What is the difference between a vaccine and an antiviral?
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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.
source: http://www.pandemicflu.gov/faq/vaccines/1090.html
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 26, 2009
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, (www.qdscore.org) was calculated from the following variables, all of which were found to independently affect the risk for incident type 2 diabetes:
◦Age
◦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
◦Ethnicity
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, (www.qdscore.org) was calculated from the following variables, all of which were found to independently affect the risk for incident type 2 diabetes:
◦Age
◦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
◦Ethnicity
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.
http://www.medscape.com/viewarticle/704205?sssdmh=dm1.483760&src=nldne
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.
http://www.medscape.com/viewarticle/704205?sssdmh=dm1.483760&src=nldne
Saturday, May 30, 2009
How Anger Management Counseling can Help
By: Mike Justin Anger.
One of the most charged emotions a person can feel. To some, it happens, but it is not an emotion that takes them over. It is maybe a slight irritation. It is something they can get under control.
For other people, it can cause rage and an intense fury. When that occurs it will turn destructive and quickly get out of control. This causes problems in relationships, work, and in your general quality of life.
A person is at the mercy of this emotion and its unpredictableness if they let it get out of control.
With my experience in anger management counseling I would like to explore a couple of ways to control this emotion. The goal of is to reduce the emotional feelings the physical arousal that anger causes.
1.First thing to try to do is relax. One relaxation technique is to breathe deeply. You can uses calming images as well. Another tool to use is to repeat slow calming words.
Don't just use these techniques when you do get angry. Try to make it a practice everyday if you feel you have an anger issue.
2.Second you have to change the way you think. Simply put, the anger may cause you to talk loudly, swear, and cause you to express yourself colorfully. These just express your inner thoughts. What you are going to have to do is change the angry irrational thoughts into more reasonable rational ones.
Instead of allowing yourself to feel you have been wronged, try to tell yourself that this is not the end of the world.
3. Third, communication is something you have to try to do better. When a person gets in a heated discussion or gets angry, the communications often breaks down.Rather than having a thoughtful comment, their emotions control what they say.
Slow down and think about how best to communicate.
4.Finally, try to change the environment you are in. A lot of times when we are angry or frustrated, just stopping and going someplace else can change our moods completely.
This changing of the environment may be enought time to quiet and calm your emotions and then get your anger under control.
Although not the end all, these tips will help you get a control on anger. If you find it does not, you will want to go get some professional help.
source Smart Articles @ http://www.articlebrain.com
One of the most charged emotions a person can feel. To some, it happens, but it is not an emotion that takes them over. It is maybe a slight irritation. It is something they can get under control.
For other people, it can cause rage and an intense fury. When that occurs it will turn destructive and quickly get out of control. This causes problems in relationships, work, and in your general quality of life.
A person is at the mercy of this emotion and its unpredictableness if they let it get out of control.
With my experience in anger management counseling I would like to explore a couple of ways to control this emotion. The goal of is to reduce the emotional feelings the physical arousal that anger causes.
1.First thing to try to do is relax. One relaxation technique is to breathe deeply. You can uses calming images as well. Another tool to use is to repeat slow calming words.
Don't just use these techniques when you do get angry. Try to make it a practice everyday if you feel you have an anger issue.
2.Second you have to change the way you think. Simply put, the anger may cause you to talk loudly, swear, and cause you to express yourself colorfully. These just express your inner thoughts. What you are going to have to do is change the angry irrational thoughts into more reasonable rational ones.
Instead of allowing yourself to feel you have been wronged, try to tell yourself that this is not the end of the world.
3. Third, communication is something you have to try to do better. When a person gets in a heated discussion or gets angry, the communications often breaks down.Rather than having a thoughtful comment, their emotions control what they say.
Slow down and think about how best to communicate.
4.Finally, try to change the environment you are in. A lot of times when we are angry or frustrated, just stopping and going someplace else can change our moods completely.
This changing of the environment may be enought time to quiet and calm your emotions and then get your anger under control.
Although not the end all, these tips will help you get a control on anger. If you find it does not, you will want to go get some professional help.
source Smart Articles @ http://www.articlebrain.com
Exercise Improves Patellofemoral Pain
From Medscape Medical News
ACSM 2009:
Jordana Bieze Foster
May 29, 2009 (Seattle, Washington) — A supervised exercise program for patellofemoral pain syndrome (PFPS) more effectively improves pain and function than usual care emphasizing rest and activity avoidance, according to a randomized clinical trial presented here at the annual meeting of the American College of Sports Medicine.
In 131 patients aged 14 to 40 years with chronic patellofemoral pain, Dutch researchers found that those who completed a 12-week exercise program reported significantly lower levels of pain and higher levels of function at 3 months and at 1 year compared with those who received "usual care" from their physicians.
The treatment intervention included exercises for quadriceps strengthening, flexibility, balance, and coordination, progressively increasing in complexity over time. Usual care, consistent with clinical guidelines for general practitioners in the Netherlands, included verbal and written information about patellofemoral pain and recommendations to avoid activities that provoke pain.
"Our outcome supports the use of supervised exercise therapy instead of a 'wait and see' approach," Robbart van Linschoten, MD, a sports medicine general practitioner at Erasmus University Medical Center in Rotterdam, the Netherlands, said during his presentation.
http://www.medscape.com/viewarticle/703552?sssdmh=dm1.478129&src=nldne
ACSM 2009:
Jordana Bieze Foster
May 29, 2009 (Seattle, Washington) — A supervised exercise program for patellofemoral pain syndrome (PFPS) more effectively improves pain and function than usual care emphasizing rest and activity avoidance, according to a randomized clinical trial presented here at the annual meeting of the American College of Sports Medicine.
In 131 patients aged 14 to 40 years with chronic patellofemoral pain, Dutch researchers found that those who completed a 12-week exercise program reported significantly lower levels of pain and higher levels of function at 3 months and at 1 year compared with those who received "usual care" from their physicians.
The treatment intervention included exercises for quadriceps strengthening, flexibility, balance, and coordination, progressively increasing in complexity over time. Usual care, consistent with clinical guidelines for general practitioners in the Netherlands, included verbal and written information about patellofemoral pain and recommendations to avoid activities that provoke pain.
"Our outcome supports the use of supervised exercise therapy instead of a 'wait and see' approach," Robbart van Linschoten, MD, a sports medicine general practitioner at Erasmus University Medical Center in Rotterdam, the Netherlands, said during his presentation.
http://www.medscape.com/viewarticle/703552?sssdmh=dm1.478129&src=nldne
Monday, May 25, 2009
Avoid Alcohol in Pregnancy
Pattern of Alcohol Use Since 1991 Remains Unchanged Among Pregnant Women
From Reuters Health Information
May 21 - The use of alcohol and the prevalence of binge drinking among pregnant women and women of childbearing age changed little between 1991 and 2005, according to investigators at the US Centers for Disease Control and Prevention.
Fetal alcohol syndrome, birth defects, and low birth weight are among the poor outcomes associated with alcohol consumption during pregnancy, Dr. C. H Denny and co-authors note in the Morbidity and Mortality Weekly Report for May 22.
To examine trends in alcohol use among women of childbearing age, the researchers analyzed data from Behavioral Risk Factor Surveillance System surveys. Included were 533,506 women 18 to 44 years of age surveyed during 1991 to 2005; of these, 22,027 (4.1%) were pregnant at the time of the interview.
"The prevalence of any alcohol use and binge drinking...did not change substantially over time," the authors report. Any alcohol use was defined as having at least one drink in the past 30 days, and binge drinking as having 5 or more drinks on at least one occasion in the past 30 days.
Among pregnant women, the average annual percentage of any alcohol use was 12.2% (range: 10.2%-16.2%), while the average annual percentage for binge drinking was 1.9% (range: 0.7%-2.9%).
Corresponding values among nonpregnant women were 53.7% (range: 51.6%-56.3%) and 12.1% (range: 10.8%-13.7%).
Dr. Denny's team recommends: "Health-care providers should ask women of childbearing age about alcohol use routinely, inform them of the risks from alcohol while pregnant, and advise them not to drink alcohol while pregnant or if they might become pregnant."
The researchers identified risk factors for problem drinking among 13,820 pregnant women surveyed during 2001 to 2005. For any alcohol use, these included older age (age 34-44 vs 18-24, adjusted odds ratio = 2.3), having a college degree (AOR = 1.9), being employed (AOR = 1.5), and being unmarried (AOR = 2.2).
Employment and single status were also associated with binge drinking among pregnant women (AORs 1.8 and 4.4, respectively).
As to why these factors are associated with drinking in pregnancy, authors of an editorial note suggest that "1) older women might be more likely to be alcohol dependent and have more difficulty abstaining from alcohol while pregnant; 2) more educated women and employed women might have more discretionary money for the purchase of alcohol; and 3) unmarried women might attend more social occasions where alcohol is served."
Mor Mortal Wkly Rep CDC Surveill Summ 2009;58:529-532.
From Reuters Health Information
May 21 - The use of alcohol and the prevalence of binge drinking among pregnant women and women of childbearing age changed little between 1991 and 2005, according to investigators at the US Centers for Disease Control and Prevention.
Fetal alcohol syndrome, birth defects, and low birth weight are among the poor outcomes associated with alcohol consumption during pregnancy, Dr. C. H Denny and co-authors note in the Morbidity and Mortality Weekly Report for May 22.
To examine trends in alcohol use among women of childbearing age, the researchers analyzed data from Behavioral Risk Factor Surveillance System surveys. Included were 533,506 women 18 to 44 years of age surveyed during 1991 to 2005; of these, 22,027 (4.1%) were pregnant at the time of the interview.
"The prevalence of any alcohol use and binge drinking...did not change substantially over time," the authors report. Any alcohol use was defined as having at least one drink in the past 30 days, and binge drinking as having 5 or more drinks on at least one occasion in the past 30 days.
Among pregnant women, the average annual percentage of any alcohol use was 12.2% (range: 10.2%-16.2%), while the average annual percentage for binge drinking was 1.9% (range: 0.7%-2.9%).
Corresponding values among nonpregnant women were 53.7% (range: 51.6%-56.3%) and 12.1% (range: 10.8%-13.7%).
Dr. Denny's team recommends: "Health-care providers should ask women of childbearing age about alcohol use routinely, inform them of the risks from alcohol while pregnant, and advise them not to drink alcohol while pregnant or if they might become pregnant."
The researchers identified risk factors for problem drinking among 13,820 pregnant women surveyed during 2001 to 2005. For any alcohol use, these included older age (age 34-44 vs 18-24, adjusted odds ratio = 2.3), having a college degree (AOR = 1.9), being employed (AOR = 1.5), and being unmarried (AOR = 2.2).
Employment and single status were also associated with binge drinking among pregnant women (AORs 1.8 and 4.4, respectively).
As to why these factors are associated with drinking in pregnancy, authors of an editorial note suggest that "1) older women might be more likely to be alcohol dependent and have more difficulty abstaining from alcohol while pregnant; 2) more educated women and employed women might have more discretionary money for the purchase of alcohol; and 3) unmarried women might attend more social occasions where alcohol is served."
Mor Mortal Wkly Rep CDC Surveill Summ 2009;58:529-532.
Friday, May 22, 2009
Relatively Low Levels of Smoking Can Lead to Severe COPD in Women
From Reuters Health Information
NEW YORK (Reuters Health) May 19 - Women seem to be more susceptible to the harmful effects of smoking than their male counterparts, according to findings from a case-control study of subjects with chronic obstructive pulmonary disease (COPD), presented Monday at the international conference of the American Thoracic Society in San Diego
The current study is not the first to suggest that smoking-related damage is worse in women than in men, lead researcher Dr. Inga-Cecilie Soerheim, from the University of Bergen, Norway, told Reuters Health. "The novel aspect of our study is that we specifically examined subgroups of COPD subjects with either early-onset of disease or low smoking exposure."
Dr. Soerheim said that her team hypothesized that "if women are more susceptible to smoking-related lung damage, they will likely experience reduced lung function at an earlier age or after less smoking exposure than men."
To look into that, the researchers studied 954 subjects with moderate or severe COPD and 955 controls. All of the subjects were either current or former smokers.
The researchers found that women had worse lung function and more severe disease than men in subgroups with early-onset COPD (<60 years of age) and low smoking exposure COPD (<20 cigarettes/day for <20 years). "In the low exposure group in this study, half of the women actually had severe COPD," Dr. Soerheim noted in a press release.
Dr. Soerheim commented that she and her colleagues were somewhat surprised by how many female smokers had severe COPD with relatively modest smoking histories.
These findings have an important public health message, Dr. Soerheim emphasized. "Many people believe that their own smoking is too limited to be harmful -- that a few cigarettes a day represent a minimal risk. But there is no such thing as a safe amount of cigarette smoking. Our data suggest that this is particularly true for female smokers."
In addition, she said that the results, "together with other studies demonstrating similar findings, should definitely urge all physicians to be aware of COPD development in female smokers."
http://www.medscape.com/viewarticle/703050?sssdmh=dm1.474949&src=nldne
NEW YORK (Reuters Health) May 19 - Women seem to be more susceptible to the harmful effects of smoking than their male counterparts, according to findings from a case-control study of subjects with chronic obstructive pulmonary disease (COPD), presented Monday at the international conference of the American Thoracic Society in San Diego
The current study is not the first to suggest that smoking-related damage is worse in women than in men, lead researcher Dr. Inga-Cecilie Soerheim, from the University of Bergen, Norway, told Reuters Health. "The novel aspect of our study is that we specifically examined subgroups of COPD subjects with either early-onset of disease or low smoking exposure."
Dr. Soerheim said that her team hypothesized that "if women are more susceptible to smoking-related lung damage, they will likely experience reduced lung function at an earlier age or after less smoking exposure than men."
To look into that, the researchers studied 954 subjects with moderate or severe COPD and 955 controls. All of the subjects were either current or former smokers.
The researchers found that women had worse lung function and more severe disease than men in subgroups with early-onset COPD (<60 years of age) and low smoking exposure COPD (<20 cigarettes/day for <20 years). "In the low exposure group in this study, half of the women actually had severe COPD," Dr. Soerheim noted in a press release.
Dr. Soerheim commented that she and her colleagues were somewhat surprised by how many female smokers had severe COPD with relatively modest smoking histories.
These findings have an important public health message, Dr. Soerheim emphasized. "Many people believe that their own smoking is too limited to be harmful -- that a few cigarettes a day represent a minimal risk. But there is no such thing as a safe amount of cigarette smoking. Our data suggest that this is particularly true for female smokers."
In addition, she said that the results, "together with other studies demonstrating similar findings, should definitely urge all physicians to be aware of COPD development in female smokers."
http://www.medscape.com/viewarticle/703050?sssdmh=dm1.474949&src=nldne
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