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Cold
Virus Lurks In Hotel Rooms
It seems to
be a bit overdone to wash your hands after touching a light switch
or clicking the remote control, but researchers from the University
of Virginia do not think that it is such a far-fetched idea during
cold and flu season.
They found that rhinovirus that was live and capable to infect,
typically found in people who have a cold and a runny nose, could
still be transferred to a fingertip 24 hours after a person with
a cold stayed in the room. Dr. Owen Hendley and his colleagues recruited
15 adults who had just come down with a rhinovirus cold to stay
overnight in a hotel room. They were not to have visitors, get all
their meals from room service and do hand washing only after using
the washroom. They spent five hours in the evening, the night and
two hours in the morning in their room before checking out. After
checkout they were asked to name the 10 to 12 objects they touched
most frequently, when they were in the room. Those were door handles,
the hotel pen, light switches, TV remote control and the phone.
All of those were sampled for residual virus, and on average on
40% of them rhinovirus was found. In the second part of the study,
a group returned to the hotel several months later, but only after
researchers had placed a drop of the subjects' own stored rhinovirus-containing
mucus on the sites most frequently touched. The test persons were
asked to touch the contaminated sites by flipping light switches
or using the phone. After each contact they rubbed their fingertip
in a collecting fluid, after which they washed their hands. If the
site had been contaminated 30 minutes earlier, viral transfer to
the fingertip occurred 60% of the time. If the contamination was
done the night before viral transfer still occurred in 33%.
It is still a step from picking up the virus on a fingertip to developing
a cold: it requires self-inoculation. Dr. Hendley points out that
it is as prosaic as keeping fingers away from eyes, nose or mouth
and do frequent hand washing. While transmission of rhinovirus through
dried nasal mucus is not efficient, it is still important to understand
that the virus remains transferable at least one day.
The
Medical Post, November 3, 2006, page 19
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Vaccine
Can Protect Against Bird Flu
To take the
flu shot or not to take it becomes an issue as the northern winter
and with it the flu season is approaching.
It has to be stressed that the influenza vaccine not only limits
flu epidemics and saves lives. It is the only reliable protection
available to protect all age groups. Of course it does not offer
protection against the common cold, but it is a preventative weapon
against many influenza strains that cause serious illness and death.
Dr. Robert Webster,
a virologist and internationally recognized influenza expert recently
quoted data from his laboratory at St. Jude's Children's Research
Hospital in Memphis. He noted that the currently recommended seasonal
influenza vaccines contain A/New Caledonia 20/99 that is an H1N1
virus. Its composition is very similar to the bird flu virus H5N1.
In animal experiments
this immunization was given, after which the test animals were exposed
to the highly lethal Vietnam 1203/04 strain of H5N1. The treated
animals had a survival rate of 50%. Controls without the vaccination
prior to exposure had a death rate of 100 %. There is indeed a basic
cross-protection and people who take the current influenza vaccine
2006/2007 will have this partial protection against the bird flu
should it suddenly become an epidemic. The bird flu (H5N1) has not
made its appearance in the Americas. Dr. Webster pointed out that
the greatest concern is its entry through the illegal trade of animals.
After drug smuggling, the smuggling of animals is probably the greatest
illegal trade in the world and at the same time the most likely
way in which the virus could come into the country and spread. The
other concern is the entry of the virus through migratory birds.
The Medical
Post, November 3, 2006, page 19
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Asthma
Medication May Not Be Enough
Doctors at an
asthma clinic in New York were puzzled as to why their patients
were not getting better even after continued medical care. Even
though the patients were compliant with their medications, they
needed oral steroids and presented with more severe asthma attacks
at the emergency department. Looking into the living conditions
of the patient group that continued having problems provided some
insight: they lived in housing units that were dilapidated. In a
program in which St. Luke's-Roosevelt Hospital and other clinics
participated, with the help of legal services of an attorney law
firm the hospital was getting help for patients, who lived in substandard
housing. When a patient lived in a building with dust, mold, roaches
or rodents, any amount of treatment for asthma was almost futile.
Even though there were letters and phone calls from social workers
to landlords, unacceptable conditions in these housing units were
not corrected. One letter from the New York Legal Assistance Group
finally did the job. In plain English the notice to the negligent
landlord said: Clean the place up or see me in court.
Dr. Luis Chug
at St. Luke followed up on the patients one year later. Patients
who needed 18 courses of oral steroids could reduce the treatment
to just 2 the year after the cleanup. Patients who had made 14 trips
to the emergency department because of asthma attacks the year before
made only 2 after the conditions were corrected. The overall asthma
of the patients also improved. Ten patients were afraid to go to
a lawyer to seek help. A year later their living conditions predictably
had remained the same. Their asthma had not improved either. The
legal action was cost effective, reported Dr. Chug. Each emergency
visit cost the hospital about $470 in services, and each course
of prednisone cost about $345. The patients do not pay legal fees.
Instead the service is funded by grants from participating hospitals.
The study shows very clearly how practical public health measures
can be used to correct health problems. The legal processes available
in New York City are not unique in North America, as many local
and regional governments have statutes requiring proper building
maintenance.
The results are also relevant to asthma patients who are not struggling
with substandard housing. Patients with asthma simply cannot get
better, when they live among irritants and allergy causing substances.
Dust, cigarette smoke, perfumes, home fragrances, vapors from household
cleansers, animal dander from house pets or feathers from a seemingly
cozy down comforter can be the culprits for patients with asthma
that does not improve despite treatment.
The Medical
Post, November 14, 2006, page 23 and 25
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Cinnamon
And Multivitamins May Boost Fertility
Prenatal vitamin
supplements are the norm, as folic acid has been known to play a
role in the prevention of neural tube defect. Generally they are
taken once pregnancy has been confirmed.
Dr Jorge Chavarro from the department of nutrition at the Harvard
School of Public Health in Boston pointed out, that multivitamin
supplementation has its place earlier than just after the pregnancy
test has become positive. In one of the largest studies involving
18,000 married pre-menopausal women, regular use of multivitamin
supplements were associated with a decrease of infertility. The
key is in the regular use. Women who took two multivitamin tablets
per week had similar infertility rates as women who did not take
supplements at all. Those who took 6 or more multivitamins had a
40% lower risk of anovultation, a condition where no eggs are released
by the ovaries.
Most of the women were Caucasian between the ages 24 and 42.
The importance of nutrition is coming increasingly into the forefront
in reproductive medicine. One condition known as polycystic ovary
syndrome (PCOS) is often a reason for infertility. It is one of
the red flags that point to the condition of insulin resistance,
and it manifests itself in menstrual irregularity and higher levels
of androgens, often showing as increased facial hair. As the metabolism
is headed for trouble, diabetes, high blood pressure, high cholesterol
and heart disease would tend to develop.
Researchers at Columbia University in New York conducted a pilot
study to see if insulin sensitivity in women with PCOS could be
improved. Cinnamon, a well-known spice, has been known to have a
favorable effect on the insulin response of the body. Researchers
found that eight weeks of treatment with cinnamon extract significantly
decreased fasting glucose and insulin resistance in women with polycystic
ovary syndrome. Dr. Jeff Wang who conducted the study reported that
no side effects or adverse reactions were reported throughout the
study period. If large-scale prospective studies confirm these findings,
then recommending cinnamon as a dietary factor may be a simple,
inexpensive lifestyle change that can be easily followed. Reducing
insulin resistance is a key to improve the overall health status
in patients with PCOS, and it ties in with reproductive health benefits
as well.
The
Medical Post, November 14, 2006, page 32
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Rotigotine
Patch For Parkinson's Also Helps Restless Leg Syndrome
One of the difficulties
in curative medicine is compliance. There are various aspects: patients
dislike the feeling of dependency on medications. In some cases there
is a dislike for swallowing that pill, and if medications have to
be taken several times per day, it can present even more of a challenge.
People are busy with their daily routines, they may forget the one
or the other dose, and it may very well compromise the effectiveness
of a medication.
Various medications can now be administered through a transdermal
patch. For sufferers of Parkinson's disease a new transdermal treatment
with the dopamine agonist rotigotine (brand name Neupro®) has
been tested. It can become the first line of defense and ease the
symptoms. The transdermal patch was generally safe, and as it was
well tolerated, patients did not discontinue the treatment. The treatment
with rotigotine can help postpone the commonly used medication levodopa,
which tends to lose effectiveness over the years.
Another study with the rogitotine patch showed effectiveness for individuals
suffering from restless leg syndrome. This disorder makes sleep difficult,
and as a result the patient turns sleepy during wakeful hours. Dr.
Karin Stiasny-Kolster, a neurologist at Phillips University in Marburg,
Germany reported on favorable results with 340 patients suffering
of restless leg syndrome. In a controlled study, those patients who
were wearing the rotigotine patch were showing improvement. Again,
the transdermal system was well tolerated and safe and there was no
problem with fluctuating
dopamine levels as shown here. Placebo-treated patients
did not respond. The product has been released in European countries
and the FDA is investigating for release in the US soon.
The Medical
Post, November 3, 2006, page 57-58
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