Researchers at UCSF Children's Hospital in San Francisco have launched a groundbreaking study to determine whether a new procedure using magnets can correct sunken chest, the most common congenital chest deformity, in the same way that orthodontic braces gradually realign teeth.
Sunken chest, which is known medically as pectus excavatum, is a deformity of the cartilage that connects the ribs to the breastbone. The deformed cartilage pulls the breastbone inward, making the chest look caved in or sunken. The condition occurs in about one in 800 children born in the United States each year and is three times more common in boys than girls.
A UCSF team developed the new procedure, in which a magnet attached to the child's breastbone is coupled with a second one outside the chest that creates a steady, controlled, outward pull on the internal magnet to reshape the bone, cartilage and chest wall.
The procedure marks one of the first times magnets have been embedded inside the body to treat a health condition, according to Michael Harrison, MD, professor of surgery and pediatrics emeritus at UCSF and lead investigator of the study.
"We needed to apply a force to gradually remodel the chest wall without piercing the skin," Harrison said. "Magnets do it."
The research team named the new technique the "Magnetic Mini-Mover Procedure," known as 3MP. The 3MP uses a device that includes two parts: a titanium-encased magnet about the size of a quarter that is surgically attached to the child's breastbone and a second magnet embedded in a lightweight plastic brace that the child wears under clothing. The attraction between the two magnets holds the brace in place.
Because the internal magnet is placed just under the skin during an outpatient visit, the child can go home on the day of the procedure with relatively little discomfort. The child wears the brace for three to 12 months, depending on the severity of the deformity. It can be adjusted to increase or decrease the pull on the breastbone in the same way that orthodontic braces are loosened or tightened.
If successful, the 3MP could revolutionize treatment of pectus excavatum, according to Harrison. Current approaches to correcting sunken chest involve major surgery to open and rebuild the chest and the insertion of metal struts to hold the chest in place while it heals. Complications can occur because the struts are under significant pressure, and the painful recovery can take months.
"The problem with present techniques is that they attempt to reshape the chest wall in one big operation," Harrison said. "A better idea is to apply a little force over a longer time, like the orthodontist moves your teeth."
The use of the magnets has been deemed safe by the U.S. Food and Drug Administration, which has reviewed and approved the 3MP device. The internal magnet is laser-welded in a titanium case, assuring its safety. The magnets have been found to have no effect on the heart or other body parts, and studies have demonstrated that long-term exposure to magnetic fields is not harmful.
Sunken chest had long been considered a cosmetic defect. But recent studies have determined that while not life-threatening, in severe cases the deformity can cause heart and breathing difficulties, because the abnormal breast bone can reduce blood flow to the heart and prevent the lungs from expanding completely, restricting the ability to exercise, according to Harrison. Some patients also suffer serious emotional difficulties and low self-esteem, especially since sunken chest often worsens during adolescence when children are self-conscious about their appearance and seek peer acceptance.
"This is not a trivial problem for these kids," Harrison said. "Most are willing to undergo a big, painful and expensive surgery to fix it. Why not a simple little outpatient procedure to fix it?"
Researchers are seeking potential study participants who have sunken chest and are between 8 and 14 years of age, otherwise healthy and willing to participate in the 12-month-long study of the new procedure.
###
More information about the medical condition is available at http://www.pedsurg.ucsf.edu/pectus/ and about the Magnetic Mini-Mover Procedure at http://www.pedsurg.ucsf.edu/m3p/.
In addition to Harrison, the research team includes Diana L. Farmer, MD, chief, UCSF Division of Pediatric Surgery; Barbara J. Bratton, MSN, PNP, UCSF Division of Pediatric Surgery; Richard Fechter and Art Moran, clinical engineers in the UCSF Department of Clinical Engineering; and Darrell Christensen, orthotics specialist in the UCSF Department of Orthopedic Surgery.
Funding for the study is provided by a grant from the Office of Orphan Products Development of the FDA, which promotes the development of products that demonstrate promise for the diagnosis and/or treatment of rare diseases or conditions.
One of the nation's top children's hospitals, UCSF Children's Hospital creates an environment where children and their families find compassionate care at the healing edge of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 1,600 babies born there.
UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care.
Contact: Carol Hyman
University of California - San Francisco
Monday, March 3, 2008
Allergy Training For Nurses Improves Patients' Quality Of Life; New Research Provides The Evidence
Recent research published by Education for Health and colleagues from the University of Edinburgh, the University of Aberdeen and the London School of Hygiene and Tropical Medicine provides evidence that structured allergy training for primary care health professionals improves quality of life in patients with perennial rhinitis(1).
In this randomised, controlled trial, twenty GPs and practice nurses completed the allergy module at Education for Health over a six month period. Patients with perennial rhinitis (blocked, runny nose) from these doctors' and nurses' practices were randomly allocated to either receive care from an allergy trained doctor or nurse or from an untrained person (usual care). All patients then completed a disease-specific quality of life questionnaire which looked at the impact of their nasal symptoms on their quality of life at baseline and at 6 months.
Results showed not only that the trained nurses and doctors were more confident and competent in delivering allergy care, but that their patients' quality of life was improved compared to those patients who had continued with their usual care. This research is important on two counts, firstly, it supports the NHS agenda of improving primary care allergy services by showing that allergy training is feasible and deliverable in primary care; and secondly, that patients benefit as a result of health professional education.
Monica Fletcher, Chief Executive of Education for Health said "Most mild or moderate allergy symptoms (e.g. hayfever, allergic asthma, urticaria and some food allergy problems), can, and should, be managed successfully in primary care with appropriate training. A recent House of Commons Health Committee report on the provision of allergy services(2) echoed this view. Clinical quality markers for allergy care must be included in the GMS contract in the future. Both publications stress the importance of postgraduate training to improve allergy practice in primary care".
Allergic diseases, including hayfever (allergic rhinitis), food allergy, drug allergy and allergic asthma affect approximately 20% of the UK population and account for approximately 6% of GP consultations. Hospital admissions for severe allergic disease have increased tenfold in the last 10 years and allergy generally is associated with significant financial cost. Symptoms can be irritating, disruptive and sometimes disabling; allergic rhinitis, often trivialised by sufferers and health professionals alike, has been shown to impair concentration and learning in children.
Mark Levy, GP with interest in Respiratory diseases and Allergy said: "Despite the high prevalence and morbidity due to allergic diseases in the United Kingdom, a small minority of health professionals are trained in provision of allergy care (4, 5). Furthermore the lack of facilities for secondary and tertiary care for people with allergic conditions, coupled with the relatively small number of specialists available to teach allergy management in primary care, has resulted in patients being managed by health professionals with little formal training in this discipline (6). This study from Education for Health, offers some hope for patients and information for commissioners of health care by providing good quality evidence of the benefit for allergy sufferers in being treated by health professionals trained in this field."
Education for Health provides Allergy training at diploma and degree level.
References:
(1) Sheikh A, Khan-Wasti S, Price D, Smeeth L, Fletcher M, Walker S. Standardized training for healthcare professionals and its impact on patients with perennial rhinitis: a multi-centre randomized controlled trial. J Allergy Clin Immunol 2007; 37:90-99
(2) Department of Health. A Review of services for allergy. The epidemiology, demand for, and provision of, treatment and effectiveness of clinical interventions. http://www.dh.gov.uk. 2006
(3) Walker SM & Sheikh A. Self-reported rhinitis is a significant problem for patients with asthma: results from a national (UK) survey. Primary Care Resp J. 2005;14:83-87
(4) Mark L Levy, David Price, Xiaohong Zheng, Colin Simpson, Phil Hannaford and Aziz Sheikh. Inadequacies in UK primary care allergy services: National survey of current provisions and perceptions of need. Clinical and Experimental Allergy, 2004; 34(4): 518-519
(5) http://dx.doi.org/10.3132/pcrj.2007.00004
(6) Mark L Levy, Aziz Sheikh, Samantha Walker, Angie Woods. Should UK allergy services focus on primary care? BMJ 2006;332:1347-1348. doi:10.1136/bmj.332.7554.1347 http://bmj.bmjjournals.com/cgi/content/extract/332/7554/1347
Education for Health
The Athenaeum
10 Church Street
Warwick, CV34 4AB
UK
Switchboard Tel: +44(0)1926 493313
http://www.educationforhealth.org.uk
Facts about Education for Health:
-- Education for Health is a not for profit organisation formed by a dynamic merger in August 2005 between two of the UK's leading education organisations for health professionals: Heartsave - National Cardiovascular Training Programme, and the National Respiratory Training Centre.
-- The two partner organisations have each earned a reputation for excellence in education in their respective areas of expertise and have trained in excess of 40,000 students both nationally and internationally. Prior to the establishment of Education for Health, The National Respiratory Training Centre had been at the frontline of the battle to achieve recognition for people with lung disease since 1986.
-- Education for Health aims to provide a consistent, comprehensive and innovative approach to professional health education across the fields of cardiovascular disease, allergy, and respiratory health, with the ultimate objective of transforming lives worldwide
-- All education is evidence based and grounded in practice; fully up to date with the General Medical Services Contract; based on key national guidelines; directly linked with the competency frameworks and Knowledge and Skills Framework; and is subject to frequent, rigorous clinical and academic review. In addition, in these days of Health Service change and uncertainty, all students are fully supported throughout their studies by a team of clinical experts.
In this randomised, controlled trial, twenty GPs and practice nurses completed the allergy module at Education for Health over a six month period. Patients with perennial rhinitis (blocked, runny nose) from these doctors' and nurses' practices were randomly allocated to either receive care from an allergy trained doctor or nurse or from an untrained person (usual care). All patients then completed a disease-specific quality of life questionnaire which looked at the impact of their nasal symptoms on their quality of life at baseline and at 6 months.
Results showed not only that the trained nurses and doctors were more confident and competent in delivering allergy care, but that their patients' quality of life was improved compared to those patients who had continued with their usual care. This research is important on two counts, firstly, it supports the NHS agenda of improving primary care allergy services by showing that allergy training is feasible and deliverable in primary care; and secondly, that patients benefit as a result of health professional education.
Monica Fletcher, Chief Executive of Education for Health said "Most mild or moderate allergy symptoms (e.g. hayfever, allergic asthma, urticaria and some food allergy problems), can, and should, be managed successfully in primary care with appropriate training. A recent House of Commons Health Committee report on the provision of allergy services(2) echoed this view. Clinical quality markers for allergy care must be included in the GMS contract in the future. Both publications stress the importance of postgraduate training to improve allergy practice in primary care".
Allergic diseases, including hayfever (allergic rhinitis), food allergy, drug allergy and allergic asthma affect approximately 20% of the UK population and account for approximately 6% of GP consultations. Hospital admissions for severe allergic disease have increased tenfold in the last 10 years and allergy generally is associated with significant financial cost. Symptoms can be irritating, disruptive and sometimes disabling; allergic rhinitis, often trivialised by sufferers and health professionals alike, has been shown to impair concentration and learning in children.
Mark Levy, GP with interest in Respiratory diseases and Allergy said: "Despite the high prevalence and morbidity due to allergic diseases in the United Kingdom, a small minority of health professionals are trained in provision of allergy care (4, 5). Furthermore the lack of facilities for secondary and tertiary care for people with allergic conditions, coupled with the relatively small number of specialists available to teach allergy management in primary care, has resulted in patients being managed by health professionals with little formal training in this discipline (6). This study from Education for Health, offers some hope for patients and information for commissioners of health care by providing good quality evidence of the benefit for allergy sufferers in being treated by health professionals trained in this field."
Education for Health provides Allergy training at diploma and degree level.
References:
(1) Sheikh A, Khan-Wasti S, Price D, Smeeth L, Fletcher M, Walker S. Standardized training for healthcare professionals and its impact on patients with perennial rhinitis: a multi-centre randomized controlled trial. J Allergy Clin Immunol 2007; 37:90-99
(2) Department of Health. A Review of services for allergy. The epidemiology, demand for, and provision of, treatment and effectiveness of clinical interventions. http://www.dh.gov.uk. 2006
(3) Walker SM & Sheikh A. Self-reported rhinitis is a significant problem for patients with asthma: results from a national (UK) survey. Primary Care Resp J. 2005;14:83-87
(4) Mark L Levy, David Price, Xiaohong Zheng, Colin Simpson, Phil Hannaford and Aziz Sheikh. Inadequacies in UK primary care allergy services: National survey of current provisions and perceptions of need. Clinical and Experimental Allergy, 2004; 34(4): 518-519
(5) http://dx.doi.org/10.3132/pcrj.2007.00004
(6) Mark L Levy, Aziz Sheikh, Samantha Walker, Angie Woods. Should UK allergy services focus on primary care? BMJ 2006;332:1347-1348. doi:10.1136/bmj.332.7554.1347 http://bmj.bmjjournals.com/cgi/content/extract/332/7554/1347
Education for Health
The Athenaeum
10 Church Street
Warwick, CV34 4AB
UK
Switchboard Tel: +44(0)1926 493313
http://www.educationforhealth.org.uk
Facts about Education for Health:
-- Education for Health is a not for profit organisation formed by a dynamic merger in August 2005 between two of the UK's leading education organisations for health professionals: Heartsave - National Cardiovascular Training Programme, and the National Respiratory Training Centre.
-- The two partner organisations have each earned a reputation for excellence in education in their respective areas of expertise and have trained in excess of 40,000 students both nationally and internationally. Prior to the establishment of Education for Health, The National Respiratory Training Centre had been at the frontline of the battle to achieve recognition for people with lung disease since 1986.
-- Education for Health aims to provide a consistent, comprehensive and innovative approach to professional health education across the fields of cardiovascular disease, allergy, and respiratory health, with the ultimate objective of transforming lives worldwide
-- All education is evidence based and grounded in practice; fully up to date with the General Medical Services Contract; based on key national guidelines; directly linked with the competency frameworks and Knowledge and Skills Framework; and is subject to frequent, rigorous clinical and academic review. In addition, in these days of Health Service change and uncertainty, all students are fully supported throughout their studies by a team of clinical experts.
Unveiling The Nature Of Human And Avian Influenza - Launch Of Influenza Photographic Exhibition Emphasises The Seriousness Of Influenza
Intriguing new photographic images and film footage released today to the public reveal the viruses responsible for seasonal influenza and the currently circulating H5N1 avian influenza 'bird flu' strain.
With contributions from world renowned photomicrographers Lennart Nilsson (Sweden) and Dennis Kunkel (USA), the public exhibition presents the whole influenza 'family tree', from seasonal to avian, epidemic to pandemic. The images have been released as part of a wider influenza exhibition launched this week, entitled Influenza through a Lens. Produced by a leading virology research centre, the images include time-lapse photography of how the strains replicate over time.
Professor John Oxford, Professor of Virology at St Bartholomew's and the Royal London Hospital, and Scientific Director of Retroscreen Virology, UK, the organisation responsible for producing the new time-lapse images, says, "There is so much talk of bird flu and fear of the pandemic, but every year we are subject to the serious threat of an outbreak of influenza which can result in severe illness and loss of life. These images show the different strains of the influenza virus and remind us to take influenza seriously in all its various guises."
H5N1 influenza, the much talked about 'bird flu', is one particular strain of the influenza virus, and is only transmitted to humans through close contact with infected birds. As of 16 February 2007, 273 people have been infected with the virus, of whom 167 have died[i][1]. Experts believe the next influenza pandemic is inevitable and possibly imminent[ii][2] and preparations are underway to try and minimise its impact.
Nonetheless, seasonal influenza remains a severe and debilitating disease and the annual onset presents a significant global threat, affecting 500 million people and claiming half a million lives each year. Regardless of the type of influenza strain which is most dominant each year, influenza's annual impact on society and the economy accounts for one in 10 of all absences from the workplace[iii][3] and costs 12 billion dollars in lost productivity annually in the US alone[iv][4].
Professor Ab Osterhaus, Professor of Virology, Medical Faculty, Erasmus Medical Center, Rotterdam, the Netherlands, states, "People can be complacent about seasonal influenza, but there is much that can be done. Current tools, such as vaccines and antivirals, are still under-used despite being both medically and economically justified. It's important for people to take seasonal influenza seriously and to take precautions to prevent and treat it whilst minimising its spread."
The findings of a recent survey[v][5] reveal some of the barriers to influenza management. Conducted in the US and Europe, the survey quizzed 132 doctors on the key reasons that limit their prescribing of influenza medication to their otherwise healthy patients. The perception of influenza as a self-limiting disease was ranked as a major factor by almost a quarter (23%), whilst a third (33%) considered over-the-counter symptomatic remedies as sufficient and almost half (46%) stated that their patients simply do not seek help in time to benefit from medical treatment for influenza.
About influenza
Influenza, commonly called "flu", is an acute respiratory illness that affects the upper and/or lower parts of the respiratory tract and is caused by an influenza virus. Flu is highly contagious and spreads rapidly by coughs and sneezes from people who are already carrying the virus. Patients become ill between 18 and 72 hours after being infected. The most common symptoms of uncomplicated influenza are an abrupt onset of fever, shivering, headache, muscle ache and a dry cough[vi][6].
There are three types of influenza viruses: A, B, and C. Influenza A subtypes and B viruses are classified by 'strains', variations of the virus caused by ongoing mutation. When a new strain of human influenza virus emerges, antibody protection that may have developed after infection or vaccination with an older strain may not provide protection against the new strain6.
The influenza 'family tree'
Influenza A viruses are divided into subtypes based on the molecules which are on their surface, called haemagglutinin (H) and neuraminidase (N). Haemagglutinin is involved in the attachment of the virus to cells in the respiratory system and neuraminidase is involved in the release of new virus particles from infected cells to uninfected cells in the body and allows the virus to spread. There are 16 types of H (H1 to H16) and 9 types of N (N1 to N9) and these combine in several ways to give the very large number of influenza sub-types e.g. H1N1, H5N1, H9N2, H7N7.
Key pandemic and seasonal strains of note include:
-- H1N1 was the first strain of influenza to be identified and labelled in 1933
-- H1N1 'Spanish flu' A in 1918 caused in excess of 40 million deaths worldwide (although, since influenza was only 'discovered' in 1933, the pandemic was at the time a mystery)
-- H2N2 'Asian flu' A in 1957 caused 1 million deaths worldwide
-- H3N2 'Hong Kong flu' A in 1968 caused 800,000 deaths worldwide in six weeks
-- H5N1 is the currently circulating avian influenza strain in birds that experts predict will mutate, becoming capable of human-to-human transmission, in the next pandemic
-- H3N2 was most dominant seasonal strain in the United States 2005/2006[vii][7]
About 'Influenza through a Lens'
'Influenza through a Lens' is sponsored by F. Hoffmann-La Roche Ltd for the advancement and support of medical, scientific, and patient initiatives.
The exhibition is open to the public from 22 February 2007, staged at Brussels Event Brewery, Rue Delaunoystraat 58 b/1, 1080 Brussels, Belgium. The exhibition unveils newly commissioned footage and photographic stills showing replication of the currently circulating H5N1 avian influenza virus and an epidemic influenza virus, and how the presence of an antiviral affects the replication of these viruses. The public will also learn about the different influenza virus strains, from human to avian, epidemic to pandemic, over the years.
About Retroscreen
Retroscreen Virology, London, UK, is one of Europe's leading contract virology research companies. The work it conducts is dedicated to creating the next generation of antivirals and vaccines in the field of biomedical research.
About the physician survey
The physician survey was conducted by an independent market research agency, Adelphi International Research, commissioned by Roche. 330 physicians were surveyed on current influenza perceptions and management across the United States and Europe (France, Germany and the United Kingdom), 132 of whom cited barriers to the prescription of influenza medication, such as antivirals, in otherwise healthy patients. This subset was asked to rank their key reasons for not prescribing such medication to patients. The overview of the results is as follows.
Base = 132
-- Influenza is as self-limiting disease
No. respondents who ranked this as 1st - 3rd reason - 30
Percentage of total respondents - 23%
-- Symptomatic remedies are effective enough for the treatment of influenza
No. respondents who ranked this as 1st - 3rd reason - 44
Percentage of total respondents - 33%
-- Patient(s) present too late
No. respondents who ranked this as 1st - 3rd reason - 60
Percentage of total respondents - 46%
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology.
www.roche.com
Roche Influenza
References
[i][1] Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO, last updated 16 February 2007 http://www.who.int/csr/disease/avian_influenza/country/cases_table_2007_02_06/en/index.html
[ii][2] WHO Avian Influenza Factsheet. Accessed 19 February 2007. http://www.who.int/csr/don/2004_01_15/en/
[iii][3] Smith A. The socioeconomic aspects and behavioural effects of influenza. In: Wood C, editor. Influenza: strategies for prevention. London UK: Royal Society of Medicine, 1988:46-52.
[iv][4] Nichol K et al. The efficacy and cost effectiveness of vaccination against influenza amongst elderly persons living in the community. N Eng J Med 1994; 331:778-84.
[v][5] Physician survey conducted by Adelphi International Research, commissioned by F. Hoffmann-La Roche Ltd, July 2006
[vi][6] European Influenza Surveillance Scheme, Influenza Factsheet. Accessed 19 February 2007. http://www.eiss.org/html/faq_influenza.html
[vii][7] Centers for Disease Control, 2008-6 US Influenza Season Summary. Accessed 19 February 2007. http://www.cdc.gov/flu/weekly/weeklyarchives2008-2006/05-06summary.htm
With contributions from world renowned photomicrographers Lennart Nilsson (Sweden) and Dennis Kunkel (USA), the public exhibition presents the whole influenza 'family tree', from seasonal to avian, epidemic to pandemic. The images have been released as part of a wider influenza exhibition launched this week, entitled Influenza through a Lens. Produced by a leading virology research centre, the images include time-lapse photography of how the strains replicate over time.
Professor John Oxford, Professor of Virology at St Bartholomew's and the Royal London Hospital, and Scientific Director of Retroscreen Virology, UK, the organisation responsible for producing the new time-lapse images, says, "There is so much talk of bird flu and fear of the pandemic, but every year we are subject to the serious threat of an outbreak of influenza which can result in severe illness and loss of life. These images show the different strains of the influenza virus and remind us to take influenza seriously in all its various guises."
H5N1 influenza, the much talked about 'bird flu', is one particular strain of the influenza virus, and is only transmitted to humans through close contact with infected birds. As of 16 February 2007, 273 people have been infected with the virus, of whom 167 have died[i][1]. Experts believe the next influenza pandemic is inevitable and possibly imminent[ii][2] and preparations are underway to try and minimise its impact.
Nonetheless, seasonal influenza remains a severe and debilitating disease and the annual onset presents a significant global threat, affecting 500 million people and claiming half a million lives each year. Regardless of the type of influenza strain which is most dominant each year, influenza's annual impact on society and the economy accounts for one in 10 of all absences from the workplace[iii][3] and costs 12 billion dollars in lost productivity annually in the US alone[iv][4].
Professor Ab Osterhaus, Professor of Virology, Medical Faculty, Erasmus Medical Center, Rotterdam, the Netherlands, states, "People can be complacent about seasonal influenza, but there is much that can be done. Current tools, such as vaccines and antivirals, are still under-used despite being both medically and economically justified. It's important for people to take seasonal influenza seriously and to take precautions to prevent and treat it whilst minimising its spread."
The findings of a recent survey[v][5] reveal some of the barriers to influenza management. Conducted in the US and Europe, the survey quizzed 132 doctors on the key reasons that limit their prescribing of influenza medication to their otherwise healthy patients. The perception of influenza as a self-limiting disease was ranked as a major factor by almost a quarter (23%), whilst a third (33%) considered over-the-counter symptomatic remedies as sufficient and almost half (46%) stated that their patients simply do not seek help in time to benefit from medical treatment for influenza.
About influenza
Influenza, commonly called "flu", is an acute respiratory illness that affects the upper and/or lower parts of the respiratory tract and is caused by an influenza virus. Flu is highly contagious and spreads rapidly by coughs and sneezes from people who are already carrying the virus. Patients become ill between 18 and 72 hours after being infected. The most common symptoms of uncomplicated influenza are an abrupt onset of fever, shivering, headache, muscle ache and a dry cough[vi][6].
There are three types of influenza viruses: A, B, and C. Influenza A subtypes and B viruses are classified by 'strains', variations of the virus caused by ongoing mutation. When a new strain of human influenza virus emerges, antibody protection that may have developed after infection or vaccination with an older strain may not provide protection against the new strain6.
The influenza 'family tree'
Influenza A viruses are divided into subtypes based on the molecules which are on their surface, called haemagglutinin (H) and neuraminidase (N). Haemagglutinin is involved in the attachment of the virus to cells in the respiratory system and neuraminidase is involved in the release of new virus particles from infected cells to uninfected cells in the body and allows the virus to spread. There are 16 types of H (H1 to H16) and 9 types of N (N1 to N9) and these combine in several ways to give the very large number of influenza sub-types e.g. H1N1, H5N1, H9N2, H7N7.
Key pandemic and seasonal strains of note include:
-- H1N1 was the first strain of influenza to be identified and labelled in 1933
-- H1N1 'Spanish flu' A in 1918 caused in excess of 40 million deaths worldwide (although, since influenza was only 'discovered' in 1933, the pandemic was at the time a mystery)
-- H2N2 'Asian flu' A in 1957 caused 1 million deaths worldwide
-- H3N2 'Hong Kong flu' A in 1968 caused 800,000 deaths worldwide in six weeks
-- H5N1 is the currently circulating avian influenza strain in birds that experts predict will mutate, becoming capable of human-to-human transmission, in the next pandemic
-- H3N2 was most dominant seasonal strain in the United States 2005/2006[vii][7]
About 'Influenza through a Lens'
'Influenza through a Lens' is sponsored by F. Hoffmann-La Roche Ltd for the advancement and support of medical, scientific, and patient initiatives.
The exhibition is open to the public from 22 February 2007, staged at Brussels Event Brewery, Rue Delaunoystraat 58 b/1, 1080 Brussels, Belgium. The exhibition unveils newly commissioned footage and photographic stills showing replication of the currently circulating H5N1 avian influenza virus and an epidemic influenza virus, and how the presence of an antiviral affects the replication of these viruses. The public will also learn about the different influenza virus strains, from human to avian, epidemic to pandemic, over the years.
About Retroscreen
Retroscreen Virology, London, UK, is one of Europe's leading contract virology research companies. The work it conducts is dedicated to creating the next generation of antivirals and vaccines in the field of biomedical research.
About the physician survey
The physician survey was conducted by an independent market research agency, Adelphi International Research, commissioned by Roche. 330 physicians were surveyed on current influenza perceptions and management across the United States and Europe (France, Germany and the United Kingdom), 132 of whom cited barriers to the prescription of influenza medication, such as antivirals, in otherwise healthy patients. This subset was asked to rank their key reasons for not prescribing such medication to patients. The overview of the results is as follows.
Base = 132
-- Influenza is as self-limiting disease
No. respondents who ranked this as 1st - 3rd reason - 30
Percentage of total respondents - 23%
-- Symptomatic remedies are effective enough for the treatment of influenza
No. respondents who ranked this as 1st - 3rd reason - 44
Percentage of total respondents - 33%
-- Patient(s) present too late
No. respondents who ranked this as 1st - 3rd reason - 60
Percentage of total respondents - 46%
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology.
www.roche.com
Roche Influenza
References
[i][1] Cumulative Number of Confirmed Human Cases of Avian Influenza A/(H5N1) Reported to WHO, last updated 16 February 2007 http://www.who.int/csr/disease/avian_influenza/country/cases_table_2007_02_06/en/index.html
[ii][2] WHO Avian Influenza Factsheet. Accessed 19 February 2007. http://www.who.int/csr/don/2004_01_15/en/
[iii][3] Smith A. The socioeconomic aspects and behavioural effects of influenza. In: Wood C, editor. Influenza: strategies for prevention. London UK: Royal Society of Medicine, 1988:46-52.
[iv][4] Nichol K et al. The efficacy and cost effectiveness of vaccination against influenza amongst elderly persons living in the community. N Eng J Med 1994; 331:778-84.
[v][5] Physician survey conducted by Adelphi International Research, commissioned by F. Hoffmann-La Roche Ltd, July 2006
[vi][6] European Influenza Surveillance Scheme, Influenza Factsheet. Accessed 19 February 2007. http://www.eiss.org/html/faq_influenza.html
[vii][7] Centers for Disease Control, 2008-6 US Influenza Season Summary. Accessed 19 February 2007. http://www.cdc.gov/flu/weekly/weeklyarchives2008-2006/05-06summary.htm
South Africa To Revise AIDS Control Program To Address XDR-TB
South Africa is taking steps to revise its HIV/AIDS control program in an effort to combat the spread of extensively drug-resistant tuberculosis, TB that is resistant to first- and second-line drugs, Nomonde Xundu, the Department of Health's chief director for HIV and TB, said on Thursday, Reuters reports. XDR-TB could exacerbate the HIV/AIDS epidemic in South Africa, where about five million out of a population of 45 million people are HIV-positive, and as many as 1,000 people die of AIDS-related complications daily, according to Reuters. About 183 people, most of whom were HIV-positive, have died from XDR-TB in South Africa since September 2006. Health planners are investigating ways to address HIV/TB coinfection and TB screening before launching a new AIDS control strategy in March, Xundu said. Health Minister Manto Tshabalala-Msimang said the "biggest challenge" remains poor treatment adherence among people with TB. She added that none of the people living with XDR-TB offered counseling in the country has declined treatment and that the government does not believe compulsory isolation is necessary (Reuters, 2/15). Tshabalala-Msimang also said that the health department plans to strengthen the DOTS strategy to prevent the spread of multi-drug resistant and XDR-TB and will continue to collaborate with local and international experts to find ways to control the spread of XDR-TB (SAPA/iAfrica.com, 2/16).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . (c) 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . (c) 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Race May Play A Role In Children's Asthma Care
Children in this country suffer from asthma more than any other chronic illness, and new research finds African American children with the condition have a greater risk than others of experiencing severe symptoms that escalate into an emergency.
Previous research has shown that in comparison with white and Hispanic children, African Americans have a higher rate of asthma, are hospitalized more and face more disability due to the condition. Because of this, "we suspected they might also exhibit relatively more severe asthma symptoms at the time of hospitalization," said Yu Bai, a doctoral candidate at Pennsylvania State University.
Bai and his colleagues analyzed the records of 7,726 white, African American and Hispanic children up to age 19 who were admitted to Pennsylvania hospitals in 2001 for asthma symptoms. The researchers then examined how the physician reported the severity of the children's condition and ranked them either as "emergency" or "non-emergency" admissions.
Ninety percent of the African American children had an emergency asthma condition compared with 60 percent of white and 64 percent of Hispanic children. In all, African-American children were more than twice as likely to have severe asthma symptoms as whites.
The study appears in the February issue of the Journal of Health Care for the Poor and Underserved.
Bai and colleagues found that children on Medicaid had the most severe symptoms at admission compared with those who had private insurance and two-thirds of African-American children had Medicaid or other public insurance.
Other studies have shown that children on Medicaid have less access to primary care for asthma and are less likely to be prescribed the proper medication, according to the authors.
Bai said there's a need for improvement: "Providing greater resources to the Medicaid program would allow for more comprehensive provision of services that would help children and their families manage asthma including case management services, provision of medically necessary equipment and supplies and referrals to asthma specialists when needed."
Barbara Tilley, Ph.D., chair of the department of biometry and epidemiology at the Medical University of South Carolina in Charleston, said the authors' results were "consistent with other studies that indicate an increased burden of asthma for African American children whether or not they are on Medicaid." She agreed there is a need for improvement in delivery of care for all children on Medicaid with asthma.
Bai Y, Hillemeier MM, Lengerich EJ. Racial/ethnic disparities in symptom severity among children hospitalized with asthma. Journal of Health Care for the Poor and Underserved 18(1), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
http://www.hbns.org
Previous research has shown that in comparison with white and Hispanic children, African Americans have a higher rate of asthma, are hospitalized more and face more disability due to the condition. Because of this, "we suspected they might also exhibit relatively more severe asthma symptoms at the time of hospitalization," said Yu Bai, a doctoral candidate at Pennsylvania State University.
Bai and his colleagues analyzed the records of 7,726 white, African American and Hispanic children up to age 19 who were admitted to Pennsylvania hospitals in 2001 for asthma symptoms. The researchers then examined how the physician reported the severity of the children's condition and ranked them either as "emergency" or "non-emergency" admissions.
Ninety percent of the African American children had an emergency asthma condition compared with 60 percent of white and 64 percent of Hispanic children. In all, African-American children were more than twice as likely to have severe asthma symptoms as whites.
The study appears in the February issue of the Journal of Health Care for the Poor and Underserved.
Bai and colleagues found that children on Medicaid had the most severe symptoms at admission compared with those who had private insurance and two-thirds of African-American children had Medicaid or other public insurance.
Other studies have shown that children on Medicaid have less access to primary care for asthma and are less likely to be prescribed the proper medication, according to the authors.
Bai said there's a need for improvement: "Providing greater resources to the Medicaid program would allow for more comprehensive provision of services that would help children and their families manage asthma including case management services, provision of medically necessary equipment and supplies and referrals to asthma specialists when needed."
Barbara Tilley, Ph.D., chair of the department of biometry and epidemiology at the Medical University of South Carolina in Charleston, said the authors' results were "consistent with other studies that indicate an increased burden of asthma for African American children whether or not they are on Medicaid." She agreed there is a need for improvement in delivery of care for all children on Medicaid with asthma.
Bai Y, Hillemeier MM, Lengerich EJ. Racial/ethnic disparities in symptom severity among children hospitalized with asthma. Journal of Health Care for the Poor and Underserved 18(1), 2007.
Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
United States
http://www.hbns.org
Sunday, March 2, 2008
Asthma Symptoms and Treatment in Adults
Asthma in young adults, those in their twenties and thirties is very similar to the childhood asthma. In fact most of the young adults who develop evident symptoms of asthma are those who have remained undiagnosed and therefore untreated in their childhood. Many children who have susceptibility towards chest infections and other bronchial disorders are often termed as “bronchial” children. They may be having asthma which does not get diagnosed. As adults they show signs and symptoms that can no longer be denied.
When asthma strikes a person in his or her middle ages it is a very different kind of disorder with very different kinds of symptoms and repercussions. Like when a person in his forties gets diagnosed with asthma it is usually non-hereditary and inheritance through the family history plays no role. Generally it is seen that in this stage in life asthma is usually of intrinsic or non-allergic type. Adult asthma is considered to be also more serious than the childhood asthma.
This is because it is more difficult to control and also because the unpredictability factor is very high. Also it strikes the women much more than the men, so there are clear indications that the disease is gender biased. Adults with asthma are more susceptible to allergy of aspirin and related drugs. In fact many times the adult asthma may remain hidden and then one day strike with full fury after getting an allergic reaction to aspirin. Also sulphite reactions, other allergies, chronic sinus problems and nasal polyps are also more common in adults.
Asthma is extremely common in the people as the age advances. In fact there are distinct indications that the frequency of asthma is rising with the advancement of age. Sometimes people do not show symptoms till they are well over sixty five years of age. But it is generally believed that such incidents are rare. Nearly one-third of all asthma cases begin in childhood and the early teens.
There are not many studies to confirm the exact statistics but it is believed that most people who get diagnosed with asthma at a later stage in life may not have been properly diagnosed earlier for asthma. This is because in adults especially in senior citizens the symptoms of coughing and wheezing are also associated with so many other diseases as well.
Another reason for this diagnostic failure in elderly is that the main perception of symptoms of asthma in senior citizens is that of chronic cough with production of mucous, while they may only show sudden bouts of wheezing. And this may be associated with emphysema or chronic bronchitis. But with breathing tests they show clear indications of asthma and respond well to conventional treatments of asthma.
Asthma triggers are very difficult to zero down to, in adults. As the age advances pin pointing them keeps getting more and more difficult. These triggers are also mostly associated with respiratory tract infections and air pollutants. As the age advances considerably there is a lot of confusing signals given out by the patients that may make the diagnoses difficult further still. Asthma symptoms may also be manifesting in the form of tightness in the chest, shortness of breath or cough.
They are also many times misinterpreted as cardio-vascular problems. The disturbance in the patterns of sleep that is associated with asthma may also be confused with urinary tract disorders. But many of the patients who are given a confirmed diagnoses for asthma after the age of fifty also are believed to have shown distinct symptoms earlier in their life, which may have either gone unnoticed or undiagnosed and untreated.
After the diagnosis is complete the next step is to take adequate precautions so as to not get caught unawares with the fury of an asthmatic attack. Most young people respond very well to conventional treatments. These coupled with some regular precautions and disciplined changes in the lifestyle make them lead healthy, happy and perfectly normal lives. Since they are in the prime of their lives and sexual activity is also important, it is advised to them to use a puff or two of inhaler before indulging in any sexual activity.
This is because the exercise factor involved in any normal sexual activity is equivalent to walking about six kilometres in an hour or can be compared to climbing about two to three flights of stairs in a few minutes. This may be very hectic for a person suffering with asthma. It is also worth mentioning that some of the drugs especially some corticosteroids taken for asthma may cause impotency or temporary decrease in sexual desires.
Asthma treatment in the elderly people my have several difficulties. There are many drug interactions with conventional asthma treatments. Glaucoma or high blood pressure medications such as beta blockers may enhance the symptoms of asthma. It is also seen that because of multiplicity of treatments in elderly people for various diseases happening all at the same time, the asthma medications may be required in smaller dosages. An average dose for a young adult may prove to be a toxic dose for an elderly patient.
Learn More About Asthma Attacks, Asthma Treatment and Adult asthma at http://www.yourasthmatreatment.com/ - Asthma Information and Treatment Guide.
When asthma strikes a person in his or her middle ages it is a very different kind of disorder with very different kinds of symptoms and repercussions. Like when a person in his forties gets diagnosed with asthma it is usually non-hereditary and inheritance through the family history plays no role. Generally it is seen that in this stage in life asthma is usually of intrinsic or non-allergic type. Adult asthma is considered to be also more serious than the childhood asthma.
This is because it is more difficult to control and also because the unpredictability factor is very high. Also it strikes the women much more than the men, so there are clear indications that the disease is gender biased. Adults with asthma are more susceptible to allergy of aspirin and related drugs. In fact many times the adult asthma may remain hidden and then one day strike with full fury after getting an allergic reaction to aspirin. Also sulphite reactions, other allergies, chronic sinus problems and nasal polyps are also more common in adults.
Asthma is extremely common in the people as the age advances. In fact there are distinct indications that the frequency of asthma is rising with the advancement of age. Sometimes people do not show symptoms till they are well over sixty five years of age. But it is generally believed that such incidents are rare. Nearly one-third of all asthma cases begin in childhood and the early teens.
There are not many studies to confirm the exact statistics but it is believed that most people who get diagnosed with asthma at a later stage in life may not have been properly diagnosed earlier for asthma. This is because in adults especially in senior citizens the symptoms of coughing and wheezing are also associated with so many other diseases as well.
Another reason for this diagnostic failure in elderly is that the main perception of symptoms of asthma in senior citizens is that of chronic cough with production of mucous, while they may only show sudden bouts of wheezing. And this may be associated with emphysema or chronic bronchitis. But with breathing tests they show clear indications of asthma and respond well to conventional treatments of asthma.
Asthma triggers are very difficult to zero down to, in adults. As the age advances pin pointing them keeps getting more and more difficult. These triggers are also mostly associated with respiratory tract infections and air pollutants. As the age advances considerably there is a lot of confusing signals given out by the patients that may make the diagnoses difficult further still. Asthma symptoms may also be manifesting in the form of tightness in the chest, shortness of breath or cough.
They are also many times misinterpreted as cardio-vascular problems. The disturbance in the patterns of sleep that is associated with asthma may also be confused with urinary tract disorders. But many of the patients who are given a confirmed diagnoses for asthma after the age of fifty also are believed to have shown distinct symptoms earlier in their life, which may have either gone unnoticed or undiagnosed and untreated.
After the diagnosis is complete the next step is to take adequate precautions so as to not get caught unawares with the fury of an asthmatic attack. Most young people respond very well to conventional treatments. These coupled with some regular precautions and disciplined changes in the lifestyle make them lead healthy, happy and perfectly normal lives. Since they are in the prime of their lives and sexual activity is also important, it is advised to them to use a puff or two of inhaler before indulging in any sexual activity.
This is because the exercise factor involved in any normal sexual activity is equivalent to walking about six kilometres in an hour or can be compared to climbing about two to three flights of stairs in a few minutes. This may be very hectic for a person suffering with asthma. It is also worth mentioning that some of the drugs especially some corticosteroids taken for asthma may cause impotency or temporary decrease in sexual desires.
Asthma treatment in the elderly people my have several difficulties. There are many drug interactions with conventional asthma treatments. Glaucoma or high blood pressure medications such as beta blockers may enhance the symptoms of asthma. It is also seen that because of multiplicity of treatments in elderly people for various diseases happening all at the same time, the asthma medications may be required in smaller dosages. An average dose for a young adult may prove to be a toxic dose for an elderly patient.
Learn More About Asthma Attacks, Asthma Treatment and Adult asthma at http://www.yourasthmatreatment.com/ - Asthma Information and Treatment Guide.
Asthma: Causes, Symptoms and Treatment of Asthma
Asthma
Asthma is a chronic respiratory disease—sometimes worrisome and inconvenient—but a manageable condition. With proper understanding, good medical care, and monitoring, you can keep asthma under control. Chronic condition characterized by difficulty in breathing due to spasm of the bronchi (air passages) in the lungs. Attacks may be provoked by allergy, infection, and stress. The incidence of asthma may be increasing as a result of air pollution and occupational hazard. An asthma attack can be very serious. If you have trouble breathing, call 9-1-1 for help right away. You can't cure asthma, but you can control it. Asthma is a chronic lung condition that is characterized by difficulty in breathing. People with asthma have extra sensitive or hyper responsive airways that cause symptoms of asthma. Airways react by narrowing or obstruction when something irritates them. Making a correct diagnosis is very important, because that is the only way to treat it appropriately.
Asthma is a disease that affects the breathing passages of the lungs (bronchioles). Asthma is caused by chronic (ongoing, long-term) inflammation of these passages. This makes the breathing passages, or airways, of the person with asthma highly sensitive to various "triggers." When an asthmatic person has an asthma attack the membranes inside the bronchial tubes release mucus and become inflamed. The inflammation causes the muscles to contract and create spasms. These muscle spasms are responsible for wheezing. Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness.
Causes of Asthma
The exact cause of asthma isn't fully understood at present. Sometimes, the symptoms flare up for no obvious reason, but you may notice certain triggers that set off an asthma attack or make your symptoms worse. These triggers irritate the airways in your lungs and can include:
oinfections such as colds and flu
oirritants such as dust, cigarette smoke, fumes
ochemicals found in the workplace - this is called occupational asthma
ollergies to pollen, medicines, animals, house dust mite or certain foods
oexercise - especially in cold, dry air
oemotions - laughing or crying very hard can trigger symptoms, as can stress
oBronchoconstriction
oInflammation
oDietary changes
oOccupational exposure
oStrong emotional expression (including crying or laughing hard) and stress.
oA condition called gastroesophageal reflux disease that causes heartburn and can worsen asthma symptoms, especially at night.
Symptoms of Asthma
oCoughing is the most common asthma symptom. Coughing associated with asthma generally worsens at night and early in the morning, making sleeping difficult.
oRapid breathing is a common asthma symptom. When breathlessness occurs, you may try to breathe faster to try to get air in and out of your lungs.
oPeak flow numbers may be in the caution or danger range
oNeck area and between or below the ribs moves inward with breathing.
oWalking causes shortness of breath.
oGray or bluish tint to skin, beginning around the mouth.
Treatment
oControllers, also called "preventers," reduce inflammation in the airways. Controllers should be taken every day. You will know that the controller medication is working because you will, over time, have fewer and fewer symptoms. When your asthma is totally controlled and you have no symptoms, do not stop taking them.
oGenerally, dairy products are not good for asthmatics. They're too mucus-forming. We have heard, though, that cheddar cheese might be an exception. It contains "tyramine," an ingredient that seems to help open up the breathing passages.
oTurmeric is valuable in asthma. The patient should be given a teaspoon of turmeric powder with a glass of milk, two or three times daily. It acts best when taken on an empty stomach.
Read about Acne Cure and Treatments and Breast Enlargement Enhancement. Also read about Beauty and Makeup Tips.
Asthma is a chronic respiratory disease—sometimes worrisome and inconvenient—but a manageable condition. With proper understanding, good medical care, and monitoring, you can keep asthma under control. Chronic condition characterized by difficulty in breathing due to spasm of the bronchi (air passages) in the lungs. Attacks may be provoked by allergy, infection, and stress. The incidence of asthma may be increasing as a result of air pollution and occupational hazard. An asthma attack can be very serious. If you have trouble breathing, call 9-1-1 for help right away. You can't cure asthma, but you can control it. Asthma is a chronic lung condition that is characterized by difficulty in breathing. People with asthma have extra sensitive or hyper responsive airways that cause symptoms of asthma. Airways react by narrowing or obstruction when something irritates them. Making a correct diagnosis is very important, because that is the only way to treat it appropriately.
Asthma is a disease that affects the breathing passages of the lungs (bronchioles). Asthma is caused by chronic (ongoing, long-term) inflammation of these passages. This makes the breathing passages, or airways, of the person with asthma highly sensitive to various "triggers." When an asthmatic person has an asthma attack the membranes inside the bronchial tubes release mucus and become inflamed. The inflammation causes the muscles to contract and create spasms. These muscle spasms are responsible for wheezing. Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness.
Causes of Asthma
The exact cause of asthma isn't fully understood at present. Sometimes, the symptoms flare up for no obvious reason, but you may notice certain triggers that set off an asthma attack or make your symptoms worse. These triggers irritate the airways in your lungs and can include:
oinfections such as colds and flu
oirritants such as dust, cigarette smoke, fumes
ochemicals found in the workplace - this is called occupational asthma
ollergies to pollen, medicines, animals, house dust mite or certain foods
oexercise - especially in cold, dry air
oemotions - laughing or crying very hard can trigger symptoms, as can stress
oBronchoconstriction
oInflammation
oDietary changes
oOccupational exposure
oStrong emotional expression (including crying or laughing hard) and stress.
oA condition called gastroesophageal reflux disease that causes heartburn and can worsen asthma symptoms, especially at night.
Symptoms of Asthma
oCoughing is the most common asthma symptom. Coughing associated with asthma generally worsens at night and early in the morning, making sleeping difficult.
oRapid breathing is a common asthma symptom. When breathlessness occurs, you may try to breathe faster to try to get air in and out of your lungs.
oPeak flow numbers may be in the caution or danger range
oNeck area and between or below the ribs moves inward with breathing.
oWalking causes shortness of breath.
oGray or bluish tint to skin, beginning around the mouth.
Treatment
oControllers, also called "preventers," reduce inflammation in the airways. Controllers should be taken every day. You will know that the controller medication is working because you will, over time, have fewer and fewer symptoms. When your asthma is totally controlled and you have no symptoms, do not stop taking them.
oGenerally, dairy products are not good for asthmatics. They're too mucus-forming. We have heard, though, that cheddar cheese might be an exception. It contains "tyramine," an ingredient that seems to help open up the breathing passages.
oTurmeric is valuable in asthma. The patient should be given a teaspoon of turmeric powder with a glass of milk, two or three times daily. It acts best when taken on an empty stomach.
Read about Acne Cure and Treatments and Breast Enlargement Enhancement. Also read about Beauty and Makeup Tips.
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