More on Health Texting

It may seem like a gimmick, but there is serious money being invested around the world in setting up systems to send mobile phone text messages for a variety of health situations. Some companies are beginning to capitalize on the concept by selling a service that companies can then provide to their employees or customers. They will send text, email or voice-mail messages reminding users to take their pills, refill prescriptions, get to appointments or check vital signs such as blood pressure or blood sugar levels. Interested parties include drug companies, insurers and large employers hoping to improve efficiency and decrease absenteeism and next year, a direct-to-consumer service is being launched that for $60 a year will offer you a personal email, text or voice-mail reminder about prescriptions and appointments. In the older age groups, 60 plus, they showed little interest in the service as generally that age group are more averse to using new technology.

The advantages are fairly clear. Text messaging is fast, cheap and private. Unlike voice mail, it is easier to recall and easier to respond to. In England, women have received text reminders to take their birth-control pills, and Rifat Atun, professor of international health management at Imperial College in London, says several hospitals in England already text-message appointment reminders and test results. AIDS patients are helped to keep to adhere to complicated drug regimens by text in Australia, and German researchers are examining how text messages can offer psychological support to bulimics.

The San Francisco Health Department started a texting service for sexual-health information last year, in response to rising venereal disease rates among adolescents and young adults. A text-message number was extensively advertised on posters, and on public transport and urged young people to call and they will get texted responses to common questions. This is similar to a programme running in the UK aimed at the same age group, and in case you wanted to know, the top three messages that were accessed by users were:

1 “what 2 do if ur condom broke,”
2 “2 find out about STDs,”
3 “if u think ur pregnant”

For the older generation, yes I do know how to spell, and those messages are exactly as they appear on the phone! It’s why I struggle with texting, I spell everything in full which takes me so long it’s much quicker just to phone someone!

Antiseptic Health Wipes – Proof Positive?

You know that theory that for every action there is an equal and opposite reaction? It certainly seems to apply to any new product development as the report in the British Medical Journal of 1 December seems to prove. Because there is such a prevalence now of bugs and viruses, the incidence of using antiseptic hand cleansing products has become much more widespread in public buildings and in our homes. However these various products from hand wipes to hand washing solutions usually contain alcohol in one form or another and there is now concern that they could be a problem to alcoholics.

Guy’s and St. Thomas’ NHS Foundation Trust did a study after investigating a case report on a patient known to have a history of alcohol dependence who displayed withdrawal symptoms even though he had not consumed alcohol for 24 hours. The patient arrived at the hospital and during admission was found collapsed, having vomited in the bathroom. He was holding an empty 500 ml bottle of alcohol hand rub with another such bottle next to him. His blood ethanol concentration at the time of collapse was nine times over the legal British driving limit and a potentially fatal concentration

The Trust then looked at hospital admissions related to children and adults exposed to alcohol hand wipes and it was found that during the 18 month period after alcohol hand wipes and hand rubs became widespread in use that 66% of the admissions were thought to result from intentional abuse. These cases all occurred within hospitals or nursing homes where their use ought to be strictly monitored, though it appears that in a normal adult as little as 360 ml of an alcohol hand rub containing 80% ethanol might potentially lead to life-threatening complications.

Any ill effects generally occur within one to two hours after ingestion and usually have symptoms of gastric pain and vomiting. More serious effects involve central nervous system depression, leading to aspiration and respiratory arrest. According to the toxicologists who wrote the report, the more serious effects are seen in those who ingest more than 500 ml of hand rub, and this is most likely to occur in confused patients and alcohol abusers seeking the desired effect.

Diabetes and the Younger Generation

First the bad news: the onset of type 2 diabetes appears to be rapidly increasing for people in their twenties. This is an age group that most doctors traditionally wouldn’t think about diagnosing for diabetes, but the evidence shows that it is now a serious factor.

Diabetes Care magazine this week ran a report from the University of Michigan study that showed there had been a 40 per cent increase in hospitalisations related to diabetes among those aged 20 to 29. Joyce Lee, M.D. and her colleagues studied data from the period 1993 to the end of 2004 and one of the conclusions they reached was that this huge increase probably was reflecting the physiological connection between obesity and type 2 diabetes. Throughout the Western world, and particularly in the USA and UK, there has been an unprecedented rise in childhood obesity. This is due to the change in diet, which has many youngsters consuming far more empty calories from snacks such as crisps and carbonated soft drinks, and this has unfortunately been mirrored by a corresponding decrease in physical exercise and activity.

Interestingly the rate of increase of childhood diabetes has remained fairly stable, leading to the possible conclusion that damage done in childhood from diet takes some time to take effect, and that most people on leaving school undertake far less exercise than they did when younger.

Now the good news: do you know anyone under the age of 30 without a mobile phone? Texting is as automatic as breathing to most young people, so some health practices are taking advantage of this to track individuals with acute and chronic medical conditions such as asthma and diabetes. This group may not respond well to conventional follow up methods, but they always check their messages so this one way to ensure that the message about medication and specific health practices is getting through. For example, in one study in Scotland, young diabetics could send a text message to their doctor to check how to modify their insulin treatment after eating certain foods, or drinking alcohol at a party.

Mobile phones and Autism Link

Do you know a child who doesn’t have, or want, their own mobile phone? There are good practical reasons for giving children a way of being in touch when away from home, but there is now new research that links mobile phone use and autism. Rates of autism, a disabling neurodevelopmental disorder, have increased nearly 60-fold since the late 1970s, with the most significant increases occurring in the past decade. The cause of autism is unknown, although theories include such potential causes as:

* Genetic predisposition

* Inability to clear heavy metals

* Increased vulnerability to oxidative stress

* Environmental exposures including mercury preservatives in vaccines

* Trans-generational accumulation of toxic heavy metals

Now a groundbreaking new theory has been suggested by a study published in the Journal of the Australasian College of Nutritional & Environmental Medicine. They believe that it is electromagnetic radiation (EMR) from cell phones, cell towers, Wi-Fi devices and other similar wireless technologies that are an accelerating factor in autism.

The study involved over five years of research on children with autism and it found that EMR negatively affects cell membranes, and allows heavy metal toxins, which are associated with autism, to build up in the body. The researchers pointed out that autism rates have increased concurrently along with the proliferation of cell phones and wireless use. EMR from wireless devices (such as laptops, bluetooth etc) works in conjunction with environmental and genetic factors to cause autism.

EMR, the researchers say, could impact autism by facilitating early onset of symptoms or by trapping heavy metals inside of nerve cells, which could accelerate the onset of symptoms of heavy metal toxicity and hinder therapeutic clearance of the toxins.

What’s the solution? At present there doesn’t seem to be one. Research on the potential health effects from mobile phone technology is evaluated periodically by the Government’s Health Protection Agency s Radiation Protection Division after the Stewart Report in 2000 recommended further research as part of an overall precautionary approach to the use of mobile phone technology. The independently managed Mobile Telecommunications and Health Research (MTHR) programme, jointly funded by Government and industry, was set up in 2001 in response to the Stewart Report recommendations. It is currently supporting a number of studies into the possible health effects but there is no definitive answer as yet. My suggestion? Seriously limit mobile phone use – especially for children – and my feeling is that being available 24/7 by phone is hugely stressful and is a health hazard in itself so switch it off unless it is an essential call! My mobile is off until I need to check my messages or call ahead about a delayed appointment.

In fact my mobile message is very specific it says ‘I do not leave this mobile switched on so do not leave a message unless you are prepared for it not to be picked for several days. Leave a message on my home phone instead’. Worth a try?

Red Wine Blues

I am one, among many apparently, who have had to give up drinking red wine because it gives me a headache. I can avoid that mostly by sticking to organic red wine, and just having one glass, but scientists at the University of California have developed a new device may be able to detect the chemicals in red wine that lead to the dreaded post-red headache.

The chemicals are called biogenic amines, and they’re found in a variety of fermented foods including wine, cheese, olives, nuts, cured meats and chocolate. The specific red wine headache is thought to be caused by two amines called tyramine and histamine, but other potential causes also exist. Red wine and sake were found to have the highest amine levels so if they are your tipple of choice then a sensible interim solution if you are susceptible to such headaches, is to avoid amine-rich food and drinks because, aside from headaches, amines can also trigger high blood pressure, heart palpitations and elevated adrenaline levels. None of which are desirable drinking companions.

The new detector, which is the size of a small suitcase, can analyse a drop of wine and determine its amine levels in five minutes. Don’t worry, they know how ridiculous you would look lugging a suitcase along to a restaurant or dinner party, so they are now in the process of developing a pocket-sized version that you can take with you. Quite how your hosts- or the sommelier – would react is another matter as my experience has been that is the very cheapest wines that have the highest number of chemicals.

Only a scientist wouldn’t think this through to the end-user stage but they could always develop a tiny first aid kit to cope with the reaction to your using it!

Lead-free for Christmas

Christmas means toys but if you are not careful it could also mean poison. The health dangers of lead are well known, and can cause blood and nervous system disorders, and even lead to death in extreme overdose cases. Children are particularly vulnerable, and although the recommended international safety limit is 0.06%, (the UK limit is 0.1%), experts believe that even such low levels can affect children’s intellectual development.

Dr Gill Lewendon, acting director of public health for North and East Cornwall Primary Care Trust, has carried out research looking at the effect of lead on children and she has said, ” research suggests there’s actually no safe level of lead in the blood.” Although she is conscious of the success achieved in reducing lead levels by introducing lead-free petrol and taking lead out of paint the reality is that some items do slip through. Children’s toys often find their way into their mouths so there has been a highly effective campaign that has made using lead based paint in children’s toys virtually unknown in the UK. However, imports are a different matter and China in particular does not have a good track record in this instance. Although there is legislation covering toys imported here, there is nothing covering children’s jewellery and high levels of lead have previously been found in such items. Shopping for Christmas, be aware of this and check the point of origin of anything you are buying.

Also, if you are planning on buying yourself a new computer this Christmas the good news is that the Intel Corp. has announced plans to stop using lead as a soldering agent in its microprocessors. Lead is particularly useful as a semiconductor, due to its specific electrical and mechanical properties. Intel began phasing out the use of lead in its products in 2002, with the introduction of a tin-silver-copper soldering alloy. This alloy had replaced lead as a soldering agent in nearly all Intel chip sets and processors by 2004, with the exception of 0.02 grams of lead that continued to be used inside each chip. This small amount will now be eliminated entirely by using a tin-silver-copper alloy, beginning with the Penryn line of processors. The company plans to have its microprocessors be lead-free by the end of this year, and to phase out lead in its 65-nanometer-process chips in 2008.

Science Fiction Comes to Life

In my teens I was a great science fiction fan, particularly the ‘golden age’ of the 1930′s to the 1950′s. I have watched bemused as so much they wrote about has come true. The idea of a meal in a box ready in minutes in a small microwave was laughable in the 1950′s and the replacing of currency with plastic was another source of entertainment. These guys were clearly highly creative, and mad as hatters. However, one of the final areas of their predictions is now in sight. Personalised medicine, where you get treatment specifically tailored to your unique genetic profile, has been one of the main dreams of the gene revolution and it was hoped that, but putting it into practice is proving tough. The decoding of the human genome in 2000 sparked hopes that a new era of tailored medicine was just around the corner and although small advances have been made it is now looking like another 20 years before it is a true reality. In fact, uncovering the genetic differences that determine how a person responds to a drug, and developing tests, or biomarkers, for those differences, is proving more challenging than initially hoped. At the Reuters Health Summit in New York last week, major drug manufacturers met to discuss this new field of Pharmacogenetics and although they could not promise widespread innovation in the short term they are optimistic that there will be very specific examples available that are currently being developed.

We are all aware of the ‘hit and miss’ prescribing that goes on – particularly for complex diseases like depression – where an individual’s reaction to the prescribed drugs are so variable and that frequently many different prescriptions have to be tried before finding the combination, or single drug, that makes the difference.

It will make future prescribing infinitely more accurate, with no risk of adverse drug reactions, so although it is not here yet, it really is on the way.

Alternative Screening for Colon Cancer

A colonoscopy is the normal method of screening for colon cancer, but it is invasive and unpleasant.

Now there is news of an alternative method called computed tomographic colonography (CTC) which has been developed over the past few years. This method is also known as “virtual colonoscopy” because it’s minimally invasive, requiring a catheter to be inserted into the rectum to fill the colon with air, followed by non-invasive optical scan. It may be less invasive, but is it as effective in detecting colon cancer? A study in the New England Journal of Medicine reported this month on US researchers at the University of Wisconsin Medical School who set out to find the answer. They compared similar numbers of patients who had undertaken one or other of the screening methods and found that with traditional colonoscopy screening 123 advanced tumours were found, compared to 121 in the CTC group which is not a significant difference statistically, but vital to the two people whose tumours were detected.

There is a drawback to traditional screening in that perforating the colon during the procedure is a risk, and in fact this occurred on 7 occasions during the study while it is obviously not a risk with CTC.

Another difference is that traditional colonoscopy routinely removes all polyps that are detected, and in fact 2,434 were removed as against only 561 for those having CTC screening. This huge difference is not about whether the polyps are detected, but arose from the fact that patients were given the option of leaving very small polyps in place or undergoing an additional procedure to remove them. It’s certainly true that very small polyps may never become a problem, but with a traditional colonoscopy they are automatically removed before they can develop further. However, in the Wisconsin study 8% of the patients underwent a follow-up colonscopy after undergoing CTC.

On balance the researchers concluded that traditional colonoscopy was still the safest and most effective screening treatment at the moment.

Preventing Childhood Allergies

As any parent will tell you, the rise of allergies amongst children is almost epidemic with asthma being a particular concern. To avoid lengthy testing and treatment prevention has got to be the better option.

There is now evidence from a Spanish study on children from birth to 6 years of age that if their diet has over 40 grams of vegetables daily (about a third of a cup) then they were less likely to suffer with symptoms of childhood asthma.

The study showed that some vegetables were more effective than others and these included cucumber, tomato, aubergine, green beans and courgettes. If you want to really protect children from inherited childhood allergies, the study done in Menorca also showed that if the same children were given small, regular, helpings of omega-3 fish such as mackerel, tuna, herring, sardines or salmon then they were less likely to from genetically inherited childhood allergies.

How do they do that? These vegetables and the oily fish contain high levels of antioxidants and are also anti-inflammatory. This means that they produce a protective and healing effect on the bronchial passageways thus offering some protection from allergies and asthma.

Decaffeinated doesn’t always mean caffeine-free

Did you know you can get withdrawal symptoms like headache and sluggishness from just 100mg of

caffeine? That’s why many people choose to reduce their caffeine intake for their health’s sake and switch to decaffeinated coffee for at least part of their daily consumption. They do this on the confident belief that when they see the words ‘caffeine-free’ that meant that the product contained no caffeine or at least only very tiny amounts. However, that is not the case as the people from the Consumer Reports organisation recently found out.

They sent out a team of ‘secret shoppers’ with the arduous task of buying cups of decaffeinated and ‘normal’ coffee from six major US concerns: Starbucks, Dunkin’ Donuts, Seattle’s Best, 7-11, McDonald’s and Burger King. At least four of those brands are available in the UK and Europe and the results were not impressive when the different coffees were analysed for their caffeine content.

If you drink a can of coca cola or pepsi – the regular kind – you are getting around 30mgs of caffeine, but you get over that (32mg) if you got a decaf from Dunkin’ Donuts. Containing a third less caffeine, but still weighing in at a whopping 20mg was Starbucks. If you want to get coffee with the lowest caffeine levels (in a decaffeinated blend) then McDonalds came out best with less than 5 mgs.

If you like your caffeine content to be high, then again the amount varies wildly. In a 120z cup the levels ranged from 58-281 mgs – and at that highest level it’s practically giving your nervous system the equivalent of an electric shock.

What’s the answer? Don’t worry so much about the levels, but monitor the effect on your nervous system – if the coffee revs you up and boosts your adrenalin levels so you feel an increased heart rate, or perhaps jumpy and nervous, then you know you are getting a caffeine hit – whatever the label says. Herb tea anyone?

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