The Department of Health and Human Services Centers for Disease Control and Prevention states that the 2010-2011 vaccine provides protection against A/H1N1(pandemic) influenza and two other influenza viruses- influenza A/H3N2 and influenza B. It will not prevent illness caused by other viruses.

Allergy Basics

Allergies are an abnormal response of the immune system.  People who have allergies have an immune system that reacts to a usually harmless substance in the enviornment.  This substance (pollen, mold, animal, dander, etc.) is called an allergen.

Allergies are a very common problem, affecting at least two out of every 10 Americans.

What Happens During an Allergic Reaction?

First, a person is exposed to an allergen by inhaling it, swallowing it, or getting it on or under their skin. After a person is exposed to the allergen, a series of events create the allergic reaction:

 1.    The body starts to produce a specific type of antibody, called IgE, to bind the allergen.

    2.  The antibodies attach to a form of blood cell called a mast cell. Mast cells can be found in  the airways, in the intestines, and elsewhere. The presence of mast cells in the airways and GI tract makes these areas more susceptible to allergen exposure.

 3.  The allergens bind to the IgE, which is attached to the mast cell. This causes the mast cells to release a variety of chemicals into the blood. Histamine, the main chemical, causes most of the symptoms of an allergic reaction.

What Are the Symptoms of an Allergic Reaction?

Common symptoms of an allergic reaction to inhaled or skin allergens include:

·                                 Itchy, watery eyes

·                                 Sneezing

·                                 Itchy, runny nose

·                                 Rashes

·                                 Feeling tired or ill

·                                 Hives (a rash with raised red patches)

Other exposures can cause different allergic reactions:

·                                 Food Allergies: An allergic reaction to food allergens can also cause stomach cramps, vomiting, or diarrhea.

·                                 Insect stings: The allergic reaction to a sting from a bee or other insect causes local swelling, redness, and pain.

            The severity of an allergic reaction’s symptoms can vary widely:

·                                 Mild symptoms may be almost unnoticeable, just making you feel a little “off.”

·                                 Moderate symptoms can make you feel ill, as if you’ve got a cold or even the flu.

·                                 Severe allergic reactions are extremely uncomfortable, even incapacitating.

Most symptoms of an allergic reaction go away shortly after the exposure stops.

The most severe allergic reaction is called anaphylaxis. In anaphylaxis, allergens cause a whole-body allergic reaction that can include:

·                                 Hives and itching all over (not just in the exposed area)

·                                 Wheezing or shortness of breath

·                                 Hoarseness or tightness in the throat

·                                 Tingling in the hands, feet, lips, or scalp

Anaphylaxis is life-threatening and requires immediate medical attention. Symptoms can progress rapidly, so head for the emergency room if there’s any suspicion of anaphylaxis.

Does Everyone Have Allergies?

No, not everyone has allergies. People inherit a tendency to be allergic, although not to any specific allergen. When one parent is allergic, their child has a 50% chance of having allergies. That risk jumps to 75% if both parents have allergies.

WebMD Medical Reference

SOURCES: 

Asthma and Allergy Foundation of America. 

National Institutes of Health. 

American Academy of Allergy Asthma and Immunology.

Medline Plus: "Allergic Reactions."

Regular Flu vs H1N1 Commonly Asked Questions:

1. Should I get a flu shot NOW? --------Yes. We began administering the flu vaccines a few weeks ago when we received them.

2. When will the H1N1 flu shots be available? --------The latest update estimates that the H1N1 vaccine will be available mid-October.

3. Should I get BOTH the Flu Vaccine and the H1N1 vaccine? -------YES. Each vaccine covers different flu strains.

4. How much do they cost? -------The regular flu vaccine is available at our office for $25. With the limited information on H1N1, we do not have an estimated price for that vaccine. As soon as more information is available we put it out to our patients.

5. Do we offer the flu mist (nasal flu vaccine)? -------No. The vaccine we have in our office is in injection form and we do not stock the flu mist.

There is a lot of information circulating about the H1N1 virus. The most up to date, reliable place to obtain information is from the CDC website. You can also obtain a wealth of other information from their site.

http://www.cdc.gov/h1n1flu/

What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses that causes regular outbreaks in pigs. People do not normally get swine flu, but human infections can and do happen. Swine flu viruses have been reported to spread from person-to-person, but in the past, this transmission was limited and not sustained beyond three people.

Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine influenza A (H1N1) viruses were first reported in Southern California and near San Antonio, Texas. Other U.S. states have reported cases of swine flu infection in humans and cases have been reported internationally as well. An updated case count of confirmed swine flu infections in the United States is kept at http://www.cdc.gov/swineflu/investigation.htm CDC and local and state health agencies are working together to investigate this situation.

Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. In the past, severe illness (pneumonia and respiratory failure) and deaths have been reported with swine flu infection in people. Like seasonal flu, swine flu may cause a worsening of underlying chronic medical conditions.

How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing of people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their mouth or nose.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before symptoms develop and up to 7 or more days after becoming sick. That means that you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general health. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food. Try not touch surfaces that may be contaminated with the flu virus. Avoid close contact with people who are sick.

Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with these swine influenza viruses. Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight against the flu by keeping flu viruses from reproducing in your body. If you get sick, antiviral drugs can make your illness milder and make you feel better faster. They may also prevent serious flu complications. For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially contagious as long as they are symptomatic and possible for up to 7 days following illness onset. Children, especially younger children, might potentially be contagious for longer periods.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth. Droplets from a cough or sneeze of an infected person move through the air. Germs can be spread when a person touches respiratory droplets from another person on a surface like a desk and then touches their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing will help you reduce the chance of getting contamination from these common surfaces.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu. There are everyday actions that can help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread this way.
• Try to avoid close contact with sick people.
• If you get sick with influenza, CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.

What is the best way to keep from spreading the virus through coughing or sneezing?

If you are sick, limit your contact with other people as much as possible. Do not go to work or school if ill. Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick. Put your used tissue in the waste basket. Cover your cough or sneeze if you do not have a tissue. Then, clean your hands, and do so every time you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?
Washing your hands often will help protect you from germs. Wash with soap and water. or clean with alcohol-based hand cleaner. we recommend that when you wash your hands -- with soap and warm water -- that you wash for 15 to 20 seconds. When soap and water are not available, alcohol-based disposable hand wipes or gel sanitizers may be used. You can find them in most supermarkets and drugstores. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work; the alcohol in it kills the germs on your hands.

What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and become ill with influenza-like symptoms, including fever, body aches, runny nose, sore throat, nausea, or vomiting or diarrhea, you may want to contact their health care provider, particularly if you are worried about your symptoms. Your health care provider will determine whether influenza testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek emergency medical care.

In children emergency warning signs that need urgent medical attention include:

• Fast breathing or trouble breathing
• Bluish skin color
• Not drinking enough fluids
• Not waking up or not interacting
• Being so irritable that the child does not want to be held
• Flu-like symptoms improve but then return with fever and worse cough
• Fever with a rash

In adults, emergency warning signs that need urgent medical attention include:

• Difficulty breathing or shortness of breath
• Pain or pressure in the chest or abdomen
• Sudden dizziness
• Confusion
• Severe or persistent vomiting

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Between 2005 until January 2009, 12 human cases of swine flu were detected in the U.S. with no deaths occurring. However, swine flu infection can be serious. In September 1988, a previously healthy 32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia after being infected with swine flu and died 8 days later. A swine flu outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than 200 cases with serious illness in several people and one death.

Can I get swine influenza from eating or preparing pork?
No. Swine influenza viruses are not spread by food. You cannot get swine influenza from eating pork or pork products. Eating properly handled and cooked pork products is safe.

(See full article here)

March 5, 2009
Recent news reports have focused attention on a long-established but little-noticed practice: doctors forcing their patients to sign forms promising not to post an online review of the physician’s performance. The forms are provided by Medical Justice, a company whose website describes it as “relentlessly protecting physicians from frivolous lawsuits.”

Medical Justice owner Jeffrey Segal, himself a physician, insists that online medical reviews “are little more than tabloid journalism without much interest in constructively improving practices,” and defends his business as trying to prevent frivolous malpractice lawsuits.

Indeed, the company’s website loudly proclaims that, “While Medical Justice is sensitive to the fact there are legitimate claims by patients who have been harmed by negligent care, the fact remains that the majority of medical malpractice cases are ultimately deemed without merit.” The site further claims that, while eight to ten percent of doctors nationwide are sued for malpractice, that number drops to less than one percent for those who use Medical Justice’s services.

Medical Justice charges $1,500 for a one-year membership, which includes the right to use the generic gag order form, an “early action strategy” to be executed if the member is sued for malpractice, and a “pre-emptive critical practice infrastructure” to deter potential plaintiffs who are considering bringing an action. The plan also promises a pursuit of counterclaims against expert witnesses.

Almost 2,000 doctors have signed up since the service began two years ago.

The company encourages doctors to have all patients sign the “gag order” forms, and to tell them to go somewhere else if they refuse. While Segal insists that the forms are meant as a shot across the bow against Web sites, the form’s language warns that patients who breach its terms could also be subject to legal action.

While the forms may seem draconian, it’s unclear whether a court would uphold them. A court could potentially find that the unequal nature of the doctor-patient relationship makes the forms voidable; since patients place a large amount of trust in their doctors, the physician arguably has the upper hand in any agreements he or she enters into with the patient.

Additionally, the threat of withholding medical service unless the patient signs the form could be seen as a kind of undue influence and, in some cases, could subject the physician to sanctions by state licensing boards.

Whether the form is enforceable or not, the physicians who fork over the $1,500 for the comprehensive plan will likely still find harsh words about them online. That’s because at least one Web site — RateMDs.com — publishes comments anonymously and has no idea who posts on their site. Cofounder John Swapceinski has also refused several recent requests from doctors to remove the complaints altogether.

Swapceinski isn’t shy in making his opinion about Medical Justice known. As he recently told the Associated Press, “They're basically forcing the patients to choose between health care and their First Amendment rights, and I really find that repulsive.” He’s planning to start a “Wall of Shame” listing the doctors who subscribe to the service.

(see the article online)

WASHINGTON -- The U.S. Food and Drug Administration Thursday warned of the risk of skin burns in patients wearing transdermal drug patches who are undergoing MRI scans.

Transdermal patches are applied to the skin and can be used to deliver pain medications, hormones and nicotine.

Most of the patches are sold by prescription except for nicotine patches, which are available over-the-counter.

In a public health advisory issued Thursday, the FDA said certain patches contain aluminum or other metal in the backing of the patches which can overheat during an MRI scan and cause skin burns in the immediate area of the patch.

Sandra Kweder, deputy director in FDA's Office of New Drugs, said there are about 60 patches on the market and fewer than 25% of such products have metal in them. She also said some patches that appear clear can contain a metal ion that could also cause a skin burn.

FDA officials said they received two or three reports of skin burns akin to a severe sun burn in patients who wore over-the-counter nicotine patches and underwent an MRI and are investigating a handful of other reports.

Ms. Kweder said the agency is currently reviewing all skin patches and will require those which contain metal to have a warning placed directly on the patch that would likely state, "remove before MRI."

While most of the packaging for patches with metal contains a warning to remove the patch before undergoing an MRI, the agency found that some products, such as Teva Pharmaceutical Industries Ltd.'s fentanyl patch, were missing the warning.

Ms. Kweder also noted that most patients likely won't have the package with them while undergoing the MRI, which is why the agency will require a warning directly on the product as well as on the package.

But until the new labeling is adopted, the FDA said patients and MRI operators should be aware of the risk of skin burns.

The agency said most MRI facilities ask patients whether they are wearing any patches but said patients should also inform health-care professionals when making an appointment for the scan and before undergoing the MRI.

(see the article online)

The cardiovascular damage wrought by an unhappy marriage may be greater for women than men, a new study shows.

While both men and women in "strained" unions, those marked by arguing and being angry, were more likely to feel depressed than happier partners, the women in the contentious relationships were more likely to develop high blood pressure, high cholesterol, high blood sugar and other markers of what's known as "metabolic syndrome," said study author Nancy Henry, a doctoral candidate in clinical healthy psychology at the University of Utah.

Metabolic syndrome is known to boost the risk of heart disease, stroke and diabetes.

While many studies have linked poor marriages with poor health, Henry said she believes her is the first to tie in depression as a possible route through which the strain boosts the risk of metabolic syndrome. "The negativity triggers the depression, which is associated with the metabolic syndrome," said Henry. This was found true, she said, only for the women in her study.

For the study, she interviewed 276 couples, median age 54, by questionnaires, asking about positive aspects of marriage quality such as mutual support and sharing, and negative aspects such as arguing, feelings of hostility and disagreeing over important issues such as kids, sex, money and in-laws. She asked about depressive symptoms.

Couples were married, on average, 27.5 years, most in their original marriage.

"For the most part, you could say, these were happily married couples," Henry said. About 20 percent of the men and 12 percent of the women in the study had metabolic syndrome (diagnosed when three of the five risk factors were present).

The men were as likely as the women to become depressed with marital strain, but the link between negativity, depression and metabolic syndrome only applied to women, she said. The depression in women accounted for the metabolic syndrome, she said.

Exactly why isn't known, but Henry speculated that women may take the negativity more to heart and ruminate about it more than men.

Henry can't say specifically how much risk of metabolic syndrome is attributed to the negativity. Earlier research has linked negativity in marriage with an increased risk of heart disease for both men and women.

She was expected to present her findings Thursday at the American Psychosomatic Society annual meeting, in Chicago.

Another researcher in the field called the findings interesting, especially the new focus on depression as a possible mechanism through which the strain influences the metabolic syndrome.

"The study raises the importance of increasing our understanding of how depression influences biological processes that result in metabolic syndrome -- and why these processes might be stronger for women than men," said Debra Umberson, a professor of sociology at the University of Texas at Austin.

The findings, Umberson said, fit in with her research finding a strong effect of marital strain on partners' overall health. But the gender difference finding differs from her research. "Basically, we find that marital strain undermines the health of men and women," she said, adding that perhaps the men in Henry's study had their health influenced in a different way.

More research is needed, Henry said, to figure out how the pieces fit together.

Meanwhile, Umberson said: "Choose your partner carefully. A strained marriage is bad for your health." If it's already strained, she said, focus on reducing conflict.

(see full article online)