Measure and diagnosis of hypertension should focus exclusively on systolic blood pressure in patients aged over 50 years, rather than using both systolic and diastolic as is current practice.
The experts say that, because of ageing populations, systolic hypertension (SH) is becoming much more common and important due to its high prevalence in patients aged 50 years and over, compared with diastolic hypertension.
Systolic blood pressure (SBP) rises with age, but diastolic blood pressure (DBP) only rises until around age 50 and falls thereafter, at a time when risk of cardiovascular disease begins to rise. Thus there is an increased prevalence of SH in patients aged 50 years and over, and an almost total disappearance of DH. Since more than 75% of people with hypertension are aged over 50 years, the burden of disease is mainly due to systolic pressure.
Also,SBP is more easily and accurately measured than DBP and is a better predictor of risk.
Saturday, June 28, 2008
Treating Herpes zoster ownway
My closely related person has acquired Herpes last week, so i start learning about Herpes zoster. Here are some very essential points that i have gathered for the patients of Shingles.
You can't prevent yourself from contracting shingles. This is because it is not contracted from someone with shingles or chickenpox infection as you get shingles from your own chickenpox virus. BUT, If you have shingles, you could transmit the virus, and people could develop chickenpox as a result of contact with you. Hence it is essential for you to remain away from others for about 7-9 days until the blisters have dried, because till then, the virus is present in the blister fluid. Isolate patient with active skin lesions to prevent him from infecting others.
Let him remain away from those people who have a poor immune system, pregnant women or those who are immunocompromised as they are at a higher risk to develop the disease.Local dressing with water at room temperature, for ½ an hour-1 hour, at least 5-6 times everyday helps some patients. Cool wet compresses also help to lessen the pain. Application of soothing lotions like Calamine or soothing bath like starch baths etc. may relieve discomfort and ease the skin irritation in some individuals.
Rubbing some coconut oil 4-5 times daily would nourish the skin and prevent dryness.
Food that one can avoid during shingles
Sugar and chocolates, Drinks like coffee, alcohol, soft drinks Fried foods, Peanuts and peanut butter,White rice and white flourProcessed meats.
You can't prevent yourself from contracting shingles. This is because it is not contracted from someone with shingles or chickenpox infection as you get shingles from your own chickenpox virus. BUT, If you have shingles, you could transmit the virus, and people could develop chickenpox as a result of contact with you. Hence it is essential for you to remain away from others for about 7-9 days until the blisters have dried, because till then, the virus is present in the blister fluid. Isolate patient with active skin lesions to prevent him from infecting others.
Let him remain away from those people who have a poor immune system, pregnant women or those who are immunocompromised as they are at a higher risk to develop the disease.Local dressing with water at room temperature, for ½ an hour-1 hour, at least 5-6 times everyday helps some patients. Cool wet compresses also help to lessen the pain. Application of soothing lotions like Calamine or soothing bath like starch baths etc. may relieve discomfort and ease the skin irritation in some individuals.
Rubbing some coconut oil 4-5 times daily would nourish the skin and prevent dryness.
Food that one can avoid during shingles
Sugar and chocolates, Drinks like coffee, alcohol, soft drinks Fried foods, Peanuts and peanut butter,White rice and white flourProcessed meats.
Merck's Gardasil not cleared for older women
U.S. regulators have told Merck & Co they cannot yet approve Merck's application to expand marketing of its cervical cancer vaccine Gardasil to an older group of women, the drugmaker said on Wednesday.
Merck had applied for the use of Gardasil in women ages 27 through 45. The U.S. Food and Drug Administration said in a letter regarding the application that it has completed its review and there are "issues" that preclude approval within the expected review time frame, Merck said.
"It's hard to get a feel for if this is a dead issue or if this is delayed," said Linda Bannister, an analyst for Edward Jones. "At the minimum, it's going to be delayed."
Merck said it also failed to win FDA approval to expand Gardasil to protect against more strains of the Human Papillomavirus that causes cervical cancer. The company for now is dropping plans to pursue that expansion, a spokeswoman said.
Shares of the New Jersey-based drug maker, which also reiterated its long-term revenue and earnings targets, fell 0.8 percent.
Gardasil, approved in June 2006 for preventing cervical cancer and genital warts in females ages 9-26, has been one of Merck's most successful newer products and has helped the company recover after the 2004 withdrawal of its Vioxx arthritis treatment.
The Gardasil setbacks could raise concerns about the degree of growth that Merck can hope to achieve with the product, which is the world's first vaccine to prevent cervical cancer.
A Merck spokeswoman said the agency has specific questions regarding Gardasil's effectiveness in this older age group.
The company said it had already discussed the questions with the FDA and expects to respond to the agency in July.
"Once we go back to the FDA, we'll have a better sense of what the review timing looks like," spokeswoman Amy Rose said.
The agency's response on the application for the older group does not affect Gardasil's current approval for females ages 9 to 26, Merck said.
Global sales of Gardasil rose 7 percent in the first quarter to $390 million. Cowen and Co has predicted annual sales of the vaccine would reach $1.9 billion in 2008 and jump to $3 billion by 2012.
Edward Jones' Bannister said she had expected Gardasil sales to reach $2.6 billion by 2012, with about one-third to come from that older age group.
Deutsche Bank analyst Barbara Ryan said failure to win approval for the older age group could reduce her $3.8 billion estimate for 2012 sales by about $300 million.
Ryan said the most important new opportunity for the vaccine will be for its use in males. The vaccine could help prevent males from contracting Human Papillomavirus and spreading it to females through sexual contact. Merck is on track to seek approval for use in males by the end of the year, Rose said.
Gardasil has benefited from lengthy delays in approval of GlaxoSmithKline's rival Cervarix vaccine. The FDA in December issued a complete response letter for Cervarix, meaning it had completed its review of the product but had further questions about it.
Bannister said the Gardasil delay reflects broader challenges facing drug makers within the U.S. regulatory environment.
"It's not specific to Merck," Bannister said. "This is an industry-wide issue."
Merck shares fell 29 cents to $36.74 in afternoon trading on the New York Stock Exchange. The shares have fallen some 37 percent this year, hurt by setbacks to its cholesterol franchise.
Sleeping sound in the belief herbal medicine works
The ancient art of herbal medicine has long been tainted with associations with new age quacks. But, as MATTHEW JENKIN discovers, there is more to the Western tradition than spells and potions.HERBAL medicines are often the last resort for people when it comes to preventing and treating illness.
However, after having a consultation with a professional, I realised the practise offers real help for many.
I have suffered from mild insomnia for many years and have tried almost everything for a quick cure.
But, apart from prescription drugs and a stiff drink, nothing seemed to work.
So, when the chance to see a medical herbalist was offered, I was the first in line.
advertisementThe consultation with Richard Adams was held at his home in Maidenstone Hill, Blackheath.
I was greeted with a smile and a cup of strong, but delicious, liquorice and fennel tea.
Reporter Matthew Jenkin looks slightly concerned at the diagnosis by medical herbalist Richard Adams
Mr Adams was quick to dispel any new age fantasy I might have had about western herbalism.
He said: "Herbal medicine covers a broad range of herbal knowledge and my tradition is the European one, dating back to the ancient Greeks.
"Because we have western medical training now it's become known as medical herbalism, to differentiate us from people simply selling herbs in the market.
"This name came about in 1864, when the National Institute of Herbal Medicine was formed.
"It still remains the main professional body for England and Ireland."
Mr Adams qualified as a medical herbalist from the College of Practitioners of Phytotherapy, in Polegate, East Sussesx, which specialises in herbal medicine, in 1990.
As well as running his own practice at his home, he lectures on herbal medicine at Middlesex University.
My consultation began like any other visit to a doctor.
My pulse and blood pressure were measured and my tongue was inspected.
But while questions on both mine and my family's medical history were unsurprising, Mr Adams's exploration of my lifestyle and emotional state was very different.
He said: "The herbal medical tradition takes a holistic approach to diagnosis and treatment of disease.
"Holistic medicine is about integrating the emotional, psychological and even spiritual elements of disease and linking people with the wider world.
"This takes a little time and attention."
After a thorough consultation, instead of the familiar scientific diagnosis, Mr Adams related my problems to the ancient Greek belief in the influence of the four elements on the body and mind.
Apparently, the predominance of fire and air means my mind is too busy and energetic - which explains my sleepless nights.
Mr Adams said a mixture of various plants and herbs would help, so I gingerly watched him pour a selection of liquids into a small brown bottle for me to take twice a day.
The bitter-tasting liquid was definitely not a spoonful of sugar, nor was it a miracle cure, but for the first time in weeks I enjoyed a restful night's sleep.
So, in an age when people are increasingly more and more reliant on drugs to cure illnesses, perhaps it is time we once again turned to Mother Nature to soothe our bodies and souls.
A healthy lifestyle cure for Arthritis
Regular exercise, maintaining ideal weight, stress reduction, being a non-smoker and getting good sleep are part of better living with arthritis. Learn why it is important to adopt these lifestyle modifications.
Exercise: Essential Treatment for Arthritis
increases energy levels
helps develop a better sleep pattern
helps with weight control
maintains a healthy heart
increases bone and muscle strength
decreases depression and fatigue
Moving the joints daily helps to keep them fully mobile. Added joint support is achieved by strengthening the surrounding muscles. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects the ends of the bones.
Types of Exercise
Range-of-motion Exercises
Range-of-motion exercises are gentle stretching exercises which move each joint as far as possible in all directions. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities. ROM (range-of-motion) exercises are especially important for arthritis patients, who because of intense inflammatory pain tend not to want to move painful joints. It is the notion of some people that normal daily activities take joints through their full range-of-motion but this is not the case. Normal daily activities, such as housework, dressing, bathing, and cooking, are not a substitute for ROM exercises.
Strengthening Exercises
Strengthening exercises help increase muscle strength. Strong muscles help to support the joints.
The best time to exercise is when pain and stiffness are at a minimum. Some patients feel the best time is after morning stiffness subsides. Other patients dislike the afternoon because they are fatigued by that time of day.
Exercise: Essential Treatment for Arthritis
increases energy levels
helps develop a better sleep pattern
helps with weight control
maintains a healthy heart
increases bone and muscle strength
decreases depression and fatigue
Moving the joints daily helps to keep them fully mobile. Added joint support is achieved by strengthening the surrounding muscles. Also, joint movement transports nutrients and waste products to and from the cartilage, the material which protects the ends of the bones.
Types of Exercise
Range-of-motion Exercises
Range-of-motion exercises are gentle stretching exercises which move each joint as far as possible in all directions. These exercises need to be done daily to help keep joints fully mobile and prevent stiffness and deformities. ROM (range-of-motion) exercises are especially important for arthritis patients, who because of intense inflammatory pain tend not to want to move painful joints. It is the notion of some people that normal daily activities take joints through their full range-of-motion but this is not the case. Normal daily activities, such as housework, dressing, bathing, and cooking, are not a substitute for ROM exercises.
Strengthening Exercises
Strengthening exercises help increase muscle strength. Strong muscles help to support the joints.
The best time to exercise is when pain and stiffness are at a minimum. Some patients feel the best time is after morning stiffness subsides. Other patients dislike the afternoon because they are fatigued by that time of day.
No Cold, Cough Medicines for Babies
The FDA today urged parents and caregivers not to give over-the-counter (OTC) cough and cold medicines to children younger than 2 because of dangerous side effects.
"We strongly recommend that over-the-counter cough and cold products should not be used in infants and young children under 2 years of age because serious and potentially life-threatening side effects can occur from use of these products," Charles Ganley, MD, director of the FDA's Office of Nonprescription Products, said at a news conference.
OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives (cough suppressants) for the treatment of colds.
An FDA news release states that rare, serious adverse events -- including convulsions, rapid heart rates, decreased levels of consciousness, and death -- have been reported with use of cough and cold products.
The FDA is still reviewing the use of cough and cold medicines in children aged 2-11.
FDA Timeline
Today's FDA recommendation is in line with the findings of an FDA advisory panel that weighed in on the topic last October, shortly after makers of OTC cough and cold drugs for infants voluntarily took those products off the market.
A key concern has been the potential for accidental overdoses if the dosing instructions for those drugs aren't followed exactly as instructed.
"I will point out that the FDA has never endorsed the use of these products in children less than 2 years of age," Ganley says. "We've always acknowledged that there was no safety and efficacy data. It was really left to the discretion of health providers to determine whether use of one of these products was appropriate in these age groups."
Ganley says the FDA decided to issue today's advisory after learning of recent surveys that show that some parents aren't aware of the warnings issued last fall about the use of OTC cough and cold drugs in kids younger than 2.
"This announcement will bring this issue back into the public consciousness, particularly since it's cold season now," Ganley says.
Industry Responds
The Consumer Healthcare Products Association (CHPA), a trade group representing makers of over-the-counter (OTC) medicines, issued a statement supporting today's FDA's decision.
"Safety has always been and continues to be our top priority," says CHPA President Linda Suydam, DPA.
"Today's decision by the FDA reaffirms the correct course of action taken by the leading makers of these medicines last fall," says Suydam, referring to the voluntary withdrawal of over-the-counter cough and cold drugs for infants.
The CHPA is working with retailers, doctors, and the FDA "to ensure that parents have the tools they need to safely and appropriately administer OTC oral cough and cold medicines to children over the age of two," Suydam says.
Tips for Parents of Older Kids
Speaking at today's FDA news conference, Lisa Mathis, MD, associate director of the FDA's Pediatric and Maternal Health Staff in the Office of New Drugs, reminded parents that the FDA hasn't finished reviewing cough and cold drugs for older children.
"We strongly recommend that over-the-counter cough and cold products should not be used in infants and young children under 2 years of age because serious and potentially life-threatening side effects can occur from use of these products," Charles Ganley, MD, director of the FDA's Office of Nonprescription Products, said at a news conference.
OTC cough and cold products include decongestants, expectorants, antihistamines, and antitussives (cough suppressants) for the treatment of colds.
An FDA news release states that rare, serious adverse events -- including convulsions, rapid heart rates, decreased levels of consciousness, and death -- have been reported with use of cough and cold products.
The FDA is still reviewing the use of cough and cold medicines in children aged 2-11.
FDA Timeline
Today's FDA recommendation is in line with the findings of an FDA advisory panel that weighed in on the topic last October, shortly after makers of OTC cough and cold drugs for infants voluntarily took those products off the market.
A key concern has been the potential for accidental overdoses if the dosing instructions for those drugs aren't followed exactly as instructed.
"I will point out that the FDA has never endorsed the use of these products in children less than 2 years of age," Ganley says. "We've always acknowledged that there was no safety and efficacy data. It was really left to the discretion of health providers to determine whether use of one of these products was appropriate in these age groups."
Ganley says the FDA decided to issue today's advisory after learning of recent surveys that show that some parents aren't aware of the warnings issued last fall about the use of OTC cough and cold drugs in kids younger than 2.
"This announcement will bring this issue back into the public consciousness, particularly since it's cold season now," Ganley says.
Industry Responds
The Consumer Healthcare Products Association (CHPA), a trade group representing makers of over-the-counter (OTC) medicines, issued a statement supporting today's FDA's decision.
"Safety has always been and continues to be our top priority," says CHPA President Linda Suydam, DPA.
"Today's decision by the FDA reaffirms the correct course of action taken by the leading makers of these medicines last fall," says Suydam, referring to the voluntary withdrawal of over-the-counter cough and cold drugs for infants.
The CHPA is working with retailers, doctors, and the FDA "to ensure that parents have the tools they need to safely and appropriately administer OTC oral cough and cold medicines to children over the age of two," Suydam says.
Tips for Parents of Older Kids
Speaking at today's FDA news conference, Lisa Mathis, MD, associate director of the FDA's Pediatric and Maternal Health Staff in the Office of New Drugs, reminded parents that the FDA hasn't finished reviewing cough and cold drugs for older children.
Cardiovascular risks in Type-2 Diabetes
In order to reduce the Cardiovascular complications in Diabetes, it is necessary to control cholesterol and blood pressure rather than controlling blood sugar, which reduces kidney and eye complications. This is what researches have found that are conducted on patients of Type-2 Diabetes.
Intense control of blood glucose levels in type 2 diabetes helps reduce the risk of kidney and eye complications, but not cardiovascular risks such as heart attacks and strokes, researchers said at a news briefing during the annual meeting of the American Diabetes Association in San Francisco.
Hemoglobin A1c is a measure representing average blood glucose control for the previous three months. The American Diabetes Association recommends A1c levels of less than 7%. People without diabetes have an A1c of about 5%.
Lowering blood glucose levels does help reduce kidney and eye complications from diabetes, but paying attention to blood pressure and cholesterol levels is crucial to reduce the heart attack and stroke-related risks that accompany a diagnosis of type 2 diabetes, researchers from both studies say.
If you want to manage cardiovascular risks, focusing on blood pressure and lipids is likely where the money is. Therefore it is not only to control blood sugar, cholesterol and blood pressure should also be kept in control in Diabetes.
Some Facts about Acne
Acne is not related to diet. It's a myth that chocolates and oily foods cause acne. Acne is an infection and the inflammation of the sebaceous glands and the sebum, which is being produced, gets infected. The production of sebum has nothing to do with what we eat.
Acne is not contagious. It is because of an individual’s susceptibility due to genetic and environmental influences that you get acne. You cannot transmit it to other person even by sharing towels and combs. But acne aggravation is seasonal. In hot and humid climate a sweat film is formed, which dissolves with the oily layer of our skin, causing irritation, and hence new lesions appear.
One should use oil free moisturisers, sunscreens in their gel form and in the spray form, and you should use water-based foundations.
Adult Acne is a term used for acne appearing in post-teenage years. It can be continuation of acne from teenage years to your twenties or it can be maturity onset acne, which can occur from 20’s to 50's. Most maturity-onset acne people, that is, those who have adult acne have first-degree relatives who have adult acne. Second, it happens to people who are working in a hot and humid climate and to those who have an oily skin and use a lot of cosmetics.
Steroids can suppress your acne but do not cure it.
Mostly steroids, either in the local form or the oral form, can cause acne. Anti-tuberculosis treatment leads to acne and lesions. And anti-epileptic treatment drugs and oral contraceptives lead to acne. Withdrawal from these sees a spontaneous recovery from acne due to these drugs. But if the medication is important, you cannot withdraw it. You should take anti-acne treatment simultaneously with your medication.
Home remedies aim at cleansing the skin; cleansers like cucumber juice in milk or rose water can be used. The aim is to remove the oil from the skin. There are other things like scrubs like oatmeal scrub made in apricot and honey, applied as a layer removes the dead layer of the skin. Home remedies are more useful if you have occasional or mild acne.
Acne is not contagious. It is because of an individual’s susceptibility due to genetic and environmental influences that you get acne. You cannot transmit it to other person even by sharing towels and combs. But acne aggravation is seasonal. In hot and humid climate a sweat film is formed, which dissolves with the oily layer of our skin, causing irritation, and hence new lesions appear.
One should use oil free moisturisers, sunscreens in their gel form and in the spray form, and you should use water-based foundations.
Adult Acne is a term used for acne appearing in post-teenage years. It can be continuation of acne from teenage years to your twenties or it can be maturity onset acne, which can occur from 20’s to 50's. Most maturity-onset acne people, that is, those who have adult acne have first-degree relatives who have adult acne. Second, it happens to people who are working in a hot and humid climate and to those who have an oily skin and use a lot of cosmetics.
Steroids can suppress your acne but do not cure it.
Mostly steroids, either in the local form or the oral form, can cause acne. Anti-tuberculosis treatment leads to acne and lesions. And anti-epileptic treatment drugs and oral contraceptives lead to acne. Withdrawal from these sees a spontaneous recovery from acne due to these drugs. But if the medication is important, you cannot withdraw it. You should take anti-acne treatment simultaneously with your medication.
Home remedies aim at cleansing the skin; cleansers like cucumber juice in milk or rose water can be used. The aim is to remove the oil from the skin. There are other things like scrubs like oatmeal scrub made in apricot and honey, applied as a layer removes the dead layer of the skin. Home remedies are more useful if you have occasional or mild acne.
Quick Test May Help Spot Male Hair Loss
A simple, 60-second hair count test may help men tell the difference between normal hair loss and problem hair loss that may be a sign of male pattern baldness.
A new study suggests that counting the hairs lost after 60 seconds of combing or brushing is a reliable method for assessing hair loss.
"Currently, there is no widely accepted or standard method for assessing the number of hairs shed daily," write researcher Carina A. Wasko, MD, of Baylor College of Medicine in Houston and colleagues in the Archives of Dermatology.
Researchers say the commonly held belief that it's normal to shed up to 100 hairs a day is based on the assumption that the average scalp contains 100,000 hairs. Although this idea is widely held, researchers say it has not been proven scientifically to be an accurate measure of normal vs. problem hair loss in men or women.
It also does not account for whether shedding remains constant with age or if normal hair loss rates are comparable among men and women.
60-Second Hair Count Test
In the study, researchers examined hair loss in 60 healthy men with no signs of male pattern baldness. Half were between the ages of 20 and 40 and the other half between ages 41 and 60.
Each of the men was given identical combs and instructed to wash their hair with the same brand of shampoo for three consecutive mornings. On the fourth, fifth, and sixth mornings, they were asked to comb hair forward over a towel or pillowcase of contrasting color for 60 seconds before shampooing and count the hairs shed.
The results showed younger men shed an average of 10.2 per 60-second test and the older men shed an average of 10.3 hairs per test.
"When repeated six months later in both age groups, the hair counts did not change much. The hair counts were repeated and verified by a trained investigator, with results similar to those of subject hair counts," write the researchers.
Researchers say that low variability between tests over time and across age groups suggests that the 60-second hair count is a simple and practical tool for assessing normal vs. problem hair loss in men.
They say the next steps are to verify the test in women and in people with male pattern baldness and other forms of problem hair loss to determine hair count measures.
A new study suggests that counting the hairs lost after 60 seconds of combing or brushing is a reliable method for assessing hair loss.
"Currently, there is no widely accepted or standard method for assessing the number of hairs shed daily," write researcher Carina A. Wasko, MD, of Baylor College of Medicine in Houston and colleagues in the Archives of Dermatology.
Researchers say the commonly held belief that it's normal to shed up to 100 hairs a day is based on the assumption that the average scalp contains 100,000 hairs. Although this idea is widely held, researchers say it has not been proven scientifically to be an accurate measure of normal vs. problem hair loss in men or women.
It also does not account for whether shedding remains constant with age or if normal hair loss rates are comparable among men and women.
60-Second Hair Count Test
In the study, researchers examined hair loss in 60 healthy men with no signs of male pattern baldness. Half were between the ages of 20 and 40 and the other half between ages 41 and 60.
Each of the men was given identical combs and instructed to wash their hair with the same brand of shampoo for three consecutive mornings. On the fourth, fifth, and sixth mornings, they were asked to comb hair forward over a towel or pillowcase of contrasting color for 60 seconds before shampooing and count the hairs shed.
The results showed younger men shed an average of 10.2 per 60-second test and the older men shed an average of 10.3 hairs per test.
"When repeated six months later in both age groups, the hair counts did not change much. The hair counts were repeated and verified by a trained investigator, with results similar to those of subject hair counts," write the researchers.
Researchers say that low variability between tests over time and across age groups suggests that the 60-second hair count is a simple and practical tool for assessing normal vs. problem hair loss in men.
They say the next steps are to verify the test in women and in people with male pattern baldness and other forms of problem hair loss to determine hair count measures.
Monday, June 16, 2008
Guidelines for Clinical Evaluation of Herbal Remedies and Medicinal Plants
For the herbal remedies and medicinal plants that are to be clinically evaluated for use in the Allopathic System and which may later be used in allopathic hospitals, the procedures laid down by the office of the Drugs Controller General of India for allopathic drugs should be followed. This does not pertain to guidelines issued for clinical evaluation of Ayurveda, Siddha or Unani drugs by experts in hospitals and clinics. All the general principles of clinical trials pertain also to herbal remedies. However, when clinical trials of herbal drugs used in recognized Indian Systems of Medicine and Homeopathy are to be undertaken in Allopathic Hospitals, association of physicians from the concerned system as co-investigators/collaborators/members of the expert group is desirable for designing and evaluating the study.
Important Points:
The herbal products can belong to either of the three categories given below
1.
A lot is known about the use of a plant or its extract in the ancient Ayurveda, Siddha or Unani literature or the plant may actually be regularly used by physicians of the traditional systems of medicine for a number of years. The substance is being clinically evaluated for same indication for which it is being used or as has been described in the texts.
2.
When an extract of a plant or a compound isolated from the plant has to be clinically evaluated for a therapeutic effect not originally described in the texts of traditional systems or, the method of preparation is different, it has to be treated as a new substance or new chemical entity (NCE) and the same type of acute, subacute and chronic toxicity data will have to be generated as required by the regulatory authority before it is cleared for clinical evaluation.
3.
An extract or a compound isolated from a plant which has never been in use before and has not ever been mentioned in ancient literature, should be treated as a new drug, and therefore, should undergo all regulatory requirements before being evaluated clinically.
It is important that plants and herbal remedies currently in use or mentioned in literature of recognized Traditional System of Medicine is prepared strictly in the same way as described in the literature while incorporating GMP norms for Standardization It may not be necessary to undertake phase I studies. However, it needs to be emphasis ed that since the substance to be tested is already in use in Indian Systems of Medicine or has been described in their texts, the need for testing its toxicity in animals has been considerably reduced. Neither would any toxicity study be needed for phase II trial unless there are reports suggesting toxicity or when the herbal preparation is to be used for more than 3 months. It should be necessary to undertake 4-6 weeks toxicity study in 2 species of animals in the circumstances pointed out in the preceding sentence or when a larger multicentric phase III trial is subsequently planned based on results of phase II study.
Clinical trials with herbal preparation should be carried out only after these have been standardized and markers identified to ensure that the substances being evaluated are always the same. The recommendations made earlier regarding informed consent, inducements for participation, information to be provided to the subject, withdrawal from study and research involving children or persons with diminished autonomy, all apply to trials on plant drugs also. These trials have also got to be approved by the appropriate scientific and ethical committees of the concerned Institutes. However, it is essential that such clinical trials be carried out only when a competent Ayurvedic, Siddha or Unani physician is a co-investigator in such a clinical trial. It would neither ethically acceptable nor morally justifiable, if an allopathic physician, based on references in ancient literature of above-mentioned traditional systems of Medicine, carries out clinical evaluation of the plant without any concept or training in these systems of medicine. Hence, it is necessary to associate a specialist from these systems and the clinical evaluation should be carried out jointly.
Important Points:
The herbal products can belong to either of the three categories given below
1.
A lot is known about the use of a plant or its extract in the ancient Ayurveda, Siddha or Unani literature or the plant may actually be regularly used by physicians of the traditional systems of medicine for a number of years. The substance is being clinically evaluated for same indication for which it is being used or as has been described in the texts.
2.
When an extract of a plant or a compound isolated from the plant has to be clinically evaluated for a therapeutic effect not originally described in the texts of traditional systems or, the method of preparation is different, it has to be treated as a new substance or new chemical entity (NCE) and the same type of acute, subacute and chronic toxicity data will have to be generated as required by the regulatory authority before it is cleared for clinical evaluation.
3.
An extract or a compound isolated from a plant which has never been in use before and has not ever been mentioned in ancient literature, should be treated as a new drug, and therefore, should undergo all regulatory requirements before being evaluated clinically.
It is important that plants and herbal remedies currently in use or mentioned in literature of recognized Traditional System of Medicine is prepared strictly in the same way as described in the literature while incorporating GMP norms for Standardization It may not be necessary to undertake phase I studies. However, it needs to be emphasis ed that since the substance to be tested is already in use in Indian Systems of Medicine or has been described in their texts, the need for testing its toxicity in animals has been considerably reduced. Neither would any toxicity study be needed for phase II trial unless there are reports suggesting toxicity or when the herbal preparation is to be used for more than 3 months. It should be necessary to undertake 4-6 weeks toxicity study in 2 species of animals in the circumstances pointed out in the preceding sentence or when a larger multicentric phase III trial is subsequently planned based on results of phase II study.
Clinical trials with herbal preparation should be carried out only after these have been standardized and markers identified to ensure that the substances being evaluated are always the same. The recommendations made earlier regarding informed consent, inducements for participation, information to be provided to the subject, withdrawal from study and research involving children or persons with diminished autonomy, all apply to trials on plant drugs also. These trials have also got to be approved by the appropriate scientific and ethical committees of the concerned Institutes. However, it is essential that such clinical trials be carried out only when a competent Ayurvedic, Siddha or Unani physician is a co-investigator in such a clinical trial. It would neither ethically acceptable nor morally justifiable, if an allopathic physician, based on references in ancient literature of above-mentioned traditional systems of Medicine, carries out clinical evaluation of the plant without any concept or training in these systems of medicine. Hence, it is necessary to associate a specialist from these systems and the clinical evaluation should be carried out jointly.
Guidelines for conducting a Vaccine Trial
The guidelines to conduct the clinical trial on investigational vaccines are similar to those governing a drug trial. The phases of these trials differ from drug trials as given below:
*
Phase I: The refers to the first introduction of a vaccine into a human population for determination of its safety and biological effects including immunogenicity. This phase includes study of dose and route of administration and should involve low risk subjects. For example, immunogenicity to hepatitis B vaccine should not be determined in high risk subjects.
*
Phase II: This refers to the initial trials examining effectiveness (immunogenicity) in a limited number of volunteers. Vaccines can be prophylactic and therapeutic in nature. While prophylactic vaccines are given to normal subjects, therapeutic or curative vaccines may be given to patients suffering from particular disease.
*
Phase III: This focuses on assessment of safety and effectiveness in the prevention of disease, involving controlled study on a larger number of volunteer (in thousands) in multicentres.
Some other points
*
Some vaccines that contain active or live – attenuated micro organisms can possibly possess a small risk of producing that particular infection. The subject to be vaccinated should be informed of the same.
*
The subjects in control groups or when subjected to ineffective vaccines run a risk of contracting the disease.
*
The risks associated with vaccines produced by recombinant DNA techniques are not completely known. However, for all the recombinant vaccines/products the Guidelines issued by the Department of Biotechnology should be strictly followed.
*
Phase I: The refers to the first introduction of a vaccine into a human population for determination of its safety and biological effects including immunogenicity. This phase includes study of dose and route of administration and should involve low risk subjects. For example, immunogenicity to hepatitis B vaccine should not be determined in high risk subjects.
*
Phase II: This refers to the initial trials examining effectiveness (immunogenicity) in a limited number of volunteers. Vaccines can be prophylactic and therapeutic in nature. While prophylactic vaccines are given to normal subjects, therapeutic or curative vaccines may be given to patients suffering from particular disease.
*
Phase III: This focuses on assessment of safety and effectiveness in the prevention of disease, involving controlled study on a larger number of volunteer (in thousands) in multicentres.
Some other points
*
Some vaccines that contain active or live – attenuated micro organisms can possibly possess a small risk of producing that particular infection. The subject to be vaccinated should be informed of the same.
*
The subjects in control groups or when subjected to ineffective vaccines run a risk of contracting the disease.
*
The risks associated with vaccines produced by recombinant DNA techniques are not completely known. However, for all the recombinant vaccines/products the Guidelines issued by the Department of Biotechnology should be strictly followed.
Guidelines for conducting A Multicentric trial
A multicentric trial is conducted simultaneously by several investigators at different centre’s following the same protocol and proformae. Ideally, these trials should be initiated at the same time at all the centre’s.
*
All the Investigators should give a written acceptance of the protocol to be followed for the trial duly approved by the ethics committee of the host institutes.
*
Meetings should be organized at the initial and intermediary stages of the trial to ensure uniform procedures at the all centre’s.
*
Training should be imparted to research staff at the participating centre’s. to familiarize them with the uniform procedures.
*
Standardization of methods for recruitment and evaluation/ monitoring of laboratory procedures and conduct of trial should be carried out.
*
There should be monitoring of adherence to protocol including measures to terminate the participation of some centre’s., if necessary.
*
Specific role of coordinators and monitors should be defined.
*
Centralized data management and analysis should be planned.
*
Drafting of a common final report and publication procedure should be decided at the outset. No individual centre should publish any data till appropriate authorities accept the combined report.
*
The code of the administered drug could be broken in the event of a severe adverse reaction occurring during the conduct of a double blind trial necessitating such a step.
Home Remedy for Shingles(Herpes Zoster)
Shingles, also called herpes zoster, gets its name from both the Latin and French words for belt or girdle and refers to girdle-like skin eruptions that may occur on the trunk of the body. This is very interesting that the virus that causes chickenpox, the varicella zoster virus (VSV), is mainly responsible for this painful condition. The virus actually become dormant in nerve cells after an episode of chickenpox and later reemerge as shingles. Initially, red patches of rash develop into blisters. As the virus travels along the nerve to the skin, it can damage the nerve and cause it to become inflamed. This condition can be very painful. If the pain persists long after the rash disappears, it is known as post-herpetic neuralgia.
First infection, at whatever age it occurs, is called primary infection. It is important to note that Primary infection does not cause shingles; shingles arises from reactivation of virus introduced to the body by an earlier, primary infection. Shingles arises in individuals who have weakened immune systems, such as the elderly or people receiving chemotherapy or bone marrow transplantation. Persons with AIDS are also vulnerable to shingles.
Besides Antiviral therapy which is standard therapy there are some home tips that can be used in order to get relief from this painful condition.
*
To provide relief, make a solution by mixing 1/2 cup of apple cider vinegar in 2 cups of water. Use a cotton cloth to dampen the affected areas by using the upward movement.
*
For Shingles, apply tea tree oil quite a few times a day, it dries the shingles and they usually go away in a few days.
*
To provide relief, make a solution by mixing 1/2 cup of apple cider vinegar in 2 cups of water. Use a cotton cloth to dampen the affected areas by using the upward movement.
*
Powder two aspirin tablets and mix it in 2 tbsp of chloroform or alcohol. Apply this paste on the affected area. This will give good relief.
The absolute best defense against herpes is a healthy immune system and a positive lifestyle. Make sure to get good nutrition- you may want to add zinc and vitamin c supplements because these are essential for the immune system. A lot of people take Lysine as well. It is an amino acid that seems to counteract another amino acid that can trigger an outbreak. Lysine is usually mixed with other natural immune boosters such as echinacea and goldenseal although it is better to take these as needed instead of all the time. It is important to reduce anxiety and stress because these can trigger an outbreak.
First infection, at whatever age it occurs, is called primary infection. It is important to note that Primary infection does not cause shingles; shingles arises from reactivation of virus introduced to the body by an earlier, primary infection. Shingles arises in individuals who have weakened immune systems, such as the elderly or people receiving chemotherapy or bone marrow transplantation. Persons with AIDS are also vulnerable to shingles.
Besides Antiviral therapy which is standard therapy there are some home tips that can be used in order to get relief from this painful condition.
*
To provide relief, make a solution by mixing 1/2 cup of apple cider vinegar in 2 cups of water. Use a cotton cloth to dampen the affected areas by using the upward movement.
*
For Shingles, apply tea tree oil quite a few times a day, it dries the shingles and they usually go away in a few days.
*
To provide relief, make a solution by mixing 1/2 cup of apple cider vinegar in 2 cups of water. Use a cotton cloth to dampen the affected areas by using the upward movement.
*
Powder two aspirin tablets and mix it in 2 tbsp of chloroform or alcohol. Apply this paste on the affected area. This will give good relief.
The absolute best defense against herpes is a healthy immune system and a positive lifestyle. Make sure to get good nutrition- you may want to add zinc and vitamin c supplements because these are essential for the immune system. A lot of people take Lysine as well. It is an amino acid that seems to counteract another amino acid that can trigger an outbreak. Lysine is usually mixed with other natural immune boosters such as echinacea and goldenseal although it is better to take these as needed instead of all the time. It is important to reduce anxiety and stress because these can trigger an outbreak.
Therapeutic drug monitoring Indications
Below are the indications where TDM is highly useful to interpretate the drug concentration.
- toxicity– diagnosing toxicity when the clinical syndrome is undifferentiated (unexplained nausea in a patient taking digoxin)
– avoiding toxicity (aminoglycosides, cyclosporin) - dosing– after dose adjustment (usually after reaching a steady state)
– assessment of adequate loading dose (after starting phenytoin treatment)
– dose forecasting to help predict a patient's dose requirements1 (aminoglycosides) - monitoring– assessing compliance (anticonvulsant concentrations in patients having frequent seizures)
– diagnosing undertreatment (particularly important for prophylactic drugs such as anticonvulsants, immunosuppressants)
– diagnosing failed therapy (therapeutic drug monitoring can help distinguish between ineffective drug treatment, non-compliance and adverse effects that mimic the underlying disease).
Another important aspect of TDM is when the sample is taken as we know different drugs have different half lives, therefore there timings are also differ.
Timing of the plasma sample ('when to do it')
Unless therapeutic drug monitoring is being used to forecast a dose or there are concerns about toxicity, samples should be taken at steady state (4–5 half-lives after starting therapy).
At steady state, plasma concentration is usually proportional to receptor concentration. Some drugs, such as perhexiline, which has a very long half-life in patients who are 'poor metabolisers',
should be monitored before steady state is achieved to prevent toxicity developing after the first few doses. Another example where early monitoring may be useful is after phenytoin loading, where measurement of the plasma concentration can give a preliminary indication of adequate dosing.
The timing of the collection of the sample is important as the drug concentration changes during the dosing interval. The least variable point in the dosing interval is just before the next dose is due. This pre-dose or trough concentration is what is usually measured. For drugs with long half-lives such as phenobarbitone and amiodarone, samples can be collected at any point in the dosage interval.
should be monitored before steady state is achieved to prevent toxicity developing after the first few doses. Another example where early monitoring may be useful is after phenytoin loading, where measurement of the plasma concentration can give a preliminary indication of adequate dosing.
The timing of the collection of the sample is important as the drug concentration changes during the dosing interval. The least variable point in the dosing interval is just before the next dose is due. This pre-dose or trough concentration is what is usually measured. For drugs with long half-lives such as phenobarbitone and amiodarone, samples can be collected at any point in the dosage interval.
Therapeutic drug monitoring
Therapeutic drug monitoring of concentrations of drugs in body fluids, usually plasma, can be used
during treatment and for diagnostic purposes. The selection of drugs for therapeutic drug monitoring is important as the concentrations of many drugs are not clearly related to their effects. For selected drugs therapeutic drug monitoring aims to enhance drug efficacy, reduce toxicity or assist with diagnosis. Despite its apparent advantages, it has inherent limitations. Some large hospitals have services which provide support with drug monitoring and interpretation of results.
Drug concentration at the site of action cannot be routinely measured, but the desired or adverse effects may correlate better with plasma or blood concentrations than they do with dose.
Therapeutic drug monitoring involves not only measuring drug concentrations, but also the clinical interpretation of the result. This requires knowledge of the pharmacokinetics, sampling time, drug history and the patient's clinical condition.
Which drugs should be monitored
* having narrow therapeutic target range.
* significant pharmacokinetic variability.
* a reasonable relationship between plasma concentrations and clinical effects.
* established target concentration range.
* availability of cost-effective drug assay.
Drug assays are costly, so the reason for monitoring and the additional information to be gained (if any) should be carefully considered. For some drugs, therapeutic drug monitoring helps to increase efficacy (vancomycin), to decrease toxicity (paracetamol) and to assist diagnosis (salicylates). Routine monitoring is not advocated for most drugs. Only clinically meaningful tests should be performed.
during treatment and for diagnostic purposes. The selection of drugs for therapeutic drug monitoring is important as the concentrations of many drugs are not clearly related to their effects. For selected drugs therapeutic drug monitoring aims to enhance drug efficacy, reduce toxicity or assist with diagnosis. Despite its apparent advantages, it has inherent limitations. Some large hospitals have services which provide support with drug monitoring and interpretation of results.
Drug concentration at the site of action cannot be routinely measured, but the desired or adverse effects may correlate better with plasma or blood concentrations than they do with dose.
Therapeutic drug monitoring involves not only measuring drug concentrations, but also the clinical interpretation of the result. This requires knowledge of the pharmacokinetics, sampling time, drug history and the patient's clinical condition.
Which drugs should be monitored
* having narrow therapeutic target range.
* significant pharmacokinetic variability.
* a reasonable relationship between plasma concentrations and clinical effects.
* established target concentration range.
* availability of cost-effective drug assay.
Drug assays are costly, so the reason for monitoring and the additional information to be gained (if any) should be carefully considered. For some drugs, therapeutic drug monitoring helps to increase efficacy (vancomycin), to decrease toxicity (paracetamol) and to assist diagnosis (salicylates). Routine monitoring is not advocated for most drugs. Only clinically meaningful tests should be performed.
Friday, June 13, 2008
Health Note: DRINK WATER ON EMPTY STOMACH
It is popular in Japan today to drink water immediately after waking up every morning. Furthermore, scientific tests have proven its value. We publish below a description of use of water for our readers. For old and serious diseases as well as modern illnesses the water treatment had been found successful by a Japanese medical society as a 100% cure for the following diseases:
Headache, body ache, heart system, arthritis, fast heart beat, epilepsy, excess fatness, bronchitis asthma, TB, meningitis, kidney and urine diseases, vomiting, gastritis, diarrhea, piles, diabetes, constipation, all eye diseases, womb, cancer and menstrual disorders, ear nose and throat diseases.
Headache, body ache, heart system, arthritis, fast heart beat, epilepsy, excess fatness, bronchitis asthma, TB, meningitis, kidney and urine diseases, vomiting, gastritis, diarrhea, piles, diabetes, constipation, all eye diseases, womb, cancer and menstrual disorders, ear nose and throat diseases.
METHOD OF TREATMENT
- As you wake up in the morning before brushing teeth, drink 4 x 160ml glasses of water
- Brush and clean the mouth but do not eat or drink anything for 45 minute
- After 45 minutes you may eat and drink as normal.
- After 15 minutes of breakfast, lunch and dinner do not eat or drink anything for 2 hours
- Those who are old or sick and are unable to drink 4 glasses of water at the beginning may commence by taking little water and gradually increase it to 4 glasses per day.
- The above method of treatment will cure diseases of the sick and others can enjoy a healthy life.
1. High Blood Pressure (30 days)
2. Gastric (10 days)
3. Diabetes (30 days)
4. Constipation (10 days)
5. Cancer (180 days)
6. TB (90 days)
. Arthritis patients should follow the above treatment only for 3 days in the 1st week, and from 2nd week onwards – daily.
This treatment method has no side effects, however at the commencement of treatment you may have to urinate a few times.
Home Treatment for Diarrhoea
Dysentery is a serious condition affecting the large intestine. The pathological condition of this disease is caused by two organisms, protozoa and bacilli. When caused by the former, the condition is generally known as amoebic dysentery, and when caused by the latter, it is known as bacillary dysentery.
Home Remedies
- Bael Fruit:Among specific home remedies, bael fruit is perhaps the most efficacious in the treatment of dysentery of both varieties. One tablespoon of the pulp of the fruit, mixed with a sufficient quantity of jaggery to sweeten it, should be given thrice daily. To deal with a chronic case of dysentery, 15 gm of the unripe fruit pulp should be roasted over the fire and the pulp mixed with 250 ml of water or buttermilk.
- Lemon: very effective in dealing with ordinary cases of dysentery. Three lemons, peeled and sliced, should be added to 250 ml of water and boiled for a few minutes. The strained infusion should be administered thrice daily.
- Give about 5 gms. of Isabgol with cold water in which about 1 teaspoonful sugar has been added.
- Take every night 3 cloves of garlic chopped and boiled in milk.
- Mixjuice of 15-20 tender curry leaves with 1 teaspoon honey and drink.
- Combine 1 teaspoon each powdered ginger powdered cumin and powdered cinnamon with honey and make into a thick paste. Take 1 teaspoon thrice daily.
- Mash 1 ripe banana along with a pinch of salt and 1 teaspoon tamarind pulp. Take twice a day.
- Drinking a unsweetened black tea is very effective for stopping diarrhoea.
- Rice is useful in treating diarrhoea in children. A teaspoon of powder of charred parboiled rice, mixed with a glass of buttermilk, should be given in does of thirty grams every half an hour. This will bring excellent results.
After the acute symptoms are over, the patient may be allowed rice, curd, fresh ripe fruits, and skimmed milk. Solid foods should be introduced very carefully and gradually according to the pace of recovery. Flesh foods of all kinds should be avoided. Other foods which should be avoided are tea, coffee, white sugar and white flour, and alcohol in all forms.
Mesothelioma
People working in Asbestose industry have high risk of developing Mesothelioma. Most of the medical students have never gone through this case but knowing how to diagnose and treat it is very essential.
How to Diagnose
- Unilateral, nonpleuritic chest pain and dyspnea.
- Distant (> 20 years earlier) history of exposure to asbestos.
- Pleural effusion or pleural thickening or both on chest radiographs.
- Malignant cells in pleural fluid or tissue biopsy.
These are primary tumors arising from the surface lining of the pleura (80% of cases) or peritoneum (20% of cases). About three-fourths of pleural mesotheliomas are diffuse (usually malignant) tumors, and the remaining one-fourth are localized (usually benign). Men outnumber women by a 3:1 ratio. Numerous studies have confirmed the association of malignant pleural mesothelioma with exposure to asbestos (particularly the crocidolite form).
The lifetime risk to asbestos workers of developing malignant pleural mesothelioma is about 8%. Sixty to 80 percent of patients with malignant mesothelioma report a history of asbestos exposure. The latent period between exposure and onset of symptoms ranges from 20 to 40 years. The clinician should inquire about asbestos exposure through mining, milling, manufacturing, shipyard work, insulation, brake linings, building construction and demolition, roofing materials, and a variety of asbestos products (pipe, textiles, paint, tile, gaskets, panels). Although cigarette smoking significantly increases the risk of bronchogenic carcinoma in asbestos workers and aggravates asbestosis, there is no association between smoking and mesothelioma.
Symptoms and Signs
- age of onset 60 years.
- shortness of breath
- nonpleuritic chest pain, and
- weight loss.
Complications
Local invasion of thoracic structures may cause superior vena cava syndrome, hoarseness, Horner’s syndrome, and dysphagia. Paraneoplastic syndromes associated with mesothelioma include thrombocytosis, hemolytic anemia, disseminated intravascular coagulopathy, and migratory thrombophlebitis.
Treatment
Clinical trial designs
The most widely used clinical trial designs to evaluate effectiveness and safety of a drug are parallel, cross - over, and titration designs.
Parallel
In a parallel design trial, patients are randomized into cohorts who receive one of the several treatments (control, dose 1, dose 2 or dose 3). ). Such a design will offer the population, rather than the individual, PK / PD characteristics. The advantage of such a design is the lack of confounding factors such as time (carry over effects) and design dependent outcomes.
Crossover
In a crossover design, each patient receives some (incomplete block) or all (complete block) of the treatments being studied.Therefore, a cross - over design is the most powerful design if deducing the individual concentration (or dose) - response curves is the ultimate aim. In a crossover design, three types of effects are evaluated. They are period effect (Period I vs Period II), Carry over effect and sequence effect (Placebo, active treatment or active treatment , placebo).The disadvantages of this approach are that of its longer trial duration, possible carry - over effects from previous doses and the need for sophisticated data analysis (nonlinear mixed effects modeling).
Titration
The titration design ensures that the patients usually start at a relatively low dose and the dose is increased gradually until either no additional benefit is observed or dose - limiting toxicity occurs. This design closely resembles the clinical practice and the individual PK / PD characteristics can be obtained. The major disadvantage of this design is that of the possibility of an inverted U-shaped PK / PD relationship, as an artifact. The patients who are less sensitive to the drug need higher doses of the drug, making it appear as if the response decreases after a certain dose. Data analysis using conventional methods such as ANOVA fail and the use of sophisticated modeling techniques is required .
Parallel
In a parallel design trial, patients are randomized into cohorts who receive one of the several treatments (control, dose 1, dose 2 or dose 3). ). Such a design will offer the population, rather than the individual, PK / PD characteristics. The advantage of such a design is the lack of confounding factors such as time (carry over effects) and design dependent outcomes.
Crossover
In a crossover design, each patient receives some (incomplete block) or all (complete block) of the treatments being studied.Therefore, a cross - over design is the most powerful design if deducing the individual concentration (or dose) - response curves is the ultimate aim. In a crossover design, three types of effects are evaluated. They are period effect (Period I vs Period II), Carry over effect and sequence effect (Placebo, active treatment or active treatment , placebo).The disadvantages of this approach are that of its longer trial duration, possible carry - over effects from previous doses and the need for sophisticated data analysis (nonlinear mixed effects modeling).
Titration
The titration design ensures that the patients usually start at a relatively low dose and the dose is increased gradually until either no additional benefit is observed or dose - limiting toxicity occurs. This design closely resembles the clinical practice and the individual PK / PD characteristics can be obtained. The major disadvantage of this design is that of the possibility of an inverted U-shaped PK / PD relationship, as an artifact. The patients who are less sensitive to the drug need higher doses of the drug, making it appear as if the response decreases after a certain dose. Data analysis using conventional methods such as ANOVA fail and the use of sophisticated modeling techniques is required .
Brain-Eating Amoeba Strikes in Summer causing Primary amoebic meningoencephalitis
Swimming in the pool having warm water may be dangerous, as it provides the favourable medium for the growth of brain-eating amoeba. There are reports of death last year after swimming in lakes or pools infested with a brain-eating amoeba.
The bad blobs -- known as Naegleria fowleri or N. fowleri -- thrive in warm, fresh water all over the world. But the key word here is warm. The amoeba loves heat. In the U.S., it inhabits the relatively hot waters of lakes, hot springs, and poorly maintained pools in Southern or Southwestern states.
How Brain-Eating Amoebas Attack
That food source is the human brain. It actually is using the brain for food.
After the amoeba enters the nose, it finds its way to the olfactory nerve. N. fowleri appears to be attracted to nerve cells, so it follows the nerve into the brain. That's when bad things happen. The amoeba has mouth-shaped structures on its surface called food cups. It's perfectly capable of chewing up brain and blood cells with these food cups, but the blob finds it more efficient to secrete enzymes and proteins that dissolve brain cells so it can suck up the debris with its food cup.
Victims usually die seven to 10 days after infection, although symptoms may not appear for up to 14 days.
Initial symptoms include headache, fever, nausea, vomiting, and stiff neck. Later symptoms include confusion, inability to pay attention to people and surroundings, loss of balance, seizures, and hallucinations. Death follows the first symptoms by three to seven days. The disease is technically called Primary amoebic meningoencephalitis, or PAM.
Initial symptoms include headache, fever, nausea, vomiting, and stiff neck. Later symptoms include confusion, inability to pay attention to people and surroundings, loss of balance, seizures, and hallucinations. Death follows the first symptoms by three to seven days. The disease is technically called Primary amoebic meningoencephalitis, or PAM.
Medicare to share data with FDA
Medicare and the Food and Drug Administration have announced a joint venture that promises to improve prescription drug safety and potentially reduce wasteful spending on medications.The agencies said Thursday they have agreed on rules for using information from Medicare's giant claims databases to create a computerized early warning network for problems with medications and medical devices that come to light after they go on the market.
Medicare will not turn over individual patient data to the FDA, but the two agencies' computers will be able to "talk" to each other, to pose and answer questions that may reveal potentially risky side effects in new drugs. Since pre-market testing usually involves a limited number of patients, serious problems sometimes become evident only after hundreds of thousands of people begin using a product.
The system, called the Sentinel Initiative, will eventually include private insurers as well - to fill in information gaps about drugs that the elderly don't use, such as contraceptives.The FDA's current early warning system relies on self-reporting by drugmakers, hospitals and doctors and is believed to capture only between 1 percent and 10 percent of problems.
Privacy advocates are expected to scrutinize the new rules.
Most Americans on Prescription Drugs
For the first time in recent times, most Americans are using prescription drugs. Pharmacy benefits manager Medco Health Solutions Inc. said that in 2007 51 percent of those insured took prescription medicines for chronic health ailments. Furthermore, around 20 percent of the U.S. population used three or more prescription drugs. The largest increase was seen in the 20- to 44-year-old age group. In this age group an increase of 20 percent was recorded.
Doctors estimate that given the current trend the number of those taking prescription medication will only increase. The 2007 numbers are up from 50 percent in 2006 and 47 percent in 2001. Dr. Robert Epstein, chief medical officer at Medco, underlined that a lot of the prescription drug use is related with the disastrous rate of obesity in the United States.
"Honestly, a lot of it is related to obesity," he said. "We've become a couch potato culture (and) it's a lot easier to pop a pill," he told AP.
The numbers will skyrocket in the next decades, as the ever-increasing weight of those who are now children will bring about near-certain problems in adult life. Health care spending in the United States is estimated to rise to 25 percent of the economy by 2025, from 16 percent now.
"These chronic conditions are incredibly costly for the nation and will become exponentially so if we're seeing these problems show up at a younger and younger age," Dr. Robert Epstein in a statement.
Understanding Arthritis Painkillers DMARDS
When you have arthritis pain, you need relief. But with so many warnings in the news about painkillers, it's hard to know the best choice. Many medications that ease arthritis pain have the potential for health risks, including increased risk for heart attack, stomach problems, or infections.
You have difficult decisions to make, whether you're fighting pain from osteoarthritis that comes with age -- or pain from rheumatoid arthritis, a debilitating immune disorder. Do you somehow tough out the pain? Or do you accept the risk because your pain requires it, and take the drug for arthritis? Which drug is right for your body? And which medicine may work best for your type of arthritis?
Easing arthritis pain can help someone with osteoarthritis "get up and going, and get walking," White tells WebMD. "If you have osteoarthritis, losing 15 pounds will stop the progression of your disease and reduce your pain. Then you can quit taking the pain medication!"
Although pain from rheumatoid arthritis cannot be reduced through weight loss, the risk of not treating this immune disease is even more dramatic. Without treatment, RA tends to progress and worsen. New drugs called biologics can stop the damaging effects of the disease. "These drugs carry a slight risk of cancer, because they suppress the immune system," says White. "Yet if you don't take them, you are going to be disabled. You have to put that risk-benefit ratio on the table."
Hadler has researched the mind-body connection in arthritis pain, and has found that people who may be lonely or depressed feel pain more acutely.
To help you understand your options, here are common medicines for arthritis pain. Keep in mind, different drugs are often used to treat osteoarthritis, rheumatoid arthritis, and other less common forms of arthritis. This information covers the most commonly prescribed painkillers. Talk to your doctor to learn about more options.
Common Medicines for Arthritis Pain
Acetaminophen
Acetaminophen (also known by the brand name Tylenol) may be used to treat mild arthritis pain from osteoarthritis or rheumatoid arthritis. It can be just as effective as some prescription anti-inflammatory pain relievers for mild pain -- and is easy on the stomach.
Anti-Inflammatory Painkillers (NSAIDs)
Nonsteroidal anti-inflammatory drugs called NSAIDs help relieve joint swelling, stiffness, and pain -- and are among the most commonly used painkillers for people with any type of arthritis. You may know them by the names such as ibuprofen, naproxen, Motrin, or Advil.
While NSAIDs are reasonably safe, when taken for months or years, they can cause stomach ulcers and may increase your risk for heart attack. Cox-2 inhibitors like Celebrex are more stomach-friendly, but may have a slightly higher risk of heart problems than milder NSAIDs such as ibuprofen or naproxen.
Recent research also indicates that people who take daily aspirin for their heart should talk to their doctors before taking any NSAID regularly for pain. NSAIDs may alter the effect of aspirin.
But here's the question that White at the Arthritis Foundation tells her patients to ask themselves: "How does a slight risk of heart disease compare to the risk of arthritis pain itself?"
To reduce the chance of side effects, turn to NSAIDs as a short-term solution if possible, says White. Ask your doctor to prescribe the lowest effective dose, or a combination of drugs.
To protect your heart, it also helps to control other risk factors of heart disease such as high blood pressure and elevated cholesterol.
Steroids
Steroids such as Decadron and prednisone are strong anti-inflammatories that calm swelling, inflammation and pain.
For osteoarthritis, steroid injections are primarily injected into the joint for a direct effect on the painful joint. They can also be used for this purpose for people with rheumatoid arthritis.
High doses of steroid pills can be taken temporarily to treat severe flare-ups of rheumatoid arthritis. Low-dose pills may be used longer term to help tame inflammation and pain.
Especially with rheumatoid arthritis, steroids can "make a huge difference," says White. "Steroids decrease the pain and swelling very rapidly." After treating rheumatoid arthritis with steroids, White often follows up with biologic medicines.
However, when taken long-term, steroids can increase a person's risk of infection, increase blood sugar levels, and thin a person's bones. Most doctors recommend steroid pills for short-term use. Steroid injections help avoid side effects outside the joint, and may be used for longer-term use.
Narcotics
Prescription narcotic painkillers -- such as codeine, fentanyl, morphine, and oxycodone -- are used for severe pain that is not relieved with other medications. The drugs work on the nerve cells' pain receptors and are very effective in controlling severe pain.
DMARDs (Disease-Modifying Anti-Rheumatic Drugs)
In rheumatoid arthritis, DMARDs such as methotrexate can help prevent the serious joint damage that is caused by inflammation (they are not used to treat osteoarthritis). Because DMARDs take weeks to really start working, steroids or painkillers are sometimes used until they kick in.
"These drugs are revolutionizing the field of rheumatology," White tells WebMD. "They really have something important to offer people, a chance to not be disabled and out of work. They also offer a chance to do basic lifestyle changes that relieve pain."
There is a downside to many DMARDs: They work by suppressing the immune system, so there is greater susceptibility to infection while taking these drugs. Also, there is risk for liver problems, low blood count, and a slightly increased risk of cancer.
White says she advises her patients to weigh the benefits versus the risks. A person with painful progressive rheumatoid arthritis could face serious disability without treatment.
Biologics (Biological Response Modifiers)
If DMARDs like methotrexate don't help stop rheumatoid arthritis, biologics are the next course of action, says Hadler.
Biologics are a more aggressive, targeted therapy that can actually significantly slow progression of rheumatoid arthritis within a few weeks -- rather than just treating the symptoms. However, biologics can cause flare-ups of other chronic diseases that are in remission, particularly infections like tuberculosis. Biologics may also cause an increased risk of cancer.
"It's something we have to consider," says White. As always, White asks her patients to weigh the risks and benefits given the stage and severity of their rheumatoid arthritis.
Hadler calls biologics "impressive drugs," but usually waits a few months before prescribing them, and is wary about prescribing them for patients in their 20s, 30s, 40s.
"We have had the drugs for a decade, so we know about toxicities for that time frame," Hadler tells WebMD. "But we don't know what these drugs will do if you're taking them for longer than 10 years or for five years and stop for awhile."
He notes that only a third of people with rheumatoid arthritis need aggressive treatment. He says he turns to biologics only for patients who have progressive rheumatoid arthritis. "If we treat them all aggressively, how will we know if they really need these serious drugs -- and for how long?"
Natural Medicine: Beating the blues with food
It may be more than coincidence that the decrease in the quality of Americans' diets has occurred simultaneously with increased reports of depression. While there are situations in which medication or psychotherapy are the only effective means to treat depression, studies show that dietary changes can sometimes be a mood booster.Here are some ways to use food as a tool to fight depression:
Schedule an appointment with your physician to help ensure your symptoms are not signs of something bigger. Food allergies, thyroid abnormalities, nutrient deficiencies and other medical conditions all can cause depression.
Increase your intake of omega-3s. Research indicates that low levels of essential fatty acids can contribute to depression. Increasing intake of fish and flax or supplementing with their oils may improve your mood.
Pump up your diet. Food contains vitamins and minerals that are essential for making neurotransmitters that keep your mood in check. Aim for whole foods first rather than nutritional supplements or fortified foods. Whole foods contain many other compounds that help the vitamins and minerals work correctly. Focus on foods rich in B-vitamins and minerals, such as grains, nuts, lean meats, and fruits and vegetables.
Reduce or eliminate alcohol, caffeine, tobacco and food additives. Processed foods may contain food additives that can interfere with normal neurotransmitter functioning in some individuals.
Consult a physician before modifying your diet or health practices to treat depression. For additional information on nutrition and depression, visit the National Alliance on Mental Illness Web site: nami.org.
Laura Hunter, dietetic intern and Debra Boutin, MS, RD, dietetic internship director and associate professor at Bastyr University.
Mesothelioma Lawsuit
A mesothelioma lawsuit is filed by a victim of mesothelioma in order to recover damages associated with their development of this asbestos related cancer. A mesothelioma case can help a victim seek reparations for medical expenses, lost income and pain and suffering. Mesothelioma develops almost exclusively as a result of toxic exposure to asbestos. This disease can remain latent in a victim for up to forty years; therefore people who were exposed to asbestos in the environment in the 1950s may still be at risk for developing this disease.
Asbestos has been used to make more than 5000 products in the last few hundred years. Asbestos is a naturally occurring group of minerals that is used to make products such as vehicle brakes and building materials. Asbestos is added to these products because it aids in heat and corrosion resistance. The deadly effects of asbestos have been known for over sixty years, though it continues to be used in a variety of industries. People in the construction, automotive, factory, railroad, shipyard, and custodial industries may all be at risk for the serious health consequences resulting from toxic exposure to asbestos.
Mesothelioma is a rare but fatal cancer that is caused by this harmful exposure to asbestos. Mesothelioma affects the mesothelium that surrounds and protects the internal organs of the body and can affect any organ in the body including the brain, heart and reproductive organs. Pleural mesothelioma is the most common and affects the lining surrounding the lungs. This lining can become cancerous when asbestos is inhaled at toxic levels. Many times the disease is asymptomatic, though symptoms may include a persistent cough, pain in the chest area or shortness of breath.
Mesothelioma also affects the peritoneal lining of the organs in the abdominal cavity. This type of mesothelioma can also remain latent and asymptomatic for several years. If symptoms do develop they might include pain and swelling of the belly, nausea, bowel problems, weight loss, swollen feet, and anemia.
Mesothelioma affects men three to five times more often than it affects women. It is diagnosed in patients at an average age of 50 to 70 years. Once diagnosed, mesothelioma is fatal. The average survival time after diagnosis is only one year, because the cancer is usually in its advanced stages by the time it is discovered. For people who are diagnosed earlier, about one half survive for two years and twenty percent make it to five years.
A mesothelioma lawsuit can be filed in the legal system in order to seek reparations for medical expenses, loss of income and pain and suffering associated with the development of this disease. Employers and manufactures of asbestos containing products can be held liable for the injuries that develop as a result, especially when they were aware of the risks associated with the level of exposure they caused or permitted. Contacting a qualified lawyer is often the first step in discovering what your legal rights and options might be in a mesothelioma lawsuit. For more information on a mesothelioma lawsuit, please contact a mesothelioma attorney who is familiar with other mesothelioma cases.
Asbestos has been used to make more than 5000 products in the last few hundred years. Asbestos is a naturally occurring group of minerals that is used to make products such as vehicle brakes and building materials. Asbestos is added to these products because it aids in heat and corrosion resistance. The deadly effects of asbestos have been known for over sixty years, though it continues to be used in a variety of industries. People in the construction, automotive, factory, railroad, shipyard, and custodial industries may all be at risk for the serious health consequences resulting from toxic exposure to asbestos.
Mesothelioma is a rare but fatal cancer that is caused by this harmful exposure to asbestos. Mesothelioma affects the mesothelium that surrounds and protects the internal organs of the body and can affect any organ in the body including the brain, heart and reproductive organs. Pleural mesothelioma is the most common and affects the lining surrounding the lungs. This lining can become cancerous when asbestos is inhaled at toxic levels. Many times the disease is asymptomatic, though symptoms may include a persistent cough, pain in the chest area or shortness of breath.
Mesothelioma also affects the peritoneal lining of the organs in the abdominal cavity. This type of mesothelioma can also remain latent and asymptomatic for several years. If symptoms do develop they might include pain and swelling of the belly, nausea, bowel problems, weight loss, swollen feet, and anemia.
Mesothelioma affects men three to five times more often than it affects women. It is diagnosed in patients at an average age of 50 to 70 years. Once diagnosed, mesothelioma is fatal. The average survival time after diagnosis is only one year, because the cancer is usually in its advanced stages by the time it is discovered. For people who are diagnosed earlier, about one half survive for two years and twenty percent make it to five years.
A mesothelioma lawsuit can be filed in the legal system in order to seek reparations for medical expenses, loss of income and pain and suffering associated with the development of this disease. Employers and manufactures of asbestos containing products can be held liable for the injuries that develop as a result, especially when they were aware of the risks associated with the level of exposure they caused or permitted. Contacting a qualified lawyer is often the first step in discovering what your legal rights and options might be in a mesothelioma lawsuit. For more information on a mesothelioma lawsuit, please contact a mesothelioma attorney who is familiar with other mesothelioma cases.
Villar doubts cheap medicines bill will work
Senate President Manuel Villar Jr. has voiced misgivings at the effectiveness of a newly passed law that promises to bring down the price of medicine, in the process apparently taking a swing at a possible rival in the 2010 presidential election. Villar said he believed that the measure which came out of the House of Representatives, which provided for a drug price regulatory board and required doctors to prescribe only generics, would have been more effective instead of the version of the Senate, whose principal author is Sen. Manuel Roxas II.
The final version of the law followed Roxas’ bill, dropping the provision that required doctors to prescribe only the generic names of medicine and, doing away with a price regulatory board, authorizes the President to impose ceilings on drug prices.
“For me any version is acceptable. I believe both versions would help lower the price of medicine. Only maybe the decrease in prices would be bigger under the House version,” Villar said.
“But prices will also go down under the approved version. What’s important is that the law has been approved,” he quickly added.
Villar and Roxas have made plain their intentions to contest the 2010 presidential elections, both taking the helm of their respective political parties (Nacionalista Party for Villar and Liberal Party for Roxas).
Congress on Tuesday ratified the final version of the law, officially called “Universally Accessible Cheaper and Quality Medicines Act of 2008” and submitted it to Malacañang for President Gloria Macapagal-Arroyo’s signature.
Villar said the Senate was ready to amend the law as needed if it failed to deliver on its promise to make medicine more affordable.
“We wouldn’t know if it would be implemented properly. I believe prices will go down, we just don’t know by how much.
“But we are ready to revise the law if the decrease in prices is not enough. We can pass a new bill to further bring down prices,” Villar said.
The law seeks to bring down the price of medicine by encouraging more competition in the local pharmaceutical market through the parallel importation of quality but cheaper medicine from abroad.
It also seeks to help the local generics industry by amending the Intellectual Property Code and strengthen the regulatory powers of the Bureau of Food and Drugs against substandard medicine.
Health Buzz: Ibuprofen and Alzheimer's and Other Health News
Those who take ibuprofen on a regular basis for five years may be less likely to develop Alzheimer's disease as they get older, according to a new study. And people who take nonsteroidal anti-inflammatory medicines in general may have a decreased risk. But the findings are not concrete enough to warrant advising patients to take a daily dose of ibuprofen, or any other type of NSAID, to ward off Alzheimer's, noted the researchers, led by Steven Vlad, a fellow in rheumatology at Boston University School of Medicine. Long-term use of NSAIDs carries a risk of gastrointestinal problems. Still, "this trial is big enough and the results are good enough that it may reopen the debate--that we should do a prevention study with these medications," William Thies, vice president of medical and scientific relations for the Alzheimer's Association, told HealthDay.
Find out how to reduce your risk for dementia by shedding excess belly fat, and learn the difference between Alzheimer's disease and other types of dementia.
Autism and Schizophrenia May Be Related
A new study supports the idea in autism research that people diagnosed with either schizophrenia or autism often share the same rare genetic mutations, Nancy Shute reports. Julie Daniels, an epidemiologist at the University of North Carolina-Chapel Hill, looked at the health records of the parents of 1,227 Swedish children with autism who were born between 1977 and 2003. Those parents were twice as likely to have been diagnosed with schizophrenia as parents of children who didn't have autism. Other studies of early childhood brain development have shown that in both autism and schizophrenia, the brain development process is accelerated from birth to age 3.
In the On Parenting blog, Shute explains why the new study--while scary on its face--is actually good news. Earlier, she reported on evidence dismissing the link between vaccines and autism. And U.S. News's Bernadine Healy recently looked into the autism-vaccine link, after the independent Office of Special Masters of the Court of Federal Claims--with a 20-year record of handling vaccine matters--conceded that the brain damage and autistic behavior of Hannah Poling stemmed from her exposure as a toddler to five vaccinations on one day in July 2000.
Wal-Mart and Target Expand Drug Discount Programs
Wal-Mart has expanded its drug discount program to include some over-the-counter medicines and additional women's health medications priced at $4, and it adds a new option to purchase 90-day supplies of certain medications for $10. Target also announced that it is expanding its drug discount program to remain competitive with Wal-Mart.
Wal-Mart provides a list of drugs that are eligible for discounts. U.S. News's Michelle Andrews reported on Wal-Mart's discount program when it first launched in 2006.
Obesity May Affect Severity of Asthma
A study published in the May issue of the American Journal of Respiratory and Critical Care Medicine points to significant differences in lung function among asthmatic women with varying body mass index numbers, Matthew Shulman reports. Obese women appear to be more prone to "dynamic hyperinflation," a condition in which air breathed into the lungs becomes trapped and cannot be exhaled. As such, these women may have more trouble breathing during an asthma attack than do nonobese women. "They may experience more shortness of breath and, compared with nonobese patients, are closer to severely exacerbating an asthma attack," says John Heffner, the immediate past president of the American Thoracic Society and a specialist in pulmonary and critical care medicine in Oregon.
For the 12th year, the American College of Allergy, Asthma, and Immunology is offering free asthma screening exams with specialists at 250 locations across the country. Also, U.S. News explains why it's important to stick with prescribed asthma medications, and why it's essential to know the policy at your child's school on access to asthma inhalers.
Cannabis to B upgraded from C
JACQUI Smith defied the Government’s own experts today by announcing that laws on cannabis will be toughened up.
The Home Secretary said the drug must be upgraded from Class C to Class B to avoid risking the future health of young people.
The move comes despite the Advisory Council on the Misuse of Drugs (ACMD) concluding that the health dangers from cannabis did not justify its inclusion in the higher category.
A report from the group said scientific evidence pointed to a probable, but weak, causal link between psychotic illness, including schizophrenia, and cannabis use.
Two faced baby
This two faced baby is only a few days old (Born Monday, March 10) and she was born in India. These illiterate people start worshiping. I hope they get medical treatment asap, I think doctors should take care, as medical assessment and possible operations, if needed, could upset the community. It’s interesting to see if this baby will not have any acute cerebral issues. I would guess it was gonna be twins, and apparently, the cells just stopped dividing. I’m sure there are many other medical issues that are present, that just are not being publicized like the obvious.Find the medical reason for that
Exubera Causes Lung Cancer
Exubera is a rapid-acting insulin indicated for the treatment of adults with diabetes mellitus for the control ofhyperglycemia. In patients with type 1 diabetes, EXUBERA should be used in regimens that include a longer-acting insulin.In patients with type 2 diabetes, EXUBERA can be used as monotherapy or in combination with oral agents or longer-acting insulins.
EXUBERA is contraindicated in patients who smoke or who have discontinued smoking less than 6 months prior tostarting EXUBERA therapy. If a patient starts or resumes smoking, EXUBERA must be discontinued immediately due tothe increased risk of hypoglycemia and an alternative treatment must be utilized.
EXUBERA is contraindicated in patients with unstable or poorly controlled lung disease, because of wide variations in lung function that could affect the absorption of EXUBERA and increase the risk of hypoglycemia or hyperglycemia. The use of EXUBERA in patients with underlying lung disease, such as asthma or COPD, is not recommended because the safety and efficacy of EXUBERA in this population have not been established.
Hypoglycemia is the most commonly reported adverse event of insulin therapy, including EXUBERA
In clinical trials, treatment with EXUBERA was associated with small, non-progressive mean declines in pulmonary function relative to comparator treatments. Because of the effect of EXUBERA on pulmonary function, all patients should have pulmonary function tests (e.g., spirometry) assessed prior to initiative therapy with EXUBERA, after 6 months oftherapy, and annually thereafter, even in the absence of pulmonary symptoms.
The long-term safety and effectiveness of EXUBERA in pediatric patients have not been established
In clinical studies, respiratory adverse events included cough, which tended to occur within seconds to minutes after EXUBERA inhalation. The incidence of cough decreased with continued EXUBERA use. Other respiratory adverse eventsincluded dyspnea, pharyngitis, sputum increase, and epistaxis. Non-respiratory adverse events reported in EXUBERA-treated patients include: hypoglycemia, chest pain, and dry mouth.
In clinical trials of Exubera, there have been 6 newly diagnosed cases of primary lung malignancies among Exubera-treated patients, and 1 newly diagnosed case among comparator treated patients. There has also been 1 post-marketing report of a primary lung malignancy in an Exubera-treated patient. In controlled clinical trials of Exubera, the incidence of new primary lung cancer per 100 patient-years of study drug exposure was 0.13 (5 cases over 3900 patient-years) for Exubera-treated patients and 0.02 (1 case over 4100 patient-years) for comparator-treated patients. There were too few cases to determine whether the emergence of these events is related to Exubera. All patients who were diagnosed with lung cancer had a prior history of cigarette smoking.
EXUBERA is contraindicated in patients who smoke or who have discontinued smoking less than 6 months prior tostarting EXUBERA therapy. If a patient starts or resumes smoking, EXUBERA must be discontinued immediately due tothe increased risk of hypoglycemia and an alternative treatment must be utilized.
EXUBERA is contraindicated in patients with unstable or poorly controlled lung disease, because of wide variations in lung function that could affect the absorption of EXUBERA and increase the risk of hypoglycemia or hyperglycemia. The use of EXUBERA in patients with underlying lung disease, such as asthma or COPD, is not recommended because the safety and efficacy of EXUBERA in this population have not been established.
Hypoglycemia is the most commonly reported adverse event of insulin therapy, including EXUBERA
In clinical trials, treatment with EXUBERA was associated with small, non-progressive mean declines in pulmonary function relative to comparator treatments. Because of the effect of EXUBERA on pulmonary function, all patients should have pulmonary function tests (e.g., spirometry) assessed prior to initiative therapy with EXUBERA, after 6 months oftherapy, and annually thereafter, even in the absence of pulmonary symptoms.
The long-term safety and effectiveness of EXUBERA in pediatric patients have not been established
In clinical studies, respiratory adverse events included cough, which tended to occur within seconds to minutes after EXUBERA inhalation. The incidence of cough decreased with continued EXUBERA use. Other respiratory adverse eventsincluded dyspnea, pharyngitis, sputum increase, and epistaxis. Non-respiratory adverse events reported in EXUBERA-treated patients include: hypoglycemia, chest pain, and dry mouth.
Cosmeceuticals
Cosmeceuticals are largely aimed at the anti-aging market. Women are encouraged to start slowing the aging process early and many women in their early twenties are already spending vast amounts of money to make sure they still look good at 60.
However, it is a case of 'buyer beware' when purchasing a skin care Product that holds out the promise of younger-looking skin. Consumer Reports published results last year demonstrating that there's no correlation between the price of a product and its effectiveness. And of the nine creams tested, not one of them was "noticeably effective" in reducing wrinkles.
Many doctors are reluctant to recommend untested cosmeceutical products and manufacturers tend to rely heavily on celebrity endorsement rather than science to boost sales. One recent skin
care product that is the result of high-tech research and new ingredients and is backed by science and recommended by doctors, is 21st Century's shielding lotion Skin MD Natural.It's a safe and effective breakthrough in natural skin care technology that may be just what consumers are looking for.
"There are many different factors that age the skin. One of those factors is environmental pollution, such as air pollution or water pollution, where the chemicals interact with our skin, causing abnormalities in our cells," said Dr. Lisa Benest, a board certified dermatologist practicing in Burbank, California. "There are thousands of skin irritants in our environment that
weren't around just decades ago. If we use a shielding lotion in our skin care routine to prevent exposure to those environmental chemicals we can keep our skin cells looking stronger, healthier
and younger for a longer period of time."
As the thousands of chemical-based skin care products and medications on the market have failed to heal our skin problems -- eczema, for example, increased from one in fifty to about one
in five of the population during the last century -- or provide the fountain of youth, it appears that healing ourselves with natural skin care products, instead of pharmaceuticals or Cosmeceuticals, may be our best option.
However, it is a case of 'buyer beware' when purchasing a skin care Product that holds out the promise of younger-looking skin. Consumer Reports published results last year demonstrating that there's no correlation between the price of a product and its effectiveness. And of the nine creams tested, not one of them was "noticeably effective" in reducing wrinkles.
Many doctors are reluctant to recommend untested cosmeceutical products and manufacturers tend to rely heavily on celebrity endorsement rather than science to boost sales. One recent skin
care product that is the result of high-tech research and new ingredients and is backed by science and recommended by doctors, is 21st Century's shielding lotion Skin MD Natural.It's a safe and effective breakthrough in natural skin care technology that may be just what consumers are looking for.
"There are many different factors that age the skin. One of those factors is environmental pollution, such as air pollution or water pollution, where the chemicals interact with our skin, causing abnormalities in our cells," said Dr. Lisa Benest, a board certified dermatologist practicing in Burbank, California. "There are thousands of skin irritants in our environment that
weren't around just decades ago. If we use a shielding lotion in our skin care routine to prevent exposure to those environmental chemicals we can keep our skin cells looking stronger, healthier
and younger for a longer period of time."
As the thousands of chemical-based skin care products and medications on the market have failed to heal our skin problems -- eczema, for example, increased from one in fifty to about one
in five of the population during the last century -- or provide the fountain of youth, it appears that healing ourselves with natural skin care products, instead of pharmaceuticals or Cosmeceuticals, may be our best option.
Fibromyalgia Pain 10 Tips for Better Sleep
Do you toss and turn at night because of fibromyalgia pain or discomfort?
"People with fibromyalgia tend to have very disturbed sleep"
Research shows that with fibromyalgia, there is an automatic arousal in the brain during sleep. Frequent disruptions prevent the important restorative processes from occurring. Growth hormone is mostly produced during sleep. Without restorative sleep and the surge of growth hormone, muscles don’t heal and neurotransmitters (like the mood chemical serotonin) are not replenished. The lack of a good night’s sleep makes people with fibromyalgia wake up feeling tired and fatigued.
The result: The body can't recuperate from the day's stresses -- all of which overwhelms the system, creating a great sensitivity to pain. Widespread pain, sleep problems, anxiety, depression, fatigue, and memory difficulties are all symptoms of fibromyalgia.
Insomnia takes many forms -- trouble falling asleep, waking up often during the night, having trouble going back to sleep, and waking up too early in the morning. Smoothing out those sleep problems -- and helping people get the deep sleep their bodies need -- helps fibromyalgia pain improve significantly, research shows.
Medications can help enhance sleep and relieve pain. But doctors also advocate lifestyle changes to help sleep come naturally.
Tips to Get Better Sleep With Fibromyalgia
Creating a comfort zone at home is key to better sleep, whether you have fibromyalgia or not. It's all about easing into bedtime feeling relaxed -- and staying relaxed so you sleep through the night.
- Enjoy a soothing (warm) bath in the evening.
- Brush your body with a loofah or long-handled brush in the bath.
- Ease painful tender points with a self-massage device (like a tennis ball).
- Do yoga and stretching exercises to relax
- Meditate to tame intrusive thoughts and tension.
- Sleep in a darkened room. Try an eye mask if necessary.
- Keep the room as quiet as possible (or use a white-noise machine).
- Make sure the room temperature is comfortable.
- Avoid foods that contain caffeine, including teas, colas, and chocolate.
If you're still having sleep problems, several therapies can help, including biofeedback, relaxation training, stress reduction, and cognitive therapy. A psychologist who specializes in sleep disorders can discuss these therapies with you.
The therapies help people handle stress better, which helps control fibromyalgia episodes, says Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical School. "Fibromyalgia comes and goes," she tells WebMD. "When you're stressed out, that's when it's worse." That's when you're most likely to have insomnia, too.
Medications can also help ease fibromyalgia pain at night, or directly treat insomnia. Medications to ease fibromyalgia at night include antidepressants, anticonvulsants, prescription pain relievers, and sleep aids.
No one therapy will control fibromyalgia pain 100%, Cope adds.
"Medications help some. Exercise helps some. Stress reduction helps some. Cognitive behavior therapy helps some... If you can get restful sleep, you're going to function better when you're awake."
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