Philippine Herbal Medicine

Rest time between sets & prohormones vs. steroids

This article concludes with the obvious “vary your workout routine for best results” but it does survey some interesting research on rest time between sets. For a few weeks you can spike testosterone and HGH with shorter (1 minute) rests between sets. However the difference declines by 5 weeks into a routine. Over 10 weeks, a 2.5 minute rest would show better gains.

This is a decent article, though the facts are somewhat disturbing. Anabolic steroids you inject are safer than all the methylated prohormones you swallow. Yet the safer option is illegal while the more dangerous option is not.

Flu season reminders

HOUSTON -- (September 18, 2009) -- Although the seasonal flu and the H1N1 (swine) influenza virus are very similar in terms of symptoms and treatment, the main difference between the two is in age-related susceptibility, according to an expert at Baylor College of Medicine.
"Since many people have partial immunity to the seasonal virus, it does not generally spread in warm weather," said Dr. Paul Glezen, professor of molecular virology and microbiology and pediatrics at BCM.
Conditions that spread virus

The seasonal virus transmission is enhanced under three conditions – when the weather is cold (with low humidity), when children are in school and when people are in close spaces. When all three conditions are present, the virus spreads quickly.
Because everyone under 40 years of age is equally susceptible to the H1N1 virus, the virus has been able to spread in warm weather and when children are out of school.

Seasonal vaccine important

It's important to get the vaccination for the seasonal flu while waiting for distribution of the pandemic H1N1 vaccination, he said. Seasonal influenza vaccine may provide some cross protection against the new H1N1 virus for persons over 40 years of age.

"Fifty thousand Americans are killed by the seasonal virus each year," said Glezen. "Don't neglect getting the vaccination."

Lower mortality rate, higher transmission rate

The overall mortality rate is expected to be lower in the pandemic than the seasonal virus, but the infection rate will be higher in young adults and children. Therefore, the age specific mortality for younger age groups will be higher – perhaps much higher – during the novel A(H1N1) pandemic than during the seasonal epidemic, he said.

"It's a myth that it's too soon to get the seasonal flu vaccine," said Glezen. "It takes 10 to 14 days to take effect."

Plenty of vaccines available

Seasonal vaccine is available in adequate supplies and in convenient locations, he said. The pandemic A (H1N1) vaccine has been produced on contract to the U.S. government and will be distributed through the state health departments beginning in October.

Submit a Comment

View BCM's privacy notices. If you wish to make a comment about this article, please use the form below. If you have a medical question, please make an appointment with a physician.

Your Name (required)

Your E-mail (required)

Your Message (required)

Comments

Volunteers needed for study on effectiveness of Norwalk vaccine

HOUSTON -- (September 16, 2009) -- Baylor College of Medicine is recruiting volunteers for a study evaluating the effectiveness of a vaccine against the Norwalk virus, a cause of short-term vomiting and diarrhea commonly referred to as intestinal flu or cruise ship virus.

"Because this virus spreads so quickly through the community, a vaccine would be extremely beneficial," said Antone Opekun, assistant professor of medicine and pediatrics at BCM.

Researchers are recruiting healthy adults between 18 and 40 years of age. Participants will receive two doses of the vaccine and must be hospitalized for observation for four days. Participants must also return for outpatient visits over a three month period, and will be compensated for their time.

For more information about the study, call 713-798-7542 or e-mail norwalk@bcm.edu.

Submit a Comment

View BCM's privacy notices. If you wish to make a comment about this article, please use the form below. If you have a medical question, please make an appointment with a physician.

Your Name (required)

Your E-mail (required)

Your Message (required)

Comments

Injection treatment option to relieve back pain

HOUSTON -- (September 15, 2009) -- Patients who suffer from lumbar disc herniations may choose a proactive option for relieving the pain, according to an expert at Baylor College of Medicine.

A herniated disc occurs in the spine when there is a tear in the outer ring of a disc and the soft, central portion bulges out. When this occurs in the lumbar region of the spine, epidural steroid injections may be a treatment option.

Reduce inflammation

"Many disc herniations tend to resolve on their own over two to three months. However, epidural steroid injections can help reduce the pain and inflammation in the meantime," said Dr. Benoy Benny, assistant professor of physical medicine and rehabilitation and director of the spine, sports and pain program at BCM.

The outpatient procedure involves injecting steroids into the epidural space, or the outermost part, of the spinal canal. Mild sedation is required, and there are usually no restrictions for the patient the next day, said Benny.

Effects vary

The effects of the treatment vary widely. Some patients do well with just one injection while others require additional injections. However, Benny warns that the treatment should not be repeated more than three times in a year, because it may suppress the actions of the adrenal glands. Symptoms of this include weakness, fatigue, weight loss and stomach problems.

"There are several causes of back pain, and this procedure cannot be used for all types, but it is an option for lumbar disc herniations," said Benny.

Benny advises getting the procedure done by a doctor who is fellowship-trained in interventional spine or pain.

Submit a Comment

View BCM's privacy notices. If you wish to make a comment about this article, please use the form below. If you have a medical question, please make an appointment with a physician.

Your Name (required)

Your E-mail (required)

Your Message (required)

Comments

New recommendations can help health providers prepare for electronic record push

HOUSTON -- (September 9, 2009) -- A new framework of recommendations created by health informatics researchers may help doctors and hospitals prepare for a federal initiative to expand the use of electronic health records.

The recommendations from faculty at The University of Texas Health Science Center at Houston, the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine appear in a commentary in the Sept. 9 edition of The Journal of the American Medical Association.

"With high-quality, well-designed, and carefully implemented systems, highly-reliable, safe health care will be achieved," said Dr. Dean Sittig, commentary author, associate professor at The University of Texas School of Health Information Sciences at Houston and member of The University of Texas - Memorial Hermann Center for Healthcare Quality and Safety.

Setting the framework

The American Recovery and Reinvestment Act of 2009 created approximately $20 billion in incentives for individuals and organizations to "meaningfully" use electronic health records beginning next year. Previous studies report that 4 percent of physicians in the outpatient setting and 1.5 percent of U.S. hospitals have a comprehensive electronic health record system.

"This framework can help make sure that electronic health records are used safely and effectively as doctors continue to adopt them," said Dr. Hardeep Singh, co-author and assistant professor of medicine and health services research at the Veterans Affairs Health Services Research and Development Center of Excellence and Baylor.

This framework of recommendations proposed by Sittig and Singh provides guidance for many key stakeholders who are either currently involved or who will soon be involved with electronic health records.

Issues to consider

"While using electronic health records, we not only have to consider issues related to technology, but also issues related to people who use them, how they interact with technology and how the electronic health record fits with the workflow of the clinic or organization that adopts it," said Singh, who noted that if the Computerized Patient Record System developed by the Department of Veterans Affairs was included in the study, the percentage of U.S. hospitals with a comprehensive electronic health record system would nearly double to 2.9 percent.

The Veterans Affairs' electronic health record system covers many aspects of patient care, including reminders for preventive health care, electronic entry of orders, display of laboratory test results, consultation requests, and pathology and imaging studies.

"The American Recovery and Reinvestment Act stipulates that clinicians and healthcare organizations can receive incentive payments for 'meaningful use' of electronic health records. Depending on the definition and timeline for 'meaningful use,' this legislation could result in a rush to implement sub-optimal systems," said Sittig, co-author of a new book that addresses electronic health record issues and is titled "Clinical Information Systems: Overcoming Adverse Consequences."

Eight essentials

For Americans to realize the full potential of electronic health records, which include reduced cost, less duplication and greater quality, Sittig and Singh believe all eight essentials in the framework, which is based on a systems engineering model for patient safety, should be followed.

1. Hardware and software - Before implementation starts, the clinician and healthcare organization must have the proper hardware and software. "Anything that slows or disrupts the clinician's work flow could negatively affect patient safety," the authors wrote. "While free electronic health record software available is available, such as Veterans Information Systems and Technology Architecture (VistA) developed by VA, all of the other seven essentials in the framework must also be addressed for safe and effective use," Sittig said.
2. Content - To make sure that information is shared effectively, the federal government has taken steps to standardize the terms used to describe clinical findings. "Adoption of a standard vocabulary is prerequisite to implementing advanced clinical decision support," the authors wrote.
3. User interface - The information should be easy to access and to enter. Ideally, the interface should present all the important patient information in a way so that clinicians can rapidly recognize problems, and respond to them appropriately.
4. Personnel - For electronic health records to work safely, healthcare organizations will need to hire trained and knowledgeable software designers, developers, trainers and implementation and maintenance staff. The American Medical Informatics Association has identified the knowledge and skills necessary for many of these jobs. The School of Health Information Sciences at Houston currently offers educational programs and degrees in these areas.
5. Work flow and communication - The electronic health record system needs to be thoroughly tested within the clinic or hospital prior to implementation. Any bugs in the system should be fixed ahead of time.
6. Organizational characteristics - There should be a system to report errors and identify obstacles to care. "Innovation, exploration and continual improvement are key organizational factors for safe electronic health record use. The VA is a model of many of these organizational features," the authors state.
7. State and federal rules and regulations - Care must to be taken to make sure regulations protect patient safety and privacy.
8. Monitoring - Oversight, even after initial adoption and use, is crucial to the success of the switch from paper-based patient records to electronic records.

"These issues are essential to maximize patient care benefits and minimize unintended errors from technology," Singh said.

The commentary is titled "Eight rights of safe electronic health record use." The authors received support from the National Library of Medicine, the Veterans Affairs National Center of Patient Safety, the Houston Veterans Affairs Health Services Research and Development Center of Excellence and the Agency for Healthcare Research and Quality.

Submit a Comment

View BCM's privacy notices. If you wish to make a comment about this article, please use the form below. If you have a medical question, please make an appointment with a physician.

Your Name (required)

Your E-mail (required)

Your Message (required)

Comments