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1
Better Control of TB Seen If a Faster Cure Is Found
The World Health Organization1 estimates that about one-third of all people are infected with bacteria that cause tuberculosis . Most times, the infection remains inactive. But each year about eight million people develop active cases of TB, usually in their lungs. Two million people die of of
it. The disease has increased with the spread of AIDS and drug-resistant forms of tuberculosis.
Current treatments take at least six months. People have to take a combination of several antibiotic drugs daily. But many people stop as soon as they feel better. Doing that can lead to an infection that resists treatment. Public health experts agree that a faster-acting cure for tuberculosis would be more effective. Now a study estimates just how effective it might be. A professor of international health at Harvard University2 led the study. Joshua Salomon says a shorter treatment program would likely mean not just more patients cured. It would also mean fewer infectious patients who can pass on their infection to others.
The researchers developed a mathematical model to examine the effects of a two-month treatment plan. They tested the model with current TB conditions in Southeast Asia. The scientists found that a two-month treatment could prevent about twenty percent of new cases. And it might prevent about twenty-five percent of TB deaths. The model shows that these reductions would take place between two thousand twelve and two thousand thirty. That is, if a faster cure is developed and in wide use by two thousand twelve.
The World Health Organization reductions the DOTS3 program in nineteen ninety. DOTS is Directly Observed Treatment, Short-course. Health workers watch tuberculosis patients take their daily pills to make sure they continue treatment.
Earlier this year, an international partnership of organizations announced a plan to expand the DOTS program. The ten-year plan also aims to finance research into new TB drugs. The four most common drugs used now are more than forty years old. The Global Alliance for TB Drug Development4 says its long-term goal is a treatment that could work in as few as ten doses.
2
Influenza
（新增）
Influenza has been with us a long time. According to some Greek writers on medical history, the outbreak of 412 B.C. was of influenza. The same has been suggested of the sickness that swept through the Greek army attacking Syracuse in 395 B.C. Flu is a disease that moves most quickly among people living in crowded conditions, hence, it is likely to attack armies.
During the nineteenth century there were five widespread outbreaks of influenza. The last of the five happened in 1889 and marked the beginning of the story of influenza in our time. Like the recent outbreak, it started in Asia.
For more than forty years before that outbreak, influenza had steadily decreased
and was believed to be dying out. A new group of outbreaks was introduced by the great outbreak of 1889-1890 and for the next quarter of a century flu remained a constant threat.
In April 918 flu broke among American troops stationed in France. It quickly spread through all the armies but caused relatively few
deaths. Four months later, however, a second outbreak started which proved to be a killer. It killed not only the old and already sick but also healthy young **s. It went through every country in the world, only a few distant islands in the South Atlantic and the Pacific remaining untouched. It brought the life of whole countries stopping, food supplies stopped and work loss was very great. Before the great outbreak ended, it had killed at least 15 million people. Thereafter there have been several great outbreaks throughout the world. It is thus clear
that influenza is a terrible infection that we have to pay more attention to.
3
One Good Reason to Let Smallpox Live
It’s now a fair bet that we will never see the total extinction of the smallpox virus. The idea was to cap the glorious achievement of 1980, when smallpox was eradicated in the wild, by destroying the killer virus in the last two labs that are supposed to have it—one in the US and one in Russia. If smallpox had truly gone from the planet, what point was there in keeping these reserves?
in reality, of course, it was naive to imagine that everyone would let go of such a potential weapon. Undoubtedly several nations still have a few much vials. And the last “official” stocks of lice virus bred mistrust of the US and Russia, for no obvious gain.
Now American researchers have found an animal model of the human disease, opening the way for tests on new treatments and vaccines. So one again there’s a good reason to keep the virus—just in case
the disease puts in a reappearance.
How do we_deal with the mistrust of the US and Russia? Simple Keep the virus under international auspices in a well-guarded UN laboratory that’s open to all countries. The US will object, of course, just as it rejects a multilateral approach to just about everything. But it doesn’t mean the idea is wrong. If the virus is useful, then let’s make it the servant of all humanity—not just a part of it.
4
Diet, Alcohol Linked to Nearly One Third of Cancers
Diet is second only to tobacco as a leading cause
of cancer and, along with alcohol, is responsible for nearly one third of cases of the disease in
developed countries, a leading researcher said on Tuesday.
Dr. Tim Key, of the University of Oxford, told a cancer conference that scientists are still discovering how certain foods contribute to cancer,but they know that diet, alcohol and obesity
. play a major role.
“Five percent of cancers could be avoided if
nobody was obese,” he said.
While tobacco is blinked to about 30 percent of cancer cases, diet is involved in an estimated 25 percent and alcohol in
about six percent.
Obesity raises the risk of breast, womb, bowel and kidney cancer, while alcohol is known to cause cancers of the mouth, throat and liver, Its dangerous impact is increased
when combined with smoking.
Key told the meeting of the charity Cancer Research UK that other elements of diet linked to cancer are still
unknown but scientists are hoping that the EPIC study, which is comparing the diets of 500,000 people in 10 countries and their risk of cancer, will provide some answers
.
Early results of the study have revealed that Norway, Sweden and Denmark have the
lowest consumption of fruit and vegetables among European countries while Italy and Spain have the highest. Eating at least five portions of fruit and vegetables a day is recommended to reduce the risk of cancer.
Key, principal scientist on the EPIC study, said it is looking at dietary links to some of the most common cancers including colorectal, breast and prostate.
5
Men Too May Suffer from Domestic Violence
Nearly three in 10 men have experienced violence at the hands of an intimate partner during their lifetimes, according to one of the few studies to look
at
domestic violence and health among men.
"Many men actually do experience domestic violence, although we don't hear about it
often," Dr. Robert J. Reid of the University of Washington in Seattle, one of the study's authors, told Reuters Health. "They often don't tell __ and__ we don't ask. We want to get the message out to men who do experience domestic violence that they are not alone and there are resources available to
them
"
The researchers asked study participants about physical abuse and non-physical
abuse
, such as threats that made them fear for their safety, controlling behavior (for example, being told who they could associate with and where they could go), and constant name-calling.
Among men 18 to 54 years old, 14.2 percent said they had experienced intimate partner __violence
in the past five years, while 6. 1 percent reported domestic violence in the previous year.
Rates were lower for men 55 and older ,with 5.3 percent reporting violence in the past five years and 2.4 percent having experienced it in the past 12 months.
Overall, 30.5 percent of men younger than 55 and 26.5 percent of older men said they had been victims of domestic
violence at some point in their lives. About half of the violence the men experienced was physical.
However, the physical violence men reported wasn't as harsh as that
suffered by women in a previous study; 20 percent to 40 percent of the men rated it as severe, compared to 61 percent of
women
Men who reported experiencing domestic violence had more emotional and mental health problems than those who had not, especially older men, the researchers found.
*6
Once-daily Pill Could Simplify HIV Treatment
Bristol-Myers Myers Squibb and Gilead Sciences have combined many HIV drugs into a single pill Sometimes the best medicine is more than one kind of medicine. Malaria, tuberculosis and HIV/AIDS,2 for example, are all treated with combinations
of drugs. But that can mean a lot of pills to take. It would be simplerif drug companies combined all the medicines into a single pill, taken just once a day.
Now, two companies say they have done that for people just startingtreatment for HIV, the virus that causes AIDS. The companies are Bristol-Myers Squibb and Gilead Sciences. They have developed a single pill that combines three drugs currently on the market.3 Bristol-Myers Squibb sells one of them under the name of Sustiva.4 Gilead combined the others, Emtriva and Viread, into a single pill in two thousand four.
Combining drugs involves more thantechnical
issues. It also involves issues of competition if the drugs are made by different companies. The new once-daily pill is the result of what is described as the first joint venture agreement of its kind in the treatment of HIV
In January the New England Journal of Medicine5 published a study of the new pill. Researchers compared itseffectiveness to6 that of the widely used combination of Sustiva and Combivir. Combivir contains
two drugs, AZT7 and 3TC.8 The researchers say that after one year of treatment, the new pill suppressed HIV levels in more patients and with fewer
side effects.9 Gilead paid for the study. Professor Joel Gallant at the Johns Hopkins School of Medicine in Baltimore, Maryland, led the research. He is a paid adviser to Gilead and Bristol-Meyers Squibb as well as the maker of Combivir, GlaxoSmithKline.
Glaxo Smith Kline reacted to
the findings by saying that a single study is of limited value. It says the effectiveness of Combivir has been shown in each of more than fifty studies.
The price of the new once-daily pill has not been announced. But Gilead and Bristol-Myers Squibb say they will provide it at reduced cost to developing countries. They plan in the next few months to ask the United States Food and Drug Administration10 to approve
the new pill.
There are limits to who could take it because of the different drugs it contains. For example, pregnant women are told not to take Sustiva because of the risk of birth disorders.11 Experts say more than forty million people around the world are living with HIV
*7
Exercise
（新增）
Whether or not exercise adds to the length of life, it is common experience that a certain amount
of regular exercise improves the health and contributes a feeling of well-being. Furthermore, exerise which
involves play and recreation, and relieves nervous tension and mental fatigue in so doing, is not only pleasant but beneficial.
How much and what kind of exercise one should take merits careful consideration.The growing child and the normal young man and young woman thrill with the exhilaration of strenuous sports. They fatigue to the point
of exhaustion but recover promptly with a period of rest. But not so with those
_of middle age and beyond. For them moderation is of vital importance. Just how much exercise a person of a given age can safely take is question hard _to answer. Individual variability is too great to permit of generalization. A game of tennis may be perfectly safe for one person of forty but folly for another. The sage limit for exercise depends on the condition of the heart, the condition of the muscles, the type of exercise, and the regularity with which it is taken. Two general suggestions, however, will serve as sound advice for anyone. The first is that the condition of the heart and general health should be determined periodically by careful, thorough physical examinations. The other is that exercise should be kept below the point of physical exhaustion.
What type of exercise one should choose _depens upon one’s physical condition. Young people can safely enjoy vigorous competitive sports, but most older persons do better to limit themselves to less strenuous activities. Walking, swimming, skating are among the sports that one can enjoy and safely participate in throughout life. Regularity is important if one is to get the most enjoyment and benefit out of exercise.
*8
Food Safety and Foodborne Illness
（新增）
Food safety is an increasingly important public health issue. Governments all over world are intensifying their efforts to improve food safety. These efforts are in response to _an increasing number of food safety problems and rising
consumer concerns.
Foodborne illnesses are defined
as diseases, usually either infectious or toxic in nature, caused by agents that enter the body through the ingestion of food. Every person is at
risk of foodborne illness.
Foodborne diseases are a widespread and growing public health problem, both in developed and developing countries. The global incidence
of foodborne disease is difficult to estimate, but it has been reported that in 2005_ alone
8 million people died from diarrhoeal diseases. A great proportion
of these cases can be attributed to contamination of food and drinking water. Additionally, diarrhoea is a major cause of malnutrition in infants and young children.
Industrialized countries, the percentage of the population suffering from foodborne diseases each year has been reported to be 10 up to 30%. In the United States of America (USA), for example, around 76 million cases of foodborne diseases, resulting in
325,000 hospitalizations and 5,000 deaths, are estimated to occur each year.
While less well documented, developing countries bear the brunt of the problem due to the presence of a wide range of foodborne diseases, including those caused by parasites. The high prevalence of diarrhoeal diseases in many developing countries suggests major underlying food safety problems.
In parternership with other stakeholders, WHO is developing policies that will further promote the safety of food. These policies cover the entire food chain from production to consumption and will make use of different types of expertise.
*9
Many Women Who Beat Cancer Don't Change Habits
Many women who battle breast cancer will tell you it's a life-changing experience. However, a new study shows that for many women, the changes aren't always positive or permanent.
Beth Snoke has watched her mother and both grandmothers battle and survive breast cancer So when she was diagnosed, there was no doubt in her mind what she had to do.
"I do exactly what the doctors say as far as the medicine that I'm on, as far as the vitamins, the diet, and the fitness. And I can't stress enough how important that is," says Beth Snoke. But a surprising new study shows that
no every woman who beats breast cancer is getting that message. In fact, nearly 40% bf them say even after
surviving breast cancer, they haven't made significant changes in the way
they eat or how much they exercise.
"Not all survivors are taking advantage of this teachable moment and making positive health changes in their
life," says Electra Paskett, PhD, at Ohio State University's Comprehensive Cancer Center. Paskett says diet and exercise have been proven to not only help women feel better during and after treatment, they may also play a role in preventing some cancers from coming back. Despite growing evidence, some women just aren't listening.
"Colon cancer survivors who exercise have actually been shown to have improved survival rates. So, yes, it is true that perhaps by making some of these healthy choices we can actually increase their health," says Paskett.
As a breast cancer survivor herself
, Paskett knows first hand how much difference diet and exercise can make
The challenge, she says, is to get more survivors to be more like Beth, during and after treatment.
Experts say exercising more and eating a healthier diet can also cut down on stress and help women overcome depression. There are more than 2 million breast cancer survivors living in the U.S. Of those, nearly a million have yet to change their diet or exercise routines.
*10
Hospital Mistreatment
According to a study, most medical interns report experiencing mistreatment, including humiliation by senior doctors, being threatened, or physical abuse in their first year out of medical school.
The findings come from **ysis of the responses to a 13-page survey mailed in January 1991 to 1, 733 second-year residents. The survey and **ysis appear in the April 15th issue of the Journal of the American Medical Association.
Overall, out of the 1,277 residents who completed surveys, 1,185 said that they had experienced at least one incident of mistreatment in their intern year. In addition to reporting incidents where they were abused, more than 45% of the residents said they had witnessed at least one incident where other persons had made false medical records. Moreover, nearly three quarters of the residents said they had witnessed mistreatment of patients by other residents, attending physicians, or nurses. Almost 40% said patient mistreatment was a frequent event.
More than 10% of the residents said they were not allowed to have enough sleep, and the average number of hours without _ sleep was 37.6. The average on-call hours during a _ typical week was 56.9 hours, but about 25% of the residents said their on-call assignments were more than 80 hours some weeks. Although 30% of the residents said they experienced some type of sexual harassment or discrimination, verbal abuse was the most common problem cited. When abusive incidents were limited to events occurring three or more times, 53% of the respondents reported that they were belittled or humiliated by more senior residents, while just over 21% reported someone taking credit for their work. Being “given tasks for punishment,” “being pushed, kicked or hit,” and having someone “threatening your reputation or career,” were reported as a more frequent occurrence by over 10% of the responding residents.
+11
Migrant Workers
In the past twenty years, there has been an increasing tendency for workers to move from one country to another. While some newly independent countries have understandably restricted most jobs to local people, others have attracted and welcomed migrant workers. This is particularly the case in the Middle East,1 where increased oil incomes have enabled many countries to call in outsiders to improve local facilities. Thus the Middle East has attracted oil-workers from the USA and Europe. It has brought in construction workers and technicians from many countries, including South Korea and Japan.
In view of the difficult living and working conditions in the Middle East, 2 it is not surprising that the pay is high to attract suitable workers. Many engineers and technicians can earn at least twice as much money in the Middle East as they can in their own country, and this is a major attraction. An allied benefit is the low taxation or complete lack of it. 3 This increases the net amount of pay received by visiting workers and is very popular with them.
Sometimes a disadvantage has a compensating advantage. For example, the difficult living conditions often lead to increased friendship when workers have to depend on each other for safety and comfort. In a similar way, many migrant workers can save large sums of money partly because of the lack of entertainment facilities. The work is often complex and full of problems but this merely presents greater challenge to engineers who prefer to find solutions to problems rather than do routine work in their home country.
One major problem which affects migrant workers in the Middle East is that their jobs are temporary ones. They are nearly always on contract, so it is not easy for them to plan ahead with great confidence. This is to be expected since no country welcomes a large number of foreign workers as permanent residents. In any case , migrant workers accept this disadvantage, along with others, because of the considerable financial benefits which they receive.
*
12
Pandemic H1N1 2009
（新增）
The most active areas of pandemic influenza transmission currently are in central and eastern Europe. Focal increases in rates during recent weeks were reported in at least two eastern European countries. A high intensity of respiratory diseases activity with concurrent circulation of pandemic influenza still exists in parts of southern and eastern Europe, particularly in Greece, Poland, and Ukraine.
In Western Europe, influenza transmission remains active and widespread, but overall disease activity has peaked. All influenza viruses in Western Europe were pandemic H1N1 2009, however, very small numbers of seasonal influenza viruses, covering less than 1% of all influenza viruses found, were reported in Russia. In addition, limited available data indicate that active, high intensity transmission is occurring in Northern African countries along the Mediterranean coast.
In Central Asia, limited data suggest that influenza virus circulation remains active, but transmission may have recently peaked in some places. In West Asia, Israel, Iran, and Iraq also appear to have passed their peak period of transmission within the past month, though both areas continue to have some active transmission and levels of respiratory disease activity have not yet returned to baseline levels. In East Asia, influenza transmission remains active but appears to be declining overall. Slight increases in ILI were reported in Mongolia after weeks of declining activity following a large peak of activity over one month ago.
In North America, influenza transmission remains widespread but has decline quickly in all countries. In the tropical regions of Central and South America and the Caribbean, influenza transmission remains geographically widespread but overall disease activity has been declining or remains unchanged in most parts, except for focal increases in respiratory disease activity in a few countries.
*13
Scientists Develop Ways of Detecting Heart Attack
German researchers have come up with
a new generation of defibrillators and early-warning software aimed at offering heart patients greater protection from sudden death from cardiac arrest.
In Germany alone around 100,000 people die annually as a result of cardiac arrest and many of these cases are caused by disruption to the heart’s rhythm. Those most at risk are patients who have already suffered a heart attack, and for years the use of defibrillators has proved useful in diagnosing life-threatening disruption to heart rnythms and correcting them automatically by intervening within seconds. These devices take on a range of functions, such as that of pacemaker.
Heart specialists at Freiburg’s University Clinic have now achieved a breakthrough with an implanted defibrillator capable
of generating a six-channel electrocardiogram (ECG) within the body. This integrated system allows early diagnosis of acute blood-flow problems and a pending heart attack. It will be implanted in patients for the first time this year. Meanwhile, researchers at the Fraunhofer Institute for Applied Mathematics in Kaiserslautern have developed new computer software that renders of ECG data more precise.
The overwhelming majority of patients at risk will not have an implanted defibrillator and must for this reason undergo regular ECGs. “Many of the current programs only get into account a linear correlation of the data. We are, however, making use in a non-linear process that reveals the chaotic patterns of heart beats as an open and complex system,” Hagen Knaf says, “In this way
changes in the heart beats over time can be monitored and individual variations in patients taken into account.” An old study of ECG data, based upon 600 patients who had suffered a subsequent heart attack, enabled the researchers to compare risks and to show that the new software evaluates the data considerably better.
*14
Homosexuals
Many homosexuals prefer to be called gay or, for women, lesbian. Most of them live quiet lives just like anyone else. Some gay people have always raised children, alone or with partners, and the use of artificial insemination is increasing among lesbians.
Gay persons are in every kind of job. Some are very open about their homosexuality, and some are more private. Some
view their sexual orientation as a biological given and others as a choice. For those women who see it as a choice, one reason often given is the inequality in most heterosexual relationships.
Homosexuality has been common in most cultures throughout history and generally
condemned.
As a result, homosexual activity became a crime, for which the penalty in early courts was death. Homosexual behavior is still illegal
in many countries and U.S. states.
Homosexuality later came to be viewed widely as less a sin than a sickness, but now no mental-health profession any longer considers homosexuality an illness. More recent theories to
account for homosexuality have included those based on biological and sociological factors. To date, however, there is no conclusive general theory that can explain the cause of homosexuality.
Attitudes
toward homosexuality began to change in the second half of the 20th century. Gays attribute this, in part, to their own struggle for their rights and pride in their orientation. Some large companies now extend
health-care benefits to the life partners of their gay employees. Many cities also have officially appointed lesbian and gay advisory committees. While some attitudes have changed, however, prejudice still exists, and in the late 1980s and early 1990s there were considerable shouts against homosexuals, with attempts to
pass laws forbidding the granting of basic civil rights to gays.
The AIDS epidemic, which started in the 1980s, has devastated the gay community and brought it together as never before. The organized gay response to the lack of government financial support for fighting AIDS and to the needs of the thousands of AIDS victims, whether they be gays or not, has been a model of community action. AIDS, however, has also
provided
people with another reason for their prejudice.
*15
Is Your Child's Stomach Pain All in His Head?
We all know there are times that kids seem to complain of a stomach ache to get out of chores or going to school. Don't be so sure that the pain they
feel is all in their minds. We're learning more now about a condition called "functional abdominal pain" that is experienced by millions of kids every day.
Like many teenagers, Kyle Brust makes it a point to do his homework as soon as he gets home. Unlike most, Kyle often did his with a terrible stomach ache. In fact, the pain often started while he was at school, but getting help there was getting harder.
"Some of my teachers wouldn't let me go, because I'd asked so many times before and they thought I was trying to get out of class ," says Kyle.
Kyle's mom Marilyn says she couldn't blame the teachers After all, she'd taken him to the
doctor several times herself, and even they couldn't find anything wrong "You know, you're running the tests and nothing's coming up. So, is it in his head, is he just an extremely stressful child? It's just frustrating because we're not finding any answers," says Marilyn.
It turns out Kyle was suffering from a condition known as functional abdominal pain, that affects as many as one out of every ten kids in this country. Even though the cause of the pain may not be obvious, there are real consequences.
"It really does hurt, and these kids really do suffer," says Dr. Campo, MD at Nationwide Children's Hospital. To help them, Campo is looking into a new approach. He's conducting clinical trials of an antidepressant that changes the way the body handles a chemical called serotonin. In a preliminary study, Dr. Campo found that in about eight out of ten cases, the drug normally used to treat emotional pain worked to ease the pain in the stomach
"We think about it as being important in anxiety and depression and that's all quite tree, but what's really interesting is that 95% of our body's serotonin is in our gut," says Campo.
Campo believes these kids have extremely sensitive intestines, and controlling the effects of serotonin may help ease the pain. It seemed to work for Kyle, who is now completely pain free for the first time in years. |
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发表于 2011-3-23 22:50
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