We continue our Foreign Student Series this week with a question from a doctor at a hospital in Vietnam. Tran Kinh Thanh in Ho Chi Minh City asks how a foreign doctor can become an American doctor.
One way is to complete a medical residency in the United States. A residency is a period of hospital training for medical school graduates.
To be accepted, foreign-trained doctors need approval from the Educational Commission for Foreign Medical Graduates. The process involves passing several tests. After that, foreign doctors can receive a visa to stay in the United States, at least for the training period.
Practicing medicine in the United States also involves other steps.
But the first thing that foreign-trained doctors have to do is make sure they attended a recognized medical school. It has to be listed in the FAIMER International Medical Education Directory. FAIMER is the Foundation for Advancement of International Medical Education and Research.
If their school is not listed, then foreign-trained doctors cannot be approved for a residency. One solution is to go back to medical school -- an American medical school.
One hundred twenty-five schools in the United States belong to the Association of American Medical Colleges. The group says more than one thousand one hundred foreign citizens applied for the current school year. One-fourth of them were admitted last fall.
Almost all medical schools in the United States require applicants to report scores from the Medical College Admission Test.
Future doctors in the United States traditionally complete four years of medical school after undergraduate school. Then, as residents, they treat patients under the supervision of experienced doctors. A residency is generally between three and seven years. The first year is called an internship.
The Association of American Medical Colleges publishes a book called Medical School Admissions Requirements. The newest one is for two thousand eight-two thousand nine. The guide has details about every school as well as information for foreign students.
The book costs twenty-five dollars and can be ordered through the association's Web site.
For a link to that site, go to voaspecialenglish.com. You can also find all of the earlier reports in our Foreign Student Series on higher education in the United States.
Showing posts with label VOA. Show all posts
Showing posts with label VOA. Show all posts
May 31, 2007
May 13, 2007
Something a Bone Will Never Say: Give Me a Break
The medical term for a broken bone is a fracture. But there are different kinds of fractures.
A single fracture is when a bone is broken in just one place. You may have heard the term hairline fracture. This is a single fracture that is very small, like the width of a hair. A complete fracture is when the bone comes apart.
When a bone is broken in more than two places or gets crushed, the name for it is a comminuted fracture.
Still another kind is a bowing fracture. This happens with a bone that bends but does not break. It happens mostly in children.
Ever heard of a greenstick fracture? This is when a bone is bent and breaks along only one side, like a young stick of wood.
Another kind of break is an open or compound fracture. This is when the bone breaks the skin. This is very serious. Along with the bone damage there is a risk of infection in the open wound.
A lot of things happen as the body reacts to an injury like a broken bone. You might suddenly feel lightheaded. You might also feel sick to your stomach.
People who are seriously injured can go into shock. They might feel cold, dizzy and unable to think clearly. Shock requires immediate medical attention.
But while broken bones can be painful, they are generally not life-threatening. Treatment depends on the kind of fracture. A doctor takes X-rays to see the break and sets a broken bone to make sure it is in the correct position.
Severe breaks may require an operation to hold the bone together with metal plates and screws.
Next, a person usually gets a cast put around the area of the break. The hard bandage holds the bone in place while it heals. Casts are usually worn for one to two months.
In some cases, instead of a cast, a splint made of plastic or metal will be secured over the area to restrict movement.
Doctors say broken bones should be treated quickly because they can restrict blood flow or cause nerve damage. Also, the break will start to repair itself, so you want to make sure the bone is lined up correctly.
Bones need calcium and vitamin D to grow and reach their full strength. Keeping your bones strong with exercise may also help prevent fractures.
Wearing safety protection like elbow pads and leg guards during activities is a good idea. If you think these might be restrictive, try a cast.
A single fracture is when a bone is broken in just one place. You may have heard the term hairline fracture. This is a single fracture that is very small, like the width of a hair. A complete fracture is when the bone comes apart.
When a bone is broken in more than two places or gets crushed, the name for it is a comminuted fracture.
Still another kind is a bowing fracture. This happens with a bone that bends but does not break. It happens mostly in children.
Ever heard of a greenstick fracture? This is when a bone is bent and breaks along only one side, like a young stick of wood.
Another kind of break is an open or compound fracture. This is when the bone breaks the skin. This is very serious. Along with the bone damage there is a risk of infection in the open wound.
A lot of things happen as the body reacts to an injury like a broken bone. You might suddenly feel lightheaded. You might also feel sick to your stomach.
People who are seriously injured can go into shock. They might feel cold, dizzy and unable to think clearly. Shock requires immediate medical attention.
But while broken bones can be painful, they are generally not life-threatening. Treatment depends on the kind of fracture. A doctor takes X-rays to see the break and sets a broken bone to make sure it is in the correct position.
Severe breaks may require an operation to hold the bone together with metal plates and screws.
Next, a person usually gets a cast put around the area of the break. The hard bandage holds the bone in place while it heals. Casts are usually worn for one to two months.
In some cases, instead of a cast, a splint made of plastic or metal will be secured over the area to restrict movement.
Doctors say broken bones should be treated quickly because they can restrict blood flow or cause nerve damage. Also, the break will start to repair itself, so you want to make sure the bone is lined up correctly.
Bones need calcium and vitamin D to grow and reach their full strength. Keeping your bones strong with exercise may also help prevent fractures.
Wearing safety protection like elbow pads and leg guards during activities is a good idea. If you think these might be restrictive, try a cast.
May 6, 2007
Breast Cancer in US Stayed Down in '04 for Second Year
Last year, researchers reported that breast cancer rates in the United States dropped in two thousand three. That was after about twenty years of rising. Many experts linked the drop to a sharp reduction in the use of hormone replacement therapy for older women.
The researchers found that breast cancer rates dropped by almost seven percent between two thousand two and two thousand three. Now, they have just reported that the decreased rates were also present in two thousand four.
Breast cancer rates were at their lowest level since about nineteen eighty-seven, they say. But they also say that in two thousand four there was little additional decrease.
The study found that the drop was mostly in women age fifty to sixty-nine. And it was mostly in the kind of breast cancer fed by estrogen. Estrogen is one of the hormones given to women in hormone replacement therapy, or HRT.
The use of HRT began to drop soon after a major study appeared in two thousand two. The Women's Health Initiative study found that the therapy did not protect against heart disease, as had been thought. Instead, it found that hormone replacement increased the risk for some kinds of cancer, as well as heart attacks and other problems.
The use of hormone replacement therapy dropped almost forty percent soon after that report appeared.
The latest findings about breast cancer rates appeared last week in the New England Journal of Medicine. The researchers used information gathered by the National Cancer Institute, one of the National Institutes of Health.
Peter Radvin and Donald Berry of the University of Texas M.D. Anderson Cancer Center led the research. Doctor Radvin notes that the kind of study they did cannot prove that hormone replacement therapy causes breast cancer.
And both researchers say they are not suggesting that all women stop the therapy. Doctor Radvin says he will continue to advise his patients to use the lowest strength of hormones for the shortest time possible.
Critics of the study include Wyeth Pharmaceuticals, a maker of hormone replacements. One question, it says, is why breast cancer rates leveled off in two thousand four even though use of the therapy continued to drop. The company says the reduction in breast cancer rates could have been the result of something unrelated to the drugs.
The researchers found that breast cancer rates dropped by almost seven percent between two thousand two and two thousand three. Now, they have just reported that the decreased rates were also present in two thousand four.
Breast cancer rates were at their lowest level since about nineteen eighty-seven, they say. But they also say that in two thousand four there was little additional decrease.
The study found that the drop was mostly in women age fifty to sixty-nine. And it was mostly in the kind of breast cancer fed by estrogen. Estrogen is one of the hormones given to women in hormone replacement therapy, or HRT.
The use of HRT began to drop soon after a major study appeared in two thousand two. The Women's Health Initiative study found that the therapy did not protect against heart disease, as had been thought. Instead, it found that hormone replacement increased the risk for some kinds of cancer, as well as heart attacks and other problems.
The use of hormone replacement therapy dropped almost forty percent soon after that report appeared.
The latest findings about breast cancer rates appeared last week in the New England Journal of Medicine. The researchers used information gathered by the National Cancer Institute, one of the National Institutes of Health.
Peter Radvin and Donald Berry of the University of Texas M.D. Anderson Cancer Center led the research. Doctor Radvin notes that the kind of study they did cannot prove that hormone replacement therapy causes breast cancer.
And both researchers say they are not suggesting that all women stop the therapy. Doctor Radvin says he will continue to advise his patients to use the lowest strength of hormones for the shortest time possible.
Critics of the study include Wyeth Pharmaceuticals, a maker of hormone replacements. One question, it says, is why breast cancer rates leveled off in two thousand four even though use of the therapy continued to drop. The company says the reduction in breast cancer rates could have been the result of something unrelated to the drugs.
Apr 29, 2007
World Health Experts Report Progress in Fight Against Tuberculosis
Tuberculosis is one of the leading infectious diseases. The World Health Organization says two billion people are infected with the TB bacteria. That is about one-third of the world’s total population.
One in ten people infected with the TB bacteria will become sick with tuberculosis at some time during their life. Almost nine million people become sick with the disease each year. About one million six hundred thousand people will die of the disease this year.
The World Health Organization says TB is a disease of poverty. It affects mostly young adults in their most productive years. The large majority of deaths from the disease are in developing countries. More than half of all deaths happen in Asia.
The World Health Organization declared TB a public health emergency in nineteen ninety-three. A new WHO report shows tuberculosis rates around the world are falling or unchanged. The report says rates were unchanged in two thousand five after reaching record high levels one year earlier.
If this continues for the next three or four years, WHO officials believe their Millennium Development Goal could be reached. The goal is to discover at least seventy percent of TB cases and successfully treat eighty-five percent of those cases by the year two thousand fifteen.
Tuberculosis is a bacterial infection that usually attacks the lungs. Most people infected with the bacteria never develop active TB. However, people with weak body defense systems often develop the disease. TB can damage a person’s lungs or other parts of the body and cause serious health problems.
The disease is spread by people who have active, untreated TB bacteria in their throat or lungs. The bacteria are spread into the air when people with the disease talk or expel air suddenly.
People who breathe infected air from a TB victim can become infected with the tuberculosis bacteria. However, most people with active tuberculosis do not expel very many TB bacteria. So, the spread of the disease usually does not happen unless a person spends a large amount of time with a TB patient. Those most at risk are family members, friends and people who live or work closely with a patient.
If a person becomes infected with the TB bacteria, it does not mean he or she has the disease. Having the infection means that the bacteria are in the body, but they may be neutral, or inactive.
When TB bacteria are inactive, they cannot damage the body. And they cannot spread to other people. People with the inactive bacteria are infected, but they are not sick. They probably do not know that they are infected. For most of them, the bacteria will always be inactive. They will never suffer signs of tuberculosis.
If the natural immune system against disease is weak, however, a person can get tuberculosis soon after the TB bacteria enter the body. Also, inactive TB bacteria may become active if the immune system becomes weak. When this happens, the bacteria begin reproducing and damaging the lungs or other organs and causing serious sickness.
The inactive TB bacteria can become active under several conditions. When a person becomes old, the immune system may become too weak to protect against the bacteria. The virus that causes AIDS can cause TB bacteria to become active. Also, doctors warn that people who drink too much alcohol or use drugs have a higher risk of becoming sick from the tuberculosis bacteria.
Tuberculosis can attack any part of the body. However, the lungs are the most common targets of the bacteria. People with the disease show several signs. They may expel air from the lungs suddenly with an explosive noise. This kind of cough continues for a long period of time. People with a more severe case of tuberculosis also may cough up blood.
People with the disease often have high body temperatures. They suffer what are called night sweats, during which their bodies release large amounts of water through the skin. TB victims also are tired all the time. They are not interested in eating. So their bodies lose weight.
One thing that is especially dangerous about TB is that people with moderate signs of the disease may not know they have it. They may spread the disease to others without even knowing it. So, it is very important for people to get tested for tuberculosis.
There are several ways to test for TB. The first is the TB skin test. It also is known as the Mantoux skin test. The test can identify most people infected with tuberculosis six to eight weeks after the bacteria entered their bodies. A substance called purified protein derivative is injected under the skin of the arm. The place of the injection is examined two to three days later.
If a raised red area forms, the person may have been infected with the tuberculosis bacteria. However, this does not always mean the disease is active.
If the skin test shows that TB bacteria have entered the body, doctors can use other methods to discover if the person has active TB. However, this sometimes can be difficult because tuberculosis may appear similar to other diseases. Doctors must consider other physical signs. Also, they must decide if a person’s history shows that he or she has been in situations where tuberculosis was present.
Doctors also use an X-ray examination to show if there is evidence of TB infection, such as damage to the lungs. Another way to test for the presence of active tuberculosis is to examine the fluids from a person’s mouth.
It is very important for doctors to identify which kind of TB bacteria are present so they can decide which drugs to use to treat the disease. Most TB cases can be successfully treated with medicines. However, the death rate for untreated patients is reported to be about fifty percent. Successful treatment of TB requires close cooperation among patients, doctors and other health care workers.
The World Health Organization has a five-step program to guarantee that TB patients take their medicine correctly. The program is called Directly Observed Treatment, Short-course, or DOTS. Directly observed means that local health care workers watch to make sure patients take their medicine every day. Full treatment usually lasts from six to nine months to destroy all signs of the bacteria.
It is very important for patients to be educated about the disease and its treatment. Sometimes patients fail to finish taking the medicine ordered by their doctors. Experts say this is because some patients feel better after only two to four weeks of treatment and stop taking their medicine. This can lead to the TB bacteria becoming resistant to drugs and growing stronger, more dangerous and more difficult to treat.
Experts say TB is a preventable disease. The goal of health organizations is to quickly identify infected persons – especially those who have the highest risk of developing the disease. There are several drugs that can prevent tuberculosis in these people.
Experts say tuberculosis can be cured if it is discovered early and if patients take their medicine correctly. And, like other diseases, education and understanding are extremely important in preventing and treating TB. Next week, we will tell you about efforts to fight TB in several countries.
One in ten people infected with the TB bacteria will become sick with tuberculosis at some time during their life. Almost nine million people become sick with the disease each year. About one million six hundred thousand people will die of the disease this year.
The World Health Organization says TB is a disease of poverty. It affects mostly young adults in their most productive years. The large majority of deaths from the disease are in developing countries. More than half of all deaths happen in Asia.
The World Health Organization declared TB a public health emergency in nineteen ninety-three. A new WHO report shows tuberculosis rates around the world are falling or unchanged. The report says rates were unchanged in two thousand five after reaching record high levels one year earlier.
If this continues for the next three or four years, WHO officials believe their Millennium Development Goal could be reached. The goal is to discover at least seventy percent of TB cases and successfully treat eighty-five percent of those cases by the year two thousand fifteen.
Tuberculosis is a bacterial infection that usually attacks the lungs. Most people infected with the bacteria never develop active TB. However, people with weak body defense systems often develop the disease. TB can damage a person’s lungs or other parts of the body and cause serious health problems.
The disease is spread by people who have active, untreated TB bacteria in their throat or lungs. The bacteria are spread into the air when people with the disease talk or expel air suddenly.
People who breathe infected air from a TB victim can become infected with the tuberculosis bacteria. However, most people with active tuberculosis do not expel very many TB bacteria. So, the spread of the disease usually does not happen unless a person spends a large amount of time with a TB patient. Those most at risk are family members, friends and people who live or work closely with a patient.
If a person becomes infected with the TB bacteria, it does not mean he or she has the disease. Having the infection means that the bacteria are in the body, but they may be neutral, or inactive.
When TB bacteria are inactive, they cannot damage the body. And they cannot spread to other people. People with the inactive bacteria are infected, but they are not sick. They probably do not know that they are infected. For most of them, the bacteria will always be inactive. They will never suffer signs of tuberculosis.
If the natural immune system against disease is weak, however, a person can get tuberculosis soon after the TB bacteria enter the body. Also, inactive TB bacteria may become active if the immune system becomes weak. When this happens, the bacteria begin reproducing and damaging the lungs or other organs and causing serious sickness.
The inactive TB bacteria can become active under several conditions. When a person becomes old, the immune system may become too weak to protect against the bacteria. The virus that causes AIDS can cause TB bacteria to become active. Also, doctors warn that people who drink too much alcohol or use drugs have a higher risk of becoming sick from the tuberculosis bacteria.
Tuberculosis can attack any part of the body. However, the lungs are the most common targets of the bacteria. People with the disease show several signs. They may expel air from the lungs suddenly with an explosive noise. This kind of cough continues for a long period of time. People with a more severe case of tuberculosis also may cough up blood.
People with the disease often have high body temperatures. They suffer what are called night sweats, during which their bodies release large amounts of water through the skin. TB victims also are tired all the time. They are not interested in eating. So their bodies lose weight.
One thing that is especially dangerous about TB is that people with moderate signs of the disease may not know they have it. They may spread the disease to others without even knowing it. So, it is very important for people to get tested for tuberculosis.
There are several ways to test for TB. The first is the TB skin test. It also is known as the Mantoux skin test. The test can identify most people infected with tuberculosis six to eight weeks after the bacteria entered their bodies. A substance called purified protein derivative is injected under the skin of the arm. The place of the injection is examined two to three days later.
If a raised red area forms, the person may have been infected with the tuberculosis bacteria. However, this does not always mean the disease is active.
If the skin test shows that TB bacteria have entered the body, doctors can use other methods to discover if the person has active TB. However, this sometimes can be difficult because tuberculosis may appear similar to other diseases. Doctors must consider other physical signs. Also, they must decide if a person’s history shows that he or she has been in situations where tuberculosis was present.
Doctors also use an X-ray examination to show if there is evidence of TB infection, such as damage to the lungs. Another way to test for the presence of active tuberculosis is to examine the fluids from a person’s mouth.
It is very important for doctors to identify which kind of TB bacteria are present so they can decide which drugs to use to treat the disease. Most TB cases can be successfully treated with medicines. However, the death rate for untreated patients is reported to be about fifty percent. Successful treatment of TB requires close cooperation among patients, doctors and other health care workers.
The World Health Organization has a five-step program to guarantee that TB patients take their medicine correctly. The program is called Directly Observed Treatment, Short-course, or DOTS. Directly observed means that local health care workers watch to make sure patients take their medicine every day. Full treatment usually lasts from six to nine months to destroy all signs of the bacteria.
It is very important for patients to be educated about the disease and its treatment. Sometimes patients fail to finish taking the medicine ordered by their doctors. Experts say this is because some patients feel better after only two to four weeks of treatment and stop taking their medicine. This can lead to the TB bacteria becoming resistant to drugs and growing stronger, more dangerous and more difficult to treat.
Experts say TB is a preventable disease. The goal of health organizations is to quickly identify infected persons – especially those who have the highest risk of developing the disease. There are several drugs that can prevent tuberculosis in these people.
Experts say tuberculosis can be cured if it is discovered early and if patients take their medicine correctly. And, like other diseases, education and understanding are extremely important in preventing and treating TB. Next week, we will tell you about efforts to fight TB in several countries.
Tuberculosis Can Be Cured, But It Must Be Treated the Right Way
The World Health Organization says one-third of the world’s population is infected with the bacteria that cause tuberculosis. That is about two billion people. One in ten people infected with the TB bacteria will become sick with tuberculosis at some time during their life. The WHO says almost nine million people became sick with the disease in two thousand five. About one million six hundred thousand people died of the disease that year. However, the WHO also says almost sixty percent of TB cases around the world are discovered. A large majority of them are cured.
Most people infected with the bacteria never develop active TB. However, people with weak body defense systems often develop the disease. TB can damage a person’s lungs or other parts of the body and cause serious sickness.
The disease is spread by people who have active, untreated TB bacteria in their throat or lungs. The bacteria are spread into the air when infected people talk or expel air suddenly.
Most TB cases can be cured with medicines. Successful treatment of TB requires close cooperation among patients, doctors and other health care workers. The World Health Organization has a five-step program to guarantee that TB patients take their medicine correctly. The program is called Directly Observed Treatment, Short-course, or DOTS. Directly observed means that patients must go to local health centers every day or several times a week to take their medicines. Health care workers watch to make sure patients take their medicine every day. Full treatment usually lasts from six to nine months to destroy all signs of the bacteria.
It is very important for patients to be educated about the disease and its treatment. Sometimes patients fail to finish taking the medicine ordered by their doctors. Experts say this is because some patients feel better after only two to four weeks of treatment and stop taking their medicine. This can lead to the TB bacteria becoming stronger, resistant to drugs, and more difficult to treat.
This kind of TB is called multi-drug resistant tuberculosis or MDR-TB. The World Health Organization says MDR-TB is one hundred times more costly to treat than the other form of the disease.
The World Health Organization says most deaths from tuberculosis are in developing countries. More than half of all deaths from TB are in Asia. And half of all new cases are in six Asian countries. They are Bangladesh, China, India, Indonesia, Pakistan and the Philippines.
More than twenty-five percent of the world's multi-drug resistant tuberculosis cases are in Asia. Patients with MDR-TB must take more powerful and costly drugs for more than two years. Some patients experience side effects from the drugs.
Experts say the fight against TB and drug resistance has been successful in Hong Kong. In the past fifty years, Hong Kong has reduced cases of TB by almost ninety-eight percent. In the nineteen fifties, the British colonial government built TB hospitals and began giving vaccines to children. The government also replaced poor, unclean housing with modern public housing.
Today, the Chinese government gives anti-TB drugs free of cost in public health centers. Health workers visit patients who fail to go to health centers to get their medicines. So Hong Kong has very low levels of drug-resistant TB.
The World Health Organization is improving its efforts against TB in China. Almost one million four hundred thousand people there develop active TB each year. Almost twenty-five percent of the world's multi-drug resistant cases are in China. The WHO says the situation is now improving. It says half of China's provinces have put the DOTS treatment method into effect. This has resulted in about a fifty percent reduction in deaths from TB.
The WHO has also set a goal for nations in the Western Pacific area. They are being urged to cut by half infection rates and deaths from TB within three years. Doctors say this goal may not be possible because the disease AIDS is a serious problem in the Western Pacific. Other problems are poverty and lack of money for public health.
In Africa, more than three million people are living with TB. Five hundred thousand people there die each year from the disease. The number of TB victims is rising quickly in Africa. This is mainly because of the virus that causes AIDS. The virus weakens the body's ability to fight disease.
Drug-resistant TB is a serious problem in South Africa. Sizwe Hospital in the city of Johannesburg treats only people with MDR-TB. Three thousand new cases of MDR-TB were identified in Johannesburg alone last year. People with this kind of TB have only a fifty percent chance of being cured. Patients must take one painful injection of medicine and as many as twenty-four pills each day. Treatment can take up to two years. The drugs have serious side effects.
Few people survive a new kind of TB, called Extreme Drug-Resistant TB. This disease is resistant to just about every drug known to science.
The National Health Laboratory in Johannesburg tests for drug-resistant TB. Its workers test five hundred samples from patients from all over southern Africa every day. The testing often last several weeks because each bacterium must be tested in several ways. Almost one-fourth of the bacteria tested are found to be drug-resistant. These have to be tested again to show which drugs they resist.
During this time, the patient may be infecting other people. So it is important to find ways to test for the disease more quickly. The laboratory is now carrying out experiments with tests that identify drug-resistant bacteria within two days. This helps health workers quickly identify an infected person and begin treatment.
Patients being treated for MDR-TB are separated from their families, sometimes for years. This causes economic and social problems for patients and family members. The head doctor at Sizwe Hospital says most patients accept treatment and separation. Health workers believe patients with drug-resistant TB should be separated to protect their communities. But human rights activists say this would be a violation of their rights.
Tuberculosis is a health emergency in Russia. In February, the Russian parliament approved almost three billion dollars to fight infectious diseases such as TB.
Russian studies show that eighty-three of every one hundred thousand people in Russia are infected with TB. Thirty thousand people die of the disease every year. However, the number of people infected is not fully known because officials say not all cases are reported. The WHO official for TB control in Central Asia says education about tuberculosis is lacking. The population does not know much about the disease or how it is treated.
The United Nations says the highest rates of reported infection in Russia are among men between thirty-five and sixty-four years of age. Many of these men are unemployed and drink too much alcohol. Many are former prisoners who are also homeless. So treating these men is difficult. Health experts say tuberculosis spreads easily in prisons. The infection rate in prisons is about twenty times higher than the general population. Drug-resistant TB is also a problem there.
World Health Organization officials say fighting TB in Russia is not just a medical problem but also one of economics and organization. They say government money is now available for health care workers to visit treatment centers to study the care and progress of the disease. There is also more money to train workers and provide equipment for laboratories. Health officials say there is now hope in the fight against TB.
Most people infected with the bacteria never develop active TB. However, people with weak body defense systems often develop the disease. TB can damage a person’s lungs or other parts of the body and cause serious sickness.
The disease is spread by people who have active, untreated TB bacteria in their throat or lungs. The bacteria are spread into the air when infected people talk or expel air suddenly.
Most TB cases can be cured with medicines. Successful treatment of TB requires close cooperation among patients, doctors and other health care workers. The World Health Organization has a five-step program to guarantee that TB patients take their medicine correctly. The program is called Directly Observed Treatment, Short-course, or DOTS. Directly observed means that patients must go to local health centers every day or several times a week to take their medicines. Health care workers watch to make sure patients take their medicine every day. Full treatment usually lasts from six to nine months to destroy all signs of the bacteria.
It is very important for patients to be educated about the disease and its treatment. Sometimes patients fail to finish taking the medicine ordered by their doctors. Experts say this is because some patients feel better after only two to four weeks of treatment and stop taking their medicine. This can lead to the TB bacteria becoming stronger, resistant to drugs, and more difficult to treat.
This kind of TB is called multi-drug resistant tuberculosis or MDR-TB. The World Health Organization says MDR-TB is one hundred times more costly to treat than the other form of the disease.
The World Health Organization says most deaths from tuberculosis are in developing countries. More than half of all deaths from TB are in Asia. And half of all new cases are in six Asian countries. They are Bangladesh, China, India, Indonesia, Pakistan and the Philippines.
More than twenty-five percent of the world's multi-drug resistant tuberculosis cases are in Asia. Patients with MDR-TB must take more powerful and costly drugs for more than two years. Some patients experience side effects from the drugs.
Experts say the fight against TB and drug resistance has been successful in Hong Kong. In the past fifty years, Hong Kong has reduced cases of TB by almost ninety-eight percent. In the nineteen fifties, the British colonial government built TB hospitals and began giving vaccines to children. The government also replaced poor, unclean housing with modern public housing.
Today, the Chinese government gives anti-TB drugs free of cost in public health centers. Health workers visit patients who fail to go to health centers to get their medicines. So Hong Kong has very low levels of drug-resistant TB.
The World Health Organization is improving its efforts against TB in China. Almost one million four hundred thousand people there develop active TB each year. Almost twenty-five percent of the world's multi-drug resistant cases are in China. The WHO says the situation is now improving. It says half of China's provinces have put the DOTS treatment method into effect. This has resulted in about a fifty percent reduction in deaths from TB.
The WHO has also set a goal for nations in the Western Pacific area. They are being urged to cut by half infection rates and deaths from TB within three years. Doctors say this goal may not be possible because the disease AIDS is a serious problem in the Western Pacific. Other problems are poverty and lack of money for public health.
In Africa, more than three million people are living with TB. Five hundred thousand people there die each year from the disease. The number of TB victims is rising quickly in Africa. This is mainly because of the virus that causes AIDS. The virus weakens the body's ability to fight disease.
Drug-resistant TB is a serious problem in South Africa. Sizwe Hospital in the city of Johannesburg treats only people with MDR-TB. Three thousand new cases of MDR-TB were identified in Johannesburg alone last year. People with this kind of TB have only a fifty percent chance of being cured. Patients must take one painful injection of medicine and as many as twenty-four pills each day. Treatment can take up to two years. The drugs have serious side effects.
Few people survive a new kind of TB, called Extreme Drug-Resistant TB. This disease is resistant to just about every drug known to science.
The National Health Laboratory in Johannesburg tests for drug-resistant TB. Its workers test five hundred samples from patients from all over southern Africa every day. The testing often last several weeks because each bacterium must be tested in several ways. Almost one-fourth of the bacteria tested are found to be drug-resistant. These have to be tested again to show which drugs they resist.
During this time, the patient may be infecting other people. So it is important to find ways to test for the disease more quickly. The laboratory is now carrying out experiments with tests that identify drug-resistant bacteria within two days. This helps health workers quickly identify an infected person and begin treatment.
Patients being treated for MDR-TB are separated from their families, sometimes for years. This causes economic and social problems for patients and family members. The head doctor at Sizwe Hospital says most patients accept treatment and separation. Health workers believe patients with drug-resistant TB should be separated to protect their communities. But human rights activists say this would be a violation of their rights.
Tuberculosis is a health emergency in Russia. In February, the Russian parliament approved almost three billion dollars to fight infectious diseases such as TB.
Russian studies show that eighty-three of every one hundred thousand people in Russia are infected with TB. Thirty thousand people die of the disease every year. However, the number of people infected is not fully known because officials say not all cases are reported. The WHO official for TB control in Central Asia says education about tuberculosis is lacking. The population does not know much about the disease or how it is treated.
The United Nations says the highest rates of reported infection in Russia are among men between thirty-five and sixty-four years of age. Many of these men are unemployed and drink too much alcohol. Many are former prisoners who are also homeless. So treating these men is difficult. Health experts say tuberculosis spreads easily in prisons. The infection rate in prisons is about twenty times higher than the general population. Drug-resistant TB is also a problem there.
World Health Organization officials say fighting TB in Russia is not just a medical problem but also one of economics and organization. They say government money is now available for health care workers to visit treatment centers to study the care and progress of the disease. There is also more money to train workers and provide equipment for laboratories. Health officials say there is now hope in the fight against TB.
Apr 23, 2007
Vaccines: How They Work
Most vaccines are designed with the same goal in mind. That is, to help the
body's own defense system prevent a disease by producing antibodies against it. Antibodies are disease-fighting proteins. The immune system produces them in reaction to viruses, bacteria and other invaders.
The vaccine tricks the body into thinking it has already successfully defeated the disease. To activate the immune system, vaccines commonly introduce the disease-causing virus or bacteria into the body. But they use weakened or killed versions.
Weakened viruses are used, for example, in vaccines against chickenpox, measles, mumps and rubella. To prevent polio, the Sabin vaccine uses a weakened form of the virus; the Salk vaccine uses a killed version.
Experts say vaccines that use killed or inactivated virus can be safely given even to people with damaged immune systems.
Researchers may spend years working on a vaccine. They have still not succeeded against, for example, H.I.V., the virus that causes AIDS, or against malaria, but they are trying.
And not all vaccines offer long-term protection. The tetanus vaccine is a good example. It offers protection for only about ten years. Then a person must be immunized again.
Some vaccines are made with animal material. For example, influenza vaccine is grown in chicken eggs. This can be a problem for people who are allergic to eggs. Also, the process is complex.
But things could change in the future. A new study in the Journal of the American Medical Association suggests that flu vaccine could come from insect cells.
Researchers in the United States tested a flu vaccine made from caterpillar cells. The study involved four hundred sixty people. There were two versions of the vaccine, one stronger than the other.
The people were not told whether they were getting the vaccine or a substitute, a placebo. Here is what the scientists reported: Seven people in the placebo group caught the flu. So did two people who received the lower strength vaccine. But no one in the stronger vaccine group got the flu.
Protein Sciences, a vaccine maker, paid for the study. The company plans to begin testing the experimental flu vaccine on a larger group in order to seek government approval.
And that's the VOA Special English Health Report, written by Caty Weaver. For more health news, along with transcripts and audio files of our reports, go to voaspecialenglish.com. I'm Steve Ember.
body's own defense system prevent a disease by producing antibodies against it. Antibodies are disease-fighting proteins. The immune system produces them in reaction to viruses, bacteria and other invaders.
The vaccine tricks the body into thinking it has already successfully defeated the disease. To activate the immune system, vaccines commonly introduce the disease-causing virus or bacteria into the body. But they use weakened or killed versions.
Weakened viruses are used, for example, in vaccines against chickenpox, measles, mumps and rubella. To prevent polio, the Sabin vaccine uses a weakened form of the virus; the Salk vaccine uses a killed version.
Experts say vaccines that use killed or inactivated virus can be safely given even to people with damaged immune systems.
Researchers may spend years working on a vaccine. They have still not succeeded against, for example, H.I.V., the virus that causes AIDS, or against malaria, but they are trying.
And not all vaccines offer long-term protection. The tetanus vaccine is a good example. It offers protection for only about ten years. Then a person must be immunized again.
Some vaccines are made with animal material. For example, influenza vaccine is grown in chicken eggs. This can be a problem for people who are allergic to eggs. Also, the process is complex.
But things could change in the future. A new study in the Journal of the American Medical Association suggests that flu vaccine could come from insect cells.
Researchers in the United States tested a flu vaccine made from caterpillar cells. The study involved four hundred sixty people. There were two versions of the vaccine, one stronger than the other.
The people were not told whether they were getting the vaccine or a substitute, a placebo. Here is what the scientists reported: Seven people in the placebo group caught the flu. So did two people who received the lower strength vaccine. But no one in the stronger vaccine group got the flu.
Protein Sciences, a vaccine maker, paid for the study. The company plans to begin testing the experimental flu vaccine on a larger group in order to seek government approval.
And that's the VOA Special English Health Report, written by Caty Weaver. For more health news, along with transcripts and audio files of our reports, go to voaspecialenglish.com. I'm Steve Ember.
Mar 21, 2007
Health report (VOA)
The United States Food and Drug Administration has ordered companies to place strong new warnings on thirteen drugs that treat sleep disorders. It also ordered the makers of the sleeping pills to provide information for patients explaining how to safely use the drugs.
Last Wednesday, the FDA announced that some of these drugs can have unexpected and dangerous effects. These include the risk of life-threatening allergic reactions. They also include rare incidents of strange behavior. These include people cooking food, eating and even driving while asleep. The patients later had no memory of doing these activities while asleep.
Last year, a member of the United States Congress said he had a sleep-driving incident. Patrick Kennedy, a representative from Rhode Island, crashed his car into a security barrier near the building where lawmakers meet. The accident happened in the middle of the night and no one was hurt. Mister Kennedy said he had earlier taken a sleep medicine. He said he was also being treated with a stomach sickness drug that can cause sleepiness.
The Food and Drug Administration did not say in its announcement how many cases of sleep-driving it has documented. However, the New York Times reported last year about people who said they had strange sleep events after taking the drug Ambien（一般名:酒石酸ゾルピデム、日本国内での商品名:マイスリー）. Some reported sleep-driving and sleep-walking. Others said they found evidence after waking in the morning that they had cooked food or eaten in their sleep. But they had no memory of carrying out the activities.
A Food and Drug Administration official says that these serious side effects of sleep disorder drugs appear to be rare. But, he also said there are probably more cases than are reported. He said the agency believes the risk of such behaviors could be reduced if people take the drugs as directed and do not drink alcohol while taking the drugs. The Food and Drug Administration has advised drug companies to carry out studies to investigate the problem.
Last Wednesday, the FDA announced that some of these drugs can have unexpected and dangerous effects. These include the risk of life-threatening allergic reactions. They also include rare incidents of strange behavior. These include people cooking food, eating and even driving while asleep. The patients later had no memory of doing these activities while asleep.
Last year, a member of the United States Congress said he had a sleep-driving incident. Patrick Kennedy, a representative from Rhode Island, crashed his car into a security barrier near the building where lawmakers meet. The accident happened in the middle of the night and no one was hurt. Mister Kennedy said he had earlier taken a sleep medicine. He said he was also being treated with a stomach sickness drug that can cause sleepiness.
The Food and Drug Administration did not say in its announcement how many cases of sleep-driving it has documented. However, the New York Times reported last year about people who said they had strange sleep events after taking the drug Ambien（一般名:酒石酸ゾルピデム、日本国内での商品名:マイスリー）. Some reported sleep-driving and sleep-walking. Others said they found evidence after waking in the morning that they had cooked food or eaten in their sleep. But they had no memory of carrying out the activities.
A Food and Drug Administration official says that these serious side effects of sleep disorder drugs appear to be rare. But, he also said there are probably more cases than are reported. He said the agency believes the risk of such behaviors could be reduced if people take the drugs as directed and do not drink alcohol while taking the drugs. The Food and Drug Administration has advised drug companies to carry out studies to investigate the problem.
Mar 18, 2007
Health report (VOA)
It might seem hard to imagine that a bad tooth could be deadly.
But doctors in the Washington area say a twelve-year-old boy died last month from a tooth infection that spread to his brain. They say it might have been prevented had the boy received the dental care he needed.
Experts at the National Institutes of Health say good dental care starts at birth. They say breast milk is the best food for the healthy development of teeth. Breast milk can help slow bacterial growth and acid production in the mouth.
But dentists say you should clean your baby's gums and early teeth after each feeding. Use a cloth with a little warm water. Do the same if you bottle feed your baby. Experts say if you decide to put your baby to sleep with a bottle, give your baby only water.
When baby teeth begin to appear, you can clean them with a wet toothbrush. Dentists say it is important to find soft toothbrushes made especially for babies. And use them very gently.
The use of fluoride to protect teeth is common in many parts of the world. This natural element is often added to drinking water supplies. The fluoride mixes with enamel, the hard surface on teeth, to help prevent holes, or cavities, from forming.
But the American Academy of Pediatric Dentistry points out that young children often swallow toothpaste when they brush. The group notes that swallowing fluoridated toothpaste can cause problems. So young children should be carefully supervised when they brush their teeth. And only a small amount of fluoridated toothpaste, the size of a green pea, should be used.
Parents often wonder about what effect thumb sucking or sucking on a pacifier might have on their baby's teeth. Dental experts generally agree that this is fine early in life.
The American Academy of Family Physicians says most kids stop sucking their thumbs by the age of four. If it continues, the group advises parents to talk to their child's dentist or doctor. It could interfere with the correct development of permanent teeth.
Dentists strongly advise a first dental visit at least by the time a child is one year old. They say babies should be examined when their first teeth appear.
Healthy teeth are meant to last a lifetime. Daily cleaning is important to preventing infections and other problems. We will talk more in the future about dental care for children and adults.
But doctors in the Washington area say a twelve-year-old boy died last month from a tooth infection that spread to his brain. They say it might have been prevented had the boy received the dental care he needed.
Experts at the National Institutes of Health say good dental care starts at birth. They say breast milk is the best food for the healthy development of teeth. Breast milk can help slow bacterial growth and acid production in the mouth.
But dentists say you should clean your baby's gums and early teeth after each feeding. Use a cloth with a little warm water. Do the same if you bottle feed your baby. Experts say if you decide to put your baby to sleep with a bottle, give your baby only water.
When baby teeth begin to appear, you can clean them with a wet toothbrush. Dentists say it is important to find soft toothbrushes made especially for babies. And use them very gently.
The use of fluoride to protect teeth is common in many parts of the world. This natural element is often added to drinking water supplies. The fluoride mixes with enamel, the hard surface on teeth, to help prevent holes, or cavities, from forming.
But the American Academy of Pediatric Dentistry points out that young children often swallow toothpaste when they brush. The group notes that swallowing fluoridated toothpaste can cause problems. So young children should be carefully supervised when they brush their teeth. And only a small amount of fluoridated toothpaste, the size of a green pea, should be used.
Parents often wonder about what effect thumb sucking or sucking on a pacifier might have on their baby's teeth. Dental experts generally agree that this is fine early in life.
The American Academy of Family Physicians says most kids stop sucking their thumbs by the age of four. If it continues, the group advises parents to talk to their child's dentist or doctor. It could interfere with the correct development of permanent teeth.
Dentists strongly advise a first dental visit at least by the time a child is one year old. They say babies should be examined when their first teeth appear.
Healthy teeth are meant to last a lifetime. Daily cleaning is important to preventing infections and other problems. We will talk more in the future about dental care for children and adults.
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