Uit de medische media

[RAdeR]

zie ook https://samendementievriendelijk.nl/
en http://english.eu2016.nl/events/2016/05/09/living-well-without-dementia

[oma]

At the London 2012 Paralympic Games, 4236 athletes strived for sporting excellence in 20 sports. It was the largest multisport event for athletes with an impairment in the world. Less than 18 months later, Sochi hosted the largest Paralympic Winter Games ever, welcoming 547 athletes. Rio expects 4350 athletes competing in 528 medal events, in no less than 22 sports. Competitive sport opportunities for athletes with an impairment – named para-sport – continue to expand rapidly and it is great to see an increased recognition of these athletic achievements.

http://www.aspetar.com/journal/viewarticle.aspx?id=284#.VvEFSOJ951s

[oma]

The World Health Organization will hold an emergency meeting Thursday on the yellow fever outbreak that has hit hardest in Angola but risks spreading further if vaccinations are not ramped up.

http://www.gulf-times.com/story/493749

[oma]

The World Health Organization will hold an emergency meeting Thursday on the yellow fever outbreak that has hit hardest in Angola but risks spreading further if vaccinations are not ramped up.

http://www.gulf-times.com/story/493749

The World Health Organization is attempting to ratchet up attention on a highly concerning yellow fever outbreak in Africa.

The global health agency announced Tuesday it is convening a panel of experts to advise it on whether the outbreak — which started in Angola but has spread from there — meets the criteria to be declared a global public health emergency. The so-called emergency committee will hold its first meeting Thursday, by teleconference.

https://www.statnews.com/2016/05/17/who-yellow-fever/

[oma]

Yellow fever - microbiologic aspects: http://www.wikidoc.org/index.php/Yellow_fever_virus

Yellow fever - clinical aspects: http://www.wikidoc.org/index.php/Yellow_fever

Yellow fever - patient information: http://www.wikidoc.org/index.php/Yellow_fever_(patient_information)

[oma]

The World Health Organization is asking for expert help charting its response to the alarming yellow fever outbreak in Angola.

It has convened an “emergency committee,” a panel of outside experts who will offer counsel to Director-General Dr. Margaret Chan.

The group holds its first meeting Thursday. Here’s what you need to know.

https://www.statnews.com/2016/05/19/yellow-fever-who-global-emergency/

[oma]

Meeting of the Emergency Committee under the International Health Regulations (2005) concerning Yellow Fever

WHO statement
19 May 2016

An Emergency Committee (EC) regarding yellow fever was convened by the Director-General under the International Health Regulations (2005) (IHR 2005) by teleconference on 19 May 2016, from 13:00 to 17:15 Central European Time1.

The following affected States Parties participated in the information session of the meeting: Angola and the Democratic Republic of Congo.

The WHO Secretariat briefed the Committee on the history and impact of the Yellow Fever Initiative, the urban outbreak of yellow fever in Luanda, Angola and its national and international spread to the Democratic Republic of Congo, China and Kenya. The Committee was provided with additional information on the evolving risk of urban yellow fever in Africa and the status of the global stockpile of yellow fever vaccine.

After discussion and deliberation on the information provided, it was the decision of the Committee that the urban yellow fever outbreaks in Angola and the Democratic Republic of the Congo is a serious public health event which warrants intensified national action and enhanced international support. The Committee decided that based on the information provided the event does not at this time constitute a Public Health Emergency of International Concern (PHEIC).

While not considering the event currently to constitute a PHEIC, Members of the Committee strongly emphasized the serious national and international risks posed by urban yellow fever outbreaks and offered technical advice on immediate actions for the consideration of WHO and Member States in the following areas:

* the acceleration of surveillance, mass vaccination, risk communications, community mobilization, vector control and case management measures in Angola and the Democratic Republic of Congo;

* the assurance of yellow fever vaccination of all travellers, and especially migrant workers, to and from Angola and Democratic Republic of Congo;

* the intensification of surveillance and preparedness activities, including verification of yellow fever vaccination in travellers and risk communications, in at-risk countries and countries having land borders with the affected countries.

The Committee also emphasized the need to manage rapidly any new yellow fever importations, thoroughly evaluate ongoing response activities, and quickly expand yellow fever diagnostic and confirmatory capacity. Recognizing the limited international supply of yellow fever vaccines, the Committee also advised the immediate application of the policy of 1 lifetime dose of yellow fever vaccine2 and the rapid evaluation of yellow fever vaccine dose-sparing strategies by the WHO Strategic Advisory Group of Experts on Immunization (SAGE).

Going forward, the Committee agreed with the planned review and revision of the global strategy for preventing urban yellow fever outbreaks in keeping with WHO’s assessment that the risk of such events is increasing.

Based on these views and the currently available information, the Director-General accepted the Committee’s assessment that the current yellow fever situation is serious and of great concern and requires intensified control measures, but does not constitute a PHEIC at this time.

The Director-General urges Member States to enforce the yellow fever vaccination requirement for travellers to and from Angola and the Democratic Republic of the Congo in accordance with the IHR (2005)3

The Director-General thanked the Committee for its thorough advice on priority actions for affected and at-risk countries, and on further yellow fever risk management work for WHO. The Director-General appreciated the concurrence of the Committee to be reconvened if needed.

http://www.who.int/mediacentre/news/statements/2016/ec-yellow-fever/en/

[oma]

LONDON — The World Health Organization says the ongoing outbreak of yellow fever in central Africa is “serious and of great concern,” but does not warrant being declared a global emergency.

https://www.statnews.com/2016/05/19/yellow-fever-outbreak-africa-who/

[RAdeR]

Yellow fever: urgent action needed to prevent international crisis
Published: 19 May 2016

Geneva, 19 May 2016:  Fears are growing that a deadly yellow fever outbreak in Angola – which has already spread to Democratic Republic of the Congo, Kenya and China - will continue to spread internationally without immediate action to prevent it, the International Federation of Red Cross and Red Crescent Societies (IFRC) warned today.

The disease is transmitted by the Aedes aegypti mosquito, which is also responsible for spreading the Zika virus, dengue and chikungunya.

Dr Julie Lyn Hall, the IFRC’s Director of Health, said that limited vaccine supplies, inadequate disease surveillance systems, poor sanitation and everyday cross-border economic and social interaction could turn a national outbreak into a global crisis, if no immediate community-based action is taken.

“Unvaccinated travellers could transform this outbreak into a regional or international crisis if we don’t move quickly to protect vulnerable populations and help communities to reduce their risk of infection,” she said.

Yellow fever has killed 293 people in Angola since the beginning of the outbreak in December 2015, and a further 2,267 people are believed to have been infected. The IFRC released 50,672 Swiss francs from its Disaster Relief Emergency Fund (DREF) on 24 February to support Angolan Red Cross work to support the vaccination of 90,000 people, and conducting community mobilization activities with 60,000 others. A further DREF allocation in support of the Red Cross of the Democratic Republic of the Congo will be issued today.

The Angolan outbreak has resulted in cases being imported to Democratic Republic of the Congo and Kenya, and has been confirmed as the source of 11 infections in the People’s Republic of China. A separate yellow fever outbreak has been confirmed in Uganda, with more than 50 suspected cases in three districts.

There are growing concerns that the outbreak could easily spread to neighbouring countries such as Namibia and Zambia, where the population is not vaccinated against the disease.

Volunteers and staff of the National Red Cross Societies in Angola, Democratic Republic of Congo and Uganda are hard at work in communities across the affected areas, identifying and eliminating mosquito breeding grounds, and helping people to reduce their risks of infection.

“Vaccination campaigns are the first lines of response, but we need to prioritise community engagement as a vital tool to prevent the spread of yellow fever,” said Dr Hall. “The continued rapid spread of the disease in the Angolan capital Luanda – where some 7 million people have already been vaccinated – underlines the importance of community engagement, surveillance and improving environmental sanitation.”

[oma]

As the holy month of Ramadan is approaching it is important to check with your doctor whether you can fast or not. The doctor assesses your diabetes status and advises you accordingly. Generally people with diabetes who use insulin injection are exempted from fasting (especially children and pregnant women). As for those who use medicines and diet as treatment, have stable blood sugar levels and no other health issues they are allowed to fast with their doctor’s permission. Prior to starting the fast it is strongly advisable to see your doctor and discuss how to adjust your diabetes treatment

The month of Ramadan brings a lot of changes in eating pattern and lifestyle that might affect diabetes and weight control. For those people with diabetes whose fasting is allowed, it is important to be aware of the effects of fasting and changes in dietary patterns on blood sugar levels:
A greater risk of low blood sugar could be present during fasting hours whereas high blood sugar values are more prominent after break of fast.  Health care providers advise to break the fast when you have any hypoglycemia symptoms or when your blood sugar level is below 70 mg/dl or higher than 300 mg/dl

* Dehydration could be a risk in hot weathers and especially with the limited amount of water taken to replace the long hours of fasting
In order to avoid the above and maintain blood sugar level within target during Ramadan you will need to:

* Do frequent blood sugar tests, especially on the first week to identify the trend in your BG with fasting and inform your doctors of any hypos and hypers to adjust the treatment accordingly. Monitoring you blood glucose level is very important at all times during Ramadan, so make sure you keep your blood sugar testing meter close to you.
* Limit the portions of food that is high in carbohydrate and sugar because it has a high impact on your blood sugar and can cause hyperglycemia
* Drink a lot of water starting from Iftar time until Suhoor to prevent dehydration and protect the kidneys

Below are practical tips to prevent low blood sugar and dehydration, In order to avoid having low blood sugar during your fasting day, make sure:

* Your Suhoor meal includes food items that are rich with fibers, such as: oats, beans, lentils, chickpeas, and fruits. Also adding sources of protein to your suhoor such as low fat cheese, labna, yoghurt and beans could prolong satiety feeling.
* Delay the Suhoor meal as much as possible
* Carry glucose tablets, or a bottle of juice, or a candy, to take it in case you had a low blood sugar while praying Tarawih at the mosque

Remember that blood sugar testing does not invalidate your fasting. Also it is important to

* Test your blood sugar before driving, to make sure you don’t have a low !
* Reduce your physical activity during fasting hours, especially before Iftar time
* Avoid sleeping for a long time while fasting, especially in the afternoon period and before Iftar time

As for reducing the risk of dehydration, in addition to drinking water, decrease the intake of caffeine found in coffee, tea, and soft drinks because caffeine causes frequent urination and water loss from the body


Conclusion
Fasting can be safe with diabetes by planning ahead with your healthcare team to assess your diabetes control, adjust your treatment and receive the appropriate education.

For questions or inquiries during Ramadan, contact QDA helpline on: 44547311 or 55274919 from 08:30 am until 01:30 pm & from 08:00 pm until 11:00 pm 55981331 .

Separate Sections on food

Engage your family in maintaining good eating habits by adopting healthy cooking and

Prepare food cooked, baked or grilled instead of fried
Avoid salty food such as nuts and pickles.
Include more fresh and cooked vegetables in your meals because they are high in fiber low in carbohydrates and provide vitamins, minerals and phytonutrients  
Remember that fatty meals when coupled with carbohydrate can cause a delayed and prolonged blood sugar increase

What type of food is high in carbohydrate? Carbohydrates affect blood sugar levels directly so one should be careful with intake of food like rice, pasta, bread and pastries, potato, legumes, and fruits.

In addition fresh and canned juices, sweet beverages, pastries and desserts cause a strong spike in blood sugar level and it is preferable to avoid them or restrict their intake to the minimum.

http://www.qda.org.qa/media-centre/news/ramadan-diabetes-workshops-en?backArt=1