MONDAY, Sept. 22 (HealthDay News) — People who are taking cholesterol-lowering statin drugs — which include Crestor, Lipitor, Pravachol and Zocor — are more likely to suffer delirium after surgery, a Canadian study indicates.
Delirium is a common, and commonly neglected, experience for older people after any sort of surgery, according to study lead author Dr. Donald A. Redelmeier, professor of medicine at the University of Toronto.
“It’s quite striking how some people are unable to recognize family members and don’t know where they are,” Redelmeier said. “It is sometimes prolonged and severe.”
His team published its findings in the Sept. 23 issue of the Canadian Medical Association Journal.
The study included more than 284,000 people, 65 years of age and older, who had surgery in Ontario hospitals. The researchers reported that the incidence of delirium was 1 out of every 90 patients, but it was 30 percent more likely to occur in those taking statins before surgery.
These statistics are almost certainly too low, however, because “there is no question that delirium is often overlooked by the surgeon or family members or even the patient himself,” Redelmeier said.
His estimate is that delirium occurs after about 10 percent of all surgical procedures, and that the incidence is 13 percent among people taking statins.
Redelmeier said he looked for a possible link between statins and post-op delirium, because “all clinical trials of statins focus on otherwise healthy outpatients under normal circumstances. Whereas, from my work in hospitals, I have found that medications that are safe under normal circumstances might not be safe at the time of surgery.” Blood-thinning medications such as Coumadin, as well as sleeping pills, are other examples of drugs that raise delirium risks, he said.
Statins might increase the risk of delirium by shunting blood away from the brain to the heart, the report proposed. “It is plausible, but there are no biological data to support it,” said one expert, Dr. Edward R. Marcantonio, associate professor of medicine at Harvard Medical School and the author of an accompanying editorial.
Marcantonio was also cautious about stopping statin therapy before surgery. “Before making a change in clinical management, I usually like to see stronger evidence in doing so,” he said.
Marcantonio cited other factors that argued against stopping statins. “We certainly don’t know the effect of taking patients off these drugs on outcomes other than delirium, such as cardiovascular conditions,” he said. “They may have cardiovascular benefits above and beyond their lipid-lowering effects.”
And, Marcantonio said, “There is always the risk of the drug never getting restarted.”
Redelmeier has no such doubts. An internist, he does not do surgery himself but is often called in for consultation by surgeons. “I take the position that a brief interruption, for one or two days prior to surgery, is extremely simple, and if desired, you could restart the statin right there in the recovery room after surgery, so you get protection without any interaction with anesthetics,” he reasoned.
More study is needed to settle the issue, Marcantonio said, and such a study would use better tools than those in the new report. Delirium has been underreported in the past because of reliance on reviews of medical records “or even abstraction into databases,” he said. “One of the real advances has been development of interview tools to enable assessment of delirium in a reliable way.”
Marcantonio has done such studies himself. “It is an expanding area of research — ongoing studies of delirium where data may be available to do this sort of evaluation,” he said. “Certainly, such a study is doable, perhaps within a couple of years.”
Wednesday, October 22, 2008
What Puts You at Risk for High Cholesterol?
Blood cholesterol is a risk factor for coronary artery disease and heart attack, so reducing your risk of high cholesterol is a worthy goal. However, the next time you brag that your cholesterol is nice and low—or lament that your number is in the mid-200s—know this: "Your total cholesterol is a pretty meaningless number," says Maureen Mays, MD, a preventive cardiologist and lipid specialist at Oregon Health & Science University in Portland. "Not only does the general public not know this, some doctors don't either."
Here's why "the number" is so misleading. Total cholesterol is calculated by adding LDL (bad cholesterol), HDL (good cholesterol), and one-fifth of your triglyceride total. "We have been using this formula of adding a bad thing to a good thing and factoring in one-fifth of a bad thing, and it's not useful," Dr. Mays says.
That's one reason 50% of people who have a heart attack have normal cholesterol readings.
Here's why "the number" is so misleading. Total cholesterol is calculated by adding LDL (bad cholesterol), HDL (good cholesterol), and one-fifth of your triglyceride total. "We have been using this formula of adding a bad thing to a good thing and factoring in one-fifth of a bad thing, and it's not useful," Dr. Mays says.
That's one reason 50% of people who have a heart attack have normal cholesterol readings.
What Stress Tests Reveal About Your Heart Health
Your doctor can't tell how well your heart is working until it's put to the test. If you have heart disease—or if you're at risk—your doctor may want to examine your heart during exercise. The stress test can spot hidden problems with your heart and help determine how much exercise you can safely handle.
Kit Cassak, 63, of Scottsdale, Ariz., had had a regular electrocardiogram (ECG or EKG) test in the past, but when she experienced shortness of breath and chest, arm, and jaw pain during physical activity, her doctor referred her to a cardiologist for a stress test. "They hooked up these different electrodes pretty much like an ECG, and they got me to walk on this treadmill, which I'd done during my normal workouts. In less than two minutes they started to see something on their screens and I told them I was feeling symptoms," she says. The cardiologist immediately stopped the test and referred her to the hospital for an angiogram to look for blockages in her blood vessels. The test determined that she needed open-heart surgery.
Kit Cassak, 63, of Scottsdale, Ariz., had had a regular electrocardiogram (ECG or EKG) test in the past, but when she experienced shortness of breath and chest, arm, and jaw pain during physical activity, her doctor referred her to a cardiologist for a stress test. "They hooked up these different electrodes pretty much like an ECG, and they got me to walk on this treadmill, which I'd done during my normal workouts. In less than two minutes they started to see something on their screens and I told them I was feeling symptoms," she says. The cardiologist immediately stopped the test and referred her to the hospital for an angiogram to look for blockages in her blood vessels. The test determined that she needed open-heart surgery.
What to Expect From an Echocardiogram
Doctors use ultrasound to detect a baby's first heartbeat, but it can also detect heart problems. An echocardiogram (ECG, EKG, or "echo" for short) uses ultrasound (high-frequency sound waves) to map the structure and functioning of the heart, and to uncover defects in the heart valves and chambers. The procedure is simple and painless.
How an "echo" works
You will lie on your back or on your left side on a bed or table. Small metal discs (electrodes) will be taped to your arms and legs to record your heart rate during the test. For more information, see the medical test Electrocardiogram.
A small amount of gel will be rubbed on the left side of your chest to help pick up the sound waves. A small instrument (transducer) which looks like a microphone, is pressed firmly against your chest and moved slowly back and forth. This instrument sends sound waves into the chest and picks up the echoes as they reflect off different parts of the heart. The echoes are sent to a video monitor that records pictures of your heart for later viewing and evaluation. The room is usually darkened to help the technician see the pictures on the monitor.
At times you will be asked to hold very still, breathe in and out very slowly, hold your breath, or lie on your left side. The transducer is usually moved to different areas on your chest that provide specific views of your heart.
The test usually takes from 30 to 60 minutes. When the test is over, the gel is wiped off and the electrodes are removed.
How an "echo" works
You will lie on your back or on your left side on a bed or table. Small metal discs (electrodes) will be taped to your arms and legs to record your heart rate during the test. For more information, see the medical test Electrocardiogram.
A small amount of gel will be rubbed on the left side of your chest to help pick up the sound waves. A small instrument (transducer) which looks like a microphone, is pressed firmly against your chest and moved slowly back and forth. This instrument sends sound waves into the chest and picks up the echoes as they reflect off different parts of the heart. The echoes are sent to a video monitor that records pictures of your heart for later viewing and evaluation. The room is usually darkened to help the technician see the pictures on the monitor.
At times you will be asked to hold very still, breathe in and out very slowly, hold your breath, or lie on your left side. The transducer is usually moved to different areas on your chest that provide specific views of your heart.
The test usually takes from 30 to 60 minutes. When the test is over, the gel is wiped off and the electrodes are removed.
What Tests Can and Can’t Reveal About Your Heart
Whether they’re trying to diagnose a problem or measure your progress, doctors have many ways to examine your heart. Tests may be as simple as a stethoscope exam to listen for an irregular heart rate, or as sophisticated as a three-dimensional computerized scan to get a clear image of your heart.
No matter how much technology is involved, no single test gives a complete picture of a patient’s risk for heart disease. Symptoms, age, lifestyle, health history, and gender all reveal important clues about a patient’s heart health.
Women may need different tests
And because women often experience heart disease differently from men, doctors are becoming more aware that diagnostic tests should be used differently for women and men, says C. Noel Bairey Merz, MD, medical director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles. Whether you’re a man or a woman, don’t hesitate to tell your doctor—and see a cardiologist if necessary—if you think you might be at risk for heart disease.
No matter how much technology is involved, no single test gives a complete picture of a patient’s risk for heart disease. Symptoms, age, lifestyle, health history, and gender all reveal important clues about a patient’s heart health.
Women may need different tests
And because women often experience heart disease differently from men, doctors are becoming more aware that diagnostic tests should be used differently for women and men, says C. Noel Bairey Merz, MD, medical director of the Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles. Whether you’re a man or a woman, don’t hesitate to tell your doctor—and see a cardiologist if necessary—if you think you might be at risk for heart disease.
Wednesday, August 27, 2008
How to Choose a Cardiologist
These state databases generally list a doctor's medical school, training hospital, certifications, and specialties, as well as any malpractice settlements and other disciplinary history. Another credential to keep an eye out for is Fellow of the American College of Cardiology (FACC), usually listed after MD. This is an elected fellowship to the leading professional society for heart specialists in the United States, based on achievement, community contribution, and peer recommendations.
Location: The overall quality of and reputation for cardiac care of the hospital where they practice is often a good benchmark for cardiologists. Several hospital rating services, such as the one offered by the Centers for Medicare and Medicaid Services, provide statistics on cardiac care. While patients might be inclined to select doctors from the biggest and best-known hospitals, Kit Cassak, a regional director for Mended Hearts, a national cardiac support network, suggests that patients should consider a small practice or hospital if it seems like it might be a better fit. "It's a bit like choosing which college to attend," she says.
Experience: A cardiologist's level of experience is critical, especially when it comes to a specific technology or procedure. Don't hesitate to ask a doctor how many times he or she has performed a surgery that you may be a candidate for. A 2005 study of more than 1,500 doctors who implanted cardiac defibrillators in their patients over a three-year period found that the rate of complications within three months of the surgery was roughly 60% higher for doctors who had implanted fewer than 10 of the devices than for doctors who'd implanted more than 29.
Gender: Your own gender, that is. Women tend to have different symptoms of heart disease and heart attack than men, in part because their bodies respond differently to risk factors such as high blood pressure. Cassak recommends asking a cardiologist about the extent of the training he or she has had specifically related to women's health—and when it took place. Women may want to seek out a specialist who is up-to-date in this emerging field of research. Cardiologists who specialize in women are more common than ever, and many hospitals—from the Mayo Clinic to small regional health centers—now have special clinics devoted to women's heart health.
Communication: When it comes to something as vital (and fickle) as the heart, personal rapport is nearly as important as credentials. When you first meet a cardiologist, be attentive to his or her willingness to answer questions and, just as important, ability to deliver answers in easy-to-understand terms.
Location: The overall quality of and reputation for cardiac care of the hospital where they practice is often a good benchmark for cardiologists. Several hospital rating services, such as the one offered by the Centers for Medicare and Medicaid Services, provide statistics on cardiac care. While patients might be inclined to select doctors from the biggest and best-known hospitals, Kit Cassak, a regional director for Mended Hearts, a national cardiac support network, suggests that patients should consider a small practice or hospital if it seems like it might be a better fit. "It's a bit like choosing which college to attend," she says.
Experience: A cardiologist's level of experience is critical, especially when it comes to a specific technology or procedure. Don't hesitate to ask a doctor how many times he or she has performed a surgery that you may be a candidate for. A 2005 study of more than 1,500 doctors who implanted cardiac defibrillators in their patients over a three-year period found that the rate of complications within three months of the surgery was roughly 60% higher for doctors who had implanted fewer than 10 of the devices than for doctors who'd implanted more than 29.
Gender: Your own gender, that is. Women tend to have different symptoms of heart disease and heart attack than men, in part because their bodies respond differently to risk factors such as high blood pressure. Cassak recommends asking a cardiologist about the extent of the training he or she has had specifically related to women's health—and when it took place. Women may want to seek out a specialist who is up-to-date in this emerging field of research. Cardiologists who specialize in women are more common than ever, and many hospitals—from the Mayo Clinic to small regional health centers—now have special clinics devoted to women's heart health.
Communication: When it comes to something as vital (and fickle) as the heart, personal rapport is nearly as important as credentials. When you first meet a cardiologist, be attentive to his or her willingness to answer questions and, just as important, ability to deliver answers in easy-to-understand terms.
5 Tips for Finding the Best Cardiologist for You
Most patients see a cardiologist for the first time after a referral from an internist or general practitioner. It can be unsettling even to realize you need a heart specialist. The process of switching cardiologists after a bad experience, or looking for one on your own, can be even more intimidating.
Comparing notes with friends, family members, and coworkers is a good way to start. But even if you have a referral from a doctor or a friend, it's important to do your own research and find a cardiologist who's right for you. Here are some important factors to keep in mind.
Credentials: In addition to their standard medical credentials, cardiologists are also certified in various subspecialties (such as interventional or nuclear cardiology) that may be important to consider in light of your condition. Most hospitals provide searchable online staff directories that list credentials and specialties, and you can also check with your state's medical board.
Comparing notes with friends, family members, and coworkers is a good way to start. But even if you have a referral from a doctor or a friend, it's important to do your own research and find a cardiologist who's right for you. Here are some important factors to keep in mind.
Credentials: In addition to their standard medical credentials, cardiologists are also certified in various subspecialties (such as interventional or nuclear cardiology) that may be important to consider in light of your condition. Most hospitals provide searchable online staff directories that list credentials and specialties, and you can also check with your state's medical board.
Tuesday, August 26, 2008
Pewarna rambut dapat meningkatkan risiko limfoma
Kalbe.co.id - Sebuah studi baru menjelaskan bahwa penggunaan pewarna rambut dapat meningkatkan risiko tipe-tipe tertentu non-Hodgkin lymphoma (NHL), suatu kanker darah pada saluran limfa.
Para penyelidik menjelakan bahwa penggunaan pewarna rambut secara pribadi merupakan faktor risiko NHL, namun studi yang menelusuri keterkaitan ini memberikan hasil yang tidak konsisten. Untuk menyelidiki isu ini, Dr. Yawei Zhang dari Yale University, New Haven dan koleganya mengumpulkan data dari 4 publikasi studi 'kasus kontrol'.
Analisis mencakup 4.461 kasus pasien NHL dan 5.799 kontrol. Diantara wanita, 75% kasus dan 70% kontrol telah menggunakan pewarna rambut. Diantara pria, 10% kedua kasus dan kontrol melakukan hal yang sama.
Secara keseluruhan, ada 30% peningkatan risiko NHL pada wanita (tapi tidak pada pria) yang mulai menggunakan pewarna rambut sebelum tahun 1980, dibandingkan dengan bukan pengguna. Dalam kelompok ini, risiko peningkatan NHL subtipe leukimia limfositik kronik(CLL)/limfoma limfositik kecil (SLL) dan limfoma folikel, tapi tidak subtipe NHL lain.
Zhang dan koleganya melaporkan bahwa wanita yang mulai menggunakan pewarna rambut tahun 1980 dan setelahnya, peningkatan risiko limfoma folikel terbatas pada pengguna cat rambut hitam.
Laporan mengindikasikan peningkatan risiko CLL/SLL terlihat pada wanita Eropa, tapi tidak pada wanita Amerika, sedangkan peningkatan risiko limfoma folikel terlihat pada wanita Eropa dan Amerika.
Para peneliti mengingatkan bahwa penggunaan pewarna rambut secara pribadi dapat berperan dalam peningkatan risiko NHL, khususnya linfoma folikel dan CLL/SLL. Studi ini juga mengindikasikan risiko berkaitan dengan penggunaan pewarna rambut pribadi terutama diamati pada wanita yang mulai menggunakan pewarna rambut sebelum 1980, risiko ini terbatas hanya pada wanita ini. Studi lanjutan diperlukan untuk menguji risiko NHL pada periode penggunaan dan kerentanan genetika.
Para penyelidik menjelakan bahwa penggunaan pewarna rambut secara pribadi merupakan faktor risiko NHL, namun studi yang menelusuri keterkaitan ini memberikan hasil yang tidak konsisten. Untuk menyelidiki isu ini, Dr. Yawei Zhang dari Yale University, New Haven dan koleganya mengumpulkan data dari 4 publikasi studi 'kasus kontrol'.
Analisis mencakup 4.461 kasus pasien NHL dan 5.799 kontrol. Diantara wanita, 75% kasus dan 70% kontrol telah menggunakan pewarna rambut. Diantara pria, 10% kedua kasus dan kontrol melakukan hal yang sama.
Secara keseluruhan, ada 30% peningkatan risiko NHL pada wanita (tapi tidak pada pria) yang mulai menggunakan pewarna rambut sebelum tahun 1980, dibandingkan dengan bukan pengguna. Dalam kelompok ini, risiko peningkatan NHL subtipe leukimia limfositik kronik(CLL)/limfoma limfositik kecil (SLL) dan limfoma folikel, tapi tidak subtipe NHL lain.
Zhang dan koleganya melaporkan bahwa wanita yang mulai menggunakan pewarna rambut tahun 1980 dan setelahnya, peningkatan risiko limfoma folikel terbatas pada pengguna cat rambut hitam.
Laporan mengindikasikan peningkatan risiko CLL/SLL terlihat pada wanita Eropa, tapi tidak pada wanita Amerika, sedangkan peningkatan risiko limfoma folikel terlihat pada wanita Eropa dan Amerika.
Para peneliti mengingatkan bahwa penggunaan pewarna rambut secara pribadi dapat berperan dalam peningkatan risiko NHL, khususnya linfoma folikel dan CLL/SLL. Studi ini juga mengindikasikan risiko berkaitan dengan penggunaan pewarna rambut pribadi terutama diamati pada wanita yang mulai menggunakan pewarna rambut sebelum 1980, risiko ini terbatas hanya pada wanita ini. Studi lanjutan diperlukan untuk menguji risiko NHL pada periode penggunaan dan kerentanan genetika.
Tramadol untuk terapi depresi
Kalbe.co.id - Pasien depresi yang susah sekali diobati, akhir-akhir ini tidak jarang dilakukan pengobatan dengan menggunakan derivat opioid seperti oxycodone dan oxymorphine serta obat golongan agonis parsial buprenorphine, tetapi akhir-akhir ini pasien dengan keadaan tersebut menunjukkan perbaikan setelah diterapi dengan tramadol hydrochloride secara monoterapi.
Awalnya publikasi terhadap terapi tramadol untuk kasus depresi dilaporkan dari hasil penelitian yang pernah dilakukan terhadap laki-laki, usia 64 tahun yang didiagnosis dengan depresi mayor kronik sesuai dengan DSM IV dan gambaran klinis melankolik lebih terlihat pada pasien. Pada episode pertama ditemukan pada tahun 1984 dan didiagnosis pada tahun 1986 dan akhirnya mendapatkan terapi obat secara berturut-turut dari mulai trisiklik amitriptyline, amoxapine, bupropion, clomipramine, doxepin, fluoxetine, fluvoxamine, imipramine, maprotiline, mirtazapine, nefazodone, paroxetine, phenelzine, sertraline, tranylcypromine, dan venlafaxine. Selanjutnya juga gagal dengan terapi bupropion, lithium, dan methylphenidate.
Penambahan terapi antidepresan, dan beberapa terapi antiansietas yang pernah dicoba tidak menunjukkan efektivitas termasuk diantaranya alprazolam, buspirone, clonazepam, lorazepam dan temazepam. Tidak juga dengan terapi suportif seperti psikoterapi dan terapi dengan ECT pun gagal.
Pada tahun 1998, pasien tersebut mengalami nyeri pada wajah akibat sunbatan pada kelenjar saliva, dan mendapatkan terapi dengan Tramadol untuk nyerinya, dan tidak pada saat itu tidak diterapi dengan pengobatan depresinya.
Dan apa yang terjadi di luar dugaan, bahwa pengobatan tramadol, membuat perbaikan depresinya hingga 60% sampai 70%. Sejak saat itulah diberikan tramadol secara terus menerus dengan dosis 100mg, 3 – 4 kali sehari. Jika pasien bangun jam 4 pagi, pasien benar merasakan jauh dari rasa tertekan.
Analgesik tramadol mempunyai banyak kesamaan dengan karakteristik antidepresan golongan SNRI Venlafaxine. Struktur obat yang bekerja pada 2 reseptor baik serotonin maupun norefinefrin, bahkan dari beberapa pasien mengalami depresi kembali setelah menghentikan tramadol setelah beberapa tahun terapi. Pasien terlihat baik efeknya setelah diterapi dengan Venlafaxine, telah terlihat efek pula bahwa Tramadol mempunyai efek profilaksi depresi. Karena efeknya sama dengan Venlafaxine, tramadol mungkin mempunyai tingkatan efek sebagai antidepresan selain untuk nyeri yang kronik.
Untuk kasus ketergantungan opioid seperti methadone, buprenorphine, dan clonidine. Tramadol mempunyai efek analgetik sentral dengan aktivitas opioid ang sama dengan rendahnya afinitas komponen utamanya dan mempunyai aktivitas yang tinggi terhadap ikatan terhadap metabolit O-demethylated untuk reseptor ยต opioid. Konsekuensinya, banyak yang bisa dijelaskan mengapa tramadol bisa digunakan untuk pasien putus obat opioid. Untuk itu dicobalah tramadol untuk terapi ketergantungan heroin yang tingkatannya moderat dengan uji klinik retrospektif kohort, yang dilakukan pada saat pasien menjalani program detoksifikasi pada sebuah RS, dimana jumlah yang ikut serta adalah 100 pecandu heroin yang masuk ke RS dan menjalani detoksifikasi selama beberapa periode, 64 pasien diterapi dengan buprenorphine atau tramadol, yang mana ikut serta, termasuk juga 20 pasien yang menggunakan buprenorphine dan 44 nya dengan tramadol. Dicocokkan juga untuk usia, seks dan hasil laporan secara kuantitas mengenai penggunaan heroin sehari-harinya. Ada kelompok yang menggunakan tramadol, nilai maksimum untuk pengukuran skalanya adalah 9,0, dan kelompok buprenorphine adalah 11,2 (P = 0,07). Pengguunaan clonidin oral perpasien pada kelompok tramadol adalah 1,6 tablet, dan buprenorphine adalah 0,1 tablet (P = 0,002). lamanya perawatan adalah 3,7 hari pada kelompok tramadol dan 4,1 untuk kelompok buprenorphine (P = 0,5). Peserta yang mendapatkan tramadok ada 4 orang telah mendapatkan 3 dosis atau lebih buprenorphine karena gejalanya tak terkontrol dan dinyatakan terapi gagal. Laporan preeliminari menunjukkan data bahwa mungkin tramadol sebanding dengan buprenorphine yang lebih besar lagi.
Awalnya publikasi terhadap terapi tramadol untuk kasus depresi dilaporkan dari hasil penelitian yang pernah dilakukan terhadap laki-laki, usia 64 tahun yang didiagnosis dengan depresi mayor kronik sesuai dengan DSM IV dan gambaran klinis melankolik lebih terlihat pada pasien. Pada episode pertama ditemukan pada tahun 1984 dan didiagnosis pada tahun 1986 dan akhirnya mendapatkan terapi obat secara berturut-turut dari mulai trisiklik amitriptyline, amoxapine, bupropion, clomipramine, doxepin, fluoxetine, fluvoxamine, imipramine, maprotiline, mirtazapine, nefazodone, paroxetine, phenelzine, sertraline, tranylcypromine, dan venlafaxine. Selanjutnya juga gagal dengan terapi bupropion, lithium, dan methylphenidate.
Penambahan terapi antidepresan, dan beberapa terapi antiansietas yang pernah dicoba tidak menunjukkan efektivitas termasuk diantaranya alprazolam, buspirone, clonazepam, lorazepam dan temazepam. Tidak juga dengan terapi suportif seperti psikoterapi dan terapi dengan ECT pun gagal.
Pada tahun 1998, pasien tersebut mengalami nyeri pada wajah akibat sunbatan pada kelenjar saliva, dan mendapatkan terapi dengan Tramadol untuk nyerinya, dan tidak pada saat itu tidak diterapi dengan pengobatan depresinya.
Dan apa yang terjadi di luar dugaan, bahwa pengobatan tramadol, membuat perbaikan depresinya hingga 60% sampai 70%. Sejak saat itulah diberikan tramadol secara terus menerus dengan dosis 100mg, 3 – 4 kali sehari. Jika pasien bangun jam 4 pagi, pasien benar merasakan jauh dari rasa tertekan.
Analgesik tramadol mempunyai banyak kesamaan dengan karakteristik antidepresan golongan SNRI Venlafaxine. Struktur obat yang bekerja pada 2 reseptor baik serotonin maupun norefinefrin, bahkan dari beberapa pasien mengalami depresi kembali setelah menghentikan tramadol setelah beberapa tahun terapi. Pasien terlihat baik efeknya setelah diterapi dengan Venlafaxine, telah terlihat efek pula bahwa Tramadol mempunyai efek profilaksi depresi. Karena efeknya sama dengan Venlafaxine, tramadol mungkin mempunyai tingkatan efek sebagai antidepresan selain untuk nyeri yang kronik.
Untuk kasus ketergantungan opioid seperti methadone, buprenorphine, dan clonidine. Tramadol mempunyai efek analgetik sentral dengan aktivitas opioid ang sama dengan rendahnya afinitas komponen utamanya dan mempunyai aktivitas yang tinggi terhadap ikatan terhadap metabolit O-demethylated untuk reseptor ยต opioid. Konsekuensinya, banyak yang bisa dijelaskan mengapa tramadol bisa digunakan untuk pasien putus obat opioid. Untuk itu dicobalah tramadol untuk terapi ketergantungan heroin yang tingkatannya moderat dengan uji klinik retrospektif kohort, yang dilakukan pada saat pasien menjalani program detoksifikasi pada sebuah RS, dimana jumlah yang ikut serta adalah 100 pecandu heroin yang masuk ke RS dan menjalani detoksifikasi selama beberapa periode, 64 pasien diterapi dengan buprenorphine atau tramadol, yang mana ikut serta, termasuk juga 20 pasien yang menggunakan buprenorphine dan 44 nya dengan tramadol. Dicocokkan juga untuk usia, seks dan hasil laporan secara kuantitas mengenai penggunaan heroin sehari-harinya. Ada kelompok yang menggunakan tramadol, nilai maksimum untuk pengukuran skalanya adalah 9,0, dan kelompok buprenorphine adalah 11,2 (P = 0,07). Pengguunaan clonidin oral perpasien pada kelompok tramadol adalah 1,6 tablet, dan buprenorphine adalah 0,1 tablet (P = 0,002). lamanya perawatan adalah 3,7 hari pada kelompok tramadol dan 4,1 untuk kelompok buprenorphine (P = 0,5). Peserta yang mendapatkan tramadok ada 4 orang telah mendapatkan 3 dosis atau lebih buprenorphine karena gejalanya tak terkontrol dan dinyatakan terapi gagal. Laporan preeliminari menunjukkan data bahwa mungkin tramadol sebanding dengan buprenorphine yang lebih besar lagi.
Ekstrak biji anggur dapat melawan alzheimer
Kalbe.co.id - Penelitian pada tikus mengungkapkan bahwa ekstrak biji anggur merah dalam sediaan minuman anggur merah, tanpa alkohol, dapat membantu melawan kehilangan memori akibat penyakit alzheimer.
Dr. Giulio maria Pasinetti dari Mount Sinai School of Medicine dan koleganya menemukan bahwa tikus yang mengalami perubahan otak seperti alzheimer menunjukkan funggsi kognitif lebih baik pada umur 11 bulan jika mereka diberikan ekstrak polifenol di dalam air minum mereka.
Senyawa polifenol merupakan antioksidan yang secara alami ditemukan di dalam anggur, teh cokelat dan beberapa sayuran dan buah. Tikusa dalam percobaan ini menerima kadar polifenol yang setara dengan polifenol pada manusia yang mengkonsumsi 1-2 gelas anggur (wine) sehari.
Sementara manfaat kesehatan yang sedang dari konsumsi anggur tidak begitu jelas, Passineti menjelaskan bahwa konsumsi sedang alkohol dalam bentuk anggur merah dapat menimbulkan komplikasi potensial bagi orang dengan penyakit metabolisme atau penyakit kardiovaskular.
Pasinetti dan tim menyelidiki apakah akstrak biji anggur yang dijual sebagai MegaNatural AZ dari polifenolics, suplier produk anggur berbasis di California, mungkin dapat mencegah berlanjutnya penyakit pada tikus. Polifenolics membantu mendanai penelitian ini.
Tikus menerima polifenol dengan jumlah setara 1 gram setiap hari pada manusia atau menerima air biasa. Setelah 5 bulan penanganan, ekstrak biji angggur yang dimakan mempunyai 30-50% lebih sedikit protein amiloid beta di dalam otak mereka. Protein amiloid beta merupakan tahap kunci dalam pembantukkan plak dan tangles di dalam otak penderita alheimer, sehingga pencegahannya dapat membantu memperlambat degenarasi otak.
Tikus yang ditangani dengan ekstrak juga menunjukkan performa lebih baik secara bermakna pada pengujian standar memori belajar spasial dibandingkan tikus yang tidka menerimanya. Namun, ekstrak tidak meningkatkan performa memalui jalan ruwet dalam tikus kontrol, yang menjelaskan bahwa hal ini memperbaiki fungsi kognitif dengan mengurangi kerusakan otak akibat pembentukan plak.
Dr. Giulio maria Pasinetti dari Mount Sinai School of Medicine dan koleganya menemukan bahwa tikus yang mengalami perubahan otak seperti alzheimer menunjukkan funggsi kognitif lebih baik pada umur 11 bulan jika mereka diberikan ekstrak polifenol di dalam air minum mereka.
Senyawa polifenol merupakan antioksidan yang secara alami ditemukan di dalam anggur, teh cokelat dan beberapa sayuran dan buah. Tikusa dalam percobaan ini menerima kadar polifenol yang setara dengan polifenol pada manusia yang mengkonsumsi 1-2 gelas anggur (wine) sehari.
Sementara manfaat kesehatan yang sedang dari konsumsi anggur tidak begitu jelas, Passineti menjelaskan bahwa konsumsi sedang alkohol dalam bentuk anggur merah dapat menimbulkan komplikasi potensial bagi orang dengan penyakit metabolisme atau penyakit kardiovaskular.
Pasinetti dan tim menyelidiki apakah akstrak biji anggur yang dijual sebagai MegaNatural AZ dari polifenolics, suplier produk anggur berbasis di California, mungkin dapat mencegah berlanjutnya penyakit pada tikus. Polifenolics membantu mendanai penelitian ini.
Tikus menerima polifenol dengan jumlah setara 1 gram setiap hari pada manusia atau menerima air biasa. Setelah 5 bulan penanganan, ekstrak biji angggur yang dimakan mempunyai 30-50% lebih sedikit protein amiloid beta di dalam otak mereka. Protein amiloid beta merupakan tahap kunci dalam pembantukkan plak dan tangles di dalam otak penderita alheimer, sehingga pencegahannya dapat membantu memperlambat degenarasi otak.
Tikus yang ditangani dengan ekstrak juga menunjukkan performa lebih baik secara bermakna pada pengujian standar memori belajar spasial dibandingkan tikus yang tidka menerimanya. Namun, ekstrak tidak meningkatkan performa memalui jalan ruwet dalam tikus kontrol, yang menjelaskan bahwa hal ini memperbaiki fungsi kognitif dengan mengurangi kerusakan otak akibat pembentukan plak.
Semangka merupakan Viagra alami
Kalbe.co.id - Menurut sebuah studi oleh para peneliti di Texas A&M Fruit and Vegetable Improvement Center, semangka menghasilkan efek yang mirip dengan Viagra dan obat-obat lain yang digunakan untuk disfungsi ereksi.
Penelitian difokuskan pada dampak semangka terhadap tubuh. Ternyata, semangka mengandung sitrulina (citrulline). Sitrulina dalam semangka memproduksi asam amino yang disebut arginin, yang secara nyata membantu rileks dan membesarkan pembuluh darah. Suatu hal yang sama dengan Sildenafil citrat (Viagra) dan obat-obat sejenis.
Peneliti Texas A&M menyatakan bahwa mereka perlu melakukan lebih banyak riset sebelum dapat menggambarkan berapa banyak semangka yang harus dikonsumsi untuk mendapatkan hasil yang sama dengan Viagra.
Jadi berapa banyak semangka yang harus dimakan untuk mendapatkan hasil yang sama ? Ilmuwan Texas A&M menyatakan bahwa Anda perlu makan di atas 6 cangkir semangka setiap hari untuk mendapatkan hasil yang sama.
Penelitian ini menyebabkan banyak orang menyebut semangka sebagai Viagra alami.
Penelitian difokuskan pada dampak semangka terhadap tubuh. Ternyata, semangka mengandung sitrulina (citrulline). Sitrulina dalam semangka memproduksi asam amino yang disebut arginin, yang secara nyata membantu rileks dan membesarkan pembuluh darah. Suatu hal yang sama dengan Sildenafil citrat (Viagra) dan obat-obat sejenis.
Peneliti Texas A&M menyatakan bahwa mereka perlu melakukan lebih banyak riset sebelum dapat menggambarkan berapa banyak semangka yang harus dikonsumsi untuk mendapatkan hasil yang sama dengan Viagra.
Jadi berapa banyak semangka yang harus dimakan untuk mendapatkan hasil yang sama ? Ilmuwan Texas A&M menyatakan bahwa Anda perlu makan di atas 6 cangkir semangka setiap hari untuk mendapatkan hasil yang sama.
Penelitian ini menyebabkan banyak orang menyebut semangka sebagai Viagra alami.
Sarapan pagi banyak dan seimbang membantu penurunan berat
Kalbe.co.id - Menurut studi baru, memulai hari Anda dengan sarapan pagi yang banyak mengandung karbohidrat dan protein serta sepotong kecil cokelat dapat membantu mengurangi rasa lapar sepanjang hari, sehingga mengarah pada penurunan berat badan yang signifikan.
Penelitian baru yang dipresentasikan di pertemuan tahunan Endocrine Society, San Fransisco, Juni 2008 menemukan bahwa wanita obes kehilangan hampir 5 kali lipat beratnya pada diet makan pagi 'besar' dibandingkan wanita yang mengikuti diet tradisional, pantangan karbohidrat rendah.
Dr. Daniela Jakubowicz, seorang profesor klinis di Virginia Commonwealth University dan ahli endokrin di Hospital de Clinicas Caracas Venezuela mengatakan, "Kami mengangani orang obes dengan memberitahu mereka untuk kurangi makan dan olahraga lebih banyak, namun hal itu tidak memperhitungkan keinginan makan dan rasa lapar. Kami harus mengubah pendekatan dan menemukan diet yang dapat mengontrol keinginan makan dan rasa lapar.
Jakubowitcz menjelaskan bahwa ketika kita bangun di pagi hari, tubuh kita siap mencari makanan. Metabolisme kita meningkat, kadar kortisol dan adrenalin berada pada kadar puncaknya. Otak kita perlu energi segera dan jika kita tidak makan atau makan terlalu sedikit, otak akan mencari sumber energi pembakaran. Untuk itu, aktivitas sistem darurat menarik energi dari otot, menghancurkan jaringan otot dalam prosesnya. Lalu ketika kita makan selanjutnya, tubuh dan otak masih dalam keadaan siaga tinggi, sehingga tubuh menyimpan makanan sebagai lemak, lanjutnya.
Menurut Jakubowicz, kadar bahan kimia serotonin dalam otak tertinggi di pagi hari, yang berarti tingkat keinginan makan Anda terendah ketika bangun pagi dan Anda mungkin tidak punya keinginan makan. Namun, ketika menjelang siang, kadar serotonin meningkat dan Anda ingin makan cokelat atau kue dan sejenisnya. Jika Anda makan makanan ini, kadar serotonin meningkat dan tubuh Anda mulai merasa nyaman, menghasilkan siklus ketagihan.
Untuk melawan siklus ketagihan dan rasa lapar tampaknya tak terelakkan saat pengurangan kalori, Jakubowicz dan koleganya merancang diet 'sarapan besar'. Dalam rencana makan ini, 2 potong keju, 2 sediaan biji-bijian, 1 olahan lemak dan 1 ons coklat susu atau permen.
Protein tinggi, campuran karbohidrat memberi tubuh energi awal untuk kebutuhan di pagi hari. Selanjutnya pada siang hari, makanan yang mengandung protein dan karbohidrat kompleks, seperti sayuran. karena protein dicerna lebih pendek, Anda tidak merasa lapar.
Dalam studi pada 94 wanita obes dengan sindroma metabolik, setengah mereka yang diberi tahu untuk diet sarapan pagi besar yang mengandung sekitar 1.240 kalori, sedangkan yang lain makan setengahnya sekitar 1.085 kalori diet tinggi protein, karbohidrat rendah selama 8 bulan.
Pada akhir bulan ke-8, mereka yang diet lebih ketat karbohidrat rendah kehilangan rata-rata 4,1 kg. namun mereka yang diet sarapan 'besar' turun hampir 18,1 kg. Hal ini sebanding dengan penurunan indeks massa tubuh rata-rata 4,5% dari mereka yang diet karbohidrat rendah dan 21,3% penurunan rata-rata dari mereka yang sarapan pagi 'besar'.
Seorang ahli nutrisi Gery Brewster mengatakan bahwa dia pernah merekomendasikan sarapan pagi seimbang dan 'besar' pada semua kliennya, karena membantu menjaga kadar gula darah tetap stabil. Menurutnya, bila kita makan sarapan tradisional, seperti sereal atau donat, kadar gula dan insulin meningkat. Sekali kadar gula darah meningkat, Anda masih punya kelebihan insulin yang sirkulasi, yang membuat Anda lapar dan keinginan makan karbohidrat.
Studi kedua yang dipresentasikan di pertemuan menekankan ide bahwa perubahan biologis terjadi jika Anda kelebihan berat. Studi ini menemukan bahwa wanita yang kelebihan berat badan tidak mengalami penurunan kadar leptin setelah berolahraga seperti halnya wanita biasa lakukan. Leptin adalah hormon yang memainkan peran dalam regulasi dan metabolisme. Brewster mengatakan dirinya tidak terkejut dengan temuan ini, karena sekali tubuh kelebihan berat badan, ia akan mempertahankan ukuran tersebut. Sel-sel lemak menjadi sistem mini endokrin sendiri untuk mempertahankan obesitas dan menjaga kadar leptin meningkat tampaknya merupakan salah satu upaya tubuh melakukan hal itu.
Penelitian baru yang dipresentasikan di pertemuan tahunan Endocrine Society, San Fransisco, Juni 2008 menemukan bahwa wanita obes kehilangan hampir 5 kali lipat beratnya pada diet makan pagi 'besar' dibandingkan wanita yang mengikuti diet tradisional, pantangan karbohidrat rendah.
Dr. Daniela Jakubowicz, seorang profesor klinis di Virginia Commonwealth University dan ahli endokrin di Hospital de Clinicas Caracas Venezuela mengatakan, "Kami mengangani orang obes dengan memberitahu mereka untuk kurangi makan dan olahraga lebih banyak, namun hal itu tidak memperhitungkan keinginan makan dan rasa lapar. Kami harus mengubah pendekatan dan menemukan diet yang dapat mengontrol keinginan makan dan rasa lapar.
Jakubowitcz menjelaskan bahwa ketika kita bangun di pagi hari, tubuh kita siap mencari makanan. Metabolisme kita meningkat, kadar kortisol dan adrenalin berada pada kadar puncaknya. Otak kita perlu energi segera dan jika kita tidak makan atau makan terlalu sedikit, otak akan mencari sumber energi pembakaran. Untuk itu, aktivitas sistem darurat menarik energi dari otot, menghancurkan jaringan otot dalam prosesnya. Lalu ketika kita makan selanjutnya, tubuh dan otak masih dalam keadaan siaga tinggi, sehingga tubuh menyimpan makanan sebagai lemak, lanjutnya.
Menurut Jakubowicz, kadar bahan kimia serotonin dalam otak tertinggi di pagi hari, yang berarti tingkat keinginan makan Anda terendah ketika bangun pagi dan Anda mungkin tidak punya keinginan makan. Namun, ketika menjelang siang, kadar serotonin meningkat dan Anda ingin makan cokelat atau kue dan sejenisnya. Jika Anda makan makanan ini, kadar serotonin meningkat dan tubuh Anda mulai merasa nyaman, menghasilkan siklus ketagihan.
Untuk melawan siklus ketagihan dan rasa lapar tampaknya tak terelakkan saat pengurangan kalori, Jakubowicz dan koleganya merancang diet 'sarapan besar'. Dalam rencana makan ini, 2 potong keju, 2 sediaan biji-bijian, 1 olahan lemak dan 1 ons coklat susu atau permen.
Protein tinggi, campuran karbohidrat memberi tubuh energi awal untuk kebutuhan di pagi hari. Selanjutnya pada siang hari, makanan yang mengandung protein dan karbohidrat kompleks, seperti sayuran. karena protein dicerna lebih pendek, Anda tidak merasa lapar.
Dalam studi pada 94 wanita obes dengan sindroma metabolik, setengah mereka yang diberi tahu untuk diet sarapan pagi besar yang mengandung sekitar 1.240 kalori, sedangkan yang lain makan setengahnya sekitar 1.085 kalori diet tinggi protein, karbohidrat rendah selama 8 bulan.
Pada akhir bulan ke-8, mereka yang diet lebih ketat karbohidrat rendah kehilangan rata-rata 4,1 kg. namun mereka yang diet sarapan 'besar' turun hampir 18,1 kg. Hal ini sebanding dengan penurunan indeks massa tubuh rata-rata 4,5% dari mereka yang diet karbohidrat rendah dan 21,3% penurunan rata-rata dari mereka yang sarapan pagi 'besar'.
Seorang ahli nutrisi Gery Brewster mengatakan bahwa dia pernah merekomendasikan sarapan pagi seimbang dan 'besar' pada semua kliennya, karena membantu menjaga kadar gula darah tetap stabil. Menurutnya, bila kita makan sarapan tradisional, seperti sereal atau donat, kadar gula dan insulin meningkat. Sekali kadar gula darah meningkat, Anda masih punya kelebihan insulin yang sirkulasi, yang membuat Anda lapar dan keinginan makan karbohidrat.
Studi kedua yang dipresentasikan di pertemuan menekankan ide bahwa perubahan biologis terjadi jika Anda kelebihan berat. Studi ini menemukan bahwa wanita yang kelebihan berat badan tidak mengalami penurunan kadar leptin setelah berolahraga seperti halnya wanita biasa lakukan. Leptin adalah hormon yang memainkan peran dalam regulasi dan metabolisme. Brewster mengatakan dirinya tidak terkejut dengan temuan ini, karena sekali tubuh kelebihan berat badan, ia akan mempertahankan ukuran tersebut. Sel-sel lemak menjadi sistem mini endokrin sendiri untuk mempertahankan obesitas dan menjaga kadar leptin meningkat tampaknya merupakan salah satu upaya tubuh melakukan hal itu.
Belimbing dapat menjadi racun bagi pasien ginjal
Kalbe.co.id - Banyak nasehat dari nenek moyang bahwa belimbing (star fruit) bisa menurunkan hipertensi. Sayangnya jika kita mengkonsumsi belimbing, bukannya tensi turun malah berbahaya.
Makan 1 biji atau 100 ml jus belimbing yang biasanya aman dapat menjadi racun bagi pasien ginjal dalam hitungan jam. Konsultan ginjal (nefrologist) Prof. Dr. Tan Si-Yen dari University Malaya Medical Centre (UMMC) mengatakan hal ini terjadi pada Tan Gon Seang, yang menderita penyakit ginjal. Warganegara malaysia berumur 66 tahun ini berada di Shenzen mengunjungi anaknya ketika meninggal pada tanggal 29 maret setelah makan belimbing dan dibawa ke Shenzen General Hospital dalam keadaan koma.
Menurut Prof. Tan, belimbing mengandung racun saraf, yang tidak ada di dalam buah lain, yang mempengaruhi otak dan saraf. pada orang dewasa sehat, ginjal menyaring dan membuangnya. Pada pasien ginjal, racun ini tidak dapat dibuang dan memperburuk keadaan ginjalnya. Lebih dari 10 pasien lain masuk rumah sakit menderita kondisi yang sama setelah mengkonsumsi belimbing. Dua diantara mereka meninggal.
Setelah penemuan berkaitan denga belimbing, Tang menjalani dialisis. Sepupunya, Teoh Thian Lye, 55 tahun, mengkonfirmasi bahwa Tang telah menjalani pengobatan masalah ginjalnya selama 3 tahun. Keluarganya meminta bantuan kepala MCA Public Compliants and Service Departement, Datuk Michael Chong untuk mengirimkan Tang kembali ke Malaysia karena kelurganya tidak dapat membiayai rumah sakit 1.000-2.000 ringgit malaysia (RM) per hari di ruang intensif.
Menurut Dr. Tan, masih sedikit kepedulian pada temuan yang relatif baru ini dan belum ada kasus secara lokal. Masyarakat harus hati-hati dengan rekasi dari buah belimbing. Amati gejala awalnya termasuk cegukan (tersedak), mati rasa dan kelelahan serta gejala-gejala neurologis seperti bingung, gelisah, epilepsi tiba-tiba, lanjutnya. Risiko kematiannya tinggi dan perlu penanganan agresif segera dengan hemodialisis harian.
Makan 1 biji atau 100 ml jus belimbing yang biasanya aman dapat menjadi racun bagi pasien ginjal dalam hitungan jam. Konsultan ginjal (nefrologist) Prof. Dr. Tan Si-Yen dari University Malaya Medical Centre (UMMC) mengatakan hal ini terjadi pada Tan Gon Seang, yang menderita penyakit ginjal. Warganegara malaysia berumur 66 tahun ini berada di Shenzen mengunjungi anaknya ketika meninggal pada tanggal 29 maret setelah makan belimbing dan dibawa ke Shenzen General Hospital dalam keadaan koma.
Menurut Prof. Tan, belimbing mengandung racun saraf, yang tidak ada di dalam buah lain, yang mempengaruhi otak dan saraf. pada orang dewasa sehat, ginjal menyaring dan membuangnya. Pada pasien ginjal, racun ini tidak dapat dibuang dan memperburuk keadaan ginjalnya. Lebih dari 10 pasien lain masuk rumah sakit menderita kondisi yang sama setelah mengkonsumsi belimbing. Dua diantara mereka meninggal.
Setelah penemuan berkaitan denga belimbing, Tang menjalani dialisis. Sepupunya, Teoh Thian Lye, 55 tahun, mengkonfirmasi bahwa Tang telah menjalani pengobatan masalah ginjalnya selama 3 tahun. Keluarganya meminta bantuan kepala MCA Public Compliants and Service Departement, Datuk Michael Chong untuk mengirimkan Tang kembali ke Malaysia karena kelurganya tidak dapat membiayai rumah sakit 1.000-2.000 ringgit malaysia (RM) per hari di ruang intensif.
Menurut Dr. Tan, masih sedikit kepedulian pada temuan yang relatif baru ini dan belum ada kasus secara lokal. Masyarakat harus hati-hati dengan rekasi dari buah belimbing. Amati gejala awalnya termasuk cegukan (tersedak), mati rasa dan kelelahan serta gejala-gejala neurologis seperti bingung, gelisah, epilepsi tiba-tiba, lanjutnya. Risiko kematiannya tinggi dan perlu penanganan agresif segera dengan hemodialisis harian.
Standar keamanan baru untuk susu formula bayi dan kacang
Kalbe.co.id - Para utusan di Genewa telah menyetujui batasan baru bakteri di dalam susu formula bayi dan racun alami dalam kacang, yang dijadikan standar keamanan untuk penajuan makanan yang dipasarkan secara internasional. Pada pertemuan the Codex Alimentarius Commsission, sebuah badan bersama antara WHO dan Food and Agriculture Organisation (FAO).
Peter Ben Embarek, ilmuwan dari divisi keamanan pangan WHO mengatakan bahwa adopsi penandaan praktek higienis untuk formula bubuk dapat menurunkan kontaminasi ari 2 bakteri yang dapat menyebabkan sakit parah dan kematian pada bayi.
Orang-orang dengan alergi gandum juga dilindungi oleh standar makanan bebas gluten dimana negara-negara memasukkan hal ini di dalam hukum negaranya dan dalam rangka memenuhi aturan WTO untuk makanan ekspornya. Negara harus menggunakan standar ini agar dapat menjualnya di pasar internasional.
Rujukan baru menyebutkan bahwa makanan bebas gluten tidak boleh mengandung gandum, rye, barley atau oats dan kadar glutennya tidak boleh melebihi 20 mg per kg. Intoleransi gluten dapat menyebabkan gejala bervariasi dari nyeri abdominal sampai osteoporosis.
Sebanyak 124 negara berpartisipasi dalam pertemuan Codex bulan Juli 2008 juga menyetujui kadar maskimum aflatoksin, sebuah toksin alami yang diketahui sebagai karsinogen di lab.
The Codex Alimentarius atau kode produk merupakan rujukan global bagi konsumen, penghasil produk, pemroses makanan, lembaga pengontrol makanan nasional dan pedagang makanan internasional. Standar ini berarti untuk mencegah kontaminasi, sakit, merupakan patokan negara-negara WTO berkaitan dengan persetujuan perdagangan internasional mengenai keamanan makanan dan sanitasi.
Komisi yang merangkap keanggotaan penuh dari 176 negara ditambah Uni Eropa juga melakukan diskusi dampak obat veteriner, pakan ternak dan pestisida terhadap keamanan pangan.
Peter Ben Embarek, ilmuwan dari divisi keamanan pangan WHO mengatakan bahwa adopsi penandaan praktek higienis untuk formula bubuk dapat menurunkan kontaminasi ari 2 bakteri yang dapat menyebabkan sakit parah dan kematian pada bayi.
Orang-orang dengan alergi gandum juga dilindungi oleh standar makanan bebas gluten dimana negara-negara memasukkan hal ini di dalam hukum negaranya dan dalam rangka memenuhi aturan WTO untuk makanan ekspornya. Negara harus menggunakan standar ini agar dapat menjualnya di pasar internasional.
Rujukan baru menyebutkan bahwa makanan bebas gluten tidak boleh mengandung gandum, rye, barley atau oats dan kadar glutennya tidak boleh melebihi 20 mg per kg. Intoleransi gluten dapat menyebabkan gejala bervariasi dari nyeri abdominal sampai osteoporosis.
Sebanyak 124 negara berpartisipasi dalam pertemuan Codex bulan Juli 2008 juga menyetujui kadar maskimum aflatoksin, sebuah toksin alami yang diketahui sebagai karsinogen di lab.
The Codex Alimentarius atau kode produk merupakan rujukan global bagi konsumen, penghasil produk, pemroses makanan, lembaga pengontrol makanan nasional dan pedagang makanan internasional. Standar ini berarti untuk mencegah kontaminasi, sakit, merupakan patokan negara-negara WTO berkaitan dengan persetujuan perdagangan internasional mengenai keamanan makanan dan sanitasi.
Komisi yang merangkap keanggotaan penuh dari 176 negara ditambah Uni Eropa juga melakukan diskusi dampak obat veteriner, pakan ternak dan pestisida terhadap keamanan pangan.
Examining Links Between AIDS And Climate Change
For that reason, several UN agencies, research institutes from Switzerland, India, South Africa and Canada as well as the International Federation of Red Cross and Red Crescent Societies gathered to analyse the existing links between AIDS and climate change in a technical meeting held in Nyon, Switzerland, on 20 May 2008.
Furthermore, a joint position paper on AIDS and climate change was commissioned by UNEP and UNAIDS from the Australian National University in February 2008. This paper, whose findings where also discussed at the Nyon meeting, focuses on scientific issues,
identifying major, minor, and speculative pathways by which HIV and climate change are likely to interact.
Summary report from the Joint UNEP-UNAIDS meeting to review a position paper on HIV and AIDS and Climate Change A joint position paper on HIV and AIDS and Climate Change was commissioned by UNEP and UNAIDS in February 2008. The draft paper
prepared by three consultants from the Australian National University, Professor Tony McMichael, Dr. Colin Butler and Dr. Haylee Weaver, was reviewed in a technical meeting held in Nyon, Switzerland, on 20 May, 2008.
Several UN agencies, research institutes from Switzerland, India, South Africa and Canada as well as the International Federation of Red Cross and Red Crescent Societies were represented at the meeting.
Described below are highlights of the main findings from the paper as well as resulting consensus on the way forward. HIV and AIDS and Climate Change are two of the most important "long wave" global issues of the recent past, the present and the future.
They share similarities, interactions, and present possibilities for a more united response. Yet, these links have received little analysis. This paper seeks to address that gap. It first focuses on scientific issues, identifying major, minor, and speculative pathways
by which HIV and climate change are likely to interact. These interactions are, here, called the HIV and Climate Change Complex (HACC).
The maximum impact of Climate Change is in the future, likely to occur decades after the peak incidence of HIV. The severity of the HACC will largely be determined by the temporal overlap of these ranges. The HACC will also have an uneven spatial distribution,
modified by the regional impact of Climate Change and the regional epidemiology of HIV, each of which varies by physical and social elements.
Populations with currently high rates of HIV are the most vulnerable to a worsening or prolongation of the epidemic due to climate change. This places the people of Sub-Saharan Africa (SSA) at the greatest risk of the HACC, though outside Africa populations, in north east India and New Guinea may also be significantly impacted.
There is agreement that the most important pathway in the HACC will be further deterioration of regional and global food security. At the individual level, nutrition is vital for good immune function, to reduce the risk of acquiring HIV if viral exposure does occur, and to slow the progression of HIV to AIDS, and of AIDS to death.
At larger scales, population nutrition is important for good governance, by helping to nurture and stimulate the "effective" demand populations need to reduce corruption and to more evenly distribute available resources. Any substantial decline in the availability and intake of calories or micronutrients brought about by Climate Change is likely to increase poverty, impair learning and expand the number of migrants. The current decline in global food
security, partly attributable to Climate Change, is already causing disproportionate nutritional harm to migrants and otherwise impoverished populations, some of whom
experience HIV and AIDS.
There is agreement that the second major pathway of the HACC is the Climate Change related alteration in the distribution of infectious diseases, which interact with HIV. Of these, malaria is the most important, due to its high burden of disease. Climate Change is
projected to reduce malaria transmission in some regions, which experience a comparatively low rate of HIV, both now and in the future.
This will reduce the beneficial impact to the burden of disease of HIV for these populations. On the other hand, a large population with a high rate of HIV lives on the plateaus of SSA, an area as yet little affected by malaria. If the climatic, eco-systemic and other
factors for malaria transmission alter sufficiently in these plateau cities, then the HIV burden of this population is likely to be substantially higher, and will also be worsened by increased poverty and greater food insecurity.
There are several other plausible biological pathways in the HACC. Of these, the relationship between Climate Change, air pollution and immunity, and Climate Change, heat stress and immunity are likely to be the most important.
More speculative is the possibility that Climate Change will harm infrastructure and governance on a scale sufficient to aggravate and prolong the burden of disease of HIV.
Again, the population of SSA is judged to be at the highest risk. This mechanism is plausible by interlinked pathways including more extreme weather events and "natural" disasters, increased mobility and additional migrants and refugees.
These factors are also likely to aggravate gender inequalities, increasing the frequency of transactional and coercive sex — pathways likely to increase the burden of disease of HIV among women and girls, via increased viral transmission and reduced access to
treatment and prevention. At the global level, Climate Change may exert an immense opportunity cost, diverting resources of the international community away from public health, including from HIV, poverty alleviation, and the other Millennium Development Goals
(MDGs).
Suggestions for a future research agenda include the more accurate assessment of the pathways within the HACC, and an improved conceptual understanding of the linkages between conflict, behaviour, governance and values, environmental factors including climate, and food production, and between each of these macro-elements and sea
level rise. This would be best done by an interdisciplinary working group.
Another research gap is the effect of Climate Change on human behavior, including behavior related directly to HIV risk. From science, the paper moves to strategies and policies. The struggle to address HIV and Climate Change has generated two vigorous
global social movements, with, as yet, little formal interaction or collaboration.
We suggest this gap is a microcosm of a separation between two even larger communities – those concerned with the environment and those concerned with social justice. Of course, this is a simplification, but on the whole our perception is that the environmental movement is insufficiently aware of poverty, while the social justice movement is still poorly informed
about the environment. The work, advocacy and activism of the leaders and actors within each community who do recognise these linkages will be strengthened by this report.
HIV has already killed tens of millions of people, while Climate Change may dwarf this number. Those concerned to reduce Climate Change can apply many lessons learned by the HIV community. These include the need to challenge conventions and to seek benefit
for the poorest and most marginalised; and to widen the Climate Change movement's emerging engagement with entrepreneurs, philanthropists and prominent personalities: tools instrumental in the growth of support for those with HIV. The HIV constituency can
benefit from the experience of humanitarian programmes, some of which already see HIV and Climate Change as cross-cutting issues.
Several actions to reduce the impact of Climate Change on HIV and AIDS are proposed.
These include the integration of HIV prevention and management into disaster management plans, particularly for populations in SSA, some of whom have already experienced extreme weather events.
Means to enhance global and regional food security, especially in SSA, are vital, and much more can be done. A quarter of the world's population is over-nourished, and a more equitable distribution of global food production will go far to defusing any future food
crisis, and is likely to improve health for both over and under-fed people. Malaria treatment and prevention in SSA can also be improved.
The Climate Change community might also consider strengthening the United Nations Framework Convention on Climate Change (UNFCCC) including formal links with agriculture, health and security.
Finally, a risk is perceived whereby a relatively privileged stratum of people and interests argue that issues of global health and global social justice must be put aside in the effort to pursue partial Climate Change adaptation.
This approach is highly dangerous for global health and global social cohesion. It would also likely to generate profound longer-term risks for currently privileged populations pursuing this strategy. A stronger alliance between the HIV and AIDS and Climate Change communities will help thwart the emergence of such a policy.
A focus on the interconnections between Climate Change, food security, HIV, health in general and the links between these and the MDGs is key to breaking out of this "either or" myopia. UNEP and UNAIDS are committed to carrying forward recommendations
resulting from the above. The draft position paper is currently being finalized, after which it
will be subjected to wider consultation to both encourage civil society engagement and expand the partnership between HIV and AIDS and Climate Change constituencies. In concurring that there is a link between Climate Change and HIV and AIDS, participants at the Nyon meeting clearly pointed out that this link needs to be understood better.
They also concurred that this process of taking forward the research agenda should be spearheaded by the Health Economics and HIV and AIDS Research Division (HEARD) at the University of KwaZulu-Natal, South Africa, supported by the partnering Department of Geography and Environmental Studies, Carleton University, Canada, and the National
Centre for Epidemiology and Population Health, Australian National University.
The UN will continue to play an integral role in all of this through partnership development and by participation in various forums related to the research agenda.
Source : Elizabeth Swanti
Society of Indonesian Health Journalist
Redaksi Idionline
Furthermore, a joint position paper on AIDS and climate change was commissioned by UNEP and UNAIDS from the Australian National University in February 2008. This paper, whose findings where also discussed at the Nyon meeting, focuses on scientific issues,
identifying major, minor, and speculative pathways by which HIV and climate change are likely to interact.
Summary report from the Joint UNEP-UNAIDS meeting to review a position paper on HIV and AIDS and Climate Change A joint position paper on HIV and AIDS and Climate Change was commissioned by UNEP and UNAIDS in February 2008. The draft paper
prepared by three consultants from the Australian National University, Professor Tony McMichael, Dr. Colin Butler and Dr. Haylee Weaver, was reviewed in a technical meeting held in Nyon, Switzerland, on 20 May, 2008.
Several UN agencies, research institutes from Switzerland, India, South Africa and Canada as well as the International Federation of Red Cross and Red Crescent Societies were represented at the meeting.
Described below are highlights of the main findings from the paper as well as resulting consensus on the way forward. HIV and AIDS and Climate Change are two of the most important "long wave" global issues of the recent past, the present and the future.
They share similarities, interactions, and present possibilities for a more united response. Yet, these links have received little analysis. This paper seeks to address that gap. It first focuses on scientific issues, identifying major, minor, and speculative pathways
by which HIV and climate change are likely to interact. These interactions are, here, called the HIV and Climate Change Complex (HACC).
The maximum impact of Climate Change is in the future, likely to occur decades after the peak incidence of HIV. The severity of the HACC will largely be determined by the temporal overlap of these ranges. The HACC will also have an uneven spatial distribution,
modified by the regional impact of Climate Change and the regional epidemiology of HIV, each of which varies by physical and social elements.
Populations with currently high rates of HIV are the most vulnerable to a worsening or prolongation of the epidemic due to climate change. This places the people of Sub-Saharan Africa (SSA) at the greatest risk of the HACC, though outside Africa populations, in north east India and New Guinea may also be significantly impacted.
There is agreement that the most important pathway in the HACC will be further deterioration of regional and global food security. At the individual level, nutrition is vital for good immune function, to reduce the risk of acquiring HIV if viral exposure does occur, and to slow the progression of HIV to AIDS, and of AIDS to death.
At larger scales, population nutrition is important for good governance, by helping to nurture and stimulate the "effective" demand populations need to reduce corruption and to more evenly distribute available resources. Any substantial decline in the availability and intake of calories or micronutrients brought about by Climate Change is likely to increase poverty, impair learning and expand the number of migrants. The current decline in global food
security, partly attributable to Climate Change, is already causing disproportionate nutritional harm to migrants and otherwise impoverished populations, some of whom
experience HIV and AIDS.
There is agreement that the second major pathway of the HACC is the Climate Change related alteration in the distribution of infectious diseases, which interact with HIV. Of these, malaria is the most important, due to its high burden of disease. Climate Change is
projected to reduce malaria transmission in some regions, which experience a comparatively low rate of HIV, both now and in the future.
This will reduce the beneficial impact to the burden of disease of HIV for these populations. On the other hand, a large population with a high rate of HIV lives on the plateaus of SSA, an area as yet little affected by malaria. If the climatic, eco-systemic and other
factors for malaria transmission alter sufficiently in these plateau cities, then the HIV burden of this population is likely to be substantially higher, and will also be worsened by increased poverty and greater food insecurity.
There are several other plausible biological pathways in the HACC. Of these, the relationship between Climate Change, air pollution and immunity, and Climate Change, heat stress and immunity are likely to be the most important.
More speculative is the possibility that Climate Change will harm infrastructure and governance on a scale sufficient to aggravate and prolong the burden of disease of HIV.
Again, the population of SSA is judged to be at the highest risk. This mechanism is plausible by interlinked pathways including more extreme weather events and "natural" disasters, increased mobility and additional migrants and refugees.
These factors are also likely to aggravate gender inequalities, increasing the frequency of transactional and coercive sex — pathways likely to increase the burden of disease of HIV among women and girls, via increased viral transmission and reduced access to
treatment and prevention. At the global level, Climate Change may exert an immense opportunity cost, diverting resources of the international community away from public health, including from HIV, poverty alleviation, and the other Millennium Development Goals
(MDGs).
Suggestions for a future research agenda include the more accurate assessment of the pathways within the HACC, and an improved conceptual understanding of the linkages between conflict, behaviour, governance and values, environmental factors including climate, and food production, and between each of these macro-elements and sea
level rise. This would be best done by an interdisciplinary working group.
Another research gap is the effect of Climate Change on human behavior, including behavior related directly to HIV risk. From science, the paper moves to strategies and policies. The struggle to address HIV and Climate Change has generated two vigorous
global social movements, with, as yet, little formal interaction or collaboration.
We suggest this gap is a microcosm of a separation between two even larger communities – those concerned with the environment and those concerned with social justice. Of course, this is a simplification, but on the whole our perception is that the environmental movement is insufficiently aware of poverty, while the social justice movement is still poorly informed
about the environment. The work, advocacy and activism of the leaders and actors within each community who do recognise these linkages will be strengthened by this report.
HIV has already killed tens of millions of people, while Climate Change may dwarf this number. Those concerned to reduce Climate Change can apply many lessons learned by the HIV community. These include the need to challenge conventions and to seek benefit
for the poorest and most marginalised; and to widen the Climate Change movement's emerging engagement with entrepreneurs, philanthropists and prominent personalities: tools instrumental in the growth of support for those with HIV. The HIV constituency can
benefit from the experience of humanitarian programmes, some of which already see HIV and Climate Change as cross-cutting issues.
Several actions to reduce the impact of Climate Change on HIV and AIDS are proposed.
These include the integration of HIV prevention and management into disaster management plans, particularly for populations in SSA, some of whom have already experienced extreme weather events.
Means to enhance global and regional food security, especially in SSA, are vital, and much more can be done. A quarter of the world's population is over-nourished, and a more equitable distribution of global food production will go far to defusing any future food
crisis, and is likely to improve health for both over and under-fed people. Malaria treatment and prevention in SSA can also be improved.
The Climate Change community might also consider strengthening the United Nations Framework Convention on Climate Change (UNFCCC) including formal links with agriculture, health and security.
Finally, a risk is perceived whereby a relatively privileged stratum of people and interests argue that issues of global health and global social justice must be put aside in the effort to pursue partial Climate Change adaptation.
This approach is highly dangerous for global health and global social cohesion. It would also likely to generate profound longer-term risks for currently privileged populations pursuing this strategy. A stronger alliance between the HIV and AIDS and Climate Change communities will help thwart the emergence of such a policy.
A focus on the interconnections between Climate Change, food security, HIV, health in general and the links between these and the MDGs is key to breaking out of this "either or" myopia. UNEP and UNAIDS are committed to carrying forward recommendations
resulting from the above. The draft position paper is currently being finalized, after which it
will be subjected to wider consultation to both encourage civil society engagement and expand the partnership between HIV and AIDS and Climate Change constituencies. In concurring that there is a link between Climate Change and HIV and AIDS, participants at the Nyon meeting clearly pointed out that this link needs to be understood better.
They also concurred that this process of taking forward the research agenda should be spearheaded by the Health Economics and HIV and AIDS Research Division (HEARD) at the University of KwaZulu-Natal, South Africa, supported by the partnering Department of Geography and Environmental Studies, Carleton University, Canada, and the National
Centre for Epidemiology and Population Health, Australian National University.
The UN will continue to play an integral role in all of this through partnership development and by participation in various forums related to the research agenda.
Source : Elizabeth Swanti
Society of Indonesian Health Journalist
Redaksi Idionline
Peranan Jaringan Orang Terinfeksi HIV Indonesia
Komisi Penanggulangan AIDS Provinsi (KPAP) DKI Jakarta berkerjasama dengan Jaringan Orang Terinfeksi HIV Indonesia (JOTHI) dan Society of Indonesian Health Journalist, melaksanakan acara temu wartawan pada tanggal 18 Juli 2008 di rumah makan Omah Sendok membicarakan seputar *peranan JOTHI dalam melakukan perubahan untuk mencapai keadilan.* Dengan narasumber; Dr. Fonny J. Silfanus mkes – Deputi Program Komisi Penanggulangan AIDS Nasional. Iman Permana – Pengurus JOTHI dan perwakilan dari Orang Dengan HIV/AIDS (ODHA).
Pada saat ini masih dirasakan oleh orang terinfeksi HIV masih rendahnya akses kesehatan (kuantitas dan kualitas) baik dari segi sarana dan prasarana (termasuk sering terhentinya ketersediaan dan distribusi ARV); penolakan terhadap pasien HIV di Rumah Sakit – Rumah Sakit; penyangkalan hak untuk mendapat pekerjaan yang layak (juga secara layak); penyangkalan terhadap asuransi kesehatan; lemahnya program – program penanggulangan AIDS oleh lembaga donor; belum adanya sinergi program dan pendanaan; lemahnya kendali hukum dalam membela posisi orang terinfeksi HIV; pemanfaatan kelompok orang terinfeksi HIV sebagai alat untuk mendapatkan pendanaan oleh LSM; sistim penjara yang tidak men-akomodir Kesehatan yang intinya menambah kontribusi terhadap jumlah infeksi baru ; serta masih banyak lagi masalah terkait yang
memerlukan suara orang terinfeksi HIV agar dapat menentukan arah penangulangan AIDS.
Pada awal tahun 2006, Pemerintah Indonesia telah lebih dahulu merespon kenyataan pentingnya pelibatan orang terinfeksi HIV melalui Perpres No.75/2006 yang menjelaskan bahwa Jaringan Nasional orang terinfeksi HIV sebagai anggota Komisi Penanggulangan AIDS Nasional (KPAN). Sampai akhir 2006 belum ada jaringan yang dibutuhkan untuk mengisi tempat tersebut.
Menurut dr. Fonny, "Sesuai dengan didalam PERMENDDAGRI no 20 th 2007 tentang
penanggulangan AIDS di daerah dan pemberdayaan masyarakat. Untuk merealisasikan kegiatan tersebut KPAN menyiapkan anggaran yg bersumber dari APBN dan Bantuan Luar Negeri untuk mendukung program pemberdayaan masyarakat"
Iman Permana menjelaskan, "Jaringan ini sudah sangat lama dipersiapkan selama kurang lebih 2 tahun terakhir. Sesuai dengan visi kami yakni penegakan HAM untuk orang yang terinfeksi HIV tanpa stigma dan diskriminasi maka dapat secara jelas dilihat fokus kegiatan kami adalah melakukan upaya upaya advokasi dengan adanya perlibatan orang yang terinfeksi HIV secara langsung dan intens"
Pada awal 2007 dibentuklah tim yang berjumlah 15 orang untuk dapat menghantarkan terbentuknya jaringan nasional orang terinfeksi HIV Indonesia. Jaringan ini akan berfungsi meningkatkan upaya pelibatan orang terinfeksi HIV secara lebih bermakna dalam penanggulangan AIDS.
Iman menambahkan."Maka untuk terealisasinya tujuan tersebut maka kami menyadari menjalin kemitraan secara taktis dan strategis dengan pihak – pihak lain dalam penanggulangan HIV dapat membantu untuk hasil yang ideal. Termasuk dalam hal ini adalah Komisi Penanggulangan AIDS."
Melalui musyawarah nasional yang berlangsung di Jakarta pada tgl 8-10 Juli 2008, pada tgl 9 Juli 2008, dihadiri oleh 124 orang terinfeksi HIV dari 27 propinsi,JOTHI resmi berdiri dan siap membantu orang yang terinksi HIV di Indonesia.
*Komisi Penanggulangan AIDS Provinsi DKI Jakarta*. Sebuah organisasi non struktural yang dipimpin oleh Wakil Gubernur Prov. DKI Jakarta selaku Ketua KPA Provinsi. *Visi*; Jakarta Sehat Terhindar HIV/AIDS. *Misi*; Pelayanan profesional, manusiawi, efektif dan efisien dengan azas keterpaduan dan kemitraan. Meningkatkan ketahanan keluarga dan masyarakat. Memberdayakan kelompok resiko tinggi tertular HIV.*Tujuan*; Terkendalinya kasus IMS & HIV/AIDS. Terselenggaranya aktifitas penanggulangan HIV/AIDS yang profesional, terjangkau, menyeluruh dan merata. Terpadunya upaya penanggulangan IMS & HIV/AIDS.
--
Elizabeth Swanti
Society of Indonesian Health Journalist
Redaksi Idionline
Pada saat ini masih dirasakan oleh orang terinfeksi HIV masih rendahnya akses kesehatan (kuantitas dan kualitas) baik dari segi sarana dan prasarana (termasuk sering terhentinya ketersediaan dan distribusi ARV); penolakan terhadap pasien HIV di Rumah Sakit – Rumah Sakit; penyangkalan hak untuk mendapat pekerjaan yang layak (juga secara layak); penyangkalan terhadap asuransi kesehatan; lemahnya program – program penanggulangan AIDS oleh lembaga donor; belum adanya sinergi program dan pendanaan; lemahnya kendali hukum dalam membela posisi orang terinfeksi HIV; pemanfaatan kelompok orang terinfeksi HIV sebagai alat untuk mendapatkan pendanaan oleh LSM; sistim penjara yang tidak men-akomodir Kesehatan yang intinya menambah kontribusi terhadap jumlah infeksi baru ; serta masih banyak lagi masalah terkait yang
memerlukan suara orang terinfeksi HIV agar dapat menentukan arah penangulangan AIDS.
Pada awal tahun 2006, Pemerintah Indonesia telah lebih dahulu merespon kenyataan pentingnya pelibatan orang terinfeksi HIV melalui Perpres No.75/2006 yang menjelaskan bahwa Jaringan Nasional orang terinfeksi HIV sebagai anggota Komisi Penanggulangan AIDS Nasional (KPAN). Sampai akhir 2006 belum ada jaringan yang dibutuhkan untuk mengisi tempat tersebut.
Menurut dr. Fonny, "Sesuai dengan didalam PERMENDDAGRI no 20 th 2007 tentang
penanggulangan AIDS di daerah dan pemberdayaan masyarakat. Untuk merealisasikan kegiatan tersebut KPAN menyiapkan anggaran yg bersumber dari APBN dan Bantuan Luar Negeri untuk mendukung program pemberdayaan masyarakat"
Iman Permana menjelaskan, "Jaringan ini sudah sangat lama dipersiapkan selama kurang lebih 2 tahun terakhir. Sesuai dengan visi kami yakni penegakan HAM untuk orang yang terinfeksi HIV tanpa stigma dan diskriminasi maka dapat secara jelas dilihat fokus kegiatan kami adalah melakukan upaya upaya advokasi dengan adanya perlibatan orang yang terinfeksi HIV secara langsung dan intens"
Pada awal 2007 dibentuklah tim yang berjumlah 15 orang untuk dapat menghantarkan terbentuknya jaringan nasional orang terinfeksi HIV Indonesia. Jaringan ini akan berfungsi meningkatkan upaya pelibatan orang terinfeksi HIV secara lebih bermakna dalam penanggulangan AIDS.
Iman menambahkan."Maka untuk terealisasinya tujuan tersebut maka kami menyadari menjalin kemitraan secara taktis dan strategis dengan pihak – pihak lain dalam penanggulangan HIV dapat membantu untuk hasil yang ideal. Termasuk dalam hal ini adalah Komisi Penanggulangan AIDS."
Melalui musyawarah nasional yang berlangsung di Jakarta pada tgl 8-10 Juli 2008, pada tgl 9 Juli 2008, dihadiri oleh 124 orang terinfeksi HIV dari 27 propinsi,JOTHI resmi berdiri dan siap membantu orang yang terinksi HIV di Indonesia.
*Komisi Penanggulangan AIDS Provinsi DKI Jakarta*. Sebuah organisasi non struktural yang dipimpin oleh Wakil Gubernur Prov. DKI Jakarta selaku Ketua KPA Provinsi. *Visi*; Jakarta Sehat Terhindar HIV/AIDS. *Misi*; Pelayanan profesional, manusiawi, efektif dan efisien dengan azas keterpaduan dan kemitraan. Meningkatkan ketahanan keluarga dan masyarakat. Memberdayakan kelompok resiko tinggi tertular HIV.*Tujuan*; Terkendalinya kasus IMS & HIV/AIDS. Terselenggaranya aktifitas penanggulangan HIV/AIDS yang profesional, terjangkau, menyeluruh dan merata. Terpadunya upaya penanggulangan IMS & HIV/AIDS.
--
Elizabeth Swanti
Society of Indonesian Health Journalist
Redaksi Idionline
Profil Keamanan Terapi Statin
Semua pengaruh menguntungkan ini dikarenakan kemampuan statin dalam menurunkan kadar LDL (low-density lipoprotein). Bahkan dalam sebuah penelitian, pasien anak dan remaja dengan hiperkolesterolemia familial yang diterapi dengan obat golongan statin, pemberian terapi statin terjadi penghambatan progresifitas penebalan intima pembuluh darah, sehingga pemberian statin pada pasien-pasien ini dapat mencegah arterosklerosis pada masa dewasa.
Enam obat statin sekarang tersedia di pasaran dunia: lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin, sedangkan pitavastatin tersedia di India dan Jepang.
Karena penggunaan statin diperkirakan akan terus meningkat karena peningkatan kejadian hiperlipidemia dan efek pleiotropik yang menguntungkan, maka keamanan dan tolerabilitas pasien sangatlah penting.
Sebuah penelitian meta analisis dilakukan untuk mengetahui efek statin terhadap kematian, kejadian vaskular serta keamanan statin pada pasien usia lanjut. Hasil meta analisis dari penelitian-penelitian yang pernah dilakukan memperlihatkan bahwa terapi menggunakan statin bermakna menurunkan kematian karena semua sebab dan kematian karena kardiovaskular dan relatif aman diberikan pada pasien usia lanjut.
Sebuah penelitian lain dilakukan oleh Dr Jane Armitage dari University of Oxford, Inggris untuk menguji keamanan obat-obat golongan statin. Kesimpulan dari penelitian yang dilakukannya adalah bahwa obat-obat golongan statin ditoleransi dengan baik. Efek samping yang sering dibicarakan seperti miopati dan rabdomiolisis jarang terjadi bila dosis yang digunakan adalah dosis standar yang dianjurkan. Dr Jane mengatakan bahwa walaupun ada beberapa keberatan mengenai pernyataan ini, namun apabila dosis yang diberikan sesuai dengan anjuran, obat-obat golongan statin merupakan obat yang relatif aman. Hasil penelitian oleh dr. Jane ini dipublikasikan dalam The Lancet bulan Juni 2008.
Dr Jane Armitage dan rekan melakukan penelitian terhadap data-data penelitian yang dipublikasikan dari tahun 1985 hingga 2006 mengenai efektifitas, efek samping dan keamanan obat golongan statin. Hasil dari penelitain yang dilakukan dr. Jane memperlihatkan efektifitas statin dalam menurunkan angka kejadian kematian karena kardiovaskular, infark miokard tidak fatal, stroke dan menurunkan perlunya revaskularisasi. Sedangkan efek samping yang sering terjadi dalam penelitian adalah toksisitas pada otot, diantaranya miopati dan rabdomiolisis, dan gangguan enzim pencernaan.
Semua obat golongan statin dapat menyebabkan miopati, yang dapat berkembang menjadi rabdomiolisis. Namun angka kejadian miopati kurang dari 1 per 10.000 pasien dengan penggunaan dosis standar statin. Risiko miopati meningkat seiring dengan peningkatan dosis, namun risiko ini tetap rendah dengan atorvastatin 80 mg. Selain itu diketahui bahwa miopati dan rabdomiolisis ini biasanya terjadi bila obat-obat statin digunakan bersamaan dengan obat lainnya, seperti golongan fibrat.
Dr. Jane mengatakan bahwa nyeri otot sering terjadi pada pasien paruh baya dan kalau pasien tersebut diterapi dengan statin, statinlah yang biasanya dipersalahkan menjadi penyebab nyeri ini. Pemeriksaan menggunakan kreatinin kinase pada pasien-pasien tersebut dapat menyingkirkan adanya miopati dan terapi statin dapat diteruskan.
Peningkatan enzim transaminase secara umum terlihat pada 6 bulan pertama terapi. Biasanya peningkatan enzim transaminase tidak disertai dengan gejala. Peningkatan enzim transaminase ini reversibel bila terapi dihentikan atau dosis dikurangi. Peningkatan enzim tergantung dari dosis dan tidak ada bukti kuat mengenai hubungan antara peningkatan enzim yang terjadi dengan kerusakan hati (hepatitis atau gagal hati).
Pemeriksaan hati rutin tidak lagi direkomendasikan dengan penggunaan simvastatin, pravastatin, atau lovastatin hingga dosis 40 mg sehari, namun tetap direkomendasikan pada penggunaan statin lainnya. Kalau enzim pencernaan meningkat 3 kali lipat dibandingkan dengan kadar enzime pada orang normal yang tidak mengalami gangguan hati, enzim pencernaan harus dipantau selama 1 minggu. Kalau enzim alanin transaminase tetap tidak menurun, statin harus dihentikan sementara. Peningkatan enzim pencernaan 2-3 kali dari batas normal orang sehat memerlukkan pemantauan, namun biasanya peningkatannya akan berkurang sedikit demi sedikit selama perjalanan terapi.
Walau sudah digunakan sejak lama dan ada telah diketahui efek menguntungkan statin terhadap kardiovaskular dan keamanannya pada usia lanjut, ada beberapa hal yang perlu diperhatikan apabila memberikan statin pada pasien tertentu.
Dan walaupun statin diketahui relatif aman pada pasien usia lanjut, penyesuaian dosis perlu dilakukan pada pasien usia lanjut. Pada beberapa penelitian yang melibatkan pasien yang lebih tua dari 80 tahun diperkirakan terjadi peningkatan risiko miopati.
Dilanjutkan pula bahwa pasien yang menerima terapi warfarin perlu menyesuaikan dosis warfarinnya pada awal dan akhir terapi menggunakan statin.
Sumber : www.kalbe.co.id
Enam obat statin sekarang tersedia di pasaran dunia: lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin, sedangkan pitavastatin tersedia di India dan Jepang.
Karena penggunaan statin diperkirakan akan terus meningkat karena peningkatan kejadian hiperlipidemia dan efek pleiotropik yang menguntungkan, maka keamanan dan tolerabilitas pasien sangatlah penting.
Sebuah penelitian meta analisis dilakukan untuk mengetahui efek statin terhadap kematian, kejadian vaskular serta keamanan statin pada pasien usia lanjut. Hasil meta analisis dari penelitian-penelitian yang pernah dilakukan memperlihatkan bahwa terapi menggunakan statin bermakna menurunkan kematian karena semua sebab dan kematian karena kardiovaskular dan relatif aman diberikan pada pasien usia lanjut.
Sebuah penelitian lain dilakukan oleh Dr Jane Armitage dari University of Oxford, Inggris untuk menguji keamanan obat-obat golongan statin. Kesimpulan dari penelitian yang dilakukannya adalah bahwa obat-obat golongan statin ditoleransi dengan baik. Efek samping yang sering dibicarakan seperti miopati dan rabdomiolisis jarang terjadi bila dosis yang digunakan adalah dosis standar yang dianjurkan. Dr Jane mengatakan bahwa walaupun ada beberapa keberatan mengenai pernyataan ini, namun apabila dosis yang diberikan sesuai dengan anjuran, obat-obat golongan statin merupakan obat yang relatif aman. Hasil penelitian oleh dr. Jane ini dipublikasikan dalam The Lancet bulan Juni 2008.
Dr Jane Armitage dan rekan melakukan penelitian terhadap data-data penelitian yang dipublikasikan dari tahun 1985 hingga 2006 mengenai efektifitas, efek samping dan keamanan obat golongan statin. Hasil dari penelitain yang dilakukan dr. Jane memperlihatkan efektifitas statin dalam menurunkan angka kejadian kematian karena kardiovaskular, infark miokard tidak fatal, stroke dan menurunkan perlunya revaskularisasi. Sedangkan efek samping yang sering terjadi dalam penelitian adalah toksisitas pada otot, diantaranya miopati dan rabdomiolisis, dan gangguan enzim pencernaan.
Semua obat golongan statin dapat menyebabkan miopati, yang dapat berkembang menjadi rabdomiolisis. Namun angka kejadian miopati kurang dari 1 per 10.000 pasien dengan penggunaan dosis standar statin. Risiko miopati meningkat seiring dengan peningkatan dosis, namun risiko ini tetap rendah dengan atorvastatin 80 mg. Selain itu diketahui bahwa miopati dan rabdomiolisis ini biasanya terjadi bila obat-obat statin digunakan bersamaan dengan obat lainnya, seperti golongan fibrat.
Dr. Jane mengatakan bahwa nyeri otot sering terjadi pada pasien paruh baya dan kalau pasien tersebut diterapi dengan statin, statinlah yang biasanya dipersalahkan menjadi penyebab nyeri ini. Pemeriksaan menggunakan kreatinin kinase pada pasien-pasien tersebut dapat menyingkirkan adanya miopati dan terapi statin dapat diteruskan.
Peningkatan enzim transaminase secara umum terlihat pada 6 bulan pertama terapi. Biasanya peningkatan enzim transaminase tidak disertai dengan gejala. Peningkatan enzim transaminase ini reversibel bila terapi dihentikan atau dosis dikurangi. Peningkatan enzim tergantung dari dosis dan tidak ada bukti kuat mengenai hubungan antara peningkatan enzim yang terjadi dengan kerusakan hati (hepatitis atau gagal hati).
Pemeriksaan hati rutin tidak lagi direkomendasikan dengan penggunaan simvastatin, pravastatin, atau lovastatin hingga dosis 40 mg sehari, namun tetap direkomendasikan pada penggunaan statin lainnya. Kalau enzim pencernaan meningkat 3 kali lipat dibandingkan dengan kadar enzime pada orang normal yang tidak mengalami gangguan hati, enzim pencernaan harus dipantau selama 1 minggu. Kalau enzim alanin transaminase tetap tidak menurun, statin harus dihentikan sementara. Peningkatan enzim pencernaan 2-3 kali dari batas normal orang sehat memerlukkan pemantauan, namun biasanya peningkatannya akan berkurang sedikit demi sedikit selama perjalanan terapi.
Walau sudah digunakan sejak lama dan ada telah diketahui efek menguntungkan statin terhadap kardiovaskular dan keamanannya pada usia lanjut, ada beberapa hal yang perlu diperhatikan apabila memberikan statin pada pasien tertentu.
Dan walaupun statin diketahui relatif aman pada pasien usia lanjut, penyesuaian dosis perlu dilakukan pada pasien usia lanjut. Pada beberapa penelitian yang melibatkan pasien yang lebih tua dari 80 tahun diperkirakan terjadi peningkatan risiko miopati.
Dilanjutkan pula bahwa pasien yang menerima terapi warfarin perlu menyesuaikan dosis warfarinnya pada awal dan akhir terapi menggunakan statin.
Sumber : www.kalbe.co.id
Perbatasan RI-PNG Rentan Penyebaran HIV/AIDS
"Sebagai sebuah wilayah perbatasan dengan tingkat mobilitas penduduk antarnegara yang tinggi, masyarakat yang bermukim di wilayah ini kini terancam punah akibat penyebaran HIV/AIDS yang signifikan," ungkap Kepala Dinas Kesehatan Kabupaten Boven Digoel, Titus Tambaip, M.Kes di Tanah Merah, Rabu (30/7).
Dia mengatakan, hampir setiap hari masyarakat di perbatasan RI-PNG saling melintas batas untuk berbagai urusan, baik urusan adat karena mereka memiliki pertalian kekerabatan juga urusan perdagangan jual-beli kebutuhan sehari-hari dan hasil bumi serta urusan pertanian dan perkebunan.
Mobilitas masyarakat yang melintasi perbatasan ini disertai penyebaran HIV/AIDS semakin hari semakin tinggi, selain karena tingkat pendidikan masyarakat masih sangat rendah sehingga kurang memahami secara baik persoalan hidup bersih dan sehat juga karena keterbatasan informasi mengenai penyakit yang mematikan itu.
HIV/AIDS justru menyebar sangat luas dan cepat di wilayah perkampungan terpencil dan terisolasi di sepanjang tapal batas kedua negara ini karena masyarakat setempat sangat kurang, malahan samasekali tidak mendapatkan informasi yang jelas dan komprehensif tentang penyakit itu.
Bersamaan dengan itu, masyarakat pun belum terbiasa dengan pola hidup bersih dan sehat. Selain tersebar di wilayah perbatasan RI dengan PNG, HIV/AIDS pun menyebar di wilayah perusahaan pengolahan kayu dan perkebunan kelapa sawit.
"Di lokasi perusahaan kayu dan perkebunan kelapa sawit yang dikelola PT Korindo, terdapat banyak sekali karyawan yang berasal dari berbagai daerah di Indonesia. Di dalam situasi kehidupan yang jauh dari keramaian dan hiburan kota serta jauh dari keluarga, maka tidak tertutup kemungkinan terjadi transaksi seks bebas yang berujung pada terjangkitnya penyakit HIV/AIDS di daerah ini," katanya.
Di dalam situasi yang serba sulit ini, lanjut Titus Tambaip, pemerintah Kabupaten Boven Digoel terus berupaya dengan kemampuan yang ada untuk mengatasi persoalan kemanusiaan ini namun patut diakui bahwa pemerintah masih mengalami keterbatasan dana sosialisasi bahaya HIV/AIDS, keterbatasan tenaga medis dan belum tersentuhnya kegiatan penyuluhan HIV/AIDS oleh LSM peduli masalah kemanusiaan ini.
"Kalau kita teliti secara baik maka dapat kita katakana bahwa belum ada LSM peduli AIDS yang masuk sampai ke wilayah tapal batas RI dengan PNG khususnya di Kabupaten Boven Digoel untuk membantu menangani bahaya HIV/AIDS," katanya.
Selain HIV/AIDS, dua penyakit lain yang juga menjadi ancaman kehidupan masyarakat Boven Digoel yang jumlah pengidapnya semakin banyak adalah malaria dan penyakit kaki gajah (Filariasis).
Di Kabupaten Boven Digoel sendiri terdapat 15 Puskesmas dan satu Rumah Sakit Umum Daerah (RSUD) dengan 20 dokter umum dan lima dokter gigi. Jumlah kasus HIV-AIDS di Provinsi Papua tercatat terus meningkat.
Data Dinas Kesehatan Provinsi Papua Triwulan III, per 30 September 2007 melaporkan jumlah 3.434 kasus. HIV sebanyak 1.964 kasus dan AIDS 1.470 kasus. Sebanyak 322 atau 9,38% sudah meninggal.
Satu hal yang mengkhawatirkan adalah kasus HIV-AIDS terbanyak justru pada kelompok usia produktif (15-39 tahun) yaitu usia yang seksual aktif sekitar 78,8 persen. Kasus HIV-AIDS tertinggi terdapat pada kelompok umur 20-29 tahun sebanyak 1.548 kasus, kelompok umur 30-39 tahun 884 kasus dan kelompok umur 39-49 tahun 285 kasus. Fakta ini memiliki korelasi kuat ancaman masa depan bagi Papua.
Epidemi HIV-AIDS di Tanah Papua sesungguhnya menyebar pada populasi umum (generalized epidemic). Apalagi, lebih dari 90 persen penyebarannya terjadi hubungan seks tidak aman. Kondom selama ini diyakini merupakan alat ampuh menghambat penularan Infeksi Menular Seksual (IMS) termasuk HIV. Meskipun demikian, ternyata tingkat penggunaan kondom di Indonesia termasuk di Tanah Papua masih dinilai sangat minim.
Rendahnya tingkat penggunaan kondom antara lain karena lingkungan sosial yang kurang mendukung penggunaan kondom sehingga stigma terhadap kondom tak kunjung hilang. Pengetahuan masyarakat tentang fungsi dan manfaat kondom pun masih kurang, serta rendahnya kesadaran akan pentingnya penggunaan kondom bagi kesehatan pribadi dan pasangan.
Sumber : KCM
Dia mengatakan, hampir setiap hari masyarakat di perbatasan RI-PNG saling melintas batas untuk berbagai urusan, baik urusan adat karena mereka memiliki pertalian kekerabatan juga urusan perdagangan jual-beli kebutuhan sehari-hari dan hasil bumi serta urusan pertanian dan perkebunan.
Mobilitas masyarakat yang melintasi perbatasan ini disertai penyebaran HIV/AIDS semakin hari semakin tinggi, selain karena tingkat pendidikan masyarakat masih sangat rendah sehingga kurang memahami secara baik persoalan hidup bersih dan sehat juga karena keterbatasan informasi mengenai penyakit yang mematikan itu.
HIV/AIDS justru menyebar sangat luas dan cepat di wilayah perkampungan terpencil dan terisolasi di sepanjang tapal batas kedua negara ini karena masyarakat setempat sangat kurang, malahan samasekali tidak mendapatkan informasi yang jelas dan komprehensif tentang penyakit itu.
Bersamaan dengan itu, masyarakat pun belum terbiasa dengan pola hidup bersih dan sehat. Selain tersebar di wilayah perbatasan RI dengan PNG, HIV/AIDS pun menyebar di wilayah perusahaan pengolahan kayu dan perkebunan kelapa sawit.
"Di lokasi perusahaan kayu dan perkebunan kelapa sawit yang dikelola PT Korindo, terdapat banyak sekali karyawan yang berasal dari berbagai daerah di Indonesia. Di dalam situasi kehidupan yang jauh dari keramaian dan hiburan kota serta jauh dari keluarga, maka tidak tertutup kemungkinan terjadi transaksi seks bebas yang berujung pada terjangkitnya penyakit HIV/AIDS di daerah ini," katanya.
Di dalam situasi yang serba sulit ini, lanjut Titus Tambaip, pemerintah Kabupaten Boven Digoel terus berupaya dengan kemampuan yang ada untuk mengatasi persoalan kemanusiaan ini namun patut diakui bahwa pemerintah masih mengalami keterbatasan dana sosialisasi bahaya HIV/AIDS, keterbatasan tenaga medis dan belum tersentuhnya kegiatan penyuluhan HIV/AIDS oleh LSM peduli masalah kemanusiaan ini.
"Kalau kita teliti secara baik maka dapat kita katakana bahwa belum ada LSM peduli AIDS yang masuk sampai ke wilayah tapal batas RI dengan PNG khususnya di Kabupaten Boven Digoel untuk membantu menangani bahaya HIV/AIDS," katanya.
Selain HIV/AIDS, dua penyakit lain yang juga menjadi ancaman kehidupan masyarakat Boven Digoel yang jumlah pengidapnya semakin banyak adalah malaria dan penyakit kaki gajah (Filariasis).
Di Kabupaten Boven Digoel sendiri terdapat 15 Puskesmas dan satu Rumah Sakit Umum Daerah (RSUD) dengan 20 dokter umum dan lima dokter gigi. Jumlah kasus HIV-AIDS di Provinsi Papua tercatat terus meningkat.
Data Dinas Kesehatan Provinsi Papua Triwulan III, per 30 September 2007 melaporkan jumlah 3.434 kasus. HIV sebanyak 1.964 kasus dan AIDS 1.470 kasus. Sebanyak 322 atau 9,38% sudah meninggal.
Satu hal yang mengkhawatirkan adalah kasus HIV-AIDS terbanyak justru pada kelompok usia produktif (15-39 tahun) yaitu usia yang seksual aktif sekitar 78,8 persen. Kasus HIV-AIDS tertinggi terdapat pada kelompok umur 20-29 tahun sebanyak 1.548 kasus, kelompok umur 30-39 tahun 884 kasus dan kelompok umur 39-49 tahun 285 kasus. Fakta ini memiliki korelasi kuat ancaman masa depan bagi Papua.
Epidemi HIV-AIDS di Tanah Papua sesungguhnya menyebar pada populasi umum (generalized epidemic). Apalagi, lebih dari 90 persen penyebarannya terjadi hubungan seks tidak aman. Kondom selama ini diyakini merupakan alat ampuh menghambat penularan Infeksi Menular Seksual (IMS) termasuk HIV. Meskipun demikian, ternyata tingkat penggunaan kondom di Indonesia termasuk di Tanah Papua masih dinilai sangat minim.
Rendahnya tingkat penggunaan kondom antara lain karena lingkungan sosial yang kurang mendukung penggunaan kondom sehingga stigma terhadap kondom tak kunjung hilang. Pengetahuan masyarakat tentang fungsi dan manfaat kondom pun masih kurang, serta rendahnya kesadaran akan pentingnya penggunaan kondom bagi kesehatan pribadi dan pasangan.
Sumber : KCM
Kita Sehat Dan Bugar Dalam Melaksanakan Ibadah Haji
Seorang muslim memiliki kewajiban melaksanakan ibadah haji minimal sekali dalam seumur hidup. Setiap tahunnya sekitar 200.000 orang dari seluruh penjuru dunia melakukan migrasi massal menuju tanah haram demi mengharap ridha Alloh SWT semata. Jamaah haji dari Indonesia selalu menjadi pemegang rekor tetap kuota jamaah haji terbanyak di dunia. Sayangnya, persiapan kesehatan calon jamaah sebagian besar terabaikan, hingga akibatnya angka morbiditas dan mortalitas jamaah di Arab senantiasa mengkhawatirkan. Demikian dikatakan Dr. Iris Rengganis dalam acara simposium “Tips Sehat dan Bugar dalam melaksanakan Ibadah Haji” yang diselenggarakan pada 17 Juli di FKUI Jakarta.
Dr. Iris melaporkan kebanyakan dari jamaah haji itu dari segi umur rata-rata usia diatas 60 tahun. Dari usia tersebut Calon Jemaah Haji (CJH) kebanyakan mengalami berbagai penyakit yang berisiko tinggi seperti penyakit kardiovaskular, penyakit kronik , DM, Liver dll.
Dr. Iris mengingatkan, bahwa seringnya Calon Jemaah Haji (CJH) membawa penyakit yang menular dari tanah air, seperti influenza, meningitis, TBC aktif dan sehingga sesampainya di Tanah Suci akan mengakibatkan penularan kepada banyak orang. Terutama pada penyakit yang membahayakan seperti TBC aktif tadi. “Oleh karena itulah perlu pencegahan sejak dini yaitu pencegahan ketika hendak berangkat seharusnya diberikan vaksinasi dahulu atau penyakit yang membahayakan harus ditunda keberangkatannya,” ujar Dr. Iris.
Melihat dari pola musim di Arab Saudi untuk haji tahun ini jatuh pada musim dingin. Diperkirakan suhu di antara tiga kota seperti Jeddah suhunya diantara 190 C, Makkah sekitar 140 C dan Madinnah pada malam hari bisa sekitar 40 C.
Pada musim dingin di Arab Saudi para calon haji sering terjadi hilang rasa atau baal daerah tungkai dan tangan, nyeri atau sakit hebat pada otot, kulit bersisik dna gatal, kulit telapak kaki dan bibir peceh-pecah, Bengkak dan kebiruan pada kulit. Rasa kaku atau beku daerah telinga, hidung, pipi, jari tangan, bahu, lengan atas atau bawah dan paha, serta dehidrasi karena kurang minum.
Vaksinasi
Pemberian vaksinasi sangat perlu diberikan kepada calon jemaah haji, dianjurkan oleh Dr. Iris, agar pemberian vaksin disuntik di area deltoid atau glutea dengan dosis tunggal 0,5 nl subkutan. Waktu pemberian sebaiknya diberikan dua minggu sebelum tiba di Arab Saudi. Sehingga antibody akan terbentuk 2 minggu setelah penyuntikan.
Mengatur haid
Saat ibadah haji, jadwal menstruasi (haid) menjadi persoalan tersendiri bagi jamaah perempuan. Berbagai upaya dilakukan kaum perempuan untuk mengatur datangnya haid. Karena Ibadah haji terikat pada waktu tertentu. Tidak bisa ditunda atau dimajukan waktunya. Bagi jamaah perempuan, hal itu bukan perkara mudah. Terutama jika pelaksanaan rukun haji di Arab Saudi tersebut bertepatan dengan hari-hari datangnya haid.
Dengan kata lain, jika jamaah haji perempuan "datang bulan" pada saat harus menjalankan rukun haji (wajib), ibadahnya tidak sah. Konsekuensinya, hajinya batal dan harus diulang pada musim haji berikutnya. Padahal, tidak semua kaum perempuan mampu secara finansial untuk kembali berhaji pada musim haji tahun berikutnya. Kalau sudah demikian, perjalanan menunaikan ibadah haji menjadi sia-sia.
Karena itu, mengatur masa-masa haid, memajukan atau menunda haid selama pelaksanaan ibadah haji, sangat diperlukan, terutama jika haid terjadi saat puncak pelaksanaan ibadah haji.
Mengapa perlu obat pengatur haid saat menunaikan ibadah haji? DR. Dr. Dwiana Ocviyanti, SpOG (K) mengatakan, karena saat menunaikan ibadah haji perempuan yang sedang haid dilarang melakukan kegiata seperti Thawaf, shalat wajib atau sunnah, berdiam di masjid dan memegang dan membaca al qur’an.
Menurut Dr. Dwiana, yang perlu dilakukan bila merencanakan mengatur haid adalah, pertama periksakan diri ke dokter sesegera mungkin, upayakan jangan kurang dari satu bulan sebelum tanggal keberangkatan. Kedua, dokter akan melakukan pemeriksaan untuk mendeteksi adanya kelainan pada organ reproduksi atau kondisi lain yang dapat menimbulkan komplikasi bila diperlukan obat pengatur haid. Ketiga dokter dapat merencanakan pemberian obat pengatur haid yang paling sesuai dengan kondisi kesehatan.
Mengandung progesterone
Untuk memilih obat pengatur haid, Dr. Dwiana menyarankan, sebaiknya obat yang mengandung progesterone dengan ciri pil yang sama dimakan setiap hari, umumnya berbentuk pil satuan dalam kemasan biasa. Dapat berupa pil KB untuk ibu menyusui dalam bentuk kemasan untuk 28 hari dengan jenis pil yang sama.
Dr. Dwiana mengingatkan, yang perlu dipaerhatikan sebelum penggunaan obat pengatur haid adalah riwayat sakit kepala hebat atau migraine, riwayat tromboflebitis atau tromboemboli, varises berat, kanker payudara, perdarahan dari vagina yang belum diketahui penyebabnya dan penyakit hari atau gangguan fungsi hati. Riwayat penyakit kuning dan riwayat preklampsi dalam kehamilan. Penyakit jantung dan pembuluh darah. Kencing manisatau diabetes yang berkomplikasi, hipertensi berat, penggunaan obat-obat rutin terutama obat TBC dan kencing manis dan riwayat depresi atau gangguan kejiwaan.
Perlu diingat pula, adalah gangguan yang dapat muncul pada penggunaan obat pengatur haid adalah rasa mual, muntah, sakit kepala dan nyeri payudara umumnya hanya pada penggunaan pil kombinasi yang mengandung hormone estrogen. Perdarahan bercak lebih sering pada penggunaan obat pil yang mengandung progesterone saja. Peningkatan berat badan, hindari konsumsi makanan tinggi kalori yang berlebihan.
Apabila jemaah haji ingin menunda haidnya, disarankan dapat menggunakan pil progesterone saja atau pil kombinasi. Pada penggunaan pil kombinasi yang digunakan hanya pil aktif, pil placebo tidak dimakan atau dibuang. Paling ideal pul mulai digunakan pada hari kedua hingga kelima haid, atau selambat-lambatnya 14 hari sebelum hari pertama haid yang ingin ditunda. Pil dihentikan segera setelah penundaan haid tidak diperlukan, dan haid akan datang 2-3 hari setelah pil dihentikan.
Perlu diingat pula, dapat digunakan bagi mereka yang siklus haidnya tidak teratur dan paling baik bila dimulai 3 hingga 6 bulan sebelum tanggal keberangkatan.
Persiapan fisik
Sementara itu Dr. Tri Juli Edi Tarigan menyarankan, untuk mempersiapkan fisik pada calon jemaah haji yang perlu diperhatikan adalah sebaiknya calon jemaah haji sebelum berangkat kurang lebih 1 bulan, maka memperbanyak jalan kaki minimal 3 x seminggu. Kemudian kenali penyakit kronik yang dimiliki. Pakaian dingin termasuk sarung tangan dan kaus kaki dan pelembab kulit. Tidak perlu bawa barang banyak-banyak.
Dr. Edi menyebutkan ada tips untuk pemilik penyakit kronik yaitu: terbuka pada saat pemeriksaan oleh dokter ditanah air, membawa dan meneruskan obat-obatan yang sedang dikonsumsi, selalu dekat dengan dokter kloter, traveling dialysis harus selalu dibawa dan segera lapor ke dokter sector, Untuk diabetisi pemakai insulin. Lebih baik jika membawa glukometer, utamakan aktifitas wajib dan hindari keramaian.
Dr. Edi juga menyarankan, untuk menghindari mimisan, dianjurkan selalu memakai masker kain yang dibasahi dengan air zamzam. Minum yang banyak, jus buah, makan buah dan sayuran. Mengkonsumsi vitamin dan jangan mengkorek-korek hidung.
Apabila calon jemaah haji keluar dari penginapan di siang hari, sebaiknya upayakan jangan terkena sinar matahari langsung. Gunakan pelembab kulit dan bibir setelah mandi. Gunakan sabun yang soft. Gunakan kaca mata hitam di siang hari.
Dr. Iris melaporkan kebanyakan dari jamaah haji itu dari segi umur rata-rata usia diatas 60 tahun. Dari usia tersebut Calon Jemaah Haji (CJH) kebanyakan mengalami berbagai penyakit yang berisiko tinggi seperti penyakit kardiovaskular, penyakit kronik , DM, Liver dll.
Dr. Iris mengingatkan, bahwa seringnya Calon Jemaah Haji (CJH) membawa penyakit yang menular dari tanah air, seperti influenza, meningitis, TBC aktif dan sehingga sesampainya di Tanah Suci akan mengakibatkan penularan kepada banyak orang. Terutama pada penyakit yang membahayakan seperti TBC aktif tadi. “Oleh karena itulah perlu pencegahan sejak dini yaitu pencegahan ketika hendak berangkat seharusnya diberikan vaksinasi dahulu atau penyakit yang membahayakan harus ditunda keberangkatannya,” ujar Dr. Iris.
Melihat dari pola musim di Arab Saudi untuk haji tahun ini jatuh pada musim dingin. Diperkirakan suhu di antara tiga kota seperti Jeddah suhunya diantara 190 C, Makkah sekitar 140 C dan Madinnah pada malam hari bisa sekitar 40 C.
Pada musim dingin di Arab Saudi para calon haji sering terjadi hilang rasa atau baal daerah tungkai dan tangan, nyeri atau sakit hebat pada otot, kulit bersisik dna gatal, kulit telapak kaki dan bibir peceh-pecah, Bengkak dan kebiruan pada kulit. Rasa kaku atau beku daerah telinga, hidung, pipi, jari tangan, bahu, lengan atas atau bawah dan paha, serta dehidrasi karena kurang minum.
Vaksinasi
Pemberian vaksinasi sangat perlu diberikan kepada calon jemaah haji, dianjurkan oleh Dr. Iris, agar pemberian vaksin disuntik di area deltoid atau glutea dengan dosis tunggal 0,5 nl subkutan. Waktu pemberian sebaiknya diberikan dua minggu sebelum tiba di Arab Saudi. Sehingga antibody akan terbentuk 2 minggu setelah penyuntikan.
Mengatur haid
Saat ibadah haji, jadwal menstruasi (haid) menjadi persoalan tersendiri bagi jamaah perempuan. Berbagai upaya dilakukan kaum perempuan untuk mengatur datangnya haid. Karena Ibadah haji terikat pada waktu tertentu. Tidak bisa ditunda atau dimajukan waktunya. Bagi jamaah perempuan, hal itu bukan perkara mudah. Terutama jika pelaksanaan rukun haji di Arab Saudi tersebut bertepatan dengan hari-hari datangnya haid.
Dengan kata lain, jika jamaah haji perempuan "datang bulan" pada saat harus menjalankan rukun haji (wajib), ibadahnya tidak sah. Konsekuensinya, hajinya batal dan harus diulang pada musim haji berikutnya. Padahal, tidak semua kaum perempuan mampu secara finansial untuk kembali berhaji pada musim haji tahun berikutnya. Kalau sudah demikian, perjalanan menunaikan ibadah haji menjadi sia-sia.
Karena itu, mengatur masa-masa haid, memajukan atau menunda haid selama pelaksanaan ibadah haji, sangat diperlukan, terutama jika haid terjadi saat puncak pelaksanaan ibadah haji.
Mengapa perlu obat pengatur haid saat menunaikan ibadah haji? DR. Dr. Dwiana Ocviyanti, SpOG (K) mengatakan, karena saat menunaikan ibadah haji perempuan yang sedang haid dilarang melakukan kegiata seperti Thawaf, shalat wajib atau sunnah, berdiam di masjid dan memegang dan membaca al qur’an.
Menurut Dr. Dwiana, yang perlu dilakukan bila merencanakan mengatur haid adalah, pertama periksakan diri ke dokter sesegera mungkin, upayakan jangan kurang dari satu bulan sebelum tanggal keberangkatan. Kedua, dokter akan melakukan pemeriksaan untuk mendeteksi adanya kelainan pada organ reproduksi atau kondisi lain yang dapat menimbulkan komplikasi bila diperlukan obat pengatur haid. Ketiga dokter dapat merencanakan pemberian obat pengatur haid yang paling sesuai dengan kondisi kesehatan.
Mengandung progesterone
Untuk memilih obat pengatur haid, Dr. Dwiana menyarankan, sebaiknya obat yang mengandung progesterone dengan ciri pil yang sama dimakan setiap hari, umumnya berbentuk pil satuan dalam kemasan biasa. Dapat berupa pil KB untuk ibu menyusui dalam bentuk kemasan untuk 28 hari dengan jenis pil yang sama.
Dr. Dwiana mengingatkan, yang perlu dipaerhatikan sebelum penggunaan obat pengatur haid adalah riwayat sakit kepala hebat atau migraine, riwayat tromboflebitis atau tromboemboli, varises berat, kanker payudara, perdarahan dari vagina yang belum diketahui penyebabnya dan penyakit hari atau gangguan fungsi hati. Riwayat penyakit kuning dan riwayat preklampsi dalam kehamilan. Penyakit jantung dan pembuluh darah. Kencing manisatau diabetes yang berkomplikasi, hipertensi berat, penggunaan obat-obat rutin terutama obat TBC dan kencing manis dan riwayat depresi atau gangguan kejiwaan.
Perlu diingat pula, adalah gangguan yang dapat muncul pada penggunaan obat pengatur haid adalah rasa mual, muntah, sakit kepala dan nyeri payudara umumnya hanya pada penggunaan pil kombinasi yang mengandung hormone estrogen. Perdarahan bercak lebih sering pada penggunaan obat pil yang mengandung progesterone saja. Peningkatan berat badan, hindari konsumsi makanan tinggi kalori yang berlebihan.
Apabila jemaah haji ingin menunda haidnya, disarankan dapat menggunakan pil progesterone saja atau pil kombinasi. Pada penggunaan pil kombinasi yang digunakan hanya pil aktif, pil placebo tidak dimakan atau dibuang. Paling ideal pul mulai digunakan pada hari kedua hingga kelima haid, atau selambat-lambatnya 14 hari sebelum hari pertama haid yang ingin ditunda. Pil dihentikan segera setelah penundaan haid tidak diperlukan, dan haid akan datang 2-3 hari setelah pil dihentikan.
Perlu diingat pula, dapat digunakan bagi mereka yang siklus haidnya tidak teratur dan paling baik bila dimulai 3 hingga 6 bulan sebelum tanggal keberangkatan.
Persiapan fisik
Sementara itu Dr. Tri Juli Edi Tarigan menyarankan, untuk mempersiapkan fisik pada calon jemaah haji yang perlu diperhatikan adalah sebaiknya calon jemaah haji sebelum berangkat kurang lebih 1 bulan, maka memperbanyak jalan kaki minimal 3 x seminggu. Kemudian kenali penyakit kronik yang dimiliki. Pakaian dingin termasuk sarung tangan dan kaus kaki dan pelembab kulit. Tidak perlu bawa barang banyak-banyak.
Dr. Edi menyebutkan ada tips untuk pemilik penyakit kronik yaitu: terbuka pada saat pemeriksaan oleh dokter ditanah air, membawa dan meneruskan obat-obatan yang sedang dikonsumsi, selalu dekat dengan dokter kloter, traveling dialysis harus selalu dibawa dan segera lapor ke dokter sector, Untuk diabetisi pemakai insulin. Lebih baik jika membawa glukometer, utamakan aktifitas wajib dan hindari keramaian.
Dr. Edi juga menyarankan, untuk menghindari mimisan, dianjurkan selalu memakai masker kain yang dibasahi dengan air zamzam. Minum yang banyak, jus buah, makan buah dan sayuran. Mengkonsumsi vitamin dan jangan mengkorek-korek hidung.
Apabila calon jemaah haji keluar dari penginapan di siang hari, sebaiknya upayakan jangan terkena sinar matahari langsung. Gunakan pelembab kulit dan bibir setelah mandi. Gunakan sabun yang soft. Gunakan kaca mata hitam di siang hari.
Monday, August 25, 2008
Knee Problems and Injuries
Most people have had a minor knee problem at one time or another. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear, overuse, or injury. Knee problems and injuries most often occur during sports or recreational activities, work-related tasks, or home projects.
The knee is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage, which absorbs shock and provides a smooth, gliding surface for joint movement. See an illustration of the structures of the knee.
Although a knee problem is often caused by an injury to one or more of these structures, it may have another cause. Some people are more likely to develop knee problems than others. Many jobs, sports and recreation activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees.
Sudden (acute) injuries
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:
Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap.
A tear in the rubbery cushions of the knee joint (meniscus).
Ligament tears. The medial collateral ligament (MCL) is the most commonly injured ligament of the knee.
Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most commonly caused by abnormal force, such as a falling on the knee, a severe twisting motion, severe force that bends the knee, or when the knee forcefully hits an object.
Kneecap dislocation. This type of dislocation occurs more frequently in 13- to 18-year-old girls. Pieces of bone or tissue (loose bodies) from a fracture or dislocation may get caught in the joint and interfere with movement.
Knee joint dislocation. This is a rare injury that requires great force. It is a serious injury and requires immediate medical care.
Overuse injuries
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and other tissues and can lead to irritation and inflammation. Overuse injuries include:
Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
Thickening or folding of the knee ligaments (Plica syndrome).
Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).
Conditions that may cause knee problems
Problems not directly related to an injury or overuse may occur in or around the knee.
Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also can cause knee pain, swelling, and stiffness.
Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.
A popliteal (or Baker's) cyst causes swelling in the back of the knee.
Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can cause pain and decreased knee movement.
A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.
Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.
Treatment
Treatment for a knee problem or injury may include first aid measures, rest, bracing, physical therapy, medicine, and in some cases surgery. Treatment depends on the location, type, and severity of the injury as well as your age, health condition, and activity level (such as work, sports, or hobbies).
Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.
The knee is the largest joint in the body. The upper and lower bones of the knee are separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones (tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the bones inside the knee joint is covered by articular cartilage, which absorbs shock and provides a smooth, gliding surface for joint movement. See an illustration of the structures of the knee.
Although a knee problem is often caused by an injury to one or more of these structures, it may have another cause. Some people are more likely to develop knee problems than others. Many jobs, sports and recreation activities, getting older, or having a disease such as osteoporosis or arthritis increase your chances of having problems with your knees.
Sudden (acute) injuries
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be caused by a direct blow to the knee or from abnormal twisting, bending the knee, or falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries include:
Sprains, strains, or other injuries to the ligaments and tendons that connect and support the kneecap.
A tear in the rubbery cushions of the knee joint (meniscus).
Ligament tears. The medial collateral ligament (MCL) is the most commonly injured ligament of the knee.
Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the tibia or fibula. Knee fractures are most commonly caused by abnormal force, such as a falling on the knee, a severe twisting motion, severe force that bends the knee, or when the knee forcefully hits an object.
Kneecap dislocation. This type of dislocation occurs more frequently in 13- to 18-year-old girls. Pieces of bone or tissue (loose bodies) from a fracture or dislocation may get caught in the joint and interfere with movement.
Knee joint dislocation. This is a rare injury that requires great force. It is a serious injury and requires immediate medical care.
Overuse injuries
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and other tissues and can lead to irritation and inflammation. Overuse injuries include:
Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
Thickening or folding of the knee ligaments (Plica syndrome).
Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
Irritation and inflammation of the band of fibrous tissue that runs down the outside of the thigh (iliotibial band syndrome).
Conditions that may cause knee problems
Problems not directly related to an injury or overuse may occur in or around the knee.
Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the morning and improves during the day. It often develops at the site of a previous injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also can cause knee pain, swelling, and stiffness.
Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the knee below the kneecap. It is especially common in boys ages 11 to 15.
A popliteal (or Baker's) cyst causes swelling in the back of the knee.
Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or bursa (septic bursitis) can cause pain and decreased knee movement.
A problem elsewhere in the body, such as a pinched nerve or a problem in the hip, can sometimes cause knee pain.
Osteochondritis dissecans causes pain and decreased movement when a piece of bone or cartilage or both inside the knee joint loses blood supply and dies.
Treatment
Treatment for a knee problem or injury may include first aid measures, rest, bracing, physical therapy, medicine, and in some cases surgery. Treatment depends on the location, type, and severity of the injury as well as your age, health condition, and activity level (such as work, sports, or hobbies).
Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a doctor.
Prostate Cancer
What is prostate cancer?
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.1 Although most men may die with prostate cancer, most men do not die from it.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.2
What are the symptoms?
Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
You have trouble starting your urine stream.
You have a weaker-than-normal urine stream.
You cannot urinate at all.
You have to urinate often.
You feel like your bladder is not emptying completely when you urinate.
You have to get up at night to urinate.
You have pain or burning when you urinate.
You have blood in your urine.
You have a deep pain in your lower back, belly, hip, or pelvis.
How is prostate cancer diagnosed?
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.
Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages. The 5-year survival rate is almost 100%.1 The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It’s important to remember that everyone’s case is different, and these numbers may not show what will happen in your case.
Should you have regular tests for prostate cancer?
It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead you to have cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.
Talk with your doctor about the reasons for and against having a PSA test for prostate cancer. The decision to have a PSA test depends on your doctor's opinion and your preferences.
How is prostate cancer treated?
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.
How can treatment affect your quality of life?
Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage them. Many times a special form of surgery, called nerve-sparing surgery, can be used to try to avoid damaging the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because of treatment. Many men recover their ability to have an erection several months or years after surgery.
Prostate cancer is the abnormal growth of cells in a man's prostate gland. The prostate sits just below the bladder. It makes part of the fluid for semen. In young men, the prostate is about the size of a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows slowly and can take years to grow large enough to cause any problems. Most cases are treatable, because they are found with screening tests before the cancer has spread to other parts of the body.1 Although most men may die with prostate cancer, most men do not die from it.
Experts don't know what causes prostate cancer, but they believe that your age, family history (genetics), and race affect your chances of getting it. Eating a high-fat diet may also play a part.2
What are the symptoms?
Prostate cancer usually does not cause symptoms in its early stages. Most men don't know they have it until it is found during a regular medical exam.
When problems are noticed, they are most often problems with urinating. But these same symptoms can also be caused by an enlarged prostate (benign prostatic hyperplasia). An enlarged prostate is common in older men.
See your doctor for a checkup if:
You have trouble starting your urine stream.
You have a weaker-than-normal urine stream.
You cannot urinate at all.
You have to urinate often.
You feel like your bladder is not emptying completely when you urinate.
You have to get up at night to urinate.
You have pain or burning when you urinate.
You have blood in your urine.
You have a deep pain in your lower back, belly, hip, or pelvis.
How is prostate cancer diagnosed?
The most common way to check for prostate cancer is to have a digital rectal exam, in which the doctor puts a gloved, lubricated finger in your rectum to feel your prostate, and a prostate-specific antigen (PSA) blood test. A higher level of PSA may mean that you have prostate cancer, but it could also mean that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the rectal exam, he or she may do a biopsy to figure out the cause. A biopsy means your doctor takes a sample of tissue from your prostate gland and sends it to a lab for testing.
Because many men have regular checkups, about 9 out of 10 prostate cancers are found in the early stages. The 5-year survival rate is almost 100%.1 The 5-year survival rate shows the percentage of men still alive 5 years or longer after diagnosis. It’s important to remember that everyone’s case is different, and these numbers may not show what will happen in your case.
Should you have regular tests for prostate cancer?
It is important to have regular health checkups, including a digital rectal exam. But experts disagree on whether regular PSA testing is right for all men. Testing could lead you to have cancer treatment that can cause other health problems, especially loss of bladder control and not being able to have an erection.
Talk with your doctor about the reasons for and against having a PSA test for prostate cancer. The decision to have a PSA test depends on your doctor's opinion and your preferences.
How is prostate cancer treated?
Your treatment will depend on what kind of cancer cells you have, how far they have spread, your age and general health, and your preferences.
You and your doctor may decide to treat your cancer with surgery, radiation, hormone therapy, or a combination. Or, if the cancer has not spread and you are around age 70 or older, you may be able to wait and watch to see what happens. During watchful waiting, you will have regular checkups with your doctor to see if your cancer has changed.
Choosing treatment for prostate cancer can be confusing. Talk with your doctor to choose the treatment that is best for you.
How can treatment affect your quality of life?
Both surgery and radiation can cause urinary incontinence (not being able to control urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the prostate. Surgery to remove the cancer may damage them. Many times a special form of surgery, called nerve-sparing surgery, can be used to try to avoid damaging the nerves. But if the cancer has spread to the nerves, they may have to be removed during surgery.
These same nerves can also be damaged by the X-rays that are used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because of treatment. Many men recover their ability to have an erection several months or years after surgery.
Colorectal Cancer
What is colorectal cancer?
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form tumors.
This cancer is also called colon cancer or rectal cancer. It is the third most common cancer in the United States. And it occurs most often in people older than 50.
When it is found early, it is easily treated and often cured. But because it usually is not found early, it is the second leading cause of cancer deaths in the United States.1 Fairly simple screening tests can prevent this cancer, but fewer than half of people older than 50 are screened. According to the American Cancer Society, if everyone were tested, tens of thousands of lives could be saved each year.
What causes colorectal cancer?
Most cases begin as polyps, which are small growths inside the colon or rectum. Colon polyps are very common, and most of them do not turn into cancer. But doctors cannot tell ahead of time which polyps will turn into cancer. This is why people older than 50 need regular tests to find out if they have any polyps and then have them removed.
What are the symptoms?
Colorectal cancer usually does not cause symptoms until after it has begun to spread. See your doctor if you have any of these symptoms:
Pain in the belly
Blood in your stool or very dark stools
A change in your bowel habits, such as more frequent stools or a feeling that your bowels are not emptying completely
How is colorectal cancer diagnosed?
If your doctor thinks that you may have this cancer, you will need a test, called a colonoscopy, that lets the doctor see the inside of your entire colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
Sometimes other tests, such as a barium enema or a sigmoidoscopy, are used to diagnose colorectal cancer.
How is it treated?
Surgery is almost always used to treat colon and rectal cancer. The cancer is easily removed and often cured when it is found early.
If the cancer has spread into the wall of the colon or farther, you may also need radiation or chemotherapy. These treatments have side effects, but most people can manage the side effects with medicines or home care.
Learning that you have cancer can be upsetting. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.
How can you prevent colorectal cancer?
Screening tests can prevent many cases of colon and rectal cancer. They look for a certain disease or condition before any symptoms appear. Regular screening is advised for most people age 50 and older. If you have a family history of this cancer, you may need to begin screening earlier than that.
These are the most common screening tests:
Fecal occult blood test. You smear a small sample of your stool on a special card and send it to your doctor or to a lab. Drops of a special solution are placed on the card. If the solution changes color, there is blood in the stool.
Sigmoidoscopy. A doctor puts a flexible viewing tube into your rectum and into the first part of your colon. This lets the doctor see the lower portion of the intestine, which is where most colon cancers grow.
Barium enema. Barium, a whitish liquid, is put into your rectum and colon. The white liquid outlines the inside of the colon so that it can be more clearly seen on an X-ray.
Colonoscopy. A doctor puts a long, flexible viewing tube into your rectum and colon. The tube is usually linked to a video monitor similar to a TV screen. With this test, the doctor can see the entire large intestine.
Colorectal cancer happens when cells that are not normal grow in your colon or rectum. These cells grow together and form tumors.
This cancer is also called colon cancer or rectal cancer. It is the third most common cancer in the United States. And it occurs most often in people older than 50.
When it is found early, it is easily treated and often cured. But because it usually is not found early, it is the second leading cause of cancer deaths in the United States.1 Fairly simple screening tests can prevent this cancer, but fewer than half of people older than 50 are screened. According to the American Cancer Society, if everyone were tested, tens of thousands of lives could be saved each year.
What causes colorectal cancer?
Most cases begin as polyps, which are small growths inside the colon or rectum. Colon polyps are very common, and most of them do not turn into cancer. But doctors cannot tell ahead of time which polyps will turn into cancer. This is why people older than 50 need regular tests to find out if they have any polyps and then have them removed.
What are the symptoms?
Colorectal cancer usually does not cause symptoms until after it has begun to spread. See your doctor if you have any of these symptoms:
Pain in the belly
Blood in your stool or very dark stools
A change in your bowel habits, such as more frequent stools or a feeling that your bowels are not emptying completely
How is colorectal cancer diagnosed?
If your doctor thinks that you may have this cancer, you will need a test, called a colonoscopy, that lets the doctor see the inside of your entire colon and rectum. During this test, your doctor will remove polyps or take tissue samples from any areas that don't look normal. The tissue will be looked at under a microscope to see if it contains cancer.
Sometimes other tests, such as a barium enema or a sigmoidoscopy, are used to diagnose colorectal cancer.
How is it treated?
Surgery is almost always used to treat colon and rectal cancer. The cancer is easily removed and often cured when it is found early.
If the cancer has spread into the wall of the colon or farther, you may also need radiation or chemotherapy. These treatments have side effects, but most people can manage the side effects with medicines or home care.
Learning that you have cancer can be upsetting. It may help to talk with your doctor or with other people who have had cancer. Your local American Cancer Society chapter can help you find a support group.
How can you prevent colorectal cancer?
Screening tests can prevent many cases of colon and rectal cancer. They look for a certain disease or condition before any symptoms appear. Regular screening is advised for most people age 50 and older. If you have a family history of this cancer, you may need to begin screening earlier than that.
These are the most common screening tests:
Fecal occult blood test. You smear a small sample of your stool on a special card and send it to your doctor or to a lab. Drops of a special solution are placed on the card. If the solution changes color, there is blood in the stool.
Sigmoidoscopy. A doctor puts a flexible viewing tube into your rectum and into the first part of your colon. This lets the doctor see the lower portion of the intestine, which is where most colon cancers grow.
Barium enema. Barium, a whitish liquid, is put into your rectum and colon. The white liquid outlines the inside of the colon so that it can be more clearly seen on an X-ray.
Colonoscopy. A doctor puts a long, flexible viewing tube into your rectum and colon. The tube is usually linked to a video monitor similar to a TV screen. With this test, the doctor can see the entire large intestine.
There's Good News About Treatment and Survival of Breast Cancer
Few things are as terrifying as thinking you might have breast cancer: Surveys show it's women's number one health worry. However, 80% of biopsies are benign. And thanks to advances in testing and treatment, breast cancer is less deadly than ever, and curing it is not the toxic, disfiguring ordeal it once was.
The importance of regular breast screening cannot be overstated—nor, for those who have been diagnosed, the importance of understanding the treatment options and finding good medical care. That's what this breast cancer Health Journey is here for: to explain the risks and tests and to guide you through the full range of choices you have on your road to cure. Along the way, we dive deeply into the emotional aspects of this disease, talk to women who have beaten breast cancer, and introduce you to the doctors and experts who have helped them do it.
Our Breast Cancer Health Journey team includes editorial adviser Julia A. Smith, MD, PhD; editor Sally Chew; research editor Michael Gollust; lead writer Lorie Parch; and many contributing journalists.
The importance of regular breast screening cannot be overstated—nor, for those who have been diagnosed, the importance of understanding the treatment options and finding good medical care. That's what this breast cancer Health Journey is here for: to explain the risks and tests and to guide you through the full range of choices you have on your road to cure. Along the way, we dive deeply into the emotional aspects of this disease, talk to women who have beaten breast cancer, and introduce you to the doctors and experts who have helped them do it.
Our Breast Cancer Health Journey team includes editorial adviser Julia A. Smith, MD, PhD; editor Sally Chew; research editor Michael Gollust; lead writer Lorie Parch; and many contributing journalists.
Wednesday, July 2, 2008
Vegetarian Diets Tips
Diet Television Tip: Macrobiotic Diets: Eating Plans For Purists
Some vegetarians - and non-vegetarians - choose to follow a macrobiotic diet for overall health, although macrobiotic diets don’t make specific claims about weight loss. A macrobiotic diet has its roots in Eastern philosophy and emphasizes the importance of eating simple, whole, unprocessed foods that are high in fiber and phytoestrogens.
A macrobiotic diet can be a vegetarian diet or it can include some meat, although a traditional macrobiotic diet keeps meat, sugar, and dairy products to a minimum. Most variations on a macrobiotic diet are low-fat and high-fiber, and most include soy products and seaweed-based products.
Western nutritional theory advocates seven components that are needed for basic nutrition and good health: Carbohydrates, proteins, fats, vitamins, minerals and water. If you are following a macrobiotic diet, your sources for these components could be as follows:
Carbohydrates: Whole grains, beans, vegetables, seeds, fruits.
Proteins: Beans, bean products, fish, seeds, nuts.
Fats and oils: Nut butters, nuts, seeds, animal products (minimal).
Vitamins: Vegetables, fruits, sea vegetables, root vegetables, leafy green vegetables.
Minerals: Salts, sea vegetables, vegetables, root vegetables, leafy green vegetables, fruits.
Water: Spring water, well water.
This isn’t a low-carb diet: Most information on macrobiotic diets shows that 50-60 percent of each meal should come from whole grains. And if you have a sweet tooth, the restrictions might be too, well, restrictive. Desserts (such as they are) should be limited to naturally sweet foods such as apples and dried fruit, and a macrobiotic diet advocates replacing sugar, molasses, and even honey with rice syrup or barley malt. And chocolate is to be avoided, which may rule out a macrobiotic diet for the chocolate lovers out there!
DietTV.com has your best and full review for each diet plan with pictures of what you can/can't eat.
Some vegetarians - and non-vegetarians - choose to follow a macrobiotic diet for overall health, although macrobiotic diets don’t make specific claims about weight loss. A macrobiotic diet has its roots in Eastern philosophy and emphasizes the importance of eating simple, whole, unprocessed foods that are high in fiber and phytoestrogens.
A macrobiotic diet can be a vegetarian diet or it can include some meat, although a traditional macrobiotic diet keeps meat, sugar, and dairy products to a minimum. Most variations on a macrobiotic diet are low-fat and high-fiber, and most include soy products and seaweed-based products.
Western nutritional theory advocates seven components that are needed for basic nutrition and good health: Carbohydrates, proteins, fats, vitamins, minerals and water. If you are following a macrobiotic diet, your sources for these components could be as follows:
Carbohydrates: Whole grains, beans, vegetables, seeds, fruits.
Proteins: Beans, bean products, fish, seeds, nuts.
Fats and oils: Nut butters, nuts, seeds, animal products (minimal).
Vitamins: Vegetables, fruits, sea vegetables, root vegetables, leafy green vegetables.
Minerals: Salts, sea vegetables, vegetables, root vegetables, leafy green vegetables, fruits.
Water: Spring water, well water.
This isn’t a low-carb diet: Most information on macrobiotic diets shows that 50-60 percent of each meal should come from whole grains. And if you have a sweet tooth, the restrictions might be too, well, restrictive. Desserts (such as they are) should be limited to naturally sweet foods such as apples and dried fruit, and a macrobiotic diet advocates replacing sugar, molasses, and even honey with rice syrup or barley malt. And chocolate is to be avoided, which may rule out a macrobiotic diet for the chocolate lovers out there!
DietTV.com has your best and full review for each diet plan with pictures of what you can/can't eat.
Top 10 Foods to Lower Cholesterol
The first step for a heart-healthy diet is to reduce your intake of bad fats — especially saturated and trans fats. If cutting out bad fats isn’t enough to reduce your cholesterol, you may want to try to improve your diet and add special foods that can lower your cholesterol. Below is a list of the top 10 foods to help you lower your cholesterol.
1. Apples.
Apple pectin is a soluble fiber that helps draw cholesterol out of the system. The flavonoids (Quercetin) in apples act as a powerful anti-oxidant that seems to short-circuit the process that leads “bad” LDL cholesterol to accumulate in the bloodstream.
2. Beans.
Beans and vegetables are an excellent source of soluble fiber and high in vegetable protein. By properly combing beans with brown rice, seeds, corn, wheat you can create a complete protein. Properly combined beans become an excellent substitute for red meat protein that is high in saturated fat.
3. Brown Rice.
The oil in whole brown rice, not its fiber, lowers cholesterol. Brown rice can be combined with beans to form an inexpensive complete protein low in saturated fat. In addition, this whole grain also supplies good doses of heart-healthy fiber, magnesium and B vitamins.
4. Cinnamon.
A study published in the journal Diabetes Care found that half a teaspoon of cinnamon a day significantly reduces blood sugar levels in people with type 2 diabetes. It also reduces triglyceride, LDL, the bad cholesterol and the total cholesterol level.
5. Garlic.
Garlic contains the chemical allicin, which has been shown to kill bacteria and fungi, and alleviate certain digestive disorders. It also lowers the blood clotting properties of blood. But the most notable attention garlic has received over recent years is its possible usefulness in lowering cholesterol levels.
6. Grapes.
Flavonoids in grapes protect LDL cholesterol from free radical damage and reduce platelet clumping. The LDL lowering effect of grapes comes from a compound that grapes produce normally to resist mold. The darker the grape, the better.
7. Oats.
Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the “bad” cholesterol. Five to 10 grams of soluble fiber a day decreases LDL cholesterol by about 5 percent. Eating 1.5 cups of cooked oatmeal provides 4.5 grams of fiber — enough to lower your cholesterol.
8. Salmon.
The major health components in salmon include: Omega 3 fatty-acid and protein. These components have a favorable cardiovascular effect. The American Heart Association recommends that people include at least two servings of fish/week, particularly fatty fish (salmon, tuna, mackerel, sardines, anchovies and herring), in their diets.
9. Soy Products.
The top health promoting components in soybeans are isoflavones and soluble fiber. Isoflavones act like human hormone that can lower LDL cholesterol and raise HDL cholesterol. All soy products (soybeans, soy nuts, tofu, tempeh, soy milk, etc.) are complete proteins.
10. Walnuts.
Walnuts can significantly reduce blood cholesterol because they are rich in polyunsaturated fatty acids. Walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.
A cholesterol-lowering diet with a little less than 1/3 of a cup of walnuts/day may reduce LDL cholesterol by 12 percent.
1. Apples.
Apple pectin is a soluble fiber that helps draw cholesterol out of the system. The flavonoids (Quercetin) in apples act as a powerful anti-oxidant that seems to short-circuit the process that leads “bad” LDL cholesterol to accumulate in the bloodstream.
2. Beans.
Beans and vegetables are an excellent source of soluble fiber and high in vegetable protein. By properly combing beans with brown rice, seeds, corn, wheat you can create a complete protein. Properly combined beans become an excellent substitute for red meat protein that is high in saturated fat.
3. Brown Rice.
The oil in whole brown rice, not its fiber, lowers cholesterol. Brown rice can be combined with beans to form an inexpensive complete protein low in saturated fat. In addition, this whole grain also supplies good doses of heart-healthy fiber, magnesium and B vitamins.
4. Cinnamon.
A study published in the journal Diabetes Care found that half a teaspoon of cinnamon a day significantly reduces blood sugar levels in people with type 2 diabetes. It also reduces triglyceride, LDL, the bad cholesterol and the total cholesterol level.
5. Garlic.
Garlic contains the chemical allicin, which has been shown to kill bacteria and fungi, and alleviate certain digestive disorders. It also lowers the blood clotting properties of blood. But the most notable attention garlic has received over recent years is its possible usefulness in lowering cholesterol levels.
6. Grapes.
Flavonoids in grapes protect LDL cholesterol from free radical damage and reduce platelet clumping. The LDL lowering effect of grapes comes from a compound that grapes produce normally to resist mold. The darker the grape, the better.
7. Oats.
Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the “bad” cholesterol. Five to 10 grams of soluble fiber a day decreases LDL cholesterol by about 5 percent. Eating 1.5 cups of cooked oatmeal provides 4.5 grams of fiber — enough to lower your cholesterol.
8. Salmon.
The major health components in salmon include: Omega 3 fatty-acid and protein. These components have a favorable cardiovascular effect. The American Heart Association recommends that people include at least two servings of fish/week, particularly fatty fish (salmon, tuna, mackerel, sardines, anchovies and herring), in their diets.
9. Soy Products.
The top health promoting components in soybeans are isoflavones and soluble fiber. Isoflavones act like human hormone that can lower LDL cholesterol and raise HDL cholesterol. All soy products (soybeans, soy nuts, tofu, tempeh, soy milk, etc.) are complete proteins.
10. Walnuts.
Walnuts can significantly reduce blood cholesterol because they are rich in polyunsaturated fatty acids. Walnuts also help keep blood vessels healthy and elastic. Almonds appear to have a similar effect, resulting in a marked improvement within just four weeks.
A cholesterol-lowering diet with a little less than 1/3 of a cup of walnuts/day may reduce LDL cholesterol by 12 percent.
HANDLE FRESH VEGETABLES WITH CARE
AUBURN, JULY 31---No food from any other part of the world beats the flavor and texture of locally grown produce. For those who live in areas governed by changing seasons, summer is the prime time for an abundance of fresh vegetables.
Local farmers do their best to raise the largest, tastiest varieties. But after that, it's up to consumers to preserve the quality of vegetables until they reach the dinner table, says Dr. Barbara Struempler, Extension nutritionist with the Alabama Cooperative Extension System.
A key point to remember is vegetables are subject to aging. Too much heat, moisture and air can ruin even the best produce. As soon as a vegetable is harvested, chemical changes begin. Growth stops, but enzymes continue to act, altering nutrient content along with texture and taste.
Not all vegetables react in the same way after being picked, says Struempler. For instance, tomatoes picked before maturity keep ripening, while sweet peas lose sugar and toughen soon after harvest. Vegetables, such as turnips, potatoes and carrots -- fleshy root or tubers -- are in a dormant state. They will remain stable for months if stored properly.
Other vegetables deteriorate rapidly. The aging rate for spinach is about nine times that of a potato. In certain cases,nutrient loss starts as soon as the vegetable is harvested. Kale loses 1 to 5 percent of its vitamin C content per hour, which adds up to about a third in its first day.
###
SOURCE: DR. Barbara Struempler, Extension nutritionist, Alabama Cooperative Extension System (334) 844-2217.
Local farmers do their best to raise the largest, tastiest varieties. But after that, it's up to consumers to preserve the quality of vegetables until they reach the dinner table, says Dr. Barbara Struempler, Extension nutritionist with the Alabama Cooperative Extension System.
A key point to remember is vegetables are subject to aging. Too much heat, moisture and air can ruin even the best produce. As soon as a vegetable is harvested, chemical changes begin. Growth stops, but enzymes continue to act, altering nutrient content along with texture and taste.
Not all vegetables react in the same way after being picked, says Struempler. For instance, tomatoes picked before maturity keep ripening, while sweet peas lose sugar and toughen soon after harvest. Vegetables, such as turnips, potatoes and carrots -- fleshy root or tubers -- are in a dormant state. They will remain stable for months if stored properly.
Other vegetables deteriorate rapidly. The aging rate for spinach is about nine times that of a potato. In certain cases,nutrient loss starts as soon as the vegetable is harvested. Kale loses 1 to 5 percent of its vitamin C content per hour, which adds up to about a third in its first day.
###
SOURCE: DR. Barbara Struempler, Extension nutritionist, Alabama Cooperative Extension System (334) 844-2217.
TOO MUCH SODA DRINKING DURING TEEN YEARS MAY CONTRIBUTE TO CRIPPLING BONE DISEASE LATER IN LIFE
AUBURN, Aug. 28---Teen-age girls beware: your manic passion for soft drinks may catch up with you later in life.
Teen-age girls who consume soft drinks at the expense of milk and other calcium-rich products may increase their risk of osteoporosis, a painful, debilitating bone disease that affects millions of older women.
"Some teen-agers, boys and girls alike, are consuming up to five cans of soda every day," says Dr. Robert Keith, an Alabama Cooperative Extension System nutritionist. "And while sodas have calories, they have no other nutritional value."
Soda drinking wouldn't be as serious an issue if kids consumed a calcium-rich diet with plenty of dairy products and green leafy vegetables, Keith says. But the fact is they don't, and therein lies the problem.
For an increasing number of young people, soft drinksare being substituted for more nutritious beverages such as milk. And while it's still possible for youngsters to compensate for this by consuming other calcium-rich foods, most don't.
"If a teen is consuming roughly 2,000 calories a day, which includes five sodas, between 30 and 40 percent of their calories are coming from soft drinks," Keith says. "If they're not going to drink milk, the next best things are the dark, green leafy vegetables, such as turnip greens, romaine lettuce and broccoli."
Of course, given young people's historic disdain for these foods, he concedes it's very unlikely they will start now.
While many teen-agers likely will pay for these nutritional lapses later in life, Keith doubts many of them would change even if they were warned of the risks.
"It's just not a specific threat," Keith says. "Life after age 50 seems especially remote to these kids and so the issue isn't perceived as an immediate threat."
Complicating this is peer pressure: soft drinks after all, have been an integral part of the teen-age social scene for decades.
Even though age 50 seems far away to these girls, the spiraling effect that eventually leads to bone loss can begin as early as age 30, Keith says.
"Bone mass usually peaks round 30," he says. "After that, you either maintain what you have or you begin losing bone mass in minute degrees every year thereafter." The people who will pay most dearly with osteoporosis are those whose bone mass wasn't as high as it should have been upon reaching age 30, Keith says.
"A lot of bone mass is laid down in earlier adolescence," Keith says "So if kids miss their opportunities early in life by not consuming enough calcium-rich foods, they never catch up."
Women are especially vulnerable to osteoporosis because of estrogen loss at menopause.
While many parents discourage kids from eating too much of the perennial favorites associated with adolescence - cheese hamburgers and pizzas - Keith says consuming these foods in moderation may actually contribute to the formation of bone mass.
While both of these foods are known for their high levels of saturated fats, both are made with cheese. So, while they won't be doing much to enhance teens cardiovascular health, they likely will be reducing teens' risk of bone loss.
If parents can't persuade kids to forgo soft drinks or to eat more calcium-rich foods, wouldn't the next-best thing be calcium-enriched soft drinks?
Yes and no. While the process has been tried, thecalcium enrichment changes both the taste and appearance of soft drinks - so much so that most people aren't willing tobuy them.
###
SOURCE: DR. BOB KEITH, Extension nutritionist, Alabama Cooperative Extension System (334) 844-3273.
Teen-age girls who consume soft drinks at the expense of milk and other calcium-rich products may increase their risk of osteoporosis, a painful, debilitating bone disease that affects millions of older women.
"Some teen-agers, boys and girls alike, are consuming up to five cans of soda every day," says Dr. Robert Keith, an Alabama Cooperative Extension System nutritionist. "And while sodas have calories, they have no other nutritional value."
Soda drinking wouldn't be as serious an issue if kids consumed a calcium-rich diet with plenty of dairy products and green leafy vegetables, Keith says. But the fact is they don't, and therein lies the problem.
For an increasing number of young people, soft drinksare being substituted for more nutritious beverages such as milk. And while it's still possible for youngsters to compensate for this by consuming other calcium-rich foods, most don't.
"If a teen is consuming roughly 2,000 calories a day, which includes five sodas, between 30 and 40 percent of their calories are coming from soft drinks," Keith says. "If they're not going to drink milk, the next best things are the dark, green leafy vegetables, such as turnip greens, romaine lettuce and broccoli."
Of course, given young people's historic disdain for these foods, he concedes it's very unlikely they will start now.
While many teen-agers likely will pay for these nutritional lapses later in life, Keith doubts many of them would change even if they were warned of the risks.
"It's just not a specific threat," Keith says. "Life after age 50 seems especially remote to these kids and so the issue isn't perceived as an immediate threat."
Complicating this is peer pressure: soft drinks after all, have been an integral part of the teen-age social scene for decades.
Even though age 50 seems far away to these girls, the spiraling effect that eventually leads to bone loss can begin as early as age 30, Keith says.
"Bone mass usually peaks round 30," he says. "After that, you either maintain what you have or you begin losing bone mass in minute degrees every year thereafter." The people who will pay most dearly with osteoporosis are those whose bone mass wasn't as high as it should have been upon reaching age 30, Keith says.
"A lot of bone mass is laid down in earlier adolescence," Keith says "So if kids miss their opportunities early in life by not consuming enough calcium-rich foods, they never catch up."
Women are especially vulnerable to osteoporosis because of estrogen loss at menopause.
While many parents discourage kids from eating too much of the perennial favorites associated with adolescence - cheese hamburgers and pizzas - Keith says consuming these foods in moderation may actually contribute to the formation of bone mass.
While both of these foods are known for their high levels of saturated fats, both are made with cheese. So, while they won't be doing much to enhance teens cardiovascular health, they likely will be reducing teens' risk of bone loss.
If parents can't persuade kids to forgo soft drinks or to eat more calcium-rich foods, wouldn't the next-best thing be calcium-enriched soft drinks?
Yes and no. While the process has been tried, thecalcium enrichment changes both the taste and appearance of soft drinks - so much so that most people aren't willing tobuy them.
###
SOURCE: DR. BOB KEITH, Extension nutritionist, Alabama Cooperative Extension System (334) 844-3273.
EATING DISORDERS AND DIABETES
AUBURN, June 12---Anyone can develop an eating disorder. Having diabetes does not increase your risk for having one, but having diabetes and an eating disorder can be very dangerous.
People with eating disorders have a very distorted view of their bodies, says Dr. Evelyn Crayton, Extension foods and nutrition specialist with the Alabama Cooperative Extension System.
"They are overly concerned about their weight and see themselves as too fat when they're really underweight. Females are more likely to be diagnosed with these disorders, but males also can have them," Crayton adds.
There are three main types of eating disorders: anorexia nervosa, bulimia nervosa and compulsive overeating. With anorexia nervosa, people restrict food so much that they are at least 25 percent below their ideal body weight. People with bulimia may be normal weight or even overweight, but binge on large amounts of food in a short period of time and then purge by vomiting, using laxatives, or fasting. With compulsive overeating, people eat large amounts of food but don't purge.
These disorders can cause wide swings in the blood sugar, says Crayton. The blood sugar may go too low when a person is purging or eating too little. Or, after a binge, the blood sugar may go so high that ketosis occurs. In both cases emergency treatment may be necessary.
People with diabetes purge in a unique way. They get rid of extra calories and pounds by taking too little insulin so they lose calories by spilling sugar in their urine. This increases their risk for ketosis, urinary tract infections, and vaginal infections. If the blood sugars continue to be poorly controlled, long-term complications such as vision loss, nerve damage, and kidney failure can occur.
No one has to suffer with an eating disorder. There are health professionals who specialize in these disorders. Early diagnosis makes recovery easier, but even people who have had the problem for years can be helped. Treatment focuses on improving self-esteem, coping with stress, developing good communication skills, and learning to eat and exercise moderately.
If you have an eating disorder, talk to your doctor, diabetes educator, dietitian, or mental health agency. Ignoring an eating disorder will not make it go away and chances are it will only get worse.
###
SOURCE: DR. EVELYN CRAYTON, Extension foods and nutrition specialist, Alabama Cooperative Extension System (334) 844-2224.
People with eating disorders have a very distorted view of their bodies, says Dr. Evelyn Crayton, Extension foods and nutrition specialist with the Alabama Cooperative Extension System.
"They are overly concerned about their weight and see themselves as too fat when they're really underweight. Females are more likely to be diagnosed with these disorders, but males also can have them," Crayton adds.
There are three main types of eating disorders: anorexia nervosa, bulimia nervosa and compulsive overeating. With anorexia nervosa, people restrict food so much that they are at least 25 percent below their ideal body weight. People with bulimia may be normal weight or even overweight, but binge on large amounts of food in a short period of time and then purge by vomiting, using laxatives, or fasting. With compulsive overeating, people eat large amounts of food but don't purge.
These disorders can cause wide swings in the blood sugar, says Crayton. The blood sugar may go too low when a person is purging or eating too little. Or, after a binge, the blood sugar may go so high that ketosis occurs. In both cases emergency treatment may be necessary.
People with diabetes purge in a unique way. They get rid of extra calories and pounds by taking too little insulin so they lose calories by spilling sugar in their urine. This increases their risk for ketosis, urinary tract infections, and vaginal infections. If the blood sugars continue to be poorly controlled, long-term complications such as vision loss, nerve damage, and kidney failure can occur.
No one has to suffer with an eating disorder. There are health professionals who specialize in these disorders. Early diagnosis makes recovery easier, but even people who have had the problem for years can be helped. Treatment focuses on improving self-esteem, coping with stress, developing good communication skills, and learning to eat and exercise moderately.
If you have an eating disorder, talk to your doctor, diabetes educator, dietitian, or mental health agency. Ignoring an eating disorder will not make it go away and chances are it will only get worse.
###
SOURCE: DR. EVELYN CRAYTON, Extension foods and nutrition specialist, Alabama Cooperative Extension System (334) 844-2224.
Food Selections Can Help Lower LDL or "Bad" Cholesterol
AUBURN, July 6---New cholesterol recommendations urge people to keep their cholesterol levels below 200 milligrams with HDL or "good" cholesterol levels above 40 milligrams. A new sliding scale has been set for LDL or "bad" cholesterol levels.
People with no other heart disease factors, should keep LDL cholesterol levels below 130 milligrams. People with one or more risk factors for heart disease, such as obesity, diabetes, high blood pressure or low HDL cholesterol levels, should keep their LDL cholesterol levels below 100 milligrams.
So what are some ways to lower total cholesterol levels and especially LDL cholesterol levels? Selecting foods that keep the cholesterol in your blood low is a good start, says Dr. Barbara Struempler, Extension nutritionist with the Alabama Cooperative Extension System.
Here are some easy ways to do that:
Use only nonfat or lowfat dairy products, including milk, yogurt and cheese. Regular dairy products, such as whole milk, butter, cheese, cream cheese and ricotta cheese, are high in saturated fat.
Limit the amount of saturated fat. No more than 5 percent of your daily calories should come from saturated fat. That's about 10 to11 grams a day for most people. One tablespoon of butter has 7 grams of saturated fat; a tablespoon of margarine has only 2 grams of saturated fat.
Avoid foods with added trans-fat. This fat comes from partially hydrogenated vegetable oils often found in fried foods and processed foods such as crackers, baked goods and desserts.
Base most of your meals on beans, vegetables, fruits and whole grains, with a minimum of low saturated fat foods from animal protein such as nonfat dairy, fish and egg whites.
Include soy protein in your diet in place of animal protein when possible. Studies show that 25 grams of soy protein per day can help lower cholesterol when part of a heart-healthy diet.
Limit intake of sugar and fructose. Doing so should lower triglycerides, aid weight loss and lower LDL cholesterol levels.
Eat foods naturally high in fiber, especially soluble fiber. Soluble fiber is found in legumes, fruits and root vegetables, as well as oats, barley and flax. For every 1 or 2 grams of soluble fiber you eat daily, you lower LDL cholesterol levels by 1 percent.
Here is a list of foods containing 2 grams or more of soluble fiber. Increasing these foods in your diet will help lower cholesterol.
1 cup barley, cooked
1 cup fresh broccoli
1 cup Brussels sprouts
1/2 cup apricots or figs
1 cup carrots
1 cup collard greens
1 cup cooked beans, peas or lentils
1 cup oat bran
1 cup oatmeal, cooked
1 cup rye cereal, cooked
1 large sweet potato
6 prunes
SOURCE: Dr. Barbara Struempler, Extension Nutritionist, Alabama Cooperative Extension System, (334) 844-2217
People with no other heart disease factors, should keep LDL cholesterol levels below 130 milligrams. People with one or more risk factors for heart disease, such as obesity, diabetes, high blood pressure or low HDL cholesterol levels, should keep their LDL cholesterol levels below 100 milligrams.
So what are some ways to lower total cholesterol levels and especially LDL cholesterol levels? Selecting foods that keep the cholesterol in your blood low is a good start, says Dr. Barbara Struempler, Extension nutritionist with the Alabama Cooperative Extension System.
Here are some easy ways to do that:
Use only nonfat or lowfat dairy products, including milk, yogurt and cheese. Regular dairy products, such as whole milk, butter, cheese, cream cheese and ricotta cheese, are high in saturated fat.
Limit the amount of saturated fat. No more than 5 percent of your daily calories should come from saturated fat. That's about 10 to11 grams a day for most people. One tablespoon of butter has 7 grams of saturated fat; a tablespoon of margarine has only 2 grams of saturated fat.
Avoid foods with added trans-fat. This fat comes from partially hydrogenated vegetable oils often found in fried foods and processed foods such as crackers, baked goods and desserts.
Base most of your meals on beans, vegetables, fruits and whole grains, with a minimum of low saturated fat foods from animal protein such as nonfat dairy, fish and egg whites.
Include soy protein in your diet in place of animal protein when possible. Studies show that 25 grams of soy protein per day can help lower cholesterol when part of a heart-healthy diet.
Limit intake of sugar and fructose. Doing so should lower triglycerides, aid weight loss and lower LDL cholesterol levels.
Eat foods naturally high in fiber, especially soluble fiber. Soluble fiber is found in legumes, fruits and root vegetables, as well as oats, barley and flax. For every 1 or 2 grams of soluble fiber you eat daily, you lower LDL cholesterol levels by 1 percent.
Here is a list of foods containing 2 grams or more of soluble fiber. Increasing these foods in your diet will help lower cholesterol.
1 cup barley, cooked
1 cup fresh broccoli
1 cup Brussels sprouts
1/2 cup apricots or figs
1 cup carrots
1 cup collard greens
1 cup cooked beans, peas or lentils
1 cup oat bran
1 cup oatmeal, cooked
1 cup rye cereal, cooked
1 large sweet potato
6 prunes
SOURCE: Dr. Barbara Struempler, Extension Nutritionist, Alabama Cooperative Extension System, (334) 844-2217
Wednesday, June 25, 2008
What is Cholesterol?
Cholesterol is a soft, fat-like, waxy substance found in the bloodstream and in all your body's cells. It's normal to have cholesterol. Cholesterol is an important part of a healthy body because it's used for producing cell membranes and some hormones, and serves other needed bodily functions. But too much cholesterol in the blood is a major risk for coronary heart disease (which leads to heart attack) and for stroke. Hypercholesterolemia is the medical term for high levels of blood cholesterol.
The Sources of Cholesterol
LDL and HDL Cholesterol: What's Bad and What's Good?
What Can Cholesterol Do?
Common Misconceptions About Cholesterol
The Sources of Cholesterol
LDL and HDL Cholesterol: What's Bad and What's Good?
What Can Cholesterol Do?
Common Misconceptions About Cholesterol
Vaptan : Golongan Obat Baru yang dapat menangani banyak kondisi penyakit (18-Jun-2008)
Kalbe.co.id - Para peneliti Belgia melaporkan sebuah kelas/golongan obat baru yang disebut vaptan kemungkinan dapat menangani berbagai kondisi secara luas, termasuk nyeri, pendarahan otak, gangguan psikotik dan glukoma. Laporan dimuat dalam jurnal Lancet edisi 10 Mei 2008.
Vaptan, kependekan dari vasopressin-reseptor antagonist, bekerja dengan sasaran sistem hormon vasopresin, yang berperan penting dalam mengatur volume darah dan air di dalam tubuh. Obat-obat ini, yang nantinya diberikan secara oral atau intravena, menghambat kerja vasopresin.
Dalam laporan itu, Dr. Guy Decaux, dari Erasmus University Hospital di Brussels dan koleganya sedang mengkaji vaptan yang terdiri dari beberapa subkelas, yang telah dikembangkan atau sedang dikembangkan. Diantara obat-obatan baru ini adalah relcovaptan yang menunjukkan hasil awal positif dalam penanganan nyeri, seperti pada penyakit Raynaud, yang mempengaruhi aliran darah pada lengan dan kaki. Juga dalam tokolisis (lahir prematur, mengarah pada kelahiran prematur).
Anggota lain subkelas vaptan termasuk mozavaptan, lixivaptan, satavaptan dan tolvaptan adalah diuretik, yang mengeluarkan air dari tubuh, sambil mempertahankan keseimbangan elektrolit tubuh atau mineral tubuh. menurut para peneliti, diuretik lain tidak mempertahankan keseimbangan elektrolit tubuh.
Beberapa vaptan digunakan untuk penanganan hiponatremia, kondisi yang mebahayakan nyawa karena kekurangan garam. Saat ini, conivaptan adalah satu-satunya vaptan yang disetujui oleh US FDA untuk penanganan hiponatremia.
Beberapa vaptan dalam pengembangan mungkin digunakan untuk penanganan gagal ginjal, nefropati diabetik, suatu penyakit ginjal preogresif yang berkaitan dengan diabetes, sirosis dan depresi.
Studi awal vaptan untuk penanganan glukoma, penyakit Menire (kondisi dalam telinga yang mempengaruhi pendengaran dan keseimbangan), pendarahan ootak dan kanker paru sel kecil, menunjukkan hasil yang menjanjikan, kata tim Decaux. Walaupun hasilnya menjanjikan, salah seorang ahli belum siap menyebut vaptan sebagai obat ajaib.
Dr. gary S. Francis, direktur koroner ICU di klinik Clevelend mengatakan bahwa hal ini kaji ulang menarik tentang munculnya kelas obat-obatan. Tapi, terlalu dini untuk mengetahui apakah mereka terbukti sangat berguna.
Vaptan, kependekan dari vasopressin-reseptor antagonist, bekerja dengan sasaran sistem hormon vasopresin, yang berperan penting dalam mengatur volume darah dan air di dalam tubuh. Obat-obat ini, yang nantinya diberikan secara oral atau intravena, menghambat kerja vasopresin.
Dalam laporan itu, Dr. Guy Decaux, dari Erasmus University Hospital di Brussels dan koleganya sedang mengkaji vaptan yang terdiri dari beberapa subkelas, yang telah dikembangkan atau sedang dikembangkan. Diantara obat-obatan baru ini adalah relcovaptan yang menunjukkan hasil awal positif dalam penanganan nyeri, seperti pada penyakit Raynaud, yang mempengaruhi aliran darah pada lengan dan kaki. Juga dalam tokolisis (lahir prematur, mengarah pada kelahiran prematur).
Anggota lain subkelas vaptan termasuk mozavaptan, lixivaptan, satavaptan dan tolvaptan adalah diuretik, yang mengeluarkan air dari tubuh, sambil mempertahankan keseimbangan elektrolit tubuh atau mineral tubuh. menurut para peneliti, diuretik lain tidak mempertahankan keseimbangan elektrolit tubuh.
Beberapa vaptan digunakan untuk penanganan hiponatremia, kondisi yang mebahayakan nyawa karena kekurangan garam. Saat ini, conivaptan adalah satu-satunya vaptan yang disetujui oleh US FDA untuk penanganan hiponatremia.
Beberapa vaptan dalam pengembangan mungkin digunakan untuk penanganan gagal ginjal, nefropati diabetik, suatu penyakit ginjal preogresif yang berkaitan dengan diabetes, sirosis dan depresi.
Studi awal vaptan untuk penanganan glukoma, penyakit Menire (kondisi dalam telinga yang mempengaruhi pendengaran dan keseimbangan), pendarahan ootak dan kanker paru sel kecil, menunjukkan hasil yang menjanjikan, kata tim Decaux. Walaupun hasilnya menjanjikan, salah seorang ahli belum siap menyebut vaptan sebagai obat ajaib.
Dr. gary S. Francis, direktur koroner ICU di klinik Clevelend mengatakan bahwa hal ini kaji ulang menarik tentang munculnya kelas obat-obatan. Tapi, terlalu dini untuk mengetahui apakah mereka terbukti sangat berguna.
Tidak ada kaitan antara MMR dengan autis (24-Jun-2008)
Kalbe.co.id - "Para ilmuwan mengatakan bahwa mereka punya bukti kuat bahwa vaksinasi MMR tidak berkaitan dengan peningkatan autis"
Para peneliti melihat insiden autis Jepang sebelum dan sesudah penarikan vaksin MMR (Measles, Mumps & Rubella) tahun 1993. Majalah New Scientist melaporkan angka autis tetap meningkat setelah vaksin MMR ditarik.
Michael Rutter dari institute of psychiatry, yang bekerja untuk studi ini mengatakan bahwa kaitan antara MMR dan peningkatan umum autis. Namun demikian, para pengkampanye autis mengatakan mereka ingin melihat bukti lebih konklusif dari studi di inggris sebelum yakin bahwa vaksin ini aman.
Kekhawatiran kaitan antara vaksin dan autis meningkat setelah sebuah studi oleh Dr. Andrew Wakefield dipublikasi dalam Lancet tahun 1998 yang mengklaim MMR dapat memicu autis. Namun demikian, tidak ada penelitian yang berhasil membuktikan kaitan ini dan kebanyakan para ahli mempercayai vaksin tersebut aman. Walaupun demikian, angka vaksinasi MMR di Inggris terus menurun. di beberapa daerah hanya berkisar 60% saja.
Studi ini pertama-tama melihat angka autis setelah penarikan vaksin. Jepang menarik MMR setelah mempertimbangkan bahwa strain vaksin mumps yang dikandung dalam vaksin MMR, digantikan dengan vaksin tunggal. MMR mulai menurun perlahan-lahan sebelum penarikannya.
Program di Jepang menargetkan umur 1 tahun. Prosporsi yang menerima vaksin menurun dari 69,8% tahun 1998 menjadi 33,6% tahun 1990 dan hanya 1,8% tahun 1992. para peneliti dari Yokohama Rehabilitation Center dan institute of Psychiatry melihat insiden gangguan spektrum autis diantara 31.426 anak-anak sampai umur 7 tahun yang dilahirkan dari tahun 1988 sampai 1996.
Penelitian yang dipublikasikan di dalam Journal of Child Psychology and Psychiatry menemukan bahwa jumlah kasus terus meningkat setelah program vaksinasi MMR dihentikan. Ada 48 kasus per 10.000 anak yang dilahirkan tahun 1998. angka terus meingkat menjadi 117,2 per 10.000 anak yang dilahirkan tahun 1996. Pola yang sama terlihat dalam insiden bentuk khusus autis pada anak yang berkembang normal dan menjadi autis, yang menurut Dr Andrew Wakefield berkaitan dengan MMR.
Prof. Ruttler menjelaskan bahwa jika benar hubungan sebab akibat antara MMR dan autis, diharapkan angka menurun setelah vaksin ditarik. kenyataannya, angak terus meningkat. temuan ini menjelaskan bahwa tidak ada kaitan antara MMR dan autis. Temuan ini menyuarakan kembali hubungan terbalik antara MMR dan autis. Menurutnya, penelitian tidak berhadapan dengan anggapan adanya kelompok kecil anak-anak yang tidak biasanya rentan oleh auts yang dipicu MMR, tapi tidak ada bukti ini yang terjadi.
Jean Golding, profesor Pedicatric and Perinatal Epidemiology di Departement of Clinical Medicine, University of Bristol melakukan penelitian penyebab autis. Menurutnya, temuan ini sejalan dengan semua peneltian yang telah dilakukan. Menurutnya ini adalah bukti bahwa tidak ada kaitan antara MMR dan autis.
Stuart Notholt dari the national Austitic Society menambahkan bahwa penelitian baru mengenai vaksinasi MMR dan autis menambah bukti. Kebanyakan mendukung hipotesis bahwa TIDAK ADA hubungan antara MMR dan autis.
Stephen Rooney dari the National Deafblind and Rubbela Association mengatakan, sejak MMR diperkenalkan, jumlah kelahiran rubella bawaan dan jumlah keguguran akibat rubella menurun secara dramatis.
Menurut Departemen kesehatan Inggris, penelitian mendukung bahwa MMR masih merupakan pertahanan terbaik terhadap measles, mumps dan rubella.
Para peneliti melihat insiden autis Jepang sebelum dan sesudah penarikan vaksin MMR (Measles, Mumps & Rubella) tahun 1993. Majalah New Scientist melaporkan angka autis tetap meningkat setelah vaksin MMR ditarik.
Michael Rutter dari institute of psychiatry, yang bekerja untuk studi ini mengatakan bahwa kaitan antara MMR dan peningkatan umum autis. Namun demikian, para pengkampanye autis mengatakan mereka ingin melihat bukti lebih konklusif dari studi di inggris sebelum yakin bahwa vaksin ini aman.
Kekhawatiran kaitan antara vaksin dan autis meningkat setelah sebuah studi oleh Dr. Andrew Wakefield dipublikasi dalam Lancet tahun 1998 yang mengklaim MMR dapat memicu autis. Namun demikian, tidak ada penelitian yang berhasil membuktikan kaitan ini dan kebanyakan para ahli mempercayai vaksin tersebut aman. Walaupun demikian, angka vaksinasi MMR di Inggris terus menurun. di beberapa daerah hanya berkisar 60% saja.
Studi ini pertama-tama melihat angka autis setelah penarikan vaksin. Jepang menarik MMR setelah mempertimbangkan bahwa strain vaksin mumps yang dikandung dalam vaksin MMR, digantikan dengan vaksin tunggal. MMR mulai menurun perlahan-lahan sebelum penarikannya.
Program di Jepang menargetkan umur 1 tahun. Prosporsi yang menerima vaksin menurun dari 69,8% tahun 1998 menjadi 33,6% tahun 1990 dan hanya 1,8% tahun 1992. para peneliti dari Yokohama Rehabilitation Center dan institute of Psychiatry melihat insiden gangguan spektrum autis diantara 31.426 anak-anak sampai umur 7 tahun yang dilahirkan dari tahun 1988 sampai 1996.
Penelitian yang dipublikasikan di dalam Journal of Child Psychology and Psychiatry menemukan bahwa jumlah kasus terus meningkat setelah program vaksinasi MMR dihentikan. Ada 48 kasus per 10.000 anak yang dilahirkan tahun 1998. angka terus meingkat menjadi 117,2 per 10.000 anak yang dilahirkan tahun 1996. Pola yang sama terlihat dalam insiden bentuk khusus autis pada anak yang berkembang normal dan menjadi autis, yang menurut Dr Andrew Wakefield berkaitan dengan MMR.
Prof. Ruttler menjelaskan bahwa jika benar hubungan sebab akibat antara MMR dan autis, diharapkan angka menurun setelah vaksin ditarik. kenyataannya, angak terus meningkat. temuan ini menjelaskan bahwa tidak ada kaitan antara MMR dan autis. Temuan ini menyuarakan kembali hubungan terbalik antara MMR dan autis. Menurutnya, penelitian tidak berhadapan dengan anggapan adanya kelompok kecil anak-anak yang tidak biasanya rentan oleh auts yang dipicu MMR, tapi tidak ada bukti ini yang terjadi.
Jean Golding, profesor Pedicatric and Perinatal Epidemiology di Departement of Clinical Medicine, University of Bristol melakukan penelitian penyebab autis. Menurutnya, temuan ini sejalan dengan semua peneltian yang telah dilakukan. Menurutnya ini adalah bukti bahwa tidak ada kaitan antara MMR dan autis.
Stuart Notholt dari the national Austitic Society menambahkan bahwa penelitian baru mengenai vaksinasi MMR dan autis menambah bukti. Kebanyakan mendukung hipotesis bahwa TIDAK ADA hubungan antara MMR dan autis.
Stephen Rooney dari the National Deafblind and Rubbela Association mengatakan, sejak MMR diperkenalkan, jumlah kelahiran rubella bawaan dan jumlah keguguran akibat rubella menurun secara dramatis.
Menurut Departemen kesehatan Inggris, penelitian mendukung bahwa MMR masih merupakan pertahanan terbaik terhadap measles, mumps dan rubella.
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