Capsules cough Tessalon fluid for children in custody by the FDA (Medical News Today)

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Main category: Pediatrics and children's health
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FDA warns that liquid capsules Tessalon (benzonatate) can have serious and sometimes fatal consequences for children under the age of 10 years who accidentally ingest. Drugs should be kept out of reach of children and child-proof containers.

Tessalon is hereby approved for the relief of the symptoms of cough in patients aged 10 years or more. The FDA (Food and Drug Administration) warns that younger children can be attracted by it because of its round gelatin capsule filled with liquid, giving him a candy appearance.

The safety and effectiveness for children less than 10 years only has not been established by the Tessalon agency adds.

Carol Holquist, R.Ph., Director of the Division of prevention of medication errors and analysis, the FDA said: "Benzonatate should be kept in a child resistant container stored out of reach of children." The FDA encourages health professionals to care for children with their patients and those at risk of accidental ingestion or overdose. "Intake accidental among children aged ten years seven cases have been reported since 1982, depending on Adverse Event Reporting System database of the Agency. Five of them every year up to two years, has died. A child under the age of two must ingest one or two capsules benzonatate for risk of death to become a reality.

The following adverse effects have been reported form child overdose - cardiac arrest, convulsions and coma.

For 15 to 20 minutes to take the drug overdosed child will have the signs and symptoms. Some children died, did so within hours of accidentally taking the medication.

A new implementation and precautions section is added to the benzonatate drug label. The goal is to warn doctors and other professionals of the health hazards of accidental overdose and ingestion in younger children.

Health professionals and consumers are encouraged to report adverse events or benzonatate, use the FDA's MedWatch Adverse Event Reporting program-related medication errors.

Source: FDA

Written by Christian Nordqvist
Copyright: Medical News Today
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Scientists spot genetic areas key to embryonic development (US News)

(Wednesday, December 15, HealthDay News) - American scientists have pinpointed 2,000 genetic regions which play a crucial role in human development at the beginning.

Regions, called enhancers, activate the expression of genes, as embryonic stem cells begin to divide to form tissues of embryo in more and more, explains the main study, Joanna Wysocka, biology of development and chemical biology and systems at the school of medicine, Stanford University assistant professor author.

"It is clear that these amplifiers are becoming active at specific times during development," Wysocka said in a University Press release. "Now we have more than 2,000 items that can be used to study the development and isolate the transitional cell populations."

The study was published online 15 December in nature.

"This will be a tremendous resource for researchers who are interested in locating cells involved in human development at the beginning," said Wysocka. "It will be very interesting to learn how these amplifiers affect gene expression in each cell type.

More information

The U.S. National Library of Medicine, says the development of the fetus.

SABCS: "sandwich" for early cancer therapy (CME / CE) (Med Page today)

SAN ANTONIO -- Women with early breast cancer finished treatment sooner with no loss of local control or increased toxicity when radiation therapy was sandwiched between chemotherapy cycles, results of a large randomized clinical trial showed.

Moreover, the possibility of a small improvement in local control could not be excluded for patients who received synchronous (sandwich) radiation versus those who received radiation and chemotherapy sequentially.

"It is certainly feasible to give sandwich treatment without a significant increase in toxicity," Indrajit Fernando, MD, of the University of Birmingham in Birmingham, England, said here at the San Antonio Breast Cancer Symposium.

"It undoubtedly shortens the treatment time. It has no disadvantage with respect to local control, dose intensity of chemotherapy, delays in radiation therapy, or survival. There may be a 2% benefit in locoregional control."

The optimal sequence for chemotherapy and radiation therapy in early breast cancer remains undefined, said Fernando.

A study published 15 years ago showed borderline improvement in five-year local control with radiation followed by chemotherapy versus administration of chemotherapy before radiation (N Engl J Med 1996; 334: 1356-1361). After 11 years of follow-up, however, the difference had disappeared (J Clin Oncol 2005; 23: 1934-1940).

A sandwich strategy for radiation and chemotherapy has the potential to shorten treatment duration and improve convenience and quality of life for patients, said Fernando. However, the impact of such a strategy on local control or toxicity was unclear.

To clarify the potential role of sandwich sequential therapy, investigators at 49 centers enrolled 2,296 patients with early invasive breast cancer. Following wide local excision or mastectomy, the patients were randomized to sequential or synchronous adjuvant therapy.

Sequential treatment started with chemotherapy (CMF, anthracycline-CMF, or another commonly used regimen), followed by radiation therapy after completion of chemotherapy.

The protocol for synchronous therapy varied according to the radiation therapy schedule. The study allowed schedules that ranged from 39 Gy administered in 13 fractions over five weeks to 40 Gy/15 over three weeks to 50 Gy/25 over five weeks. In most cases, the 15-fraction regimen was administered between cycles two and three of CMF or between cycles five and six of anthracycline-CMF.

Patients treated in more than 15 cycles received radiation concurrently with chemotherapy but at the same intervals as in the sandwich strategy.

The patients had a mean age of 51 to 52, 55% to 56% had breast-conserving surgery, and three-fourths underwent complete axillary lymph node dissection. Fernando said the treatment groups did not differ with respect to tumor size, tumor grade, or extent of nodal involvement.

The primary endpoint was locoregional recurrence. After a median of 8.8 years of follow-up, the five-year locoregional relapse rates were 5.4% with synchronous therapy and 7.4% with sequential therapy, an 18% reduction which was nonsignificant in the hazard for recurrence (P=0.19).

An analysis limited to in-field (local) recurrence at five years yielded a statistically significant advantage in favor of synchronous therapy (2.8% versus 5.9%, P=0.05). Subgroup analysis showed a consistent pattern favoring synchronous therapy, regardless of nodal status, tumor size, tumor grade, type of chemotherapy regimen, and excision margin.

The five-year overall survival was 83% with synchronous therapy and 82% with sequential, and five-year disease-free survival was 79% versus 78%.

Fernando said synchronous therapy modestly increased the incidence of skin toxicity and telangiectasia (primarily with more than 15 fractions). Chemotherapy dose intensity was similar in the two treatment groups, as was the frequency of delays in radiotherapy greater than seven days.

Use of marijuana and adolescent alcohol downwards (Denver channel)

POSTED: 8: 01 pm MST on December 14, 2010UPDATED: adolescents 14 December 2010 8: pm MST WASHINGTON- Bush's use of marijuana and less alcohol, according to a study of the Government of the eighth - annual, 10th and 12th graders across the country. Some 6.1% of persons aged school reported using marijuana this year, from 5.2% in 2009, in accordance with the monitoring the future survey released by the National Institutes of Health. Use of marijuana by 10th-graders rose by 2.8% to 3.3% and for the students of eighth - edged place 1.0 to 1.2%. "These high rates of adolescent marijuana use and years groups when the brain continues to grow, place particularly our young people at risk", said Dr. Nora d. Volkow, Director of the National Institute on Drug Abuse. On the other hand, binge drinking are on the decline. Although 23.2% of high school seniors reported five drinks in a row, which is low by 25.2% or more a year earlier. Excessive consumption for this age group rate peaked at 31.5% in 1998. Other topics, the survey revealed:-use of ecstasy, which had declined at the beginning of the 2000s, is on the increase again. -There is a small increase in adolescents to inject heroin, but only among 12th-graders. -L' cocaine use has remained low after the lower levels in the 1980s and 1990s. The survey conducted by the University of Michigan covered 46,482 students in schools 396. Copyright 2010 by the Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.The following feedback from our users. The opinions expressed are not created or endorsed by TheDenverChannel.com. By posting a comment, you agree to accept our conditions of use. Comments are moderated by the community. To report an offensive or otherwise inappropriate comment, click the "Flag" link that appears under this comment. The comments reported by a number of users will be automatically deleted.

Release of stress and anxiety - learn how to breathe fully to live everything! (Self-improvement Blog)

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By Donna Packard.

Do you know that most people are breathing barely enough to be alive? Most people breathe in a shallow manner, just bringing the breath barely into the chest. We have been conditioned to hold in our stomachs, and to wear tight clothing, inhibiting our ability to breathe fully. Have you watched a new baby breathing? The baby's belly rises with the inhales and falls gently with the exhales. It's kind of like watching the ocean waves rising and falling in a natural rhythm. There is no pause between the inhales pp. exhales. This is our natural breathing rhythm.

Many of us have shut down our breathing, and no longer breathe in this natural rhythm due to stressors, repressed emotions, fears, anxiety, etc that we have experienced throughout our lifetimes. Think of what happens when you get equal in traffic, for instance. Chances are you are holding your breath.

Our culture has taught us to repress many of our emotions and feelings. If someone is crying, what do we do? We try to get them to stop, where, if we simply allowed them this space to feel, they would move through the feelings, or 'storm', clearing them from their emotional and physical bodies. It's like the ocean that has and clears to peaceful sea storms. Unfortunately, when we repress feelings, they are held in the body's memory and we begin to breathe in a more shallow way to hold the in feelings.

Additionally, we carry a lot of stress in our bodies. If we are breathing fully, we cannot hold stress in the body. Yet, most of us carry stressors around for many years! For instance, let's say you have an argument with a loved one or a boss or friend. Your stress level goes way up, and, ideally, it would be best to find a way to relax and bring it back down as soon as possible. Instead, you carry it with you.You think about it later in the day and your stress level rises again. You may think about it the next day and the same thing happens, or months later. Sometimes years later, you are still carrying that residual tension around with you. And, chances are, you are not breathing as fully because of it This is where we get into trouble for carrying this around with us leads to dis-ease stress. Most diseases are related to stress in one form or another. I have heard that cancer cannot live in cells that are oxygenated and there are studies that show that heart patients have not had reoccurence of their problems once they learned to breathe fully.

It's also fascinating how when we learn to breathe fully, not only do we learn ways to relax and relieve stress, we begin to live more fully. It is as if we get back in touch with what is in our hearts, our True Selves, and, often, we also reconnect with our source, in whatever form and we each view that way. In working with hundreds of people over the years, teaching them how to repattern their breathing, I have witnessed many many people finding a place of inner serenity of peace. Oftentimes, they were embraced by the consciousness of pure love.

So, I ask you, in this moment, to take a breath in and out. Does your breathing feel restricted? Ideally, a full breath fills your belly like it is filling a balloon, then rises up through your chest and then releases freely. It may be likened to the ocean waves, where the wave rises in the belly, flows into the shore (the chest) and then flows back out, as the exhales. And, then again in flows, with no pause between the inhales and exhales, in a perfect circle of breathing, flowing in and out freely.

It may be helpful to imagine you are filling a jug with your breath. You fill all the way to the bottom when inhaling, the bottom being the top of your pubic bone and then filling the jug with the air all the way to the top, which you may imagine as the throat area or even to the top of your head.

I invite you in this moment, to practice breathing fully and freely.

Exercises:

1 Lie down and place one hand on your abdomen and one hand on your chest. Breathe in your normal fashion. Which hand rises as you inhales? Since many people are shallow some breathing only into the chest. You may find that the hand on the chest raises up with the inhales. Bringing the practice inhales deep into your belly and fill your belly with the air, like you are filling a balloon. You may want to place a small pillow on your abdomen to see if it is rising as you inhales. (One woman I worked with would have her small dog lie on her belly to watch to see if it she was raising him up and down as the breath moved into her belly:) This type of breathing may take practice and, at first may seem like a lot of work. Yet, in the end, you will be happy you learned to breathe deeply. Getting the breath into your belly is the first step.

2 Once you are able to breathe deeply into your belly, as in step 1. above, next you want to practice bringing the breath into your belly, as above, and then continues to bring it from there up through your chest and heart, and then release it. Breathe in, pull up and release. Do not force the exhales, let it fall like a sigh. Then breathe in again, with no pause between the exhales and inhales and breathe again deeply into your belly. Practice for 5 minutes to start.

3 Begin to notice throughout the day whether you are breathing or not. You may find various times you are holding your breath or not fully breathing. Remind yourself from time to time to take a deep breath! The more fully you breathe, the more fully alive you will be.

When you begin breathing more fully, at first, you may experience different sensations in your body which may not be used to getting as much oxygen. You may tingling feeling in your hands, or face, or feet, or other places. You may feel uncomfortable feelings in various parts of your body at first. You may feel feelings! Just feel what you feel and keep breathing through it! Know it is safe to breathe! The breath carries what gives you life.

Breathe Fully and Live Fully!

Many blessings and remember to Breathe Peace in each moment, Donna, m.ed., "The Inspirer" http://www.BreathePeace.com

Copyright 2009 Donna Packard. All rights reserved. Please feel free to pass this along lesson, or reprint it, and prompt / encourages others to be a part of the Breathe Peace movement. Just be sure to include my name as the author and the website contact information as listed above.

I invite you in this moment to Breathe Peace, Donna l. Packard, m.ed., "The Inspirer"
http://www.BreathePeace.com
E-mail: info@breathepeace.com

Relax, reconnect, move into a consciousness of love. Learn to Breathe Peace.http://www.breathepeace.com for free mini-lesson series, information, resources,
and more!

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http://EzineArticles.com/?Release-Stress-and-Anxiety—Learn-to-Breathe-Fully-to-Live-Fully!&ID=2296262

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Healthy habits slash AMD risk (CME / CE) (MedPageToday)

Women who exercise, eat right, and don't smoke could cut their risk of developing age-related macular degeneration (AMD) by more than two-thirds, a large observational study suggested.

Compared with sedentary smokers who ate lots of fatty processed foods, participants in the Women's Health Initiative (WHI) Observational Study who had healthy lifestyle habits were found to have an adjusted odds ratio of 0.29 for developing AMD over a six-year span (95% CI 0.09 to 0.75), according to Julie A. Mares, PhD, of the University of Wisconsin in Madison, Wis., and colleagues.

"Adopting these healthy habits may markedly lower the prevalence of early AMD, the number of people who develop advanced AMD in their lifetime, and healthcare costs associated with treatment for this condition," Mares and co-authors wrote online in Archives of Ophthalmology.

The findings came from the Carotenoids in Age-Related Eye Disease Study (CAREDS), an ancillary study associated with the WHI, involving 1,313 women ages 55 to 74 at baseline. CAREDS was designed to assess the role of carotenoid compounds in age-related eye diseases, including AMD.

Participants were recruited from a sample of women who had provided detailed dietary and lifestyle histories as part of the WHI an average of six years before AMD was assessed -- making them a nearly ideal sample for examining links between behavioral factors and AMD -- a leading cause of vision loss among U.S. adults ages 60 and older, the researchers noted.

Of the 1,313 CAREDS participants, 202 had signs of AMD seen with stereoscopic fundus photography after a mean of six years. All but 6% had early-stage disease.

Self-reported diets at baseline were scored according to the content of relatively healthy foods, such as whole grains, vegetables and fruits, and milk, as well as unhealthy foods including saturated fats, sodium, and added sugar.

Responses to questionnaire items on recreational and household physical activity were translated into estimated energy expenditures, expressed as metabolic energy task-hours (MET-hours) per week.

For analytical purposes, diet scores and activity levels were categorized into quintiles.

The highest quintile of diet scores, reflecting good eating habits, was a range of 70 to 80. Scores for the lowest quintile were 42 to 59.

Activity scores for the highest quintile were 25 to 119 MET-hours/week, whereas participants in the lowest quintile had no more than 2 MET-hours/week of activity.

Associations with AMD risk were about equal for diet and exercise, the analysis showed.

Comparing the highest with lowest quintiles -- and adjusting for age, smoking status, diabetes, cardiovascular disease and other potential confounders -- odds ratios were 0.54 for diet (95% CI 0.33 to 0.88) and 0.46 for physical activity (0.27 to 0.78).

Smaller reductions in AMD risk were seen for participants in other quintiles of diet and exercise, but the trends were highly significant: P=0.01 for diet scores and P=0.002 for exercise.

Smoking by itself was not a particularly strong risk factor for AMD in this study. Compared with participants who never smoked, those with a history of eight to 125 pack-years of smoking had an adjusted odds ratio for AMD of 1.45 (95% CI 0.98 to 2.12).

But all three factors combined were a powerful indicator of AMD risk -- in contrast to women in the top quintiles for good diets and exercise who had a 71% lower risk for the degenerative eye disease.

The odds ratio for AMD among those in the fourth quintile of a composite "healthy living index" was 0.53 (95% CI 0.32 to 0.87), the researchers found.

The risk reduction was also significant for the third quintile (OR 0.62, 95% CI 0.40 to 0.96).

The observational study provided no hard evidence for a causal mechanism, but Mares and colleagues suggested that healthy lifestyles may keep blood pressure down, which, in turn, could reduce AMD risk.

Behavioral factors can also affect the composition of macular pigment, they indicated, potentially making the macula more or less vulnerable to various pathologies such as oxidative damage.

Limitations cited by the authors included the use of self-reported diet and exercise levels, nonrepresentative socioeconomic status in the study sample, and a lack of genotype information on the participants.

The latter is important both because family history is a known risk factor for AMD and because some gene variants have been specifically linked to the condition.

Wrote Mares and colleagues, "[the study] results also serve to remind us that risk for AMD is passed to subsequent generations not only through genes but also possibly through the lifestyle habits we model and encourage."

The analysis was supported by the National Eye Institute.

The Women's Health Initiative is funded by the National Heart, Lung, and Blood Institute.

Mares reported no potential conflicts. One co-author has consulted for EyeTech, served on an advisory board for Abbott, and received research funding from Alcon, Novartis, Ophtherion, Genentech, Alimera, Sirion, EyeTech, Regeneron, Pfizer, Thrombogenics, and Occulogix.

Major challenge for mediation in Medical Malpractice: doctor participation (WSJ)

A study of mediation in cases of medical malpractice finds this approach possible benefits, including lower costs of litigation and a reduction in medical errors. A key ingredient missing, however, is the doctors themselves.

The study, published in the journal of Health Politics, Policy and Law, looked in 31 cases mediation in non-profit hospitals in New York. As defined by the study, mediation is a "conflict voluntary, confidential resolution process in which a third party neutral party, the Ombudsman (or co-mediators), helps the parties to negotiate a mutually acceptable solution."

One of two principal investigators of the co-mediated in almost all cases, and conducted interviews with participants subsequently law students study.

In these cases, 16 were settled at mediation, 5 settled subsequently and 10 have not been settled. While defence counsel are least likely to agree to mediation that counsel for the plaintiff lawyers who engages reported satisfaction with the process, such as "the applicants, the representatives of the hospital and the insurers," the study concluded.

The authors write that in no case have physicians participate in mediation. Lacking some of the possibilities - first "repair the relationship between human beings," it is the doctor-patient (or family of the patient), Carol Liebman, co-author of the study, a Professor of law at the Faculty of Columbia law school mediation clinic Director tells health Blog. " It also misses the opportunity to gather information from patients, families and physicians to fill the empty spaces of what is really past, and if there is an error, how to prevent it from happening once again, she says. Used in the study mediation approach holds that any important information to someone at the table, not only what is legally relevant can be discussed. (The information disclosed during mediation are confidential).

When you do not have the participation of "the person who is involved in these decisions, the day and the day, you get valuable information", Liebman said. "Use of a lawyer is to defend the case not reshape politics." Mediation, says, offers the possibility to improve patient safety in a dispute in a way impossible.

Counsel cited as a pattern of absences physicians complete work schedules, the study found. Liebman believes that many things are underway. "Doctors and nurses care much about their work and they feel horrible when something go wrong", she says. "They want to talk about their patients, but it is not easy to do." They are also probably discouraged from attending by the directors of the hospital and the lawyers who think in advance so that if the case goes to trial.

Doctor health blog readers, never would you consider mediation if involved in a malpractice lawsuit medical?

Image: courtesy