Penting Sehat

Leafy greens top source of food poisoning in U.S.

Written By Unknown on Kamis, 31 Januari 2013 | 22.45

About 1 in 5 illnesses were linked to leafy green vegetables, the CDC found. (Rogelio V. Solis/Associated Press)

A big U.S. government study has fingered leafy greens like lettuce and spinach as the leading source of food poisoning, a perhaps uncomfortable conclusion for health officials who want us to eat our vegetables.

"Most meals are safe," said Dr. Patricia Griffin, a government researcher and one of the study's authors who said the finding shouldn't discourage people from eating produce. Experts repeated often-heard advice: Be sure to wash those foods or cook them thoroughly.

While more people may have gotten sick from plants, more died from contaminated poultry, the study also found. The results were released Tuesday by the U.S. Centers for Disease Control and Prevention.

Each year roughly 1 in 6 Americans — or 48 million people — gets sick from food poisoning. That includes 128,000 hospitalization and 3,000 deaths, according to previous CDC estimates.

It's estimated there are about 11 million cases of foodborne illness in Canada every year, according to the Canadian Food Inspection Agency's website.

The new report is the most comprehensive CDC has produced on the sources of food poisoning, covering the years 1998 through 2008. It reflects the agency's growing sophistication at monitoring illnesses and finding their source.

What jumped out at the researchers was the role fruits and vegetables played in food poisonings, said Griffin, who heads the CDC office that handles foodborne infection surveillance and analysis.

About 1 in 5 illnesses were linked to leafy green vegetables — more than any other type of food. And nearly half of all food poisonings were attributed to produce in general, when illnesses from other fruits and vegetables were added in. It's been kind of a tough month for vegetables.

A controversy erupted when Taco Bell started airing a TV ad for its variety 12-pack of tacos, with a voiceover saying that bringing a vegetable tray to a football party is "like punting on fourth-and-1." It said that people secretly hate guests who bring vegetables to parties.

Hygiene standards on farms

The fast-food chain on Monday announced it was pulling the commercial after receiving complaints that it discouraged people from eating vegetables.

Without actually saying so, the CDC report suggests that the U.S. Food and Drug Administration should devote more staff time and other resources to inspection of fruits and vegetables, said Michael Doyle, director of the University of Georgia's Center for Food Safety.

Earlier this month, the FDA released a proposed new rule for produce safety that would set new hygiene standards for farm workers and for trying to reduce contact with animal waste and dirty water.

Meanwhile, CDC officials emphasized that their report should not be seen as discouraging people from eating vegetables. Many of the vegetable-related illnesses come from norovirus, which is often spread by cooks and food handlers. So contamination sometimes has more to do with the kitchen or restaurant it came from than the food itself, Griffin noted.

Also, while vegetable-related illnesses were more common, they were not the most dangerous. The largest proportion of foodborne illness deaths — about 1 in 5 — were due to poultry. That was partly because three big outbreaks more than 10 years ago linked to turkey deli meat.

But it was close. CDC estimated 277 poultry-related deaths in 1998-2008, compared to 236 vegetable-related deaths. Fruits and nuts were credited with 96 additional deaths, making 334 total deaths for produce of all types. The CDC estimated 417 deaths from all kinds of meat and poultry, another 140 from dairy and 71 from eggs.

Red meat was once seen as one of the leading sources of food poisoning, partly because of a deadly outbreak of E. coli associated with hamburger. But Griffin and Doyle said there have been significant safety improvements in beef handling. In the study, beef was the source of fewer than 4 per cent of food-related deaths and fewer than 7 per cent of illnesses.

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MRI-friendly implantable defibrillator a life-changer

An Ontario woman who is the first in North America to receive a unique implantable defibrillator says she now feels fantastic and relieved that doctors can monitor both her heart and brain as closely as needed.

Justine Bovenkerk, a 35-year-old mother and dental assistant in Newmarket, Ont., needed a defibrillator to treat a condition that can cause her heart to both race and slow. Doctors say she also requires regular MRIs to monitor lesions in her brain.

Dr. Atul Verma was excited to find an implantable defibrillator that worked not only for his patient's heart but also her brain monitoring needs. (Courtesy Southlake)

"It puts us into a quandary," said Dr. Atul Verma, a cardiologist and cardiac electrophysiologist at Newmarket's Southlake Regional Health Centre in Ontario who treats Bovenkerk. CTs are not as effective for monitoring and current pacemakers that are safe for MRIs only speed up the heart.

Bovenkerk needed an implantable cardioverter defibrillator, but the current metallic devices aren't compatible with the magnetic fields of an MRI. That's when Bovenkerk's medical team turned to a model that is approved for use in Europe. Within five days, Health Canada approved the application to try it in her case as the device meets Canadian, U.S. and European regulations for reliability.

"We're excited we're able to give Justine exactly what she needed," Verma said Wednesday.

"The big difference which makes it compatible with MRI are there are some subtle engineering changes in the design of both the defibrillator and the wires that attach to the defibrillator to make them less likely to interact with the magnets."

Bovenkerk was diagnosed with myotonic dystrophy at age 24 when she experienced problems getting her hand muscles to relax. After her younger brother suffered sudden cardiac death, genetic tests showed she and her mother and siblings all had the heritable condition. She is the most affected.

In December, paramedics took Bovenkerk to Southlake after she awoke to find she was blind in her right eye and her arm was numb. The brain lesions were diagnosed during the hospitalization.

"One minute it just feels just like pins and needles or something and then all of sudden I just have no feeling. I was like 'OK, this is not normal.'"

The minimally invasive implant procedure was performed on Dec. 24 — just in time to allow Bovenkerk to spend Christmas Day at home with her husband and six-year-old son as he wished in a letter to Santa.

Bovenkerk recalled the night Verma told her the implant was approved. "I started to cry. I'm under the hands of the best care. It was a relief to know that when I go home, if something happens, I feel safe. I don't have to worry so much. It was an amazing feeling.

"If it had happened about two years ago, this wouldn't even be option," Verma said.

Before the implant, Bovenkerk said she was often tired from her heart rate slowing and stressed over the possibility of being rushed to hospital. Now she said she feels excellent, has returned to work and is starting to resume workouts at the gym.

Although Bovenkerk is still wearing zip-up shirts to avoid lifting her arm too high, she was able to enjoy building a snowman recently. Initially nervous to be a guinea pig, Bovenkerk is now happy to share her story with other Canadians who may need an implantable cardioverter defibrillator.

While Bovenkerk's situation is rare, Verma said older individuals often need a defibrillator and some could benefit from MRIs, such as for stokes or other neurological conditions.

He pointed to studies that suggest between 10 per cent to 25 per cent of patients who get an implantable defibrillator may need an MRI at some point in the next two decades. The hope is that MRI will pick up changes early enough when medical treatment can make a difference to the course of the illness.

The Southlake hospital has a provincial mandate to deliver advanced diagnostic and treatment services within six regional programs, including cardiac and cancer.

Verma said the Berlin-based manufacturer of Bovenkerk's implantable defibrillator confirmed it was the first import of the device to North America.

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Teen pregnancies jump by staggering 40 per cent in N.B.

New numbers on teen pregnancy rates in New Brunswick show the province had the biggest jump in the number of pregnancies between 2006 and 2010.

During that time, pregnancy rates for girls aged 15 to 19 saw a 40 per cent increase in New Brunswick over a previous study period between 2001 and 2005.

'They don't want to be young parents but we do find that the efforts and practices towards preventing that are often worse — particularly for those who have less of an orientation towards a positive future.'—Dr. Lucia O'Sullivan, Canada research chair in adolescent sexual health behaviour

The data comes from a study released Tuesday by the Sex Information and Education Council of Canada (SIECC) in the Canadian Journal of Human Sexuality.

New Brunswick wasn't the only Atlantic province to see a rise. Between 2006 and 2010 teen pregnancy rates rose by 35.7 per cent in Newfoundland, and 17.4 per cent in Nova Scotia.

All of these increases are well above the national teen pregnancy rate that rose just 1.1 per cent during the most recent study period.

Prince Edward Island was the only Atlantic province to see a decrease, with the number of teen pregnancies down two per cent over the results obtained from the 2001 to 2005 study. Though, researchers point out that sample sizes from P.E.I. are relatively small compared with larger provinces.

Lucia O'Sullivan, a psychology professor at the University of New Brunswick and Canada research chair in adolescent sexual health behaviour, said teen pregnancy rates are linked to the socioeconomic strength of a province.

"What we do find is that the provinces that have the most dramatic increases tend to be the ones that have poorer socioeconomic forecasts and profiles," said O'Sullivan.

"When times are good, young people tend to have a future orientation that makes childbearing more expensive in a way and so they will delay having children and the costs of having children at such a young age is higher — especially when they have such strong and positive expectations for education and employment," she said.

"When times are worse we find that the motivation to avoid childbearing tends to be lower ... We tend to find there is less effort to avoid childbearing and that is in large part because the costs are lower for them in terms of their future orientation."

However, O'Sullivan stresses that these teens are usually not actively trying to become pregnant.

Long-term national trends show steady decline

Overall, the trend in teens getting pregnant shows a steady decline since records were first recorded in 1974.

Researchers in an American study found that only 11 per cent of women seeking an abortion used contraception. (REUTERS/Cheryl Ravelo )

Longer term, the Canadian teen pregnancy rate dropped 20.3 per cent from 2001 to 2010.

The SIECC study did not specifically look at the reasons behind the jump across most of Atlantic Canada but linked to a recent U.S. study that looked at woman seeking abortions.

The researchers in the American study found that only 11 per cent of women seeking an abortion used contraception.

When those who didn't use contraception were asked why, 42 per cent said that they did not think they would become pregnant, 40 per cent said they had a hard time getting contraception and 38 per cent said they hadn't planned on having sex.

Preventing unwanted teen pregnancies

The SIECC study outlined a few ways to prevent unwanted teen pregnancy:

Developing more youth programs for teens.
Ensuring teens have access to affordable and effective contraception.
Providing sexual health education for teens.

"Access to sustainable birth control would be fantastic, teaching people how to obtain birth control, also good, but really working on the motivation and understanding the costs in some ways of having children at a young age — what that can involve," said O'Sullivan.

"New Brunswick is a very important case because we have so many young people that have migrated away in search of jobs, and who's left?" she asked.

"The people that are left are ones who either didn't feel they could leave or wanted to leave or had the same opportunities available to them."

She said, though, these teen girls are generally not making a conscious effort to have babies.

"They don't want to be young parents but we do find that the efforts and practices towards preventing that are often worse — particularly for those who have less of an orientation towards a very positive future," said O'Sullivan.

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7 obesity myths shattered

Many widely held beliefs about weight loss don't stand up to scientific scrutiny, say doctors who want to set the public health record straight on myths like the calorie-burning benefits of sex or the value of eating breakfast.

In Wednesday's online issue of the New England Journal of Medicine, U.S. doctors tackle seven obesity-related myths commonly found in the media and material from government agencies as well as six presumptions thought to be true despite a lack of convincing evidence.

The myths were:

Small sustained changes in energy intake or expenditure will produce large, long-term weight changes.
Setting realistic goals in obesity treatment is important, because otherwise patients will become frustrated and lose less weight.
Large, rapid weight loss is associated with poorer long-term weight outcomes than is slow, gradual weight loss.
Assessing the stage of change of diet readiness is important in helping patients who seek weight-loss treatment.
Physical-education classes in their current format play an important role in preventing or reducing childhood obesity.
Breastfeeding is protective against obesity.
A bout of sexual activity burns 100 to 300 calories for each person involved.

The myths were based on sources such as national health guidelines and studies from the 1960s of very-low-calorie diets. In his paper, David Allison of the University of Alabama at Birmingham and his co-authors discuss more recent experimental studies that debunk each myth.

"I always say to my patients, the first victory is to stop gaining weight," Tom Ransom, a Halifax endocrinologist and obesity specialist said of the goal-setting myth. "The second is to lose some weight, and the third victory is to tolerate the plateau, because it will happen."

Randomized control trials do not support that snacking contributes to weight gain but the type and size of snacks matter. (Peter Dejong/Associated Press)

Ransom told CBC News that the paper is a great topic of discussion on what works and doesn't.

Stefanie Senior, a registered dietitian in Toronto, agreed the paper offers important information for health professionals and the general public who she said may tend to believe something once they hear it without researching contradictory advice.

On the streets of downtown Toronto, one woman said burning calories during sex "depends who's doing all the work."

Senior rejected the calorie-burning benefits of jumping in the sack.

"At the end of the day, it only burns less than 50 calories," she told CBC News.

The researchers also tackled six presumptions including the purported benefits of regularly eating breakfast, eating fruits and vegetables, snacking and yo-yo dieting, also called weight cycling.

Breakfast no guarantee

"If you're snacking on carrot sticks or Doritos, there's a big difference," Ransom said of snacking. Whether the snacks are in addition to calories already consumed in meals matters, too.

The same line of thinking applies to eating breakfast. If someone eats a well balanced meal in the morning and tapers their food over the day, it tends to help with managing hunger and appetite but it's not a guarantee that they'll consume less, Senior said.

Both experts stressed what works for weight loss varies between individuals. A host of factors like other medical conditions, sleep and medications all need to be considered when assessing and planning weight loss.

Diana Petramala of Toronto said she tried fad diets that just decreased her energy.

"It's all dedication," she said of how she lost about 30 pounds over three years through "clean eating" and staying active.

The study was funded by the U.S. National Institutes of Health. Several authors have received grants payments from multinational food and pharmaceutical companies.

With files from CBC's Kim Brunhuber and Pauline Dakin

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Double arm recipient aims to drive

Written By Unknown on Rabu, 30 Januari 2013 | 22.45

A former U.S. soldier who lost four limbs in Iraq has regained some arm movement following a double arm transplant.

Brendan Marrocco, 26, of Staten Island, N.Y., told a news conference at Johns Hopkins Hospital in Baltimore, Md., on Tuesday that the arms "feel great." He scratched his face and rotated his left elbow slightly.

"I feel like I'm getting a second chance to start over after I got hurt, so I'm excited for the future to see where I can go with it," Marrocco said of the transplanted arms.

He said he looks forward to being able to drive a Dodge Charger SRT8, hug his family, gesture, swim and play sports like hand cycling.

"I can't give up because I haven't driven [the car] yet."

Marrocco said he doesn't yet have any movement or feeling in the hands.

Dr. Andrew Lee, a plastic surgeon at Johns Hopkins, stressed it could take months or years to regain hand movement, considering how long it takes nerves to regenerate with intensive rehabilitation.

Lost limbs in 2009

Marrocco lost both legs above the knees, his left arm below the elbow and his right arm above the elbow in Iraq when a military vehicle he was driving in 2009 was struck by a roadside bomb.

He's already impressed his medical team with his progress. Six weeks after the transplant surgeries, Marrocco said he uses his transplanted arms to text, use a computer and style his hair.

Marrocco, who uses prosthetic legs, delivered a message of hope to amputees. "There's a lot of people who will say you can't do something. Just be stubborn and do it anyway."

Retired infantryman Brendan Marrocco uses his transplanted arm to brush his hair back. (Gail Burton/Associated Press)

With the "determination and stamina Brendan's demonstrated, we have no doubt this was the right thing to do," Lee agreed.

Dr. Jaimie Shores, the hospital's clinical director of hand transplantation, said Marrocco is eager to progress.

"I suspect that he will be using his hands for just about everything as we let him start trying to do more and more. Right now, we're the ones really kind of holding him back at this point," Shores said.

Brendan's mother, Michelle Marrocco, called it a tremendous experience for the family. She said they look forward to him returning home as an independent man, "the Brendan we've been looking for."

The transplants are only the seventh double-hand or double-arm transplant ever conducted in the United States.

Marrocco received bone marrow from the deceased arm donor to help his body accept the transplants with minimal anti-rejection medications.

Lee said a double arm transplant patient who had an above elbow operation recently showed him he was able to tie shoelaces. Lee said the man used chopsticks in a video he was sent.

The U.S. military is sponsoring such operations to help wounded troops. About 300 have lost arms or hands in the wars in Afghanistan and Iraq.

With files from The Associated Press

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GermBullet ads misleading: FDA

U.S. regulators say a Florida company has been marketing an untested inhaled formula as a flu remedy in violation of drug safety regulations.

The U.S. Food and Drug Administration and the Federal Trade Commission issued a warning letter to Flu and Cold Defence LLC for making misleading, unproven claims about its GermBullet inhaler.

The FDA says GermBullet's website includes false and misleading promotional statements. (Germbullet.com)

The warning comes amid a worse-than-usual flu season that has hit the elderly particularly hard. So far, half of confirmed flu cases are in people 65 and older.

FDA regulators say they are seeing an uptick in bogus flu remedies, including fake flu vaccines, counterfeit antiviral drugs and air filters that allegedly remove the flu from the air.

"When there is a particular health issue in the news fraudulent products spike," said Howard Sklamberg, FDA's director of compliance. "So right now fraud products to prevent or treat the flu are big with scammers."

The Boca Raton, Fla.-based Flu and Cold Defence advertises the product as a "proprietary blend of 11 organic botanicals."

The company's website claims that "an FDA recognized virology lab" tested the formula and "confirmed that it has the potential capability to kill cold and flu viruses."

But FDA regulators say the mixture has never been reviewed as safe and effective and the company is violating drug safety regulations.

All new drugs marketed in the U.S. must be submitted for approval to the FDA before they can be sold to consumers.

Sklamberg says consumers should remember that "there aren't any legally marketed over-the-counter products to prevent or treat the flu."

The GermBullet is sold online through retailers like CVS.com and at a handful of small pharmacies and natural food stores in Florida.

A man reached by phone at Flu and Cold Defence's office could not immediately comment on the warning letter.

This year's flu season started about a month earlier than normal and the dominant flu strain is one that tends to make people sicker.

Vaccinations are recommended for anyone 6 months or older.

Flu and Cold Defence issued a news release early in the month saying GermBullet "may help protect you so your immune system is not overwhelmed as the flu reaches epidemic levels." FDA and FTC regulators take issue with that statement and a number of others from the company's website, including that the inhaler is "shown to reduce illness-causing bacteria, cold and flu viruses and fungi."

The letter, dated Jan. 24, was posted to the FDA's website Tuesday.

Regulators gave the company 15 business days to correct the problematic statements.

"The FTC strongly urges you to review all claims for your products and ensure that those claims are supported by competent and reliable scientific evidence," states the letter.

The FDA regularly issues warning letters to companies that do not follow regulations for manufacturing and promoting drugs and medical devices. The letters are not legally binding, but the FDA can take companies to court if they are ignored.

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6 ways to avoid illness when travelling

Most Canadian travellers come down with some type of illness when flying abroad, says a travel medicine doctor offering prevention tips.

"The estimates in the literature suggest between 50 and 75 per cent of travellers acquire some type of illness," said Dr. Jay Keystone of the Medisys Travel Health and Immunization Clinic in Toronto.

Food, water, vaccinations and pills are all considerations for travellers, said Dr. Jay Keystone. (David MacIntosh/CBC))

In general, travellers are advised:

Don't drink the water.
Don't have ice cubes.
Keep salads and street vendors to a minimum.
Keep prescribed antibiotics on you.
Avoid getting injections in other countries.
Get the appropriate vaccinations and anti-malarial pills for the area you're visiting.

Mild travellers' diarrhea is the most common illness, he said. He recommends taking both over-the-counter drugs as well as prescribed antibiotics if the diarrhea interferes with daily activities.

For more serious illnesses that sicken less than 10 per cent of travellers, getting vaccinated is the best prevention but many people leave it too late, Keystone said.

"travellers should be going to a travel clinic six to eight weeks before travel, and the older you are, the earlier you should go," he advised.

Jill Fairbrother headed to the clinic on Tuesday ahead of her trip to Ecuador, where she's hoping to enjoy a visit to the rainforest and the Galapagos. It's the home of the blue-footed booby, a penguin-like bird with bright blue feet she's looking forward to seeing.

"We have had advice about malaria tablets," said Fairbrother. "We received the yellow fever shot and hepatitis A. Feeling actually like we'll be much more safe when we do travel."

Last week, the Public Health Agency of Canada alerted people to cholera in certain areas of Cuba. Elsewhere recently, meninogoccocal outbreaks occurred in sub-Saharan Africa, dengue fever cases showed up Italy, and malaria has been resurgent in parts of Greece.

To put those risks into perspective, however, Keystone said motor vehicle accidents are still the main killer.

For people returning to their homeland after a decade or more, malaria is a concern. Fever in a returning traveller should be considered malaria and treated seriously until proven otherwise, he advised.

With files from CBC's Kim Brunhuber

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Leafy greens top source of food poisoning in U.S.

About 1 in 5 illnesses were linked to leafy green vegetables, the CDC found. (Rogelio V. Solis/Associated Press)

Each year roughly 1 in 6 Americans — or 48 million people — gets sick from food poisoning. That includes 128,000 hospitalization and 3,000 deaths, according to previous CDC estimates.

It's estimated there are about 11 million cases of foodborne illness in Canada every year, according to the Canadian Food Inspection Agency's website.

What jumped out at the researchers was the role fruits and vegetables played in food poisonings, said Griffin, who heads the CDC office that handles foodborne infection surveillance and analysis.

Hygiene standards on farms

The fast-food chain on Monday announced it was pulling the commercial after receiving complaints that it discouraged people from eating vegetables.

Earlier this month, the FDA released a proposed new rule for produce safety that would set new hygiene standards for farm workers and for trying to reduce contact with animal waste and dirty water.

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Lumpectomy survival rates 'should reassure women'

Written By Unknown on Selasa, 29 Januari 2013 | 22.45

Survival rates among women with early breast cancer were better with lumpectomy and radiation than with mastectomy, a U.S. study suggests.

When researchers followed more than 112,000 women in California with early stage breast cancer for 14 years, they found women were more likely to survive breast cancer after having breast conserving surgery plus radiation than mastectomy.

Survival after breast-conserving therapy when combined with radiation is at least equivalent to mastectomy for early-stage cancers, researchers say. (Torin Halsey/The Wichita Times-Record-News)

"The findings in this study should reassure women that among all age groups and tumor types, lumpectomy continues to be an excellent choice for women with small early breast cancers, " study author Dr. Shelley Hwang of Duke Cancer Institute in Durham, N.C., said in a release.

The effect was strongest for women over age 50 with hormone-sensitive cancers, the study's authors said in Monday's issue of the journal Cancer.

"These findings support the notion that breast-conserving therapy, when combined with radiation, confers at least equivalent and perhaps even superior survival to mastectomy as definitive breast cancer treatment," they concluded.

Differences in mastectomy rates

The findings come as some women in the U.S., particularly those who are younger, affluent and living in cities are increasingly opting for mastectomy for very small cancers, the researchers said. They speculated that improvements in reconstructive techniques, changing attitudes toward mastectomy or a desire to reduce anxiety associated with long-term surveillance could be contributing to the trend in the U.S.

In Canada, mastectomy rates vary widely between provinces, with the highest rates reported among those living in the least affluent areas, the opposite of the U.S. trend. In a report last year, researchers with the Canadian Institute for Health Information and the Canadian Partnership Against Cancer suggested the long courses of radiation often recommended after lumpectomies and travel time could be reducing use of the less-invasive surgery.

Earlier randomized clinical trials showed equivalent survival for breast conserving surgery with radiation and mastectomy for early-stage breast cancer but didn't look at women in the general population.

In the latest study, 55 per cent of the women received lumpectomy and radiation, while 45 per cent had mastectomy without radiation.

Among those over 50 years old with hormone-sensitive breast cancers, the risk of dying from breast cancer during the follow-up was 14 per cent lower in the breast conserving group than similar cancers treated with mastectomy.

In the first three years after surgery, women who underwent mastectomy had a higher risk of dying from heart disease and other diseases than women who had lumpectomy. It's possible that those in the lumpectomy group were generally healthier, Hwang said.

Since the study was observational in nature, the link between breast-conserving treatment and survival is only an association and no cause-and-effect relationship can be drawn.

Surgical patterns changed over the course of the study, the authors noted. Factors such as tumour grade, race, tumour size and age at diagnosis were considered in the analysis.

The study was funded by the U.S. National Cancer Institute.

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B.C. man died from Hantavirus, Yukon officials confirm

A female deer mouse has a monitor attached to her left ear at the Adirondack Ecological Center in Newcomb, N.Y., Wednesday, Oct. 3, 2007. The Hantavirus disease is spread through the animal's urine and droppings. (The Associated Press)

Health officials from B.C. and Yukon are in Atlin, B.C., today looking for the source of a deadly case of Hantavirus.

The rare disease is normally spread through the urine and feces from deer mice.

Officials confirmed the virus was responsible for the death of Gerhard Holmok, 45, earlier this month. Holmok died suddenly Jan. 9 at the Whitehorse hospital.

Doctor Ronald Chapman, the Chief Medical Health officer for northern B.C., said the Atlin death is the most northerly case of Hantavirus ever diagnosed in the province.

"Up until 1995, the farthest north the virus occurred in B.C. is up to Williams Lake, so this is certainly the farthest north."

Health officials advise people to wear gloves and masks when working around or cleaning out areas where there may be mice.

The hantavirus infection, also known as hanta virus pulmonary syndrome (HPS), is a very rare viral disease which can be fatal.

Early symptoms of hantavirus infection include fever and muscle aches, possibly with chills, headache, nausea, vomiting, diarrhea, abdominal pain and cough, which progresses to respiratory illness, the province said in a release.

The symptoms develop within one to six weeks after exposure to deer mouse droppings.

Chapman said investigators in Atlin hope to find the source of the virus by trapping the diseased rodents.

He said it's usually just one or two infected mice that are responsible.

Chapman said there is no cause for public concern at this point.

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Outcome of doctor talks may lead to health premiums, Redford suggests

Alberta Premier Alison Redford ratcheted up the pressure on doctors in contract talks Monday, potentially pitting them against taxpayers by reviving health-care premiums.

In a teleconference town hall with 5,000 party supporters, Redford suggested that how talks go with the physicians could affect whether the province brings back Alberta Health premiums after a four-year absence.

"We know that doctors earn between 20 and 29 per cent more in Alberta than they do across the country," said Redford.

"Quite frankly, before I start asking Albertans to pay health care premiums, I want to make sure that we're getting the best deal possible with our doctors.

"At the end of the day, I think that's really where we start to save some money with respect to things like health care."

The Alberta Medical Association and the province have been negotiating a new deal for doctors for almost two years. The deadline for those talks was recently extended until after Redford's government delivers its 2013-14 budget on March 7.

The premiums brought in $1 billion a year to provincial coffers before being cancelled by former premier Ed Stelmach in 2009, fulfilling an election promise he made a year earlier.

Until the province took it over, the premium cost families about $1,056 a year. Single Albertans paid half that amount. According to budget documents in 2008, axing the premiums was equivalent to a 12 per cent cut in personal income tax.

Redford says times have changed. Last Thursday, in a televised address to the province, she said her government is facing a $6-billion shortfall in the upcoming budget due to declining oil revenues.

The negotiations with doctors have been acrimonious.

Frustrated by the lack of progress, Health Minister Fred Horne imposed a deal on doctors last November -- a deal they said violated an earlier interim deal and one that would actually roll back their wages

In the face of loud protests from doctors, Horne backed off from the imposed settlement, allowing talks to continue.

Last week, the Canadian Institute for Health Information reported Alberta doctors made a gross yearly income of almost $350,000 in 2010-11, compared with a national average of $307,000.

But Dr. Michael Giuffre, head of the Alberta Medical Association, has said overhead costs eat up as much as 60 per cent of that $350,000 and that the rest is taxed aggressively at a rate of 40 per cent.

Monday's town hall was one component in what has become a public relations blitz by Redford's communications team to brace Albertans for what the government is promising will be a challenging budget.

In last Thursday's TV address, Redford said falling oil prices are expected to halve the $13 billion her government was projecting to take in during 2013-14 from oil and gas.

She followed that up with interviews for TV, radio, print and Web reporters over the weekend, reinforcing the message that the budget will be a "once-in-a generation" chance to remake how the government spends, saves, and invests in new technologies and reduce dependence on roller-coaster energy royalties.

Redford reiterated that point in Monday's town hall. She recounted a trip to Lethbridge last year, sitting having a coffee and watching a long, winding train go by filled with "car after car" loaded with windmill blades bound for B.C.

"It just spoke to me about the fact that there is excellent research being done at our universities and our colleges, with people that are incredibly qualified and passionate about diversification -- and we're not making the most of it," she said.

"We're doing a pretty good job, but we're not actually seizing the opportunity."

The province is expected to come in with a $3-billion deficit on record spending of $41-billion in the current 2012-13 budget. That red ink is expected to be erased by the rainy day savings Sustainability Fund, thereby avoiding long-term debt

The communications campaign is emphasizing social media. Redford has granted one-on-one interviews with Web bloggers, and earlier Monday two senior ministers outlined the budget problems via short videos posted to YouTube.

In one video, Finance Minister Doug Horner reiterates the message that austerity is the word for the coming year.

"We're going to have to be very aggressive and rein in our spending," Horner says on the video.

"We're going to have to make some very difficult choices. We're going to have to make choices on programs that have been around for some period of time."

In the second video, Energy Minister Ken Hughes outlines how growing oil production in the United States, Alberta's sole customer, is driving down the price Alberta can demand for its oilsands product.

Hughes reiterates that the long-term goal is getting oil to ocean ports to sell abroad.

"We have to become connected to the rest of the world to get world price," says Hughes.

Leaders of all three opposition parties say Redford's PR blitz is an attempt to deflect attention away from her own incompetence in managing the budget.

They say Redford's government had known for over a year that the price dip was widening between the North American benchmark for oil, the West Texas Intermediate, and the oilsands' Western Canadian Select.

They say Redford won last spring's election on the strength of unrealistic revenue projections and extravagant spending promises for health, education and social programs.

The current spot price for West Texas Intermediate is US $86 — about $30 a barrel higher than Western Canadian Select

A year ago, before the provincial election, Western Canadian was selling at around US $77 a barrel, about $20 a barrel lower than West Texas Intermediate.

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Meal timing matters for weight loss success

When you eat could play an important role in weight loss, a new study suggests.

Researchers looked at the role of meal timing in 420 men and women in southeast Spain participating in a 20-week weight-loss treatment following several studies in animals showing a relationship between the timing of feeding and weight regulation.

"Our results indicate that late eaters displayed a slower weight-loss rate and lost significantly less weight than early eaters, suggesting that the timing of large meals could be an important factor in a weight loss program," Frank Scheer, director of the medical chronobiology program at Brigham and Women's Hospital in Boston, said in a release.

Of the participants, 51 per cent were early eaters who ate their main meal, lunch, before 3 p.m. The other 49 per cent had lunch after three.

The researchers found energy and nutrient intake, estimates of calories burned, appetite hormones and hours of sleep were similar between both groups.

"Nevertheless, late eaters were more evening types, had less energetic breakfasts and skipped breakfast more frequently than early eaters," Scheer and his co-authors wrote in Tuesday's issue of the International Journal of Obesity.

They suggested that new weight loss strategies should incorporate the timing of food as well as the classic look at calorie intake and distribution of carbohydrates, fats and protein.

Evening types or "night owls" like to stay up late at night and sleep late in the morning while early birds feel they perform best when they go to bed early and rise at dawn.

Timing has metabolic consequences

The researchers said that changes in these "chronotypes," genetic background and how the circadian system functions may be implicated.

Recently, fat tissue has been found to have an active circardian or body clock. The study's authors suggested that timing of feeding, for high energy meals in particular, could have metabolic consequences such as the development of obesity and weight loss.

A previous U.S. study showed that eating after 8 p.m. was associated with increased body mass index independently of sleep timing and duration.

In the study, late eaters had a lower estimated insulin sensitivity, a risk factor for Type 2 diabetes.

Study participants were given recommendations about the number of portions they should eat from each food group. They were free to eat those portions when they wished.

Most studies of shift workers also suggest they are more prone to obesity than day workers, even when they have the same energy intake, the researchers said.

The study was funded by grants from Tomás Pascual and Pilar Gómez-Cuétara Foundations, Spanish Government of Science and Innovation, Séneca Foundation from the Government of Murcia, the U.S. National Heart, Lung, and Blood Institute grants, U.S. National Institute of Diabetes and Digestive and Kidney Diseases, and the U.S. Department of Agriculture Research.

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Teens mixing alcohol and energy drinks a growing problem

Written By Unknown on Senin, 28 Januari 2013 | 22.45

About one in five Canadian students say they have mixed alcohol with energy drinks, which researchers call a public health concern.

Doctors say energy drinks mask the symptoms of intoxication and can lead to more risk-taking behaviour, such as drunk driving. That in turn increases the likelihood of injury, compared with drinking alcohol alone in the short term.

Students were asked if they consumed alcohol along with energy drinks in the previous year. (Jack Dempsey/Associated Press)

Mark Ashbridge of Dalhousie University in Halifax used nationally representative data from 36,155 students who were in grades 7 to 12 in 2010-2011 to determine how commonly alcohol is consumed together with energy drinks or in premixes sold in a bottle or can.

About 20 per cent of participants said they did mix energy drinks and alcohol, which is in line with previous studies of university students in Canada, the U.S. and Europe.

Use was highest in British Columba (26 per cent) and Nova Scotia (26 per cent) and lowest in Prince Edward Island (16 per cent).

"Consumption of these drinks is substantial among Canadian high school students and can lead to many potential harms," the study's authors concluded in this week's issue of the journal CMAJ Open.

"Given that youth continue to drink alcohol illegally, alternative strategies may be more effective than top-down, abstinence-based programs."

The main concern should be underage drinking, the researchers said.

They suggest a flat tax on energy drinks or a variable tax that reflects caffeine content, such as Saskatchewan's, as well as harm-reduction campaigns to encourage young people not to mix alcohol with energy drinks.

While there were provincial differences in consumption, it's not known if variations in the availability of energy drinks, prices or provincial taxes made a difference.

Use of alcohol mixed with energy drinks was higher among younger students, marijuana users, and those who were frequently absent from school, involved in sports and had more spending money.

Doing well in school and feeling more connected to school seemed to be protective.

The researchers noted that the students were reporting on their own use of the substances, which is a sensitive subject.

The team did not have demographic data such as family income or the students' mental health that could influence consumption.

Students from all provinces except New Brunswick were included.

In January, researchers in the U.S. said the number of people seeking emergency treatment after consuming energy drinks has doubled across the country over the past four years. Most of the cases involved teens or young adults.

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Over-the-counter painkillers risky for kids' kidneys

Children taking common pain relievers may be at higher risk for kidney damage, a U.S. study finds.

The researchers called nonsteroidal anti-inflammatory or NSAIDs such as ibuprofen, perhaps the most common avoidable risk for acute kidney failure in children. The drugs are given to relieve pain and fever.

Doctors called the use of NSAIDs an avoidable cause of acute kidney injury in children. (Bruno Domingos/Reuters)

In Friday's online issue of the Journal of Pediatrics, Dr. Jason Misurac of Indiana University School of Medicine in Indianapolis said NSAID use accounted for 27 cases or nearly three per cent of kidney damage they reviewed at a local children's hospital.

The percentage is small but four of the preschoolers needed dialysis and at least seven suffered permanent kidney damage.

The researchers called the study the largest to date pointing to use of NSAIDs as an avoidable cause of acute kidney injury in children, which in some cases needs to be monitored for years.

Over 11½ years, they found 1,015 cases of children and teens who'd been treated for acute kidney injury from any cause. Kidney injuries that could have been caused by other factors such as congenital heart disease were excluded.

Most children who developed kidney damage were previously healthy, had taken the recommended dose for an average of four days.

Many of the patients came to hospital with an acute illness that caused dehydration, which tends to compound damage to the kidneys, the researchers said.

The most common NSAID given was ibuprofen (67 per cent) followed by naproxen (11 per cent.)

They said the results lead to questions of whether kidney function tests should be routinely ordered before giving NSAIDs in hospital.

Dr. Felix Ramirez-Seijas, director of pediatric nephrology at Miami Children's Hospital, said NSAIDs are "overused and abused, both by doctors and patients."

Ramirez-Seijas suggested to HealthDay News that most fevers in children outside of hospital should not be treated, adding that parents should make sure a child is well hydrated if they are going to give NSAIDs.

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Wear face mask or get flu shot, hospital staff told

A change in Sudbury hospital policy says employees who don't have an influenza shot and won't wear a surgical mask during flu season will be sent home.

A portion of a letter from Health Sciences North administration to hospital employees that highlights a new hospital protocol to protect patients during flu season. (Hilary Duff/CBC)

Health Sciences North sent a letter to its employees late last week requiring employees to comply with one of two options: get a flu shot or wear what they call an "isolation mask."

"Our ID badge shows on the back of it if we've had our immunization," said radiation therapist Nadya Gabel as she showed the bright pink sticker now affixed to her hospital ID.

She said the change has hospital employees talking.

"It's everybody's choice what they do with their own health care so, of course, there are people who are unhappy about it," Gabel said.

"I feel strongly for it and other people feel strongly against it, so that's their own possible choice."

'Need to protect patients'

Health Sciences North officials say the new policy complies with recently released best practices from the Provincial Infectious Disease Advisory Committee.

Joe Pilon, chief operating officer of Sudbury's Health Sciences North. (CBC)

The chief operating officer at the hospital said the hospital is relying on staff to follow the new rules.

"If you can't demonstrate that you've been immunized, then you have to wear a mask," Joe Pilon said.

"If you're not going to wear a mask, then you can't care for patients and you would be sent home."

Employees are required to wear the isolation mask until influenza season ends at the beginning of April — and this will be the protocol for all future influenza seasons, he said.

"We try to rely on people's professionalism to say that you need to protect patients," Pilon added.

"We expect people to see the reasonableness of it, but at times people don't comply — and when you don't comply with policies — then there needs to be a discussion, there needs to be some consequence."

Pilon estimated about 50 per cent of hospital staff have been immunized this year.

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Abortion barriers still exist in Sask. 25 years after historic ruling

Monday marks 25 years since the Supreme Court of Canada struck down the country's abortion law, but in Saskatchewan access to the procedure remains uneven.

Abortions are only performed in two cities in the province, Saskatoon and Regina.

Women who choose to go to Saskatoon have to make two trips — one to see the doctor, and the other for the procedure itself.

Evelyn Reisner, who runs Saskatoon's Sexual Health Centre (formerly known as Planned Parenthood), is working to change the two-visit requirement.

"We work very closely with the doctors," said Reisner. "And have very good relationships with the doctors, and a lot of the doctors are quite happy about this idea."

Still, when it comes to access to abortion, doctors remain the gatekeepers.

According to Reisner women depend on a few willing doctors.

"I had a call last week of a woman whose doctor told her that if she chose to terminate a pregnancy the doctor would refuse to be her doctor anymore," said Reisner.

First abortion clinic in Canada in Quebec

Dr. Henry Morgentaler broke the country's existing abortion laws in 1969 and opened the country's first abortion clinic. At the time, abortion was only legal if a committee of doctors signed off that it was necessary for the physical or mental well-being of the mother and the procedure was performed in a hospital.

The Montreal doctor became one of the most Canada's controversial figures.

During the next two decades Morgentaler was assaulted, arrested, jailed.

In 1988 the Supreme Court of Canada granted him victory and declared the country's abortion law unconstitutional. Canada is now one of only a few countries with no legal restrictions on abortion.

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Controversial brain test of awareness questioned

Written By Unknown on Minggu, 27 Januari 2013 | 22.45

Doctors should resist the temptation to use an inexpensive tool that probes the brain's electrical activity when evaluating vegetative patients who can't communicate.

Drs. Adrian Owen and Damian Cruse of the Centre for Brain and Mind in London, Ont., promoted the use of electroencephalography or EEG that can be used at a patient's bedside to determine if there's neurological activity in people in a vegetative state — those who are unresponsive in traditional tests of awareness.

Dr. Damian Cruse adjusts EEG sensors that his team uses to check for neurological activity in people thought to be in a vegetative state. (Courtesy UWO)

In a letter published in Thursday's issue of the medical journal The Lancet, Dr. Jonathan Victor of Weill Cornell Medical College in New York and his co-authors reanalyzed data shared from Owen's 2011 paper in the same journal.

"I think we'd be very, very cautious about using this technology as it stands now," said Victor.

Both groups agree the use of EEG technology remains promising to evaluate patients. The challenge, Victor said, is researchers can't be certain about their interpretations when faced with families trying to communicate with their loved ones, including for end-of-life discussions.

The critique casts doubt on the original statistical approach and assumptions, which didn't hold when analyzed with a different model.

In a rebuttal, Owen's team defended its approach as the only way to draw valid conclusions from vegetative patients and account for their variations.

"There are few 'known truths' when attempting to detect covert awareness," Owen's team wrote. "Some are likely to be truly vegetative, while others may appear to be vegetative behaviorally, but are in fact, covertly aware."

Ryan D'Arcy, a neuroscientist at Simon Fraser University and Surrey Memorial Hospital in Vancouver, is part of a team developing a similar device to detect consciousness.

For D'Arcy, the challenge is turning a laboratory procedure into a test that can be used on patients.

"You need to be able to convert the data which are very sophisticated and complex into a valid clinical score," D'Arcy said.

The teams' discrepancies could lead to vastly different approaches to caring for patients, anesthesiologists George Mashour of the University of Michigan, Ann Arbor, and Michael Avidan of Washington University said in a journal commentary.

The critique's authors "present a compelling argument that this claim of neurophysiological responsiveness has a questionable statistical basis, potentially undermining the interpretation of two studies by Cruse and colleagues," Mashour and Avidan wrote.

The pair commended the two teams for sharing their data and publicly debating the controversy.

Victor is working with Owen's team to figure out the best way of interpreting the signals.

With files from CBC's Kim Brunhuber and Pauline Dakin

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New norovirus strain turning more stomachs

Japan tourists point to the sights around dock where the cruise ship The Queen Elizabeth 2 is docked following a norovirus outbreak. (Marco Garcia/Associated Press)

A new strain of stomach bug sweeping the globe is taking over in the U.S., health officials say.

Since September, more than 140 outbreaks in the U.S. have been caused by the new Sydney strain of norovirus. It may not be unusually dangerous; some scientists don't think it is. But it is different, and many people might not be able to fight off its gut-wrenching effects.

Clearly, it's having an impact. The new strain is making people sick in Canada, Japan, Western Europe, and other parts of the world. It was first identified last year in Australia and called the Sydney strain.

In the U.S., it is now accounting for about 60 per cent of norovirus outbreaks, according to report released Thursday by the Centers for Disease Control and Prevention.

Norovirus — once known as Norwalk virus — is highly contagious and often spreads in places like schools, cruise ships and nursing homes, especially during the winter.

Last month, 220 people on the Queen Mary II were stricken during a Caribbean cruise.

Sometimes mistakenly called stomach flu, the virus causes bouts of vomiting and diarrhea for a few days.

Every two or three years, a new strain evolves — the last was in 2009. The Sydney strain's appearance has coincided with a spike in influenza, perhaps contributing to the perception that this is a particularly bad flu season in the U.S.

Ian Goodfellow, a prominent researcher at England's University of Cambridge, calls norovirus 'the Ferrari of viruses' for the speed at which it passes through a large group of people.

"It can sweep through an environment very, very quickly. You can be feeling quite fine one minute and within several hours suffer continuous vomiting and diarrhea," he said.

Health officials have grown better at detecting new strains and figuring out which one is the culprit. They now know that norovirus is also the most common cause of food poisoning in the U.S.

It's spread by infected food handlers who don't do a good job washing their hands after using the bathroom. But unlike salmonella and other foodborne illnesses, norovirus can also spread in the air, through droplets that fly when a sick person vomits.

"It's a headache" to try to control, said Dr. John Crane, a University of Buffalo infectious disease specialist who had to deal with a norovirus outbreak in a hospital ward a couple of years ago.

Each year, noroviruses cause an estimated 21 million illnesses and 800 deaths, the CDC says.

For those infected, there's really no medicine. They just have to ride it out for the day or two of severe symptoms, and guard against dehydration, experts said.

The illness even got the attention of comedian Stephen Colbert, who this week tweeted: "Remember, if you're in public and have the winter vomiting bug, be polite and vomit into your elbow."