Your healthcare news library

Archive for February, 2012

Tomato baked eggs


Eggs over tomato for a change

  • Cook 60 mins
  • Prep 0 mins

Nutrition per serving

204 kcalories, protein 9.0g, carbohydrate 7.0g, fat 16.0g, saturated fat 3.0g, fibre 3.0g, salt 0.27g

Ingredients

Serves 4

  • 2lb ripe vine tomatoes
  • 3 garlic cloves
  • 3 tbsp olive oil
  • 4 large free range eggs
  • 2 tbsp chopped parsley and/or chives

    Method

    1. Preheat the oven to fan 180C/ conventional 200C/gas 6. Cut the tomatoes into quarters or thick wedges, depending on their size, then spread them over a fairly shallow 1.5 litre ovenproof dish. Peel the garlic, slice thinly and sprinkle over the tomatoes. Drizzle with the olive oil, season well with salt and pepper and stir everything together until the tomatoes are glistening.
    2. Slide the dish into the oven and bake for 40 minutes until the tomatoes have softened and are tinged with brown.
    3. Make four gaps among the tomatoes, break an egg into each gap and cover the dish with a sheet of foil. Return it to the oven for 5-10 minutes until the eggs are set to your liking. Scatter over the herbs and serve piping hot with thick slices of toast or warm ciabatta and a green salad on the side.

 

Read More: GoodFood

Pear and Arugula Smoothie With Ginger and Walnuts

Arugula may seem like a strange ingredient for a smoothie, but this combination is a real winner, a great lunchtime smoothie.

1/2 cup freshly squeezed orange juice

1 cup arugula, tightly packed (about 30 grams)

1 tablespoon walnuts (7 grams)

1/2 ripe pear, cored and peeled (100 grams)

1 quarter-size piece of fresh ginger, peeled

2 to 4 tablespoons plain low-fat yogurt (to taste)

3 ice cubes

Place all of the ingredients in a blender and blend for 1 full minute.

Yield: 1 generous serving.

Advance preparation: This is best enjoyed right away.

Nutritional information per serving: 184 calories; 6 grams fat; 1 gram saturated fat; 4 grams polyunsaturated fat; 1 gram monounsaturated fat; 2 milligrams cholesterol; 31 grams carbohydrates; 4 grams dietary fiber; 30 milligrams sodium; 5 grams protein

Read More: NYT

Sleeping pills ‘linked to increased death risk’

By Michelle Roberts Health reporter, BBC News

Sleeping pills used by thousands of people in the UK appear to be linked with a higher death risk, doctors warn.

The American study in BMJ Open compared more than 10,000 patients on tablets like temazepam with 23,000 similar patients not taking these drugs.

Death risk among users was about four times higher, although the absolute risk was still relatively low.

Experts say while the findings highlight a potential risk, proof of harm is still lacking.

They say patients should not be alarmed nor stop their medication, but if they are concerned they should discuss this with their doctor or pharmacist.

UK guidelines for NHS staff say hypnotic drugs should only be used for short periods of time because of tolerance to the drug and the risk of dependency. But they make no mention of an associated death risk, despite other studies having already reported this potential risk.

The Medicines and Healthcare products Regulatory Agency said it would consider the results of this latest study and whether it has any implications for current prescribing guidance.

The study needs to be replicated in a different sample and I think we need to hold judgement until we have further studies”

Malcolm Lader Professor of clinical psychopharmacology at the Institute of Psychiatry at King’s College London

Millions prescribed

In 2010 in England, there were 2.8 million prescriptions dispensed for temazepam and almost 5.3 million for another common sleeping pill called zopiclone.

There were also more than 725,000 prescriptions dispensed for zolpidem and more than 9,400 for zaleplon, two other drugs in this same family.

The latest study looked at a wide range of sleeping pills, including drugs used in the UK, such as benzodiazepines (temazepam and diazepam), non-benzodiazepines (zolpidem, zopiclone and zaleplon), barbiturates and sedative antihistamines.

The investigators, from the Jackson Hole Centre for Preventive Medicine in Wyoming and the Scripps Clinic Viterbi Family Sleep Centre in California, found that people prescribed these pills were 4.6 times more likely to die during a 2.5-year period compared to those not on the drugs.

Overall, one in every 16 patients in the sleeping pill group died (638 out of 10,531 in total) compared to one in every 80 of the non-users (295 deaths out of 23,674 patients).

This increased risk was irrespective of other underlying health conditions, such as heart and lung diseases, and other factors like smoking and alcohol use, which the researchers say they did their best to rule out.

The researchers say it is not yet clear why people taking sleeping tablets may be at greater risk.

The drugs are sedating and this may make users more prone to falls and other accidents. The tablets can also alter a person’s breathing pattern as they sleep and they have been linked to increased suicide risk.

‘Meagre benefits’

In this latest study, those taking the highest doses of sleeping tablets also appeared to be at greater risk of developing cancer.

The researchers say: “The meagre benefits of hypnotics, as critically reviewed by groups without financial interest, would not justify substantial risks.”

They say even short-term use may not be justifiable.

But Malcolm Lader, professor of clinical psychopharmacology at the Institute of Psychiatry at King’s College London, said people should not panic as a result of the findings.

“The study needs to be replicated in a different sample and I think we need to hold judgement until we have further studies.

“What we don’t want is people stopping sleeping tablets and then going through a very disturbing period of insomnia.

“People should discuss this with their GP but should not under any circumstances stop taking their medication.”

Nina Barnett, of the Royal Pharmaceutical Society, said: “This is an important study and although it is unlikely to radically change prescribing in the immediate term, it should raise awareness and remind both patients and prescribers to the potential risks of sedative use for insomnia.

“The association between mortality and sedation is not new and this research tells us that people who took these medicines were more likely to die than people who didn’t take them.

“However it does not mean that the deaths were caused by the medicine.”

A spokesman for the Association of the British Pharmaceutical Industry said the safety of medicines was closely monitored and continued even after regulatory approval.

Read More: BBC

相關網頁→ 中國時報

Omega-3s May Guard Against Brain Decline

In the first study of its kind, researchers link blood levels of healthy fats to brain size and memory loss.
By Matt McMillen/Health.com | February 28, 2012

 

 

 

Eating a diet rich in omega-3 fatty acids — healthy fats found in abundance in oily fish such as salmon — may protect against premature aging of the brain and memory problems in late middle age, according to a study published today in the journal Neurology.

 

Fish has long had a reputation as a brain food. The new study, however, is the first to link blood levels of omega-3s with brain shrinkage, mild memory loss, and declines in cognitive function, all of which are associated with a higher risk of developing Alzheimer’s disease and other forms of dementia.

 

The study included 1,575 people between the ages of 58 and 76 who underwent MRI brain scans, blood work, and various mental-function tests.

Compared to those with the highest blood levels of omega-3s, men and women with the lowest levels had smaller brain volumes and performed more poorly on tests of visual memory and abstract reasoning.


“The lower the omega-3s, the poorer the performance,” says lead author Dr. Zaldy Tan, an Alzheimer’s researcher at the University of California, Los Angeles. “We factored in the participants’ age, gender, education, body mass index, smoking, et cetera — and even after that, the relationship was still there.”

 

Previous studies have found a similar link between omega-3s and dementia, but those relied on food surveys in which the participants were asked to recall what they ate over a given week or month, a method that can be inaccurate.

Blood tests, on the other hand, show precisely how much of the healthy fats a person’s body has absorbed.

 

“This is the very first time this has been correlated, so this is very exciting,” says Dr. Gisele Wolf-Klein, the director of geriatric education at the North Shore–LIJ Health System, in New Hyde Park, N.Y., who was not involved in the research. “This study will generate a lot of further research.”


A smaller brain isn’t necessarily cause for concern, since the brain naturally shrinks with age.

But the study participants with the lowest levels of omega-3s had brain volumes typical of people two years older, Tan says.

 

In addition, people with low levels of omega-3s also tended to have greater buildup of white matter in their brains.

These so-called white matter hyperintensities have been linked to a higher risk of dementia and stroke.

 

The findings don’t mean that people should stock up on fish or fish-oil supplements, the other main source of omega-3s. “Don’t read this study and run to the store to get omega-3 tablets,” Wolf-Klein says.

“This was not an intervention study that can be translated into clinical recommendations.”


Federal dietary guidelines currently recommend eight ounces of seafood per week for the prevention of heart disease. (Flax seeds and walnuts also are excellent sources of omega-3s.)

Tan says that intake is “probably adequate” for most people, although he notes that research has yet to determine what constitutes a normal, healthy amount of omega-3s in the bloodstream.

“Will supplements get you to where you need to be? We don’t know. We don’t have established recommendations, so we don’t know what to aim for,” he says. “But what’s good for the heart appears to be good for the brain as well.”

 

Dr. Brian Appleby, a psychiatrist at the Cleveland Clinic’s Lou Ruvo Center for Brain Health, says that observation is the study’s biggest take-home message.

 

“Cardiovascular health is linked to cognitive health,” says Appleby, who did not participate in the research. “This study strengthens the need to tell people that.”

Read more: TIME

Many drugs ‘non-vegetarian and need better labelling’


Tablets can be encased in gelatin

People who choose not to eat animal products may be unaware that common medicines could contain them, a study suggests.

Many tablets and liquid medicines use gelatin, derived from animal bones or skin.

A survey in the Postgraduate Medical Journal shows a quarter of patients are unknowingly prescribed drugs containing gelatin contrary to their beliefs.

The report authors say clearer drug labelling is needed.

A spokesman for the ABPI, which represents the pharmaceutical industry in the UK, said that European Union legislation required the disclosure of all ingredients in the leaflet accompanying the drugs.

He added: “Patients are able to check if a product contains a material which may cause them concern. If patients are unsure if an ingredient is derived from animals they can seek the advice of their pharmacist or contact the company manufacturing the product.

Some vegetarians will be shocked to learn about the widespread use of animal ingredients in medicines”

Liz O’Neill The Vegetarian Society

“There is a general trend for manufacturers to move away from the use of animal derivatives in medicines but there remain occasions where the nature of the product, or quality or safety issues, preclude the effective use of non-animal-derived ingredients.”

There are many ingredients in tablets, capsules and other medicines which, while usually not part of the active treatment, help hold it together or thicken liquids.

Gelatin is commonly used, particularly in generic medicines – versions of a drug mass-produced more cheaply once the initial patent has expired.

The Manchester Royal Infirmary researchers, led by a consultant urologist, surveyed 500 patients, and found that approximately 40% in their inner-city catchment said they preferred not to consume animal products in their day-to-day lives, either because they were vegetarians, or for other cultural and religious reasons.

Of the 200 following a restricted diet in this way, 49 were found to be already taking drugs which contained gelatin, despite their wishes.

While many of the 200 said they would be prepared to take a drug containing animal products if there was no alternative, the report authors said that more effort should be made to help them, by both doctors and pharmacists.

They wrote: “In particular, we would recommend that every doctor needs to be aware that it is not just the active drug being dispensed but a whole group of other agents which may have relevance to an individual patient’s compliance with treatment when oral treatments are prescribed.”

They suggested that drug companies could adopt an “ingredients” list similar to that found on food packaging, or even use recognised symbols such as those promoted by the Vegetarian Society.

In addition, they said that plenty of vegetarian alternatives to gelatin were available and should be considered by manufacturers when formulating their products.

Liz O’Neill, spokesman for The Vegetarian Society, said that it frequently received calls from patients concerned about animal products in their medication.

She said that current labelling made it hard for them to make an informed choice.

“Some vegetarians will be shocked to learn about the widespread use of animal ingredients in medicines.

“This is a complex area with no overnight solutions, but the Vegetarian Society believes that everyone has a right to know what they are consuming.”

Read More: BBC

Free HIV treatment on NHS for foreign nationals


Ministers say treating people with HIV means they are unlikely to pass the infection on to others

 

Foreign nationals are to be offered free treatment for HIV on the NHS under plans backed by the government.

 

Campaigners say the move in England will reduce the risk of Britons being infected and cut the costs of more expensive later treatment.

 

Currently only British residents are eligible, which excludes migrants.

 

The Department of Health said it would bring England into line with Scotland and Wales, and there would be safeguards against “health tourism”.

 

Extend treatment

 

There are an estimated 25,000 people with undiagnosed HIV in Britain, many of whom were born abroad.

 

People from overseas cannot be treated for the condition unless they pay, which is not the case for other infectious diseases.

 

This group of people includes failed asylum seekers, students and tourists.

 

Conservative former cabinet minister Lord Fowler, who headed the government’s Aids awareness campaign in the 1980s, has called for an amendment to the Health and Social Care Bill currently before the Lords.

 

This would extend free treatment to those who have been in Britain for six months.

 

The proposal will be introduced by the government in a Statutory Instrument rather than as part of the legislation.

 

‘Good news’

 

Public Health Minister Anne Milton said: “This measure will protect the public and brings HIV treatment in to line with all other infectious diseases. Treating people with HIV means they are very unlikely to pass the infection on to others.”

 

Yusef Azad, director of policy at the National Aids Trust, said: “If someone is tested and treated early, it is much cheaper than them presenting themselves in hospital with a much more serious, complex condition that can cost tens of thousands of pounds to treat.”

 

Professor Jane Anderson, chairwoman of the British HIV Association, said: “This is good news for people living in the UK who are HIV positive and also for public health in general.”

 

Critics claim the decision could prompt so-called health tourism and put the NHS under further financial pressure.

 

But the government pledged tough guidance to ensure the measure is not abused.

 

The Department of Health said it would be difficult for somebody to come to the UK specifically for treatment as the process took months to administer and monitor.

 

Read More: BBC

1月2次 安眠藥 害人罹癌早死

  • 2012-02-29 01:02
  • 中國時報
  • 【江靜玲/倫敦廿八日電】

根據《英國醫學月刊》發表的一項最新研究報告,使用安眠藥會增加提早死亡及罹患癌症的機率。每月服用安眠藥兩次,提早死亡的機率,比一般未服用安眠藥者,平均增加四倍;罹患癌症的機率則比未服用者,平均高出三五%。這項研究再次喚起安眠藥泛濫和服用問題。

這項發表在英國醫學刊物《British Medical Journal Open》的報告指出,美國加州的一家睡眠醫療中心以一萬五百名服用不同種類安眠藥,及二萬三千五百名未服用安眠藥的成人進行追蹤調查後,顯示習慣服用高 劑量安眠藥Temazepam的人,未來兩年半內,提前死亡的機率是一般人的六倍。

Temazepam屬於較早一代的安眠藥,需要經由醫生開處方簽,才能購買。另外兩種比較新一代的處方安眠藥Zolpidem和 Zopiclone,也包含在這項調查研究中。報告指出,經常服用前者的提早死亡機率,是一般人的五點七倍;後者是英格蘭地區目前使用最廣泛的安眠藥,二 ○一○年紀錄顯示,醫生共開出了五百三十萬張Zopcilone的處方簽。而在台灣,迄至二○○六年,Zolpidem,則是最普遍的安眠藥,佔台灣安眠 藥處方簽的半數以上。

這項研究調查,安眠藥劑量愈高,危險性愈大。一年服用十八顆安眠藥提早死亡機率是未服用者的三點六倍;服用十八顆到一百三十二顆提前死亡機率為四點四倍;一百三十二顆以上者,提前死亡機率為未用藥者的五點三倍。

至於服用安眠藥的致癌機率,這項調查顯示,服用安眠藥者罹患癌症的機率平均比未服用者,高出三十五%。其中使用Temazepam者患癌症的機率為未服用者的六點六倍; Zolpidem則為五點七倍。

根據英國國家健康服務(NHS)服藥準則,低劑量的Zolpidem,最多只能服用四個星期;Zopiclone則為兩星期。

針對這項研究報告,英國藥劑學會發言人表示,這項報告足以提高公眾對安眠藥的警惕。

此間醫學和心理專家呼籲大眾多運動,保持身心平衡,並選擇以心理咨詢和行為認知療法,取代服用、依賴安眠藥的習慣。

相關網頁→ 中國時報

世界首例四肢移植手術失敗

 

據土耳其哈西德佩大學(Hacettepe)消息,世界上第一個四肢移植手術失敗。

 

上周五, 27歲的全球首例四肢移植者Şevket Çavdar ,因為組織不相容,醫生不得不移除他的兩個胳膊和兩條腿。

 

據紮曼今天的報告,由於排斥反應,上周日醫生們移除了Çavdar移植的一條腿。本周一他的另一條腿和兩個胳膊也被移除了。

Çavdars是在1998年因不慎觸電失去了他的雙臂和雙腿。

 

這次四肢移植手術是一月份在Akdeni大學附屬醫院未能成功的全球首例三體移植手術再次嘗試,當時,34歲的Atilla Kavdir 接受了兩條胳膊和一條腿的移植手術,由於器官移植反應,醫生們不得不移除移植的腿。

 

相關網頁→醫藥日報

每天半包菸 26歲男心肌梗塞

012-02-24 中國時報 張睿纖/台北報導

 
一名26歲士官平常有抽菸習慣,每天需抽半包香菸,春節期間連續熬夜打麻將,平均每天只睡2小時,初四晚上忽然胸痛、盜汗且一動就感到很喘,嚇壞一堆親 友,緊急送醫後,發現是急性心肌梗塞,緊急進行冠狀動脈氣球擴張術併支架植入,才撿回一命。醫師表示,年輕人心肌梗塞近幾年病例有增加趨勢,應在日常生活 做好保健工作。

 

三軍總醫院心臟內科主治醫師林維祥表示,冠心病早期沒有徵狀,一般人難以察覺,多數年輕人認為急性心肌梗塞多是發生在中老年人身上,但該病患雖然年紀 輕,卻從16歲開始抽菸,菸齡已達10年,且血液檢查有高膽固醇血症,體重也過重,危險因子高,產生心肌梗塞機會也大大提高。

 

這名患者就醫後,醫療人員立即給予病患氧氣、抗血小板藥物及抗凝血藥物標準治療後,在黃金時間90分鐘內,安排冠狀動脈攝影發現病患左迴旋動脈近端完全阻塞,緊急冠狀動脈氣球擴張術併支架植入,在加護病房觀察後順利出院。

 

林維祥指出,三總去年發生急性心肌梗塞病人中,年紀小於45歲的年輕成人占比大約只有7%,但年輕人產生心肌梗塞在近幾年病例有增加趨勢,包括抽菸、家族病史、高血脂、糖尿病,肥胖等都是常見的急性心肌梗塞危險因子,其中抽菸是最主要的危險因子。

 

醫師提醒,並非做過心導管手術就可以「高枕無憂」,患者應按時服用雙重抗血小板凝集藥物、降血脂藥物,且不可忽然停藥。此外,日常生活也要保持良好作息,需戒菸、減肥、飲食均衡及適度運動,避免再次發生心肌梗塞。

 

相關網頁→ 中國時報

Why cancers recur

Lowering the risks is more than just avoiding certain foods, writes Dr Muhammad Azrif Ahmad Annuar

RUN

EGGS, chicken, sugar, milk. It sounds like the grocery list my wife gives me before I go to market. However, a significant number of my patients swear by it and relate, in hushed tones, how their relatives know of a friend who had completed treatment for cancer three years ago only to develop a recurrence soon after eating the chicken curry at a niece’s wedding.

How I wish it is that simple. I can then give my patients a list of foods to avoid with a 100 per cent guarantee that their cancer will not recur. And it is funny how the same relatives will happily pile the offending food on their plates without giving a second thought to its “cancer-causing” potency.

Realistically, the reason why cancers recur is because these malignant cells have not been completely eradicated. A few remain behind to grow and metastasise. There are several possibilities. The original cancer may recur in the same organ. It may have metastasised, undetected, before the surgery or a new separate primary may occur many years later.

 

BACK AGAIN

The first scenario is addressed by the surgeon painstakingly removing the cancerous tumour so as to achieve clear margins i.e. the edges of the excised specimen is free of cancer cells. However, it has been shown in countless studies that approximately one in every three women who have undergone a lumpectomy alone for breast cancer, will develop a recurrence in the same breast within 10 years.

However, this happens to only one in 10 women if radiotherapy is given soon after surgery. This allows the concept of organ or tissue preservation as lumpectomy with radiotherapy is equivalent to mastectomy (removing the whole breast) in terms of recurrence in the breast.

This organ preservation approach can be extended to other cancers. The use of newer chemotherapy regimens and the addition of chemotherapy to radiotherapy have allowed the curative treatment of inoperable cancers of the head and neck.

The second scenario is addressed by giving chemotherapy after surgery. Not all patients need it, as the chance of undetectable metastases may be too low to be worth the trouble of undergoing chemotherapy. However, for patients with biologically more aggressive cancers, the administration of chemotherapy may well be curative.

The existence of cancer stem cells that may be more resistant to chemotherapy has been postulated as a possible mechanism whereby cancers can recur even after chemotherapy.

NEW CONCEPT

The concept of immune-surveillance where the immune system identifies with and attacks cancer cells holds great promise for the future and is currently under research with cancer vaccines being actively developed. However, these new therapies will need to be extensively tested and proven to be of value before they become standard treatment.

Otherwise, patients and governments will be spending huge amounts of money for what may turn out to be very expensive, ineffective treatments.

There are therapies that purport to promote the growth of normal cells after chemotherapy to reduce side effects. Anyone with even a basic knowledge of cancer biology will know how well cancer cells have hijacked the signalling pathways of normal cells and it is puzzling how these therapies are able to specifically promote normal cells and not cancer cells. It may be worthwhile asking this question to the next person who tries to sell you these treatments.

BIGGEST HURDLE

The final scenario is the most important and probably the most difficult to manage as it means encouraging patients to change habits formed over decades. Many patients diagnosed with cancer suffer from diabetes and hypertension due to a sedentary lifestyle and unhealthy diet.

The very same risk factors that predisposed the patient to the first cancer are still there and, if not adequately addressed, may lead to the development of a second cancer.  The message is simple: Stop smoking, lose weight, eat more whole grains, fruit and vegetables and exercise regularly. It is well known that regular exercise will enhance mood, increase stamina, improve sleep and appetite as well as boost the immune system and reduce the risk of heart disease and stroke.

WORK YOUR BODY

I believe that the value of regular exercise is underestimated by society. Studies in colorectal cancer patients show that those who exercise regularly are less likely to develop a relapse compared to those who do not.

The risk reduction is greater and more consistent than any dietary modification. A good way to start would be to go for a brisk walk for half an hour every day.

This means more effort on the part of the patient and society as we need to make a conscious effort to set aside work and make time to exercise.

This is why the popular alternative — avoiding sugar, milk, chicken, eggs — is so much easier and appealing.

Read more: NST

Tag Cloud