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Friday, June 30, 2006



Mumps is a viral infection that primarily affects the parotid glands — one of three pairs of salivary glands, located below and in front of your ears. If you or your child contracts mumps, it can cause swelling in one or both parotid glands.

Your odds of contracting mumps aren't very high. Mumps was common until the mumps vaccine was licensed in 1967. Before the vaccine, up to 200,000 cases of mumps occurred each year in the United States. Since then, the number of cases has dropped dramatically.

Outbreaks of mumps still occur in the United States, and mumps is still common in many parts of the world, so getting a vaccination to prevent mumps is important.
Signs and symptoms

About one in five people infected with the mumps virus have no signs or symptoms. When signs and symptoms do develop, they usually appear about two to three weeks after exposure to the virus and may include:
Swollen, painful salivary glands on one or both sides of the face
Pain with chewing or swallowing
Weakness and fatigue

The primary — and best known — sign of mumps is swollen salivary glands that cause the cheeks to puff out. In fact, the term "mumps" is an old expression for lumps or bumps within the cheeks.

You have three pairs of salivary glands that secrete saliva. Each gland, including the parotid in the cheek, has its own tube (duct) leading from the gland to the mouth.

Mumps is characterized by swollen, painful salivary glands in the face, causing the cheeks to puff out.

The cause of mumps is the mumps virus, which spreads easily from person to person through infected saliva. If you're not immune, you can contract mumps by breathing in saliva droplets of an infected person who has just sneezed or coughed. You can also contract mumps from sharing utensils or cups with someone who has mumps. Mumps is about as contagious as the flu.
When to seek medical advice

If you suspect that you or your child has mumps, see your doctor. Mumps has become an uncommon illness, so it's possible that your signs and symptoms are caused by another more common condition. Swollen glands and a fever could be an indication of inflamed tonsils (tonsillitis) or a blocked salivary gland. Other, rarer viruses can infect the parotid glands, causing a mumps-like illness.
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Screening and diagnosis

If your doctor suspects that you or your child has mumps, a virus culture or a blood test may be needed. The blood test can detect mumps antibodies, which indicate whether you've had a recent or past infection.

Complications of mumps are potentially serious, but rare. These include:
Orchitis. This inflammatory condition causes swelling of one or both testicles. Orchitis is painful, but it rarely leads to sterility — the inability to father a child.
Pancreatitis. This is swelling of the pancreas. Signs and symptoms of pancreatitis include pain in the upper abdomen, nausea and vomiting.
Encephalitis. A viral infection, such as mumps, can lead to inflammation of the brain (encephalitis). Encephalitis can lead to neurologic problems and become life-threatening. Although it's serious, encephalitis is a rare complication of mumps.
Meningitis. Meningitis is infection and inflammation of the membranes and fluid surrounding your brain and spinal cord. It can occur if the mumps virus spreads through your bloodstream to infect your central nervous system. Like encephalitis, meningitis is a rare complication of mumps.
Inflammation of the ovaries. Pain in the lower abdomen in women may be a symptom of this problem. Fertility doesn't seem to be affected.
Hearing loss. In rare cases, mumps can cause hearing loss, usually permanent, in one or both ears.

If you or your child develops a complication from mumps, contact your doctor.
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Because the cause of mumps is a virus, antibiotics are not an effective treatment.

Like most viral illnesses, mumps infection must simply run its course. Fortunately, most children and adults recover from an uncomplicated case of mumps within two weeks.

In general, you're considered immune to mumps if you've previously had the infection or if you've been immunized against mumps.

The mumps vaccine is usually given as a combined measles-mumps-rubella (MMR) inoculation, which contains the safest and most effective form of each vaccine. Doctors recommend that children receive the MMR vaccine between 12 and 15 months of age, and again between 4 and 6 years of age — before entering school.

Do you need the MMR vaccine?
You don't need a vaccine if you:
Had two doses of the MMR vaccine after 12 months of age or one dose of the MMR vaccine plus a second dose of measles vaccine
Have blood tests that demonstrate you're immune to measles, mumps and rubella
Are a man who was born before 1957
Are a woman who was born before 1957 and you don't plan to have any more children, you already had the rubella vaccine or you have a positive rubella test

You should get a vaccine if you don't fit the criteria listed above and you:
Are a nonpregnant woman of childbearing age
Attend college, trade school or postsecondary school
Work in a hospital, medical facility, child care center or school
Plan to travel overseas or take a cruise

The vaccine is "not" recommended for:
Pregnant women or women who plan to get pregnant within the next four weeks
People who have had a life-threatening allergic reaction to gelatin or the antibiotic neomycin

If you have cancer, a blood disorder or another disease that affects your immune system, talk to your doctor before getting an MMR vaccine.

Side effects of the vaccine
You can't get mumps from the MMR vaccine, and most people experience no side effects from the vaccine. About 25 percent of people feel some achiness in their joints, 10 percent develop a fever between five and 12 days after the vaccination, and about 5 percent of people develop a mild rash. Less than one out of a million doses causes a serious allergic reaction.

In recent years, some news reports have raised concerns about a connection between the MMR vaccine and autism. However, extensive reports from the American Academy of Pediatrics, the Institute of Medicine, and the Centers for Disease Control and Prevention conclude that there's no scientifically proven link between the MMR vaccine and autism. In addition, there's no scientific benefit in separating these vaccines. These organizations note that autism is often identified in toddlers between the ages of 18 and 30 months, which happens to be about the time children are given their first MMR vaccine. But this coincidence in timing shouldn't be mistaken for a cause-and-effect relationship.
More On This Topic
Immunization: Why vaccines are so important to safeguarding health
Immunization schedule for children
Childhood immunizations: First line of defense against illnesses

If you or your child has mumps, time and rest are the best treatments. There's little your doctor can do to speed recovery. But you can take some steps to ease pain and discomfort and keep others from becoming infected:
Rest in bed until the fever goes away.
Isolate yourself or your child to prevent spreading the disease to others.
Take acetaminophen (Tylenol, others) or a nonsteroidal anti-inflammatory drug such as ibuprofen (Advil, Motrin, others) to ease symptoms. Adults may also use aspirin. Don't give aspirin to children because of the risk of Reye's syndrome, a rare but potentially fatal disease.
Use a cold compress to ease the pain of swollen glands.
Wear an athletic supporter to ease the pain of tender testicles.
Avoid foods that require lots of chewing. Instead, try broth-based soups or soft foods, such as mashed potatoes or cooked oatmeal, for nourishment.
Avoid sour foods, such as citrus fruits or juices, that stimulate saliva production.
Drink plenty of fluids.
Plan low-key activities.

If your child has mumps, the most important thing you can do as a parent is to watch for complications. In boys, watch especially for high fever, with pain and swelling of the testicles. In girls, abdominal pain may mean involvement of the ovaries. Abdominal pain in boys or girls may be a sign of pancreatitis. If your child's fever is very high, contact your doctor for advice.

Monday, June 26, 2006

The nurse is in: Nurse practitioners filling void in primary care

KENNETT SQUARE, Pennsylvania (AP) -- Marguerite Harris and her staff of eight provide prenatal care and child immunizations, write prescriptions, and diagnose and treat ailments from diabetes to the sniffles.

Though it may sound like a typical doctor's office, no one on staff at Project Salud is a doctor. The medical center is run by nurse practitioners -- registered nurses with specialized training and advanced degrees -- whose numbers in the United States have risen from 30,000 in 1990 to 115,000 today.

Increasingly, U.S. patients are being treated by nurse practitioners. Nurse-managed primary care centers such as Project Salud have increased to about 250 nationwide today, from a small handful 15 years ago.

"We've come a long way since the early days, the knockdown drag-outs with doctors who thought we were overstepping our roles," said Harris, a nurse practitioner at the Philadelphia-area medical center since 1974.

The change is attributed to factors that include a drop in the number of doctors choosing primary care as their specialty, a falloff expected to continue.

According to the American College of Physicians, U.S. medical school surveys showed that from 1998 to 2005, the percentage of third-year residents intending to pursue careers in general internal medicine dropped from 54 percent to 20 percent. Many new doctors, saddled with high student loans, are choosing more lucrative specialties.

The supply of general practice physicians is falling just as the American baby boomer population is aging and in greater need of medical care, and nurse-run medical centers are helping to bridge the gap.

Nurse practitioners first appeared about 40 years ago in pediatrics, and quickly expanded into obstetrics and gynecology, family medicine, and adult primary care.

They can perform many of the duties of primary care doctors such as performing physical exams, diagnosing and treating common health problems, prescribing medications, ordering and interpreting X-rays, and providing family planning services.

However, some physicians' groups are concerned about the trend.

The American Medical Association is against giving full autonomy to nurse practitioners, stating as its official policy position that a physician should be supervising nurse practitioners at all times and in all settings. An AMA spokeswoman said the association would not provide additional comment on its position.

"There is an element within the physician community that gets a little antsy. ... They think it's going to take away revenue and business from them," said Dr. Jan Towers, director of health policy for the American Academy of Nurse Practitioners. "Really, there's more than enough for everybody."

A 2000 study in the Journal of the American Medical Association concluded that patients who receive primary care from nurse practitioners fare just as well as those treated by doctors and report similar levels of satisfaction with their care.

Nurse practitioners also have steadily been gaining greater acceptance by insurers and in most states. In about half of America's states, nurse practitioners -- who frequently have lower fees for office visits than doctors -- are now recognized by insurance carriers as primary care physicians.

"One of the statistics that stands out is that we (nurse practitioners) see our patients twice as often as similar practices of physicians," said Tine Hansen-Turton, executive director of the National Nursing Centers Consortium, a Philadelphia-based industry group. "Doing primary care well is the foundation for saving health care dollars -- working on improving health early instead of, for example, paying for coronary surgery and bypasses later."

Copyright 2006 The Associated Press. All rights reserved.This material may not be published, broadcast, rewritten, or redistributed.

Saturday, June 24, 2006

Cancer test delays force woman into surgery

London: Some women with a family history of breast cancer are opting to have surgey rather than wait uo to two years for test result which would confirm whether they are at risk, a charity said yesterday.
A report by Breakthrough Breast Cancer said waiting times for test results have risen for three yeasr to reach an average six months, well above the goverment's two month target. Women wiht relatives who had breast cancer can take genetic tests to check whether they are at a higher risk of developing the diseas and could receive early treatment. "Some feel forced to have their breasts removed without knowing their results, simply because they are too worried to wait any longer," the charity said. Break-through's Chief Executive Jeremy Hughes said laboratories where the tests are checked are struggling to cope with the workload. A baclog of tests in london won't be cleared until the end of 2007."It is unacceptable that women are forced to put their lives on hold as they wait so long to get these vital test results,"he said.
About 4,500 women who fear they have a heightened risk of breast cancer have the egenetic tests each year. Hughes had no figures for the number who choose to have breast removal surgey rather than wait for the results. Reuters

essentials in buying trainers

You might think the concept of different trainers of diffenrent sports is amarketing ploy by shoe manufacturers to get you to spend more. But the experts say not. Research from the Medical College of Wisconcin shows that the wrong shoes may contribute to development of stress fractures. "It's important to choose the appropriate shoe for your chosen activity, as the demands of each vary," says consultant podiatric surgeon Ron McCulloch, from the London Podiatry Clinic (
For example, tennis involves lots of lateral movement and change of direction, while running is pure forward motion. 'You would be looking for a nice stable upper and lateral support in the tennis shoe, while cushioning and stability would be more important in the running shoe," explains Mike Buss, on the road coordinator for adidas.
If every sport has its perfect shoe, wjere do cross-trainers fit in?"Jack of all trades, and master of none.If you re doing anything more than the most basic non impact exercise and gymwork, you need more support and cushioning.