Do statins interfere with the vaccine against the flu?

Do statins interfere with the vaccine against the flu? - Statins are powerful, unusual, and as He Niño and Tom Cruise, it is not well understood. Statins have enormous potential. Improve survival after a heart attack and reduce the risk of recurrent stroke.  

They are also the only drugs to lower cholesterol that has been clearly shown to reduce heart attacks and death in high-risk patients without heart disease. In addition to lowering cholesterol, statins also lower levels of inflammation in the body.  

Reduce inflammation, statins help probably prevent heart attacks and strokes. However, evidence is emerging that these effects statins may also have a downside, hampering the ability of the immune system to fight infections.

Tease the relationship between statins and immune response 

Two recent studies have examined the relationship between statins and immune response to the vaccine against influenza. For the first study, Emory University researchers analyzed a large database of patients in a managed care organization to see if there was a link between the use of statins, vaccination against influenza, and frequency of visits to doctors for influenza-like illness.  

They found that patients who received the vaccine against influenza were more likely to seek treatment for a respiratory illness during flu season if they were also taking a statin, compared with patients who received the vaccine against influenza but they not take statins.  

This suggests that patients treated with statins may not have responded so well to the vaccine against influenza than those not taking the drug to lower cholesterol.

The other study provides concrete evidence of the lowest immunization against influenza in people taking statins immune response. For this study, researchers analyzed data from over 5000 patients in a clinical trial of a new vaccine against influenza. They found that levels of antibodies against the flu virus were lower in patients taking statins compared to patients not taking statins.

Both studies were a major constraint. Patients taking statins were more likely to have serious underlying diseases such as diabetes, heart disease, COPD, neurological disorders, or kidney disease, compared with patients not taking statins.  

Thus, the poor response to the vaccine against influenza and the apparent increased risk of influenza statins in patients with the disease could have been the result of its high burden of chronic disease, and no treatment with statins. It should be noted that a randomized trial in young healthy volunteers showed no statin treatment effect in antibody responses to the vaccine against hepatitis A. 

There is also a bewildering variety of other research on statins and their effects on the human immune response. At various times, statins were associated with each of the following: a lower risk of dying from the flu; a lower risk of dying from the flu in some years but not others; a slightly increased risk of shingles (herpes zoster); a lower risk of pneumonia; neutral effect on the risk of pneumonia; and a lower risk of dying from pneumonia.

But do not leave your statin ...

According to current data, I do not think we need to change how we prescribe statins, which are extremely beneficial medications, but I need more information on how statins influence the risk of infection. Patients taking statins may consider getting a flu vaccine against high doses, resulting in higher levels of antibodies and increased protection against the flu, compared with standard-dose vaccine.  
By: John Ross MD,FIDSA

 

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Teach gratitude during this season - and all year

Teach gratitude during this season, and all year - For most children, the holidays are also on donations.  

It's understandable; It was definitely my favorite part of the holidays when I was growing up. But sometimes expectations can get out of hand. And often, parents are asked why their children are not a little more grateful for what they have.

Gratitude is important - not only because it is good to have social tolerance. It is also essential for the general happiness. When we are grateful, we understand that there are still good things in our lives, even when things do not go as planned (like when we do not get this cool toy - or cool job).  

Without understanding and gratitude of practice, we always feel like there's more than we have, no matter what we already have. 
Gratitude should be taught - and it takes practice. This holiday season, why not be part of the culture of routine and your family? Here are some suggestions to help you:

      *  When buying gifts, buy a little shelter or a toy. Let your child help you pick them up and deliver them.
 
      *  Take your child grocery party. Buy extra food. Take your child with you when you take it to the food pantry.

      *  Before the holidays, go through old toys and clothes to "make room" for new things. Give all you can to shelters and other charities. Involve your child in all this, too.
 
      *  With your child, make a list of everyone he or she help or are special to him. Find ways to recognize that during the holidays. For example, make cookies gift set.

     *  Make sure your child always says "please" and "thank you." There is a small thing, but it makes a difference.

      *  Always have your child write thank-you notes (or draw pictures of appreciation, if they can not write yet) to receive gifts. 

     *  Give children tasks to do, starting when they are young. It helps them understand that families are designed to work - and help them to be more grateful for the work others do for them in the house.
 
      *  Create a gratitude daily ritual. If you are part of a faith tradition, the night prayers consider. And make sure that some of these prayers implies a list of things you are grateful. If you're not part of a tradition of faith, try something like what my friend Wendy Sue Swanson Dr. made his son: Every day, each person in the negotiations of the family about his "BPOD" or instead of the day. The same act to stop thinking that your BPOD it helps teach gratitude.
 
      *  Be sure to talk about what is grateful too. As with all things, children pay more attention to what we do than what we say.

You may find that teaching your appreciation of the Child, to be grateful to yourself. This is a wonderful way to not only make your child happy in life, but also make your life happier, too. 
By: Claire McCharty,MD 

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The myth of the Hippocratic Oath

The myth of the Hippocratic Oath - Shortly after his shootout with police in 2013, one of the alleged attackers Boston Marathon was transported to an area hospital with serious injuries. 

A reporter covering the story describes how, despite the heinous crimes that were charged, doctors work hard to save their lives, because they made an oath to do so. I knew she was referring to the Hippocratic oath. But he knew it was wrong. 

There was a good chance that these doctors had never taken the Hippocratic oath, but even if they had, there is nothing in the oath that obliges specifically to meet suspects.Maybe it should, but it does not. 

Indeed, the Hippocratic Oath today covers only a portion relevant to the ethical practice of medicine topics. It covers important things. Some of these things is controversial, and was considered generous. But many simply left the original side.

What is the Hippocratic Oath? 

The Hippocratic Oath is named after the ancient Greek physician Hippocrates. It is widely regarded as its author, although its true origins are uncertain; It may have been written by one of his students, or more than one person. There is a long tradition as a guide for doctors and other health professionals as they begin or end their training. Swear to respect the principles contained in the oath, healthcare professionals promise to behave honestly and ethically.

Those who make the commitment "original" Hippocratic Oath:
 
    *  respect and support of their teachers
    *  Medical knowledge sharing with other interested
    *  use their knowledge of medicine and food to help patients
    *  prevent harm to patients, including providing any "deadly medicine", but asked to do so
    *  Not provide a "cure" that causes abortion
    *  seek help from other doctors (as a surgeon) when necessary
    *  avoid "bad," "injustice" and "sex" during home visits for patients
    *  keep patient information confidential.

The latest revisions avoided any mention of abortion and, as a popular magazine in 1964 (by Dr. Louis Lasagna, a doctor at Johns Hopkins), euthanasia is more nuanced:

"... It may be ... in my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty Above all, I must not play God.".

In addition, Mr. Lasagna encouraged a comprehensive and preventive approach to care:

"I will remember that I am not seeking an array of fever, a cancerous growth, but a sick human being, whose illness may affect the family of the person and economic stability. My responsibility includes these problems, if I am to care adequately for the sick. I will prevent disease whenever I can, for prevention is better than cure ".

What is missing?

Doctors today face a number of important ethical issues that are not included in the Hippocratic oath. For example, it makes no mention of:

      *  honoring patient preferences
      *  exchange medical information of patients
      *  avoid conflicts of interest, that the benefits in ordering tests or unnecessary treatments
      *  protecting patients who enroll in research studies
      *  treat all patients equally, regardless of their ability to pay, class, education, race or suspicion of crime
 
      *  avoiding the practice of medicine while impaired (due to physical or mental illness).

Who takes the oath?

According to a 1989 survey, only half of the medical schools in the United States use any form of the Hippocratic oath and only 2% used the original. In a 2011 study published in the Archives of Internal Medicine, 80% of practicing physicians reported having participated in a swearing-in ceremony, but only a quarter felt that significantly affected oath how they practice.

Beyond the Hippocratic Oath

In the United States, where medical newly enrolled students are covered in freshly starched white coat, an oath of some sort is often read as part of the ceremony. But there is more to these new students to learn and understand such a short or as old as the Hippocratic oath passage could capture. Today, healthcare professionals are regularly ethical challenges in modern clinical practice.  

Instead of relying on the well-meaning but outdated principles, they must rely on their experience and training, modern guidelines widely accepted advice from mentors, and his personal sense of right and wrong to understand that We have to do. Fortunately, there are many useful resources beyond the Hippocratic oath to guide them in the right direction.   
By: Robert Shmerling,M.D.  

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10 tips for mindful eating - Just in time for the holidays

The leftover Halloween candy. Thanksgiving meals marathon. Up-to-suit office chocolates. A part follows another ... and another.

If you want to avoid overeating and gaining those extra pounds, you need to control your sugar levels in the blood (for example, if you have diabetes), or just want to eat only what your body If necessary, the holiday season can make this goal difficult.

But mindful eating can help you achieve it.

Mindfulness refers to the practice of being conscious at the time. Too often our thoughts wander elsewhere than where we are now. Maybe we are concerned about what happened an hour of worried what could happen tomorrow or stressed about what we have to do next week. Mindfulness encourages us to notice these concerns, and then we gently bring to society.

Mindfulness can help you enjoy a meal and dining experience - in moderation and restraint. Some studies suggest that practices based on mindfulness help improve eating habits. For those who binge-eating or eating for comfort or stress, mindful eating can even help you lose weight.
 
Here are 10 tips for a more conscious diet. Not all of these tips may feel good for you - try more and see how they work.
 
1. Think.

Before starting to eat, take a moment to think about how you feel. Are you in a hurry? I stressed? Sad? Bored? Hungry? What are your needs and what are their needs? The difference between the two. Having taken this time to reflect, then you can choose to eat, what you eat and how you eat.

2. Sit. 

Do not eat on the way. Have a seat. It is less likely to appreciate your food when you are multitasking. It is also difficult to track how much you eat when you snack on the go.

3. Turn off the TV (and everything else with a screen. 

Have you ever looked down at your phone or tablet or computer, only to wonder where all the food was? These distractions make us less aware of what and how much they eat.

4. Serve on your portions. 

Resist eating straight from the bag or box. Not only is it easier to overeat when you can not see how you were, but it is also more difficult to fully appreciate your meal when hidden from view.

5. Choose the small plate. 

You crave less if you see less. Smaller plates will help with portion control - a particularly good strategy for all-you-can-eat buffets.

6. Give thanks.

Before you start eating, pause and take a moment to recognize the work that went into providing them food - either by farmers, factory workers, animals, Mother Earth, chiefs, or even his teammates on Table.
 
7. Chew 30 times. 

Try to get 30 to chew each mouthful. (30 is a rough guide because it may be difficult to achieve even 10 chews out a mouthful of oatmeal!) Take time to taste the flavors and textures in the mouth before swallowing. This can also help prevent overeating, give your time to the gut to send messages to the brain that you are full.

8. Leave your utensils. 

Often we are already preparing the next bite with his fork and knife, while we are still in our last bite. Try to put your utensils after each mouthful, and not try again until you have enjoyed and swallowed what you already have in your mouth.
 
9. waive clean plate club.

Many of us were raised to finish everything on our plates and were not allowed to leave the table until we did. Ok to cancel your membership in the Clean Plate Club. Consider away the leftovers to go, or just let the last bites. While no one wants to waste food, to stuff you will not help the needy. (This is also the case Tip # 5 is very convenient.) 

10. Silence. 

Try eating your meals in silence occasionally. When it is quiet, it is natural that the mind wander; recognize these thoughts, and then see if you can gently return to your dining experience. I am aware of the consistency of the food, flavor, taste and smell, and fully appreciate the moment.  

Of course, the meal time can be an important time to share the day when the whole family gathers in order to have a complete meal in silence could be impractical or just uncomfortable. But even spend the first five to 10 minutes in silence can be refreshing and establish a grateful tone for the rest of the meal.

Mindfulness has many advantages over the year, but can be especially useful during the holidays, even beyond healthy diet. Incidentally focus your attention on the present can help you embrace the company, connectivity and overall satisfaction and help make the season more meaningful for you.
By: Wynne Armand, MD   
 

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The Alexander Technique can help (literally) to relax

The Alexander Technique can help (literally) to relax - In the 1890s a Shakespearean actor named F. Matthias Alexander started to discover why his voice is often lost when he performed. (Imagine yourself as a Shakespearean actor, totally dependent on his voice to pay your bills, find you, speechless when necessary to complete!) Needless to say, Alexander had to find out why this was happening.

He began by observing himself in multiple mirrors, while preparing to perform. In fact, it was discovered that something has changed before his speech: He contracted the muscles of the upper part of your body, especially the neck so hard that his whole attitude has changed. He theorized that the loss of voice may be the result of his interrupted position.

Fortunately, his hypothesis proved correct. When he was able to release the tension in your muscles with a variety of movements, not only did their loss of voice of determination, but was able to change the habit he had developed to obtain neck.  

While continuing to refine and improve its methods, Alexander realized they could help others improve their health and wellbeing. Their findings, which have already been codified in the Alexander Technique (AT), are still in use today.

What is the Alexander Technique used today?
 
Today, AT is considered a mental discipline that teaches people to let go of the tension in the body and how to allow the body to move with ease and minimal effort. AT is used to treat a variety of conditions, musculoskeletal pain and repetitive strain injury to breathing problems, loss of voice, and sleep disorders.  

Many artists, musicians, dancers, singers and actors use AT to help improve their performance. The purpose of the AT, ultimately, is to allow people who systematically unlearn maladaptive habits (negative) - which can occur in the way we sit, eat, walk or talk - and instead learn to return the body to a steady state relaxed alignment and balance. 

AT is for you?

But you need not be a musician or dancer for the benefit of AT. This is just an example: You, like most of us live in the world today, spend much of their time on a computer or check their e-mails and texts smartphones. This means that you spend much of their time looking down instead of forward, the way they were designed to support the head vertebrae. 

Keep your head tilted for long periods puts continuous pressure on the large muscles of the neck, which are normally intended to be lax. Conversely, small neck muscles (which are designed to keep the neck vertebrae) are not used and therefore are loose. The result is that the vertebrae lose their support if you find yourself not only with neck stiffness or pain, but perhaps some degeneration of the cervical spine, too.

AT can address this habitual contraction of the neck and teach you to keep your phone, how to position the head, and finally, how to restore a better posture and ease in your body.

Is there science to support?

A recent randomized controlled study published in the Annals of Internal Medicine found that Alexander Technique lessons led to significant reductions in long neck pain 12 months, compared to usual care. (Interestingly, the study also found that acupuncture reduces pain and compared with usual care.)

Another interesting study published in the medical journal BMJ in 2008 tried a variety of treatments for back pain. A total of 579 patients with chronic or recurrent low back pain were randomly divided into four groups. 

The first group received "usual care" of them (for example, they were the control group). The second group received massage. The third was six Alexander Technique lessons. The fourth group took 24 Alexander Technique lessons.  

Half of each group also received a prescription for exercise (especially walking) of a doctor, in addition to a nurse behavioral counseling. The results showed that patients who had lessons with an exercise plan improved more. In addition, the combined response was also the most cost-effective (in particular by taking six lessons combined with an exercise plan).

What does this mean for you?

Supporters of Alexander Technique would say start paying attention. Pay attention to your posture - the way you walk, talk, sit, stand, or generally anything, even lifting a piece of food in his mouth. If you are like most people, your body is probably trapped in tense muscular habits that can cause many problems, headaches back pain, perhaps even anxiety. It may behoove you to unlearn these blocked patterns that can pass through your life easier - and a lot less pain,.

If you are interested in the Alexander Technique, the American Society for the Alexander Technique can help you find an instructor.  
By: Eva Selhub,MD  

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Can withstand dela actually worsen the pain of arthritis?

Can withstand dela actually worsen the pain of arthritis? - If you have arthritis, you may have noticed that the weather affects your symptoms. What I hear from my patients all the time. 

While the weather can aggravate arthritis pain, how it works? Is there scientific evidence to explain? People have asked these questions for many years without finding good answers. But that keep researchers are trying to understand it better.

What (we) know 

Previous studies that examined the effects of rain, moisture and other factors related to weather conditions in arthritis symptoms were conclusive and in some cases contradictory. Some suggest that the key variable increases barometric pressure.  

Other studies have found the opposite - that the pressure drop can cause pain or stiffness. There have even been attempts to artificially vary the environmental conditions to simulate climate change, such as placement with arthritis in barometric pressure chambers and varying from top to bottom. 

Despite this, I still do not know if this is a particular feature of the weather or a combination of features that count. There are many potential factors - humidity, temperature, precipitation and barometric pressure between them.  

Even if we could identify precisely what is happening with the weather affects pain and stiffness of arthritis, which is always why - biologically speaking - time should have no impact on joint symptoms.

Having received the studies, I'm not sure how to respond to my patients who ask me why their symptoms worsen reliable when the weather is wet or rain comes, or when another weather event happens. Usually I say, first, I think there is a link between time and joint symptoms, and on the other hand, researchers have not been able to find exactly what you're looking for weather and symptoms or arthritis it must be a connection.
 
The most recent studies
 
Only in the last year, two new studies have intervened in the question of whether the climate has an impact on the symptoms of arthritis. And both found that yes, indeed, climate issues! 

In the first study, researchers enrolled 222 Dutch people with the hip - the most common type, the "wear and tear" arthritis - and its symptoms reported with a variety of weather variables are compared.  

They found that over a period of two years, the pain and stiffness were slightly worse with increase in barometric pressure and humidity, although the overall impact was small. The second study involved more than 800 adults living in one of the six European countries and had osteoarthritis of the hip, knee or hands.  

While changes in the weather does not seem to affect symptoms, higher humidity was associated with increased pain and stiffness, especially in cold weather. So while these studies varied in the details, we now have a little more evidence linking long joint symptoms.

So what? 

It is a good question. After all, even if we were able to demonstrate a clear and powerful impact of time on the symptoms of arthritis, how is it useful to know? It's not like doctors tend to suggest that a patient's movement to a friendly climate of arthritis.  

It is even less likely that patients follow this recommendation. So we can not control the weather or precisely our internal environments, these new studies will probably have little impact on the individual victim of arthritis. 

However, identifying a relationship between a particular type of weather and joint symptoms may help to understand the causes and mechanisms of arthritis symptoms. And that could lead to better treatments and even prevention strategies.  

Also, find out why some people seem to feel worse in some circumstances, while others see no change (or even feel better) in these environments could help us understand the subtle differences between types of arthritis or of ways in which people respond.

"Everyone keeps talking about the weather ...

... But nobody does anything about it. "That's an old line, but of course there is no truth. But even if the weather affects the symptoms of arthritis and there's nothing you can do about the weather, it not mean that there is nothing!. to about arthritis, there are more treatment options than ever before, with and without the use of medication If you have a large and persistent pain , stiffness or swelling, see your doctor - rain or shine.
By: Robert Shmerling,MD

 

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