Hepatitis: In search of increased protection for a silent infection
By SOLA OGUNDIPE
July 31
FIFTEEN years before the doctor said to him: “Go home and get your affairs in order because there is nothing further we can do for you”, John was already aware that a problem existed.
Blood had started showing up, infrequently and in small amounts in his stools. “I’d kept this information to myself, mainly due to embarrassment and the possibility that it may only be haemorrhoids, something most people would pass off as not worth the hassle, “ he noted.
Time passed quickly. Blotches started appearing on his skin, barely noticeable at first but becoming larger and more numerous and pronounced as time progressed...continue reading..
Side Effects of the Two New Hep C Drugs
Just like any drug, the two newly approved medications for Hepatitis C have side effects.
Both of the new Hepatitis C drugs, Victrelis (boceprevir) and Incivek (telaprevir) are explicitly for use in conjunction with the current combination of pegylated interferon and ribavirin. Thus, any side effects occurring with Victrelis or Incivek are in addition to the side effects seen with the previous standard treatment regimen.
Read more.
Related On This Blog; Hepatitis C Drug Incivek (telaprevir); What are the side effects ?
Doctors to sensitize barbers about Hepatitis C risks
Karachi—
Doctors comprising members of SMC Alumni Association has taken upon themselves to sensitize barbers as well as beauticians, in Karachi, to protect themselves against Hepatitis B and C.
Dr. Natasha Mustafa, Coordinator of the Campaign told APP Friday that beauticians and barbers are also being approached to bring about extremely important changes in handling of their clients.
“This is very important as many a time unassuming people hold chance to contract Hepatitis C and B and even HIV infections during minor cuts experienced during shave or hair cut at a barber’s shop,” she said.
The young doctor also referred to vulnerability of people undergoing pedi-cure or mani-cure due to poor hygienic practices. Re-use of sharp tools, though obsolete, but still used for skin cleaning purposes in many of the beauty parlors, is also a risk that is often ignored, said Dr. Natasha.
“The hair dressers and beauticians are also at risk due to application of contaminated tools, knives and blades,” Dr. Natasha said in reply to a question.The exercise to educate professionals, she said, is part of the ongoing SMC Alumni campaign, focussed on prevention and control of Hepatitis C.
She said more than 500 students of Sindh Medical College had also joined the walk, arranged by SMC Alumni Association, Pakistan chapter, to mark the world hepatitis day.
Dr.Sameer Qureshi, President, SMC Alumni Association (Pakistan) led the walk that started from Emergency Department of the Jinnah Post Graduate Medical Center and ended at its ENT Department.—APP
Transplant
One H1N1 Vaccine Not Enough for Kids With New Livers (CME/CE)
7/30/2011 MedPage Today Gastroenterology (MedPage Today) --
A single dose of the monovalent pandemic 2009 H1N1 influenza vaccine was not enough to protect immunocompromised pediatric liver transplant recipients, a small study suggested.
Pharmaceutical
Merck Hep C Drug Draws More Atttention Than Job Cuts
NEW YORK (TheStreet) --
The 75%/25% market share split in sales between Vertex and Merck had been expected by analysts who cover Vertex, based on third-party drug tracking firm data.
It's obvious that Merck would prefer to be on the 75% market share side of the equation, but no one expected that to be the case, even if Vertex performance was better than existing high expectations....Continue reading...
Off The Cuff
From Reuters Health Information
Medicine Professor Calls Prince Charles, Others "Snake-Oil Salesmen
By Kate Kelland
LONDON (Reuters) Jul 25 - A leading professor of complementary medicine accused Britain's heir-to-the-throne Prince Charles and other backers of alternative therapies on Monday of being "snake-oil salesmen" who promote products with no scientific basis.
Edzard Ernst, who is stepping down from his post as Britain's only professor of complementary medicine at Exeter University, also said a long-running dispute with the Prince about the merits of alternative therapies had cost him his job -- a claim Prince Charles's office denied.
"Almost directly, Prince Charles has managed to interfere in my professional life and almost managed to close my unit," Ernst told reporters at a briefing.
A spokeswoman for Prince Charles told Reuters the royal heir was not involved in the dispute with Ernst and that she would not respond to professor's comments about snake-oil salesmen.
Ernst's complementary medicine research unit at Exeter's Peninsula School of Medicine had been threatened with outright closure, but the university has now offered it a reprieve and says it is seeking a successor to Ernst to lead it.
"It looked as though I had to go, and that was the price for the unit to continue," Ernst said. "I pay the price gladly as it is a small price to pay for the unit to continue."
Ernst said that during his 18 years of researching the efficacy of hundreds of different types of alternative medicine -- from acupuncture, to herbal remedies, to homeopathy and chiropractic therapy -- he has found that "snake-oil salesmen and pseudo-science are ubiquitous and dangerous".
Asked whether he included Prince Charles in that category, he said, "yes".
He said Prince Charles, a long-time advocate of alternative and integrated medicine and sustainable agriculture, was one of the main obstacles to allowing proper scientific analysis of the efficacy of complementary therapies.
Referring to the prince's Duchy Originals food company as "dodgy originals," he said the firm's promotion of a "detox" tincture made from artichoke and dandelion was an example of how the prince peddled scientifically unproven therapies.
In 2009 Ernst accused Prince Charles of "outright quackery" for promoting the detox tincture and other such products "under the banner of holistic and integrative healthcare."
The 62-year-old prince founded Duchy Originals in 1990 to promote organic food and farming, with profits going to charity.
Duchy Originals describes the product as "a food supplement to help eliminate toxins and aid digestion" and a spokeswoman for the firm said it had no comment about Ernst's remarks.
Ernst's dispute with Prince Charles dates back to 2005, when the professor was asked to look at a report by an economist, Christopher Smallwood, who was investigating whether alternative remedies were cost-effective and should be offered more widely on Britain's taxpayer-funded National Health Service (NHS).
Ernst objected to the report and decided to voice his concerns before it was published. In one section, the report said the NHS could save billions of pounds if some doctors could switch from prescribing conventional medicines to offering alternative therapies. "That was so unspeakable to me that I had to speak out," Ernst said.
Ernst was accused in a letter from an adviser to Prince Charles, Michael Peat, of having breached a confidentiality agreement on the report and an investigation was launched. Ernst was cleared of wrongdoing, but he says he had by that time lost the support of his institution and its commitment to raise more funding for his work.
A spokeswoman for Prince Charles said he "had no knowledge that a letter was being sent to the University of Exeter by Sir Michael Peat about Edzard Ernst's breaching of confidence of the Smallwood report in 2005" and was not involved in the dispute.
Ernst and his team have run many clinical trials and published more than 150 meta-analyses of complementary and alternative medicines.
He says he has identified around 20 such therapies which "demonstrably demonstrate more good than harm" including the herbal remedy St John's Wort for the treatment of mild depression, hypnosis for the relief of labor pain, and hawthorn for the treatment of congestive heart failure.
Healthy You
Low Vitamin D Linked to Chronic Musculoskeletal Pain
By: DIANA MAHONEY, Internal Medicine News Digital Network
Is vitamin D a neglected analgesic for chronic musculoskeletal pain? Dr. Suzan Abou-Raya, professor of geriatric medicine at the University of Alexandria in Egypt, thinks it could be and recommends that physicians should consider oral supplementation for all pain patients. Dr. Abou-Raya based her opinion on the findings of a recent study in which she and her colleagues evaluated the association between vitamin D status and chronic musculoskeletal pain in a cohort of community-dwelling older adults.
The investigators compared the vitamin D status of 265 adults aged 65 years and older who presented to their institution for musculoskeletal pain management with that of 200 other adults who were free of chronic musculoskeletal pain. These controls were matched to the cases by age, sex, and body mass index, according to Dr. Abou-Raya. Individuals with known vitamin D deficiency and calcium abnormality were excluded from the study, as were those with severe cognitive impairment or infectious, blood, hepatic, and renal disorders.
All of the participants in the study, which was conducted during the months of April through September to account for seasonal variation, underwent an initial survey about sun exposure and nutritional intake to assess daily intake of vitamin D and calcium, Dr. Abou-Raya explained. All of the participants underwent a comprehensive clinical examination, during which pain was assessed using the Brief Pain Inventory and Visual Analogue Scale. "Chronic pain was defined as pain that was present in the previous month and for at least 3 months during the previous year, and it was assessed according to the site of pain, the overall severity of the pain, and interference with daily activities," she said. Additionally, all of the patients completed a joint pain questionnaire to assess chronic musculoskeletal pain in the hands and wrists, shoulders, back, hips, knees, and feet, and they were directed to record daily pain in a diary.
Levels of pain were assessed at monthly intervals during follow-up, as was physical performance using activities of daily living, grip strength, six-minute walk distance, and the timed Get up and Go Test of mobility, Dr. Abou-Raya stated. Additionally, serum vitamin D was measured by Liaison immunoassay and levels between 10 and 30 ng/ml were classified as vitamin D insufficiency and levels lower than 10 ng/ml were classified as vitamin D deficiency, she noted.
In musculoskeletal patients, the mean 25-hydroxy vitamin D level was 18.4 ng/ml compared with 28.9 ng/ml in the control group, which represents a statistically significant difference, Dr. Abou-Raya reported. "The overall prevalence of suboptimal vitamin D levels among patients was 70% vs. 32% in the controls," she said, noting that 41% of the chronic musculoskeletal pain patients and only 1% of the controls met the criteria for vitamin D deficiency. "We also found that patients with multisite chronic pain had significantly lower levels of vitamin D compared with patients reporting sing-site chronic pain, and patients with more severe pain at baseline had significantly lower vitamin D levels than those with less severe pain."
After multivariate adjustment, "chronic, multisite, musculoskeletal pain was associated with lower levels of 25-hydroxy vitamin D, and lower levels of vitamin D correlated with pain severity and poor physical performance," Dr. Abou-Raya stated. One likely contributing factor is that sun exposure in the chronic pain group was significantly lower than that of the controls, with 40% of the pain patients reporting that they received fewer than 15 minutes of sun exposure weekly compared with 11% of the controls, likely due to limitations on physical activity associated with chronic pain, she said.
The results of this observational study should not be used to infer causation, Dr. Abou-Raya stressed. "They simply demonstrate that patients with chronic musculoskeletal pain have lower levels of vitamin D compared with individuals who are pain free, thus the possibility of inadequate vitamin D should be considered in the differential diagnosis of chronic musculoskeletal pain sufferers," she said at the annual European Congress of Rheumatology.
The implication of the findings, she continued, "is that all patients with chronic musculoskeletal pain should receive oral vitamin D supplementation, as optimal vitamin D levels appear to be associated with less pain and better physical performance."
Dr. Abou-Raya disclosed having no financial conflicts of interest related to her presentation.
For Your Reading Pleasure; Grand Rounds
Grand Rounds is a weekly summary of the best health blog posts on the Internet. Each week a different blogger takes turns hosting Grand Rounds, and summarizing the best submissions for the week.
Hosted By;
Welcome to Better Health’s Grand Rounds Volume 7, Number 44! This is our second time hosting Grand Rounds and we’re excited about sharing the posts we received. The theme of this week’s collection came from a recent Health Affairs blog post by CFAH president, Jessie Gruman, Patient Advocates: Flies In The Ointment Of Evidence-Based Care, which addresses a few of the many challenges of basing health care practices, policies, and decisions on evidence of effectiveness.
A Few Submissions, read all entries here
Val Jones of Better Health tells us Why She’s Afraid For Anyone to Enter the Healthcare System…Ever. Val’s post offers resources for patients, caregivers and health care professionals to ensure they are “on the right diagnostic pathway, getting the most appropriate care that suits their needs and preferences, and protecting them from errors and missteps.”
Rheumatologist Irwin Lim, in One Fracture, Two Fracture, Three Fracture…Enough! writes about the need for targeted interventions for high-risk groups…especially patients with osteoporotic fractures that “are getting a surgical fix or a cast, but not assessed and therefore, not treated for osteoporosis…this causes pain, suffering, disability and loss of independence. It also costs….a lot of…money.”
Amy Berman, of the John A Hartford Foundation HealthAGEnda blog, shares her experience with what she believes was an overly aggressive treatment recommendation in Can Good Care Produce Bad Health?. She says, “It doesn’t matter if care is cutting-edge and technologically advanced; if it doesn’t take the patient’s goals into account, it may not be worth doing.”
Posting a sick kid’s photo on Facebook led to the swift diagnosis of a dangerous, fast-moving illness. David E. Williams, in the Health Business Blog, explores the role of social media and crowd-sourcing in his post, Diagnosing an Illness with Facebook.
Read All Submissions .............
This Week On The Blog
Obesity Linked to Risk for Decompensation of Cirrh...
Big Pharma Wants to 'Friend' You
Cannabis use linked to earlier psychosis onset
High fish intake reduces diabetes risk in men
Get Tested; Free Hepatitis C Test
Friday News Digest;Hepatitis a risk to everyone
Chronic hep C treatment in HIV-infected patients w...
New Zealand- Hepatitis war can be won - expert
Video;HIV and Children Study
Best tool in fight against hepatitis is knowledge
Hepatitis C-Vertex/INCIVEK Development Progress Up...
Video; Hepatitis C cure
J&J cuts maximum Tylenol dose to prevent overdoses...
No comments:
Post a Comment