who were considered overweight — with a body mass index over 25 — had an increased risk of adenocarcinoma of the oesophagus. Of the patients with the cancer, 45 per cent had the disease because they were overweight.

Professor Hill said certain cancers were associated with being overweight including cancer of the colon, endometrium, postmenopausal breast, kidney and myeloid leukaemia.

"This study shows how much impact you could make in reducing the burden of cancer by in fact changing the prevalence of the risk factor, in this case, overweight/obesity," Professor Hill said.

Mattel Makes A Third Toy Recall

2007-09-04T22:43:00.000-04:00

Mattel, Inc. announced today that, as a result of the company's ongoing investigation of its toys manufactured by vendors in China, the company has voluntarily recalled 11 toys globally, including eight pet and furniture playsets sold under the Barbie® brand and three Fisher-Price® toys, due to impermissible levels of lead. No Barbie® dolls are included within the recall. In total, there are 530,000 affected toys in the U.S., and 318,000 affected toys outside of the U.S. Mattel has completed the testing program for the majority of its toys, including all of its toys currently sourced from vendors.

The voluntary recall results from Mattel's thorough investigation of vendor-sourced toys. Mattel has also globally implemented a strengthened, three-point check system to test toys throughout the manufacturing process.

"In August we promised that we'd continue to focus on ensuring the safety and quality of our toys through extensive testing of finished products, thorough investigation of our vendors and the implementation of a strengthened three-point check system. As a result of our ongoing investigation we discovered additional affected products. Consequently, several subcontractors are no longer manufacturing Mattel toys. We apologize again to everyone affected and promise that we will continue to focus on ensuring the safety and quality of our toys," said Robert A. Eckert, chairman and chief executive officer, Mattel.

In the U.S., there are seven recalled Barbie®-branded toys. The specific affected parts include:

* Dream Puppy House™– orange on miniature dog
* Dream Kitty Condo™– brown on miniature cat
* Table & Chairs Kitchen Playset – yellow food on two dinner plates, brown on miniature dog, yellow and orange on potato chip bowl, orange on salad bowl
* Bathtub & Toilet Playset – brown on miniature cat
* Desk & Chair Bedroom Playset – brown on miniature dog
* Living Room Playset (deluxe) – brown on miniature cat
* Living Room Playset (premium) – yellow flower on purse

The playsets affected by the recall were produced by Holder Plastic Company (Holder), a Mattel contract vendor, which subcontracted the painting of miniature toy pets and small furniture pieces to Dong Lian Fa (DLF) and Yip Sing (YS). DLF and YS used uncertified paint and are no longer producing toys for Mattel.

Mattel's investigation revealed that the subcontractors painted the affected toys between March 2007 and August 2007. However Mattel is being cautious and recalling the entire production of the seven toys painted by the subcontractors. Therefore, toys manufactured beginning in October 2006 are included within the recall. The toys being recalled were sold at retail between November 2006 and August 2007.

Among the three Fisher-Price® toys recalled are two Fisher-Price® GEOTRAX™ toys and one "It's a Big Big World" toy. Fisher-Price® toys with specific parts affected include:

* GEOTRAX™ Rail & Road System Freightway Transport™– yellow headlights on train car and miniature ladder
* GEOTRAX™ Special Track Pack™ – yellow headlights on train car and miniature ladder
* "It's a Big Big World" 6-in-1 Bongo Band – painted decal on top of clear plastic on drum

The two GEOTRAX™ toys were manufactured by Apex Manufacturing Company Ltd. (Apex), one of Mattel's contract vendors, which outsourced paint work to a subcontractor, Boyi Plastic Products Factory (Boyi). Apex supplied Boyi with certified paint; however, the toys were manufactured with uncertified paint. Boyi is no longer in business. The two GEOTRAX™ toys that tested for impermissible levels of lead were manufactured between July 31, 2006, and September 4, 2006; however, the painted parts were stored and incorporated into toy production throughout the year. Mattel is being cautious and recalling toys shipped between August 3, 2006, and July 31, 2007.

The Fisher-Price® "It's a Big Big World" 6-in-1 Bongo Band toy was manufactured by Shun On Factory, one of Mattel's contract vendors, which outsourced the molding and painting of one plastic piece. A subcontractor, Jingying Tampo Printing Processing Factory, used uncertified paint on the affected piece. The "It's a Big Big World" 6-in-1 Bongo Band was manufactured between May 19, 2007, and August 1, 2007.

Mattel is working in cooperation with the U.S. Consumer Product Safety Commission and other regulatory agencies worldwide. Mattel is also working with retailers worldwide to identify and remove affected products from retail shelves.

For additional information regarding this recall, including a full list of affected products, please contact Mattel at (888) 496-8330, or visit the company's Web site at www.service.mattel.com. A full list of products is also published by the Consumer Products Safety Commission.

How to Return Affected Toys/Parts:

1) The first step is for consumers to determine if they have a toy that has been affected by the recall. To do so, they can visit www.service.mattel.com where they will find a complete list of each toy recalled, including color photos, toy model numbers and affected date codes. Consumers can locate toy model numbers on the bottom of most recalled toys.

For consumers without a computer, or for those preferring phone support, they may call (888) 496-8330

2) Once consumers determine that they think they own a Mattel toy affected by the recall, they are prompted to fill out a form (online) or provide their postal address (via phone), and Mattel will send to consumers (via email or to a postal address) a color brochure with photos, toy numbers and date code ranges of every affected toy, as well as a pre-paid mailing label for return of the affected part(s).

3) After receiving consumers' returned, affected part(s), Mattel will send consumers replacement parts for each affected product, as well as bonus pieces/parts.

Mattel recommends that consumers do not return toys to retailers for three reasons:

1) Mattel can help consumers determine if a toy has been affected by the recall (vs. returning an unaffected toy)

2) Mattel will provide consumers with a replacement part for each toy part affected by the recall

3) Mattel will handle affected products in an environmentally friendly way

Consumers do not need to have the toy's original packaging or a receipt to return affected products to Mattel.

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Some 20 Million Condoms Recalled In South Africa

2007-08-28T13:52:00.000-04:00

South Africa's health department said Tuesday it has recalled 20 million potentially defective condoms approved by an official accused of taking bribes from a manufacturer.

Unsafe sex is especially risky in South Africa, which has one of the world's highest HIV infection rates with an estimated 12 percent of its 47 million people infected with the virus.

There are up to 1,000 AIDS-related deaths in South Africa every day and free condom distribution is a crucial part of the government's efforts to combat the spread of the epidemic.

"An official of the South African Bureau of Standards (SABS), has put millions of people at risk by illegally passing millions of condoms, which had not met the quality assurance requirements," said health department spokesman Sibani Mngadi.

Mngadi said even though only a batch of 7 million condoms was affected, the department decided to recall all 20 million condoms supplied by the manufacturer since last year, and will no longer be dealing with that company.

The SABS official accused of taking bribes and two directors of the manufacturing company have been arrested and are out on bail, said the spokesman. They will be appearing in a Pretoria court on September 10 to face charges of corruption and fraud.

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LEGAL ACTION

The condoms did not meet several standard tests for strength, pressure and lubrication, said Mngadi.

The SABS Web site alerted the public, saying the faulty condoms were distributed by brand names including Ultramour, Randy Rat and Positions.

SABS said it had instructed Latex Surgical Products (LSP) to recall the condoms and that it would take legal action against the manufacturer.

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The Health Department is also recalling condoms produced by LSP from its national HIV/AIDS supply chain.

LSP was not immediately available to comment.

Besides a struggling health-care system characterized by a lack of doctors and nurses, many of whom have left the country for better pay abroad, the fight against AIDS has been hampered by conflicting messages from senior government officials.

Researchers, scientists and health-care workers said in a conference in South Africa in June that they were encouraged by the government's fresh approach to the crisis and improved weapons to protect those most at risk of infection.

But fresh controversy over the government's AIDS policies has erupted.

President Thabo Mbeki sacked Deputy Health Minister Nozizwe Madlala-Routledge this month for insubordination, sparking an outcry from AIDS activists who strongly backed her policies and critics who say she was fired for political reasons.

Madlala-Routledge had clashed with Health Minister Manto Tshabalala-Msimang, dubbed "Dr Beetroot," who had horrified

AIDS activists with her advocacy of garlic, lemon and African potatoes over conventional anti-retroviral drugs.

The health department said it does not know how many of the defective condoms have been used, and it is urging the public to return them.

Moderate Exercise Relaxes Blood Vessels

2007-08-25T08:59:00.000-04:00

Moderate exercise might help older adults' blood vessels relax, a study has found - pointing to one reason why exercise lowers the risk of heart attacks and strokes.

As people age, their blood vessels can become more constricted and less pliable in response to blood flow, a change that contributes to high blood pressure and clogged arteries.

But in the new study, older men who took up regular exercise were able to substantially reduce this effect of ageing.

The findings are good news for sedentary older adults, researchers say, because the benefit required only moderate activity - namely, taking a walk five times a week.

"This is exercise that I would stress can be done by most older adults," said senior study author Dr Christopher A. DeSouza of the University of Colorado in Boulder.

He and his colleagues report the findings in the medical journal Hypertension.

The study included 28 healthy but sedentary men: 13 in their 20s and 15 in their 60s. For the first phase of the research, DeSouza and his colleagues used a test called plethysmography to measure blood vessel function in each man's forearm. They found that the older men's blood vessels were generally more constricted than those of their younger counterparts.

Next, the researchers had eight of the older men begin a three-month exercise program, while the rest remained sedentary. The exercisers worked out moderately, typically walking for about an hour, five days per week.

At the end of the three months, the exercise group showed a sharp turnaround in blood vessel constriction - with test results looking more like those of the younger men from the earlier study than the sedentary group their own age.

The improvement in blood vessel function occurred without improvements in the men's weight, body fat, blood pressure or other traditional indicators of heart health.

This is important, DeSouza told Reuters Health, because even if people aren't seeing obvious benefits from exercise - like a smaller waistline - they may still be making improvements on the inside.

Another key point, he noted, is that all of the older men in the study had been long-time couch potatoes, yet were still able to benefit from starting an exercise routine in their 60s.

"It's that old adage, 'It's never too late to start," DeSouza said.

Short-Burst Oxygen Therapy Benefits Few COPD Patients

2007-08-25T08:49:00.002-04:00

Although home use of short-burst oxygen therapy is widely prescribed in the UK for patients with COPD, it may be helpful only in a small minority of patients, researchers report in the current issue of Thorax.

"Short-burst oxygen therapy is used extensively despite little evidence of benefit," lead investigator Dr Simon J Quantrill told Reuters Health. Although "18 million pounds ($A44.13 million) per year are spent on oxygen cylinders used for short-burst oxygen therapy," he noted, "no guidelines exist on how and when to use short-burst oxygen therapy."

To investigate whether short-burst oxygen therapy helps COPD patients with daily activities, Quantrill and colleagues at Whipps Cross University Hospital, London, studied 39 patients who all reported that short-burst oxygen therapy was helpful.

They were asked to choose two routine activities, such as walking upstairs or vacuuming, for which they used short-burst oxygen therapy to relieve breathlessness. The patients were then given two cylinders, one of which contained oxygen and the other, compressed air.

Using nasal prongs, the participants inhaled from one cylinder to recover from breathlessness after performing one of the tasks, and then, at least 15 minutes later, they used the other cylinder after repeating the task. The subjects then went on to use the same two-cylinder procedure for their other chosen activity.

Based on the results of pulse oximetry, the average recovery time over two activities was 38 seconds less when oxygen rather than compressed air was inhaled. The recovery time reported by the patients was about the same, at 34 seconds.

Five of the patients were able to correctly identify when oxygen was employed and the difference in recovery times with oxygen versus indicated a greater benefit of oxygen therapy.

"There may be a small group of patients with severe COPD who do in fact benefit" from short-burst oxygen therapy, Quantrill said.

Nevertheless, he noted, "this needs further research with bigger numbers of patients." Moreover, Quantrill concluded, "further research is needed to be able to produce guidelines on short-burst oxygen therapy usage."

Inflammatory Bowel Disease Low Among Children Exposed To Farm Animals

2007-08-25T08:49:00.001-04:00

Infants who are regularly exposed to farm animals appear to be less likely than others to develop inflammatory bowel disease in childhood, according to the findings of a German study published in the journal Paediatrics.

"Approximately 12,000 children and adolescents in Germany suffer from inflammatory bowel disease (IBD)," write Dr Katja Radon and colleagues at Ludwig-Maximilians-University, Munich.

The recent increase in Crohn's disease, a type of inflammatory bowel disease, especially in industrialised countries, and its pronounced geographical variation, suggest that environmental factors contribute this condition.

The researchers examined the association between contact with farm animals in infancy and the development of Crohn's disease or ulcerative colitis in childhood. Data were analysed for 748 IBD cases (444 with Crohn's disease and 304 with ulcerative colitis) and 1,481 healthy "control" children.

The children with IBD were more likely than the control children to live in urban areas. Regular contact with farm animals during the first year of life was inversely associated with IBD, the investigators report.

Specifically, the children with Crohn's disease or ulcerative colitis were about 50 per cent less likely to have regular contact with farm animals in infancy compared with the healthy children.

"The results of this study indicate that farm animal contact during infancy, one of the major factors protecting individuals against childhood allergies, might also decrease the risk of juvenile IBD," Radon's team concludes. The findings also support the hypothesis that allergic diseases and IBD might have similar paths of development.

Alcohol Reduces Risk Of Kidney Cancer

2007-08-25T08:49:00.000-04:00

Alcohol consumption may lower the risk of developing kidney cancer, according to a report in the British Journal of Cancer.

Dr Alicja Wolk from the Karolinska Institute, Stockholm, and colleagues investigated the association of different types of alcoholic beverages and of total alcohol consumption with the risk of kidney cancer in a large population-based study in Sweden.

The study involved 855 subjects with kidney cancer and 1204 "controls" without cancer.

They reported their alcohol consumption in terms of standard portion sizes - a glass of beer being 200 millilitres, a glass of wine being 100 mL, and a glass of strong wine or hard liquor equal to 40 mL.

The investigators rated the alcohol content of different beverages: medium-strong beer had 2.8 grams alcohol per 100g, red wine had 9.9 g per 100 g, and hard liquor 32g alcohol per 100g.

The team found that the odds of developing kidney cell cancer was about 40 per cent lower among those who consumed 620g ethanol per month compared to those who did not drink at all.

Drinking more than two glasses of red wine per week was associated with a 40 per cent reduction in kidney cell cancer risk compared with drinking no red wine, the investigators observed, and there were similar trends for more than two glasses per week of white wine or strong beer.

In contrast, there was no relation between kidney cell cancer risk and consumption of light beer, medium-strong beer, strong wine, or hard liquor.

"A reduced risk associated with consumption of wine and beer might be due to the phenolics they contain as these possess antioxidant and antimutagenic properties," the authors speculate.

"However, the lower risk that we observed for three different alcoholic beverages and total ethanol intake suggests that alcohol itself rather than a particular type of drink is responsible for the reduction in risk.

Pregnancy Where Orgasm Is Not Safe.

2007-08-24T15:33:00.000-04:00

Orgasms cause the uterus to contract, sometimes with great intensity, lasting for one-half to one hour after intercourse. Contractions are more frequent as the due date approaches, but may be present in the early second trimester. In general, these contractions do not result in a change in the cervical dilatation or effacement.

If contractions persist for more than an hour after intercourse, or if there is an increase in pelvic pressure or heavy vaginal bleeding, you should contact your caregiver immediately.

For most women, intercourse results in no problems. However, in certain high risk pregnancies (premature labor, incompetent cervix, multiple gestations, placenta previa), "pelvic rest" is advocated to decrease the possibility of premature labor or bleeding. There currently is great debate over the relationship of intercourse to premature labor.

Chemicals present in seminal fluid, called prostaglandins, also cause increased uterine activity. For some women near term, unprotected intercourse can result in more contractions that may cause cervical dilatation or effacement. However, it is impossible to predict who would benefit from having intercourse to stimulate the onset of labor.

Quite often, the mother's pregnant abdomen can cause intercourse to be awkward, and some couples worry that intercourse may, in some way, harm the fetus. In an uncomplicated pregnancy, intercourse is completely safe for both mother and child.

Bird flu Spreads To 2 More Provinces In Vietnam

2007-08-24T14:43:00.000-04:00

Bird flu has spread to two more provinces in Vietnam, killing hundreds of chickens and ducks, the Agriculture Ministry says.

The outbreak of H5N1 in the northern province of Thai Nguyen and Dong Thap to the south brought to four the number of provinces on the government's current bird flu watchlist.

Vietnam has 64 provinces.

A total of 150 ducks and 35 chickens fell sick on Wednesday in Thai Nguyen, 80 km north of Hanoi, and tests have confirmed they had the H5N1 virus, the ministry's Animal Health Department said in a report.

The virus also struck a farm in the southern Mekong delta province of Dong Thap where 250 chickens were found dead on Sunday, it said.

Bird flu has infected seven people in Vietnam so far this year, four of whom have died, bringing the death toll since late 2003 to 46, the government said.

Globally, the H5N1 virus has killed 195 people out of 322 known cases, according to a tally of the World Health Organisation. Hundreds of millions of birds have died or been slaughtered.

Impotence Drug, Viagra, Increases Feelings Of Love

2007-08-23T19:57:00.000-04:00

Impotence drugs such as Viagra may do more than help men physically have sex - they may also boost levels of a hormone linked with feelings of love, US researchers said today.

Viagra, known generically as sildenafil, raised levels of the hormone oxytocin in rats, the team at the University of Wisconsin-Madison said in a report published in the Journal of Physiology.

This hormone is involved in nursing and childbirth but also in orgasm and feelings of sexual pleasure.

And it seems Viagra and related drugs act on the part of the brain that controls release of oxytocin, said Wisconsin physiology professor Meyer Jackson.

"This is one piece in a puzzle in which many pieces are still not available," Prof Jackson said.

"But it raises the possibility that erectile dysfunction drugs could be doing more than just affecting erectile dysfunction."

Viagra, made by Pfizer, is an inhibitor of an enzyme called phosphodiesterase type 5.

Related drugs such as Eli Lilly's Cialis, known generically as tadalafil, and Levitra or vardenafil, sold by GlaxoSmithKline, Bayer and Schering-Plough, are also PDE-5 inhibitors.

They block this enzyme, which in turn breaks down other compounds. This increases blood flow in the muscles but it also affects a brain structure known as the posterior pituitary.

This, in turn, boosts oxytocin, at least in the rats. It probably does the same thing in people, Prof Jackson said.

"It does the same thing it does in smooth muscle - instead of (levels) coming down in a minute or two, they stay up a little longer," Prof Jackson said.

Oxytocin was known for years to be involved in labour and it is the hormone that causes the "let-down" of milk in breastfeeding babies. Only in recent decades has it been found to have a function in men - in sexual arousal and function.

This could suggest other uses for Viagra and related drugs, Prof Jackson said - perhaps promoting social bonding.

"What I hope is that people read our paper who can test these ideas in animals and humans," Prof Jackson said.

"I hope that this doesn't cause some wild orgy of inappropriate recreational use."

Some groups have complained that people use the impotence drugs for fun, instead of using them as prescribed for sexual dysfunction caused by low blood flow to the genitals.

The drugs can cause fatal side-effects if used with certain other drugs, and some studies also suggest they may affect the eyes in some patients, so doctors stress they are not for casual use.

West Nile Virus Infection Reported In The State Of Indiana

2007-08-23T19:50:00.000-04:00

Indianapolis State health officials report two probable human cases of West Nile virus, one in Lake County and another in Randolph County. These are the first two human cases of West Nile virus infection in Indiana this year. In 2006, there were 80 cases of West Nile virus, including 5 deaths.

"West Nile virus is potentially a very serious disease," said State Health Commissioner Judy Monroe, M.D. "We have seen cases where healthy, active individuals who become infected with the virus left devastated by the disease, including being unable to walk without assistance. I cannot underscore enough how important it is for people to take the simple steps necessary to protect themselves."

Dr. Monroe recommends that people take the following protective steps when they are outdoors:

* Avoid being outdoors during prime mosquito biting times, dusk to dawn, when possible;
* Apply insect repellent containing DEET, picaradin, or oil of lemon eucalyptus to clothes and exposed skin; and
* Wear long-sleeved shirts and pants.

West Nile virus is transmitted to humans by mosquitoes that have first bitten an infected bird. A person bitten by an infected mosquito may show symptoms three to 15 days after the bite.

Health officials say that although individuals over age 50 are at greatest risk for serious illness and even death from West Nile virus, people of all ages have been infected with the virus and have had severe disease.

The virus usually causes West Nile fever, a milder form of the illness, which can include fever, headache, body aches, swollen lymph glands, or a rash. However, a small number of individuals can develop a more severe form of the disease with encephalitis or meningitis and other neurological syndromes, including flaccid muscle paralysis.

"There is no cure for West Nile virus, but it is preventable," said Dr. Monroe. "In the past, we've seen most of the human cases in the state reported in the months of August and September, so this is an important time for people to protect themselves and their families."

State health officials say the previous hot, dry weather conditions have created the perfect breeding environment for the mosquitoes that carry the West Nile virus.

As a result, Dr. Monroe is also asking Hoosiers to take steps to rid their properties of potential mosquito breeding grounds by:

* Repairing failed septic systems;
* Drilling holes in the bottom of recycling containers that are left outdoors;
* Keeping grass cut short and shrubbery trimmed;
* Disposing of old tires, tin cans, plastic containers, ceramic pots or other unused containers that can hold water;
* Cleaning clogged roof gutters, particularly if leaves tend to plug up the drains;
* Aerating ornamental pools, or stock them with predatory fish; and
* Emptying containers holding water from recent rain storms.

Indianapolis State health officials report two probable human cases of West Nile virus, one in Lake County and another in Randolph County. These are the first two human cases of West Nile virus infection in Indiana this year. In 2006, there were 80 cases of West Nile virus, including 5 deaths.

"West Nile virus is potentially a very serious disease," said State Health Commissioner Judy Monroe, M.D. "We have seen cases where healthy, active individuals who become infected with the virus left devastated by the disease, including being unable to walk without assistance. I cannot underscore enough how important it is for people to take the simple steps necessary to protect themselves."

Dr. Monroe recommends that people take the following protective steps when they are outdoors:

* Avoid being outdoors during prime mosquito biting times, dusk to dawn, when possible;
* Apply insect repellent containing DEET, picaradin, or oil of lemon eucalyptus to clothes and exposed skin; and
* Wear long-sleeved shirts and pants.

West Nile virus is transmitted to humans by mosquitoes that have first bitten an infected bird. A person bitten by an infected mosquito may show symptoms three to 15 days after the bite.

Health officials say that although individuals over age 50 are at greatest risk for serious illness and even death from West Nile virus, people of all ages have been infected with the virus and have had severe disease.

The virus usually causes West Nile fever, a milder form of the illness, which can include fever, headache, body aches, swollen lymph glands, or a rash. However, a small number of individuals can develop a more severe form of the disease with encephalitis or meningitis and other neurological syndromes, including flaccid muscle paralysis.

"There is no cure for West Nile virus, but it is preventable," said Dr. Monroe. "In the past, we've seen most of the human cases in the state reported in the months of August and September, so this is an important time for people to protect themselves and their families."

State health officials say the previous hot, dry weather conditions have created the perfect breeding environment for the mosquitoes that carry the West Nile virus.

As a result, Dr. Monroe is also asking Hoosiers to take steps to rid their properties of potential mosquito breeding grounds by:

* Repairing failed septic systems;
* Drilling holes in the bottom of recycling containers that are left outdoors;
* Keeping grass cut short and shrubbery trimmed;
* Disposing of old tires, tin cans, plastic containers, ceramic pots or other unused containers that can hold water;
* Cleaning clogged roof gutters, particularly if leaves tend to plug up the drains;
* Aerating ornamental pools, or stock them with predatory fish; and
* Emptying containers holding water from recent rain storms.

Adequate Intake of Vitamin D Reduces Breast and Colon Cancer Rates

2007-08-23T19:45:00.000-04:00

Sufficient intake of Vitamin D3 might prevent 60,000 cases of colon and breast cancer every year across the globe, a new study has found.

Vitamin D3 is available through diet, supplements and exposure of the skin to sunlight.

The study was conducted by a team of researchers led by Cedric F. Garland at the Moores Cancer Center at the University of California, San Diego (UCSD).

As part of the study, researchers combined data from surveys of serum vitamin D levels during winter from 15 countries. The data was then applied to 177 countries to estimate the average serum level of a vitamin D metabolite of people living there.

The study found an inverse association of serum vitamin D with risk of colorectal and breast cancer and estimated that 250,000 colorectal cancer cases and 350,000 cases of breast cancer could be prevented worldwide by increasing intake of vitamin D3, particularly in countries north of the equator.

“For the first time, we are saying that 600,000 cases of breast and colorectal cancer could be prevented each year worldwide, including nearly 150,000 in the United States alone,” Garland said.

The researchers suggested that increasing vitamin D levels in populations, particularly those in northern climates, might both prevent and possibly serve as an adjunct to existing treatments for cancer.

“This could be best achieved with a combination of diet, supplements and short intervals – 10 or 15 minutes a day – in the sun. It could be less for very fair-skinned individuals. The appropriate dose of vitamin D in order to reach this level, could be very little in a lifeguard in Southern California… or quite a lot for someone in Northern Europe who tends to remain indoors most of the year,” Garland said.

Do-Good Protein Related To A Brutal Toxin That Kills

2007-08-23T19:39:00.000-04:00

Australian scientists have uncovered an unlikely family relationship between two archenemies in the disease world - a protein that fights infection and a brutal toxin that kills.

In a surprise discovery, researchers found that immune proteins enlisted by the body to fend off cancer and infection belong to an ancient and lethal toxin family previously only found in bacteria.

These bacterial toxins are responsible for deadly diseases like anthrax, flesh-eating disease, gas gangrene and scarlet fever.

The findings, published in the international journal Science, will be used to develop new ways to fight disease.

Study leader Professor James Whisstock, from the School of Biomedical Sciences at Monash University in Melbourne, said he was astounded to find these "yin and yang" fighters - proteins called perforins and nasty bacterial toxins - had a common ancestor.

"Over millions of years of evolution bacteria developed these proteins as weapons of attack," Prof Whisstock said.

"But as it turns out, animals stole that toxin from the bacteria and turned it on the enemy.

"I find that completely extraordinary. It's a molecular arms race and there's still no clear winner."

Perforins got their name because they kill bacteria, virally-infected cells and cancerous cells by punching tiny holes that perforate them.

People who lack one of these perforins can develop a serious blood disease called hemophagocytic lymphohistiocytosis, and may be predisposed to develop cancer, he said.

Prof Whisstock said certain perforins were not only important for defending humans against attack by bacteria and viruses, but also helped propagate the human species because of their role in embryo implantation.

"It is ironic that we fear diseases such as anthrax yet from the same family of toxins comes a protein that is involved in reproduction," he said.

But these proteins could also be dangerous, wreaking "absolute havoc" in the immune system if they're not controlled properly.

The researchers investigated how they work to find ways to control them in infectious diseases and areas such as transplantation rejection.

Using X-ray crystallography, the team worked out the structure of a perforin called Plu-MACPF, which, due to its similarity to the bacterial toxins, told them how the whole perforin family worked.

The findings are a culmination of nine years of research.

"Now we finally know what perforins look like and how they work, we can use this knowledge to develop new ways to fight disease," said co-author Dr Michelle Dunstone.

The research team included scientists from the National Health and Medical Research Council, the Australian Research Council and the Peter MacCallum Cancer Centre.

Gastric Bypass Surgery Increase Longevity And Drops Obese Weight

2007-08-22T22:44:00.001-04:00

Gastric bypass surgery not only helps obese people drop weight and look better, it also helps them live significantly longer, according to two reports published on Wednesday.

The studies in the New England Journal of Medicine confirm what doctors had long suspected but never proved.

The years gained are significant, with life span prolonged by up to 40 per cent and rates of diabetes, cancer and heart disease all lower.

"The question as to whether intentional weight loss improves life span has been answered, and the answer appears to be a resounding yes," Dr George Bray of Louisiana State University wrote in a commentary.

More than 30 per cent of the US population is now considered obese, with severely obese people tending to die five to 20 years earlier than people of healthy weight.

At the same time, more than 100,000 stomach operations of some type are performed in the United States each year to help people lose weight.

One of the studies found that gastric bypass surgery - in which doctors reduce the size of the stomach to limit the amount of food a person can eat - cut the death rate by 40 per cent among 7,925 volunteers who had been followed for an average of seven years.

The risk of heart disease dropped 56 per cent, the diabetes rate was 92 per cent lower and the likelihood of cancer was 60 per cent less compared with 7,925 severely obese people identified by data from their drivers' licences.

But the news was not completely good for the surgery patients.

The chance of death from something other than disease, including accidents, suicide and poisoning, was 58 per cent higher in the surgery group.

Earlier research has shown that obese people who have the operation are more likely to suffer from mood disorders, post-traumatic stress disorder or the after-effects of childhood sexual abuse.

"After a mean follow-up of 7.1 years, in the surgery group, 171 deaths from disease were prevented per 10,000 operations," Ted Adams of the University of Utah School of Medicine and colleagues wrote in their study.

"On the other hand, there was an increase of 35 non-disease deaths per 10,000 operations, for a net prevention of 136 deaths."

The other study, conducted in Sweden, found that about 11 years after surgery, the death rate was 27 per cent lower among 2,010 patients who had undergone some type of operation, including gastric bypass, to lose weight.

That team, led by Lars Sjostrom of Gothenburg University, found gastric bypass produced the greatest sustained weight loss - about 25 per cent - and that the death rate during the follow-up period was 5 per cent in the surgery group, compared to 6.3 per cent among those who did not have an operation.

World Health Report - Infectious Disease Emerging And Spreading Worldwide

2007-08-22T22:44:00.000-04:00

Infectious diseases were emerging more quickly around the globe, spreading faster and becoming increasingly difficult to treat, the World Health Organisation (WHO) has said.

In its annual World Health Report, the United Nations agency warned there was a good possibility that another major scourge like AIDS, SARS or Ebola fever with the potential of killing millions would appear in the coming years.

"Infectious diseases are now spreading geographically much faster than at any time in history," the WHO said.

It said it was vital to keep watch for new threats like the emergence in 2003 of SARS, or Severe Acute Respiratory Syndrome, which spread from China to 30 countries and killed 800 people.

"It would be extremely naive and complacent to assume that there will not be another disease like AIDS, another Ebola, or another SARS, sooner or later," the report warned.

Since the 1970s, the WHO said, new threats have been identified at an "unprecedented rate" of one or more every year, meaning that nearly 40 diseases exist on Friday which were unknown just over a generation ago.

Over the past five years alone, WHO experts had verified more than 1,100 epidemics of different diseases.

With more than two billion people travelling by air every year, the UN agency said: "an outbreak or epidemic in one part of the world is only a few hours away from becoming an imminent threat somewhere else."

The report called for renewed efforts to monitor, prevent and control epidemic-prone ailments such as cholera, yellow fever and meningococcal diseases.

International assistance may be required to help health workers in poorer countries identify and contain outbreaks of emerging viral diseases such as Ebola and Marburg haemorrhagic fever, the WHO said.

It warned that global efforts to control infectious diseases have already been "seriously jeopardised" by widespread drug resistance, a consequence of poor medical treatment and misuse of antibiotics.

This is a particular problem in tuberculosis, where extensively drug-resistant (XDR-TB) strains of the contagious respiratory ailment have emerged worldwide.

"Drug resistance is also evident in diarrhoeal diseases, hospital-acquired infections, malaria, meningitis, respiratory tract infections, and sexually transmitted infections, and is emerging in HIV," the report declared.

Although the H5N1 bird flu virus has not mutated into a form that passes easily between humans, as many scientists had feared, the next influenza pandemic was "likely to be of an avian variety" and could affect some 1.5 billion people.

"The question of a pandemic of influenza from this virus or another avian influenza virus is still a matter of when, not if," the WHO said.

It said all countries must share essential health data, such as virus samples and reports of outbreaks, as required under international health rules, to mitigate such risks.

Accidents involving toxic chemicals, nuclear power and other environmental disasters should also be communicated quickly and clearly to minimise public health threats.

Sulforaphane From Broccoli, Brussels Sprouts.... Helps to Prevent Skin Disease

2007-08-22T15:09:00.000-04:00

Sulforaphane, a chemical present at high levels in a precursor form in broccoli and related veggies (cauliflower, Brussels sprouts, etc.), helps prevent the severe blistering and skin breakage brought on by the rare and potentially fatal genetic disease epidermolysis bullosa simplex (EBS).

The researchers treated newborn mice with a severe form of EBS—so bad they all died within three days—with a topical solution containing sulforaphane and found marked improvement; after four days more than 85 percent of the treated mice were alive and blister-free. These findings appear online this week in Proceedings of the National Academy of Sciences.

The basis of EBS, notes study author Pierre Coulombe, Ph.D., professor of biological chemistry, lies in two specific genes that make proteins known as keratins. Normally, the keratins join together and form highly resilient fibers in the lower portion of skin, helping make it durable. If either keratin is defective, they don’t mesh and the lower skin tissue becomes unusually fragile and gets damaged from the mildest mechanical stress — leading to blistering pain, a higher risk of infection, and in the most severe cases, death.

'Humans have around 54 distinct keratins, many of which are similar in structure and function,' says Coulombe. 'We figured we might be able to exploit this similarity and dial up a replacement by triggering the activation of a suitable signaling pathway in skin.' He predicted that sulforaphane might stimulate the formation of a surrogate skin-strengthening keratin to stand in for the defective one.

The desire to learn more about sulforaphane led Coulombe and his co-workers to Paul Talalay, M.D., professor of pharmacology who had previously identified sulforaphane as a cancer-preventive agent. 'It turns out that treatment with low doses of sulforaphane triggers the expression of selected keratin genes in skin,' says Coulombe. 'So we began what evolved into a highly rewarding collaboration and found it does indeed work in a mouse model for EBS.'

'This is the first suggestion that we may be able to treat this terrible disease,' adds Talalay, a co-author of this study. 'And we didn’t need to invent a new drug; sulforaphane is naturally found in our diet.'

The team will next test whether sulforaphane can stimulate the proper keratin protein in the appropriate subset of human skin cells — a vital matter for any future medical hopes. Beyond that are issues of how effective a topical application would be on human skin, which is considerably thicker than mouse skin, as well as examining the long term effects of sulforaphane treatment.

'If we can clear these important hurdles, then sulforaphane can potentially be a tremendous therapeutic, with the added benefit of having anticancer properties,' Coulombe says. 'And when you consider that the only current option for EBS is wrapping gauze around trauma-prone areas to minimize breakage, and otherwise avoiding infection and making sure blisters heal properly, then even a mild success would be a significant benefit for these patients.'

New Vaccine To Control Immune System Of Alzheimer's Sufferers

2007-08-22T14:48:00.002-04:00

Researchers at the NYU Medical Center believe that a new vaccine can harness the immune system in Alzheimer. The vaccine can fight the pathological form of tau protein, a key protein related to Alzheimer’s disease.

The researchers created the vaccine in mice that suppresses aggregates of tau protein which otherwise amasses into dangerous tangles in the memory center of the brains of Alzheimer’s patients. The research was led by Einar Sigurdsson Ph.D., Assistant Professor of Psychiatry and Pathology at New York University School of Medicine.

The vaccine successfully slowed the deterioration of motor abilities produced by excessive amounts of tau in the central nervous system of mice, according to the study published in the August 22, 2007 issue of the Journal of Neuroscience. Dr. Sigurdsson plans to conduct follow-up studies using mice that slowly develop tangles and cognitive impairments without movement problems.

The study used mice that were genetically engineered to produce abnormal tau proteins early in life. These became entangled in several regions of the central nervous system. The resulting loss of motor coordination was significantly reduced in those immunized with a specific piece of the detrimental tau protein. By producing antibodies that could enter the brain and bind to irregular tau, the immune system prevented their harmful aggregation and associated behavioral impairments.

“This approach may have extensive therapeutic implications because you can specifically target the problematic protein,” said Dr. Sigurdsson. “Tau aggregates are inside the cell, making it especially difficult to develop a therapy to target and clear them from the cell.” Alzheimer’s disease is estimated to affect five million Americans. While treatments exist that may modestly alleviate its symptoms, none delay or prevent the onset of the disease, according to the Alzheimer’s Association.

The disease is associated with neurons in the memory center of the brain becoming choked by the buildup of two types of proteins: tau, which turns destructive when it is prone to forming fibrous tangles, and amyloid beta. Compared to extracellular amyloid plaques, tau aggregates are confined inside of brain cells, making them more difficult to reach.

“It’s likely that there’s a synergism in the pathology,” said Dr. Sigurdsson. “Amyloid pathology may cause tau pathology and tau pathology might cause more amyloid pathology. What you have is a vicious cycle. If you can target both of these proteins you’ll likely have more efficacious treatment.”

The therapeutic approach is based on using fragments of abnormal tau protein as a vaccine. These fragments are studded with phosphate groups, which are thought to promote the aggregation of tau. The antibodies generated by the vaccine are therefore likely to bind to abnormal tau and promote its breakdown. Normal tau, which would be far less affected, has such important biological functions as facilitating transport of chemicals within neurons and maintaining their structure.

In previously published studies and in ongoing work, Dr. Sigurdsson has been developing ways to target the amyloid beta peptide, the other major hallmark of Alzheimer’s disease. Those experiments employed a different but complementary approach and were performed in collaboration with NYU School of Medicine’s Thomas Wisniewski, M.D., Professor of Neurology, Pathology and Psychiatry, David Quartermain, Ph.D., Professor of Neurology and Neuroscience and Physiology and Blas Frangione, M.D., Ph.D., Professor of Pathology and Psychiatry.

The transgenic mice in the new study were predisposed to forming tau tangles early in life. Although a decline in motor abilities had progressed by eight months, the mice still remained healthy enough to walk, feed and attempt simple behavioral tasks. But the mice did not undergo thorough cognitive testing, which requires intact mobility to navigate various mazes.

The battery of behavioral tests at five and eight months of age showed that immunized mice performed better—they traveled faster during exploratory activity, exhibited better balance on a rotating rod and committed less foot-slips while traversing a narrow wooden beam. These mice were also found to have less tau protein tangles in the brain. Object-recognition test showed that immunized mice and their controls remained cognitively normal, although mental deficits were expected to appear after the maximum 8-month period allowed in the study.

The mice in the study also had tau aggregates in the hippocampus, a brain region important for cognition and memory. The vaccine cleared tangles in this region as well, suggesting the immunotherapy could improve cognition.

The antibodies raised by the vaccine must reach the brain by traversing the organ’s protective blockade, the blood brain barrier. “Normally antibodies aren’t getting into the brain in any large quantities,” said Dr. Sigurdsson. “In this animal model—and also in Alzheimer’s disease—there’s a breakdown of the blood brain barrier.

In addition, it is well established that neurons have receptors that can bind to and promote uptake of antibodies and our studies seem to indicate that sick neurons that are accumulating tau aggregates take up more antibodies than healthy neurons. The antibodies then end up at the site where they can interact with pathological tau protein in the neuron, and promote its clearance.”

Teflon Version Drug From Frog Skin - A Good Antibiotic

2007-08-22T14:48:00.000-04:00

A research team led by biological chemist E. Neil Marsh has created a Teflon version drug from frog skin which is a good antibiotic. This new drug is much better at preventing bacterial defenses and it also enhances their efficiency.

This natural antibiotic called antimicrobial peptides (AMPs) is produced by all animals from insects to human especially in injured or infected frog skin, the linings of the human respiratory and gastrointestinal tracts. AMPs are the immune system's early line of defense, battling microbes at the first places they try to penetrate: skin, mucous membranes and other surfaces and crank out the short proteins in response to invading pathogens. AMPs have many medical benefits as they not only fight bacteria but also attack viruses, fungi and even cancer cells.

Scientists have been interested in exploiting these natural antibiotics since their discovery in the 1980s, but they haven't been able to overcome some limitations. In particular, AMPs are easily broken down by protein-degrading enzymes (proteases) that are secreted by bacteria and are also naturally present in the body. Increasing the concentration of AMPs in an effort to get around that problem can cause toxic side effects, such as the destruction of red blood cells---those critical carriers of oxygen in the bloodstream. That seems to happen because sticky parts of the AMP molecule interact with the cell membrane in a harmful way.

Marsh had the idea of replacing sticky portions of the peptides with nonstick analogs. His inspiration came from the kitchen as much as the chemistry lab: nonstick cookware is coated with fluorinated polymers, plastic-like compounds composed of chains of carbon atoms completely surrounded by fluorine atoms. The fluorine not only makes Teflon slippery, it also makes the coating inert to almost every known chemical.

When Marsh and co-workers swapped sticky parts of their AMP molecule with nonstick, fluorinated versions, the molecules became much more resistant to proteases.

"The difference was quite striking," said Marsh, a U-M professor of chemistry. "When we treated them with purified proteases, the nonfluorinated AMPs were all degraded within 30 minutes. Under the same conditions, the fluorinated AMP was completely intact after 10 hours. We think that should make them more effective, as they'll stay around longer in the body.

"We also showed that they seem to be at least as good at killing bacteria as their nonfluorinated counterparts, and for some bacteria they're actually significantly better."

Next, the researchers plan experiments to learn whether Teflon AMPs are also less toxic than their stickier equivalents. If they are, and if further studies continue to point to their promise, eventually producing large enough quantities of fluorinated AMPs for clinical trials should be quite feasible, Marsh said.

Though the research now has obvious practical applications, it started as an exploration in basic science.

"We were just interested in translating useful properties of man-made materials into biological molecules," Marsh said. "But fairly immediately we saw the potential for applying our fundamental science to a very important clinical problem, which is the way that more and more bacteria are becoming resistant to more and more conventional antibiotics."

The Basics Of Skin Fungi Infections

2007-08-21T20:43:00.000-04:00

Skin fungus infections are hard to recognize. The itching, flaking, redness, and thickened skin of fungal infections can look just like other types of dermatitis or skin allergies. In fact, eczematous skin often becomes infected with fungi, so both are present simultaneously. Doctors use microscopes to help them diagnose skin fungus infections, so there’s no way you can really be sure at home. The Advisory will focus on the five most easily recognized skin fungus infections, but even after looking at the pictures don’t be too confident. If the recommended treatment doesn’t work after two weeks, see your doctor.

Athlete’s Foot (tinea pedis). Every year, over 10% of the U.S. population develops this problem. Probably 75% of us will have athlete’s foot at some time during our lives. The most common form occurs between your third, fourth, and fifth toes, sometimes spreading to the sole. Between the toes, your skin becomes white, moist, and easily rubbed off; the tops of the toes may be red, dry, and flaky. Intense itching and burning are the rule. Athlete’s foot usually occurs with hot, moist conditions, or if you wear shoes constantly.

Jock Itch (tinea cruris). The same conditions of heat, moisture (sweat) and poor air circulation leading to athlete’s foot also cause fungus infections of the groin, or jock itch. As its name implies, intense itching and burning are the usual symptoms. You will also find redness, flaking and peeling on the inner thighs, pubic area, and scrotum.

Ringworm (tinea corpora). This is caused by a microscopic fungus, not a worm. The infected area spreads out slowly from its central starting point and creates a slightly raised, intensely red ring surrounding a less red, flaky, itchy area. Over weeks, the ring slowly enlarges. It can occur anywhere on the body and in multiple sites at once, so it’s often confused with other kinds of dermatitis.

Candidiasis. This brownish-red, itchy discoloration affects the underarms, corners of the mouth, rectal area, and beneath the breasts. The same type of fungus causes vaginal yeast infections (candida albicans).

Tinea Versicolor. This fungus actually changes the color of the skin it infects; the patches may be lighter or darker than your normal surrounding skin. This spotted pattern and the fine scaly flakes at the margins make this fungal infection the easiest to identify. Since itching and irritation are mild, it’s also the least bothersome.

Prevention

Warmth, humidity, sweating, and poor air circulation all help bring about these fungal infections. But they are contagious, too. Athlete’s foot is believe to be passed on locker room and shower floors, and by sharing footwear and socks; you can acquire tinea versicolor from vinyl surfaces of weight lifting benches; and of course ringworm is contagious through direct contact (usually kids).

Because of all these factors, prevention is a matter of both personal hygiene and minimizing contact with potential carriers or contaminated objects. See the chart below for guidelines on prevention.

Preventing Skin Fungus Infections

Personal Hygiene

Use anti-perspirants and talcum powder to keep high-risk areas dry.

If you’re susceptible to athlete’s foot, use an anti-fungal powder (see Recommended Products section) and anti-fungal socks.

In high humidity, keep clothing loose and light; avoid knits and less breathable synthetic materials.

Avoidance

Don’t share towels or clothes.

Wear thongs or other footwear in public locker rooms, pools, and showers.

Always wear a thick T-shirt or sweatshirt and long shorts or sweat pants while sharing exercise equipment.

Wipe off vinyl surfaces with a dry towel before using exercise equipment.

Treatment

There are several effective OTC anti-fungal medications. Because different fungi affect different locations, medications are sometimes specific for those locations. The recommendations below should help you sort it out.

Athlete’s Foot - Tolnaftate is the only OTC medicine approved for both prevention and treatment of athlete’s foot. Be patient, though. It could take a month or more of daily treatment for it to completely clear. Consider preventive use if the condition recurs.

Tinea Versicolor - Although not a Category I agent, selenium sulfide shampoo is universally recognized by dermatologists as an effective OTC remedy for tinea versicolor. Since it often affects large areas of the trunk, applying this shampoo once a day for five minutes, then washing off, is a lot easier and cheaper than using a whole tube of anti-fungal cream twice daily. Tinea versicolor also tends to recur easily, but this shampoo can prevent it if used once a week after the initial 2-4 week treatment cycle.

Candidiasis, Ringworm, and Jock Itch - Miconazole or clotrimazole are quickly effective (1-2 weeks) for each one of these conditions, and come in cream, lotion, or spray. Avoid alcohol-based products since they can sting chafed and delicate skin.

Recommended Products

* Dermisil AF. This soothing all-natural product is excellent for the treatment of athlete’s foot fungus and jock itch.

* Selsun Blue shampoo (active ingredient: selenium sulfide). See Treatment for discussion of using this shampoo for Tinea Versicolor.

* Dermisil R. This breakthrough product has a high cure rate for skin fungus infections like ringworm.

When To See Your Doctor

There are situations where self-treatment of fungus infections is inappropriate:

* Spread of athlete’s foot into the toenail beds. (toenails can't be successfully treated with OTC products)

* Bacterial secondary infections of athlete’s foot (indicated by spreading redness or swelling from the original site, extreme tenderness, foul odor, and yellow or cloudy drainage from a weeping area between the toes).

* Large areas impractical to treat with topical creams (prescription tablets treat the entire body).

* Recurrent infections despite appropriate treatment (other underlying medical problems or medication side-effects could be the real culprits).

As mentioned above, many different skin conditions mimic the appearance of fungal infections. If following the treatment guidelines above with appropriate medications doesn’t resolve the suspected fungal infection, have a doctor evaluate your rash. Examination and further testing may reveal something completely unexpected.

Australian Lawyers Question Discrepancies Surrounding The Use Of Prexige

2007-08-20T07:29:00.000-04:00

Lawyers have questioned why the banned drug Prexige was available in Australia at higher doses and with fewer warnings than in other countries.
Product liability law firms have started fielding calls from patients claiming to have suffered serious side-effects on the osteoarthritis painkiller urgently withdrawn one week ago.
The Therapeutic Goods Administration (TGA) pulled Prexige after receiving eight reports of liver damage, including two deaths and two patients who required liver transplants.
About 60,000 Australians have taken Prexige since it was registered in November 2005, with most prescribed after it joined the Pharmaceutical Benefits Scheme last August.
Most were on the controversial 200mg dose - double the dose recommended in other countries - and all eight cases under investigation involved 200-400mg doses.
Brisbane-based law firm Nicol Robinson Hallets, which has received legal queries from Prexige patients, said high dosing and poor warnings had put Australians at increased risk.
"We want to know why the TGA was allowing prescriptions to be authorised at 200mg and more," said lawyer Simon Harrison.
"There are 50 countries in the world that have approval for Prexige and only 15 actually sell it, and not one of those 15 countries have a dosage that's in excess of 100mg, so why did we?"
Mr Harrison also said Australia's Prexige pack labels contained none of the liver damage warnings included in other nations.
"In the UK, for example, the warning labels make four separate references to potential liver damage," he said.
"But warnings handed out on prescription labels here contain no reference to liver damage at all."
Mr Harrison said these discrepancies would strengthen the legal case for patients suffering adverse effects from the drug.
Bill Madden, head of medical negligence action at law firm Slater and Gordon, said the company had received at least four calls from patients "very severely affected" by the drug.
He expected numbers to grow over the next month as people return to their doctors to get liver function tests.
"There may some form of a claim under the Trade Practices Act against the manufacturer or the distributor," Mr Madden said.
"And there may also be some broader negligence claims, but they will depend a lot on what the manufacturer knew about these effects and whether the warnings were adequate."
Mr Harrison said the legal case would bear some similarities to another disgraced drug in the problematic Cox-2 inhibitor family, Vioxx, which was linked to cardiac problems.
However, the Prexige case was more straightforward because liver problems, unlike heart problems, were usually only triggered by alcohol abuse or genes, he said.
The TGA did not respond to media queries on Prexige dosage and warnings.

Western Australian Government To Cut Down Amphetamines Use In ADHD Treatment

2007-08-19T15:53:00.000-04:00

The Western Australian government aims to cut reliance on amphetamines in treating Attention Deficit Hyperactivity Disorder (ADHD) under a multi-million-dollar program.
Studies show dexamphetamines account for a substantial amount of amphetamine use by young people in WA.
The state has the nation's highest rate of amphetamine usage overall, and the highest rate of prescriptions of amphetamines for children diagnosed with ADHD.
WA Premier Alan Carpenter announced $9 million would be pumped into treatment of ADHD and the associated use of dexamphetamine.
"The teams will include professionals from a range of disciplines including psychiatrists, paediatricians, clinical psychologists, clinical nurses, speech pathologists, occupational therapists and social workers," Mr Carpenter said.
"While medication may still be required for severe cases of ADHD, this new approach will ensure that stimulant medication is not the first line of treatment."
The move is one of 49 recommendations adopted after a summit meeting held last month to tackle the illicit amphetamine scourge in WA.
Mr Carpenter said there was evidence to link the use of dexamphetamines during childhood to the broader use and abuse of amphetamines in adulthood.
"There is some evidence and a strongly held view amphetamines for the treatment of ADHD leads and encourages the use of amphetamines more broadly and clearly, obviously, the abuse," Mr Carpenter said.
Drug and Alcohol Office executive director Terry Murphy said the use of medication for ADHD patients was not wrong, but reliance on amphetamines in ADHD treatment was too heavy.
"Medication is not wrong per se. There will be some people for whom that is the optimum treatment, but here in Western Australia with the highest (rate) in the country, we think there is too heavy a reliance on that," Mr Murphy said.
Mr Murphy said 6.5 per cent of WA high school students reported using amphetamines and 5.5 per cent reported using diverted dexamphetamines.
"There's a big overlap between those two figures," Mr Murphy said.
A $16 million package has been earmarked to carry out recommendations to curb amphetamine use in WA, including tougher penalties for dealers who sell drugs around children or near licensed premises.
Under the changes, the sale of drugs to a child at or near a school or a public place where children are often present, will be considered an aggravated offence.

Recurrence of Stage III Colon Cancer Traced to High-Fat Diets

2007-08-15T11:29:00.000-04:00

After curative surgery and adjuvant chemotherapy for stage III colon cancer, patients who ate a high-fat diet were more likely to have a recurrence than those who ate a so-called prudent diet, found researchers here.

Those with a higher recurrence risk ate more meat, fat, French fries, refined grains, and desserts. Jeffrey A. Meyerhardt, M.D., M.P.H., of the Dana-Farber Cancer Institute, and colleagues, reported in the Aug. 15 issue of the Journal of the American Medical Association.

By contrast, a "prudent diet," high in fruits, vegetables, poultry, and fish, had no effect on cancer recurrence or death.
The findings came from a prospective observational study of 1,009 patients with stage III disease enrolled in a randomized adjuvant chemotherapy trial from April 1999 through May 2001. The NCI-sponsored Cancer and Leukemia Group B (CALGB) trial compared with weekly fluorouracil and leucovorin with weekly irinotecan, fluorouracil, and leucovorin.
Previous epidemiological studies have indicated that dietary factors are associated with the risk of developing colon cancer, the researchers wrote. "However, the influence of diet and other lifestyle factors on the outcome of patients with established colon cancer is largely unknown," they added.
It is possible, they said, that after resection of stage III colon cancer, increasing intake of the high-fat and processed foods in the Western diet may facilitate a milieu that allows residual microscopic disease to proliferate and spread.
Also, they said, patients rated high for consumption of foods in the Western diet after diagnosis may have had a similar diet before diagnosis and consequently may have had more biologically aggressive tumors. Nonetheless, there was no significant association between dietary pattern and tumor-related characteristics, the researchers said.
Patients filled out a semiquantitative food frequency questionnaire during and six months after adjuvant chemotherapy. Using factor analysis, the researchers identified two major dietary patterns, the fat-heavy Western diet and the prudent diet. Patients were then followed up for cancer recurrence or death.
During a median follow-up of 5.3 years for the overall cohort, 324 patients had a cancer recurrence, 223 died as a result, and 28 died without documented cancer recurrence.
Compared with patients in the lowest quintile of the Western pattern, those in the highest quintile had a more than three-fold higher risk of cancer recurrence or death (adjusted hazard ratio hazard ratio for disease-free survival, 3.25, 95% confidence interval 2.04-5.19; P for trend <0.001).
Patients in the highest quintile were also 2.9 times more likely to have a recurrence than those in the lowest quintile (adjusted HR, 2.85; CI, 1.75-4.63, P for trend <0.001).
Similarly, a significantly higher overall risk of death was observed compared with the lowest quintile (adjusted HR, 2.32; CI, 1.36-3.96, P for trend <0.001).
The reduction in disease-free survival with the Western diet was not significantly modified by sex, age, nodal stage, body mass index, physical activity level, baseline performance status, or treatment group.
No relationship was seen for recurrence-free survival (P for trend =0.84) or overall survival (P for trend =0.54) across various intakes of the prudent dietary pattern.
The adjusted hazard ratio comparing the highest and lowest quintiles of the prudent diet was 1.20 (CI, 0.83 -1.75) for disease-free survival (P for trend 0.78).
Similarly, no relationship was seen for recurrence-free or overall survival across the various intakes for those who ate a prudent diet.
Higher prudent diet scores were found for patients who were physically active, had a lower BMI six months after adjuvant therapy, and were less likely to be smokers.
Higher undesirable Western scores were seen among men, whites, and past or current smokers.
In contrast, other characteristics, particularly tumor types known to predict prognosis, did not vary significantly among the quintiles of either dietary pattern, the researchers reported.
The researchers pointed out that they could not completely exclude the possibility that a higher intake of the Western pattern may have reflected other predictors of poor prognosis.
Nevertheless no significant association between diet and predictors associated with cancer recurrence (extent of invasion into bowel wall, number of positive lymph nodes) was observed.
Because the study was observational, causality cannot and should not be drawn from these data, Dr. Meyerhardt wrote. Nonetheless, the data suggest that eating more red and processed meat, sweets and desserts, French fries, and refined grains increases the risk of recurrence and decreases survival.
"Further analyses are under way to better delineate specific nutrients or food groupings that may have the strongest association," the authors concluded.
Eric Jacobs, Ph.D., a senior epidemiologist at the American Cancer Society, called the study by Dr. Meyerhardt and colleagues well-designed and addressing "an important question that has not been studied so far."
He pointed out that diet and the risk of colon cancer studies have not been consistent, but there has been almost nothing about the risk of recurrence. "The effect of diet on recurrence may be biologically different from the original risk," he noted. "Other studies will have to attempt to duplicate the results and then see where it leads."
As to why the prudent diet showed no benefit beyond not stimulating recurrence is an important question, he added. "Stay tuned," Dr. Jacobs said. "It's a really important question and needs more research."

Do Not Ignore Those Heat Cramps

2007-08-14T12:43:00.001-04:00

Heat cramps occur in people who are exerting themselves during periods of significant heat and humidity. They shouldn't be ignored, because heat cramps can be the first signs of more serious conditions, including heat exhaustion or heat stroke.The American Red Cross suggests these steps if you get heat cramps or additional warning signs of heat-related illness:
If you have heat cramps or more serious symptoms of heat-related illness, immediately stop all activity and rest. Go to an air-conditioned or shady place, if possible.
Symptoms of more serious heat-related illness include: moist, pale skin; headache, dizziness, weakness, exhaustion or nausea.
Drink cool water or a sports drink slowly and in small amounts.
Stretch the cramped muscles, and hold the stretched position for about 20 seconds. Repeat the stretching until the cramps have stopped.
If symptoms persist, seek immediate medical attention. Resume activity only if you no longer have any symptoms. But be very careful of overexertion and overheating.

Pictures Of Mattel Toy Recall

2007-08-14T11:14:00.000-04:00

Mattel has a reputation for being one of the most conscientious toy makers and is known for having sophisticated inspection and testing systems at many of its China facilities to guard against flawed, defective or tainted products. However, Mattel has recently voluntarily recalled some products for two different reasons: impermissible use of lead paint and risks associated with small, high-powered magnets. Below are photographs of such toys.

Painkiller Prexige Recalled In Australia

2007-08-11T23:19:00.000-04:00

A PAINKILLER used by 60,000 Australians has been ordered off the shelves after the deaths of two people.

The Therapeutic Goods Administration yesterday announced the urgent recall of the drug Prexige, used to treat osteoarthritis and acute pain. Patients using the drug, also known by its chemical name lumiracoxib, are advised to stop taking it immediately and ask their doctor for an alternative prescription.

The TGA made the decision after receiving reports of eight people who suffered serious liver reactions, including two deaths and two liver transplants. Six of the reports occurred since the beginning of July.

TGA medical adviser Rohan Hammett said in a statement yesterday the drug was being recalled to prevent further cases of severe liver damage.

"It seems that the longer people are on the medicine, the greater chance of liver injury," Mr Hammett said.

Australia is the first country in the world to withdraw the drug, which is produced by Novartis Pharmaceuticals. Novartis estimates the drug has been used by about 60,000 Australians.

It is not yet known whether the 50 other countries that sell the drug will follow suit. Prexige is still awaiting approval by the US Food and Drug Administration.

Prexige went on sale in Australia in November, 2005 and gained widespread use since being listed on the Pharmaceutical Benefits Scheme in August last year. At the time, patients were warned to exercise caution with Prexige because it belonged to a family of drugs known as Cox-2 inhibitors linked with heart attack and stroke.

Cox-2 inhibitors, dubbed "super aspirin", have been under a cloud since a popular painkiller Vioxx was withdrawn in 2004 for increasing the risk of cardiovascular disease. Australia's National Prescribing Service - an independent, government-funded agency that advises doctors about the safe use of medications - warned last year that not enough was known about the long-term safety of Prexige.

Novartis spokeswoman Rebecca Fisher-Pollard urged people who used the drug not to panic. She said liver damage was known as a possible side effect but the incidence was rare.

"The information has always been there," Ms Fisher-Pollard said.

Novartis has set up a patient helpline to answer queries. Patients are advised to return any unused Prexige tablets to their pharmacist, who will give them a full refund. All GP groups and pharmacists have been alerted about the drug recall.

Babies' Health In Danger From Plastic Baby Bottles

2007-08-09T14:46:00.000-04:00

A federal panel of scientists concluded Wednesday that an estrogen-like compound in plastic could be posing some risk to the brain development of babies and children.

Bisphenol A, or BPA, is found in low levels in virtually every human body. A component of polycarbonate plastic, it can leach from baby bottles and other hard plastic beverage containers, food can linings and other consumer products.

Culminating months of scientific debate, the decision by the 12 advisors of the Center for the Evaluation of Risks to Human Reproduction -- part of the National Institutes of Health -- is the first official, government action related to the chemical. Their recommendation will be reviewed for a federal report that could lead to regulations restricting one of the most used chemicals.

The scientists ranked their concerns about BPA, concluding they had "some concern" about neurological and behavioral effects in fetuses, infants and children, but "minimal" or "negligible" concern about reproductive effects. The findings put the panel roughly in the middle -- between the chemical industry, which has long said there is no evidence of danger to humans, and the environmental activists and scientists who say it is probably harming people.

Steve Hentges of the American Chemistry Council's polycarbonate division said the panel's report was "strong reassurance to consumers" that products containing BPA are safe.

Frederick vom Saal, a University of Missouri-Columbia reproductive toxicologist who has conducted studies on BPA, was disappointed that the panel did not rank the risk higher. But, he said, "the panel is now on record saying there are human health concerns."

The panel reviewed about 500 animal studies, many of which reported that the estrogen-like chemical alters various functions and parts of the body. Some have found altered brain development, precancerous changes in prostates and mammary glands, low sperm counts, and damage to the uterus. Plastics industry representatives say the lab experiments are inconclusive and flawed.

No study has looked for effects in people exposed to the plastic products, which have contained BPA for 50 years.

The panel had five rankings for its findings: negligible concern, minimal concern, some concern, concern and severe concern. In its conclusion, the level was "some concern."

For fetuses, pregnant women, infants and children, the panel reported there was "some concern that exposure to bisphenol A causes neural and behavioral effects." In studies of newborn animals, low doses of BPA cause structural changes in the brain that trigger learning deficits and hyperactivity.

For fetuses and children, they said there was "minimal concern" that BPA harms the prostate gland and causes premature puberty, and "negligible concern" that it causes birth defects.

For adults, they reported "negligible concern about adverse reproductive effects."

John Bucher, associate director of the National Toxicology Program, which oversees the reproductive health center, said the panel gave the most weight to neurological effects in children, infants and fetuses because studies consistently have found those effects when newborn animals are exposed to low doses similar to what people encounter. Bucher said that because the science remains uncertain, it is up to individuals to decide whether they want to avoid products containing BPA.

"To me, we're still in that stage of scratching around at the surface of this issue," he said.

Last week, Vom Saal and 37 other scientists published a consensus statement in a scientific journal concluding it was likely that BPA affected humans, even at low doses. The federal panel's findings were not as strongly worded.

Environmentalists lambasted the panel, saying it had minimized the risks and ignored important research.

"Only the chemical industry agrees with the decision that BPA has little or no human health risks. That by itself should speak volumes about the corrupted process endorsed by the panel today," said Dr. Anila Jacob of the Environmental Working Group.

In March, the Los Angeles Times reported that the panel's preliminary report on BPA was drafted by a private consulting firm with financial ties to the chemical industry. The National Toxicology Program fired the company but ruled that the report was unbiased.

Part of the reason the panel ranked the risks as less serious than did the other group of scientists is that the panel rejected several dozen animal studies that found reproductive effects. In those studies, animals were exposed through injections, rather than through their diet. The decision to reject the studies has been controversial with toxicologists.

Two of the panel's scientists are from private pharmaceutical companies, six from universities and two from federal agencies. It was chaired by Robert Chapin, head of developmental toxicology at Pfizer Inc. None has expertise in BPA.

Their recommendations will go to the National Toxicology Program, the federal scientists who help regulators mold policy about toxic substances. Officials there will send their report out for review by other scientists before deciding whether to declare BPA toxic to humans. Bucher said he would also update it with the consensus statement and studies published last week.

The final report could trigger a review of BPA by California officials under Proposition 65, which requires warnings on consumer products that pose a risk of cancer or reproductive harm.

FDA OK Prilosec And Nexium For Heartburn

2007-08-09T12:24:00.000-04:00

The popular heartburn drugs Prilosec and Nexium don't appear to spur heart problems, the Food and Drug Administration announced Thursday.

The agency reviewed the issue after the drugs' manufacturer, AstraZeneca, sent regulatory officials a preliminary analysis of two small studies in May that suggested the possibility of a risk.

Those studies compared treating the chronic heartburn known as gastroesophageal reflux disease, or GERD, with drugs or surgery. The company's initial analysis counted more patients treated with drugs who had heart attacks, heart failure or heart-related sudden death.

The FDA followed up on those studies, and found that they seemed skewed: Patients who underwent surgery were younger and healthier than those treated by drugs, suggesting the heart link was a coincidence.

The agency then looked at 14 additional studies of the drugs, and found no evidence of heart risks. In fact, in a few studies where patients received either medication or a dummy pill, those who took the heartburn drugs actually had a lower incidence of heart problems.

The FDA plans to complete its probe within three months, but issued a public notice Thursday that it "does not believe that health care providers or patients should change either their prescribing practices or their use of these products at this time."