On 9:49 AM by NY Drs. Urgent Care
Health Canada gave the green light for the anticoagulant apixaban (Eliquis) to be used for the prevention of stroke and systemic embolism in patients with atrial fibrillation (Afib).
Apixaban, an oral factor Xa inhibitor, was just approved for the same indication in the European Union.
However, in the U.S., the FDA has postponed its decision on whether to approve the drug for stroke prevention in Afib, requesting additional data.
The Canadian approval of apixaban is based on data from the ARISTOTLE and AVERROES studies, which evaluated almost 24,000 patients. The studies compared apixaban with warfarin and aspirin, respectively, and looked at efficacy relating to stroke and systemic embolism, as well as safety relating to major bleeding as the primary endpoints. All-cause death was the secondary endpoint.
As a class, new oral anticoagulants have been officially recognized by the Canadian Cardiovascular Society (CCS) clinical practice guidelines for stroke prevention in Afib as a preferable option to warfarin, previously considered the standard of care.
Health Canada had previously approved apixaban for the prevention of venous thromboembolic events in adult patients who have already undergone elective knee or hip replacement surgery.
On 5:26 AM by NY Drs. Urgent Care
Benefits of Apple Cider Vinegar: Myth or Reality?
What are the health benefits of apple cider vinegar?
Apple cider vinegar has been hailed as a cure-all dietary supplement, with health benefits ranging from relief from allergy symptoms to helping the body burn fat and lose weight. Supporters of the health benefits of apple cider vinegar cite testimonials from people who believe that drinking apple cider vinegar has helped them, but is there any evidence to back up these claims?
Alexa Schmitt, a clinical dietitian at Massachusetts General Hospital, says, "No." While a few studies have been conducted on the possible health benefits of apple cider vinegar, the number of people in these studies is typically small, and the evidence is not yet convincing. "We have to look at the science," says Schmitt. "One or two small studies is not enough to prove a benefit."
Sorting Out Health Benefits of Apple Cider Vinegar
- Weight loss. According to Schmitt, the idea that apple cider vinegar somehow "speeds up fat loss is altogether a myth." There is no evidence to suggest that apple cider vinegar can affect metabolism, which is the way an individual breaks down food and burns calories.
- Feeling full. A 2006 study found that people who took doses of vinegar while eating bread reported feeling more full than people who ate bread alone. While this study has been cited by those who believe in the health benefits of apple cider vinegar, it is important to note that it only tested 12 individuals, and the authors concluded that much more research was needed before firm conclusions could be drawn. This study did not suggest that the way these people burned calories was affected.
- Cholesterol. Schmitt mentions a successful study that was done on rats but has yet to be replicated in humans. The study found that rats on a diet with an acetic acid supplement had lower cholesterol levels than rats without the acetic acid supplement. Acetic acid is one of the ingredients in apple cider vinegar and many other kinds of vinegar. For those who believe in the health benefits of apple cider vinegar, this study is promising. But there are other things to consider before assuming that the findings will be true in humans — primarily that there are key differences between the metabolism of rats and humans. The study authors recommend that the next trial be on hamsters, which break down fat in a way that is more similar to humans.
- Diabetes. A few studies have found that apple cider vinegar helped in the management of diabetes; however, these studies are also limited by their small size. One study, which found that taking vinegar at bedtime reduces blood sugar levels the next morning in people with type 2 diabetes, examined only 11 people. Another study found that taking cider vinegar might have some effect on insulin sensitivity in some diabetes patients, but that research, too, was limited by the small number of people being studied.
On 7:59 AM by NY Drs. Urgent Care
CDC Says “Take 3” Actions To Fight The Flu
Sadly Flu season is here and greater then ever. The Flu is a serious contagious disease that can lead to hospitalization and even death.
CDC urges you to take the following actions to protect yourself and others from influenza (the flu):
Take time to get a flu vaccine.
- CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses.
While there are many different flu viruses, a flu vaccine protects against the three viruses that research suggests will be most common.
Everyone 6 months of age and older should get a flu vaccine as soon as the current season's vaccines are available.
Vaccination of high risk persons is especially important to decrease their risk of severe flu illness.
People at high risk of serious flu complications include young children,pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease and people 65 years and older.
Vaccination also is important for health care workers, and other people who live with or care for high risk people to keep from spreading flu to high risk people.
Children younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. People who care for them should be vaccinated instead.
Take everyday preventive actions to stop the spread of germs.
- Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
- Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand rub.
- Avoid touching your eyes, nose and mouth. Germs spread this way.
- Try to avoid close contact with sick people.
- If you are sick with flu-like illness, CDC recommends that you stay home for at least 24 hours after your fever is gone except to get medical care or for other necessities. (Your fever should be gone without the use of a fever-reducing medicine.)
- While sick, limit contact with others as much as possible to keep from infecting them.
- See Everyday Preventive Actions and Nonpharmaceutical Interventions (NPIs) for more information about actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza
Take flu antiviral drugs if your doctor prescribes them.
- If you get the flu, antiviral drugs can treat your illness.
- Antiviral drugs are different from antibiotics. They are prescription medicines (pills, liquid or an inhaled powder) and are not available over-the-counter.
- Antiviral drugs can make illness milder and shorten the time you are sick. They may also prevent serious flu complications. For people with high risk factors, treatment with an antiviral drug can mean the difference between having a milder illness versus a very serious illness that could result in a hospital stay.
- Studies show that flu antiviral drugs work best for treatment when they are started within 2 days of getting sick, but starting them later can still be helpful, especially if the sick person has a high-risk health or is very sick from the flu. Follow your doctor’s instructions for taking this drug.
- Flu-like symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people also may have vomiting and diarrhea. People may be infected with the flu, and have respiratory symptoms without a fever.
Visit CDC’s website to find out what to do if you get sick with the flu and how to care for someone at home who is sick with the flu.
On 1:01 PM by NY Drs. Urgent Care
Have you ever been told that coffee is bad and that you should switch to green tea or health smoothies or wheat grass juice….
Over the past few years, researchers have discovered that:
- With each additional cup of coffee you drink, your relative risk of developing T2D drops by 7-8 per cent
- Chlorogenic acid and trigonelline found in coffee causes a reduction in your your body’s glucose and insulin responses – helpful for avoiding T2D.
- Moderate coffee consumption is not associated with an increased risk of hypertension, stroke or coronary heart disease.
- Moderate coffee consumption is inversely related to your risk of heart failure
- All in all, coffee looks to have some significant health benefits.
On 12:48 PM by NY Drs. Urgent Care
The fungal meningitis outbreak caused by contaminated injectable steroids continues to spread. Here are the latest facts, as of October 11, 2012:
- October 11th- Tere has been 137 cases identified and 12 deaths; more since then.
- It’s estimated that as many as 13,000 people have received the potentially contaminated steroid injections. Thus, we expect to see more cases of meningitis.
- Cases of fungal meningitis have now presented in 10 states; New Jersey is the most recent.
- The earliest (and most) cases occurred in Tennessee. That state has expanded its initial warning to patients, now urging anyone with possible exposure (i.e. patients who received epidural injections from one of the contaminated lots) to seek immediate care for meningitis-like symptoms that occur for up to 3 months after the injection.
- A 2nd fungus (Aspergillus was the first) has been identified in the contaminated vials. This new organism is Exserohilum. Unfamiliar to most of us, Exserohilum is a common environmental inhabitant but rarely a human pathogen.
- Emergency rooms have reported a dramatic surge in the number of patients concerned about possible exposure, despite widespread reassurance that fungal meningitis does not spread from person-to-person. We would like to take this opportunity to reinforce that only people who have received an epidural injection of methylprednisolone for back pain are at risk. If you are in that category and are experiencing symptoms, see your primary care provider or go to an emergency room immediately.
- The compounding pharmacy responsible for the outbreak, New England Compounding Center, has closed, surrendered its state license, and recalled all of its products.
- Legislation will be introduced at the federal level to empower the FDA to inspect, maintain, and assess the safety and efficacy of compounding pharmacies. At present, about 10% of pharmaceuticals come from compounding pharmacies, which are not required to submit to FDA oversight, but are overseen by state health pharmacy boards.
What Are the Symptoms of Meningitis?
Symptoms of meningitis may appear within days to several weeks of the injections. They may include headache, rash, stiff neck, and/or fever. Some of those affected have also presented with stroke-like symptoms, such as slurred speech or weakness in one extremity.
On 12:10 PM by NY Drs. Urgent Care
Last month (November) was Epilepsy Awareness Month. Epilepsy is a neurological condition, which affects the nervous system. Epilepsy is also known as a seizure disorder. It is usually diagnosed after a person has had at least two seizures that were not caused by some known medical condition like alcohol withdrawal or extremely low blood sugar. Sometimes, according to the International League Against Epilepsy, epilepsy can be diagnosed after one seizure, if a person has a condition that places them at high risk for having another.
The seizures in epilepsy may be related to a brain injury or a family tendency, but most of the time the cause is unknown. The word "epilepsy" does not indicate anything about the cause of the person's seizures, what type they are, or how severe they are.
Types of seizures
There are three types of diagnoses a doctor might make when treating a patient with epilepsy:
Idiopathic - this means there is no apparent cause.
Cryptogenic - this means the doctor thinks there is most probably a cause, but cannot pinpoint it.
Symptomatic - this means that the doctor knows what the cause is.
There are three descriptions of seizures, depending on what part of the brain the epileptic activity started:
Partial seizure - this means the epileptic activity took place in just part of the patient's brain. There are two types of Partial Seizures:
Simple Partial Seizure - the patient is conscious during the seizure. In most cases the patient is also aware of his/her surroundings, even though the seizure is in progress.
Complex Partial Seizure - the patient's consciousness is impaired. The patient will generally not remember the seizure, and if he/she does, the recollection of it will be vague.
Generalized Seizure - both halves of the brain have epileptic activity. The patient's consciousness is lost while the seizure is in progress.
Secondary Generalized Seizure - the epileptic activity started as a partial seizure, but then it spread to both halves of the brain. As this development happens, the patient loses consciousness.
What are the symptoms of epilepsy?
The main symptoms of epilepsy are repeated seizures. There are some symptoms which may indicate a person has epilepsy. If one or more of these symptoms are present a medical exam is advised, especially if they recur:
- A convulsion with no temperature (no fever).
- Short spells of blackout, or confused memory.
- Intermittent fainting spells, during which bowel or bladder control is lost. This is frequently followed by extreme tiredness.
- For a short period the person is unresponsive to instructions or questions.
- The person becomes stiff, suddenly, for no obvious reason
- The person suddenly falls for no clear reason
- Sudden bouts of blinking without apparent stimuli
- Sudden bouts of chewing, without any apparent reason
- For a short time the person seems dazed, and unable to communicate
- Peculiar changes in senses, such as smell, touch and sound; to name a few.
For more information on Epilepsy, you can go HERE to the National Epilepsy Website.
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