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(Media-Newswire.com) – This document provides updated information on obesity and morbid obesity as risk factors for serious 2009 H1N1-related complications based on findings from recent studies.

How are obesity and morbid obesity defined?
Body mass index ( BMI ) is a measure of body fat based on height and weight. Obesity is defined as a BMI of greater than or equal to 30 kilos per meter squared and morbid obesity is defined as a BMI greater than or equal to 40 kilos per meter squared. Among Americans 20 years and older, 28% are obese and 5% are morbidly obese.

Have obesity or morbid obesity been considered risk factors for serious flu-related complications in the past?
The Advisory Committee on Immunization Practices considers that certain chronic health conditions place persons at higher risk of serious flu related complications, including asthma, diabetes and heart disease, and emphasizes the importance of vaccination in people with these health conditions. In the past, neither obesity or morbid obesity have been considered independent risk factors that would place people at higher risk for serious flu-related complications.

What has been learned from the 2009 H1N1 pandemic about obesity and risk of serious influenza disease death?
During the 2009 H1N1 pandemic, early reports from the United States and abroad suggested that obesity was more frequent among persons hospitalized with 2009 H1N1 disease or who died following 2009 H1N1 infection.

Since that time, a number of studies have suggested that many 2009 H1N1patients tend to be morbidly obese. The study “Morbid Obesity as a Risk Factor for hospitalization and Death due to 2009 Pandemic Influenza A ( H1N1 ) Disease,” published in PLoS ONE, sought to determine whether or not obesity or morbid obesity were in fact independent risk factors for serious 2009 H1N1-related complications, including death.  This study found that morbidly obesity persons have a higher risk of hospitalization for 2009 H1N1 infection compared to persons with normal weight. Data from this study also suggest that the risk of death following H1N1 infection may be higher for morbidly obese individuals.

What has been learned from the 2009 H1N1 pandemic about morbid obesity and risk of death?
People who are obese or morbidly obese may be at a higher risk of dying from 2009 H1N1, even without any other previously recognized high risk conditions.

Should obesity be considered a high risk condition?
Scientific findings to date, including the PLoS ONE study, support the conclusion that people who are morbidly obese are at increased risk from complications of 2009 H1N1; these individuals should get vaccinated against it and should be treated early with antivirals if they do become sick. It is unclear based on this study, however, if a casual relationship exists between obesity and severe complications from 2009 H1N1 independent of other factors.

What should morbidly obese people do based on these findings?
Getting a flu vaccine is the most important action people can take to prevent influenza and its complications.  Because people who are morbidly obese are at a higher risk of serious 2009 H1N1-related complications, it’s especially important that they get vaccinated against 2009 H1N1.

With the ACIP recommendation on February 24, 2010 to adopt universal influenza vaccination for the 2010-2011 season, everyone 6 months and older is now recommended to get an annual flu vaccination.  Next year’s seasonal influenza vaccine will contain the 2009 H1N1 virus, in addition to two other viruses that research indicates are most likely to circulate during the upcoming season.

Losing weight by eating healthier and getting moderate physical activity several times a week can also improve one’s overall health and may lessen chances for developing severe outcomes from the flu.

What should clinicians do in terms of treating morbidly obese patients based on these findings?
Clinicians should evaluate morbidly obese patients with possible influenza illness for the presence of chronic medical conditions.  If these conditions are present, or if persons with morbid obesity show signs of lower respiratory tract infection or other signs of severe illness, these patients should receive empiric antiviral treatment as early as possible.  Earlier treatment of people with influenza who have a high risk condition such as morbid obesity can decrease the risk of severe illness and death.

Should morbid obesity be considered a high risk condition?
Yes. Morbid obesity, with or without the presence of other underlying high risk health conditions, is associated with a higher risk of 2009 H1N1-related hospitalization and, possibly death.

People who are morbidly obese often suffer from other medical conditions and it is possible that some people who are morbidly obese have unrecognized chronic medical conditions.

What other studies exist to support the conclusion that morbid obesity is a high risk factor?
Other recently published data discusses obesity as a high risk factor severe for 2009 H1N1-related complications:

Louie JK, Acosta M, Winter K, et al. Factors associated with death or hospitalization due to pandemic 2009 influenza A( H1N1 ) infection in California. JAMA 2009;302:1896-902.
Webb SA, Pettila V, Seppelt I, et al. Critical care services and 2009 H1N1 influenza in Australia and New Zealand. N Engl J Med 2009;361:1925-34.
Miller RR, 3rd, Markewitz BA, Rolfs RT, et al. Clinical findings and demographic factors associated with intensive care unit admission in Utah due to 2009 novel influenza A ( H1N1 ) infection. Chest 2009;[epub ahead of print].
Kumar A, Zarychanski R, Pinto R, et al. Critically ill patients with 2009 influenza A( H1N1 ) infection in Canada. JAMA 2009;302:1872-9.

HONG KONG — A newspaper article by one of China’s best-known investigative reporters has reawakened a controversy over whether provincial authorities improperly stored vaccines in rooms without air conditioning, rendering them ineffective, and then let them be administered to children.

China’s Health Ministry said on Thursday that it would look into the report, by Wang Keqin in the China Economic Times, while cautioning that it had examined the evidence in late 2008 and not found a widespread problem.

But Chen Taoan, the former chief spokesman of the Shanxi Province Disease Control and Prevention Center and still on the center’s staff, said in a telephone interview on Thursday that a senior official there had been relieved of all duties at the end of last year because of improprieties related to the vaccines.

Mr. Chen said that the center, which is part of the Shanxi Health Department, had required all hospitals in the province to buy vaccines at steep prices. To monitor compliance by the hospitals, the center put a sticker on each package of vaccine to show that it had been approved.

But the stickers would not adhere to the packages in air-conditioned rooms, Mr. Chen said, so the center routinely through 2006 and 2007 had the vaccines transferred to a warm room where the stickers were attached, Mr. Chen said.

“I saw boxes and boxes of vaccines piled up high like a hill in a hot room without air-conditioning,” he said. “Over the course of two years, I complained more than 30 times to the center’s leaders that these vaccines were no longer effective.”

Mr. Chen said that he was still on the center’s payroll but had been relieved of his duties because of his objections to the handling of the vaccines. The center stopped exposing the vaccines to heat in 2008 but did not recall those that might have already been damaged, he said.

The press office of the Shanxi Health Department declined to comment, saying that it had already made a statement to the official Xinhua news agency. Xinhua reported that Li Shukai, the deputy director of the department, had said that the China Economic Times article was “basically not true.”

The article said that the parents of 4 children who died and 74 children with severe illnesses were blaming the vaccines. Mr. Li told Xinhua that provincial health experts had examined some of the children and concluded that their problems were not caused by vaccines.

Mr. Wang said in a statement that he used pseudonyms to disguise the identity of many of the children in a list he published of those affected, and that the provincial authorities had not requested the true names of the children to check on their health.

Faced with complaints by parents like the ones in Shanxi Province, China’s Health Ministry faces a delicate balancing act between maintaining public confidence in vaccines and ensuring that any improprieties are punished.

World Health Organization data show that 99 percent of Chinese children receive all three doses of polio vaccine and 97 percent receive all three doses of a vaccine against diphtheria, tetanus and pertussis. They also show the percentage of Chinese infants receiving vaccinations for hepatitis B, one of China’s leading health problems, rose to 91 percent in 2008, from 76 percent in 2004, the earliest year the figures were reported.

Hilda Wang contributed reporting

source  http://www.nytimes.com/2010/03/19/world/asia/19china.html

THURSDAY, March 18 (HealthDay News) — The obesity epidemic is hitting children harder than ever, with 7.3 percent of boys and 5.5 percent of girls classified as extremely obese in a California study, researchers from Kaiser Permanente report. Click here to find out more! The news is even worse for black and Hispanic kids: Among black teenage girls, 11.9 percent were classified as extremely obese, as were 11.2 percent of Hispanic teenage boys. Extreme obesity among children is defined as weighing more than 1.2 times the 95th percentile, or having a body-mass index (BMI) of 35 kilograms per meter squared. “There is an alarming high frequency of extremely obese children,” said study author Corinna Koebnick, a research scientist at Kaiser Permanente Southern California Department of Research and Evaluation in Pasadena. Koebnick said the obesity epidemic is driven by a combination of lack of physical activity and poor eating habits. “It’s unhealthy eating habits — fast food versus slow food,” she said. Parents need to be role models for their children, Koebnick stressed. “There are studies suggesting parent’s weight has a significant influence on the child’s weight,” she noted. Extreme obesity can lead to serious health problems such as diabetes and heart disease, Koebnick added. “We need to watch these extremely obese kids more carefully, and we need to try to prevent adverse health effects that may come up in the near future,” she said. “Children who are extremely obese may continue to be extremely obese as adults, and all the health problems associated with obesity are in these children’s futures. Without major lifestyle changes, these kids face a 10 to 20 years shorter life span and will develop health problems in their 20s that we typically see in 40- [to] 60-year-olds,” Koebnick said in a Kaiser Permanente news release. Although these findings cover only children in southern California, Koebnick thinks they are representative of what is happening throughout the United States. The report is published in the March 18 online edition of the Journal of Pediatrics.

For the study, Koebnick’s team collected data on 710,949 children and teens aged 2 to 19 who belonged to Kaiser Permanente Southern California integrated health plan in 2007 and 2008. Using these data, the researchers found that 7.3 percent of boys and 5.5 percent of girls were extremely obese, which is more than 45,000 extremely obese children among all the children studied. Obesity peaked at age 10 for boys and age 12 for girls. The most extremely obese were black teenage girls and Hispanic boys. The least extremely obese were Asian-Pacific Islanders and white children, the researchers found. Samantha Heller, a dietitian, nutritionist and exercise physiologist, said that “the results of this survey are not surprising, but are heartbreaking when you consider the health consequences that these children will be facing, not to mention the social, emotional and psychological repercussions.” It is critical for parents to learn how to provide healthy food for their families, Heller noted.

“Healthy food can be affordable and delicious but consumers are led to believe that fast food, junk food and sweets are the easiest and cheapest way to go,” she said. The public is bombarded with food advertising that targets children, Heller said. The 2008 Federal Trade Commission Report to Congress found that more than $1.6 billion was spent in 2006 marketing food and beverages to children. “Imagine if that money, or even a fraction of it, was used to promote healthy foods like vegetables, fruits, whole grains and beans, and nutrition education for the public,” she said. “People would learn how to buy and prepare healthy foods on a budget and we could reduce the prevalence of obesity and chronic diseases like diabetes, heart disease and cancer, in our children,” Heller explained. “Health professionals, food companies and local and state governments need to find ways to help educate, motivate and empower adults and children to lead healthier lives before it is too late to save our children,” Heller added.

source : http://www.usnews.com/health/diet-fitness/diet/articles/2010/03/18/more-kids-now-extremely-obese.html

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By Salynn Boyles
WebMD Health News
Reviewed by Louise Chang, MD

Feb. 26, 2010 — In response to research confirming that even small elevations in blood sugar during pregnancy can lead to sick babies, an international panel of experts is recommending sweeping changes in how gestational diabetes is diagnosed.

If adopted, the changes would mean that in the future two or three times as many pregnant women would be diagnosed and treated for gestational diabetes.

About 5% of pregnant women in the United States receive a diagnosis of gestational diabetes.

But Northwestern University Feinberg School of Medicine Professor of Metabolism and Nutrition Boyd Metzger, MD, says closer to 15% of pregnant women and their babies would benefit from treatment.

“Current recommendations for the diagnosis of gestational diabetes are designed to identify women at risk for developing diabetes after pregnancy,” Metzger tells WebMD. “But we now know that many low-risk women with blood sugar levels considered normal in the past are at risk for having overweight babies.”

High-birth-weight babies have an increased risk for obesity and diabetes later in life, and women carrying large babies are at increased risk for premature delivery and C-section delivery.

WASHINGTON — The FDA has formally approved the enzyme replacement therapy velaglucerase alfa (VPRIV) — already okayed for pre-approval marketing — for pediatric and adult patients with Gaucher disease.  Gaucher disease is a rare genetic disorder affecting between 1 in 50,000 and 1 in 100,000 in the general population.

It limits production of the enzyme glucocerebrosidase, the lack of which allows fatty lipids to build up in the liver, spleen, bones, bone marrow, and nervous system.  Drug manufacturer Shire had been given the go-ahead in September 2009 to market the drug before formal approval to ease a supply shortage of imiglucerase (Cerezyme), the only drug then approved for Gaucher’s patients. (See New Gaucher Drug Goes to Market During Shortage)  Approval of VPRIV was based on clinical trials involving 82 patients ages 4 and older with Type 1 Gaucher disease, some of whom switched from imiglucerase.  “The approval of VPRIV will provide a safe and effective alternative treatment for patients with Gaucher disease,” Julie Beitz, MD, director of the FDA’s Office of Drug Evaluation III, said in a statement. “Patients who previously received Cerezyme as an enzyme replacement therapy for their Type 1 Gaucher disease can be safely switched to VPRIV.”  The most common adverse reactions to VPRIV are allergic ones, although headache; dizziness; pain in the abdomen, back and joints; nausea; fatigue/weakness; fever; and prolonged activated partial thromboplastin time have also been noted.

Source: www.medpagetoday.com/ProductAlert/DevicesandVaccines/18719

Dialysis is dialusis in greek language ,dia means through but lusis means loosening it is an artificial replacement of kidneys in case of lost kidney function.

According to National Kidney Foundation Dialysis is a treatment that does some of the things done by healthy kidneys. It is needed when your own kidneys can no longer take care of your body’s needs.

Hemodialysis machine

When your kidneys are healthy, they clean the blood and also make hormones to keep your bones strong and your blood healthy. But when your kidneys fail, you need treatment to replace the work your kidneys used to do. Unless you have a kidney transplant, you will need a treatment called renal dialysis.

There are two types of dialysis : hemodialysis and peritoneal dialysis.

Related videos:

Peritoneal dialysis

Preventing Hemodialysis Catheters Problems