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Lancet Examines Obama's Pledge To Fight HIV/AIDS
The journal Lancet Infectious Diseases examines whether President Obama is fulfilling his campaign promises to tackle HIV/AIDS abroad and at home. Although Obama has surrounded himself "[w]ith lauded experts ò€¦ concerns have been raised by activists that investment plans are not matching up to the rhetoric," Lancet writes.
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Editorials, Opinion Pieces React To Kansas Abortion Provider Tiller's Murder
Several newspapers on Wednesday published editorials and opinion pieces responding to the shooting death of Kansas abortion provider George Tiller, who was one of the few physicians in the country providing care for women in need of the procedure later in pregnancy. Summaries appear below.Editorials~ Boston Globe: Although officials are calling Tiller"s murder ""the act of an isolated individual," ... the generalized culture of violence and hate in the antiabortion movement that feeds the fanaticism of disturbed individuals with guns is not so easily explained away," a Globe editorial states. The editorial notes, "Many responsible abortion opponents, including Americans United for Life, condemn the killing," but "other so-called pro-life leaders insist on finding a moral equivalence between Tiller"s murder and abortion." The editorial continues, "Also victimized by Tiller"s murder are the anguished women who have sought late-term abortions because their pregnancies have gone horribly wrong." According to the editorial, the "sad irony" is that these procedures "are not a matter of "choice,"" as the "overwhelming majority of these women desperately wanted their children to be born." It adds, "Tiller"s brave and compassionate care saved the lives of these women and their futures as mothers." In his speech last month at the University of Notre Dame"s commencement ceremony, President Obama "called for people of good will on both sides of the abortion issue to bridge the divide," the editorial states, concluding, "An end to the hateful rhetoric over issues of faith that lead unhinged individuals to murder would be a good place to start" (Boston Globe, 6/2).~ USA Today: Tiller"s "insistence" on continuing to practice, despite protests and threats of violence, "was remarkably courageous," but, "[r]egrettably, threats by antiabortion activists have worked all too well," a USA Today editorial states. According to the Guttmacher Institute, the number of abortion providers has decreased by 40% since a peak in 1982, and 87% of U.S. counties have no provider, forcing many women to travel long distances to obtain care, the editorial says. "Mainstream pro-life groups should not be blamed for the actions of a suspected killer who appears to have lurked in the violent and twisted fringe of the movement," the editorial continues. However, the "braying of cable TV hosts," such as Fox News" Bill O"Reilly, "and activists such as Operation Rescue founder Randall Terry contributes to a climate of intolerance that can encourage deranged individuals," the editorial says. According to USA Today, "Thwarted in legislatures and courts, some antiabortion activists are achieving with intimidation and harassment what they can"t through the political process," but "[r]egardless of personal beliefs about abortion, authorities have an obligation to protect those providing and receiving abortion services, and to prosecute those who harass or threaten them." The editorial concludes that "Tiller"s death will only be compounded if it frightens away more doctors and makes a legal procedure even harder to come by" (USA Today, 6/3).~ Washington Post: Tiller"s death "is a tragedy for his family, his patients and his profession," and "[i]t should serve as a wake-up call that more must be done to ensure that women have access to this legal procedure," a Post editorial states. "It is unclear how this violence has affected decisions by health care providers," according to the editorial. However, it is clear that "the number of places where women can go for abortions has been declining since 1982," and "[v]ery few are performed in hospitals -- a sign that mainline medicine is not living up to its responsibility," the editorial says. The editorial notes that Attorney General Eric Holder "is offering U.S. Marshals Service protection for abortion clinics and the doctors who staff them," concluding, "It"s the right call, but one that underscores the urgency of coming up with better solutions for the delive
News of the day
A Compound Found In The Sea Provides Promising New Treatment For Neuropathic Pain
A paper just published in the British Journal of Pharmacology reports that a compound originally isolated from a soft coral (Capnella imbricate) could lead scientists to develop a new variety of treatments for neuropathic pain. This composite is collected at Green Island off Taiwan and could be a new option for treatment. Neuropathic pain is chronic and occasionally follows damage to the nervous system. Presently this type of pain is very poorly controlled by the usual analgesics: aspirin like drugs (NSAIDS) or even opioids like morphine. New treatments are urgently required.
Public Health

What Is Cellulitis? What Causes Cellulitis?

Cellulitis and cellulite are two completely different things. Cellulitis is a bacterial infection of the dermis - the deep layer of skin - as well as the subcutaneous tissues (fat and soft tissue layer) that are under the skin. While cellulite is caused by fatty deposits under the skin that give it an orange peel or cottage cheese look. This article is about the bacterial infection - cellulitis. Bacteria are present on the skin and do not generally cause any harm. However, if they go deep into the skin they can cause infection. They generally get in through cuts, grazes or bites. People with eczema or psoriasis have a higher risk of bacteria getting into the skin. What causes cellulitis? Bacteria, most commonly streptococci or staphylococci groups, get under the skin and cause infection. Streptococci and staphylococci groups are commonly found on the surface of the skin and cause no harm - but if they get under the skin they can. For the bacteria to get in they need a route - a break in the skin caused by: *An ulcer *A burn *A bite *A graze *A cut *Some skin conditions, such as eczema, athlete"s foot, or psoriasis The bacteria may also enter by some other route, such as through the blood or lymphatic system. This is most likely if no potential entry route can be identified on the skin of the patient. Who are more susceptible to cellulitis? *Obese people - obese people are more likely to have swelling in their legs. This raises the chances of developing cellulitis. *People with a weakened immune system - such as patients undergoing chemotherapy or radiotherapy, those with AIDS/HIV, and very elderly people. *People with diabetes - if the diabetes is not properly treated or controlled the patient"s immune system will be weaker, he/she will have circulatory problems which can lead to skin ulcers. Poor control of blood glucose levels allows bacteria to grow faster in the affected tissue and facilitates rapid progression if the infection enters the bloodstream. *People with blood circulation problems - if a person has poor circulation he/she is more likely to develop skin infections because the blood supply is not ideal for fighting off infections. *People with chickenpox and shingles - chicken pox and shingles cause skin blisters. If the blisters break they become ideal routes for bacteria to get into the skin. *People with lymphodema - people with lymphodema tend to have swollen skin which is more likely to crack. Cracks in the skin may become perfect entry routes for bacteria. *People who have had cellulitis before - anybody who has had cellulitis has a higher risk of developing it again compared to others. *People who inject illegal drugs - drug addicts who do not have access to a regular supply of clean needles are more likely suffer from infections deep inside the skin. *Highly densely populated areas - there is a higher incidence of cellulitis among people who share common living quarters, such as military installations, school/college dormitories, and homeless shelters. What are the symptoms of cellulitis? Although symptoms may appear in any part of the body, the legs are most commonly affected. The affected area will become: *Warm *Tender, inflamed *Swollen *Red *Painful Some patients may have blisters. The infected person may also have a fever, chills, nausea, and he/she may shiver. Swollen lymph glands - these may become tender. If the cellulitis has affected the patient"s leg the lymph glands in the groin will be tender. How is cellulitis diagnosed? Diagnosis is usually fairly straightforward and does not generally require any complicated tests. A GP (general practitioner, primary care physician) can do this. The doctor will examine the patient and assess the symptoms. The number of cases where Lyme disease has been misdiagnosed as staph- or step-induced cellulitis is growing. It is important to discard the possibility that some other condition may have caused the symptoms, such as varicose eczema. The doctor may take a swab (sample) if there is an open wound. This will help him/her find out what type of bacteria it is. After treatment the patient needs to come back for a follow-up so that the doctor can confirm that the treatment has worked. What is the treatment for cellulitis? *Medication Cellulitis nearly always responds rapidly to antibiotics. Some patients experience a slight worsening of the reddening of the skin at the start of antibiotic treatment - this usually subsides within a couple of days. Anyone who experiences fever or vomiting after two days of antibiotic treatment should contact their doctor immediately. Most doctors in the UK prescribe flucloxacillin for cellulitis. For those who cannot take flucloxacillin, erythromycin is a good alternative. Treatment will generally last 7 days. If a patient"s infection was caused by contaminated water he/she may have to take two antibiotics simultaneously - usually doxycycline, or ciprofloxacin combined with flucloxacillin or erythromycin. Oral antibiotics will be given to patients whose infection has not spread to the bloodstream or lymph system, and if they do not have any medical problems. Otherwise the medication may be administered intravenously or by injection. *Things you can do yourself *Drink plenty of water *Keep the affected area elevated, this helps reduce swelling and pain *Take a pain killer if you need to (check with your doctor). If you have had stomach problems, such as a peptic ulcer, ask your doctor what painkiller you can take. If you have asthma, check with your doctor before taking a pain medication. Doctors do not recommend aspirin for cellulitis pain treatment. In some countries the pharmacist can be a useful of advice. Treatment in hospital Some patients with severe cellulitis may require hospital treatment, especially if the cellulitis is deteriorating, if the patient has a high fever, vomiting, fails to respond to treatment, or has recurrences of cellulitis. Most people who are treated in hospital will receive their antibiotic through a vein in their arm (intravenously, using a drip). What are the complications of cellulitis? In the vast majority of cases cellulitis treatment is effective and the patient will have no complications. A small percentage of patients may have serious complications. The risk of complications is higher if the cellulite is not treated. *Blood poisoning (septicemia) When the bacteria get into the bloodstream the patient has a higher risk of developing septicemia. A person with septicemia will have a fever, accelerated heart beat, rapid breathing, hypotension (low blood pressure), dizziness when standing up, diarrhea, reduced urine flow, sweaty and cold skin, and pale skin. It is not uncommon for patients to eventually lose consciousness. Anybody who suspects blood poisoning should call the emergency services (ambulance) immediately. *Infection goes elsewhere This is very unusual, but the bacteria that caused the cellulitis can spread to other parts of the body, including muscle, bone or the heart valves. If this happens the patient needs treatment immediately. *Permanent swelling People who do not have their cellulitis treated have a higher risk of eventually having a permanent swelling in the affected area. Is cellulitis preventable? Some cases of cellulitis are not preventable. There are things people can do to reduce their chances of developing it. However, there are no large studies confirm some of the suggestions below. *Treat your cuts and grazes If your skin is broken because of a cut, bite or graze, keep it clean and disinfected. Apply antiseptic cream after running tap water on the damaged area. Keep the cut covered with a plaster (band aid) or dressing. Keep the dressing clean and dry. *Reduce the likelihood of scratching and infecting your skin If your fingernails are short and you have itchy skin you are less likely to create an opening for the bacteria to get in when you scratch your skin. Make sure your fingernails are clean. *Don"t let your skin go dry Use moisturizers to prevent your skin from cracking if your skin is dry. If you have greasy skin you will not need to do this. *Lose weight if you are obese Obesity raises the risk of developing cellulitis. *Diet and lifestyle If you eat a well a well-balanced diet including plenty of fruits and vegetables, and do regular exercise, your immune system will benefit. Your immune system will have a better chance of fighting off any bacteria that penetrate through the skin. *Protect your skin If you are going to do some gardening there are things you can do to protect your skin from cuts and grazes; wear gloves, wear long sleeves if you are going to reach into prickly bushes, do not wear shorts if there is a likelihood of grazing the skin of your legs. Written by Christian Nordqvist Copyright: Medical News Today Not to be reproduced without permission of Medical News Today


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