PRODUKTRESUME LÆGEMIDLETS NAVN Aldurazyme 100 E/ml koncentrat til opløsning til infusion. 2. KVALITATIV OG KVANTITATIV SAMMENSÆTNING 1 ml indeholder 100 enheder (ca. 0,58 mg) laronidase. Hvert hætteglas med 5 ml indeholder 500 enheder laronidase. Den aktive enhed (E) defineres som hydrolysen af én mikromol substrat (4-MUI) pr. minut. Laronidase er en rekombinant form a
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Mnawf.org.myWhat are the main responsibilities of a pet owner? How does one care for a pet? What does a pet require? The answers to these questions are addressed in this article contributed by our Deputy Chairman, Dr. S. Sivagurunathan. With our main focus this year being on responsible pet ownership, we felt it would be appropriate to highlight some key points on the subject for the benefit of our members. This is the first of a two-part article, to be continued in our next update. From being treated merely as decorative pieces in ancient days of the Chinese and Western nobility, for example, animals were later adopted for more functional roles as guard dogs, hunting dogs and "pest control agents" (cats to catch mice). Things gradually improved, with some animals being utilised for social roles as companion animals or pets. Today, pets are accepted as an integral part of most societies. People from all walks of life have started to allow animals into their homes. Once inside the confines of the home, special care must be exercised to regulate the pet's behaviour. Owners must ensure that their dogs do not bark incessantly, chase or attack other pets or people in the neighbourhood and become a public nuisance. The irresponsible behaviour of some owners who have allowed their pets to breed indiscriminately and make excessive noise has led to various laws and legislation being passed by town and city councils. Thus laws are instituted by the various councils in order to reduce the nuisance that could be caused by pets. The detailed legislation outlines the relationship between society and pets and touches on various aspects of pet ownership such as persistent barking, roaming and number of animals per household. Widespread control in urban areas has made it mandatory for dogs to be registered and licensed. Responsibilities of a Pet Owner Responsible pet owners should get to know their pets better, ensure they are healthy all through their lives, understand their behavioural problems, teach them obedience and adopt preventive measures for their pets. When all these factors are diligently practiced, pets can be easily raised to become pleasant companions to owners and well behaved social animals in public. A pet owner's responsibility includes: - Confining pets within the parameter of the house and preventing them from wandering beyond it. - Providing suitable space for pets in order to eliminate unwanted behaviour associated with boredom, such as excessive barking. - Attending to the pet's health. Maintaining the animal on a preventive health course rather than seeking a veterinarian's help only when it is sick. - Spending enough time with pets - exercising, training, feeding and grooming according to the needs of the specific species. - Complying with relevant by-laws such as removal of faecal deposits in public areas and complying with licensing requirements. "Pooper scoopers" must be used when taking pets out to defecate in public places. These responsibilities are collectively known as an owner's social responsibility and commitment to his or her pet. Owners can also learn more about their pets and animals by obtaining information from veterinarians, animal welfare organisations, local councils, animal behaviourists and interested groups and individuals. Interest groups include Obedience Training Centres, Kennel/Cat Clubs and Puppy Parties which promote socialisation between pets and owners. There are also media outlets via television offering programmes like "Discovery", "National Geographic" and "Wildlife" and various publications, all providing more insight into the world of animals. Animal behaviourists provide suggestions on breeds of dogs and cats that are suitable for prospective pet owners, their lifestyles and expectations through the "select a pet" programme. These sources of information also educate the young about animals, their behaviour patterns and personality traits. In this way, young children will not be afraid of cats and dogs, but instead will learn to treat them with respect and care, as well as view them as natural inhabitants of the environment and co-exist with them. Preventive Health Care Owners must regularly provide Preventive Health Care for their pets. A Preventive Health Care programme includes disease prevention, risk factor management and wellness programmes, and is aimed at promoting the health and well-being of pets. Owners are obliged to ensure that their pets receive all the health services recommended for them. The Preventive Health Care concept also differs from the traditional veterinary perspective which focuses on diagnosing and curing individual disease entities. Preventive Health Care is also an important component of companion animal practise and responsible pet ownership. It involves all aspects of a pet's health such as genetic factors, its history, age, oral health, nutrition and the environment. The history of the individual pet, the results of its physical examination and laboratory data are essential elements of a good health care programme. Risk Factor Maintenance Intrinsic to health maintenance is the detection and management of health risk factors. There are two complementary approaches that can be used to reduce risk factors in pet or animal population. The first is aimed at the general pet population while the second is targeted at individuals with defined risk profiles. Genetic and environmental interactions play an important role in determining chronic disease outcomes. There should be an effective prevention strategy aimed at the general pet population. This should be complemented with recommendations for individual patients who are at high risk. Vaccination and parasite control are some of the traditional Preventive Health Care services offered by veterinarians. Advice on pet selection and prophylactic dentistry are equally important for an effective health maintenance programme. The services provided in the programme vary according to the animal's functions, its age and the environment in which it lives. Choice of Pet It is advisable for prospective pet owners to consult veterinarians or animal behaviourists before they select a pet that would best suit their lifestyles and perceived needs. Wrong choices and inappropriate behaviour result in pets being abandoned, euthanised, sent to animal shelters or returned to pet stores, breeders or the original owners. Behavioural problems make owners dissatisfied, and adversely affect the pet's health. Choosing A Puppy: For illustration, I have provided below the personalities of two different breeds of dogs: Chow Chow It has a unique confirmation, one man loyalty, highest ranked breed in territorial defence, ranked moderate in terms of snapping at children with perhaps lowest ranking in obedience training. It is a strong dog and such breed can only be used as guard dogs and as companion animals for adults. Retriever Good with children - very seldom snaps at children, moderate and does not demand attention from a single person, ranks average in terms of protection, easy to train and house break. A good family dog. Posters on "Choosing A Puppy To Suit Your Lifestyle" are available for sale, the proceeds of which will be donated to the Foundation. Choosing A Cat: Cats, like dogs, make good companion animals. The size of cats often makes them more suitable than dogs for some environments. The fact that cats use litter boxes for elimination and do not make as much noise or nuisance as dogs, contributes to the popularity of cats in high rise buildings and high density residential areas. Furthermore, cats can be left alone for most of the day, which makes them optimum pets for those who are working. Cats should be carefully selected according to size, coat, breed predelections to medical problems, colour and gender, to meet the lifestyle of the family. (To be continued in next issue.) [Extract from book by Dr. S. Sivagurunathan entitled "Pets Have Feelings Too", the proceeds from sales of which were donated to MNAWF. The book is available for sale. For info or inquiries, contact (03) 443 5113 [Part 2 of article contributed by our Deputy Chairman, Dr S. Sivagurunathan. Part I appeared in Vol. 2/99 Sept-Dec '99] Congenital defects are caused by hereditary or environmental factors or both. These defects are expressed as clinical problems. Health maintenance programmes should include screening protocols for these diseases. Known and suspected genetic disorders in dogs and cats according to breeds can also be detected under the programme. Three routine screening protocols in adults involve the skeletal system, eye and haemostatic mechanism. Hip dysplasia is the result of hereditary and environmental factors, specifically nutritional defects. Routine screening protocols include radiographic procedures to detect changes in adult dogs. As much as 15 per cent of all congenital defects in dogs involve the eye. Similarly, successful genetic screening programmes can detect bleeding disorders, particularly Von Willebrand disease in Dobermans. Behaviour is a combination of inherited trends (species specific) and learned components. In fact, most behaviour problems are not due to abnormal behaviour but due to normal species-specific behaviours that must match the lifestyle of the owner, for example, excessive barking, excitability, territorial defence, snapping at children and playfulness. Behavioural problems are the leading cause for euthanasia or abandonment of pets. This can be avoided through counselling and advice from veterinarians or animal behaviourists. The environment in which a pet lives profoundly influences its health. Pets housed in-doors are less susceptible to environmental extremes such as weather, motor vehicle accidents and other trauma while animals that roam freely are at greater risk of trauma and weather-related injuries. 75 percent of all trauma suffered by dogs and cats involve motor vehicle accidents, interaction with animals and other injuries. Vaccines for dogs protect them against distemper, adenovirus, infectious hepatitis, para-influenza, leptospirosis, parvovirus, corona virus and rabies. Other vaccines can be included to the canine's health maintenance programme depending on local disease incidences and veterinarian's recommendation. Cats are usually vaccinated against viral rhino-tracheitis, calicivirus, feline panleukopenia or distemper and feline infectious peritonitis and feline leukemia. Like dogs, other vaccines can be added to a feline's health maintenance programme depending on local disease incidences. Annual vaccination is encouraged after an initial series of vaccinations are completed on juvenile animals. In the tropics, external parasites of concern in pets include fleas, ticks and ear mites. An annual faecal examination is recommended for intestinal parasites. Intestinal parasites of concern in adult dogs are hookworms, whip-worms and cestodes. Heartworm prevention with either diethycaramazine or ivermectin should be continued in the adult pet. In endemic areas, adult dogs should be examined routinely through heartworm antigen test, whether the animal is or is not receiving routine medication. One of the major decisions that owners must make which may affect a pet's health and longevity is neutering. Behavioural characteristics most influenced by neutering include roaming, feline urine spraying, canine urine marking and inter-male aggression. Neutering pets at an early age will prevent the occurrence of all tumours of the reproductive tissues with the notable exceptions of canine prostatic adenocarcinoma and feline mammary cancer. Tumour of the testicles is the second most common neoplasm that affects male dogs. This disease is extremely rare in male cats. Intact males also suffer from canine perineal hernias, prostatic disease and sexually transmitted diseases such as transmissible venereal tumour and brucellosis. The most common tumour in female dogs is mammary gland in origin. Ovariectomy performed before the first oestrus virtually eliminates the risk of mammary tumour in dogs and cats. Research has proven that the risk factor increases by two and a half times when ovariectomy is delayed after the first oestrus. Periodontal disease or gum disease is the munber one cause of premature loss of teeth in dogs and cats. Research has proven that more than 70 per cent of dogs and cats above six years have periodontitis, although it is not a geriatric disease. Initial gingivitis (a reversible form) of periodontal disease develops at one or two years of age and progresses to periodontitis (an irreversible form) by four to six years of age, which then results in tooth loss. As such, preventive dental care in young adults will prevent periodontitis. Routine dental prophylaxis and education on oral hygiene can help teach owners how to take better care of their pet's teeth and gums at home. It is true that the skin is a reflection of general health, but pets with ungroomed coats could be the result of neglect. Unkempt, poorly groomed coats invite external parasites and dermatological problems which can lead to acute pyotraumatic dermatitis. Normal grooming procedures for the individual type of coats should be emphasised to owners as part of the health maintenance programme in young dogs and cats. Owners must be taught to spend a few minutes regularly grooming their pets rather than several hours sporadically or occasionally. Most well trained pets thoroughly enjoy being groomed. Animals that need to be groomed include Persians, Himalayans, Poodles, Pekinese and Maltese. Optimal nutrition during all the different stages of a pet's life is an important part of any health maintenance programme. Manufactured pet foods contain more than adequate levels of all the essential nutrients needed by dogs and cats. It is a well-established fact that infections are more likely to be fatal in hosts experiencing clinical and sub-clinical malnutrition. Malnutrition and infection are found to be synergistic. The immunological basis for the relationship between nutrition and health states that protein and energy malnutrition will consistently suppress cell-mediated and humoral immunity. Excesses of certain essential nutrients will also compromise immune responses. Optimal nutrition is important when feeding reproductive females, stressed animals and in managing obesity. Preventive Health Care programmes can lessen existing problems of aging, slow or prevent pathology and add quality years to a pet's life. Nutrition is a vital part of this process. As such, small animal practitioners should provide nutrition counselling to pet owners. Now that the lifespan of pets has extended over six years of age, Geriatric Medicine and Management have been included as part of routine Geriatric Health Care Programmes. Aging pets are less active and have less organ reserves. Four common problems found in aging pets are obesity, kidney diseases, hepatic diseases and cardio vascular diseases. Geriatric programmes can screen for these diseases through lateral and thoracic radiography, electro-cardiography, analysis of blood and urine, and weight control. Annual dental care can also prolong the life of pets. The Geriatric Health Maintenance programme is best performed through a system review every six months. The review should include a thorough history and complete physical examination. Extended laboratory tests which include a complete blood count, serum bio-chemical profiles, urinalysis and other laboratory tests that are necessary, should be perfortned to screen the pet's system to detect probable diseases. An annual thoracic radiograph and electro cardiogram or echo cardiograms or both are necessary to detect cardiac murmurs if there Is history of coughing or abnormal respiratory symptoms. Sometimes these procedures could also reveal a tumour before it is felt or seen. A complete opthalmic evaluation including a fundic examination might be necessary to detect abnormalities. At the same, vaccination, parasite control, grooming and oral health prophylaxis should be reviewed. Lastly, dietary management for obesity, chronic progressive renal diseases, heart failures and constipation should also be addressed.
The Marketing of Your Personal Health Information: The HIPAA Loophole What is the Marketing “Loophole”? The HIPAA Privacy Rule prohibits the use of an individual’s personal information for marketing purposes without the patient’s prior written authorization. Under the Rule, health care entities covered by HIPAA – e.g., providers, plans and pharmacies – do not need to get prior