Thursday, September 29, 2011
Allergy Relief for Your Child
Long-lasting sneezing, with a stuffy or runny nose, may signal the presence of allergic rhinitis—the collection of symptoms that affect the nose when you have an allergic reaction to something you breathe in and that lands on the lining inside the nose.
Allergies may be seasonal or they can strike year-round (perennial). In most parts of the United States, plant pollens are often the cause of seasonal allergic rhinitis—more commonly called hay fever. Indoor substances, such as mold, dust mites, and pet dander, may cause the perennial kind.
Up to 40 percent of children suffer from allergic rhinitis, according to the National Institute of Allergy and Infectious Diseases (NIAID). And children are more likely to develop allergies if one or both parents have allergies.
The Food and Drug Administration (FDA) regulates both over-the-counter (OTC) and prescription medicines that offer allergy relief as well as allergen extracts used to diagnose and treat allergies.
Immune System Reaction
An allergy is a reaction of the immune system to a specific substance, or allergen. The immune system responds to the invading allergen by releasing histamine and other chemicals that typically trigger symptoms in the nose, lungs, throat, sinuses, ears, eyes, skin, or stomach lining, according to the American Academy of Allergy, Asthma and Immunology.
In some children, allergies can also trigger symptoms of asthma—a disease that causes wheezing or difficulty breathing.
If a child has allergies and asthma, "not controlling the allergies can make asthma worse," says Anthony Durmowicz, M.D., a pediatric pulmonary doctor in FDA's Division of Pulmonary, Allergy, and Rheumatology Products.
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Avoiding the Culprit
If your child has seasonal allergies, you may want to pay attention to pollen counts and try to keep your child inside when the levels are high.
In the late summer and early fall, during ragweed pollen season, pollen levels are highest in the morning.
In the spring and summer, during the grass pollen season, pollen levels are highest in the evening.
Some molds, another allergy trigger, may also be seasonal. For example, leaf mold is more common in the fall.
Sunny, windy days can be especially troublesome for pollen allergy sufferers.
It may also help to keep windows closed in your house and car and run the air conditioner when pollen counts are high.
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Allergy Medicines
For most children, symptoms may be controlled by avoiding the allergen, if known, and using OTC medicines. However, if a child's symptoms are persistent and not relieved by OTC medicines, it is wise to see a health care professional to assess your child's symptoms and see if other treatments, including prescription medicines, may be appropriate. Five types of drugs are generally available (see table below) to help bring your child relief.
While some allergy medicines are approved for use in children as young as six months, Dianne Murphy, M.D., director of FDA's Office of Pediatric Therapeutics, cautions, "Always read the label to make sure the product is appropriate for your child's age. Just because a product's box says that it is intended for children does not mean it is intended for children of all ages."
"Children are more sensitive than adults to many drugs," adds Murphy. "For example, some antihistamines can have adverse effects at lower doses on young patients, causing excitability or excessive drowsiness."
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More Child-Friendly Medicines
Recent pediatric legislation, including a combination of incentives and requirements for drug companies, has significantly increased research and development of drugs for children and has led to more products with new pediatric information in their labeling. Since 1997, a combination of legislative activities has helped generate studies in children for 400 products.
Many of the older drugs were only tested in adults, says Durmowicz, "but we now have more information available for the newer allergy medications. With the passing of this legislation, there should be more confidence in pediatric dosing and safety with the newer drugs."
The legislation also requires drugs for children to be in a child-friendly formulation, adds Durmowicz. So if the drug was initially developed as a capsule, it has to also be made in a form that a child can take, such as a liquid with cherry flavoring, rapidly dissolving tablets, or strips for placing under the tongue.
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Allergy Shots
Children who don't respond to either OTC or prescription medications, or who suffer from frequent complications of allergic rhinitis, may be candidates for allergen immunotherapy—commonly known as allergy shots. According to NIAID, about 80 percent of people with allergic rhinitis will see their symptoms and need for medicine drop significantly within a year of starting allergy shots.
After allergy testing, typically by skin testing to detect what allergens your child may react to, a health care professional injects the child with "extracts"—small amounts of the allergens that trigger a reaction. The doses are gradually increased so that the body builds up immunity to these allergens.
Allergen extracts are manufactured from natural substances, such as pollens, insect venoms, animal hair, and foods. More than 1,200 extracts are licensed by FDA.
Some doctors are buying extracts licensed for injection and instructing the parents to administer the extracts using a dropper under the child's tongue, says Jay E. Slater, M.D., director of FDA's Division of Bacterial, Parasitic and Allergenic Products. "While FDA considers this the practice of medicine (and the agency does not regulate the practice of medicine), parents and patients should be aware that there are no allergenic extracts currently licensed by FDA for oral use."
"Allergy shots are never appropriate for food allergies," adds Slater, who is also a pediatrician and allergist. But it's common to use extracts to test for food allergies so the child can avoid those foods.
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Transformation in Treatment
"In the last 20 years, there has been a remarkable transformation in allergy treatments," says Slater. "Kids used to be miserable for months out of the year, and drugs made them incredibly sleepy. But today's products are outstanding in terms of safety and efficacy."
Forgoing treatment can make for an irritable, sleepless, and unhappy child, adds Slater, recalling a mother saying, after her child's successful treatment, "I didn't realize I had a nice kid!"
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FDA-Approved Drug Options for Treatment of Allergic Rhinitis (Hay Fever) in Children
Drug Type
How Used
Some Examples of Over-the-Counter (OTC) or Prescription (Rx) Drugs (many are available in generic form)
Common Side Effects
Nasal corticosteroids
Usually sprayed in nose once a day
Rx:
Stinging in nose
Nasonex (mometasone furoate)
Flonase (fluticasone propionate)
Oral and topical antihistamines
Orally (pills, liquid, or strip placed under the tongue), nasally (spray or drops), or eye drops
Oral OTC:
Some antihistamines may cause drowsiness
Benadryl (diphenhydramine)
Chlor-Trimeton (chlorpheniramine)
Allegra* (fexofenadine)
Some nasal sprays may cause a bitter taste in mouth, headache, and stinging in nose
Claritin* (loratadine)
Zyrtec* (cetirizine)
Oral Rx:
Clarinex (desloratadine)
Nasal Rx:
Astelin (azelastine)
* non-sedating
Decongestants
Orally and nasally (some-times taken with antihistamines, which used alone do not treat nasal congestion)
Oral Sudafed (pseudoephedrine*), Sudafed PE (phenylephrine)
Using nose sprays or drops more than a few days may cause "rebound" effect, in which nasal congestion gets worse
Oral Rx:
Allegra D, which has both an antihistamine (fexofenadine) and decongestant (pseudoephedrine*)
Nasal OTC:
Neo-Synephrine (phenylephrine)
Afrin (oxymetazoline)
* Drugs that contain pseudoephedrine are non-prescription but are kept behind the pharmacy counter because of their illegal use to make methamphetamine. You'll need to ask your pharmacist and show identification to buy these drugs.
Non-steroidal nasal sprays
Nasally used 3–4 times a day
OTC:
Stinging in nose or sneezing; can help prevent symptoms of allergic rhinitis if used before symptoms start
NasalCrom (cromolyn sodium)
Rx:
Atrovent (ipratropium bromide)
Leukotriene receptor antagonist
Orally once a day (comes in granules to mix with food, and chewable tablets)
Rx:
Headache, ear infection, sore throat, upper respiratory infection
Singulair (montelukast sodium)
This article appears on FDA's Consumer Updates page, which features the latest on all FDA-regulated products.
ayman
Wednesday, September 28, 2011
لماذا تخشى بعض السيدات من تأثير الرضاعة على مظهر الثدي؟
أثبتت دراسة أمريكية حديثة أن السيدات اللاتي خضعن لجراحة زراعة ثدي يعتقدن أن الرضاعة الطبيعية سوف تغير من مظهر الثدي، وبهذا يكن أقل قدرة على إرضاع أطفالهن رضاعة طبيعية بأمان.
وقد أشار باحثون من الجمعية الأمريكية لجراحة التجميل أن عدد مرات الحمل وليس الرضاعة الطبيعية هي التي تتسبب في تهدل الثديين مع مرور الزمن.
وصرحت الدكتور نورما كروز عضو هيئة الجراحة بالجمعية الأمريكية لجراحة التجميل "إذا ما اعتقدت سيدة ما أن الرضاعة الطبيعية سوف تؤثر علي مظهر الثديين فهي تقلل من فرصها للنجاح في رضاعة أطفالها رضاعة طبيعية. لسوء الحظ هذا الفهم الخاطئ يكلف الكثير. يجب طمأنة الأمهات أن الرضاعة الطبيعية لن تؤثر في شكل الثديين كما أن لها فوائد صحية هامة على كل من الأم والطفل الرضيع" .
وفي هذه الدراسة قام الباحثون بدراسة عادة الرضاعة الطبيعية لـ160 سيدة ممن خضعن في السابق لجراحة زراعة ثدي. ووجدوا أن 86% من الأمهات الـ97 اللاتي فشلن في إرضاع صغارهن رضاعة طبيعية يعتقدن أن الرضاعة سوف تجعل مظهر الثدي سيئ. ويشير المسؤول أن هذا الفهم الخاطئ كان له الأثر المباشر على فرص نجاحهن".
وأضافت كروز: "يمكننا القول أن مرضى تزايد حجم الثدي سوف يهتمون بمدى تأثير الرضاعة الطبيعية على مظهر الثدي، ففي النهاية هؤلاء السيدات قد أنفقن الكثير من المال على هذه الجراحة. إلا أن الأدلة المتاحة تخبرنا أنه بالرغم من أن الثدي يكبر حجمه أكثر مع كل حمل، فإن الرضاعة الطبيعية لا تزيد من سوء الوضع مع السيدات سواء ممن خضعن لجراحة زراعة ثدي أم لا".
وأشارت وزارة الصحة الأمريكية إلى أن الرضاعة الطبيعية تساعد في تقوية العلاقة بين الأم والرضيع، كما أنها ترتبط بعدد من الفوائد الصحية للسيدات، بما في ذلك تقليل مخاطر الإصابة بالبول السكري وسرطان الثدي والمبيض والإحباط الذي يتبع الحمل والوضع.
كما أكد الباحثون أن لبن الأم يساعد الرضيع على بناء جهاز مناعي قوي يقاوم الأمراض.
Listeria in Cantaloupes: Deadliest Outbreak in a Decade
Sept. 28, 2011 -- The CDC says 72 people have been sickened and 13 have died as a result of eating cantaloupes tainted with listeria bacteria, making it the deadliest outbreak of food-borne illness in the U.S. in a decade.

State officials say they are investigating three more deaths -- one each in New Mexico, Kansas, and Wyoming -- that may also be connected to the contaminated Colorado cantaloupes.
The new numbers mean that the death toll has outpaced the number of deaths tied to an outbreak of salmonella in peanut products nearly three years ago. Nine people died in that outbreak.
According to the CDC, this is the third deadliest outbreak of food-borne illness since the agency began keeping records. In 1985, cheese contaminated with listeria killed 52 people. In 1998, listeria-contaminated hot dogs killed 21 people.
The melons involved in the current outbreak, "Rocky Ford" brand cantaloupes sold by Jensen Farms, were recalled on Sept. 14.
But health officials warn that that people may still have recalled melons in their refrigerators. They have also been used in some cut-fruit salads.
Unlike other many other kinds of food-borne pathogens, listeria bacteria can continue to grow despite the cold temperatures of a refrigerator.
"If they can't confirm that it's not Jensen Farms, then it's best to throw it out," said CDC Director Thomas R. Frieden, MD, in a news briefing on Wednesday.
Officials also say that because it can take weeks for people to get sick after coming into contact with listeria bacteria, they expect the number of deaths and illnesses linked to the melons to rise.
"The time between when you consume it and when you get sick is longer than it is for many other bacteria," Frieden said, "so people who consumed it some time ago may continue to develop illness in the coming days and weeks.
ayman
Depression: Helping Someone Get Treatment
- Depression is a disease. It's not being lazy, and you can't "just get over it."
- Depression is very common and is nothing to be embarrassed about.
- The best thing you can do for someone who has depression is to help him or her get treatment.
- Don't ignore talk about suicide. Talk to a doctor, or call 911 or emergency help if needed.
- Treatment works, and there are many choices in treatment. Many types of health practitioners can treat depression.
- Depression can be caused by another medical problem. Treating the problem may stop the depression.
Sunday, September 25, 2011
Saturday, September 24, 2011
Friday, September 23, 2011
Thursday, September 22, 2011
Latest Jobs Posted On Linked5.com
ayman
Friday, September 16, 2011
Best Dressed at the Oscars ( Which one you Liked )
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Saturday, September 10, 2011
Smoking And Drinking Responsible For More Women Developing Kidney Stones
Urology Consultant Mr Noor Buchholz stated on the evening of the European Section of Urolithiasis (EULIS) Stone Conference to be held at Barts that the number of women who required kidney stone surgery has doubled within the last five years.
According to Buchholz:
"Five years ago, we treated 400 women a year for kidney stones - in the last year that figure increased dramatically to 800. We've had to expand our services to cope with the number of people requiring treatment and it doesn't show any sign of slowing down. New research and technology means we have been able to develop better surgery for patients that eliminates the stones more quickly and reduces patients' recovery time."
Barts Hospital and the London NHS Trust are one of the few trusts that can treat kidney stone patients without waiting lists by using a specialized, quick procedure called lithotripsy that uses shock waves to break up stones.
Kidney stones are caused by various factors, such as having a sedentary lifestyle, excessive smoking and drinking as well as eating too much meat and salt.
Mr Buchholz commented:
"There is no doubt in my mind that the increase in poor lifestyle choices including smoking and drinking among women is the key reason we are treating so many more of them."
Statistics show that forty years ago men were three times more likely to require kidney stone treatment compared with women; however since then these numbers have drastically changed. Seven times more women require kidney stone treatment compared to four decades ago. Experts suggest that the dramatic rise, which started in the seventies, is due to women taking up the same bad habits as men in terms of smoking and drinking.
Mr Buchholz added:
"One in eight people in this country will develop kidney stones at some point. Traditionally they were seen as a man's disease, but that is no longer the case with women fast catching up with men."
As kidney stones can be prevented in most cases, doctors are issuing the following advice to women to help reduce their risk:
- Drinking plenty of water
- Eating a varied diet including lots of fruit and vegetables for better digestion. Magnesium and potassium-rich foods, such as spinach and bananas are ideal.
- Consuming alcohol in moderation - women should not drink more than three units per day
- Daily exercising
- Stop smoking as it causes a build-up of toxins in the kidneys that may contribute to kidney stones
Tuesday, September 6, 2011
Behavorial economics: How your emotions can cost you money
George Loewenstein, a professor of economics and psychology at Carnegie Mellon, has devoted his career to figuring out how our complex and often mysterious emotions affect money and life decisions.
His field, known as behavioral economics, is now quite trendy -- it's been embraced by would-be reformers ranging from the Obama administration to Britain's Conservative Party-- but Loewenstein warns that understanding emotions doesn't lead to easy solutions.
He recently spoke with MONEY contributing writer David Futrelle; the conversation has been edited.
What's the most important lesson you've learned about the role of emotions in people's economic behavior?
It's dangerous to make long-term decisions based on short-term emotions.
So just take a deep breath before making a big money decision?
Not exactly. Often the problem isn't that we're too emotional. It can also be that we're unemotional now and don't appreciate how emotional we're going to be in the future. I call this an empathy gap -- we don't fully empathize with our future selves.
How would my inability to imagine how my future self will feel mess up my financial planning?
My colleagues -- chiefly, Leaf Van Boven -- and I have studied the illusion of courage: People think they will be more willing to take risks in the future than they really will be. They underestimate the fear they will experience when they get into a fear-inducing situation.
In many of our studies, we asked people whether, in exchange for a payment, they would be willing to take social risks, like miming, dancing, or telling a joke in front of a group. When the performance is in the future -- say, a week off -- lots of people volunteer to do it, but then when the moment of truth arrives, most of the volunteers end up chickening out.
How to invest in a scary economy
The same pattern applies to investors. When markets are calm, investors think they'll stand pat when the markets begin gyrating. But at the moment of truth, many end up bailing out, often at the worst moment.
What's the best way to avoid this?
Many people solve the problem by hiring investment professionals. Advisers I've spoken to have told me they view their job much more as one of preventing impulsive decisions than of picking the optimal portfolio.
Of course, having your portfolio managed by someone else can be costly. A cheaper, if likely less effective, strategy is the out-of-sight, out-of-mind approach. Put a chunk of your financial wealth into a portfolio you are comfortable with and then try, ideally, to forget about it.
Does the empathy gap affect savings decisions?
The empathy gap tends to promote undersaving because we can't imagine either the pleasures of an affluent retirement or the pains of a lean one. Many investment firms have expended time and effort trying to figure out how to help investors imagine how they'll feel in retirement.
They want to know whether it's more effective to show an investor vivid images depicting the miseries of people who didn't save enough or images of happy people who did. The answer is "neither."
What would work better?
A far more effective strategy is for investors to set short-term goals designed to accomplish long-term goals. Investment institutions should give their clients constant feedback about how well they are meeting their short-term goal to save regularly, whether the amount they put into savings this week will ultimately lead to a poor retirement or to a rich one. That's far more likely to create the kinds of immediate pain and pleasure that help people reach goals.
You once suggested a savings plan combined with a lottery, to make saving immediately enjoyable.
Other countries do have lottery-based savings bonds. With British "premium bonds," for example, instead of getting a fixed interest rate, every pound you invest entitles you to a chance at cash prizes. I tried to pitch the idea of a lottery ticket where half the money would go to savings, though I had misgivings.
It would be bad if it encouraged people who had been saving to instead put money into the lottery. In any case, the state lottery authority I pitched it to wasn't interested because lotteries make a lot from "churn" -- when people win, they spend the money on more tickets. The authority wanted winnings paid out in cash, so that people could buy more tickets; I wanted them to go to savings. We couldn't agree, and the idea never went anywhere.
Worried about your finances? Send the Help Desk your questions.
So it's tricky to apply psychological insights to real life. In fact, you've recently warned that behavioral economics can be overdone.
I've come to the view that behavioral economics solutions are often being used as a substitute for more fundamental efforts. British Prime Minister David Cameron is a big fan of behavioral economics and gave a talk in which he said, "The best way to get someone to cut their electricity bill is to show them their own spending, to show them what their neighbors are spending, and then show them what an energy-conscious neighbor is spending."
This idea plays on Bob Cialdini's research documenting the impact of social norms on behavior. It's a great idea, and leads to reductions in energy use of a few percent, but showing someone their neighbor's bill is not the best way to get them to cut their own bill. The best way is to charge an amount that reflects the true cost of the electricity, including social costs from importing oil, pollution, climate change, and so on.
Behavioral economics has a lot of great insights to contribute to public policy, but it will be unfortunate if it substitutes tried-and-true approaches involving taxes and regulation.
Proposals for financial reform often hinge on disclosure -- for example, making brokers say if they are paid to sell a product. Will that work?
There's very strong evidence that disclosing conflicts of interest can have all sorts of perverse consequences.
For example, say you know that your doctor has a conflict of interest; that he's going to get a payment if you enter a clinical trial. What are you supposed to do with that information?
Most people trust their doctor and take his advice. But in our research we find that people giving advice do respond to having disclosed: They tend to be more vehement about their advice because they're worried it will be discounted. And they can justify this by saying to themselves, "I warned him." The net effect is the doctor, in this example, gives more emphatic advice, and people are more likely to follow it.
You also say the disclosure can change how consumers react.
Another important piece of the puzzle is what we call insinuation anxiety.
Suppose I recommend this clinical trial to you and there's no discussion of conflict of interest. If you say no, it probably just means you like the drug you're on now or you're risk-averse.
But what if I say, "By the way, I'm going to get $1,000 if you join the clinical trial"? Now if you say no, it suggests you don't trust me. The paradox is that disclosing the conflict can make you trust the advice less, yet feel pressured to follow the advice.
Despite that, I believe in disclosing conflicts. If my doctor prescribes a drug, it's my right to know if he's getting paid by the manufacturer. The question isn't if disclosure is good or bad -- it's good -- but learning how to make it more effective. That's a major focus of our current research
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Friday, September 2, 2011
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