Is it really advisable for the whole family to be immunized against flu? Please discuss flu in your column.

Flu or influenza is an acute infection of the respiratory tract that is caused by any of the three types of influenza viruses (A, B, and C), each of which has several subtypes or strains. Localized outbreaks of flu occur almost every year in practically all countries. The flu viruses enter the mouth or nose by inhalation of droplets that are coughed, sneezed, or exhaled out by people with the disease; by direct contact with secretions from infected people; or by touching contaminated objects and then touching the nose or mouth with the hands.

Signs and symptoms, clinical course and treatment of flu

The signs and symptoms of flu are similar to those of common cold and some bacterial upper respiratory infections, but in flu, they are usually more severe and they come more abruptly. They include fever, chills, cough, nasal discharge, sore throat, body malaise, muscle pain, and headache.

Flu is mostly a benign and self-limited illness. Generally fit and healthy individuals usually overcome the disease in a few days to a week even without seeing a doctor. A significant number of flu patients, however, develop life-threatening complications like pneumonia. In fact, globally, thousands die yearly from complications of flu. Especially susceptible to complications are the very young (children), the elderly, and the debilitated.

The flu confers lifetime immunity against the strain of the virus that caused it, but it does not protect against other strains.

There are no medicines against the flu viruses. Treatment for the condition consists of bed rest, liberal fluid intake, and analgesics—such as paracetamol and ibuprofen—and decongestants to relieve fever, aches and pain, and nasal stuffiness.

Can flu be prevented?

Flu is a largely preventable disease and the best way to prevent it is by having an annual flu shot (i.e., immunization or vaccination).

In the Philippines, two types of flu shots are currently available. The trivalent flu vaccine protect against two influenza A strains and one influenza B strain while the quadrivalent flu vaccine protect against the same strains as the trivalent vaccine plus an extra influenza B strain.

The flu vaccines are safe, even for pregnant women. Its adverse effects, which occur rarely, are generally mild, and include soreness, redness or swelling at the injection site, low-grade fever, and aches.

But the vaccines have limitations. They provide only 65 to 80 percent protection against the illness in young adults and just 30 to 40 percent protection among the elderly, but those who develop flu even when already immunized have lower risk for complications. Additionally, the vaccines have to be administered annually not only because they confer protection for only 12 months but also because the prevalent type and strains of the virus vary from year to year and it is not technically possible to incorporate all the strains in one vaccine. The composition of the vaccine is changed by the manufacturers annually based on the recommendations of the World Health Organization (WHO).

Who should get flu shots?

The flu shot should be mandatory for health care providers, children between six months and five years of age, people with chronic diseases such as diabetes, asthma, and heart disease, and people 50 years old and older. For all others above five years, it is not a must but still desirable.

When to get the shot?

The best time to get the vaccine is before the start of the flu season, which coincides with the rainy season in the Philippines, i.e., from June to September, sometimes up to December. It is, thus, best to get the vaccine between February and June, ideally March or April, but it is still okay to get the shot outside these months.

source: Manila Bulletin
http://lifestyle.mb.com.ph/2017/03/21/its-march-time-for-a-flu-shot/

With springtime and summer just around the corner, many people will be heading back to the gym in the hope of busting cellulite, a seemingly unshakeable curse for many women. However, cellulite, which has both genetic and hormonal causes, can be improved with a comprehensive long-term strategy.

Here are a few facts and fictions about the dreaded “orange-peel effect” before you get started.

Exercise gets rid of cellulite

False. Unfortunately, exercise alone isn’t enough to shift those lumpy fatty deposits anchored deeply under the skin. This type of fat corresponds to metabolized fat from food and genetic fat stores often found around the buttocks and thighs. However, exercise (walking, running, water biking, skipping) forms part of an overall cellulite-busting strategy, giving a real boost to venous and lymphatic circulation.

Hormonal balance affects cellulite

True. Harmonizing your hormonal balance could help reduce and halt the further development of adipocyte fat cells. A lack of progesterone can often create a cellulite effect. Borage oil and chaste tree are herbal remedies that are recommended for boosting the hormone progesterone. Changing to a contraceptive pill with a different dose of hormones can also be an option. Ask your healthcare provider for more information.

Cutting calories is the only way to get rid of cellulite

False. Slim women have cellulite too. Losing weight by forcing yourself to follow a drastic and highly restrictive diet won’t solve the problem. In fact, it can prove counterproductive, since you also risk losing muscle mass and accentuating any cellulite buildup.

The Mediterranean diet is the most effective

True. Cellulite, by definition, is an inflammatory condition. A Mediterranean diet based on foods rich in antioxidants (fruit and vegetables, seeds, nuts, wholegrain cereals) is the best weapon of mass destruction in the fight against lumpy deposits. Foods containing fast-acting sugars, with high glycemic indexes, should generally be avoided because they promote the storage of fat and cause insulin levels to spike. Watch out for hidden salt, too, which is often responsible for water retention. Avoid soup in the evening and fill up on protein.

Herbal remedies can help tackle cellulite

True. The key active ingredients in certain plants can help the body to eliminate toxins, flushing out tissue that’s full of water and fat. These include dandelion, birch, fennel, artichoke, black radish, fumaria, red vine leaf, witch hazel and ginkgo biloba, which can help boost blood flow back to the heart and aid the lymphatic system. Drinking lots of water will also stimulate digestive transit to help get rid of inflammatory toxins.

source: Philippine Daily Inquirer
http://lifestyle.inquirer.net/257827/five-facts-fictions-cellulite/

A newer class of type 2 diabetes drugs significantly cut the risk of death and hospitalization for heart failure compared with other medicines for the disease, according to data released on Sunday from a so-called real world study sponsored by AstraZeneca.

The drugs, known as SGLT-2 inhibitors, work by removing blood sugar via the urine and include Astra's Farxiga, Jardiance from Eli Lilly and Co and Boehringer Ingelheim, and Invokana from Johnson & Johnson.

Jardiance caused a stir in 2015, when a clinical trial conducted to reassure it does not cause heart problems instead showed it reduced the combined risk of hospitalization for heart failure or death from heart failure by 39 percent in high risk patients. The heart benefit has since been incorporated into Jardiance's label.

AstraZeneca is conducting its own large clinical trials to determine the heart effect of Farxiga with results expected in 2019.

But the latest data presented by Dr. Mikhail Kosiborod at the American College of Cardiology scientific meeting in Washington appears to indicate that heart protection is not limited to Jardiance.

"The fact that the results are remarkably consistent from country to country regardless of which compound predominates, that certainly seems to suggest that it's a class effect," said Kosiborod, a cardiologist from Saint Luke's Mid America Heart Institute in Kansas City. He noted that most Americans in the data were taking Invokana, while Farxiga was dominant in Europe.

The study, which analyzed data from more than 300,000 type 2 diabetes patients collected from six countries, found the SGLT-2 drugs slashed the combined risk of hospitalization for heart failure and death from any cause by 46 percent.

The data was obtained from real-world sources, such as medical records, claims databases and national registers.

Most patients were taking Farxiga or Invokana with less than 10 percent on Jardiance. The comparator medicines included a wide variety of diabetes treatments, including metformin, DPP-4 inhibitors, such as Merck & Co's Januvia, and insulin, among others.

The vast majority of patients had no history of heart disease. But heart disease is the number one killer of people with diabetes, and mounting evidence of heart protective qualities of SGLT-2 drugs could lead to greater use.

"This class has a real potential of improving patient outcomes," Kosiborod said.

Given the observational nature of the study the possibility of unmeasured confounding factors exists, researchers noted.

More than 400 million people worldwide have diabetes, of whom at least 90 percent have type 2.

source: Reuters Health
http://www.reuters.com/article/us-heart-astrazeneca-diabetes-idUSKBN16Q0T1

Non-invasive magnet therapy is being trialed by Australian researchers to slow the development of Alzheimer’s disease.

Using a new type of Transcranial Magnetic Stimulation (TMS) called Theta-burst stimulation, researchers from the Monash Alfred Psychiatry Research Centre (MAPrc) have been able to stimulate nerve cells on the surface of the brain.

Kate Hoy, the MAPrc group leader, said that using Theta-burst stimulation allowed a shorter burst of high frequency stimuli to four regions of the brain in three minutes compared to other treatments which took 40 minutes to target one region of the brain.

Hoy said the treatment targeted the build-up of plaque proteins around brain cells which inhibited the ability of those neurons to communicate.

“How well our brain cells talk to each other is what underlies how we think, our information processing and our memory,” Hoy told News Limited on Wednesday.

“We’re targeting the regions that are affected in this way and trying to increase their ability to talk to each other by strengthening their connections.”

Some 100 people with mild to moderate Alzheimer’s aged 50-95 years old will participate in the six-week trial.

Jo Duff, a 78-year-old participant whose cognitive scores improved throughout the trail, said that she and those around her noticed a significant difference in her thinking and ability to remember things.

“I was much clearer in my thinking. I could express myself a lot better,” Duff said.

“Alzheimer’s gives you a foggy feeling in the brain, but that lifted. It felt just like someone tapping my forehead.”

source: Manila Bulletin
http://lifestyle.mb.com.ph/2017/03/15/aussie-scientists-trial-magnet-therapy-to-slow-alzheimers-disease/