Aimee Copeland, 24, is currently at JMS Burn Center in Augusta battling necrotizing fasciitis.

(Credit:Facebook) (CBS News) Aimee Copeland, the 24-year-old graduate student who is fighting for her life against the flesh-eating disease necrotizing fasciitis is very responsive and coherent, according to a blog posted on a University of West Georgia Psychology department student website.

Aimee Copeland, 24, battles flesh-eating necrotizing fasciitis following zip-lining accident

in a post written Thursday afternoon, Aimee’s classmate Ken Lewis  provided an update for those following the tragic story, saying Aimee unfortunately will need her hands and her remaining foot amputated because the blood vessels have died.

Last week doctors had performed a hip-high amputation on Aimee’s left leg. not all the news was bleak, with Lewis writing that Aimee is responding to specific commands and has even selected the music she wants to hear.

“The neurologist says that there is no indication of any brain damage,” Lewis wrote. “The cardiopulmonologist says that her lungs are slowly healing.”

Aimee’s sister Paige also wrote an update today on the Facebook page their father had set to raise awareness about Aimee’s condition.

“Seeing Aimee this morning was so refreshing,” Paige wrote Thursday afternoon. “Her eyes are wide open and she is nodding or shaking her head to the questions we ask. My hope for her recovery is stronger than ever!”

According to the Atlanta Journal-Constitution, a “Love Aimee” vigil is being held tonight at the University of West Georgia campus. Blood donations are also being accepted at the JMS Burn Center in Augusta where she has been hospitalized since last Friday.

Last Friday, emergency room doctors at Tanner Medical Center in Carrollton, Ga., diagnosed Copeland with necrotizing fasciitis. According to the Journal-Constitution, Copeland received a nasty cut on her leg last Tuesday on a homemade zip line she was using that broke as she and her friends kayaked along the little Tallapoosa River in Carrollton.

Doctors closed the gash with 22 staples, but her conditioned worsened over the next few days until she was eventually hospitalized and diagnosed with the disease. The paper reports the bacteria that caused the disease was Aeromonas hydrophila, which is typically found in freshwater.

Symptoms of necrotizing fasciitis include a small red painful lump or bump in the skin that changes to a very painful rapidly growing bruise (sometimes within an hour), and the center of the bruise may become black and die, or break open and ooze fluid. Other symptoms include fever, sweating, chills, nausea, dizziness and shock. immediate treatment, such as with powerful IV antibiotics or surgery is necessary to prevent death.

WebMD has more on necrotizing fasciitis.

DOCTORS CORNER with Dr JOHN KABUNGOLAST Sunday, I discussed the role sport can play in the prevention of malaria. This time around it is important to look at the problems which athletes with malaria encounter.Malaria is always a worrying condition in sport because of the many effects it has on the performance of an athlete. it is always a matter of concern when a team, and in this case a football team, is preparing for an important game and then it is reported that one of the team’s best players is struck with malaria.The issue becomes even more complicated when the malaria which someone has is not simple but complicated. I will try to explain a few things on the presentation of either simple or complicated malaria.I am very sure that a majority of Zambians have had malaria at some point and it won’t be a big hustle for me to go through how we can actually tell that someone has a bout of malaria. However it will be important to differentiate between simple and complicated malaria.these two forms of malaria will have a great impact on a player in terms of time taken for recovery and when the player will be allowed to get back and fully participate in a competitive match.Malaria affects all age groups with more serious and life-threatening forms occurring in children and pregnant women.In sport, both athletes and officials can be affected. Nowadays there is a lot of movement of players and match officials to different countries and this is the reason why everything must be done to have maximum protection of our athletes from malaria.FIFA has actually classified malaria to be amongst the BIG THREE medical conditions of public health interest. The other two conditions of this group are Tuberculosis (TB) and HIV/AIDS.The world soccer governing body has joined the many organisations in recognising that the three conditions are a threat to mankind and deserve to be given priority in terms of awareness and therefore reduce on the sufferings that come as a result of infections with these conditions.Malaria is the main parasitic infection affecting more than 500 million people and causing more than one million deaths each year world over. about 40 percent of the world’s population is at risk of getting malaria, mostly those living in the poorest countries.In football, due to the wide and rapid travel required by international match schedules, teams from malaria-free areas are exposed to infection.All sports persons travelling to malaria-endemic countries even for a short period may be at risk of becoming infected with malaria.In Zambia, malaria is still one of the leading causes of morbidity (sickness) and mortality (death) in our health institutions.Malaria has been around us for such a long time and so many resources and research have gone into ways of reducing transmission, finding drugs, which the malaria parasite is more susceptible to, and more importantly prompt and effective diagnosis of malaria.The most commonly asked questions regarding malaria are how long does it take for an individual to suffer the symptoms of malaria after being bitten by a mosquito? How can someone suspect that they have malaria?What is it that has to be done when malaria is suspected? What are the main treatment modalities involved? What are the effective preventive measures? How long should someone stay away from participating in sport once they suffer from a bout of malaria?for the transmission of malaria to occur, an infected female anopheles mosquito has to be involved. The bite from an infected female anopheles mosquito is a must! The time taken from the time one is bitten up to the time the symptoms of malaria appear is what is referred to as the incubation period.The minimum period between getting an infective bite and becoming ill with malaria is at least six days. Malaria symptoms can actually occur many months after being bitten by an infected mosquito.The specific parasite that commonly causes malaria and of great importance in our country is plasmodium falciparum. The other types of plasmodia which are found include plasmodium vivax, plasmodium ovale and plasmodium malariae.The main signs and symptoms of malaria are a headache, fever, flue-like symptoms including bouts of feeling cold and shivery, profuse sweating, joint and body pains, loss of appetite and general feeling of weakness (malaise).Malaria is a great pretender and can present in many ways including a bout of diarrhoea, vomiting, muscle pain or just a backache.these symptoms can occur at intervals and they basically form the simple type of malaria. However, other complications can occur, including mild to severe anaemia, because of the massive destruction of red blood cells by the malaria parasite.The anaemia in most cases is accompanied by dizziness, headaches and the heart beating faster than normal.The other complications can involve the kidneys, leading to renal failure, cerebral malaria accompanied by convulsions and mental confusion.In some cases malaria can result in a player or person going into a coma and if not properly treated this can result in death.The blood sugar levels are drastically reduced (Hypoglycaemia) by the malaria parasite and therefore affecting the energy levels of the individual.Sport, especially soccer, requires a lot of energy and malaria will deplete the energy stores and will not just allow the player to take part in training or a game. Malaria affects almost all systems of the body because of the said primary infection of red blood cells, which are vehicles to deliver oxygen to the many body tissues and organs.it is for this reason that a player or athlete suffering from malaria will not be able to participate in sport for some time.their participation in sport will depend on the improvement of their clinical picture after receiving appropriate treatment. there is no specific time frame with which return to normal physical activity is allowed, however careful monitoring and follow up of players with malaria are of great importance, especially if they are to participate at a very high level.at times recovery can take 10-14 days before an athlete returns to competition.Malaria is mainly diagnosed using a thin or thick blood smear on a glass slide and then competent laboratory personnel have to examine the slide.However, this type of examination or sending of a blood slide to the lab is not practical when the team is out where laboratory facilities are not easy to get.Nowadays the use of RDTs (Rapid Diagnostic Tests for malaria) has extremely made life easy. The tests mainly target the products from the malaria parasite in the blood stream.these tests are very easy to do and can be done by any person who has been oriented in skills of obtaining a drop of blood and the results are ready within a few minutes.Prevention of malaria has to be prioritised if sportsmen and women want to enjoy their sport.it must be emphasised that all camping facilities for sportspersons should have surroundings that are clean and not overgrown with grass.Overgrown grass and stagnant water are perfect breeding sites for mosquitoes.All sportspersons should make sure that they sleep under a treated mosquito net whether in camp or at their respective homes.The use of insect repellents either as applied directly to the skin or sprays has to be encouraged though this might prove to be costly in the long run.Sportspersons should be encouraged to wear long-sleeved clothing to cover the exposed areas and thus prevent the mosquito bites, especially at night when the malaria-causing mosquitoes are active.Another preventive measure is the use of drugs, especially when one is moving from a place where the incidence of malaria is lower than where they are visiting.This is known as chemoprophylaxis against malaria and this is done when an individual travels to a malaria zone (e.g. from Europe to Sub-Saharan Africa).The preventive measures have to target breeding sites for mosquitoes or areas where mosquitoes are likely to be found. In all the districts of Zambia, the Indoor Residue Spraying (IRS) is currently being done to help get rid of mosquitoes.The use of Rapid Diagnostic Tests kits by all teams’ must be encouraged because these are portable and easy to use.The recommended drug of choice for malaria as per our Zambian policy is the artemesinin-based combination therapy and the drug of choice is Coartem for treatment of all forms of simple malaria.many countries in our region have put this as the first line of choice for simple malaria for it has proved to be very effective and with no known serious side effects.The use of fansidar is only reserved for pregnant women in Zambia. The switch from the old chloroquin and fansidar has been due to the many malaria strains which do not respond to these drugs.My role now is to warn sportspersons to be wary of the fansidar they buy off the counter in chemists, BEWARE!!!You might take the fansidar with no response to your suspected malaria.The recommended anti-malaria for complicated malaria is QUININE.  The quinine can be given via the intravenous route or can be taken as an oral drug in tablet or capsule form.it is always important that an early diagnosis and treatment of malaria are instituted so that sportspersons can get back to their normal activities in the shortest time possible.Malaria can be such a huge drawback for an athlete and the entire team. Malaria can be prevented, so all sportspersons must make an Insecticide-Treated Net their number one training partner.Malaria will definitely affect an athlete in training or in competition and full recovery has to be allowed before resuming full activity.For questions and contributions write to: Dr Kabungo Joseph e-mail:

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“We took biopsies in [1999] and couldn't establish a causative agent for the hair loss then,” Tony DeGange, chief of the biology office at the USGS Science Center in Anchorage, told the Washington Times. “But now we have this unexplained mortality event going on with seals. And they haven't been successful in figuring out what caused the seal deaths. Is it just a matter of coincidence or is it related? We don't know.”

More than 100 ringed seals and Pacific walruses washed up on the shores of Alaska, Canada and Russia last summer. they showed fur loss and skin lesions accompanied by labored breathing and fatigue. the majority of the animals eventually died, according to the National Oceanic and Atmospheric Administration.

“Despite extensive testing for a wide variety of well-known infectious agents, the cause(s) of the observed condition in walruses and ice seals remains unknown,” the USGS said in a statement. “Advanced testing techniques for unidentified infectious agents is continuing as well as further testing for potential causes including man-made and natural biotoxins, radiation, contaminants, auto-immune diseases, nutritional, hormonal and environmental factors.”

Even though scientists are investigating radiation as a possible cause, they stressed it's unlikely the illness is being caused by contamination from Japan's Fukushima nuclear power plant, which was damaged last year in an earthquake.

While no polar bears have died yet, the appearance of a disease spreading through their population is “disturbing,” Andrew Wetzler, director of the Land and Wildlife Program for the National Resources Defense Council, said in a blog post.

“At the very least, it should serve as a caution flag to scientists and government officials,” he wrote. ”With polar bears already vulnerable to the effects of climate change, and now showing signs of a new emergent illness, this is not the time to be playing Russian roulette with the Beaufort Sea population either by rushing ahead with offshore oil exploration and drilling or by continuing Canada's commercial trade in polar bear skins.”

The State of Alaska Division of Public Health said there's no evidence of the disease spreading to humans.

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New test for blood donors after international travel

12:30am Wednesday 28th March 2012 in News

A test for West Nile Virus (WNV) will be introduced for certain blood donors in England and North Wales, from may 1.

Blood from donors who have returned from countries where WNV is prevalent will be tested, meaning immediate donation will be allowed by people who may have visited an affected country.

Previously donors had to wait 28 days before donating, after returning from a country where WNV is endemic.

These include the USA, Canada, Italy, mainland Greece, Romania, Former Yugoslav Republic of Macedonia, Turkey, Albania, Israel and some areas of Russia.

Welcoming the change, Dr Lorna Williamson, Medical & Research Director for NHS Blood and Transplant said: “Ensuring the safety and sufficiency of the blood supply is a priority.

“Testing for WNV ensures the risk of the infection is removed, while helping to keep blood stocks more stable over the summer months.

“This is particularly important this year, with the extra Bank Holiday and Olympics, so we would urge donors to try and attend when invited.”

Tests will be carried out on donations during the risk period, may 1 and November 30 when less than four weeks have passed since the donor’s return from an area where WNV is endemic.

West Nile Virus is spread by mosquitoes and was first recognised in 1937 in Uganda.

it emerged in new York in 1999 and in 2002, transfusion transmitted cases were reported in the USA.

by 2003, 46 US states were reporting human cases and the UK blood services began to defer donors returning from North America.

During the intervening years, WNV has been reported in a growing number of countries in Europe. Currently there is no vaccine and the best way to prevent infection is to avoid being bitten by mosquitoes.

For most people, WNV infection will produce no symptoms or result in mild flu-like symptoms.

however for a small number, infection could result in a more severe form of the disease which could result in death for those with a poor immune system, for example small babies or patients who have received stem cell transplants.

Donor acceptance guidelines ensure not only that donated blood is safe for patients but also that donating blood is safe for donors. They are regularly reviewed and revised when necessary.

other recent changes include an amendment to the donor guidelines to reduce the risk of faints, which are significantly more common in younger women.

Research has shown that a blood loss of 15 per cent of estimated blood volume can result in shock.

using a donor’s weight and height to estimate blood volume and only allow donation from those not thought to be at risk, will help to remove this risk.

more News stories

New research shows that blood screenings can accurately spot multiple telltale biomarkers in patients with classic symptoms of depression.

PROBLEM: Depression has traditionally been diagnosed with a questionnaire that assesses patients’ reported symptoms. this process varies greatly, however, since it relies heavily on the clinician’s experience and resources.

METHODOLOGY: to test if an objective biological test could improve diagnosis accuracy, scientists recruited 36 adults with major depression and 43 healthy participants for a blood screening. they measured the levels of nine biomarkers associated with depressive symptoms, such as inflammation, the development and maintenance of neurons, and the interaction between brain structures involved with stress response and other key functions.

RESULTS: The blood test indicated the presence of depression in 33 of the 36 patients and registered false positives for eight of the 43 participants in the control group. The scientists validated these findings with a second trial where 31 of the 34 depressed patients were also successfully diagnosed.

CONCLUSION: Blood tests can detect depression.

CAVEAT: The scientists are planning on conducting larger-scale studies in clinical settings to fine-tune their test. for now, though, study co-author John Bilello hopes that “the biological basis of this test may provide patients with insight into their depression as a treatable disease rather than a source of self-doubt and stigma.”

SOURCE: The full study, “Assessment of a Multi-Assay, Serum-Based Biological Diagnostic Test for Major Depressive disorder: a Pilot and Replication Study,” is published in the journal Molecular Psychiatry.

Image: Themalni/Shutterstock.

Sen. mark Kirk, Republican of Illinois, suffered a debilitating stroke on Monday, a tragedy for him and his family. Ironically, it occurred on the eve of one of the more important Medicare meetings of the year, which convened Wednesday at the Baltimore headquarters of the Center for Medicare and Medicaid Services to discuss the best ways to prevent strokes in at-risk older adults.

Kirk, only 52, is reportedly asking for his Blackberry from his hospital bed, a good sign. he was stricken at an age when strokes are relatively rare and survival likely. But two-thirds of the 829,000 people who suffer strokes each year are over 65, and 85 percent of the 136,000 deaths each year from stroke are among that Medicare-eligible population.

No wonder that CMS, which pays the health care bills for the nation’s 45 million seniors, is concerned. The cost of treating the nearly half million Medicare beneficiaries who survive a stroke each year is staggering. It’s not just the hospitalizations, which can last a week or more, but the long-term rehabilitation and care. many stroke victims are permanently disabled. Preventing strokes can be very cost-effective.

Physicians have long wondered how to prevent strokes. sometimes there are warning signs: slurred speech, or the sudden loss of eyesight in one eye. People with chronic hypertension and under high stress or who are obese are clearly at risk. Nearly a century ago, medical scientists noticed that strokes were often preceded by a narrowing of the carotid artery that feeds the brain. As imaging technologies evolved, it became possible to identify people with severe plaque build-up.

Technologies to reduce blockages soon followed. Drug treatment became possible with the development in the 1950s through 1980s of blood thinners and new drugs to lower blood pressure and cholesterol. Surgeons developed an operation to clean out that major artery called carotid endarterectomy.

And then, in the late 1990s and early in the last decade, the medical device industry developed carotid stents to prop open the crucial blood vessel leading to the brain. Though more expensive, physicians and hospitals increasingly used the procedure, and performed it on asymptomatic patients deemed at risk because of the plaque seen in imaging studies.

Now imagine you’re a person identified by your physicians as being seriously at risk of a stroke because of blockage in your carotid artery, even though you have no overt symptoms of disease. Which of these technologies, if any, should you use? while there isn’t clear cut medical evidence for you or your doctor, there are clear cut risks from the operations.

A technology assessment conducted by Blue Cross and Blue Shield for yesterday’s meeting showed the 30-day rate of deaths or strokes after the procedures (and thus considered procedure-related) were 6 percent for stenting and 3.2 percent for carotid endarterectomy in symptomatic patients, and 2.5 percent and 1.4. percent, respectively, in asymptomatic patients.  The assessment concluded that the risks outweighed the benefits for stenting in asymptomatic patients, and hadn’t proved it was as good as endarterectomy for either group.

That’s not what people thought a half decade ago. Pushed by manufacturers like Abbott, Boston Scientific and Medtronic and intervention cardiologists, Medicare approved payment for the stenting procedure in 2004 despite the absence of solid clinical trial evidence. Use quadrupled in the next two years to more than a thousand operations a month as its use expanded to asymptomatic patients.

Meanwhile, the use of the older and less expensive carotid endarterectomy procedure declined, at great cost to Medicare. a study that will be presented at Wednesday’s meeting by the Society for Vascular Surgery – they back endarterectomy, of course – claims the stent procedure costs $12,000 to $13,000 more “due to equipment and instrumentation.”

Stent manufacturers continued to push their favored approach at the meeting. The two procedures “have similar net outcomes, and they are comparable alternatives,” Charles Simonton, chief medical officer for Abbott Vascular, said in his written presentation, which was released earlier this week. he called for a “personalized approach” and expressed confidence that either procedure was “superior to best medical therapy (drugs) alone,” even though no clinical trial comparing the various approaches head-to-head has ever be done.

Despite the Blue Cross technology assessment, the advisory committee voted that there wasn’t enough evidence to provide a clear answer on what is the best treatment — surgery, stents, or medication — for Medicare patients with carotid plaque-buildup. That’s not what a recent editorial in the Archives of Internal Medicine said. Written by Seth Berkowitz and Rita Redberg of the University of California, San Francisco, the cardiologists raised serious concerns about the rapid increase in use of the pricey carotid artery stents.

Men over 70 fared worse with stenting, as did women in all age groups, they wrote.  Asymptomatic patients, who are at much less risk of having a stroke in the first place, shouldn’t get the operation at all given the heightened risk of stroke and death from the procedure. “Future trials may show that carotid stenting reduces the morbidity and mortality caused by cerebrovascular disease in asymptomatic patients,” Berkowitz and Redberg concluded. “Until then, however, carotid stenting . . . gets a ‘Less Is More’ designation because it has definite harms but unclear benefits.”

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Check-ups during pregnancy tend to focus around the waist. But there’s growing debate about which mothers-to-be should have a gland in their neck tested, too.

Numerous studies since 1999 have found that an underactive thyroid can raise a woman’s risk of miscarriage, premature birth, or a lower IQ for her baby — even if it’s so mildly sluggish that she feels no symptoms.

The problem: while serious cases are treated with a hormone pill, so far there’s little evidence that treating the milder cases makes a difference. So guidelines about who should be tested vary widely.

Now a peek at prenatal testing from one of the country’s largest medical labs suggests that nearly a quarter of pregnant women are getting the simple thyroid blood test regardless of whether they have symptoms.

Researchers at Quest Diagnostics examined records for half a million pregnant women. of those who got tested, a higher-than-expected number — 15 percent — had an underactive thyroid. That’s five-fold higher than some previous estimates, partly because the way in which the condition is diagnosed has changed recently, says the study published by the Journal of Clinical Endocrinology & Metabolism.

The vast majority of those women were in the gray zone, with milder cases where no one knows for sure if a diagnosis helps or wastes money on testing and thyroid medication.

The finding adds pressure for science to settle this long-running controversy.

“We still don’t have perfect answers,” says Dr. Elizabeth Pearce, a well-known endocrinologist at Boston Medical Center, where a recent survey found widespread prenatal thyroid testing. But, “if it’s my patient in my office, or it’s me or my family member, I’m going to treat every time.”

Obstetricians seem more wary.

“There are studies on both sides of the fence,” says Dr. Dena Goffman of New York’s Montefiore Medical Center, which tests only women at high risk. “If you don’t know what to do with the results, you probably shouldn’t order the test,” she said.

The unassuming thyroid — a small bow tie-shaped gland nestled in the front of the neck — plays a big role in good health for everyone. it produces hormones that regulate metabolism and can affect almost every type of tissue in the body. About 20 million Americans are estimated to have a malfunctioning thyroid that, if serious enough, can contribute to heart disease, bone-thinning osteoporosis and infertility.

An overactive thyroid, called hyperthyroidism, speeds up bodily functions, causing such symptoms as weight loss, nervousness, anxiety and increased heart rate and vision problems.

Much more common is an underactive thyroid, called hypothyroidism. it slows body functions, causing such problems as fatigue, weight gain, depression, constipation and dry skin. it even can contribute to high cholesterol, according to the National Institutes of Health.

Thyroid problems increase with age, but they affect far more women than men — and pregnancy puts extra stress on the gland.

Having enough thyroid hormones is important for fetal brain development, especially during the first trimester, when the fetus depends solely on the mother for them. the hormones also play a role in avoiding miscarriage or premature birth.

Mothers also may harbor immune system cells called antibodies that subtly attack the gland and likewise are linked to miscarriage and prematurity. Italian researchers found that treating those women lowered their risk of encountering this problem.

There is broad agreement that women with overt hypothyroidism — a seriously underactive gland — should be treated, most likely given a once-a-day hormone pill long known to be safe in pregnancy. But it takes blood testing to diagnose overt disease because even those women don’t always report the vague symptoms.

Those $25 blood tests are sure to uncover women with mild hypothyroidism, too, the people in the so-called gray zone. Some research has raised questions about whether mild cases really pose a pregnancy risk, and preliminary results from a large British study recently found no overall IQ benefit to the resulting children if their mothers had been treated.

But the damage might already have been done by the time treatment began late in the first trimester, notes Boston’s Pearce. in the U.S., doctors are anxiously awaiting a similar National Institutes of Health study; results aren’t expected until 2015.

What’s the advice until then? the American College of Obstetricians and Gynecologists recommends testing only pregnant women who have thyroid symptoms, have had previous thyroid problems, or have similar autoimmune diseases such as Type 1 diabetes — those considered at risk for overt disease.

The American Thyroid Association goes further. last summer it advised also testing all pregnant women age 30 and older, and those with enlarged thyroids, previous pregnancy problems or those who are obese, says Pearce, who co-authored the guidelines.

Most guidelines cite the lack of evidence for treating mild cases. the thyroid association does urge treatment if those women harbor the worrisome antibodies.

A final tip: Pregnant women should check that their prenatal vitamins contain iodine, important for proper thyroid function, Pearce says. not all do. Most Americans get enough iodine from dairy products, bread, seafood and iodized table salt. But women need extra during pregnancy.

Untreated hypertension may lead to heart attack or stroke.  Even without noticeable symptoms, unsuspecting victims of high blood pressure may experience significant health effects.  Paramus Health Officer, Judith Migliaccio reminds us that because hypertension can be treated, early detection is necessary for good management.  Healthy eating and daily physical activity can have beneficial results.  For that reason, Paramus residents will be offered several opportunities in January to have their blood pressure checked by the Borough nurses.

Hypertension screening will be offered along with blood testing for diabetes at Borough Hall on Wednesday, January 11th from 1:00 to 3:00 p.m.  on this date an appointment is necessary and can be made by calling the Board of Health.  Residents are invited to drop in to the Board of Health without an appointment on the fourth Friday of the month, January 27th, from 9:30 to 11:00 a.m. A decrease in daily physical activity along with an increase in the consumption of high calorie foods has resulted in an epidemic of diabetes in our country.  other risk factors for diabetes include being over age 40, being overweight or having a known diabetic as a close relative.  Consistent high blood sugar may result in increased thirst and urinary frequency or change in vision.

The Board of Health offers an opportunity for blood glucose testing on January 11th from 1:00 to 3:00 p.m.  A simple finger stick yields immediate results and anyone with an elevated response will be advised to see their own physician.  For accurate test results, no alcohol may be taken 24 hours prior to testing and simple dietary rules must be followed by a 2 hour fast.  For complete instructions and an appointment please call the nurses office at 201-265-2100, Ext. 615 or 618. Board of Health President, Dr. Holly Driscoll encourages residents to take advantage of these valuable services offered to Paramus residents.

Doubts have been growing about Yasmin, Yaz and their sister contraceptives for several years now. And those doubts reached full flower at a Food Drug Administration advisory panel on Thursday.

After hours of circular debate about the safety of this family of oral contraceptives, 15 of the FDA’s 26 expert advisors voted that the benefits of these birth control pills outweigh the risk of dangerous blood clots.

But that’s no tub-thumping victory for Bayer. it created this family of contraceptives, which now includes Beyaz and Safyral. They contain a hormone called drospirenone that’s found in none of the other two dozen or so birth control pills available to American women.

And many who voted in favor of Bayer’s drugs expressed serious reservations because of the risks. “I voted yes, but it was a difficult vote,” said Sean Hennessy of the University of Pennsylvania. “I think the drug probably ought to be rarely used.”

Underscoring those doubts, 21 of the 26 panelists voted for strengthening the warnings on labels of Bayer’s contraceptives to reflect the findings of seven studies that the company’s team had spent much of the day trying to discredit.

One of the seven was a 835,000-woman study commissioned by the FDA; it found about a two-fold increase in blood clots for Bayer’s pills compared to competitors’ products.

Nobody’s completely satisfied with the quality of the evidence on the safety of Bayer’s contraceptives containing drospirenone.

But many pointed out that the studies Bayer relies on most to argue for the drugs’ safety were paid for by the company. Bayer makes a bundle on its contraceptives, although U.S. sales have fallen sharply since doubts began to be raised in 2009.

Much of the public comment featured people who urged the FDA to pull Bayer’s contraceptives off the market. “In my opinion, absolutely, these drugs should not be on the market because there are safer alternatives,” said Diana Zuckerman, president of the National Research Center for Women and Families, a consumer group.

The most wrenching testimony came from patients who say they suffered disabling blood clots, and from parents of young women who died after taking these pills.

One of them was Cindy Rippe, whose daughter 20-year-old Elizabeth died three years ago from pulmonary embolisms two months after she switched to Yasmin.

“Elizabeth was a very smart young woman,” Rippe told the panel. “If Elizabeth had been clearly warned that Yasmin had more risk – maybe twice as much risk as other pills – she never would have switched to Yasmin – never. And she would be alive today.”

Rippe is among 10,000 plaintiffs suing Bayer in cases that are to be tried beginning next month.

It doesn’t help Bayer’s case that a former FDA commissioner, Dr. David Kessler, has filed an affidavit in a Chicago federal court accusing Bayer of withholding early reports of blood clots from the federal agency back in 2004. Plaintiffs’ lawyers leaked Kessler’s statement to reporters on the eve of this week’s hearing.

Asked about withholding of data, Bayer executive Dr Leo Plouffe Jr., said:

“We’ve always had a very open communication with the FDA. We’ve responded openly to all requests for information from the FDA. And the information we’re presenting today is in total openness. I hope that puts your mind at rest.”

Bayer’s strongest witness was Dr. Andrea Lukes, a North Carolina gynecologist who said her patients on drospirenone contraceptives often have less bloating, acne and breast tenderness.

“In my experience,” Lukes said, “patients who begin Yaz or Yasmin are less likely to change and are happier with this pill… drospirenone pills provide an important and unique role for contraception.”

That argument had some impact with panel members. Dr, Naomi Tepper of Emory University voted for the proposition that drospirenone contraceptives’ benefits outweigh their risks because she was afraid that a no-vote “would mean pulling them from the market. And if there are women who believe this pill benefits them, that has to be taken into consideration.”

But many were unpersuaded that Yasmin and her sisters confer any special benefits, or at least not enough to outweigh the risks of fatal lung clots or longterm disability from deep-vein thromboses. “I wouldn’t recommend this to my patients and I wouldn’t have my daughter take it,” said Dr. Peter Kaboli of the University of Iowa.

The decision on what to make of all this rests with the FDA. It’s expected to strengthen the warning labels of these birth control pills – although many panel members worried about what consumers and doctors can make of an even-more-complicated litany of conflicting studies.

The agency says it intends to do more definitive studies on the risks of drospirenone contraceptives. but one staffer acknowledged that it hasn’t identified the funds for that yet.

Published: 2:00 AM – 12/14/11

Q. What is “white coat syndrome?”

A. if you suffer from “white coat syndrome,” your blood pressure jumps as soon as a doctor or nurse approaches you. if your doctor knows this, he or she may recommend a home blood-pressure monitor or ambulatory monitor that is worn around the clock and takes your pressure every half-hour.

Blood pressure tends to spike when you are excited by an emotion such as anger or fear. But high blood pressure — known as hypertension — is very sneaky. It’s called the silent killer, because it usually has no symptoms.

Doctors say you have high blood pressure if you have a reading of 140/90 or higher. A blood pressure reading of 120/80 or lower is considered normal. Pre-hypertension is blood pressure between 120 and 139 for the top number, or between 80 and 89 for the bottom number.

The first number represents your systolic pressure when the heart beats. The second number represents the diastolic pressure when the heart rests. if only one number is elevated, you still have high blood pressure with all its dangers.

When you go to your doctor to have your blood pressure taken, there are a few things you can do to get an accurate reading. first, don’t drink coffee or smoke cigarettes for a half-hour before your pressure is taken. (What are you doing smoking, anyway?). empty your bladder, because a full tank can affect the reading. Sit quietly for five minutes before the test.

Q. How can I eat healthier?

A. To maintain a plan for healthy eating, follow these tips from the National Institutes of Health:

Q. What is the difference between Type 1 diabetes and Type 2 diabetes?

A. if you have diabetes, your body can’t produce insulin or use it properly. Insulin is a hormone that helps control the sugar in your blood. Insulin is made by the pancreas, a large organ behind the stomach.

A small percentage of diabetics have Type 1 diabetes, which usually occurs in people under age 30. Diabetics with this form of the disease cannot produce insulin.

About 90 percent of Americans with diabetes have Type 2 diabetes. It is most common in adults over age 40, and the risk of getting it increases with age. with this form of diabetes, the body does not always produce enough insulin or does not use insulin efficiently. Being overweight and inactive increases the chances of developing Type 2 diabetes.

Type 2 diabetes can be prevented in people who are at an increased risk or have pre-diabetes, a condition in which glucose levels are higher than normal but not yet high enough for a diagnosis of diabetes. People with pre-diabetes are more likely to develop diabetes within 10 years and are also more likely to have a heart attack or stroke.

Email questions to freelance health-care writer Fred Cicetti at . Cicetti’s book, “How to be a Healthy Geezer,” is available for purchase at healthygeezer.com.

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