Sunday, August 8, 2010

Pertussis Support

* Preventive care: Vaccination

Pertussis vaccine
In France, the pertussis vaccine was introduced in 1959 it was extended in 1966 because of its association with diphtheria, tetanus and polio. (1)

Since the introduction of vaccination, it was found:

* 95% collapse in the number of pertussis cases and deaths
* But a resurgence of the disease in adolescents and adults.

The currently used vaccine (acellular) is better tolerated than the older vaccine (whole cell vaccine) that marketing is currently stopped. The secondary reactions, especially fever are less frequent. (6.10)

The pertussis vaccine provides immunity excellent but transient (not exceeding ten years): Callbacks vaccine are needed. (7)

In France, the vaccination is recommended at the age of 2 months because the infant pertussis can cause serious and sometimes fatal.

General recommendations (3)

Vaccination against pertussis is practiced with the acellular pertussis vaccine combined with other valences.

The primary immunization of infants has three injections one month apart, followed by a booster at 16-18 months. Given the persistence of a high incidence of pertussis in young infants, infected adolescents or young adults, a booster is recommended since 1998, between the ages of 11 and 13 years.

This second recall in early adolescence should be practiced in conjunction with the third recall diphtheria, tetanus and polio with a vaccine DTCaPolio.

For children who have escaped this recall at 11-13 years, catching up will be performed by the administration of a quadrivalent vaccine DTCaPolio, at the age of 16-18 years.

For children who received out recommendations, a pertussis booster at age 5-6 years, the pertussis booster 11-13 years will be deferred and a quadrivalent vaccine dTcaPolio be proposed at the age of 16-18 years.

In addition to the strategy called cocooning (see below "specific recommendations"), catching up with the pertussis vaccine quadrivalent dTcaPolio be proposed at any adult who had not received vaccination against pertussis during the last ten years, including at the decennial booster diphtheria-tetanus-polio 26-28 years, with the quadrivalent vaccine dTcaPolio.

In the current state of knowledge, including the duration of protection and safety of repeated doses, there is no need to administer more than one dose of quadrivalent vaccine dTcaPolio adults.

Specific recommendations (3)

Vaccination against pertussis is also recommended for adults who become parents in the months or years (called cocooning strategy), and during pregnancy. The updating of vaccinations for other family members (children not updated for this vaccination, adults who have not received vaccination against pertussis during the last ten years) is also recommended as follows:

* During pregnancy for the father, brothers and sisters possible and, where applicable, the adult responsible for the custody of the infant during the first 6 months of life, but also the grandparents may occasionally keep their grandchildren ;
* For the mother immediately after birth (breastfeeding is not a cons-pertussis to vaccination);

In adults, the minimum time between vaccination DTPolio administration of quadrivalent vaccine dTcaPolio can be reduced to two years.

Occupational hazards (3)

Vaccination against pertussis is recommended for:

* Nursing staff as a whole, including in residential homes for frail elderly (retirement homes), with a quadrivalent vaccine dTcaPolio at a point ten DTPolio,
* Students of medical and paramedical courses, on the same principle as the caregivers,
* Professionals in contact with infants too young to have received three doses of pertussis vaccine,
* The medical and paramedical staff of maternity hospitals, neonatal units, or any department of Pediatrics supports infants under 6 months
* Staff of early childhood (nursery, daycare, ...).

For all of these medical professionals, paramedical and in contact with infants, small children or the elderly, the minimum time between vaccination DTPolio the quadrivalent vaccine dTcaPolio can be reduced to two years.

Upon the occurrence of clusters in communities, this period may be reduced to a month.

Schedule of immunization against pertussis

* Primary immunization of infants: one dose at 2, 3 and 4 months and a booster dose at 16-18 months with a combined vaccine.
* Call to adolescence at 11-13 years (1 dose with a vaccine DTCaPolio).
* Call to adulthood at 26-28 years but if draft parenting, family environment of a pregnant woman, and no vaccination against whooping cough for 10 years (1 dose with a vaccine dTcaPolio ).

Note: A single dose of quadrivalent vaccine is now sufficient dTcaPolio adults. (3)

The goals of adult immunization against pertussis are:

* Reduce the incidence of pertussis in adolescents and adults
* Reduce the contamination of newborns and small infants unvaccinated
* To increase the immune vaccinated groups vis-à-vis this bacterium
* Reduce the circulation of this bacterium

Despite these recommendations, pertussis vaccination coverage in adults remained insignificant in 2006 (7)

* The cure

* Antibiotic treatment:
Antibiotic treatment has no effect on the evolution of the disease and has little effect on the cough but it is nevertheless essential because it eliminates the presence of the bacterium in nasopharyngeal secretions in 3-5 days, which decreases the risk of contamination. (7)
Antibiotic treatment is recommended for all persons in the immediate environment of the patient regardless of age or immunization status.

* Hospitalization in specialized of all infants younger than 3 months is systematic, constant surveillance with a cardiorespiratory monitor. (6.8)

* The single room isolation is important as the subject is contagious, that is to say during the five days following the initiation of appropriate antibiotic treatment. (6)
* A satisfactory hydration.
* From the Respiratory physiotherapy to ensure drainage and bronchial pulmonary ventilation satisfactory.
* An adequate supply of food, split, or energy supplements

Friday, August 6, 2010

Pertussis Risk Factors

The main risk factor for the extreme ages of life:

* Infants (age less than 6 months and certainly less than two months).
In infants, pertussis can be very serious or even fatal (5). The majority of deaths occur in infants younger than 6 months.
* Seniors: because of their fragility.

Pregnant women are another risk category.

Finally, point out that there are professions contamination as caregivers because of their contact with the elderly, children, infants under 6 months or more students in medical and paramedical courses. (3)

Monday, August 2, 2010

Food-antioxidants prevent cancer

The food-antioxidants prevent cancer?

The antioxidant foods they help in preventing cancer and heart disease?

Start with a definition: An anti-oxidant is an agent that slows the breakdown of food and certain organic compounds or materials due to the effects of oxidation. Antioxidants can neutralize the harmful effects of free radical molecules that can potentially have toxic effects. Some foods contain anti-oxidants. Some food additives contain anti-oxidants and thus have anti-oxidant.

Statistics show that people who eat fruits and vegetables rich in polyphenols and anthocyanins, lower their risk of cancer, heart disease and some neurological diseases. However, despite the clear role of oxidation in cardiovascular disease, controlled studies using antioxidant vitamins have observed no reduction in the risk of developing heart disease.


This suggests that other substances in fruits and vegetables may explain the better cardiovascular health of people who consume more. The researchers found that people taking Vitamin E supplements reduce the risk of developing heart disease. But none of these studies showed a statistically significant effect of Vitamin E on overall number of deaths or deaths from heart disease.

He is not certain that the doses used in these tests or doses found in most dietary supplements are capable of producing a significant decrease in oxidative stress. A recent study "en dash Supplementation Vitamins and Minerals Antioxidants (SU.VI.MAX) evaluated the effect of the addition of a food supplement at doses comparable to that obtained with diet healthy.

In this study, 12,500 French men and women took low-dose antioxidants or placebo tablets for an average of seven and a half. The researchers found that there was no statistically significant effect of antioxidants on cancer, heart disease and overall survival. However, an analysis of sub-group showed a 31% reduction in cancer risk among men, but no significant reduction among women.

Our recommendation?

This study shows that it would be unwise to consider dietary antioxidants and more generally food supplements as an effective safeguard to prevent cancer. These products are rarely prescribed by physicians, and medical shows traditionally a reluctance on the latter. It can provide additional protection only. For us, this study shows clearly that it is much better to encourage a healthy diet rich in fruits and vegetables.

Sunday, July 18, 2010

The main challenges in the mental sport

Focus - Mental preparation:

"Having nerves of steel", "cool head", "handle the pressure" or "playing small arms" are expressions that reflect ancient or recent origin and complexity for an athlete to achieve his athletic goals with the fullness of his physical and mental together. Today, consult a psychologist who specializes in sports is an important element in achieving its Ojectives. In reading this issue you will learn to cope with difficult situations that you have already rubbed shoulders for sure you have the means to achieve performance that meets your expectations. So make the plunge lock "that you sleep in calls for professionals and mental preparation you progress!

Stress

Stress is a normal reaction of the body. It already indicates that you are mentally prepared for competition. However, too much stress can be harmful and cause a decrease in performance.
There are techniques of regulation of emotions. The latter may not suffice. In this case, it is to understand the psychological reasons for the arrival of stress and difficulty to manage it.

Confidence

It is rare that an athlete has a sense of complacency. In general, he saw this excess once in his career. This experience will teach him not to sell the bear's skin before killing him.
By cons lack of confidence is a problem frequently encountered by the athlete, and this, whatever their level. Some regional competitors have difficulty imagining that even elite athletes, the elite, may experience this type of problem.
In sport, believe in yourself, in its possibilities is vital. Confidence allows us to dare to take risks, make choices, to address competition serenely ...
Thus, to attack, a cyclist must have a minimum of confidence. Otherwise, it just follows the movement. There will be places but rarely win with people of his level.
The trust is also involved in learning a gesture, especially when it comes to abandon an old automation to acquire another more powerful. This swimmer will hope to level up and learn a different technique in his gestures and then accept to be less effective during this time of learning.
It is all history of self-confidence in his potential, but also, in his coach.
The work on trust is sometimes long because it often results in the education received by our parents but also by our first coaches, educators.
It is also in parallel to learn athlete lacking in confidence to change its stance on him having a more positive discourse.

Concentration

mental preparation Sports er timely focus often allows the athlete to optimize its performance. Like a shooting at the biathlon (Read the interview with Sandrine Bailly), which should reach to get into the bubble and meet targets heartbeats high, like a basketball player to throw observed by an audience, like a tennis player at service for a ball math, as a climber in the ascent of a route far.
Again, there are techniques to learn to concentrate better. But it is also important to know and evaluate upstream which may disturb our concentration.

De motivation
The main motivation is the key to success. It allows us to experience the stress of driving in a less difficult. It is also invaluable to our progress, to set ourselves goals and achieve them. Most of the time it remains broadly stable over the season. However, it may happen that the urge passes, is shrinking: there is more fun. Sometimes, lack of motivation led to the abandonment of the activity.
The reasons for this motivation: the training too difficult, routine, trainer too authoritarian, too competitive atmosphere in the team, this excessive pressure, physical exertion and / or emotional ...
The psychologist will try to understand how the sport arrived at this state there and help him gradually to restore what he likes about the sport, to finally regain the performance. However, sometimes the athlete discovers that his choice of sport or how to play his sport did not match, is not really his choice. It stops or changes of activity but consciously.

Saturday, July 17, 2010

Chemotherapy Cancer Treatment

Chemotherapy, sometimes called systemic therapy is the treatment of cancer using drugs. Cancer is a disease in which certain body cells multiply uncontrollably. Cancer cells can destroy healthy cells and invade other parts of the body (metastasis).

Chemotherapeutic agents act on cells that multiply rapidly. Cancer cells and some normal cells reproduce rapidly. When chemotherapy affects healthy cells, temporary side effects can occur. There are ways to alleviate it.

Chemotherapy can be administered alone or with other drugs. It may also be administered simultaneously with other treatments against cancer, or before or after these other treatments such as surgery, radiotherapy or hormone therapy.

Chemotherapy can be administered in many ways. Usually, drugs are injected into a vein (intravenously). For some types of cancer, the doctor may recommend an oral treatment, that is to say taking tablets by mouth. It can also be injected chemotherapy drugs into a muscle (intramuscular), under the skin (subcutaneously) in an artery (intra-arterial) or abdomen (intraperitoneal).

Catheters:

A catheter is a thin, flexible tube with a smooth surface that is placed in a large vein and allowed up as long as necessary. We often install a catheter to patients who require intravenous treatment. In this way, we did not insert a needle each time. The catheter used to administer medicines or to take samples of blood. Sometimes it is connected to a small injection chamber - a small hard round plastic or metal placed under the skin and leaves it up as long as necessary.

Thursday, July 15, 2010

Bronchiolitis in infants

Bronchiolitis in infants: no panic!

Bronchiolitis in infants are often impressive. Yet experts point out that, in most cases, these respiratory infections recover within a few days without complications and without requiring hospitalization.

With the approach of winter, pediatric services are flocking first victims infants with bronchiolitis. The workload is such that at the height of the epidemic waves some hospitals are forced to use temporary staff. It is true that viral infection of the small airways (bronchioles) is extremely common: 500,000 babies, or nearly one third of children under two years are affected each year. But the use of hospitalization is often misused, as most of bronchiolitis are actually benign and easily cured at home. This is one of the conclusions outlined by the experts assembled by the Anaes, national agency for medical assessment to make recommendations on the management of this important public health problem.

Kine sis rather than drugs:

Bronchiolitis affects infants under two years and are mostly due to respiratory syncytial virus, or RSV. Everything starts with a common cold, without much fever and no signs of concern. In five cases, the infection does not resolve spontaneously and is spreading to the bronchi and bronchioles, causing a thickening of the mucosa and an accumulation of secretions, which makes breathing difficult. Cough, faltering and the passage of air into the airways causes a whistling sound audible on auscultation and sometimes even to the ear.

What to do before the degenerates that cold? First consult your doctor and not go to hospital, experts said. In fact, hospitalization is required only rarely. Generally the difficulty breathing ceases in 8-10 days, although cough may persist a minor fortnight. The treatment resulted in two measures:

* A daily chest physiotherapy to help the child to cough up, if the doctor considers it necessary;
* The clearing of the nose by instillation of saline.

However, it is not necessary, except in special cases, administer antibiotics ineffective against viral infections, or cough medicine, the thinner bronchial or any other drug.

Too many hospitalizations:

Two out of three, parents take their child to the hospital. This type of initiative entails risks to bottle pediatric services and increase the risk of contagion, the authors lament. Hospitalization should be reserved for the most vulnerable children, including infants less than six weeks and those with signs of poor tolerance. In summary, parents should consult their doctor promptly if the baby no longer drinks his bottles, vomiting or diarrhea does not respond normally, becomes more and more out of breath, or if the fever rises. The doctor can then decide on a hospital to monitor the child and help him through this difficult period.

It is not uncommon for a baby to go through several bronchiolitis. From the third episode, we talk about asthma in infants. But this does not mean that the infant becomes a child with asthma. Indeed, the development of asthma is largely related to the existence of an allergic remind the experts. Bronchiolitis does not seem in itself to promoting effect.

Friday, July 9, 2010

Heart disease, women are they at risk?

What is heart disease?

The term heart disease can designate many different heart problems. The most common heart disease is coronary artery disease. She says when a fatty substance called plaque clogs the arteries that carry oxygen and nutrients to the heart. A heart attack occurs when an artery is completely blocked.

What is the incidence of heart disease on women?

Cardiovascular disease, including heart disease part, are the leading cause of death among Canadian women. Women are more likely to die from cardiovascular disease than any other disease.

The obstruction of blood vessels occurs slowly. The damage to the heart over the years can interfere with daily activities.

What are the risk factors for heart disease in the case of women?

Menopause:
At menopause, women are at greater risk of contracting heart disease. Researchers do not know precisely why. They believe that the increased risk may be related to decreased levels of estrogen in women during menopause. Not so long ago, it was believed that hormone therapy could help reduce risk in the case of menopausal women. However, according to recent studies, certain types of hormones (estrogen combined with progestogen) can actually increase the risk of heart attack, stroke, blood clots and breast cancer in some women. Therefore, hormone therapy is not recommended now as a preventive measure against heart disease, although it may be useful for other symptoms of menopause such as hot flashes. Women should always discuss with their healthcare provider to monitor the appropriateness of hormonal therapy.

Hypertension:
Hypertension (or high blood pressure) causes the heart to work harder than normal and requires an extra stress to the muscle. It also damages the walls of blood vessels and increases the chances they get clogged.

Cholesterol:
Cholesterol is a type of fat found in foods and also produced by the liver. It is an essential nutrient for the body. However, excess cholesterol can clog arteries and increase the risk of contracting heart disease.

Diabetes:
Women with diabetes are at greater risk of suffering from heart disease. A number of factors, including hypertension, hypercholesterolemia and abnormally high blood sugar, are taken into account the deterioration of the arteries that carry blood to the heart. The plate is formed more easily once the arteries are damaged.

Smoking:
Women who smoke, especially those under 50 years are more likely to have a heart attack than those who do not smoke. The risks are even higher in the case of smokers over 35 who also take oral contraceptives. Women who do not smoke but who are frequently exposed to secondhand smoke also are at greater risk.

Inactivity:
Inactive women are twice as likely to contract heart disease than active women. Thirty minutes of exercise four to six times a week, helping to strengthen the heart and prevent heart disease.

Top Overweight:
The more overweight a woman is important, the more likely she contracted a heart disease are high. Weight loss, if only a few pounds, can reduce these risks.

Family history:
A woman is most at risk for heart disease if a close blood relatives (eg, father or mother) was diagnosed with heart disease before age 65.

Race:
Although women of all races are at risk for heart disease, this risk is higher in the case of black women and South Asians.

Social and economic factors:
Women whose levels of education and income are lower are more likely to suffer from heart disease. This may be explained by the obstacles they must overcome in order to adopt and maintain a healthy lifestyle can prevent illness.