October is Liver Awareness Week: Are you protecting your liver?

The American Liver Foundation reminds us this month to take measures to protect our the health of our liver. Liver disease affects one out of every ten US citizens - 30 million people. A healthy liver is essential to a healthy life because our liver is busy quietly detoxifying our body - performing 5,000 functions per minute to maintain health. Everything we eat, drink and breathe gets filtered through our liver. Toxic fumes from paints, aerosol cleaners, pesticides all get filtered through the liver. Our livers process the medications, vitamins and herbal supplements we take.

Hepatitis A, B and C are the most common causes of liver disease in the US and are caused by viruses. Protecting yourself from Hepatitis A and B can be as accomplished by getting a vaccine. Consult your primary care provider or, if you work in a high risk environment, your employer about getting vaccinated against these diseases. Ten million people worldwide contract Hepatitis A each year - if you travel, if you eat seafood, if you are gay - it is worth your while to get the Hepatitis A vaccine.

The Centers of Disease Control and Prevention (CDC) is advocating vaccinating incarcerated persons with chronic hepatitis C against hepatitis A and B. CDC has recommended a comprehensive program for preventing and control of viral hepatitis in the incarcerated population. Wonder if that will include providing condoms? Didn't see that in the policy...

Limit alcohol intake as alcohol is toxic to the liver - especially in combination with other medications like acetaminophen.

Thank you AJC1 for use of image of Hepatitis C virus...way cool.

Labels: hepatitis, liver disease, vaccination

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After the Fires: Safe Clean Up

Fires raging in California are destroying lives and property. People returning to their homes to clean-up may feel overwhelmed and bewildered. With so many electronics, synthetics and other toxic products in our homes these days, it is important to be extremely careful during cleanup. Ash will likely have cancer-causing chemicals. Therefore, it is important to avoid exposure to the skin, lungs, nose and throat. The California Department of Health Services recommends the following:

• Do not allow kids to play in the ash
• Wash off toys before allowing kids to play with them
• Wear gloves, long sleeved shirts and long pants to avoid skin contact
• Wash any ash off of your skin as soon as possible
• Wash any fruits or vegetables thoroughly before eating them
• Avoid using leaf blowers or any other tools that will distribute ash into the air
• Avoid use of shop vacuums which blow particles into the air. Use a HEPA filter vacuum instead
• Use a well fitting dust mask rated N-95 or P-100 for cleanup to avoid breathing particles
• People with heart, lung disease and asthma should avoid clean up of ash and use of a mask unless cleared to do so by their physician
• The Regional Water Control Quality Board asks us not to wash ash into storm drains to avoid contaminating the water supply
• Collect ash in regular plastic trash bags and dispose of it, avoiding disturbance of contents
• Gently sweep and dust indoor surfaces with a damp cloth

Finally, don't forget to hose down your pets if they have been exposed to ash. The chemicals in ash may affect them, too.

Thank you ocgirl for use of photo, Madjeska Fire.

Labels: ash, california fires, cleanup, safety, toxic

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FDA Approves First Drug to Treat Fibromyalgia: Lyrica

Millions of people suffer from the mysterious, chronic condition of fibromyalgia. There is no known cause for this syndrome of chronic pain, fatigue and sleeping difficulties - and no definitive treatment. On June 21, 2007, the US Food and Drug Administration (FDA) approved use of Pfizer's Lyrica (pregabalin) to treat fibromyalgia. Lyrica has been found to decrease pain and improve function for people with the condition.

Most fibromyalgia patients are women and researchers believe it may be the result of brain changes in the response to chronic stress that result in chronic pain and fatigue. The most common side effects of Lyrica are dizziness and drowsiness. Some people experience swelling of the hands and feet, blurred vision, weight gain or dry mouth. Lyrica is also used as an anticonvulsant and for treating neuralgia (nerve pain) due to shingles and diabetic neuropathy.

Pfizer is doing further studies to test the safety and effectiveness of Lyrica for children and breastfeeding women with fibromyalgia.

Thank you cameradawktor for use of photo.

Labels: fibromyalgia, Lyrica

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World Osteoporosis Day: October 20, 2007

The National Osteoporosis Foundation wants us to take steps for strong bones by walking every day. Osteoporosis - a disease of porous bone and low bone mass leading to fragile bones and susceptibility to fractures - is both preventable and treatable. It is a major public health risk - especially for women who account for 80% of those affected.

Osteoporosis is a silent disease because bone loss occurs without symptoms and people do not realize their bones are getting weak until they have a fracture. To prevent osteoporosis:

• Eat a diet rich in calcium and vitamin D
• Exercise, exercise, exercise - weight-bearing, resistance-training and aerobic
• Do not smoke and limit alcohol intake
• Have bone density testing when appropriate
• take medication as indicated

We do not have to accept osteoporosis as an inevitable part of aging. Osteoporosis isn't a disease that is limited to older, thin white women. It strikes all people at different stages of life - unless you follow the tips for prevention above. Osteoporosis is costly and can be deadly- see my post in Healthline Connects Who Knew? Hip Fractures pose Greater Risk to Women than Cancers.

Labels: osteoporosis, strong bones

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World Food Day October 16

Today is World Food Day, an international event to increase awareness to alleviate hunger. This year the focus is on the issue of climate change and its impact on the poor. Food security for millions is an increasingly urgent global public health issue due to climate change. Each year, hunger claims as many lives as AIDS, tuberculosis and malaria combined. Hunger and malnutrition are the number one risk to health worldwide.

The UN Food and Agriculture Organisation (FAO) states that 854 million people do not have enough food to support health. Half of those are children The agency is placing increased emphasis on sustainable development and human rights. The number of people going hungry continues to rise, despite pledges at the 1996 World Food Summit to decrease the number.

• Every five seconds a child dies of hunger
• One in four children in developing countries is underweight
• Malnutrition in early life wreaks havoc on the developing brain, diminishing hope for success in later life. 70% of brain development occurs in the first two years of life.
  

Africa, Asia, the Middle East and Columbia are areas of the world where mass hunger and malnutrition are rampant. Pockets of hungry people exist all over the world, even in the wealthiest nations.

Test your knowledge about this important subject on the BBC News website: World Food Day Quiz.









Thank you World Food Day and ConAgra, Inc. for use of WHEAT by Thomas Hart Benton.

Labels: climate change, food security, global warming, hunger

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Isentress (raltegravir) - New First-In-Class HIV Medication

On Friday October 12th 2007 the FDA granted a new drug, Isentress (raltegravir), accelerated approval for the treatment of HIV infection. Isentress (raltegravir) belongs to the class of HIV medications known as Integrase Inhibitors and it is the first drug in it's class to hit the market. Specifically, when used in combination with other anti-HIV medications, Isentress (raltegravir) was found to both reduce HIV viral load and increase CD4 count. CD4 cells, also known as T-cells, are a type of blood cell that helps to fight off infections.

Isentress (raltegravir) is indicated for use in adult HIV patients, aged 16 years and above who have a documented resistance to multiple, or at least one, in any of the other classes of anti-HIV medications. The drug has not been tested in pregnant women but those who do get pregnant while on HIV medications are encouraged to register with the Antiretroviral Pregnancy Registry.

Isentress (raltegravir) is supplied in 400mg tablets and dosing is one tablet twice a day with or without food. As with other HIV medications, users should NOT stop taking this medication abruptly or for any length of time unless instructed to do so by their physician. Doing so may cause one's viral load (the amount of the HIV virus in the blood) to increase or the virus may become resistant to the drug and thus make it more difficult to treat.

The most common side effects that were reported with use of Isentress (raltegravir) were diarrhea, nausea, and headache. The drug can also increase levels of a certain muscle enzyme known as creatine kinase and this can result in users developing certain muscle problems.

Isentress (raltegravir) is manufactured and distributed by Merck & Co., Inc. If you need more information about the drug or to contact them regarding it you may go www.ISENTRESS.com or call 1-800-622-4477.

Photo courtesy of Robert Miller.

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Dimetapp, PediaCare, & Triaminic Gone... Oh My!

It's all over the news now...the manufacturers of infant formulations of cough and cold medicines have voluntarily withdrawn them from the shelves. Note, this withdrawal was voluntary, it was not mandated by the FDA. These medications are safe when taken in the recommended doses for the right users, and most people do use them safely and properly for themselves and their children. The manufacturers of these products collectively decided to move forward with this decision in response to some incidences of drug misuse resulting in infants being overdosed (and sometimes in death) and out of "an abundance of caution". Do note that the only medications withdrawn are those targeted for use in infants, not those for children ages 2 and above. Fourteen products are affected by this recall and for a picture list of all them, since the names tend to be too long to remember, click here. For a list of the names of the withdrawn products please see the bottom of this post.

The FDA's Non-prescription Drugs Advisory Committee and Pediatric Advisory Committee will be meeting on October 18th and 19th, 2007 where they will discuss this issue further and come up with some recommendations.

So how should you respond to this? First of all you can be sure that the manufacturers realize the inconvenience this may cause especially since cold and flu season is just around the corner so they are offering refunds on the withdrawn drugs (you do need to take it back to where you got it from though) and some of them are also offering coupons (you'll need to contact the manufacturer directly to receive them). If you choose instead to dispose of any remaining unused portions of these products you may have, do NOT flush it away or pour it down the drain unless specifically instructed to do so. Rather, to be sure children and pets are protected, dilute the medication with water and mix it into either kitty litter or a solid kitchen substance like coffee grinds then place in a sealed bag and dispose of.

Withdrawn products:

• Dimetapp® Decongestant Plus Cough Infant Drops
  

• Dimetapp® Decongestant Infant Drops

• Little Colds® Decongestant Plus Cough

• Little Colds® Multi-Symptom Cold Formula
  

• PEDIACARE® Infant Drops Decongestant containing pseudoephedrine)
  

• PEDIACARE® Infant Drops Decongestant Cough (containing pseudoephedrine)

• PEDIACARE® Infant Dropper Decongestant (containing phenylephrine)
  

• PEDIACARE® Infant Dropper Long-Acting Cough

• PEDIACARE® Infant Dropper Decongestant & Cough (containing phenylephrine)

• Robitussin® Infant Cough DM Drops

• Triaminic® Infant & Toddler Thin Strips® Decongestant

• Triaminic® Infant & Toddler Thin Strips® Decongestant Plus Cough

• TYLENOL® Concentrated Infants' Drops Plus Cold

• TYLENOL® Concentrated Infants' Drops Plus Cold & Cough

Photos courtesy of Inferis and Jef Poskanzer

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Mental Illness Awareness Week October 7-13: What About the Children of our Troops?

The American Psychiatric Association (APA) and the National Alliance on Mental Illness (NAMI), a patient advocacy organization observe Mental Illness Awareness Week every year to reduce the stigma of mental illness.

We have covered the issues of the burden of mental illness in our veterans returning from Iraq and Afghanistan in other posts. The work is stressful - but what about the children who are left behind when parents are deployed to fight? Our mental health system is strained as a result of the continuing burden of war. Mental health workers need to consider the effects of separation on military children. Children and spouses of deployed troops experience increased incidence of depression compared with families of nondeployed troops. The depression manifests as internalized symptoms rather than behaviors in these children, so outreach is especially important in this population. Boys were found to be more vulnerable than girls, younger boys in particular.

Children, recognizing that the family unit is under stress, may hide their symptoms of depression and anxiety. Clinicians suggest that when parents return from duty and life resumes as before the deployment, affected children let off steam and may manifest behavior problems. Thus, health care providers can not rely on the reports of parents and caregivers to determine the mental health status of the child. The child must be interviewed and assessed.

Military life does provide good social support systems as well as free medical care to families that should help buffer families through stressful times. Mental health experts recommend these tips for deployed service members:

• Discuss the deployment with your children and reassure them. Answer their questions honestly with age appropriate information
• During your deployment, write each child a separate letter or send each an individual audio or videotape expressing your love for them
• Arrange for older male companionship (uncles, grandfathers) for young boys
• Before returning home, discuss with children that both the deployed parent and the children will have changed during the absence
• Allow time for family members to get reacquainted and adjust to the change

Remember - the child, especially younger children and boys - may be suffering in silence. Reach out and ask how they are doing, how they are feeling. Provide support during the absence of the parent. Kids are resilient, but not as tough as we think they are.


Thank you pingnews.com for use of photo Greeting Family by Jacob Sippel, US Navy.

Labels: Desert Storm, mental illness, military children, parental absence, stress

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October 10 is World Mental Health Day

The 2007 World Mental Health Day Campaign is focuses on transcultural mental health services and treatment. With so many migrants in any given country, the need for culturally sensitive care is increasingly important - so important that the United Nations offers a Guide to Working from Within: 24 Tips for Culturally Sensitive Programming. Some of the advice the UN offers is:

• Never Give Up - closed societies change slowly. Small changes are significant and may be more enduring over the long term
• Mobilize traditional and religious leaders: engage respected authorities to shape opinions
• Outreach through popular culture: Use music and dance to communicate ideas and involve young people in the process
• Honor commitments: Follow through on any promise you make to build confidence and trust
• Be a facilitator rather than authority: You don't have all the answers so communicate a message of neutrality and encourage others to share their views

Working with interpreters is challenging - especially in delicate matters of mental health

• Ask the interpreter to translate literally rather than paraphrase
• Maintain eye contact with the client and direct questions to the client, not the interpreter
• Ask short, simple questions, one at a time

The culturally competent clinician takes the time to gain knowledge about cultures and populations and:

• values diversity
• is aware of transcultural dynamics and sensitive to them
• adapts to the cultural values of others

The elderly lead the world's new cases of mental illness. Respecting the elderly and their culture is especially important. Awareness of religious and spiritual beliefs will help bridge barriers. Maintaining professionalism and confidentiality is an important aspect of building trust.

Thank you freshlysqueezed for use of photo Sikh elder.

Labels: culture, diversity, mental illness, respect

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National Depression Screening Day: Stop a Suicide Today

Each year in the US, 30,000 people take their own life and 70% of them tell someone they are planning to do so, or give warning signs. National Depression Screening Day events hope to identify people at risk and get them into treatment. Depression takes a toll on the lives on the depressed individual and family, but the effects of a suicide are indelible, like a tattoo.

Find a site near you by clicking on your state at their website. This year, returning military personnel and their families are especially encouraged to participate. Want more anonymity? You can complete the screening process online. Colleges are also participating in CollegeResponse. Young adults are vulnerable during their first time away from home.

SOS Signs of Suicide programs are now reaching out into High Schools and Middle Schools. I just signed the form yesterday for my own daughter to participate in her middle school program. I will never forget my two high school friends who I lost to suicide. Bill Lane - senior class president, class clown. Rich Erpel - brilliant violinist. You both made me laugh. Rest in peace, where ever you are... My wish for today is that no other child has to feel the pain of that tragic loss.

Labels: depression, screening, suicide prevention

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October is Children's Health Month: Requiem for Deamonte Driver

We can celebrate and observe Children's Health Month in the context of the Environmental Protection Agency (EPA) applying ten years of environmental protection research to protecting the lives of children. But the devil is in the details. On February 25, 2007, 12 year old Deamonte Driver of Maryland died due to a bacterial brain abscess. The bacterial brain abscess was caused by untreated oral disease - rotted teeth. An $80 tooth extraction might have prevented his death, but his mother did not have health insurance, the family lost Medicaid insurance, and oral surgeons who accept Medicaid are difficult to find anyway. Cost of care for the two surgeries and six weeks of hospital care required to treat the brain abscess? $250,000.

Millions of children in the US do not have access to basic preventive and restorative dental care. Federal public officials need to stop shortchanging oral health programs. We need water fluoridation, and universal availability of preventive care so that children can feel good about themselves and participate fully in school and extracurricular activities. Americhoice, (a subsidiary of UnitedHealth Group), provided a $200,000 grant to the University of Maryland Dental School in August, 2007 to provide outreach to poor children in Maryland. Alyce Driver, Deamonte's mother, participated in the ceremony.

Representative Elijah Cummings of Baltimore, MD introduced legislation - Deamonte's Law -
to help end the silent epidemic of untreated oral disease in our nation's poor children. An estimated 20 million children lack access to care. The 155,000 member American Dental Association (ADA) supports the legislation which highlights the need for pediatric dental specialists.

45 million Americans have no health insurance -10 million of those are children. The National (State Children's Health Insurance Program) SCHIP bill now awaits President Bush's approval. The bill provides stop gap insurance for families who are not poor enough to qualify for Medicaid but without resources to pay for private insurance. The funds to pay for it are proposed to come from increased tax on cigarettes. The Senate passed the bill last week, as did the House of Representatives, but with less than the majority needed to override presidential veto. Tragic to think we have been denied the gift of one child's life due to lack of insurance. How many other Deamonte's walk among us, quietly bearing their pain, trying to get their homework done, unable to get the care they need through no fault of their own?


Thank you Children's Defense Fund for use of Deamonte's picture.

Labels: access to care, children, Deamonte, insurance

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Thank You Dr.Rob! Or Is It Dr.Seuss?

Thank you to Dr.Rob of Musings of A Distractible Mind for hosting Grand Rounds this week and including my posting Musings of a Befuddled Pharmacist. Grand Rounds is a compilation of blogs from all across the medical blogosphere that is held once a week. Please pop over and check out this weeks' spread.

I guarantee you will be very entertained...or your money back!

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