Newsletter "Your Health"
- 2 new vaccines now free
- Medication for osteoarthritis
- Psoriasis. A distressing skin problem.
- Should you have an STI check?
- What is your ‘absolute’ risk of CVD?
- Should I take fish oil capsules every day?
- What’s new in cholesterol treatment?
- What can I do to help myself beat depression?
- Sore throat. Can your doctor help?
- Giving medicines to young children
- Pasta peperonata
Two new vaccines are now free after the federal government recently made funding available. Females aged 12-26 can receive cervical cancer vaccination and babies will be immunised for rotavirus gastroenteritis.
Cervical cancer vaccine
This vaccine prevents about 70% of cancers of the cervix and is given as a course of 3 injections over 6 months. There are two programs operating
which depend on the age of the patient:
School-based program
12 and 13 year old girls
13 to 18 year old girls will be vaccinated in a free catch-up program
over the next two years only
This program started in April 2007.
General practitioner program
18-26 year old women can be immunised by their GP from July 2007. There is no charge for the vaccine but there may be a fee for the GP visit.
The vaccine is not yet approved for women over the age of 26 years.
After vaccination, sexually active women still need 2-yearly Pap smears.
For more information speak to your GP, ring the Immunise Australia National Hotline on 1800 671 811 or go to www.health.gov.au/cervicalcancer.
Rotavirus vaccine
Rotavirus is the most common cause of severe diarrhoea in young children. The new rotavirus vaccine is well tolerated and prevents 85-100% of severe cases.
Free oral vaccine (by mouth) is available from your GP from 1 July 2007 (there may be a fee for your GP visit). All babies born from 1 May 2007 are eligible.
There are two brands of rotavirus vaccine. Depending on which brand is used, your child will receive either 2 doses (at 4 and 6 months) or 3 doses (at 2, 4 and 6 months). The vaccines will generally be given with the other routine vaccinations at 2, 4 and 6 months.
www.ncirs.usyd.edu.au > the facts.
MEDICATION FOR OSTEOARTHRITIS
Pain and stiffness are an unwelcome part of winter for many people. Usually this is due to osteoarthritis (OA), the most common cause of joint pain, especially in people over 50 years of age.
OA most often affects the hands, spine, knees and hips. It is a chronic (long term) condition which has no cure.
First line medications
Paracetamol is the preferred pain killer for osteoarthritis. It gives good pain relief and has a low risk of side effects. Long acting paracetamol is now available on the PBS for osteoarthritis and is taken 3 times daily.
A 3 month trial of the natural product glucosamine (1,500mg daily) with or without chondroitin (1,100 mg daily) is worth considering, especially for knee arthritis.
Anti-inflammatory creams and gels are safe and effective in many cases.
Anti-inflammatory drugs
If you are still in pain, your GP may suggest an anti-inflammatory drug, either a traditional NSAID (non-steroidal anti-inflammatory drug) or a newer ‘COX-2 selective’ drug.
These drugs can give considerable pain relief and improved quality of life, but as with all drugs, there is a risk of side effects.
Recent media reports have blown this risk out of proportion. With long-term use, almost all anti-inflammatories cause a small increased risk of cardiovascular events such as heart attack and stroke. Studies have shown that this risk is only about 3 events per 1,000 patients taking these medications regularly for 1 year. The added risk disappears soon after they are ceased.
Other possible side effects include fluid retention, raised blood pressure and (rarely) heart failure and kidney damage.
All anti-inflammatories should be taken in the lowest effective dose and ceased when they are no longer needed.
The pain relief will usually outweigh the small risks. Speak to your doctor to weigh up the pros and cons in your particular case or visit www.arthritisaustralia.com.au.
PSORIASIS. A DISTRESSING SKIN PROBLEM.
Psoriasis is an unsightly skin condition which can cause considerable psychological stress. Although this common condition is not curable, many effective treatments are available to improve it.
Psoriasis causes raised, red patches often covered with a silvery scale. The rash can be itchy and can occur anywhere on the body, especially the elbows, knees, scalp, groin, armpits and genital area. Psoriasis can also damage the nails and cause pain and swelling of the joints (arthritis).
Psoriasis can start at any age, but first appears most often in young adults. It is a fluctuating, lifelong illness which frequently runs in families. Flare-ups can be triggered by infections, injury to the skin, emotional stress and certain drugs. It is not contagious.
Treatments for psoriasis
Psoriasis can be well controlled in the vast majority of cases. Treatment is usually started with a cream or ointment.
Steroid creams work quickly and are the most commonly used treatment. However, with long term use, they become less effective and can cause thinning of the skin.
Coal tar is another proven first line therapy. Newer preparations are now available which are not smelly or greasy and do not stain the skin or bedding, like the older products. Tar shampoos are useful for scalp psoriasis and the resulting dandruff.
Calcipotriol, tazarotene and dithranol creams are also effective, although the latter can stain clothes and skin.
Emollients such as 10% glycerol in sorbolene cream are soothing and help relieve irritation. Salicylic acid is often added to soften and lift thick, scaly areas.
Ultraviolet light therapy and potent oral (by mouth) medication is available from specialists in more severe or widespread cases.
Ask your GP for advice or visit www.psoriasis.org or www.dermcoll.asn.au.
SHOULD YOU HAVE AN STI CHECK?
Sexually transmitted infections (STIs) such as genital herpes, chlamydia, gonorrhoea genital warts, syphilis, hepatitis B and HIV/AIDS, are easily spread during sexual contact. Some of these infections are serious and can lead to infertility, liver failure and even death.
The proper use of condoms every time you have sex (vaginal, oral or anal) with a new partner reduces, but does not eliminate, the risk of catching an STI. Try to avoid any exchange of blood, semen or vaginal fluids with your partner.
Well woman STI check-up
One of the problems is that STIs often cause no signs or symptoms. So how do you know if you need testing? Consider a check:
- In a new relationship. Get checked with your partner before stopping condoms.
- If you have had unprotected sex with a new partner or if a condom breaks
- If you are under 25, especially if you have had multiple partners
- If you have a partner who has an STI
What if I have symptoms? See your GP if you have:
- An unusual vaginal discharge
- Pain during sex or urination
- Sores, blisters, ulcers, lumps or a rash in the genital area
- Genital itch or irritation
An STI check may involve a genital examination, blood and urine tests and a genital swab. Blood tests may need to be repeated later as they can take up to 3 months to turn positive in some cases.
Don’t be embarrassed to discuss your concerns with your doctor. Your sexual health is a normal part of your health care.
www.health.nsw.gov.au/sexualhealth
WHAT IS YOUR ‘ABSOLUTE’ RISK OF CVD?
Cardiovascular disease or CVD (heart, stroke and blood vessel disease) is the leading cause of death in Australia. People at high absolute risk have most to gain from preventative strategies.
What is absolute risk?
Your absolute risk is your chance of having a cardiovascular event (such as a heart attack or stroke) over a period of time, usually the next 5 years. You are at high absolute risk if you already have cardiovascular disease, diabetes or kidney disease.
However, your absolute risk may also be raised if you have some CVD risk factors:
- High blood pressure
- Raised cholesterol
- Smoking
- Overweight and obesity
- Physical inactivity
- Depression
Why does it matter?
Increasingly, doctors are basing decisions to treat you on your absolute risk level. For example, a slightly raised blood pressure requires drug treatment in someone with diabetes, because the risk of further cardiovascular events is already high.
On the other hand, a moderately high blood pressure in a young, healthy person at low absolute risk may not require therapy at all. In this situation, the benefits of treatment may not justify the risk of side effects.
The more risk factors you have, the greater is your risk. A mildly raised blood pressure and cholesterol in an overweight person create a substantial increased risk requiring aggressive management.
For best results, treat all your risk factors, not just one or two. Treating your blood pressure is good, however you will get a much greater risk reduction if you lower cholesterol and lose weight as well.
www.heartfoundation.com.au
Fish oil (from fish or capsules) is rich in omega-3 fatty acids which have proven health benefits.
Fish oil is recommended by the National Heart Foundation for people with existing heart disease to prevent heart attacks. Doctors also use it to lower triglycerides (a harmful blood fat). Fish oil has anti-inflammatory effects and reduces pain and stiffness in rheumatoid arthritis.
Oily fish such as sardines, trout, salmon, tuna, herring and mackerel are particularly rich in omega-3 fats. We should all try to eat at least 2 fish meals a week (fresh or canned), adding fish oil capsule supplements if required.
WHAT’S NEW IN CHOLESTEROL TREATMENT?
Treatment of high cholesterol now mainly targets the LDL-cholesterol level (low density lipoprotein), not your total cholesterol. LDL or ‘bad’ cholesterol is the type of cholesterol which causes most harm.
The National Heart Foundation (NHF) recommends an LDL-cholesterol below 2.5 mmol/L for average risk patients. For patients at high absolute risk (see opposite), the target is < 2.0 mmol/L, although even lower is better.
The NHF no longer recommends a target level for total cholesterol.
WHAT CAN I DO TO HELP MYSELF BEAT DEPRESSION?
Exercise was reported to be the most effective self-help strategy for people with depression according to a recent large study by the Black Dog Institute in Sydney.
Exercise was followed by yoga/meditation, relaxation and massage. Herbal preparations and omega-3 fatty acids were reported to be the least effective treatments.
Medication and counselling were not included in the study.
SORE THROAT. CAN YOUR DOCTOR HELP?
Children often have sore throats in winter and most get better on their own. When should you go to the doctor for treatment?
Most sore throats are due to pharyngitis an infection causing a general redness at the back of the throat (pharynx). Pharyngitis is usually part of a head cold or flu.
Sometimes the cause is tonsillitis, an infection of the tonsils, the two soft, pink lumps at the back of the mouth, one on either side. When they become infected, they get red and swollen, sometimes with white patches (pus) on the surface.
Tonsillitis causes a sore throat, difficulty swallowing, fever and swollen, tender neck glands.
Will an antibiotic help?
Both types of sore throat are usually caused by viruses, which do not respond to antibiotics. Most children are over their infection within a week whether they take antibiotics or not. Furthermore, antibiotics can have unpleasant side effects such as diarrhoea, tummy upsets and rashes.
Nevertheless, if your doctor suspects the infection is bacterial, he or she may recommend an antibiotic as it may shorten the illness. The medication should be taken for a full 10 day course.
Give your child paracetamol every four hours if required for pain relief. Frequent warm drinks are soothing and soft foods such as custards and jelly are easier to swallow.
When to see your doctor
See your GP if the sore throat lasts over 48 hours, if you are worried or if your child:
- Is unable to swallow
- Vomits frequently
- Has difficulty breathing
- Has a high fever or a skin rash
GIVING MEDICINES TO YOUNG CHILDREN
1. Measure the dose carefully
Young children’s bodies are not large, so even small errors in the dose of medicine can have serious consequences. The correct dose is usually based on the child’s weight, rather than their age.
Use a proper medicine measuring device, such as a medicine spoon, cup, dropper or syringe. Don’t use an ordinary kitchen teaspoon, which can hold anything from 2 to 8 ml.
2. How to get the medicine down
Don’t put the medicine in a baby’s milk or juice bottle. If they don’t drink the whole bottle, they won’t get the full dose.
To prevent a baby spitting out their medicine, place the dose on the inside of the cheek and keep their mouth closed until they’ve swallowed it.
3. Avoid child poisoning
Keep all medicines out of sight and at least 1.5 metres above floor level. Replace child-resistant lids immediately after use and keep handbags in a safe place.
Take unwanted or out-of-date medicines to any pharmacy for free and safe disposal. Don’t pour them down the sink or toilet as this pollutes the environment.
If you suspect a child has taken a medicine, ring the Poisons Information Centre on 13 11 26, or go to the nearest hospital.
4. Where to get more information
i. Talk to your GP or pharmacist or ring the free Medicines Line on 1300 888 763 (Monday to Friday 9am – 6pm EST).
ii. The National Prescribing Service (NPS) website at www.nps.org.au/consumers.
iii. Subscribe to MedicinesTalk, a free quarterly NPS newsletter on using medicines wisely. Write to the NPS, PO Box 1147, Strawberry Hills, NSW 2012 or order at the website above.
1 red capsicum (400g)
1 yellow capsicum (400g)
Vegetable oil spray
350g penne pasta
1 tablespoon olive oil
1 red onion, finely chopped
2 cloves garlic, crushed
200g zucchini, sliced in half lengthwise and finely sliced
1 cup tomato passata
1/4 cup chopped basil leaves
Method
1. Preheat oven to 2000C. Place capsicums in roasting dish, spray well with vegetable oil spray. Cook 45 mins till skin black and flesh soft.
2. Remove from oven and cover with clean, damp tea towel for 10 mins. Peel and discard seeds and skin. Slice flesh into strips.
3. Cook pasta, then drain and keep warm. Meanwhile place olive oil in large saucepan over medium heat. Cook onion and garlic for 2-3 minutes until soft. Add zucchini and cook 3-4 mins. Stir through passata, capsicum and 1/2 cup water, cook for 5-7mins. Stir in pasta, basil and ground black pepper to taste.
From: The Australian Healthy Food Guide.
