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Childhood obesity: how to help children have a healthy weight

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on 13-01-2020

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In recent years the percentage of obese children has been much higher than 20 years ago, when there was no talk of improving healthy lifestyle habits among children, according to the Paediatrics Department at Vithas Xanit International Hospital

Obviously, over the course of years, we have changed our way of living and that has harmed our health. As a society in general, we are increasingly leading a sedentary lifestyle, we are subjected to stress and the level of pollution increases day by day. The Mediterranean diet that we are so proud of is being swapped for processed meals, we do not sit down to eat with the family and do not exercise enough.

To try to understand the danger of childhood obesity and how to overcome it, we spoke with a specialist in this topic: Dr Pablo Ercoli, a paediatrician at Vithas Xanit International Hospital. The first question that we would like to ask the specialist is obvious:

 

From what parameters can you say that a child is obese?

By linking the weight and height of the child, we can get a parameter called Body Mass Index (BMI). If we compare it with a population of the same age and sex, we will be able to know if, within these parameters, the index is high or low, which is quantified by the so-called percentiles. In this case, percentiles express the percentage of the population with a lower BMI than the studied individual. Children between the 90th and 97th percentile would be defined as overweight patients. Those above the 97th percentile would fall within the definition of obesity.

 

Consequences of obesity on children’s health

Today we know that obesity is a proinflammatory state, which worsens the current and also future health of the child (diabetes, hypertension, hypercholesterolemia, etc.). Specifically, it generates various problems, from joint pain, back pain or trouble breathing well, especially when sleeping. There are also other triggers for childhood obesity, such as increasingly evident problems arising at school in the form of bullying, which is usually what makes the child and the family consult a specialist.

As previously said, as likely health consequences, in adulthood obese children will suffer from hypertension, hypercholesterolemia, diabetes, heart problems to name a few. It goes without saying that it is always better to prevent these pathologies rather than having to fight them later on in life!

Are there differences between the feeding of a boy and a girl?

Healthy and varied eating should be the same for everyone, although it is true, for example, that in adolescence more iron intake is recommended for girls and more calories in boys.

As for the recommended daily calories, they depend closely on the age and specific needs of each child. Although paediatricians usually calculate individual caloric needs, it is generally better to focus on healthy eating, without calorie numbers as we adults do.

 

Healthy foods for proper feeding of children

In general, children should eat everything, as long as it is healthy.

Fruits and vegetables can never be missed. It is advisable to eat three pieces of fruit and 2 servings of vegetables a day, 5 in total, like the fingers of one hand! And if both are seasonal, it’s better.

Fish and legumes are also very important. Another food that can never be missing to accompany our meals is olive oil, however, in the amounts recommended for its high caloric load.

Also, there is increasing emphasis on the importance of the consumption of natural nuts, and processed nuts (fried, salted, ticked, etc.) should be avoided.

Finally, we will have to avoid processed and ultra-processed foods, excess salt, sugars, fats and proteins. Avoid specially packaged juices, pastries and sugary drinks.

 

Fewer fresh juices and more fruit pieces for children

Let’s take orange juice as an example. To fill a glass, squeezing without pulp, we will need about six oranges. That brings us too many sugars.

Besides, its absorption rate, which is called the “glycemic index”, is also essential. By extracting the juice from any fruit we make this glycemic index much higher, almost similar to that of refined sugars (sweets, pastries, etc.), which has known negative effects on health. Taking the whole fruit, in addition to reducing the net amount of sugar that is ingested, causes that, thanks to the pulp and the rest of its components, the glycemic index is considerably reduced, which results in a very positive way in health.

Therefore, it is certainly preferable to eat one or two whole oranges than a glass of natural juice made from several squeezed oranges.

 

How parents should act with an overweight child

The first thing is to assume that there is a problem and that it also has a solution.

A correct diet and proper exercise will make your child enjoy a full, healthy life now and when they grow up.

Overweight, obesity and undernourishment can be included in the concept of malnutrition. It is likely that even if a single family member has the diagnosis, everyone in the house has dietary habits that can be improved. It makes us think that malnutrition is a family and social problem rather than that of a single person, and that changing habits will improve the quality of life of everyone in the house.

We have to eat again as a family, taking our time, without watching television while we are eating. Going back to the “spoon” meal, grandmother’s recipes and the Mediterranean diet of local products. Besides, if we combine it with exercise, we will have healthy habits for life!

The Three Wise Men have visited our hospital!!!!

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on 26-06-2019

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On Friday, the 4th of January, Vithas Xanit International Hospital had a visit from the Three Wise Men, much to children amusement, both those who were hospitalised and those who at the time were found in the Paediatric Emergency Room and the Paediatric Outpatient Clinics.

The Three Kings or the Three Wise Men, further to visiting the hospitalised children, marked the Vithas Family Day along with the children of the hospital’s staff, with a guided tour of the hospital that ended in the Congress Hall where all the children present received a gift.

Here are a few photos from the visit.

Use of X-rays in patients, is it safe?

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on 14-11-2018

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Many of us would like to know what happens when we undergo a diagnostic test, particularly tests with equipment emitting X-rays or radioactive isotopes in nuclear medicine. In these cases, the question arises whether they pose a risk to our health and whether they are indispensable.

Today, Dr Manzano, Head of the Medical Physics and Radiological Protection Department at Vithas Xanit International Hospital, tells us how safe is the use of X-rays and isotopes in Nuclear Medicine and what progress we are making regarding the information available to the patient.

How safe are X-rays?

Almost everything we do in our day to day life carries some degree of probability of complication, contemplated as risks of the kind, one in a thousand or one in a million.

An activity should be considered safe when the risk of an adverse effect occurring is less than one for every million times repeated: that is, what probability would it be if we repeated the same activity thousands or millions of times.

We are all fully aware of the fact that since its discovery, X-rays were one of the most significant advances of humanity, and they have allowed the medicine to understand how diseases occur within the human body without having to cut it open, saving the lives of millions of people. The X-ray machine was chosen as the most important scientific invention in the world, surpassing even penicillin (London Science Museum Survey).

For most studies, the dose received may be the same as that received by any person NOT subjected to an X-ray test in a year. The more complex and time-consuming studies can be equivalent to several years of natural radiation, still being at low risk, between one in hundred thousand and one in ten thousand.

As for the risk of developing some malignant disease, we need to know that the risk in chest or limb studies is considered minimal, less than one in a million. We can also make a comparison by saying that a test of these characteristics is equivalent to the natural radiation which we receive in the course of a few days.

We have to understand that the X-ray guarantees us the more precise diagnosis, which in return gives more opportunities to receive a correct treatment for a disease or ailment in question.

Therefore, we can conclude that X-rays are quite safe for the patient and that the benefits of any radiological study will always exceed the risk of these small doses of radiation: this is the principle of justification laid down in the legislation and on which any diagnostic test should be based.

What changes will occur concerning the information that will be offered to the patient?

There is already a draft royal decree on medical ionising radiation planned for this year. The text updates the national legislation on Directive 2013/59/Euratom replacing Royal Decree 815/2001 of 13 July concerning the use of ionising radiation in the field of medicine.

It proposes stricter requirements regarding the information to be provided to patients, the recording and reporting of doses of medical-radiological procedures, the use of reference levels for diagnosis and the availability of dose indicator devices.

With all this mentioned, we can see that we are already making significant progress for the patients of the 21st century, who will be progressively more informed about the treatments and be more aware of their environment.  Such a sign of progress implies advances when it comes to diagnosis, as well as more information about the medical acts and the risks to which we may be exposed.

An important fact when it comes to providing information is that it must be written in a clear and understandable manner, not causing further doubts and queries. Therefore, it would be good if we all knew something about the radiation and its use, the advances it has made in medical technology and its benefits that millions of people worldwide have enjoyed.

Non-alcoholic fatty liver

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on 20-09-2018

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Fatty liver occurs when there is an accumulation inside its cells of small droplets containing different types of fats(mainly fatty acids and triglyceride). It is a widespread pathology in the western world and in Spain, where it affects 25% of the population.

It can occurafter taking certain drugs, in people who consume significant amounts of alcohol (in which cases we call it fatty liver or alcoholic steatosis), but also in people who do not consume drugs or significant amounts of alcohol. It is in these latter cases when we use the term FATTY LIVER OR NON-ALCOHOLIC STEATOSIS.

 

 The causes are multiple

Although genetic predispositionis one of the causes of this pathology, it is not the only one, since other factors also play a role, among which we can highlight overweight and obesity, which fundamentally affects the increase in the abdominal perimeter. Fatty liver is a pathology that also develops especially in diabetic patients(more than half of the patientsdiagnosed with diabetes develop a fatty liver), and in patients with increased levels of fats such as cholesterol and triglyceride in the blood. When all these factors coincide, we say that the patient has metabolicsyndrome. Metabolic syndrome implies that a series of alterations occur in some of the proteins that regulate the formation and elimination of fats inside the liver cell, causing fat to accumulate inside small vacuoles or fat droplets. These gradually increase in size until they cause the rupture of the hepatic cell, and in affected patients it is reflected in frequently altered “liver transaminase” (enzymes found inside the hepatic cell and which pass into the blood, elevating their levels with the ruptures of the hepatocyte). Thisis often the only sign of the disease, asthepatient usually has no or very mild symptoms.

 The Risks

Most patients with non-alcoholic fatty liver have mild liver inflammation, and the likelihood of long-term severe liver lesions or complications in liver function is low. However,in 20% of cases, the damage caused to the liver is significant, and the patients may develop cirrhosis, thereby increasing the risk of liver failure or complications such as liver tumours.But this isn’t the only complication of fatty liver. It is knownthat the presence of significant hepatic steatosis is also an indirect cardiovascular risk,with these patients having a higher incidence of cardiac and vascular complications.The incidence of other tumours outside the liver is also higher among patients with the non-alcoholic fatty liver.

Diagnosis

Diagnosing non-alcoholic fatty liver in patients with the suspectedliver disease is a challenge. The study of these patients, at the first instance, has to rule out the existence of other coinciding liver pathologies,such as hepatitis or alcohol abuse, as well as those that could worsen the prognosis of the patients. It is also important to try to identify those cases when a patient has a fatty liver with more pronounced inflammation and is, therefore, more likely to have complications in the future. Detection of such cases allows special surveillance for this high-risk subgroup, as well as the implementation of a therapeutic plan based on the combination of a diet and physical exercise to reduce the overweight and insulin resistance usually present in diagnosed patients. Besides, the use of some drugsin certain circumstances can also help control and improve the disease and its associated comorbidities.

Back pain at work and school

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on 06-09-2018

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Some pains arevery familiar to all of us. One of them is back pain. This ailment is, for various reasons, one of the most frequent reasons for medical consultations both in adults and children, but why? As we approach back-to-schooland back-to-work time of the year, what recommendations can we use to prevent and alleviate these annoying pains?

Dr Antonio Narvaez, Head of the Traumatology Department at the Vithas Xanit International Hospital in Benalmádena tells us why our back hurts, and also offers us some advice on how to address this problem.

Back pain is very common among the general population and is largely due to bad postural habits in a spine with poorly exercised back musculature.

Back pain problems can vary according to patient’s age – in children they may be due to problems of scoliosis or small fractures in some parts of the vertebrae.In middle age patients, the back problems are mainly due to pathological intervertebral discsthat can trigger herniated discs and in elderly patients,the back pain is usually due toproblems in disc dehydration, resulting in nerve compressions and instabilities in the spine. Whetherwe are dealing with cervical or lumbar pain, usually in almost all cases the origin of the pain is in disc pathologies which are a commondenominator.

Recommendations for back-to-school… and work

Oftenwhen children complain of back pain at school, the main recommendation is to maintain good postures while studying, avoid carrying heavy loads on the back and do physical exercise.

For adults with back problems at work, the recommendations are similar, fundamentally postural changes and building muscle strength and flexibility.

We might avoid back pain or prevent its recurrence by improving our physical condition and learning and practisingproper body mechanics.

If we analyse the way we should hold our body, the correctposture is sitting with the back upright, avoiding flexure.We should choose a seat with good lower back support, armrests and a swivel base.

We must avoid, whenever possible, carrying the heavy load on our back, movements that twist or strainour back and avoid heavy lifting. Our spinal column is not designed to carry heavy loads. We should be using alternative weight-bearing systems so that our vertebrae and discs do not have to sufferthe weight, thus helping us maintain the health of our back.

Well-practisedsportsactivity can also help us to prevent back pain, because the strengthenmusculature stabilisesthe spine. However, it is important that we carry out the physical activity in a controlled way and whenever possible to be monitored by a good instructor, and to avoid exercises with heavy weights without being supervised.

We cantake measures to prevent or relieve most back pain episodes simply by following the recommendations given by the specialists in this field. However, in the case of severe pain, or development of further complications and symptoms, we should seek medicalhelp.

Vitamin D: A source of health for our body (Part II)

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on 09-07-2018

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There is a common belief that there is only one type of Vitamin D. In fact, there are several. Of these, those that interest us for our health are D2 and D3.

Vitamin D2 is a prohormone that is mainly found in fungi as of ergosterol molecules in combination with ultraviolet radiation from the sun. Some plants contaminated with fungi are capable of having Vitamin D2 in their composition.

On the other hand, Vitamin D3 is generated by plants in their normal state and by animal cholesterol molecules together with the interaction of ultraviolet light.

 

Vitamin D3 or D2: which one is better?

Until recently it was believed that both forms of Vitamin D were similar. However, clinical trials have shown that D3 is much more beneficial.

Clinical studies have revealed that Vitamin D3 is much more effective than D2. People who take Vitamin D3 get twice the level of Vitamin D in their body, compared to those who take Vitamin D2.

 

Fortification of food with Vitamin D

In recent years, many retailers in the food industry have enriched their products with Vitamin D2 in the belief that it meets the daily needs of consumers. However, clinical studies have shown that Vitamin D3 is much more effective than Vitamin D2.

People who eat foods that contain Vitamin D3, such as fish, eggs, or Vitamin D3 supplements, increase their Vitamin D levels much more than people who eat foods that contain Vitamin D2, such as bread or milk enriched with Vitamin D2 or dietary supplements of Vitamin D2.

 

Curiosities of Vitamin D

It has been proventhat 90% of Vitamin D is produced directly in the body using UVB radiation from the sun and that only the remaining 10% is acquiredthrough diet.

The farther we live from the equator, the darker skin we have, the more overweight we are and the less exposedwe are to the sun, in those cases we should be taking more Vitamin D supplements, either through food or as a dietary supplement, to achieve healthy blood levels of this vitamin.

Walking for 20 minutes a day in winter may be well-intentioned advice, but it is not enough to synthesise the amount of Vitamin D needed for our body.

Vitamin D has an antimicrobial effect by enhancing the immune system as well as anti-inflammatory properties. Thus, it plays a decisive role in preventing acute or chronic inflammation and accelerating the healing process.

Vitamin D is used to prevent Alzheimer’s, as it facilitates communication between nerve cells and therefore, protects them from long-term death.

Russian and German athletes have used the benefits of the sun to improve physical performance for the past 30-40 years. They knew that Vitamin D promotes muscle efficiency and endurance, and, therefore, helps improve sports performance.

Clinical studies show that Vitamin D is essential for maintaining optimal conditions of our brain and state of mind and that its deficiency can lead to depression.

With age, the body gradually loses the ability to synthesise Vitamin D through sunlight. At the same time, the age increases the body’s need for Vitamin D.

Antidepressants, anticoagulants, corticosteroids, and medications to treat peptic ulcer and epilepsy may inhibit the absorption of the Vitamin D we take through our diet. Also, people with heavy alcohol consumption may be at increased risk of Vitamin D deficiency. They are advisedto take Vitamin D as a supplement.

Vegans, in particular, are at higher risk of Vitamin D deficiency, as this vitamin is usually contained mainly in foods of animal origin. However, mushrooms and avocados also contain Vitamin D2 and a precursor of Vitamin D3.

Sunscreens prevent the synthesis of Vitamin D. For that reason, to get our body to generate Vitamin D, we should walk for 10-20 minutes without sun protection and then apply the sunscreen.

However, the sun exposure poses a dilemma, while it may be useful for producing Vitamin D, which protects us against certain types of cancer, osteoporosis, Alzheimer’s and other diseases, it is worth considering whether it can cause skin cancer.

Vitamin D: A source of health for our body (Part I)

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on 03-07-2018

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We have always talked about Vitamin D as something essential to strengthen our bones. However, it is now knownthat further to keeping our bones and teeth healthy, it intervenes in the functioning of almost every organ and tissue in our body. More specifically, it is essential for the metabolic process of the intestine, brain, heart, pancreas, skin and lymphocytes.

That is why a deficit of Vitamin D affects our whole body, and it is essential to re-establish its normal, required levels as soon as possible.

 

Vitamin D protects our health and prevents us from possible illnesses

Maintaining proper levels of Vitamin D in our body is imperative. Because, apart from its benefits for our bones, Vitamin D prevents the onset of a large number of diseases:

  • Autoimmune diseases
  • Common cold
  • Bone diseases (including rickets)
  • Osteoporosis
  • Bone and back pain
  • Depression
  • Diabetes
  • Cardiovascular diseases
  • Hypertension
  • Chronic inflammation
  • Disorders of the immune system
  • Muscle weakness
  • Psoriasis
  • Rheumatoid arthritis
  • Neurological diseases
  • Alzheimer
  • PMS
  • Cancer

We cannot say that these diseases are caused solely by a deficiency of Vitamin D. However, researchers believe that the lack of Vitamin D is a decisive factor contributing to the development of these pathologies and that, on the other hand, we can minimise their risks by maintainingadequate levels of Vitamin D.

 

Threedifferent ways to get Vitamin D

Our body can obtain its daily needs of VitaminD in 3 different ways:

  • Daily sun exposure can provide an indirect source of vitamin D. Although sunlight itself does not contain Vitamin D, it promotes the synthesis of this vitamin in the body. Healthy exposure to the sun’s UVB rays is the most natural and practical way to achieve the right levels.
  • By eating natural foods that contain this vitamin: oily fish, butter, milk, egg yolk, cheese…
  • There arevitamin D supplementsthat become a good option for people with vitamin D deficiency. They are practical and very effective.

Symptoms of a Vitamin D deficiency

Many symptoms makeus suspect that a patient has a deficit of Vitamin D:

  • Rickets in children
  • Osteomalacia (softening of the bones)
  • Osteoporosis(fragile bones)
  • Musculoskeletalpain
  • Susceptibility to allergies
  • Respiratory tract infections
  • Organic pain

 

These symptoms improve and even disappear when the level of Vitamin D in the body normalises.

Infectious meningitis in children

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on 24-05-2018

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The paediatric meningitis is, without a doubt, one of the diseases that cause the mostconcern for parents. However, we should emphasise that, despite the potential severity of the disease, it is rare in Spain, with the majority of cases occurring in children under five years of age, especially children under one year of age and adults over 65. This post aims to give parents a little insight into the symptoms of bacterial meningitis and how to treat them. First of all, let us find out a bit more about this disease.

 

What is Infectious Meningitis?

The meninges are membranes that cover and protect the Central Nervous System (brain, cerebellum and spinal cord), further to performing other functions. Between the meninges, there is the cerebrospinal fluid, which surrounds the Central Nervous System and also contributes to its functions.

When a germpenetrates these membranes and reaches the Central Nervous System,inflammation of the meninges (“meningitis”)occurs as a result of both the pathogenic activity of the germ and the body’s defensive response to the invasion. Some patients may also have certain risk factorsthat make them especially prone to some types of meningitis.

In addition to infectious meningitis, which is the most common type, other diseases can cause meningeal inflammation by abnormal activation of the immune system in the absence of infection (autoimmune meningitis).

 

Types of meningitis depending on the causing germ

Viral meningitis:Produced by a multitude of different viruses. It is the most frequent type of meningeal inflammation.

Bacterial meningitis:Caused by different bacteria. It is the most severe type of meningitis. The most common bacteria in our environment today are meningococcus and pneumococcus. In newborns, the most common are germs related to the birth canal.

Tuberculous meningitis: Caused by the bacteria that causes tuberculosis. It is also a severe type of inflammation, more frequent in immunocompromised patients. However, nowadaysit is very rear to see this type of meningitis in our environment.

 

Symptoms of Meningitis

Symptoms, as in almost any infection in Paediatrics, depend on the age of the patient. In general,the younger the child, the more non-specific are the symptoms, although fever is present in virtually all cases.

Innewborns and small children, irritability or drowsiness may also occur.

In older children, headache, vomiting, stiff neck, or sleep tendency are more common.

In all cases,seizures or other signs of neurological involvement may occur. The range of possibilities is very wide.

 

In any case, it is essential to bear in mind that these symptoms can be non-specific and could be a part any other banal infectious process,so when in doubt, it is crucial to assess the patient by a paediatrician.

 

How we diagnose Meningitis

First, thecomplete medical historyis analysed, and a detailed physical examinationis performed to establish the diagnosis of suspected acute meningitis.

If there is any suspicion, a blood testis usually requested, which in many cases can help the diagnosis and differentiate one type of meningitis from another.

However, the only test that can confirm or rule out the diagnosis of meningitis and identify the germ causing the infection is the lumbar puncture.

Besides,imaging tests, such as cranial ultrasound or computed tomography (CT), are sometimes performed at the discretion of the paediatrician.

 

Lumbar puncture as a definitive test

It is the only test that can confirm or rule out the diagnosis of meningitis and identify the germ causing the infection, so it should always be performedif meningitis is suspected and in the absence of any of its few contraindications.

Cerebrospinal fluid sampling is a technique in which a sample is removedthrough a puncture in the lower back. It is usually performed under topical anaesthesia in the form of cream over the puncture site, although depending on the age and the specific case, it can also be performed under sedation with systemic mediation, generally, but not exclusively, intravenously.

With this technique, complications are infrequent and almost always local (pain after the puncture, local bleeding, etc.). In children, pain or stiffness in the back after the puncture is much less common than in adults. In some children, especially newborns and small infants (because of their small size) the technique may be somewhat more complicated and more than one attempt may be needed to obtain a valid sample (it may even be that no sample is obtainedat all).

 

Treatments for infectious meningitis

Viral meningitisrequires almost no specific treatment at all.It heals on its own after a few days, so the only treatment is theusual analgesicsto control possible symptoms (such as a headache, malaise). Many of the patients affected by viral meningitis do not even need hospital admission and can be treatedat home. A notable exceptionis the case of infection with the herpes virus(herpetic meningoencephalitis), which is a severe condition thatrequires hospital admission,often in paediatric ICU, and prolonged intravenous antiviral treatment.

In all cases, bacterial meningitisrequires hospital admission and intravenous antibiotic treatment, sometimes with more than one antibiotic until the causal germ is identified. Also, other treatments,such as corticosteroids, anti-epileptics or intravenous fluids, may be necessary.

 

Infectious Meningitis Prognosis

Viral meningitis heals itself, and the possibility of complications or sequelae is extraordinarily rare, except in the case of herpetic meningoencephalitis, which is associatedwith a high percentage of neurological sequelae and mortality, even with adequate treatment.

Bacterial Meningitishas a mortality of practically 100% of the cases if proper antibiotic therapy is not started, although with a correct treatment patient clinical progress is usually good. However, even in this case, it can also be associated with neurological sequelae and mortality.

Still, the actual prognosis depends on many factors(age of the patient, progress period, the presence of other risk factors, causal germ).

 

Can infectious meningitis be prevented?

Viral meningitis cannot be prevented.The viruses that cause it are multiple, and of constant circulation between humans, so it is impossible to avoid contact with them. The exception is herpetic meningoencephalitis,in which case there are some measures to avoid infection in the birth canal in newborns, although there is no real prevention option at a later age.

Most bacterial meningitis can be preventedby using vaccines.Severe meningitis caused by some bacteria very common a few years ago, such as those produced byHaemophilus influenza type B or meningococcus C, have decreased drastically today (they have almost disappeared in the case of Haemophilus) thanks to the vaccination of the entire population against these germs included in the vaccination calendar financed by the Public Health System. Another bacterium that causes many cases of meningitis is pneumococcus, whose vaccine (Prevenar 13®) has also recently been includedin vaccination programs throughout Spain.

Finally, vaccines against the rest of the meningococcal serogroups are also available on the private market.In this respect, it is worth noting:

  • Vaccinesagainst meningococcus B: Bexsero®and Trumenba®. The first type of vaccine can be administeredto infants sixweeks old and the second, to children from 10 years onward. They are recommendedfor all children, especially those under the age of 5, when the disease outbreak is most common.
  • ACWY meningococcalvaccines: Nimenrix®and Menveo®. Recommended for teenagers who are going to travel to risk areas or who have some factors that make them especially susceptible to the disease. The administration of this particular vaccine can also be assessed in other adolescents to increase the degree of individual protection.

In some specific cases, such as in patients with risk factors, those under current outbreaks of the disease or laboratory personnel, these vaccines may be financed by Social Security.

In addition to vaccines, preventive antibiotic treatmentis recommendedwhen in close contact with confirmed cases of bacterial meningitis, which, in the event of school outbreaks, can be extended to all school staff and students.

Chronic Hepatitis C. New direct-acting antiviral treatments

Posted by Xanit Internacional Xanit Internacional | Posted in Various, Xanit salud | Posted on 28-02-2018

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The hepatitis C virus is a small RNA virus which has a special affinity for infecting liver cells. It is an infectious disease which, the majority of the time, is transmitted by exposure to blood contaminated with the virus.

In this post Dr. Juan Carlos Gavilan, from the Department of General Internal Medicine, explains about the new direct-acting antiviral treatments for chronic hepatitis C infection.

How is this virus transmitted?

In the past, before there was a blood test available to test blood donors, contaminated blood transfusion or the use of syringes and/or contaminated material in patients who were drug users was the most common method of transmission. Nowadays transmission through transfusion is highly unlikely. The risk of sexual transmission of the virus is low, although not impossible. However, a high percentage of patients who have the infection do not have any of the risk factors mentioned, therefore they very probably acquired it as a result of “unnoticed” exposure to blood or material contaminated with infected blood. 

 

How does the hepatitis C virus act?

Once in the body the virus multiplies leading to acute hepatitis, but in many cases the patient does not become jaundiced and the symptoms present as tiredness and weakness which are attributed to other factors, the infection passing unnoticed.

In approximately 20% of cases, the body’s defence system is able to effectively eliminate the infection, with it resolving spontaneously, but in 80% of cases this does not happen, and CHRONIC HEPATITIS develops. In other words it persists long term, causing continuous inflammation of the liver, which in a third of patients can lead to liver cirrhosis years later, and with it complications such as liver failure or liver cancer.

During the chronic phase, the infection presents few symptoms and frequently passes unnoticed until it is found incidentally on blood tests, or when donating blood. Spontaneous elimination during the chronic phase is very unlikely. Between 1 and 2% of the Spanish population may be affected, with a percentage of infected patients being unaware, precisely because of the lack of symptoms presented.

Possible treatment for hepatitis C

For years there was no effective treatment available to eliminate the virus; subsequently there were treatments such as interferon and ribavirin which had many side effects with low rates of recovery.

Nowadays however we have a wide range of direct-acting antiviral drugs, in tablet form. In more than 95% of cases these are capable of eliminating the infection with less than 12 weeks of treatment, and with few side effects.  Elimination of the virus during the chronic hepatitis phase, before the virus has caused significant damage to the structure of the liver, particularly in relation to the degree of fibrosis caused in the organ, makes the final prognosis after treatment excellent.

In cases where effective elimination of the virus takes place, but the liver already has a significant degree of fibrosis at the time of treatment, particularly if there is established cirrhosis, prognosis also improves. However elimination of the virus does not reduce possible future complications to zero as the liver can be affected by the consequences of cirrhosis, in these cases special monitoring is therefore recommended.

Detection of undiagnosed cases and their treatment will allow future eradication of the infection and of the complications which could result from the risk of progression to cirrhosis in many of these patients.

Bruxism exercises to improve jaw tension

Posted by Xanit Internacional Xanit Internacional | Posted in Various | Posted on 22-02-2018

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Bruxism refers to a biomechanical alteration of the temporomandibular joint that causes teeth grinding and jaw clenching. This alteration, although it may occur at any time, day or night, has a higher incidence during the night.

Dental pieces are usually the most subjected to this alteration, getting worn out due to the continuous movement of the upper teeth over the lower, in the form of compressing and grinding. Bruxism affects the teeth, but it also affects or may affect, other parts of the head.

Francisco Luis Garrido Luque, from the Physiotherapy Unit of the  Vithas Xanit Internacional Hospital, explains today the causes and symptoms of bruxism, offering some advice and recommendations on how to fight it.

Causes of Bruxism

Bruxism is a mechanical pathology with the psychological or emotional origin,in which stressis the leading cause. Other factors can exacerbate symptoms, such as poor eating habits, lack of rest, among other.

Symptoms of Bruxism

Many symptoms accompany bruxism. As we mentioned above, tooth wear is one of the main symptoms, but there are many others, which we will elaborate below:

  • Pain and inflammation of the jaw joint.
  • A headache: The permanent contraction of the muscles involved in chewing generates pain of referred character to the head area. Also, there are many nerve structures in that area that can be overstimulated.
  • Ear pain, due to the relationship between the jaw joint and the auditory canal.

 

Exercises and tips to combat Bruxism and relax the mandibular joint

Meditation or relaxation

For a minute, we should focus on our breathing. To do this, we are going to lie down in a comfortable position, with arms and legs relaxed. Then we should close our eyes, and observe our breathing, and its two phases. The inspiratory phase, and the expiratory phase. During the observation stage, we will realise how many thoughts we have on our mind, which we will ignore, only focusing on our breathing, as if it were a roller coaster, going up and down. We observe its amplitude, symmetry. This exercise will clean our mind. As we have already mentioned, a good emotional state is essential to control bruxism and work on the same.

Massage of the muscles involved

Another technique that we can perform is massaging all the hypertonic muscles which relaxation will help their decompression. Besides, the massage will improve the entire circulation of the musculature.

Ear traction

Commonly known as “ear pull” is a technique used in cranial osteopathyfor decompression of the temporal bone, bone of vital importance in the constitution of the temporomandibular joint or jaw joint. Lying in a comfortable position, we press our earlobe with the thumbs and forefingers, and we will pull it gently towards the feet. When we notice a resistance, we should maintain the traction. Little by little, we will notice that the tissues relax.

Exercises for mobilisation and relaxation of the joint

We can also perform exercises to open and close the mouth, displacements of the lower jaw bone in both directions, right and left, in order to stretch the musculature.

Cervical stretching

We can also performcervical stretches, taking the ear to one shoulder and maintaining the tension for thirty seconds, in a smooth, slow and progressive way. We will perform stretching on both sides, in addition to combining them with breathing exercises, to achieve total relaxation of the tissues.

If after a period of following these recommendations we continue with Bruxism, it would be advisable to seek help from our GP or physiotherapist.