05.01.09
Posted in Uncategorized at 4:50 am by Luis
Medical Research News
Help is at hand for those who suffer from extreme shyness. Shyness in its extreme form can have a huge impact on peoples' lives because it results in an avoidance of the usual common social situations, such as meeting new people or going on a date, and can also have an impact on work situations.
Shyness which is extreme is known as social phobia or social anxiety and is thought to affect as many as 7% of the population and is the third largest mental health care problem in the world today - it affects about one in 20 Australians.
Social phobia is defined as a fear of social situations that involve interaction with other people and involves fear and anxiety of being judged and evaluated by other people.
People with social phobia are often seen by others to be shy, quiet, backward, withdrawn, inhibited, unfriendly, nervous, aloof, and disinterested, when in fact they want to make friends and they want to be involved and engaged in social interactions - social phobia can lead to loneliness and depression if it is not treated appropriately.
People with a social phobia usually experience significant distress being introduced to other people, being teased or criticized, being the centre of attention,being watched or observed while doing something, having to speak in a formal, public situation, and meeting people in authority. They feel insecure and out of place in social situations, are easily embarrassed and avoid eye contact.
Social phobia can result in anxiety, intense fear, nervousness, automatic negative thinking cycles, racing heart, blushing, excessive sweating, dry throat and mouth, trembling, and muscle twitches - but constant, intense anxiety is the most common feature.
Cognitive-behavioural therapy for social phobia has been found to be very successful and for some social phobics medication is also useful when used in conjunction with cognitive-behavioural therapy.
Researchers at Macquarie University say social phobia is one of the more chronic and perplexing disorders a person can have and they have been trying to refine the process involved in current treatments, including cognitive therapy, to further improve outcomes.
In a new study the researchers showed that with a few adjustments to existing cognitive behaviour therapy, outcomes for people with social phobia can improve dramatically.
The improvements they added to existing treatments included giving sufferers clear, detailed feedback about their social performance and teaching them how to better focus their attention when feeling frightened.
The study participants were divided into small groups and over 12 weekly sessions they were taught some basic anxiety management techniques and were gradually encouraged to face their fears.
At the end of treatment, the researchers say over 40% of the participants showed large and dramatic changes in how they coped with their fears while many others showed good improvements.
Professor Ron Rapee, Director of the Centre for Emotional Health at Macquarie University, who led the study, says people with social phobia have high levels of shyness, and worry other people will think badly of them.
Professor Rapee says when a shy person feels they are the centre of attention, they immediately assume that the attention is negative and they are being judged and found lacking in some way, so they avoid the social activities most of us take for granted, such as meeting new people, going on dates, talking to authority figures, and speaking in public.
Professor Rapee says that while no one knows entirely what causes social phobia, it's clear that the people who suffer from this disorder have lives that are dramatically limited by their fears and in extreme cases, social phobia can interfere with relationships, work and social life.
The study is published in the Journal of Consulting and Clinical Psychology.
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Posted in Uncategorized at 4:46 am by Luis
Disease/Infection News
The World Health Organisation (WHO) says as from now the new influenza virus, currently tagged 'swine flu' will be known as influenza A(H1N1).
The WHO is coordinating the global response to human cases of influenza A (H1N1), monitoring the situation, providing up to date information on the potential threat of an influenza pandemic, tracking the situation as it evolves and offering access to both technical guidelines and useful information for the general public.
In the latest update as of the 30th April 2009, 11 countries have officially reported 257 cases of influenza A (H1N1) infection.
In the United States there are 109 laboratory confirmed human cases, including one death, in Mexico there have been 97 confirmed human cases of infection, including seven deaths, 1 in Austria, 19 in Canada, 3 in Germany, 2 in Israel, 1 in the Netherlands, 3 in New Zealand, 13 in Spain, 1 in Switzerland and 8 in the United Kingdom - none of these laboratory confirmed cases have been fatal.
The WHO has raised the worldwide pandemic alert level to Phase 5 but at present the WHO has not advised any restriction of regular travel or closure of borders but does say however that it would be 'prudent' for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities.
The WHO also reiterates that there is no risk of infection from this virus from consumption of well-cooked pork and pork products and recommends that people wash their hands thoroughly with soap and water on a regular basis and seek medical attention if they develop any symptoms of influenza-like illness.
In U.S. the Centers for Disease Control and Prevention (CDC) has also confirmed 109 cases - 50 in New York, 26 in Texas, 14 in California, 10 in South Carolina, 2 each in Kansas and Massachusetts, and 1 each in Indiana, Ohio, Arizona, Michigan and Nevada.
Across the U.S. almost 300 schools are closed and many events have been cancelled or postponed.
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Posted in Uncategorized at 4:44 am by Luis
Disease/Infection News
According to the latest available research, should a global influenza pandemic become a reality, small stockpiles of a secondary flu medication, provided they are used early enough in local outbreaks, could extend the effectiveness of large primary stockpiles of drugs such as Tamiflu.
Tamiflu (oseltamivir) has been stockpiled by many countries anxious to be prepared should a flu pandemic strike, but the problem according to an international team of researchers, is that influenza viruses can become resistant to antiviral drugs, and the widespread use of a single drug is likely to increase the risk that a resistant strain will emerge.
The concern is that if such a strain were to spread widely, the effectiveness of antiviral drugs such as Tamiflu in treating infected patients, as well as their ability to slow the spread of a pandemic, would be greatly reduced.
The international research team, led by Joseph Wu of the University of Hong Kong, included scientists from the UK and the U.S. who used a mathematical model to represent the global spread of an influenza pandemic.
The team found that treating just the first 1% of the population in a local epidemic with a secondary drug, rather than with oseltamivir, could substantially delay the development of resistance to oseltamivir and this reduction in resistance was predicted to benefit not only local populations, but also those in distant parts of the world where the pandemic would subsequently spread through air travel.
The team say in the current emerging swine flu situation, the secondary drug could be Relenza (zanamivir), the only other approved drug to which the new H1N1 strain has been found to be susceptible.
This strategy say the researchers could be as effective because it delays use of the primary stockpiled drug until a certain proportion of the local population (about 1.5% according to the model) has been infected with virus that remains susceptible to the primary drug - with drug-sensitive virus in the majority as people recover from infection and develop immunity, only a minority of further infections are likely to be resistant to the primary drug.
The researchers say technically, such a delay could be achieved by postponing the launch of any antiviral intervention, but because even a short delay would mean denying antiviral drugs to people who would benefit from them, the researchers instead propose the deployment of a small stockpile of a secondary antiviral during the early phase of the local epidemic.
The model was prepared before the current swine flu crisis, and considered two possible strategies, "early combination chemotherapy" (treatment with two drugs together while both are available, assuming that clinical trials show such a combination to be safe for patients) and "sequential multi-drug chemotherapy" (treatment with the secondary drug until its stockpile is exhausted, then treatment with the primary drug).
The researchers say while either strategy could be effective in principle, only the sequential strategy would be practical in responding to the currently emerging H1N1 swine flu, because the safety of combining zanamivir with oseltamivir (for combination therapy) is not established.
After simulating the impact of these strategies in a single population, the researchers then introduced international travel data into their model to investigate whether these two strategies could limit the development of antiviral resistance at a global scale.
They say this analysis predicted that, provided the population that was the main source of resistant strains used one of the strategies, both strategies in distant, subsequently affected populations would be able to reduce the consequences of resistance, even if some intermediate populations failed to control resistance.
The research is published in PLoS Medicine.
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Posted in Uncategorized at 4:39 am by Luis
Medical Research News
Australian researchers have discovered that many critically ill patients in intensive care are deficient in vitamin D.
A small study by researchers at the Garvan Institute of Medical Research in Sydney, has found that as many as 45% of patients in an intensive care unit were vitamin D-deficient.
The lead author of the study Dr. Paul Lee, an endocrinologist and research fellow at the Institute says the sicker the patients were, the lower their vitamin D levels and he says it is unclear whether this is just an association, or whether vitamin D deficiency itself contributes to the severity of the disease.
Vitamin D is a fat-soluble vitamin that is naturally present in only a few foods - some fish, such as salmon and tuna, cheese, egg yolks and some mushrooms - vitamin D is also found in fortified milk and cereals.
The best natural source is when sunlight strikes the skin and triggers vitamin D production in the body.
Vitamin D is essential for the body's calcium absorption in the gut and bone growth and health - a shortage of vitamin D means bones can become thin, brittle, or misshapen.
Vitamin D prevents rickets in children and osteomalacia in adults and together with calcium, helps protect older adults from osteoporosis.
Vitamin D also plays a roles in the immune system and the reduction of inflammation and some experts believe vitamin D deficiency is increasingly being linked to adverse health outcomes.
For the study, the researchers measured vitamin D levels in 42 people being treated in an intensive care unit and found almost half were vitamin D-deficient.
The researchers say three patients died during the study and it was found that they had the lowest levels of vitamin D in the study group.
Dr. Lee says that vitamin D is involved in controlling blood sugar levels, calcium levels, heart function, gastrointestinal health and in defending against infection.
While the researchers are unable to explain the exact cause of the vitamin D deficiency, they suggest an absence of sun exposure could play a role, as could a lack of dietary intake of vitamin D. Dr. Lee says it may be that the tissue demand for vitamin D is increased during infection, metabolic disturbances and inflammation and vitamin D may therefore be used up during critical illness.
He says this hypothesis and the relationship between vitamin D and critical illness needs more research as vitamin D deficiency is likely to be common in seriously ill patients.
While some experts agree that more research is called for, some suggest that further studies need to be done to see if replacing the lost vitamin D would benefit these patients.
They say it is known that in stable situations, vitamin D deficiency has a potential link to mortality, and vitamin D replacement does improve outcomes, but they say it is too early to tell from this study, if there would be a mortality benefit from vitamin D replacement and for immobile patients, there is a risk of creating calcium levels that are too high.
In the current study, 10 patients were given vitamin D supplements, and no protective effect was found.
The study results were published in letter form in the April 30th issue of the New England Journal of Medicine.
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