Archive for April, 2009
April 30th, 2009 by Nina Thompson, ARNP
“The 1918 influenza epidemic started with cases in the spring, seemingly disappeared over the summer, and then returned with a vengeance in the fall”, according to the CDC.
In the Northern hemisphere, the usual seasonal flu virus tends to disappear by April and re-emerges by November. It can, however, be caught at any time of the year.
The real concern over this most recent outbreak may well occur this coming Fall.
April 29th, 2009 by Nina Thompson, ARNP
Nobody knows whether swine influenza A (H1N1) will cause a pandemic, become endemic in humans causing continuous small outbreaks, or fizzle out and disappear, according to Dr. Klaus Stohr in an article in MedPage Today.
“If the virus were to “disappear” though, that would not necessarily eliminate the need to prepare for its re-emergence if it remained in an animal reservoir”, said Klaus Stohr, D.V.M., vice president and global head of Novartis Vaccines and Diagnostics and former head of the World Health Organization’s global influenza program. “The earliest the public would see a vaccine against the disease would be September”, a researcher said at the conference on Influenza Vaccines for the World, according to MedPage Today.
The swine flu outbreak serves as “a stark reminder of the unpredictability of the timing and of the speed by which the pandemic situation can change,” Dr. Klaus added.
Read more:
Source: MedPage Today, April 29, 2009
April 29th, 2009 by Nina Thompson, ARNP
The World Health Organization has raised the global alert level for swine flu to Phase 4, indicating that the
virus is becoming more adept at spreading among humans. The increase in the pandemic alert phase indicates that the likelihood of a pandemic has increased.
The CDC has issued a travel warning recommending that people avoid non-essential travel to Mexico. Health officials are urging people to follow important, common sense preventive measures:
- Wash your hands often with soap and water, especially after you cough or sneeze, before eating or touching your face, mouth or nose. Flu viruses can survive for two hours or longer on surfaces, such as doorknobs and countertops.
- Alcohol-based hands cleaners are also effective. Carry a small bottle with you at all times to use when a sink is not available.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Try to avoid close contact with sick people.
Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people. It is not spread by eating pork because cooking to an internal temperature of 160 F (71 C) kills the virus. So eating properly cooked pork is safe. Swine flu is spread like any other respiratory disease, via droplets from sneezes and coughs. You can breathe in these droplets or become infected by touching a contaminated surface and then touching your eyes or mouth.
If you get sick, the CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them. Call your doctor or health care provider for further recommendations. An important note for children, always check with your pediatrician before giving your child any cold medicines. Do Not Give Aspirin To a Child or Teenager Who Has the Flu or Flu-like symptoms.
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Source: CDC, April 28, 2009
April 27th, 2009 by Nina Thompson, ARNP
A public health emergency was declared on Sunday to manage new cases of swine flu. At this time, 42 U.S. cases of swine flu have been reported in five states–California, Texas, Kansas, New York and Ohio.
Officials suspect that this particular strain of swine flu might be the same strain that has also been identified in Mexico and Canada. However, in Mexico this same strain appears to be killing dozens of people, whereas cases in the United State have been mild. Health authorities don’t yet understand this difference.
As of April 27, 2009, the United States Government has reported 40 laboratory confirmed human cases of swine influenza A(H1N1), with no deaths. Mexico has reported 26 confirmed human cases of infection with the same virus, including seven deaths. Canada has reported six cases, with no deaths, while Spain has reported one case, with no deaths. Many of the people under observation around the world have reported recent travel to Mexico.
According to the CDC, there are everyday actions people can take to stay healthy.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
- Avoid touching your eyes, nose or mouth. Germs spread that way.
- Try to avoid close contact with sick people.
Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
If you get sick, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
Major airlines, including American, United and Continental, have begun revising their policies so that travelers flying to Mexican cities can change their plans without fees or penalties.
This is a rapidly evolving situation and the CDC will provide updated guidance and new information as it becomes available.
Read more about Influenza from Bay Area Medical Information
If you are traveling to Mexico, read the following important travel information from the CDC
Source: Center for Disease Control, April 27, 2009; World Health Organization, April 27, 2009
April 17th, 2009 by Nina Thompson, ARNP
Eating a breakfast with a low glycemic index may increase the fat burning during exercise, according to British researchers. They studied fat-burning rates with exercise after two different types of breakfast–one that had a high glycemic index and one that had a low glycemic index. Women exercised by walking briskly for 60 minutes three hours after their morning meal. The researchers found that fat burning remained significantly higher in those who had a breakfast with a low glycemic index. Those who ate a high glycemic-index breakfast had a lower rate of fat burning.
In a previous study, the same researchers found that active women who consumed a low glycemic-index breakfast three hours before a 60-minute run increased fat burning by about 55% compared with those who ate a high glycemic-index breakfast.
Low and high glycemic-index foods were chosen on the basis of the International Table of Glycemic Index and Glycemic Load Values. In the most recent study, the low glycemic-index breakfast had an index rating of 44 compared with 78 for the high glycemic-index breakfast. Test breakfasts for each group totaled 265 calories. The LGI breakfast consisted of museli, skim milk, apple juice, an apple, canned peaches and yogurt. The HGI breakfast included corn flakes, white bread, jam, skim milk, margarine and a carbonated glucose drink (Lucozade).
Carbohydrates with a low glycemic index (LGI) have less impact on blood glucose levels and insulin response than carbohydrates with a higher glycemic index. LGI foods include whole grain foods such as cereals made from oats, barley, and bran, as well as whole grain breads and most vegetables other than potatoes. Highly processed foods made with white flour or white sugar fall in the higher glycemic index category.
Source: Stevenson EJ, et al “Fat oxidation during exercise and satiety during recovery are increased following a low-glycemic index breakfast in sedentary women” J Nutr 2009; 139: 890-97.
April 14th, 2009 by Nina Thompson, ARNP
Frequently patients who survive critical illnesses later become clinically depressed, according to researchers from Johns Hopkins University. In their recent study of intensive care (ICU) patients who suffered either multiple organ failure, underwent surgery, or received high doses of benzodiazepine (Xanax, Valium) while in the ICU, 26% of the participants were suffering symptoms of depression at six months after ICU discharge.
Depression is a true medical condition that strikes people of all ages, backgrounds, and ethnic groups. The exact cause of it is not entirely certain, but we do know: depression tends to run in families, it is cyclical and tends to recur, it is usually triggered by a stressful event, and it is associated with an imbalance of chemicals in the brain.
Normal function of the brain involves a complex interaction of chemicals, called neurotransmitters. Depression is associated with an imbalance of these neurotransmitters.
Depression occurs in waves, or spells, and can last for months or even years if left untreated. Sometimes people who are depressed try to feel better by using alcohol or drugs. This doesn’t help the depression in the long run; in fact, alcohol and illegal drug use are well known for making depression worse and can easily lead to a vicious downhill path of substance abuse and addiction.
Depression is not a sign of weakness or a character flaw. It is a true medical condition like diabetes or hypertension, and it is often an overwhelming disease. Depression deeply affects not only the person who is depressed, but close family and friends are usually greatly impacted as well.
More people suffer from depression than you might think. Twenty-five percent of all women and up to 12% of all men in the U.S. will experience an episode of major depression some time in their lives. A person who is depressed to the point that it interferes with daily activities should seek medical care.
There are many treatments available. Prescription medicines for depression or anxiety may be helpful. Talking to a mental health professional and your friends and family about your feelings and the experience can also help. Regular daily exercise, if you are medically able, is extremely helpful in treating depression.
Read about
Source: Dowdy D, et al “Are intensive care factors associated with depressive symptoms 6 months after acute lung injury?” Crit Care Med 2009; DOI: 10.1097/CCM.0b013e31819fea55.
April 10th, 2009 by Nina Thompson, ARNP
Two prescription medications commonly prescribed for Parkinson’s, and also used to relieve the symptoms of restless legs syndrome, have again been linked to compulsive gambling and hypersexuality. A recent study from the Mayo Clinic found that of 66 patients who were taking either pramipexole (Mirapex) or ropinirole (Requip) for Parkinson’s, seven developed one of the destructive behaviors which resolved after the medications were discontinued or the doses were reduced.
Previous studies have identified a link between these drugs and compulsive behavior as well. In addition to gambling and hypersexuality, therapeutic levels of the medications have also been associated with compulsive eating, as well as excessive shopping or spending. Less destructive behaviors such as compulsive gardening, excessive fishing or hobby work have also been related to these drugs.
Mirapex and Requip are used alone or with other medications to treat the symptoms of Parkinson’s disease. They are also used in lower doses to help relieve the symptoms of restless legs syndrome. They are in a class of medications called dopamine agonists. A natural substance in the brain, Dopamine is needed to control movement.
Patients, as well as spouses or family members, need to be aware of this potential dangerous side effect of these drugs. ”The onset can be insidious and overlooked until life-altering problems develop”, according to the researchers in an article in MedPage Today. Contact your health care provider if new symptoms arise while on either of these drugs.
Source: Bostwick J, et al “Frequency of new-onset pathologic compulsive gambling or hypersexuality after drug treatment of idiopathic Parkinson disease” Mayo Clin Proc 2009; 84: 310-316.
Source: “Parkinson’s Drugs May Increase Compulsive Behavior”, MedPage Today, April 9, 2009
April 9th, 2009 by Nina Thompson, ARNP
Being overweight or obese raises a person’s risk of developing heart failure, according to a recent analysis of two large Swedish studies, from the Cardiovascular Epidemiology Research Unit of Beth Israel Deaconess Medical Center in Boston.
In these two studies, waist size was also a factor for women, but not for men. In women, body mass index was a risk factor for heart failure, but only among those with the largest waists. Whereas for men, waist size was not a factor, but for each one-point increase in BMI, the risk of heart failure increased by 4%.
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Source: “Heart Failure” Circulation, April 7, 2009
April 8th, 2009 by Nina Thompson, ARNP
People who have abdominal obesity are more likely to have Restless Legs Syndrome (RLS), according to researchers from Harvard Medical School. In a recent study of more than 88,000 American adults, obese men and women were 42 percent more likely to have RLS than those who were of normal weight, and those with abdominal obesity were particularly prone to RLS.
Restless legs syndrome (RLS) is a condition in which an unpleasant, restless sensation in the legs arises after prolonged inactivity such as sitting or lying down. The longer the period of rest, the greater the chance the symptoms will occur and the more severe they are likely to be. These symptoms are typically relieved by walking or movement of the legs such as jiggling, stretching or massaging legs to get relief. As soon as the movement stops however, the symptoms recur.
The exact uncomfortable sensation of RLS varies from person to person and can be described as burning, creeping, crawling, jittery, aching, or tugging, sensation inside the legs, feet, or arms. Ranging in severity from uncomfortable to painful, the symptoms of RLS typically arise in the evening, and dissipate in the early morning hours.
Obesity is medically defined as having a body mass index (BMI) of 30 kg/m2 or higher. Unhealthy waist circumference is usually defined as over 40 inches in men and over 35 inches in women. This is determined by placing a measuring tape snugly around the smallest area of your waist. Also, you can more precisely find out if you have abdominal obesity by calculating your waist to hip ratio.
Excess abdominal fat also appears to be linked with high blood pressure, diabetes, heart disease, migraine, stroke, diverticulitis and diverticular bleeding.
The best way to trim excess abdominal fat is with exercise. While any type of exercise is always helpful for those who can tolerate it, periodic, intense exercise is best for burning the fat around the midsection, according to researchers.
It’s very important to note, however, that anyone new to exercise should start off slow and gradually build the intensity, duration and frequency of workouts. Older adults and people with chronic health conditions should always talk to their doctors before starting an exercise program.
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Source: Dr. Xiang Gao, Harvard Medical School
April 7th, 2009 by Nina Thompson, ARNP
When it comes to weight loss, cutting down on sugary drinks may work better than eating less, say researchers from the Johns Hopkins Bloomberg School of Public Health. Weight loss efforts were more successful in their recent study of people who cut down on sugary beverages versus those who eliminated the same amount of calories from solid food.
One explanation for these findings is that the body tends to self-regulate its intake of solid food. In other words, a person who eats a large breakfast and lunch will naturally be less hungry at dinner. This self-regulation does not occur with sugary liquids. In fact, sodas and other sugary beverages, including alcohol, simply don’t satisfy and account in large part for the growing obesity epidemic. By 2015, experts contend that 75 percent of U.S. adults could be overweight or obese.
SOURCES: Liwei Chen, M.D., Ph.D., M.H.S., assistant professor of epidemiology, School of Public Health, LSU Health Science Center, New Orleans; Connie Diekman, M.Ed, R.D., director, University Nutrition, Washington University, St Louis; April 1, 2009, American Journal of Clinical Nutrition
