Archive | November 2022

QUOTE FOR WEDNESDAY:

“Anyone can get monkeypox. In Africa, most cases are among children under 15 years old. Outside of Africa, the disease appears to be more common in men who have sex with men, but there are numerous cases in people who don’t fall into that category.

Monkeypox is usually a self-limited disease with symptoms lasting from two weeks to four weeks. Most people with monkeypox get better on their own without treatment. Following diagnosis, your healthcare provider will monitor your condition and try to relieve your symptoms, prevent dehydration and give you antibiotics to treat secondary bacterial infections if they develop.

There’s currently not an approved antiviral treatment for monkeypox. Antiviral drugs may help, but they haven’t been studied as a treatment for monkeypox. Several investigational antivirals with activity against monkeypox are available, but only as part of a research study.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/22371-monkeypox)

What is monkey pox?

Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox. Since then, monkeypox has been reported in people in several other central and western African countries: Cameroon, Central African Republic, Cote d’Ivoire, Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Republic of the Congo, and Sierra Leone. The majority of infections are in Democratic Republic of the Congo.

There are two distinct genetic clades of the monkeypox virus – the Central African (Congo Basin) clade and the West African clade. The Congo Basin clade has historically caused more severe disease and was thought to be more transmissible. The geographical division between the two clades has so far been in Cameroon – the only country where both virus clades have been found.

Monkeypox is a viral zoonosis (a virus transmitted to humans from animals) with symptoms very similar to those seen in the past in smallpox patients, although it is clinically less severe. Monkeypox virus is an enveloped double-stranded DNA virus that belongs to the Orthopoxvirus genus of the Poxviridae family.   With the eradication of smallpox in 1980 and subsequent cessation of smallpox vaccination, monkeypox has emerged as the most important orthopoxvirus for public health. Monkeypox primarily occurs in Central and West Africa, often in proximity to tropical rainforests and has been increasingly appearing in urban areas. Animal hosts include a range of rodents and non-human primates.

Various animal species have been identified as susceptible to monkeypox virus.. This includes rope squirrels, tree squirrels, Gambian pouched rats, dormice, non-human primates and other species. Uncertainty remains on the natural history of monkeypox virus and further studies are needed to identify the exact reservoir(s) and how virus circulation is maintained in nature.

Monkeypox cases in people have occurred outside of Africa linked to international travel or imported animals, including cases in the United States, as well as Israel, Singapore, and the United Kingdom.

The natural reservoir of monkeypox remains unknown. However, African rodents and non-human primates (like monkeys) may harbor the virus and infect people.

Symptoms of Monkey Pox:

People with monkeypox get a rash that may be located on or near the genitals (penis, testicles, labia, and vagina) or anus (butthole) and could be on other areas like the hands, feet, chest, face, or mouth.

  • The rash will go through several stages, including scabs, before healing.
  • The rash can initially look like pimples or blisters and may be painful or itchy.

Other symptoms of monkeypox can include:

  • Fever
  • Chills
  • Swollen lymph nodes
  • Exhaustion
  • Muscle aches and backache
  • Headache
  • Respiratory symptoms (e.g. sore throat, nasal congestion, or cough)

Monkeypox symptoms usually start within 3 weeks of exposure to the virus. If someone has flu-like symptoms, they will usually develop a rash 1-4 days later.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. To date, however, there is no evidence that monkeypox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

Monkeypox can more accurately be described as “sexually transmissible.” In other words, sex is just one of the ways that monkeypox can be spread. In the past, monkeypox outbreaks have been linked to direct exposure to infected animals and animal products, with limited person-to-person spread. In the current monkeypox outbreak, the virus is spreading primarily through close personal contact. This may include contact with infectious lesions or respiratory secretions via close, sustained skin-to-skin contact that occurs during sex. However, any close, sustained skin-to-skin contact with someone who has monkeypox can spread the virus. The contact does not have to be exclusively intimate or sexual.

Monkeypox can spread from person to person through direct contact with the infectious rash, scabs, or body fluids. It also can be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling, or sex.

A person with monkeypox can spread it to others from the time symptoms start until the rash has fully healed and a fresh layer of skin has formed. Some people have been found to have infection but no symptoms. To date, however, there is no evidence that monkeypox spreads from people with no symptoms. CDC will continue to monitor for new or changing information about transmission.

When to get tested:

  • Currently, testing is only recommended if you have a rash consistent with monkeypox.
  • If you think you have monkeypox or have had close personal contact with someone who has monkeypox, consider taking precautions and visit a healthcare provider to help you decide if you need to be tested for monkeypox.

How its diagnosed:

  • You will likely need to fill out paperwork before you get tested.
  • To get a specimen to test, the healthcare provider will use a swab to rub vigorously across lesions of your rash. They will take swabs from more than one lesion.
  • This swabbing may be uncomfortable but is necessary to get enough material to detect the monkeypox virus from the specimens.
  • The specimens will be tested in a lab to see if the monkeypox virus is detected.
  • Results are usually available within a few days.
  • While you are waiting for your results, take precautions to avoid getting or spreading monkeypox virus to others.

The CDC states there is no treatment specifically for monkeypox.   But because the viruses that cause monkeypox and smallpox are similar, antiviral drugs developed to protect against smallpox may be used to treat monkeypox effectively.”  At at this time there’s currently not an approved antiviral treatment for monkeypox.  Monkeypox is usually a self-limited disease with symptoms lasting from two weeks to four weeks.

Most people with monkeypox get better on their own without treatment. Following diagnosis, your healthcare provider will monitor your condition and try to relieve your symptoms like preventing dehydration and give you antibiotics to treat secondary bacterial infections if they develop.

The CDC states “Two vaccines may be used for the prevention of monkeypox disease:

  • JYNNEOS vaccine is approved for the prevention of monkeypox and smallpox. During the current outbreak, JYNNEOS is the main vaccine being used in the United States.
  • ACAM2000 vaccine is approved for immunization against smallpox and made available for use against monkeypox under an Expanded Access Investigational New Drug (EA-IND) protocol.
  • People may be vaccinated after exposure to monkeypox virus to help prevent monkeypox disease (i.e., post-exposure prophylaxis).
  • No data are currently available on the clinical efficacy or effectiveness of JYNNEOS or ACAM2000 for monkeypox disease.”

The CDC states “As of November 29, 2022 The total U.S. cases are 29, 325 and the total deaths in the U.S. 15.”

 

 

 

 

QUOTE FOR TUESDAY:

“The Schnitzler syndrome is a rare and underdiagnosed entity which is considered today as being a paradigm of an acquired/late onset auto-inflammatory disease. It associates a chronic urticarial skin rash, corresponding from the clinico-pathological viewpoint to a neutrophilic urticarial dermatosis, a monoclonal IgM component and at least 2 of the following signs: fever, joint and/or bone pain, enlarged lymph nodes, spleen and/or liver, increased ESR, increased neutrophil count, abnormal bone imaging findings. It is a chronic disease with only one known case of spontaneous remission. Except of the severe alteration of quality of life related mainly to the rash, fever and pain, complications include severe inflammatory anemia and AA amyloidosis. About 20% of patients will develop a lymphoproliferative disorder, mainly Waldenström disease and lymphoma, a percentage close to other patients with IgM MGUS. It was exceedingly difficult to treat patients with this syndrome until the IL-1 receptor antagonist anakinra became available. ”

National Library of Medicine-NIH  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018454/)

Schnitzler Syndrome

 

Schnitzler syndrome is considered to be a rare disorder characterized by a monoclonal IgM protein and chronic urticaria that is associated with considerable morbidity. We hypothesized that the syndrome may be under-recognized and patients may be deprived of highly effective therapy in the form of anakinra (an interleukin-1 receptor antagonist=inhibits interleukin 1).  This treatment controls the condition but does not cure it. Around 15% of people develop complications, but the condition generally does not shorten life

Schnitzler is a rare disease characterised by onset around middle age of chronic hives (urticaria) and periodic fever, bone pain and joint pain (sometimes with joint inflammation), weight loss, malaise, fatigue, swollen lymph glands and enlarged spleen and liver.

How its Diagnosed:

Blood tests show a high concentration of specific gamma-globulins (monoclonal gammopathy) of the IgM type. It almost always has light chains of the κ-type. A variant in which IgG is raised has been described, which appears to be one-tenth as common.

CBC, this could show signs of inflammation are often present: these include an increased white blood cell count (leukocytosis) and a raised erythrocyte sedimentation rate=we would see this in what we call a simple Complete Blood Count(CBC) and C-reactive protein blood test.

-There can be anemia of chronic disease showing low red blood count again in a simple CBC.

-Bone abnormalities can be seen on radiological imaging (often increased density or osteosclerosis)

-Biopsy

-What we call the Lipsker criteria require hives, the presence of monoclonal IgM, and at least 2 of the following: fever, joint pain or arthritis, bone pain, swollen lymph nodes, enlarged spleen or liver, elevated erythrocyte sedimentation rate, high levels of white blood cells, and findings of problems in bone imaging.

-What we call the Strasbourg criteria, the person must have hives and the presence of monoclonal IgM or IgG. Schnitzler’s is diagnosed if the person has IgM and two of the following, or IgG and three of the following: recurrent fevers, abnormalities in bone imaging, with or without bone pain, findings of neutrophil infiltration in a skin biopsy, high levels of white blood cells or C-reactive protein.

Other conditions which can cause periodic fevers, paraproteins or chronic hives that should be ruled out, include (and are not limited to) autoimmune or autoinflammatory disorders such as adult-onset Still’s disease, angioedema, hematological disorders such as lymphoma or monoclonal gammopathy of undetermined significance (MGUS), other causes of hives, cryoglobulinemia, mastocytosis, chronic neonatal onset multisystem inflammatory disease or Muckle–Wells syndrome.

Treatment:

As of 2017 no drug was approved to treat Schnitzlers. Drugs that inhibit interleukin 1 activity have been the preferred treatment since they emerged in 2005; since 2012 a consensus guideline has recommended treatment with anakinra. Immunosuppressant drugs such as corticosteroids, cyclooxygenase inhibitors, interferon alpha may be effective.

 

 

QUOTE FOR MONDAY:

“Antimicrobial resistance (AMR) is a threat to humans, animals, plants and the environment. It affects us all. This is why this year’s theme calls for collaboration across sectors to preserve the efficacy of these critical medicines. Fighting AMR is a truly global endeavour and must be addressed through a One Health approach.

To curb it effectively, all sectors must join forces and encourage the prudent use of antimicrobials, as well as preventive measures. Strengthening infection prevention and control in health care facilities, farms and food industry premises, ensuring access to vaccines, clean water, sanitation and hygiene, implementing best practices in food and agriculture production, and guaranteeing the sound management of waste and wastewater from key sectors are critical to reducing the need for antimicrobials and minimizing the emergence and transmission of AMR.”

UN environment programme (https://www.unep.org/events/unep-event/world-antimicrobial-awareness-week-2022)

Global Antibiotic Awareness Month

 

In the lead-up to World Antibiotic Awareness Week, the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Organisation for Animal Health (OIE) are together calling for responsible use of antibiotics in humans and animals to reduce the emergence of antibiotic resistance.

Antibiotic resistance is rising to dangerously high levels in all parts of the world and threatening our ability to treat common infectious diseases. Infections affecting people – including pneumonia, tuberculosis, blood poisoning and gonorrhoea – and animals alike are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

Antibiotics are often overprescribed by physicians and veterinarians and overused by the public. Where they can be bought for human or animal use without a prescription, the emergence and spread of resistance is made worse. Examples of misuse include taking antibiotics for viral infections like colds and flu, and using them as animal growth promoters on farms or in aquaculture.

To tackle these problems, WHO, FAO and OIE are leveraging their expertise and working together in a ‘One Health’ approach to promote best practices to reduce the emergence and spread of antibiotic-resistant microbes in both humans and animals.

“Antibiotic resistance is a global crisis that we cannot ignore,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “If we don’t tackle this threat with strong, coordinated action, antimicrobial resistance will take us back to a time when people feared common infections and risked their lives from minor surgery.”

“The overuse of antimicrobials blunts their effectiveness, and we must reduce their misuse in food systems,” says José Graziano da Silva, Director-General of FAO. “Antimicrobial veterinary medicines are a crucial tool for animal health and welfare and safe food production, but they are by no means the only tool.”

“Like in human health, veterinary medicine has tremendously progressed thanks to antibiotics. Preserving their efficacy and availability through their responsible use associated with good husbandry and prevention practices, is therefore essential to preserve animal health and welfare,” highlights Dr Monique Eloit, Director-General of OIE.

QUOTE FOR THE WEEKEND:

“Your heart may leap with delight at the electronic gizmo or emerald bracelet that you’ve just unwrapped from under the Christmas tree. But you can’t say the same for that nasty holiday surprise known as the “Merry Christmas coronary” or “Happy Hanukkah heart attack”.

For many years, researchers have been intrigued by a disturbing pattern: Deadly heart attacks increase during the winter holiday season. One study even found distinct spikes around Christmas and New Year’s Day.

We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smoking, hypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age.

But we’re also learning that there are certain triggers for cardiovascular events,  including time of the year and seasons. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease.

The holiday season and how it impacts the heart with increasing risk of an MI.

It’s the holiday season—cardiac patients not careful in eating but indulging in junk food may put you at high risk for a bomb to go off in the heart=heart attack.

While colder weather may play a role, studies have shown that the spike in heart events during the holiday season occurs even in It’s no secret that holiday celebrations offer many temptations to overindulge. Many holiday foods are high in saturated fats or sodium. Overindulgence in these foods can increase cholesterol levels or blood pressure, making it more difficult for blood to flow through arteries and upping the chance of a blockage. What you may not know is that eating a heavy holiday meal may affect you even after you’ve pushed away from the table. “Research shows that anyone with coronary-artery disease or high cholesterol has a heightened risk for heart attack for up to one day after eating a heavy meal,” said Mittleman. Mittleman participated in a study, “Heavy Meals May Trigger Heart Attacks,” led by Francisco Lopez-Jimenez, MD, currently the Director of the Cardio-metabolic Program at the Mayo Clinic. This study, which focused on nearly 2,000 former heart attack patients, found that 10 percent of them suffered a coronary within 26 hours of eating a heavy meal.

“People often change their eating habits during the holidays,” said Dr. Anne Riley, a cardiologist at BIDMC. “For those with congestive heart failure [CHF], salty foods can cause fluid retention and high blood pressure, which place added stress on an already weakened heart.”

Your heart may leap with delight on the couch after Thanksgiving or at the electronic gizmo or emerald bracelet that you’ve just unwrapped from under the Christmas tree. But you can’t say the same for that nasty holiday surprise known as the “Happy Thanksgining” or “Merry Christmas coronary” or “Happy Hanukkah heart attack.”

For many years, researchers have been intrigued by a disturbing pattern: Deadly heart attacks increase during the winter holiday season. One study even found distinct spikes around Christmas and New Year’s Day.

Recommended Related to Heart Health

Read Amazing Facts About Heart Health and Heart Disease:

You can feel your heart thudding away every time you put your hand to your chest, but do you have any idea what’s really going on in there or what keeps your heart ticking as it should? WebMD the Magazine asked Richard Krasuski, MD, director of Adult Congenital Heart Disease Services and a staff cardiologist at the Cleveland Clinic, to help explain some amazing and little-known facts about the human heart.

“We certainly know that there are certain risk factors for coronary artery disease. There’s obviously smoking, hypertension, dyslipidemia [high cholesterol], diabetes, lack of exercise, and age,” says Robert A. Kloner, MD, PhD, a researcher at Good Samaritan Hospital in Los Angeles and a professor at the Keck School of Medicine at the University of Southern California.

“But we’re also learning that there are certain triggers for cardiovascular events,” he adds, “including time of the year and seasons. If we can get a true handle on the seasonal variation, we could knock down death from coronary disease.”

Coronary artery disease stems from atherosclerosis, a condition in which fatty plaques narrow the arteries to the heart. When a plaque ruptures, it can trigger a blood clot that leads to a heart attack.

In a national 2004 study published in Circulation, researchers at the University of California, San Diego, and Tufts University School of Medicine examined 53 million U.S. death certificates from 1973 to 2001. They discovered an overall increase of 5% more heart-related deaths during the holiday season. When researchers looked at individual years, they found varying increases in cardiac deaths for every holiday period they studied, except two.

Doctors have long known that cold weather is hard on the heart. Blood vessels constrict, which raises blood pressure. Blood also clots more readily. Frigid temperatures increase strain on the heart, and too much physical exertion can worsen the burden and trigger a heart attack. For example, doctors have treated many patients whose heart attacks followed strenuous snow shoveling.

Not to put a damper on holiday frivolity, but heart attacks increase during winter. For one reason, cold weather is tough on the heart. Blood vessels constrict, which causes blood pressure to rise. Additionally, blood clots more easily. (I’m getting this info, by the way, from the boldface link a sentence or two ago).

“People tend to consume much more fat, salt, sugar, and alcohol during the holiday season,”.   “Also, people tend to be less active due to the cooler weather. Overindulgence of food and alcohol along with inactivity raises the blood pressure and cholesterol levels. These risk factors combined increase your chances of having congestive heart failure, a stroke, or even a heart attack.” says Roberto Wayhs, MD, chief of cardiology at Methodist Charlton Medical Center.

To put a stop to that, or at least decrease your chances, he offers these tips:

Limit foods and beverages that are salty and/or rich. Blood pressure tends to go up the more salt you intake. Rich and sugary foods raise blood sugar levels.

Be consistent in taking your daily medications. You need them at all times of the year to maintain good health.

Get enough sleep. Sleep loss is related to weight gain, which also can affect the heart. Aim for at least seven hours.

Control your stress. “Holiday sadness adds stress,” Wayhs says. “Don’t be afraid to seek professional help if you need it.”

Limit alcohol intake.  “High alcohol intake has been linked to irregular and rapid heartbeats (atrial fibrillation) and congestive heart failure,” says Dr. Wayhs.

Maintain your normal exercise routine. “Don’t place your healthy habits on the back burner,” he says.

If you don’t have time for your usual workouts, try a shorter one.

Oh and, of course, stop smoking. But you knew that already.

 

QUOTE FOR FRIDAY:

“Do not weigh yourself the day after Thanksgiving. The extra sodium and carbs may cause your weight to temporarily jump up 3 pounds. Wait at least 3 days.  If you end up eating a lot more than you planned, don’t beat yourself up. Tell yourself it was one day and get back on track the next day.  If you are in someone’s home for the weekend and are surrounded by leftovers, focus on the healthier ones like turkey and veggies.  If you are really tempted, allow yourself one “treat” a day for the rest of the weekend. Maybe a dessert one day or a portion of stuffing and gravy.  If you are home for the holiday, make sure you plan activities for the day after Thanksgiving as well as the weekend. This will get you out of the house and away from the leftovers.”

Martha  McKittrick – a RN, registered dietitian and a certified diabetes educator.  (http://marthamckittricknutrition.com)

Post Thanksgiving Strategy for the 2 days after gobbling festive food for the turkey holiday and the day after.

post thanksgiving or xmas or NYD 2 

How to stop the eating motion and go back a step back into healthy eating after a parting day or weekend with on top leftovers. Thanks to RN NETWORK.com they have words of wisdom to offer and here they are:

“Turkey, stuffing and pie, oh my! Thanksgiving can be a stressful time for people looking to manage their weight because it is a holiday that:

1) Primarily focuses on food

2) Signifies the start of the holiday season which is full of parties, celebrations and special family meals. And unfortunately, most of these celebrations are not serving huge platters of veggies, grilled chicken, hummus and whole wheat pita with fruit for dessert!

While an all-day eating holiday like Thanksgiving can wreak havoc on otherwise good eating habits, one non-ideal meal (or day) does not lead to pounds of weight gain. The big issue for many is how to deal with the days following Thanksgiving when we have lots of temptations to keep the celebration going on. Friday (all those leftovers) and Saturday (well I’ve already gone overboard so may as well enjoy myself) and Sunday (I’ll start fresh on Monday) and Monday (I wanted to eat better but my coworkers brought in pie/cake and leftovers!) and . . . you get the idea.

To successfully tackle Black Friday, use the following three tactics:

  • Have a “Leftovers” Plan: We tend to run into trouble when we open the fridge the day after Thanksgiving and see tons of tempting foods staring back at us. Creating a way to control leftovers will make sure that we can indulge on our terms, not on our refrigerator’s terms (i.e. I’ve got to eat this pie and half a turkey or it will go bad). The adage still applies, “Out of sight, out of mind, out of stomach.” So if you’re hosting Thanksgiving dinner, send your guests home with care packages containing pie and casseroles.  If you didn’t then send some out to neighbors, close family, bring to work or even to church to homeless.  You can figure it out.
  • Keep Active: Nothing like falling asleep in front of the football game on TV after Thanksgiving dinner to get our weekend started on the less active foot. A great way to help our bodies deal with extra food is to keep our metabolism high throughout the weekend. Consider a bike ride, jog or workout the day after Thanksgiving into this weekend to keep you motivated to continue exercising throughout the entire holiday season. Check out the 1 hour-tip below for another activity that will let you kill two birds (pun intended) with one stone.
  • Preventing “Holiday Mode”: As previously mentioned, most of the issues with Thanksgiving and the holidays are when we let our celebratory meals spill into the next day, and the day after that. Many people have the the day after Thanksgiving  off of work and we often are busy focusing on other activities like holiday shopping so we just go for whatever food is around: usually leftovers or eating out. Being mindful that the food-related Thanksgiving holiday ends on Thursday if not Post day is the first crucial step to setting yourself up for success over the rest of the weekend.Have 1 Minute? Give away unwanted leftovers.Have 5 Minutes? Plan a healthy Black Friday weekend.Have 15 Minutes? Portion your leftovers.Have 60 Minutes? Work out by cleaning up.
  • After breakfast on this weekend, get your workout in while taking care of one of the most dreaded post-Thanksgiving activities by setting aside an hour to do some vigorous cleaning all around the house if not already done. By increasing the intensity of your cleaning (a little bit faster, more elbow grease) you will clean more and burn a few hundred calories per hour.”
  • Sometimes the issue is not about what the leftovers are, but more how much of them are left. Spend some time Thursday night or the night after or this weekend putting the left over thanksgiving food in portion leftovers  for  future balanced meals for Friday and the rest of the weekend so you do not become tempted to take extra-large helpings or only eat lots of your favorite food. Freeze some leftovers too so you can enjoy them throughout the holiday season and not feel pressured to eat them all within a few days.
  • Plan a healthy day of eating for this weekend by writing down what you ate, from breakfast to your after-dinner snack. This will reduce that chance that you miss a meal or become tempted to eat something that is out of your routine. If you normally eat breakfast, do not skip it on Friday. Remember some of the keys to balanced meals: lean protein, complex carbs, plenty of fruits and veggies and healthy fats (avocado, olive oil, nuts, salmon, etc.). Consistency is key: make sure you eat on Friday the same way you ate the month, week and day before Thanksgiving.
  • Create a leftover delegation list with each family or person coming to Thanksgiving and the associated foods you will send them home with. Ask guests to bring their containers with them or make sure you have enough that you don’t mind parting with.

About the author: Jason Machowsky, MS, RD, CSCS is a registered dietitian, certified personal trainer.