H1N1 (Swine) Flu Update

A California study of H1N1 influenza, reported in Nov. 4 JAMA (Journal of the American Medical Association), showed that this strain seems to affect younger and obese patients. The median age was 27 years. Of 268 adults aged 20 years or older, 58% was obese (body mass index >30.)

Among studied patients, 11% died. The most common causes of death were viral pneumonia and acute respiratory distress syndrome.

Authors of the study recommended doctors give antiviral treatment to all hospitalized patients with 2009 H1N1 infection as soon as possible, regardless of when symptoms start.

Shostakovich's Second Waltz by Andre Rieu

Exercise and Health

A retrospective study analyzing physical activities of 10,269 Harvard alumni over 12 years showed that men who engaged in vigorous sports had a 23 percent lower risk of death than those who did not. Vigorous sports were defined as brisk walking, cycling, swimming, and yard work for 30 minutes a day on most days.

The Health Professionals' Follow-up Study evaluated the relationship between intensity of exercise and cardiovascular benefit in 44,452 men. The study found several types of sports that would result in a significant reduction in risk of coronary heart disease. The studied sport activities were:

• Running for one hour or more per week
• Brisk walking for 30 minutes or more per day
• Lifting weight for 30 minutes or more per week
• Rowing for one hour or more per week

Somewhere My Love by Ray Conniff

Hepatitis A

Hepatitis A (HAV) is spread via fecal-oral route. It is more common in areas where there is poor hygien. The most common risk factors are:

• Travel to Mexico, South America, Africa, Asia
• Contact with people inflicted with HAV
• Food-borne outbreaks
• Daycare center
• Injection drug use

HAV causes injury to liver where human immune system fights against viruses that hide inside liver cells, a.k.a hepatocytes. Fierce battles can result in severe hepatitis which typically presents with jaundice (yellowish discoloration of skin, eyes) and enlarged liver. Your doctors may want to confirm the diagnosis by way of blood tests such as ALT, AST, bilirubin, alkaline phosphatase, and anti-HAV IgM antibody.

The good news is that HAV is a self-limited condition: 85 percent of cases have full recovery within 3 months, and nearly 100 percent have complete recovery by 6 months.

HAV, however, can be fatal in those who have concurrent chronic hepatitis C. These individuals die of fulminant hepatic failure.

Prevention involves handwashing, avoidance of water and foods from endemic areas.

HAV vaccines also are available.