Posted by pjoylek03 in November 25, 2009
James Nebus, 71, never expected to walk his daughter down the aisle or see the birth of his first grandson.
While the holiday time is supposed to joyful, that was not the case for the Nebus family. In December of 2000, they received the grim news that Nebus had a brain tumor and only had months to live. But with highly aggressive treatment, a fighting spirit and a supportive family, he is now a cancer survivor who is hoping to inspire other patients with his story.
Diagnosed with a glioblastoma multiforme (GBM), the most aggressive form of brain tumors, Nebus took his prognosis head on and researched available treatment options. That was when he found Dr. Phillip G. St. Louis, a Florida Hospital neurosurgeon, and Dr. Nicholas Avgeropoulos, a Florida Hospital Cancer Institute neuro-oncologist, who teamed up to help give Nebus his fighting chance.
Shortly after the initial diagnosis, Nebus underwent brain surgery to remove the tumor and implant Gliadel Wafers. Approved by the Food and Drug Administration, these chemotherapeutic wafers are inserted directly into the cavity where the tumor was removed.
Over several days, the wafers release chemotherapy and attack cancer cells. Gliadel Wafers are the only FDA-approved treatment to provide highly concentrated chemotherapy directly to the brain, while avoiding systemic side effects usually associated with chemotherapy. These biodegradable wafers are clinically proven to prolong survival without jeopardizing quality of life, as is often the case with such aggressive therapies.
It has been more than five years since Nebus had this initial operation. Since his diagnosis, Avgeropoulos has carefully watched over Nebus, administering additional therapies, to provide combined benefits of the treatments.
“Implanting the Gliadel Wafers only added a few minutes onto the initial surgery, yet the effects have contributed to James living more than five years after surgery” said Avgeropoulos. “We are thrilled by the progress of this remarkable man.”
Soon after the brain surgery, Nebus returned to his normal life. He played cards, traveled and spent time with his family. And although he retired, his family has maintained the family business, Rock Creek RV Resorts in Naples, Fla.
Each year, the family organizes a fundraiser at the RV resort to raise money for the Florida Hospital Cancer Institute and inspire other local GBM patients with Nebus’ story of survival. They want to tell other families to never lose hope, no matter what the diagnosis.
Nebus’ tumor has returned twice since that initial operation. Both times, St. Louis removed the tumor and implanted additional Gliadel Wafers. Nebus’ family cannot be certain how much time he has left, but they are incredibly thankful for the past five and a half years and the priceless memories they have shared as a family. – NU
Posted by pjoylek03 in November 23, 2009
When bird flu hit most Asian countries, it prompted the World Health Organization (WHO) to urge China to test its wild birds, particularly geese that migrate from its waters during the harsh winter. The disease spread so fast from one bird to another that about 5,000 birds were killed in one season. People who have close or direct contact to infected poultry can contract the disease after coming in contact with bird secretions or feces.
Although many are divided on the possibility of direct human to human transmission of the virus, this possibility has not been ruled out. Viruses, in general, are known to mutate. In the case of bird flu, family members infected with it may show different severity of symptoms, prompting a misdiagnosis. Also, if a person who has the common flu becomes infected with bird flu at the same time, it can lead to the mutation of the bird flu virus.
At the University of Leicester in Great Britain, it was discovered that a full-blown bird flu pandemic could cause an 80% mortality rate. A team led by Karl Nicholson is developing the bird flu vaccine with the goal of decreasing the fatality should a fourth major pandemic occur. In the last century, there have been three recorded major pandemics: the Spanish Flu in 1918, the Asian Flu in 1957 and the Hong Kong Flu in 1968. In total, the three pandemics claimed at least 20 million people.
The bird flu virus, which can be transmitted through direct contact with a bird’s infected saliva, nasal secretions and feces, can survive for up to a week at 22 degrees Celsius. At freezing temperatures, the virus can survive indefinitely. It is no surprise that the bird flu virus tends to last in colder climates and is pronounced to be almost as deadly as SARS (severe acute respiratory syndrome). In addition to the transmission of the disease from the migration of wild birds traveling great distances, the disease is also spread when contaminated birds are exported and imported in the international market.
In terms of safety in food handling and preparation, a cooking temperature of about 70 degrees Celsius is enough to kill the bird flu virus. It is important, however, to avoid raw birds and other raw markets meats from being contaminated. Cook eggs properly and check that the yolks are not runny. The simple act of washing your hands thoroughly with soap and water after handling raw meats could spell the difference. Keep in mind that transmission of the bird flu virus to humans usually happens during the slaughtering process and handling of infected bird fluids. After slaughtering infected poultry, the virus typically stays in the intestinal and respiratory tracts, not in the meat itself. Cooking at right temperatures can help avoid the virus from spreading.
The symptoms of bird flu are very similar to human flu. However, the severity of a disease can sometimes give way to announcements of a pandemic, which can cause political issues. In Asia where the incidence and actual cases of human transmission of bird flu occurred, WHO and the United States immediately took precautionary measures. The British Medical Journal, on the other hand, declared that a pandemic is still far from happening.
No travel advisory has been issued restricting anyone from going to countries affected by bird flu although WHO has issued a warning to travelers. Travelers are advised against going to live poultry markets, getting close contact to any farms and having direct exposure to feathers, feces or droppings, eggs and poultry meat products. Travelers coming from afflicted countries are also not being screened. However, precautionary measures are in place, particularly in the media. Information is being disseminated in order to make people aware of the bird flu, its effects and what to do to avoid getting infected.
Viruses are constantly mutating and evolving. Health watchers, practitioners and scientists are concerned about this because if a pandemic occurs, there won’t be enough time to prepare and develop a vaccine. They fear that we are once again on the brink of another major pandemic threat. However, with the strides being made by technology every day, hopefully the casualty won’t be nearly as high as the casualty of the past three major pandemics that claimed at least 20 million lives worldwide.
Posted by pjoylek03 in November 22, 2009
The recent hurricanes Katrina and Rita have been powerful reminders of how destructive the forces of nature can be, and how preparation for them can mitigate their effects. Avian influenza, commonly referred to as “bird flu,” is a powerful force of nature that we must prepare for—or suffer the potentially devastating health and financial consequences. Bird flu is a viral contagious disease, just like the regular seasonal flu, but it might turn out to be 70 times more deadly. And, because of the nature of the virus, it might be most deadly for healthy children and adults, and pregnant women—just like the so-called Spanish flu of 1918-19 was.
The report of the U.S. National Intelligence Council’s 2020 Project, Mapping the Global Future, identified a global pandemic (an epidemic that is worldwide) as the single most important threat to the global economy. According to Shigeru Omi, regional director of the World Health Organization, “The world is now in the gravest possible danger of a pandemic.” And according to Dr. Robert Webster, a world-renowned influenza researcher at St. Jude’s Children’s Research Hospital in Memphis, Tennessee, “We could be heading for a global catastrophe.” Infectious-disease experts have repeatedly warned that it’s not a question of whether a bird-flu pandemic is coming; it’s only a question of when.
Judging from the federal government’s incredibly inadequate response at all levels to hurricane Katrina—which is emblematic of its ineptness in dealing with large national emergencies, its slow and superficial response to bird flu to date, and its lack of leadership on this issue—it is clear that you cannot count on the government to protect you. You must take the initiative to prepare yourself and your family for the coming bird-flu pandemic.
There are four essential areas that you must address to prepare for the bird-flu pandemic: 1) “social distancing”; 2) commodities—including food, 3) personal protective equipment (PPE), and 4) financial preparation. Social distancing refers to your living and work situations when the pandemic strikes. Without going to extremes, you want you and your family to be as far away from other people as possible. Bird flu is just like the regular seasonal flu in that you become infected from other people, not birds. (Although it might be possible to acquire the viral infection from birds, it is much more likely that, if you do become infected, you will have acquired the virus from another person, not a bird.)
The bird-flu virus is extremely contagious; it is transmitted though casual contact with a contagious person (who might not have any symptoms during the first 24 hours of infection), through touching contaminated objects, and through the air. Because of this, you want to stay away from people as much as possible, and that means spending more time at home. Your children will not be at school, they will be home. If your home is on the 73rd floor in an apartment building in New York City, how are you going to avoid other people? You might want to think of an alternative living situation for a few months.
The same principle applies to your work setting. If you can telecommute, that is the best scenario. If you don’t telecommute now, but because of the type of work you do it might be a possibility, discuss it with your employer. If you will have to continue to work closely with others at your job site, what can be done there to help protect you and others from infection? How can policies and procedures be amended to minimize contact with coworkers or customers? Are there hand-washing stations available? What are your employer’s plans for dealing with the coming pandemic? Discuss these and related issues with your employer and coworkers.
The second area that must be addressed is “commodities—including food.” There will be sporadic difficulties manufacturing or producing goods—because workers around the globe will be sick or otherwise absent from work. There also will be supply chain disruptions—both because workers will be sick or otherwise absent from work, and because of regional, national and/or international restrictions on travel. These problems will cause a decrease or the unavailability of most or all of the products we easily have access to now.
Commodities such as soap, toothpaste, toilet paper, and virtually everything you can buy at stores such as Wal-Mart will be difficult or impossible to obtain—for periods of weeks or months at a time. This includes the most important commodity—food. The federal government is always telling us to stock up on emergency supplies for three days. This will not be sufficient preparation for the coming deadly bird-flu pandemic. There will likely be limited food available in stores. In addition, stores are places you want to avoid anyway, because potentially contagious people might be there. Stock up now so that you have sufficient commodities, including food, for a period of months.
The third area to address is so-called personal protective equipment (PPE), which you will have to use, depending upon circumstances. PPE includes special face masks, called N95 respirators, which help prevent infection through inhalation of the virus. Remember that avian influenza (“bird flu”) is a very contagious disease that can be transmitted through the air. The only way to counter this source of infection is through the use of special N95 respirators. These are disposable face masks that can be worn for up to eight hours.
N95 masks were the type of masks worn by hospital workers during the 2003 severe acute respiratory syndrome (SARS) pandemic that struck a number of cities around the world, including Toronto, Canada. Surgical masks or other common face masks, sometimes used when sanding or painting and so forth, are not effective.
Other elements of PPE include disposable latex or vinyl gloves, eye goggles or face shields, gowns impervious to liquids, and sometimes disposable booties or disposable head caps. Keep in mind that during the pandemic, most people who become infected will have to be cared for at home, not in crowded and overwhelmed hospitals. This means that caregivers taking care of loved ones at home need to be protected from the virus, just like hospital workers working in hospitals. The only way to be protected is to wear PPE. (Just washing your hands—the federal government’s primary recommendation for caregivers at home—will not be enough.) Once the pandemic starts, demand for PPE will be huge and supplies will be in very short supply—or nonexistent. Buy now or suffer the consequences later.
The last area that must be addressed before the bird-flu pandemic strikes is personal finances. This is an area that governments at all levels have been mute on. However, preparing your finances to sustain yourself and your family during (and after) the pandemic could prove to be the most important area of preparation. Although the bird-flu virus is deadly and many of us will fall ill, most of us will not die from it—only one to two percent of the population will likely die. The vast majority will live—but under what circumstances?
Think of hurricane Katrina—where most people survived—but where hundreds of thousands are now homeless and underemployed or unemployed. Because of the potentially severe local, national, and international economic consequences of the bird-flu pandemic, many of us will suffer financially. Businesses around the world will not be able to make or distribute products or provide services. There will be layoffs and some companies will go out of business altogether. At a minimum, people will be out of work for periods of weeks or months. Your child or children, if you have any, will be at home—not in school or day care. Will that force one parent to stay home from work to care for them? How will you pay your rent or mortgage and your bills under these circumstances?
At Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.” When it comes to bird-flu preparation could make the difference between life and death, how much you and your family eat, and whether or not you can pay your bills, including your rent or mortgage. The government will not resolve these issues for you. Just like Smoky the Bear’s admonition, “Only you can prevent forest fires.” Only you can take stock of this situation and do something about it. Think about it—and then do something about it.
Posted by pjoylek03 in November 21, 2009
Bird flu is a disease caused by a specific type of avian (bird) influenza virus, the so-called H5N1 virus. This virus was first discovered in birds in China in 1997, and since then has infected 125 people in Vietnam, Cambodia, Thailand, and Indonesia, killing 64 of them. It is spread by infected migratory birds (including wild ducks and geese) to domestic poultry (primarily chickens, ducks, and turkeys), and then to humans.
Some infected people have developed abnormal clotting profiles resulting in excessive bleeding—which was a frequent clinical symptom in the deadly so-called Spanish influenza of 1918-19, which killed more than 100 million people worldwide. Indeed, bird flu shares a number of disturbing characteristics with the 1918-19 influenza virus. These two viruses have, in fact, recently been shown to be similar genetically. And in a recent laboratory experiment with mice, the 1918-19 virus was found to produce 39,000 times more viruses four days after infection than the regular seasonal human flu strain. The 1918-19 virus killed 100 percent of the mice that were infected with it, compared to none of the mice infected with the regular flu strain. With a current “case fatality rate,” or death rate of approximately 50 percent in humans, bird flu is obviously also a very deadly disease.
There are only a few reports in the medical literature describing the clinical features of bird flu in humans. The clinical spectrum of H5N1 infection ranges from asymptomatic infection—where the person doesn’t even know he or she is infected—to fatal pneumonia and multiple organ failure. Some infected individuals develop liver or kidney dysfunction, and there were two children who died from the virus that came to medical attention because of diarrhea and seizures related to encephalitis (infection of the brain). However, the most common presentation is one of fever, cough, and trouble breathing. Approximately 70 percent of patients also have diarrhea, and a few patients have had only gastrointestinal symptoms (such as stomach ache, vomiting, and diarrhea) and no breathing problems.
Deaths have generally been in normally healthy people. The first report in the medical literature of deaths from bird flu was on 12 patients living in Hong Kong. Their median age was nine years, with a range of one to 60 years. All presented with fever, and eight had symptoms or signs of upper-respiratory infections (five had clinical and X-ray evidence of pneumonia when first diagnosed). Gastrointestinal (GI) symptoms, including stomach pain, vomiting, and diarrhea, were present in eight patients. There were a total of five deaths (one died with Reye’s syndrome, which is associated with taking aspirin in children).
In a study of 10 patients in Vietnam with laboratory-confirmed avian influenza (H5N1), the mean age of the patients was 13.7 years. For eight of the patients, there was a clear history of either direct handling of poultry (chickens or ducks) or exposure to sick poultry in the week before the onset of illness. All presented in January 2004 with cough, shortness of breath, and fever, and seven had diarrhea; none had myalgia (muscle aches)—which is often found in the regular seasonal flu. Notably, oseltamivir (Tamiflu) was administered to five patients, four of whom died (treatment was probably started too late for the medication to be effective—it must be given within 48 hours after onset of symptoms to be effective). In total, eight of the patients died, for an 80 percent case fatality rate or death rate.
As is apparent from the descriptions above, the presenting symptoms of individuals with bird flu are very similar to the symptoms of the normal seasonal flu. Infections caused by either the bird-flu virus (H5N1) or the seasonal influenza virus can be completely asymptomatic—that is, cause no symptoms at all. Fever, cough, malaise (feeling ill), and gastrointestinal symptoms are common to both infections. Excessive bleeding occurs only with bird flu, but currently this symptom doesn’t appear to be common. Difficulty breathing is more common with severe cases of bird flu, not seasonal flu. Runny nose and sneezing are found only with colds (or allergies).
The cough in either type of infection is what is referred to in medicine as “nonproductive”—meaning there is no sputum brought up when coughing, or if any sputum is brought up, it is white in color. This type of cough is characteristic of upper respiratory viral infections. As either type of infection progresses or worsens, tissues may be damaged, disrupting the normal structure and function of the infected cells. This in turn may allow bacteria to grow and also cause damage. When this happens following a viral infection, it is referred to as a “secondary” bacterial infection. When this occurs, the color of the sputum characteristically turns yellow or green. If this happens, antibiotics are indicated to treat the bacterial infection. (Antibiotics are not indicated in the treatment of viral infections, because they don’t work.)
It is safe to assume that during a bird-flu pandemic, most individuals who become infected with the bird-flu virus will either be asymptomatic—having no symptoms—or their illness will not be severe enough to require hospitalization. The small percentage who do become seriously ill will have to be hospitalized, and treated with either of the two antiviral agents available, oseltamivir (Tamiflu) or zanamivir (Relenza). A smaller subset of that group will develop life-threatening complications such as acute respiratory distress syndrome (ARDS), which requires treatment with a mechanical ventilator, a respirator.
Some individuals may develop other serious complications such as liver failure, kidney failure, neurological problems—such as seizures, paralysis, psychiatric problems such as delirium or psychosis, or bleeding problems. However, it is reasonable to predict that most people infected with the virus will not die and will not have significant residual symptoms, although a small percentage will.
Posted by pjoylek03 in November 20, 2009
Can eating your broccoli and cabbage help protect you against lung cancer? According to a study published in the October 29, 2005 issue of the British medical journal, Lancet, the answer is yes.
This isn’t the first time that it’s been suggested that cruciferous vegetables may have a preventive effect against lung cancer, but it is the largest scale study to date. There have been a number of smaller observational studies that reported a possible link between the vegetables and lung cancer prevention, but they were considered to be too small to be definitive. This study, conducted by a group of researchers at the Genetic Epidemiology Group at the International Agency for Research on Cancer in Lyon, France, compared 2,141 people diagnosed with lung cancer with a group of healthy people in the Czech Republic, Romania, Russia, Hungary, Poland and Slovakia. They chose countries where the consumption of vegetables like cabbage, broccoli and Brussels sprouts has been traditionally high.
“We found protective effects with at least weekly consumption of cruciferous vegetables,” the research letter in the Lancet stated.
Researchers believe that the beneficial effects of cruciferous vegetables are due to the high content of isothiocyanates, phytonutrients that seem to have a strong anti-cancer effect. They are a more bioavailable form of glucosinolates, which also have been shown to have anti-cancer effects. The research conducted at Lyons takes the knowledge a step further.
Studies have shown that isothiocyanates neutralize cancerous cells by inhibiting cell proliferation. The cycle of a normal cell in the body proceeds from cell division, through specialization, and eventually, when the cell has either become damaged or has finished doing its job, to apoptosis – or cell death. The problem with cancer cells is that they don’t go through apoptosis. For some reason, their mutations make them resistant to the message that it’s time to die. Isothiocyanates appear to be a catalyst that triggers apoptosis. In laboratory experiments, they’ve induced apoptosis in a number of cell lines. They also seem to slow proliferation of a number of types of cancer cells, including lung cancer lines.
The researchers at Lyons found that there is also a correlation between genetics and the preventive effect of cruciferous vegetables. There are two genes that produce an enzyme that remove isothiocyanates from the body. The Lyons study correlated the results from a diet questionnaire with blood tests to determine whether those studied had inactive or active forms of those genes. They found that in people who had an inactive form of one of the two genes had a 37% lower risk of developing lung cancer. Those with an inactive form of the other had a 33% lower risk of developing lung cancer. In those with both genes inactive, there was a 72% reduction in lung cancer risk. In those who had two active gene types, there was no difference in risk at all.
Said Paul Brennan, lead author of the research letter, “…this indicates that there is a specific protective effect against lung cancer from cruciferous vegetables.”
Random trials to absolutely confirm the findings would be expensive and time consuming, Brennan notes. In the meantime, though, including cabbage, kale, Brussels sprouts, broccoli or turnips in your diet at least once a week may help reduce your risk of developing lung cancer.
