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Archive for May 15, 2012

流感高企 疑因H3變種

【明報專訊】天氣酷熱但流感仍持續高企。監測系統監察每周流感發現,公共衛生檢測中心每周檢測出的流感病毒數目,由4 月14日的一周199宗,升至本月12日的一周共442宗,顯示流感活躍程度維持高水平,病毒分析指甲型流感H3N2佔88.1%。學者懷疑H3基因出現 變種,減低市民抵抗流感的防衛。

防護中心表示,乙型流感病毒佔個案10.8%,甲型流感H1N1(2009)病毒只佔0.8%。中文大學內 科及藥物治療學系教授李禮舜指出,H3N2甲型流感病毒在抗原位置出現小型變種,估計因H3基因出現變種,令市民對流感抵抗力減低。他又懷疑現時使用的流 感疫苗保護力不足以對抗變異的H3病毒,中大正研究了解病毒變異對疫苗保護能力的影響。

防護中心表示,現時流行的甲型流感H3N2,在抗原上與現時的疫苗病毒「甲型/珀斯/16/2009H3N2」類病毒類同,但不一致。不過,預期現時疫苗對甲型H3N2流感能提供一定保護作用。

防護中心:現疫苗可抗H3N2

自今年1月13日至昨日,中心錄得159宗(包括92宗死亡個案)確診感染流感,並需入住深切治療部或死亡的個案,較去年冬季流感高峰期的123宗(包括34宗死亡個案),增幅約三成。鑑於流感持續活躍,防護中心會繼續監察本地情况。

雅虎香港

紅酒是否可以預防癡呆症 26所研究機構合作試驗

科學家研究發現飲用紅酒可以防止癌症,糖尿病和心髒病,但它是否可以預防癡呆病。近日,科學家們將開始對紅酒是否可以延緩阿爾茨海默氏病的發展進行臨床試驗。

來自26所學術研究機構組成的阿爾茨海默氏病合作研究會的科學家們,本周三將第一次招聘誌願者,進行白藜蘆醇對輕度和中度癡呆症患者影響的政府性臨床研究。

白藜蘆醇是一種天然的有化合物,可以在紅葡萄,紅葡萄汁,紅酒,巧克力,西紅柿和花生等日用食品中發現。早先的研究顯示白藜蘆醇可以阻止衰老的分子機製,並防止與衰老有關的疾病,比如,老年癡呆症、糖尿病、心髒病、甚至癌症的發生。

喬治敦大學醫學中心記憶障礙項目組首席研究員斯科特·特納(Scott Turner)博士在研究會的新聞發布會稱,通過這項臨床研究,我們將會發現是否每天服用純白藜蘆醇是否可以推遲和改變因阿爾茨海默氏症而引起輕度和中度癡呆患者的記憶力衰退。

盡管那些在這項研究中將不會包括已患有糖尿病的患者,但在這項研究中,還會測試白藜蘆醇是否改善年長者葡萄糖和胰島素代謝。

研究者指出,白藜蘆醇還沒有被美國食品藥品監督管理局(FDA)批準治療阿爾茨海默氏症,而現在也沒有明確的證據證明白藜蘆醇可以減緩這種疾病的發展。根據國家問題老年研究所的數據,美國有超過530萬人患阿爾茨海默氏病,而每隔70秒將有一名新的病人發展成輕度思維疾病。

試驗方法與劑量問題

為保證試驗的客觀性,這項研究采取的是雙盲試驗的方法,即參與者和實驗者都不知道誰服用的是白藜蘆醇還是安慰劑。 試驗過程中,一半的登記參加者將會收到白藜蘆醇,而另一半將會收到安慰劑。

試驗之前,首先需要確定白藜蘆醇的劑量,因為這是第一次對癡呆症服用白藜蘆醇的劑量的進行生物性基準測試,所以需要非常謹慎。正如Turner說:“在已有大多數動物模擬實驗的研究顯示,白藜蘆醇確實對健康是有好處的。但是比如說在老鼠的實驗中,那個劑量遠遠不是隻是小啜幾口紅酒或咬幾口巧克力就行的。”

研究人員初步每天分配每名參與者1000mg劑量白藜蘆醇,這相當與每天要喝1000瓶紅酒,對此,Turner表示,我們需要努力確保這種水平的安全性,我認為這個水平已經安全了。是的,一當我們確定這個水平進行研究,那以後的研究者想開發任何適合消費水平的物品,還有很多工作要做,但這已經是個大進步了。

試驗原理與試驗者要求

研究者稱,這項即將開始的臨床研究將重點關注神經元纖維纏結(NFT)。和認知功能正常的人相比, 阿爾茨海默氏症患者大腦細胞死亡更快速,Tau蛋白水平更高。大腦中的Tau蛋白會形成神經元纖維纏結,這種纏結會破壞神經元上的突觸。而突觸是神經元細胞之間進行信息的通道,這是有正常認知功能的關鍵。

為了確定白藜蘆醇是否會減緩和減少神經元的損失,同時還為了確定白藜蘆醇的安全性和耐受性。研究人員在12個月裏會每三個月增加一次劑量。

因此,每名白藜蘆醇II期臨床試驗的參與者將被要求有一位研究夥伴(配偶,朋友或者監護人)。在超過一年的臨床試驗研究期間,他們將要拜訪喬治敦大學醫學中心10次。

在研究過程中,患者將需要接受腰椎穿刺(一種針插入到下脊椎收集流體的手術)。三次大腦核磁共振成像(MRI),血液和尿液測試。而且試驗者在12個月的研究期間。必須放棄食用和飲用含有大量白藜蘆醇的食物和飲料。

醫藥日報

食療養生:久坐族便秘發胖煩惱 8種蔬菜可潤腸通便

  萵苣性微寒,味甘苦,入脾、胃、肺經,具有開通、疏利、消積的作用。萵苣富含維生素C、天然葉酸、鐵,常食萵苣,促進腸蠕動,預防便秘,減輕肛門局部血管的壓力,可有效預防和治療痔瘡。

  蕹菜又稱空心菜、空筒菜。性寒、味甘,有治療便秘、便血、痔瘡的作用,蕹菜對大便經常幹結的痔瘡病人最為適宜。

  韭菜含粗纖維較多,且比較堅韌,不易被胃腸消化吸收,能增加大便體積,促進大腸蠕動,防止大便秘結,故對痔瘡便秘者有益。

 

菠菜性涼、味甘,有養血、止血、潤燥、滑腸、通便的作用。

  紅薯其所含纖維物質在腸內能吸收大量水分,增加糞便體積,對促進胃腸蠕動和通便非常有益,常用來治療痔瘡及肛裂等。

 

  卷心菜又名球甘藍,別名圓白菜或洋白菜。性平、味甘,多吃卷心菜,可增進食欲,促進消化,預防便秘,是治療痔瘡的有效食品。

  白蘿卜生吃可促進消化,還有很強的消炎作用,其辛辣的成分可促胃液分泌,調整胃腸功能。另外,所含豐富的粗纖維,能促進胃腸蠕動,保持大便通暢。


  木耳菜又名西洋菜,肥厚而黏滑,俗稱木耳菜。其營養素含量極其豐富,經常食用有降血壓、益肝、清熱涼血、利尿、預防便秘等功效。

新華新聞

27% of India’s doctors exist only on paper

NEW DELHI: Around 27% of India’s registered doctors and almost 63% nurses aren’t active anymore.

Union health ministry’s presentation to the Consultative Committee, which included several MPs, admitted to some worrying trends in human resources in health.

According to joint secretary in the ministry Dr Vishwas Mehta’s presentation, the Medical Council of India (MCI) has 7.5 lakh doctors registered under it.

However, Union health ministry’s scrutiny has found that two lakh of the registered doctors aren’t working anymore. Of the 10.7 lakh nurses registered, six lakh don’t exist.

At present, there is only one doctor for every 2,000 population. The target is to have one doctor for every 1,000 population.

While the international nurse to doctor ratio is 3:1, India’s count stands at 1.5:1.

Besides, the number of female allopathic doctors (medical graduates with a bachelor’s or postgraduate specialist diploma or degree registered with the Indian Medical Council) is abysmally low.

Only 17% of all allopathic doctors and 6% of allopathic doctors in rural areas are women. There is less than one female allopathic doctor per 10,000 population in rural areas (0.5), whereas it is 6.5 in urban areas.

Union health minister Ghulam Nabi Azad informed the Committee that the ministry is giving a special push to nursing education.

“During the last two years, the ministry has sanctioned 132 Auxillary Nurse Midwives (ANM) and 137 General Nursing Midwifery (GNM) schools all over the country. These 269 schools will produce an additional 20,000 nurses every year. Six nursing colleges are also being established at the new AIIMS being set up under the Pradhan Mantri Swasthya Surakhsha Yojana and these will be functional by next year,” Azad said.

A skewed distribution of medical colleges is another big problem. The ministry’s presentation said 45% of medical colleges are located south India, with 47% of the MBBS seats. North India is home to 17% of the medical colleges, with 16% of the MBBS seats. Western India accounts for 21% of colleges and 22% of the MBBS seats.

In comparison, central India has 5% of medical colleges and 5% of MBBS seats, east has 10% of colleges and only 9% MBBS seats. Northeastern states are most neglected. It has only 3% of medical colleges and 3% MBBS seats.

The Planning Commission recently said geographic and rural-urban imbalance exists in training and availability of human resource. Medical colleges are unevenly spread across the states with wide disparities in the quality of education. Of the 640 districts, only 193 have a medical college.

Azad, however, said that in last three years alone the number of post-graduate seats to produce super specialty doctors has increased by more than 9,100. “The number of PG seats available in this academic year is 22,194 as against 13,043 in the year 2008-09. During 2009-12, 46 new medical colleges have been set up,” the minister added.

Under-representation of women in healthcare workforce is seriously affecting women’s access to health care. Now, nearly two-thirds or 66% of all health workers are men.

According to the paper “Human Resources for Health in India” published in the British Medical Journal The Lancet recently, one in five dentists are women, while there is one woman in 10 pharmacists.

Against a World Health Organization recommended norm of 23/25 health workers (doctors, nurses, midwives) per 10,000 population, India has 19 health workers per 10,000 (doctors – 6, nurses and midwives – 13).

India has 270 medical schools, from which 28,158 doctors graduate every year.

The southwestern states of Andhra Pradesh, Maharashtra, Karnataka, Kerala, and Tamil Nadu, which together account for 31% of India’s population, account for 58% of all medical colleges – both public and private – in the country.

Times of India

Kimia Farma Bangun RS Khusus Hati

JAKARTA – PT Kimia Farma Tbk (KAEF) mengalokasikan dana sebesar Rp300 miliar untuk membangun rumah sakit khusus penyakit hati.

Pembangunan rumah sakit khusus ini dengan menggandeng PT Trasforma Indonesia melalui pembentukan perusahaan patungan (joint venture/ JV). Direktur Utama Kimia Farma M Sjamsul Arifin mengatakan, perseroan telah mengajukan izin pembentukan perusahaan patungan ke Kementerian Hukum dan HAM.“Kita sudah ajukan nama PT Kimia Farma Hospital namun diganti menjadi PT Kimia Farma Medika karena tidak boleh menggunakan bahasa Inggris,” kata dia dalam paparan publik di Jakarta kemarin.

Dia mengungkapkan, dalam perusahaan patungan tersebut, Kimia Farma sebagai pemilik mayoritas, yaitu mencapai 60%. Perseroan pada tahap awal akan membangun rumah sakit di Jalan Saharjo, Jakarta Selatan. Targetnya, rumah sakit ini akan rampung pada akhir 2013. Setelah rumah sakit di Jakarta Selatan rampung, menyusul rumah sakit sejenis di sejumlah wilayah. “Kita punya lahan strategis, yang akan kita gunakan untuk membangun rumah sakit liver, di antaranya Makassar, Bandung, Surabaya, Denpasar, dan Medan,”imbuh Sjamsul.

Direktur Keuangan Kimia Farma Rusdi Rosman menambahkan, sumber pendanaan berasal dari perusahaan patungan dan akan mengeluarkan secara bertahap. Pada tahap pertama perseroan akan mengeluarkan dana sebesar Rp24 miliar. Dana tersebut di luar belanja modal (capital expenditure/ capex) perseroan tahun ini senilai Rp165 miliar. “Dalam RKAP (rencana kerja dan anggaran perusahaan), capex tahun ini kita anggarkan sebesar Rp165 miliar.Namun, nilai itu di luar pengembangan rumah sakit,”ujar Rusdi.

Berdasarkan roadmap perusahaan, pengembangan sejumlah rumah sakit ini akan memberi kontribusi sekitar 10% terhadap pendapatan perusahaan. Selain membangun rumah sakit baru, perseroan berencana mengakuisisi sejumlah rumah sakit milik BUMN. Sementara, Kimia Farma pada kuartal I tahun ini berhasil mencatat pertumbuhan penjualan bersih sebesar 11,9% menjadi Rp709,84 miliar, dibanding periode yang sama tahun sebelumnya yaitu Rp634,38 miliar.

Naiknya pendapatan mendorong naiknya laba bersih perseroan pada periode yang sama. Laba bersih perseroan tumbuh 27,4% menjadi Rp30,6 miliar dari posisi pada kuartal I tahun lalu senilai Rp24,02 miliar. Rusdi mengungkapkan, Kimia Farma pada tahun ini menargetkan penjualan mencapai Rp4 triliun dengan laba bersih Rp220 miliar. Jika rencana penggabungan (regrouping)dan penerbitan saham baru (rights issue) terealisasi tahun ini, kinerja perseroan tahun ini diperkirakan akan lebih tinggi.

Analis Indosurya Asset Management Reza Priyambada mengatakan, pasar sangat menanti hasil regrouping BUMN di sektor farmasi tersebut. Apalagi diperkirakan, pasar kedua perusahaan akan sangat besar.

The Hidden Dangers of Baby Bottles, Pacifiers and Sippy Cups

Toddlers, don’t drink and run (or walk): most falls while sucking on a bottle occur around age 1, when children often tend to be taking their first steps.

David Lees / Getty Images

David Lees / Getty Images

They’re synonymous with infancy, but baby bottles, pacifiers and sippy cups may not be as baby-friendly as parents would like.

Between 1991 and 2010, about 45,000 children under age 3 were treated in emergency rooms for injuries due to these products, according to a report in the journal Pediatrics. Most of the injuries were caused by toddlers falling while using them, with 71% of the injuries, including lacerations, mouth-related.

Most of these accidents occurred among 1-year-olds, who were more likely to be just taking their first unsteady steps, says Sarah Keim, a principal investigator at the Nationwide Children’s Hospital in Columbus, Ohio and the study’s lead author. Compared to infants under 1 year, these toddlers were 7.6 times more likely to take a tumble and be harmed by something they had in their mouths.

Perhaps more reassuring was the fact that other sources of injury, including defects in the products, were far less common, especially after manufacturers changed the design of pacifiers to include ventilating holes to prevent choking and asphyxiation.

The study is the first to take a nationwide look at the incidence of injuries related to these commonly used products and show that during the nearly two decades of the trial, the rate of injuries has dropped by nearly 30%. That’s good news, but Keim says parents could be paying more attention to how their toddlers are using bottles and sippy cups to lower the incidence even further.

“When parents go to baby-proof homes, especially when infants are more mobile, closer to age 1, they should consider other aspects of the environment in addition to the usual things like putting up baby gates,” she says, “These include things like the products their children are using, and they should think about habits they might want to start with their children, like eating and drinking at the table in order to help reduce injuries.”

Being aware of children’s changing mobility and physical skills is also important to make sure that infants are moving from bottles and pacifiers to sippy cups or even lidless cups when they are ready. The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommends that infants transition from bottles to cups without lids after 12 months, and following that advice may also help to reduce some of these injuries, says Keim.

In the study, over half of injuries among 2-year-olds involved a bottle, suggesting that a good proportion of toddlers aren’t learning to drink from lidless cups yet. Using cups — because they’re harder to hold — could also help youngsters get in the habit of sitting down or remaining still while drinking rather than moving around, which can increase their risk of falling.

 

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