Archive for March, 2008

The healthy way to start the day

March 10th, 2008 Von

by Maricel Laxa-Pangilinan

Breakfast is important. We all know that. But we tend to forget how important it really is. This daily event is often taken for granted because life is so fast-paced nowadays, even for our children. It just seems that we are always chasing time. But no matter how hectic everything gets in our family, I always make sure that we all have time for breakfast.

We have a routine at home where we wake up the children early enough to have time for a hearty breakfast, which we eat together as a family. It gives me and my husband time to bond with our children before they start their day. I make sure my family does not miss breakfast simply because how you start your day affects how you end it. As a parent, I believe I have the responsibility to ensure my children start their day right.

There are so many breakfast options available these days like fruits, cereals, traditional Filipino breakfast, noodles, and all kinds of meat treats like corned beef, luncheon meat, etc. But sad to say, not all of them are healthy. I notice that children naturally gravitate to foods that are tasty but are often harmful for them. As parents, we should offer a variety of healthy options and not be limited to serving what our children prefer. In our home, we regularly ask our children for feedback about their food preferences and offer them suggestions on how to make their meals healthy. We also have a rule that all must follow and that is to taste, at least once, food they’ve never eaten before. That way, they may have basis for why they like or don’t like a certain food. We also expose our children to a variety of food options for breakfast so that their idea of breakfast is wide-ranging. We regularly invite them to eat with us at buffet breakfasts in hotels and spend a lot of time discussing what they like to include in our menu at home. We also encourage them to get only what they can finish.

Ensuring my children start the day right is not just about seeing them eat a lot for breakfast, though it is always nice. It is about seeing them eat right. For me, having a healthy breakfast is all about choosing foods rich in energy and nutrients like those made from whole grain such as cereals, and foods rich in fiber such as fruits and vegetables.

A healthy breakfast does wonders. My kids are healthier. They’re more energetic during the day because they start their day right so they have the energy to concentrate in class and focus on their lessons.

After my children experienced the consequences of not eating enough breakfast, such as headaches, fatigue and crankiness as a result of choosing to stay in bed too long, they vowed to get up earlier to enjoy their first meal of the day. They already know that we won’t allow breakfast to be eaten in the car, so the key is to wake up early. Since it is not easy sometimes to make sure the children eat healthy and their taste preferences usually lean towards the not-so-healthy foods, we have certain methods at home to make sure our children eat right:

• We lead by example. We make sure we eat breakfast with our children and use the time to have meaningful conversations with them by setting aside the morning paper or the TV set.

• We encourage them to try new foods. We wake them up early enough to have ample time to eat comfortably so we do not have to rush them through their meal just to get to class on time.

• We offer a variety of choices and allow them to come up with alternatives for breakfast. We also give them cereals which they love, which is the easiest way to make sure that those we offer are rich in whole grain and energy.

When it comes to sowing the seeds of a healthy child, I’d have to say that the first step is the first meal of the day: breakfast with whole grain and a variety of foods that include fruits and veggies that are presented well and eaten with delight.

Source: Philippine Star
http://www.philstar.com/index.php?Health%20And%20Family&p=49&type=2&sec=41&aid=20080303183; photo courtesy of www.rendezvoushotels.com

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Novel drug vs hypertension introduced

March 10th, 2008 Von
For over a decade, no new kind of therapy has been developed to treat high blood pressure (hypertension), a silent killer that afflicts about seven million Filipinos and nearly a billion people worldwide.

That is, until Swiss pharmaceutical company Novartis AG developed a breakthrough drug that controls hypertension by blocking an enzyme that can trigger the condition.

Aliskiren is the first and only high blood pressure medication that inhibits renin, a kidney enzyme associated with the regulation of blood pressure.

Unlike other available high blood pressure medications that act at later stages of the renin system, a key blood pressure regulation process, Aliskiren, acts at the beginning of this process.

“It is well established that the renin system plays an important role in blood pressure control and is the target of several antihypertensive agents,” said Dr. Matthew Ryan Weir, professor and director of the University of Maryland School of Medicine.

“However, targeting the renin system at its point of activation — renin — has long been regarded as offering the potential for a more comprehensive approach to hypertension and cardiovascular disease treatment,” Weir said.

Weir was the keynote speaker during the Asia-Pacific launch of Aliskiren in a pre-convention satellite symposium during the 13th joint annual convention of the Philippine Society of Hypertension and Philippine Lipid and Atherosclerosis Society.

More than 250 top cardiologists and other specialists attended the launch symposium at the Crowne Plaza Galleria Hotel last Feb. 12.

“The launch of Aliskiren in the Philippines manifests Novartis’ strong commitment to find innovative ways to help doctors care and cure patients with high blood pressure worldwide,” said Peter Goldschmidt, president and CEO of Novartis Healthcare Philippines, Inc.

In most parts of the world, including the Philippines, the rate of uncontrolled hypertension is 85 percent or higher, highlighting the need for more effective and well tolerated antihypertensive drugs.

Aliskiren, a direct renin inhibitor (DRI), represents a novel and exciting approach to superior blood pressure control, excellent tolerability, and potential target organ protection either as monotherapy or in combination with other anti-hypertensive medications.

In clinical trials involving more than 6,000 people with hypertension, Aliskiren has been shown to consistently lower blood pressure for 24 hours and beyond.

“The efficacy of Aliskiren to lower blood pressure for 24 hours and beyond is important because many high blood pressure medications are unable to sustain their blood pressure-lowering effect throughout the day, especially during the early morning hours when blood pressure surges occur,” said Dr. Francis Domingo, Novartis Philippines’ medical director.

In his lecture, Weir cited the results of a randomized clinical trial on Aliskiren and valsartan combination therapy, which showed that despite discontinuation of the drug, blood pressure remained low.

“The blood pressure remained down even after the drug had been discontinued, in some cases, for two to four weeks,” he said.

Aliskiren was the gold prize winner of the Wall Street Journal’s seventh annual Technology Innovation Awards held last September.

Editors of the respected business newspaper received more than 800 applications for the award, which was eventually whittled down to 150 entries. A panel of judges from business, research and academic organizations chose winners in 12 categories, along with overall Gold, Silver, and Bronze winners.

To win the award, a technology had to be a breakthrough from traditional methods, not just an incremental improvement.

Throughout the clinical trial program, Aliskiren was well tolerated by patients. When used with other anti-hypertension medications such as ACE inhibitors, angiotensin receptor blockers (ARBs), calcium channel blockers or diuretics, it delivered additional blood pressure reductions, helping people already on therapy to reach their blood pressure goals.

Aliskiren was also well tolerated when used with the most common diabetic and cardiovascular medications.

An extensive clinical program (ASPIRE HIGHER) is currently evaluating the long-term potential of Aliskiren and direct renin inhibition in patients with cardiovascular or kidney disease.

Aliskiren is a prescription medicine and should only be taken upon a doctor’s advice.

Aliskiren has also been approved in more than 40 countries and used in more than 130,000 patients worldwide.

Source: Philippine Star
http://www.philstar.com/index.php?Science%20and%20Technology&p=49&type=2&sec=36&aid=2008030579

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Human papilloma virus: A real threat to young people

March 3rd, 2008 Von
Human papilloma virus (HPV) is a common virus that affects both males and females.

It is transmitted through skin to skin contact. Certain types of the virus can lead to cancer – most notably cervical cancer, vaginal and vulvar cancers. HPV can also cause diseases such as genital warts and pre-cancer.

“Genital warts are usually cauliflower flesh-colored growths affecting the vulva. Warts are mostly the disease of young people,” said, obstetrician-gynecologist and gynecologic cancer specialist. “This is because of the changing sexual behaviours of our youth today,” she explained.

Dr. Palma, head of the Gynecologic Oncology Section of St. Luke’s Medical Center, shared that in the 1993 Philippine Demographic and Health Survey and the 1998 National Statistics Office Survey, the median ages of first sexual contacts were 21.8 years old and 22.1 years old respectively.

However, in a more recent study, the 2002 Yong Adult Fertility and Sexuality Study (a nationwide study of 20,000 adolescents aged 15 to 27 years) revealed the age of “first sex” is getting younger. It showed that 1.2 percent of both young males and females had already engaged in sex before they turned 13 years old.

The figures rose sharply when the study looked into ‘engaged in age before 18’ where it displayed a probability of 12 percent among females and 28 percent of males. The study also showed that 1/5 or 23 percent of young people have engaged into premarital sex (31.1 percent in boys and 15.4 percent in girls). A more up-to-date study of the Filipino youth’s sexual attitude and behavior is needed.

Although not lethal, genital warts are nonetheless a form of HPV (human papillomavirus) infection – just of the 100 plus HPV strains that a young boy or girl can catch.

Generally, 90 percent of HPV infections are transient, asymptomatic, and resolve spontaneously because of the body’s natural defense system. However, for some people, cervical cancer and other HPV-associated diseases can develop.

According to Dr. Palma, the virus can persist. External factors such as smoking, oral contraceptive pills, other STDs (sexually-transmitted diseases), and certain types of HPV contribute to the persistence of the virus. The virus especially HPV 16 and 18 could also lead to cervical pre-cancer and then to invasive cervical cancer.

In 1997, a landmark study identified the human papillonavirus to be associated with cervical cancer specimens taken from different countries by special molecular technology.

Now, data ha shown that about 70 percent of cervical cancer cases are associated with HPV types 16 and 18. The Centers for Disease Control of the United Stateshas published that about 40 percent of vaginal cancers, 40 percent of vulvar cancers, 40 percent of penile cancers, 90 percent of anal cancers, and 12 percent of oropharyngeal cancers have also been linked with HPV.

Cervical cancer is the second leading cause of cancer death among women in the Philippines and in the world. According to the 2005 Philippine Cancer Facts and Statistics, 52 percent of those afflicted with cervical cancer will die within five years of diagnosis.

It is reported that 22,000 out of every 100,000 patients (about two-thirds) were already in the advance stages upon diagnosis. Worldwide, there are 493,243 new cases and 231,000 deaths due to cervical cancer every year. It comprises 12 percent of all cancers in women, while 80 percent of all cases are found in developing countries, such as the Philippines.

Dr. Palma emphasized that screening and early detection of cervical cancer is a key measure to better survival rate. In the Philippines, a Department of Health study in 2000 revealed that only 42 percent of 389 hospitals around the country offer screening/detection services for cervical cancer and a meager 21 percent of hospitals have a cytology technician available for the Pap test analysis.

Pathologists, on the other hand, are available in only 45 percent of hospitals. On the average, it takes a patient 47+/- 11 days to get a Pap smear result.

Dr. Palma added that besides regular screening, early detection and treatment, total sexual abstinence and a life-long mutually monogamous relationship (or having only one sexual partner) can help prevent cervical cancer brought on by HPV.

Through the use of condom may also help reduce the risk of HPV diseases, it is only 70 percent effective. Genital HPV diseases can be acquired through two means: Sexual contact and non-sexual routes. Sexual contact includes sexual intercourse, genital-genital contact, manual-genital contact, and oral-genital contact.

Non-sexual routes include transmission from infected mother of newborn or through fomites, such as infected undergarments, surgical gloves, biopsy forceps.

The world’s first cervical cancer vaccine manufactured by Merck Sharp & Dohme (MSD) is recommended for girls as young as nine years old up to the age of 26. The vaccine has been available in more than 80 countries and has been recommended by the US Centers for Disease Control. For women beyond that age group, studies are currently underway to include older women in the recommended vaccination age range.

Dr. Palma concluded that the older women may benefit from vaccination. She hopes that more women, particularly the rural folks would be better informed and would also be given more access to regular screening tests and preventive approaches.

Source: Manila Bulletin

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Dyspepsia

March 3rd, 2008 Von
by Gary S. Sy

Sometimes, people see their doctors for stomach pain that they think is caused by an ulcer, but it isn’t.

Although you may have gnawing upper abdominal pain, diagnostic tests don’t reveal an ulcer or other digestive problem — all tests come back normal. If this is so, you may have a type of indigestion called Dyspepsia (nonulcer stomach pain).

Dyspepsia sometimes long-lasting (chronic) disorder of the upper gastrointestinal system, which includes your esophagus and first part of your small intestine (duodenum) as well as your stomach. The disorder can cause signs and symptoms that resemble those of a peptic ulcer, such as pain or discomfort in your upper abdomen, often accompanied by bloating, belching, and nausea.

Dyspepsia occurs for no apparent reason and isn’t necessarily related to a particular disease. Rather, the culprit may be a temporary problem, such as eating too quickly, overeating or dealing with a stressful event. For some people, stomach pain is a chronic condition. For many people, however, the symptoms of dyspepsia are often short-lived and preventable.

Signs and symptoms

A burning sensation or discomfort in your upper abdomen or lower chest, sometimes relieved by food or antacids; bloating; belching; gas (flatulence); an early feeling of fullness with meals; and nausea.

An unhealthy lifestyle can contribute dyspepsia. Stress, fatigue, poor diet, not enough rest, and lack of exercise may aggravate its signs and symptoms.

Causes

The exact cause of dyspepsia is unknown. In some cases it may occur after a viral infection, but this is rare. Doctors consider it a functional disorder not necessarily related to a specific disease. However, temporary and often aggravating factors can be common causes of the signs and symptoms of dyspepsia.

Risk factors

Some people naturally are at higher risk. Certain lifestyle factors can increase your risk, including:

Overeating; eating too quickly, sometimes with air swallowing; drinking carbonated beverages; eating spicy foods; eating greasy or fatty foods; consuming too much caffeine or alcohol; smoking; taking certain medications, especially nonsteroidal anti-inflammatory drugs (NSAIDs); and stress.

Complications

Because Dyspepsia is a disorder unrelated to disease, it doesn’t lead to more serious conditions. However, complications may include:

Problems caused by tests done to rule out other disorders; side effects of medications taken to treat the condition; and worry about having other conditions.

Prevention

Maintaining a healthy lifestyle can often prevent dyspepsia. The following lifestyle modifications may help alleviate your signs and symptoms:

Diet

* Eat smaller, more frequent meals. Having an empty stomach can sometimes produce signs and symptoms similar to those of nonulcer dyspepsia. Nothing but acid in your stomach may make you feel sick. Try eating a small snack, such as a cracker or a piece of fruit. Avoid skipping meals. Avoid large meals and overeating. Eat smaller meals more frequently.

* Avoid trigger foods. Some foods may trigger the signs and symptoms of nonulcer stomach pain, such as fatty and spicy foods, carbonated beverages, caffeine and alcohol. Avoid consuming more than three caffeinated beverages a day.

* Chew your food slowly and thoroughly. Allow time for leisurely meals.

* Limit beverages during meals. If you feel full early on during the meal, restrict your intake of beverages.

* Take steps to avoid excessive air. To reduce excess gas and belching, refrain from activities that result in excessive air swallowing, such as smoking, eating rapidly, chewing gum and drinking carbonated beverages.

* Don’t lie down right after a meal. Wait to lie down until at least two hours after eating.

* Maintain a healthy weight. Excess pounds put pressure on your abdomen, pushing up your stomach and causing acid to back up into your esophagus.

* Create a calm environment at mealtime. This may help relieve stress-related indigestion.

* Identify current stressors in your life. Learn how to manage your stress by exercising and listening to soothing music.

Source: Manila Bulletin
http://www.mb.com.ph/OPED20070926104026.html

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Naps, mammograms, blood-sugar tests can show stroke risk – study

March 3rd, 2008 Von
NEW ORLEANS (AP) — What do mammograms, blood-sugar tests and daytime dozing have in common? All may offer clues that someone is headed for a stroke, new studies suggest.

Higher stroke risk was seen in women with artery buildups accidentally revealed by mammograms, in non-diabetics starting to have insulin problems, and in older people who tend to nod off a lot.

People should not panic if they have one of these signs. But if grandma falls asleep in front of the TV all the time, it may be worth checking to see if she has a sleep disorder raising her risk of stroke, doctors say.

Likewise, a test that rules out breast cancer may give a valuable clue to heart disease and stroke risks — if radiologists report the findings to women and their doctors for follow-up.

“You’re getting information in two important areas,” but people often focus on just the cancer risk, said Dr. Philip Gorelick, neurology chief at the University of Illinois in Chicago. He is chairman of the International Stroke Conference, a medical meeting in New Orleans where the studies were presented.

Daytime drowsiness may be due to nighttime sleep apnea, a common condition where people briefly stop breathing, causing spikes in blood pressure as they startle awake. Snoring can be a sign, but doesn’t always mean trouble — except for others trying to sleep.

“It’s not healthy because you’re not staying in your normal sleep pattern. You’re waking up many times in the night and in the daytime are tired,” Gorelick explained.

Columbia University researchers led by Bernadette Boden-Albala found that a simple scoring system to evaluate daytime dozing strongly predicted stroke risk.

They asked 2,100 people, average age 73, how often they nodded off during specific situations during the day — watching TV, reading, sitting and talking to someone, sitting in traffic, or sitting quietly after lunch.

In the next two years, 40 had strokes and 127 had other blood vessel-related problems such as heart attacks or blood clots in the lungs.

The odds of having a stroke were nearly five times greater among heavy dozers, and nearly three times greater among occasional dozers, compared with people who rarely nodded off. The chances of other vessel-related problems were higher, too.

Unintentional dozing is different from purposely taking a nap, although “we need to look at that” to see if regular siestas are also a sign of poor nighttime sleep, Boden-Albala said.

Frequent dozers should talk with their doctors about being evaluated for a sleep disorder. Possible solutions include a device that helps maintain continuous air pressure, losing weight if they are overweight, and even surgery if the airway is obstructed.

The mammography study was led by medical student Amy Loden and Dr. Paul Dale of the University of Missouri Medical School in Columbia, Mo.

They studied calcium deposits in the walls of arteries that supply the breasts, which are different from the calcifications in breast tissue that can signal the presence of a tumor.

“Everytime I see one I think, ‘That woman has a breast full of calcifications. I wonder if her heart looks the same,”’ said Dale, a cancer surgeon.

He previously published studies tying these artery deposits to a higher risk of heart disease. In the new study, he and fellow researchers found these deposits in 11 percent of roughly 800 women having routine mammograms at their hospital.

Next, they looked at the mammograms of 204 stroke patients and found the deposits in 56 percent of them — five times more often. Greater stroke risk was seen in women of all ages with the deposits, but especially among those in their 40s and 50s.

“We’re not saying just because you have these you’re going to have a stroke — it’s just identifying women at risk,” Dale said.

He is starting a new study to see whether calcium deposits can be used to predict who will suffer strokes later, and thinks radiologists should report deposits to doctors so follow-up tests can be considered for stroke and heart disease.

Radiologists usually do not report artery deposits, which are more common as women age, said Dr. Carol Lee, an American College of Radiology spokeswoman from Memorial Sloan-Kettering Cancer Center in New York.

“I don’t know that many radiologists emphasize it, especially in older people,” she said.

“It may be a simple marker” for the risk of a lot of things, said Dr. Ralph Sacco, neurology chief at the University of Miami Miller School of Medicine.

The third study looked at clues of stroke risk from a different test — HOMA, a ratio of blood sugar and insulin levels measured after fasting.

Source: Philippine Star
http://www.philstar.com/index.php?Science%20and%20Technology&p=49&type=2&sec=36&aid=2008022742

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