Oseltamivir is an effective treatment for influenza, but little is known about whether it reduces infectiousness. To explore this possibility, researchers performed a secondary analysis of a community-based trial that took place in Hong Kong during the influenza seasons of 2007 and 2008, before the 2009 influenza A (H1N1) epidemic. Individuals were enrolled in the trial at the time of influenza diagnosis and were followed, along with household members, for 7 to 10 days. Decisions regarding oseltamivir use were made by the treating physician.
Of the 384 eligible study participants, 90 received oseltamivir; the rest received no antiviral therapy. Oseltamivir use was associated with a significant reduction in the time to resolution of all symptoms (P=0.01) and of respiratory symptoms (P=0.03), in particular. However, the drug was not associated with a significant reduction in the duration of viral shedding or in the likelihood that household contacts would become infected. The secondary attack rate did vary, though, according to the time of initiation of oseltamivir: 4.7% when it was initiated within 24 hours of symptom onset, 6.0% when it was initiated within 24 to 48 hours after symptom onset, and 7.0% when it was initiated >48 hours after symptom onset (P for trend<0.01).
Reference: Journal Watch Infectious Diseases (March 24, 2010)
Take home message: Oseltamivir is effective in reducing severity of influenza symptoms and shortens recovery time. However, it may not have an effect on decreasing the infectiousness unless administered early on in the course of the infection.
Thursday, March 25, 2010
FDA Tells Physicians to Temporarily Stop Using Rotarix Vaccine
The FDA is advising clinicians to temporarily stop using the rotavirus vaccine Rotarix because components of a separate virus, porcine circovirus 1 (PCV1), have been detected in the vaccine.
PCV1 is not known to cause illness in humans, and according to FDA Commissioner Dr. Margaret Hamburg, "there is no evidence at this time that there is a safety concern."
The agency says that children who've already received one dose of Rotarix can receive RotaTeq instead for the next two doses to complete the series.
The FDA will continue to investigate the finding and expects to make additional recommendations on the use of rotavirus vaccines after an expert advisory committee meets in about 4 to 6 weeks.
Reference: Physician's First Watch
Background information:
Retrovirus causes stomach flu, it is a common infection that affects infants and young children worldwide. Once a child has had the infection, immunity develops. Rotavirus infection leads to vomiting, diarrhea, malabsorption and a low grade fever. Covnetional treatment focuses on symptom management ensuring adequate re-hydration and electrolyte replacement. In severe cases, death can result, however, with proper management, prognosis is excellent.
PCV1 is not known to cause illness in humans, and according to FDA Commissioner Dr. Margaret Hamburg, "there is no evidence at this time that there is a safety concern."
The agency says that children who've already received one dose of Rotarix can receive RotaTeq instead for the next two doses to complete the series.
The FDA will continue to investigate the finding and expects to make additional recommendations on the use of rotavirus vaccines after an expert advisory committee meets in about 4 to 6 weeks.
Reference: Physician's First Watch
Background information:
Retrovirus causes stomach flu, it is a common infection that affects infants and young children worldwide. Once a child has had the infection, immunity develops. Rotavirus infection leads to vomiting, diarrhea, malabsorption and a low grade fever. Covnetional treatment focuses on symptom management ensuring adequate re-hydration and electrolyte replacement. In severe cases, death can result, however, with proper management, prognosis is excellent.
For those of you with new babies, it is important to read the following!!
"Infantino has recalled 1 million of its SlingRider and Wendy Bellissimo infant slings because they pose a suffocation hazard, according to the U.S. Consumer Product Safety Commission.
Consumers should immediately stop using the slings in infants younger than 4 months and contact the company for replacement products. Three infants died in these slings in 2009."
To read the news release by the Consumer Product Safely Commission, go to: http://www.cpsc.gov/cpscpub/prerel/prhtml10/10177.html
Source: Physician's First Watch
"Infantino has recalled 1 million of its SlingRider and Wendy Bellissimo infant slings because they pose a suffocation hazard, according to the U.S. Consumer Product Safety Commission.
Consumers should immediately stop using the slings in infants younger than 4 months and contact the company for replacement products. Three infants died in these slings in 2009."
To read the news release by the Consumer Product Safely Commission, go to: http://www.cpsc.gov/cpscpub/prerel/prhtml10/10177.html
Source: Physician's First Watch
Wednesday, February 10, 2010
Weight Loss Tips
It February, this is the time when many people are starting to go downhill with their New Year's resolutions. If being more healthy and achieving a healthier body weight is one of your new years resolutions, make this the last “new year's resolution” by actually making it happen!
The following are some tips to help you stay on track in your journey to a healthier weight.
1. Never skip breakfast!!
Upon waking, your metabolism jump starts, as your body goes from sleeping (lying down) to standing. If you do not eat a breakfast that provides energy boost and necessary nutrients to sustain you until the next meal, your metabolism will fall. The human body is designed to be “energy efficient”, if it is made to think that it is “famine time” (by you not eating breakfast), it will slow down your metabolism to conserve energy until the next time that food is available (lunch), at which time, it will store as much energy (fat) as possible to compensate for the earlier lack of food.
2. Eat better, not eat less
For the purpose of losing weight, often people cut down on the amount of food that is eaten by focusing on counting calories (and nothing else). If this is something you've done in the past or are thinking of doing again (but more strictly this time around), you are doing your weight-loss plan a dis-service. What you would neglected by only counting calories, is that you are putting yourself at more risk of cravings; which you will end up satisfying with a tiny slice of cake (to save on calories) that still doesn't satisfy your body it's real need, that is the need for quality nutrients, leaving you crashing after a brief sugar high. Instead, if you ate adequate calories but in food items that are packed with necessary nutrients, you won't have the cravings, and as a result be more successful with your weight-loss goals.
3. Manage your stress
Stress leads to increased hormones in the body such as adrenaline, which increases blood sugar. When you are stressed (be it mental or physical), your body is unable to “rest and digest” optimally, causing the body's cells to utilize sugar less resulting in more sugar to be stored away, exessive amount of stored sugar also leads to fat storage.
4. Go to the bathroom
Having regular bowel movments (once a day) helps to eliminate toxins including by-products of cholesterol metabolism and exessive fat. Stool remaining inside your colon are not simply staying there waiting to be excreted. The colon walls are actively reabsorbing back toxins and water back into your body, which can contribute to gas, bloating and water weight.
5. Sleep tight
Sleeping is seemingly an activity that burns little energy, indeed it does. Study shows that inadequate sleep is correlated with weight gain. In fact, a study done at the University of Chicago shows that chronic partial sleep may increases obesity. The mechanism is yet to be clearly understood, however, it is known that inadequate sleep negatively impacts the body's ability to metabolize glucose, leading to fat-storage. It also cause the body to crave more carbohydrates and blinding the brain's ability to realize that enough food has been eaten even after adequate meals. Sleep also decreases growth hormone, as a result negatively affects body composition (less muscle tissue, more fat tissue).
If you are overly stressed, have chronic constipation or suffer from insomnia, a consultation with our naturopath would be greatly beneficial to you. She is also able to design a nutritional plan specifically for you to help achieve a healthy body weight!
It February, this is the time when many people are starting to go downhill with their New Year's resolutions. If being more healthy and achieving a healthier body weight is one of your new years resolutions, make this the last “new year's resolution” by actually making it happen!
The following are some tips to help you stay on track in your journey to a healthier weight.
1. Never skip breakfast!!
Upon waking, your metabolism jump starts, as your body goes from sleeping (lying down) to standing. If you do not eat a breakfast that provides energy boost and necessary nutrients to sustain you until the next meal, your metabolism will fall. The human body is designed to be “energy efficient”, if it is made to think that it is “famine time” (by you not eating breakfast), it will slow down your metabolism to conserve energy until the next time that food is available (lunch), at which time, it will store as much energy (fat) as possible to compensate for the earlier lack of food.
2. Eat better, not eat less
For the purpose of losing weight, often people cut down on the amount of food that is eaten by focusing on counting calories (and nothing else). If this is something you've done in the past or are thinking of doing again (but more strictly this time around), you are doing your weight-loss plan a dis-service. What you would neglected by only counting calories, is that you are putting yourself at more risk of cravings; which you will end up satisfying with a tiny slice of cake (to save on calories) that still doesn't satisfy your body it's real need, that is the need for quality nutrients, leaving you crashing after a brief sugar high. Instead, if you ate adequate calories but in food items that are packed with necessary nutrients, you won't have the cravings, and as a result be more successful with your weight-loss goals.
3. Manage your stress
Stress leads to increased hormones in the body such as adrenaline, which increases blood sugar. When you are stressed (be it mental or physical), your body is unable to “rest and digest” optimally, causing the body's cells to utilize sugar less resulting in more sugar to be stored away, exessive amount of stored sugar also leads to fat storage.
4. Go to the bathroom
Having regular bowel movments (once a day) helps to eliminate toxins including by-products of cholesterol metabolism and exessive fat. Stool remaining inside your colon are not simply staying there waiting to be excreted. The colon walls are actively reabsorbing back toxins and water back into your body, which can contribute to gas, bloating and water weight.
5. Sleep tight
Sleeping is seemingly an activity that burns little energy, indeed it does. Study shows that inadequate sleep is correlated with weight gain. In fact, a study done at the University of Chicago shows that chronic partial sleep may increases obesity. The mechanism is yet to be clearly understood, however, it is known that inadequate sleep negatively impacts the body's ability to metabolize glucose, leading to fat-storage. It also cause the body to crave more carbohydrates and blinding the brain's ability to realize that enough food has been eaten even after adequate meals. Sleep also decreases growth hormone, as a result negatively affects body composition (less muscle tissue, more fat tissue).
If you are overly stressed, have chronic constipation or suffer from insomnia, a consultation with our naturopath would be greatly beneficial to you. She is also able to design a nutritional plan specifically for you to help achieve a healthy body weight!
Friday, November 13, 2009
To Vaccinate or Not to Vaccinate Against the H1N1 Virus
This flu season, the focus is on the H1N1 influenza virus. It has become a pandemic, it is affecting more flu cases than the regular seasonal influenza virus. The question regarding whether or not one should get vaccinated against the H1N1 virus continues to be a controversy. What are the risks? What are the benefits? Should you get vaccinated?
Whether or not to get the H1N1 vaccine is a personal decision. Read the following carefully, and click on the links for more detailed information before making your decision. Whatever your decision is, be sure that it is a well-informed one.
H1N1 Flu Statistics:
Up to date, there has been over 1600 cases of H1N1 infection across Canada
Of theses cases, 101 have died from complications related to the infection
Each year, 2000-8000 Canadians die from the seasonal flu
Teenagers and young adult are the majority of the infected population
Rate of hospitalization is the highest in very young children (6months – 5years of age)
Between 1% to 10% of patients with clinical illness require hospitalization.
Of hospitalized patients, from 10% to 25% require admission to an intensive care unit and 2% to 9% have a fatal outcome.
7% to 10% of all hospitalized patients are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely than the general population to require admission to an intensive care unit when compared with the general population.
Are there oral drugs available to treat the H1N1 flu virus?
Early research has shown that oseltamivir (Tamiflu) and zanamivir (Relenza) that are effective in treating the H1N1 Flu Virus.
These are not recommended to give these drugs for mild disease or for preventative purposes.
No sufficient information is available to suggest that H1N1 virus requires the use of antivirals.
Most patients in Canada are recovering well on their own.
There is a risk that the virus could be resistant to antiviral treatment if antivirals are overused to treat mild illness.
The known and potential benefits of Tamiflu outweigh the known and potential risks for children under 1 year. Treatment decisions remain with a physician, who would consider prescribing Tamiflu after weighing the potential risks and benefits to any individual patient.
What's in the H1N1 vaccination?
Non-adjuvant type contains:
Split influenza virus, inactivated, containing antigen
Thimerosal (mercury derivative), sodium chloride, disodium hydrogen phosphate, potassium dihydrogen phosphate, potassium chloride, water, egg proteins, formaldehyde, sodium deoxycholate and sucrose
Ajuvant type contains:
The above ingredients plus DL-α-tocopherol (vitamin E), squalene oil, polysorbate
What are the benefits vs. side effects of getting vaccinated?
According the Public Health Agency of Canada, the seroprotective rate is 97%. (note: seroprotective rate does not necessarily translate into clinical protection rate.)
Side effects
Pain, swelling, redness in the local area
systemic symptoms include: fatigue, headaches, arthralgia, myalgia, sweating, fever
in extreme cases, vaccination has been linked to Guillian Barre syndrome and neuropathy
Who are most at risk for contracting the H1N1 flu?
children under 5 yr of age
pregnant women
people with chronic conditions including:
Heart disease
kidney disease
diabetes
asthma and chronic lung disease
liver disease
blood disorders
severe obesity
immunosuppressed (those on cancer drugs and people with HIV/AIDS)
neurological disorders
What is the difference between a cold and H1N1 flu symptoms?
Symptom
Cold
H1N1 Flu
Fever
Fever is rare with a cold.
Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the H1N1 flu.
Coughing
A hacking, productive (mucus- producing) cough is often present with a cold.
A non-productive (non-mucus producing) cough is usually present with the H1N1 flu (sometimes referred to as dry cough).
Aches
Slight body aches and pains can be part of a cold.
Severe aches and pains are common with the H1N1 flu.
Stuffy Nose
Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week.
Stuffy nose is not commonly present with the H1N1 flu.
Chills
Chills are uncommon with a cold.
60% of people who have the H1N1 flu experience chills.
Tiredness
Tiredness is fairly mild with a cold.
Tiredness is moderate to severe with the H1N1 flu.
Sneezing
Sneezing is commonly present with a cold.
Sneezing is not common with the H1N1 flu.
Sudden Symptoms
Cold symptoms tend to develop over a few days.
The H1N1 flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains.
Headache
A headache is fairly uncommon with a cold.
A headache is very common with the H1N1 flu, present in 80% of flu cases.
Nausea, Vomiting, Diarrhea
Nausea, vomiting and diarrhea are fairly uncommon with a cold
Nausea, vomiting and diarrhea are sometimes present in H1N1 flu.
Chest Discomfort
Chest discomfort is mild to moderate with a cold.
Chest discomfort is often severe with the H1N1 flu.
What can I do to prevent myself from contracting the H1N1 virus?
Wash hands often with soap and warm water for at least 20 seconds, or use hand sanitizer.
Keep your hands away from your face.
Cough and sneeze into your arm, not your hand. If you use a tissue, dispose of it as soon as possible and wash your hands.
Get immunized.
Keep common surface areas—for example, doorknobs, light switches, telephones and keyboards—clean and disinfected.
Eat healthy foods and stay physically active to keep your immune system strong.
If you get sick, stay home.
If you would like more specific advice on individualized treatment or preventative measures (ie. Specific dietary modifications, nutritional supplementation, or herbal medicine treatments), contact naturopathic doctor Lei Gu for an appointment.
References:
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/legislation/interimorders-arretesurgence/prodinfo-vaccin-eng.php#a2
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/index-eng.php
http://www.boardofnaturopathicmedicine.on.ca/
Whether or not to get the H1N1 vaccine is a personal decision. Read the following carefully, and click on the links for more detailed information before making your decision. Whatever your decision is, be sure that it is a well-informed one.
H1N1 Flu Statistics:
Up to date, there has been over 1600 cases of H1N1 infection across Canada
Of theses cases, 101 have died from complications related to the infection
Each year, 2000-8000 Canadians die from the seasonal flu
Teenagers and young adult are the majority of the infected population
Rate of hospitalization is the highest in very young children (6months – 5years of age)
Between 1% to 10% of patients with clinical illness require hospitalization.
Of hospitalized patients, from 10% to 25% require admission to an intensive care unit and 2% to 9% have a fatal outcome.
7% to 10% of all hospitalized patients are pregnant women in their second or third trimester of pregnancy. Pregnant women are ten times more likely than the general population to require admission to an intensive care unit when compared with the general population.
Are there oral drugs available to treat the H1N1 flu virus?
Early research has shown that oseltamivir (Tamiflu) and zanamivir (Relenza) that are effective in treating the H1N1 Flu Virus.
These are not recommended to give these drugs for mild disease or for preventative purposes.
No sufficient information is available to suggest that H1N1 virus requires the use of antivirals.
Most patients in Canada are recovering well on their own.
There is a risk that the virus could be resistant to antiviral treatment if antivirals are overused to treat mild illness.
The known and potential benefits of Tamiflu outweigh the known and potential risks for children under 1 year. Treatment decisions remain with a physician, who would consider prescribing Tamiflu after weighing the potential risks and benefits to any individual patient.
What's in the H1N1 vaccination?
Non-adjuvant type contains:
Split influenza virus, inactivated, containing antigen
Thimerosal (mercury derivative), sodium chloride, disodium hydrogen phosphate, potassium dihydrogen phosphate, potassium chloride, water, egg proteins, formaldehyde, sodium deoxycholate and sucrose
Ajuvant type contains:
The above ingredients plus DL-α-tocopherol (vitamin E), squalene oil, polysorbate
What are the benefits vs. side effects of getting vaccinated?
According the Public Health Agency of Canada, the seroprotective rate is 97%. (note: seroprotective rate does not necessarily translate into clinical protection rate.)
Side effects
Pain, swelling, redness in the local area
systemic symptoms include: fatigue, headaches, arthralgia, myalgia, sweating, fever
in extreme cases, vaccination has been linked to Guillian Barre syndrome and neuropathy
Who are most at risk for contracting the H1N1 flu?
children under 5 yr of age
pregnant women
people with chronic conditions including:
Heart disease
kidney disease
diabetes
asthma and chronic lung disease
liver disease
blood disorders
severe obesity
immunosuppressed (those on cancer drugs and people with HIV/AIDS)
neurological disorders
What is the difference between a cold and H1N1 flu symptoms?
Symptom
Cold
H1N1 Flu
Fever
Fever is rare with a cold.
Fever is usually present with the flu in up to 80% of all flu cases. A temperature of 100°F or higher for 3 to 4 days is associated with the H1N1 flu.
Coughing
A hacking, productive (mucus- producing) cough is often present with a cold.
A non-productive (non-mucus producing) cough is usually present with the H1N1 flu (sometimes referred to as dry cough).
Aches
Slight body aches and pains can be part of a cold.
Severe aches and pains are common with the H1N1 flu.
Stuffy Nose
Stuffy nose is commonly present with a cold and typically resolves spontaneously within a week.
Stuffy nose is not commonly present with the H1N1 flu.
Chills
Chills are uncommon with a cold.
60% of people who have the H1N1 flu experience chills.
Tiredness
Tiredness is fairly mild with a cold.
Tiredness is moderate to severe with the H1N1 flu.
Sneezing
Sneezing is commonly present with a cold.
Sneezing is not common with the H1N1 flu.
Sudden Symptoms
Cold symptoms tend to develop over a few days.
The H1N1 flu has a rapid onset within 3-6 hours. The flu hits hard and includes sudden symptoms like high fever, aches and pains.
Headache
A headache is fairly uncommon with a cold.
A headache is very common with the H1N1 flu, present in 80% of flu cases.
Nausea, Vomiting, Diarrhea
Nausea, vomiting and diarrhea are fairly uncommon with a cold
Nausea, vomiting and diarrhea are sometimes present in H1N1 flu.
Chest Discomfort
Chest discomfort is mild to moderate with a cold.
Chest discomfort is often severe with the H1N1 flu.
What can I do to prevent myself from contracting the H1N1 virus?
Wash hands often with soap and warm water for at least 20 seconds, or use hand sanitizer.
Keep your hands away from your face.
Cough and sneeze into your arm, not your hand. If you use a tissue, dispose of it as soon as possible and wash your hands.
Get immunized.
Keep common surface areas—for example, doorknobs, light switches, telephones and keyboards—clean and disinfected.
Eat healthy foods and stay physically active to keep your immune system strong.
If you get sick, stay home.
If you would like more specific advice on individualized treatment or preventative measures (ie. Specific dietary modifications, nutritional supplementation, or herbal medicine treatments), contact naturopathic doctor Lei Gu for an appointment.
References:
http://www.hc-sc.gc.ca/dhp-mps/prodpharma/legislation/interimorders-arretesurgence/prodinfo-vaccin-eng.php#a2
http://www.phac-aspc.gc.ca/alert-alerte/h1n1/index-eng.php
http://www.boardofnaturopathicmedicine.on.ca/
Wednesday, August 5, 2009
A study published in the British Journal of Sports Medicine (July, 2009) found that men who exercised for at least 30 minutes a day at moderate to high intensity halved their risk of dying prematurely from cancer, mainly gastrointestinal and lung cancer. Regular exercise at adequate intensity benefits the health of gastrointestinal tract and the lungs. Since many cancer deaths result from colon or lung cancers that have been spread from the primary cancer source, lifestyle that benefits colon and lung health can help prolong lifespan of cancer patients.
The protective mechanism of exercise is the result of the following. First, regular exercise encourages regular bowel movements, which means that the carcinogens in the stool have less chance of being reabsorbed back into the body through intestinal walls, thereby reducing cancer development, especially in the colons. Also, excessive body fat has been correlated with increased cancer risk, therefore, regular exercise (which helps to maintain healthy body weight) translates into decreased cancer risk. Lastly, regular exercise also modulates antioxidant enzymes activities as well as regulating hormonal levels, both of which contribute to decreased cancer risk and progression.
It is important to note that regular exercise (in this case) refers to at least 30 minutes daily, of moderate to high intensity.
The protective mechanism of exercise is the result of the following. First, regular exercise encourages regular bowel movements, which means that the carcinogens in the stool have less chance of being reabsorbed back into the body through intestinal walls, thereby reducing cancer development, especially in the colons. Also, excessive body fat has been correlated with increased cancer risk, therefore, regular exercise (which helps to maintain healthy body weight) translates into decreased cancer risk. Lastly, regular exercise also modulates antioxidant enzymes activities as well as regulating hormonal levels, both of which contribute to decreased cancer risk and progression.
It is important to note that regular exercise (in this case) refers to at least 30 minutes daily, of moderate to high intensity.
Wednesday, July 8, 2009
Patients Not Informed of Abnormal Lab Test Results
According to a poll done by Medscape, about 1 of every 14 abnormal (lab) tests was not reported to the patient.
So be sure to follow up with your doctor after you've had tests done. Medical labs are usually able to get the results to the medical doctors within a week (with some exceptions, some tests take an entire week to perform, in which case, it would take two weeks. Many assume that no news (from the doctor's office) is good news. That is not a safe assumption to make. It is your health, be sure that you get all the answers you are looking for.
-Dr. Lei Gu ND
According to a poll done by Medscape, about 1 of every 14 abnormal (lab) tests was not reported to the patient.
So be sure to follow up with your doctor after you've had tests done. Medical labs are usually able to get the results to the medical doctors within a week (with some exceptions, some tests take an entire week to perform, in which case, it would take two weeks. Many assume that no news (from the doctor's office) is good news. That is not a safe assumption to make. It is your health, be sure that you get all the answers you are looking for.
-Dr. Lei Gu ND
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