Friday, June 26, 2009

H1N1 Flu - vaccine or antiviral?

What is the difference between a vaccine and an antiviral?


Vaccines are usually given to prevent infections. Influenza vaccines are made from either pieces of the killed influenza virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body’s immune system makes antibodies which will fight off infection if exposure to the virus occurs.

Antivirals are drugs that can treat people who have already been infected by a virus. They also can be used to prevent infection when given before or shortly after exposure and before illness occurs. A key difference between a vaccine and antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken while a vaccine can be given long before exposure to the virus and can provide protection over a long period of time.

Why won't the annual flu vaccine protect people against pandemic influenza?Influenza vaccines provide the best protection against viruses closely related to the vaccine strains. Current annual influenza vaccines include influenza A subtype H3N2 and H1N1 viruses. A vaccine made from these viruses would not provide protection from other influenza A viruses (such as H5N1) that are not closely related to them.


My comment: do not use anti viral against flu indiscriminately or without medical prescription (to avoid wrong dosing or wrong diagnosis) - this may allow the virus to develop resistant strains to the antiviral making future treatment options very hard indeed.

Friday, June 19, 2009

QDScore Helps Estimate 10-Year Risk for Diabetes

by Laurie Barclay & Charles Vega
Medscape News

March 19, 2009 — The QDScore, which includes both social deprivation and ethnicity, is the first risk prediction algorithm to estimate the 10-year risk for diabetes, according to the results of a prospective open cohort study reported in the March 18 Online First issue of the BMJ.

"Although several algorithms for predicting the risk of type 2 diabetes have been developed, no widely accepted diabetes risk prediction score has been developed and validated for use in routine clinical practice," write Julia Hippisley-Cox, from University Park, Nottingham, United Kingdom, and colleagues. "Previous studies have been limited by size, and some have performed inadequately when tested in ethnically diverse populations. A new diabetes risk prediction tool with appropriate weightings for both social deprivation and ethnicity is needed given the prevalence of type 2 diabetes, particularly among minority ethnic communities, appreciable numbers of whom remain without a diagnosis for long periods of time."

The goal of this study was to develop and validate the QDScore for estimating 10-year risk of acquiring diagnosed type 2 diabetes during a 10-year period, with use of routinely collected data from an ethnically and socioeconomically diverse population

Obesity has been a growing problem in Western countries for decades, and a study by Christakis and Fowler suggests that social networks play a prominent role in the risk for obesity. Their research, which was published in the July 26, 2007, issue of the New England Journal of Medicine, demonstrated that an individual's risk of becoming obese increased by 57% if he or she had a friend who became obese in a given interval. Moreover, incident obesity among siblings and spouses also increased subjects' risk for obesity. However, the development of obesity in a neighbor had no significant effect on the personal risk for obesity.

The epidemic of obesity has led to a sharp increase in the prevalence of type 2 diabetes. The current study examines a tool to predict the risk for incident type 2 diabetes without the use of laboratory data

The risk tool, the QDScore, ( was calculated from the following variables, all of which were found to independently affect the risk for incident type 2 diabetes:
◦Body mass index
◦Family history of diabetes
◦Smoking status
◦Treated hypertension
◦Use of corticosteroids
◦Diagnosed cardiovascular disease
◦Social deprivation, as measured by the Townsend deprivation scale

Thursday, June 11, 2009

AHA Urges Exercise to Cut CV Risk in Diabetics

by Steve Stiles

June 10, 2009 (Dallas, Texas) — At least two and half hours per week, spread out over at least three sessions--that's the amount of moderate-intensity exercise recommended by the American Heart Association for reducing cardiovascular risk in people with type 2 diabetes, according to a scientific statement published online June 8, 2009 in Circulation [1].

Ninety minutes per week of "vigorous-intensity cardiorespiratory exercise" can be an alternative for some patients, but both options are considered minimums, according to the document, from a writing group chaired by Dr Thomas H Marwick (University of Queensland School of Medicine, Brisbane, Australia). In addition, "moderate- to high-intensity" resistance training three times per week is highly recommended.

The document is rich with evidence from the literature to support the recommendations, but "unfortunately, only a few large-scale, randomized, controlled trials are available."

Still, it reviews likely physiologic mechanisms by which exercise improves CV risk factors, such as improvements in insulin sensitivity and vascular function, as well as potential CV risks of exercise training. Recommendations on counseling and other strategies for promoting adherence are included. And it describes how some patients, especially the many who may start out deconditioned or are limited by comorbidities, can begin lightly and work their way up to the training goals.