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Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
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Children, Nutrition & Exercise
Beat the Heat!
Cold Weather Workouts
Concussions
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Exercise is Medicine
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FITT Prescription
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From Surviving to Thriving
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Get Moving!
Get Motivated
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Jump Start Weight Loss
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Live Actively
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Plantar Fasciitis
Prehistoric Workout
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Teen Sports Injuries
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7 Wonders of Walking
Adolescent Health
Full Listing with story descriptions
Acne
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Adolescent Growth & Development
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Body Piercing
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Chronic Diseases in Teens
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Concussion in Sport
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Depression
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Female Physical Exam
First Period
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Junior High
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A Woman's Physical
Your First Job
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Childbirth
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Medication & Pregnancy
Miscarriage
Managing Your Own Labour
Monitoring Your Labour
Nausea & Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Pregnancy Weight
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun & Photos
Natural Remedies in Pregnancy
Vaccinations During Pregnancy
Vacuum & Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Childhood
Full Listing with story descriptions
Asthma in Children
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Childhood Obesity
Choosing A Babysitter
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Developmental Milestones
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Daytime Wetting
Introducing Solid Foods
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Feeding Your Baby
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Head Lice
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How Children Grow
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Hearing Issues in Newborns
Heart Murmers
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Iron
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Children and Sports Injuries
Lazy Eye (Amblyopia)
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Not Just Baby Fat
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Preparing for Lab Tests
Recognizing Learning Disabilities
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
School
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Sick Toddler
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Toddler Safety
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Urinary Tract Infections
Vaccinations
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Introduction
Managing Your Pain
Movement Matters
Moving Forward
Nutrition
Opioids
Pacing
Pain Medications
Prevention
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
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Dentures and Healthy Jaw
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Fluoride
Fluoride Findings
First Dental Visit
Headaches
A Healthy Mouth
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Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Mouth Protection Equipment
Oral Cancer Screening
Oral Healthcare
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Oral Health Care Products
Orthodontics
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
The Smile You Want
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Smiling through the Senior Years
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
DIABETES
Full Listing with story descriptions
10,000 Steps
A1C Test
Accurate Blood Glucose Testing
Alchohol and Diabetes
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Glucose Testing Tips
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Constipation
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Debunking Diabetes Myths
Driving and Diabetes
Diabetes and Menopause
Diabetes and OTC Medications
Diabetes Care Team
Diabetes and Celiac
Diabetes and Depression
Diabetes Diet
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out
Drinking and Diabetes
The Discovery of Insulin
Eating Disorders
Easing the Strain of Stress
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fats
Fibre
Fill Your Day with Energy
Financial Support for Diabetes
Food Temptation
Foot Care
Footwear and Foot Health
Fruits and Veggies
Gastroparesis
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Grocery Shopping Tips
Guidelines for Diabetes Management
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization & Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Insurance
Ketones
Kidney Disease - Reducing the Risk
Living with Diagnosis of Diabetes
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Metformin
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
Microalbuminuria
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Over-the-Counter Medications
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Sensible Snacking
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Sodium
Social Media & Diabetes
Solving the Insurance Puzzle
Stress and Diabetes
Success in School
Supplements
Supporting Spouse with Diabetes
Sweeteners
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Understanding Ketones
Used Sharps
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Walking
Wise Choices About Natural Medicines
Wonderful Water
Natural Medicines & Diabetes
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Allergies
Antibiotic Use
Arthritis
Aspirin Every Day?
Asthma
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
Bladder Problems
Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Check-Up
Colon Cancer Screening
Contact Lenses
Contraception
COPD
Cost of Doctor's Visit
Diabetes Management
Diarrhea
Diagnostic Tests
Do I Need a Bone Density Test?
Doctor Visit
Driving Vision
Dizziness
Dealing with Dry Eyes
Does My Sore Knee Require an MRI?
Do I Need an Annual Physical?
Eczema
Electronic Medical Records
Epilepsy
Eye Exam
Family Doctor
Fibromyalgia
Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Gallbladder
Get Active!
Glare
Headaches
Healthcare Teams
Heart Health
Hemorrhoids
Hepatitis C
Human Papilloma Virus
High Blood Pressure
High Blood Pressure Risks
How to Talk to Your Doctor
Hypothyroidism
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Irritable Bowel Syndrome
Joint Replacement Surgery
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Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
Migraine
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Multiple Myeloma
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Opioid Myths
Primary Healthcare Reform
Prostate Problems
Quitting Smoking
Red Eyes
Respiratory Tract Infections
Restore Your Core
Rosacea
Screening Tests
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Special Diagnostic Tests
Stopping Stroke
Stroke
Superbugs
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Urine Tests
Vaccination Controversies (ask the doctor)
Win by Losing
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
Burns
Choking
Cuts and Scrapes
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
Nosebleeds
Poisoning - Household
Emergency Care Guidelines
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Growing Older
Full Listing with story descriptions
Advance Care Plans
Age-Related Macular Degeneration
Alzheimer Disease
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Building Strength
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Cataracts
Can I see Well Enough to Drive?
Cholesterol
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Coping with Dementia
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Controlling Medications
C.O.P.D.
Delirium
Dizziness (Vertigo)
Eating Well
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Exercise Benefits
Erectile Dysfunction
Eye Care
Eyesight and Driving
Feet
Frailty
Fungal Nail Infections
Get Active!
Glaucoma
Grief
Have Health, Will Travel
Health Tips for Seniors
Hearing
Incontinence
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Lab Tests
Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
Memory Loss
New Corneal Treatments
Nutrition for Seniors
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Parkinson Disease
Problem Gambling
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Retirement
Seniors and Medications
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Sexually Transmitted Infections
Screening Tests
Seniors and Driving
Sleeplessness
Skin Structure
Skin Protection
Skin Over 50
Solving Sleep Issues
Staying Healthy
Stroke Prevention
Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
Full Listing with story descriptions
Abuse
Acupuncture
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
Antidepressants
Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Depression
Diabetes Epidemic
Discipline
Diseases from Pets
Downsizing
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
Grief
Harassment
Healing Through Music
Healthy Computing
Humidex
Hypnotherapy
Ice Safety
Indoor Air Quality
Lymphedema
Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Schizophrenia
Smokeless Tobacco
Sexually Transmitted Diseases
Soy
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Sunburn
Time Management
Travel Health Protection
Travel Comfort Tips
Travel Immunization
Understanding Change
Unplugging
Whiplash
Wind Chill Index
Workplace Drug Testing
Workplace Health
Nutrition
Full Listing with story descriptions
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter & Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits & Veggies - 5-10 a Day
Fats
Fat Phobias
Fats & Cholesterol
Feeding Your Kids
Fibre
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Iron
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits & Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Probiotics
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss
Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biologics
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heartburn
Heart Health
Insomnia
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports & Nutrition Supplements
Sunscreen
Taking Medication
Take as Directed
Using Antibiotics Wisely
Viagra
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Prevention
Full Listing with story descriptions
Accident Prevention
Alcohol
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Bedbugs
Disaster Planning
Diseases from Pets
Caffeine
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Meningitis
Norovirus
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
Vision Damage
Water Wisdom
West Nile Disease
Whooping Cough
Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Anemia
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception
Contraception for Mature Women
Cosmetic Procedures
Cystitis
Endometriosis
Estrogen's Effect on the Brain
Fear of Fracture
Fibroids
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
The IUD
Menopause - What Men Should Know
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menopause
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Osteoporosis
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
xx
Sexually Transmitted Infections
Urinary Incontinence
Vaginitis
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
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Family Health Magazine - FAMILY MEDICINE

Antibiotic Use
Not all bugs need drugs

Antibiotics are clearly one of the most important discoveries of modern medicine. In the 60 years since they have been discovered, antibiotics have saved millions of lives. Unfortunately, some bacteria can no longer be killed by antibiotics. This antibiotic resistance is due to the ability of bacteria to change and adapt. The World Health Organization has called antibiotic resistance a global health crisis needing urgent solutions.

Half of the antibiotics used in the world today are used in humans. The rest are used in agriculture to treat and prevent infections in animals and plants. Agricultural use of antibiotics has been identified as one of the factors contributing to antibiotic resistance.

Overuse and inappropriate use of antibiotics in humans has been recognized as another major contributor to this problem. Of the antibiotics used in humans, 80 per cent are used to treat infections in the community. The rest are used for more serious infections in hospitals.

Most of these infections are respiratory tract infections occurring along the pathways taken by the air we breath. These tract infections include colds, flu, sore throats, ear infections, sinusitis, croup, laryngitis, bronchitis, bronchiolitis and pneumonia. Bronchitis is an infection in the breathing tubes in the lungs. Bronchiolitis is an infection in the tiny breathing tubes of a young child and it often causes wheezing.

Pneumonia is an infection deep in the lung where oxygen from the air reaches the blood. With the exception of pneumonia, most respiratory infections are due to viruses. Antibiotics do not work against viruses. Yet up to 75 per cent of antibiotics are used to treat respiratory tract infections. About one half of prescription antibiotics intended to treat respiratory tract infections are not necessary and can be harmful.

In 1997, the Canadian Committee on Antibiotic Resistance issued a mandate to decrease the use of antibiotics in respiratory tract infections by 25 per cent. Given the overuse of antibiotics, this would seem an achievable goal. Unfortunately there are some mistaken ideas that need to be resolved before antibiotic use can be curbed. For example, a survey done in February 2000 by the National Information Program on Antibiotics indicates that 54 per cent of adults in Canada believe antibiotics are effective against viruses.

Public pressure to receive antibiotics influences the over-prescribing of antibiotics. In a recent survey conducted in the Capital Health Region (Edmonton), 31 per cent of adults interviewed expect an antibiotic from their doctor when they have symptoms of a respiratory tract infection. If it is their child who has these symptoms, 35 per cent expect antibiotics. It is also a concern that 11 per cent of people interviewed would seek another doctor if an antibiotic prescription was not given by the first doctor.

Antibiotic Resistance

Using antibiotics when they are not needed can lead to antibiotic resistance. Bacteria can become resistant to the affects of the antibiotic. This is sometimes a difficult concept to understand, as people may believe that their immune system is making them resistant to antibiotics. In fact, this is not the case at all. Antibiotic resistance has nothing to do with a person’s immune system.

It is the bacteria that are resistant to antibiotics - not people. This means even very healthy people who have never taken antibiotics can be exposed to antibiotic resistant bacteria from others! These bacteria are sometimes resistant to many antibiotics, and there may not be any way to treat them.

The good news is antibiotic resistance can be reduced by using fewer antibiotics. Since most respiratory infections are due to viruses, the use of antibiotics in these infections could be drastically reduced.

Not All Bugs Are Created Equal

Both bacteria and viruses can cause infections of the respiratory tract. However, viruses cause most of these illnesses. Bacteria and viruses are very different types of germs. They are different in their structure, the way they cause infections and the ways they can be killed.

Antibiotics act in various ways to kill or control bacteria. Because of the big difference between bacteria and viruses, antibiotics do not work at all against viruses. In fact, giving antibiotics to someone who has a virus may actually be harmful. It exposes the bacteria in the body to antibiotics. This allows the bacteria the chance to develop resistance to the antibiotic. With time this ability to become resistant can be passed to the more serious disease-causing bacteria.

Rely on your doctor’s advice if an antibiotic is not prescribed for a respiratory illness.

Viruses

Viruses are more contagious than bacteria. If more than one person in the family has the same illness, odds are it is a viral illness. Colds, flu, croup, laryngitis, chest colds and most sore throats are due to viruses. Bronchitis is another name for a chest cold. In adults and children who otherwise have healthy lungs it is also due to viruses. It is one of the most common reasons why adults get antibiotics that are not needed.

Contrary to what many people believe, viruses can make a person just as sick, if not sicker, than a bacterial infection. This is especially true for the flu. Generally, a viral illness will last four to five days. However, it may take up to three weeks or more to feel completely better.

Bacteria

Bacterial infections are less common than viral infections and are less contagious. It is important to remember that pneumonia, the most serious respiratory tract infection, is usually caused by bacteria. Pneumonia can be a serious illness, sometimes resulting in death. The major reason for making sure antibiotics are used wisely is to ensure they still work for this, and other, potentially fatal illnesses.

The most common bacteria to cause pneumonia (Streptococcus pneumoniae) is now developing resistance. Antibiotics that would have worked very well several years ago are no longer effective!

When to Wash Your Hands

  • Before meals
  • Before feeding children, including breastfeeding
  • Before and after preparing food, especially raw meat, poultry or fish
  • After using the toilet, changing a diaper or helping a child use the toilet
  • After blowing your nose, coughing or sneezing
  • Before and after being with someone who is sick
  • Before and after treating a wound
  • Before inserting or removing contacts
  • After playing with toys shared with other children
  • After handling animals or pets or their waste

How to Wash Your Hands

  • Use soap and warm water.Water alone does not get rid of germs.
  • Rub hands together for 20 seconds, the time it takes to sing Twinkle Twinkle Little Star. Pay special attention to the fingertips and under the fingernails. Ninety-five per cent of germs are found under the fingernails.
  • Rinse hands for 10 seconds.
  • Dry hands completely. Use a clean, dry towel if possible.
  • Care must be taken, especially in public places, not to recontaminate the hands by touching dirty surfaces. After washing your hands in a public washroom, use paper towel to turn off the taps and open the door.

Hand Washing

Hand washing is the single most important way to stop the spread of infections. In fact, hands spread 80 per cent of the most common infections.

A single hand can harbour as many as 200 million organisms including bacteria, viruses and fungi. Most of the organisms on the skin are good bacteria, called resident flora. These bacteria protect from infection by crowding out bad bacteria and viruses. The bad germs, referred to as transient flora, can live on hands for short periods of time. They can cause infection when they enter the body, by the hands by touching mucous membranes like the mouth, nose or eyes.

Developing good hand washing habits will prevent many infections. This life skill should be taught to children early. The key is to make hand washing a habit rather than a chore. Germs are easily removed by proper hand washing with regular soap and water.

Antibacterial soap

There has been a trend in the last few years, to use antibacterial soap. These products are effective in killing the bacteria on the skin. The problem is they also kill the good bacteria that protect from the disease-causing bacteria and viruses. Repeated exposure of bacteria to these antibacterial products can make the bacteria resistant. This resistance can be transferred from the resident bacteria to some of the disease-causing transient bacteria.

There is no need to use antibacterial soaps in the home, school or workplace. Proper hand washing with regular soap and water can remove germs very effectively. Antibacterial soaps should be reserved for hospital settings (for example surgeons who are preparing for surgery).

Respiratory Tract Infections (RTI)

Here are descriptions of and treatment for some of the more common RTIs.

Fever

Fever is often a symptom that makes people worry and seek medical advice. A high fever is sometimes thought to mean a bacterial infection. This is not necessarily the case, as viral infections may also be associated with high fevers.

Fever, in fact, is one of the ways the body has to fight infection, and is usually helpful. Fever occurs with most respiratory tract infections, both viral and bacterial. Acetaminophen or ibuprofen may help to relieve a fever. Do not give children under the age of 18 years drugs that contain acetylsalicylic acid (e.g. ASA, Aspirin™) due to the risk of Reye’s syndrome which causes damage to the liver and brain.

When a fever is reduced in a child with a viral infection, the child usually feels better. In a child with a bacterial infection, especially pneumonia, the child will usually still feel miserable, even when the temperature is brought down.

Colds

There are about 200 different viruses that cause colds. On average, children get eight to 10 colds per year. Adults get fewer colds. This is mostly because they have built up immunity against some of the cold viruses to which they have been previously exposed.

Most colds bring a cough or a sore throat. When a person has the other familiar symptoms of a cold (runny nose, irritated eyes), the cough and sore throat are also due to the virus and do not need further investigation or an antibiotic. A yellow or green discharge from the nose is one of the most common reasons people receive antibiotics for colds. Yet this is the normal progress of a cold - not a new bacterial infection. The change in colour shows that the immune system is in full gear to fight the virus. It means that the body has mobilized some of its infection fighting cells (mostly white blood cells).

Colds usually last four to five days but it may take up to three weeks or more to feel completely better. The best treatment for colds is fluids, especially warm fluids, rest and acetaminophen or ibuprofen for fever. Cough suppressants, such as dextromethorphan (DM), may help to relieve a cough.

Salt water nose drops are especially useful for babies and toddlers to relieve nasal congestion.

Flu

The flu (influenza) is caused by a virus. The flu season starts in November or December and ends in April or May. The flu can make a person very sick with fever, chills, muscle and body aches, sore throat and cough. It typically lasts four to five days but it may take three weeks or more to feel completely better.

The best way to prevent the flu is to get a yearly flu vaccine. The vaccine is about 70 per cent effective in preventing the flu. Because the flu virus is always changing, it is necessary to get a new vaccine every year.

If a person has the flu, the best way to prevent the spread of the virus is regular hand washing. As well, a tissue should be used for blowing the nose, and coughing or sneezing on anyone should be avoided. In the first few days of illness it is important for the sick person to stay away from school or work to prevent spreading the virus. Adults spread the virus for three to five days after first feeling sick, while children can spread the virus for up to one week.

There are new drugs available called antivirals that can work against the flu virus. These drugs must be taken within the first 48 hours of the flu symptoms to be effective. The problem is this is often when people are not sure they have the flu. The best treatment for the flu is fluids, rest and acetaminophen or ibuprofen for the fever, aches and pains. Cough suppressants, such as dextromethorphan (DM), may help to relieve a cough.

Sore throats

Most sore throats are symptoms of colds or the flu. These do not require further investigation and will not be helped by an antibiotic. About 15 per cent of sore throats are due to bacteria called Streptococcus pyogenes (Group A Strep). This is referred to as Strep throat. Although it may occur in adults, this infection affects mainly school-aged children between the ages of five and 10. Strep throat is more common in the fall and winter.

Unfortunately, it is not possible to tell just by looking whether a sore throat is due to a virus or bacteria. A throat swab must be taken. It usually takes 48 hours to get a result. If the result is positive, penicillin will usually be prescribed for the Strep throat. Antibiotics do not greatly decrease the symptoms of a sore throat. However, they help prevent complications that can occur after having an infection with Streptococcus bacteria. If the swab result is negative, it means this is probably a viral infection and antibiotics will not help. While waiting for the results, acetaminophen or ibuprofen should be given for pain and fever.

A throat swab is only necessary if a person has a sore throat and no other symptoms. People with cold symptoms and a sore throat may show Streptococcus bacteria on a throat swab, but in fact the symptoms are due to a virus. This is because healthy people can carry Streptococcus bacteria in their throat with no symptoms. For these people, a swab may falsely show Strep throat and antibiotics may be prescribed inappropriately.

A sore throat associated with a cold or the flu does not need a throat swab or an antibiotic.

Ear infections

Ear infections are one of the most common reasons why children are prescribed antibiotics. Young children are more prone to ear infections. This is because the eustachian tube that connects the ear to the throat can easily become blocked during a cold. This blockage can lead to a bacterial infection in the ear.

Not all earaches are due to a bacterial infection. During a viral infection, fluid may build up in the ear causing pain. Redness inside the ears is often seen in children who are sick and have been crying. This is also not a reason to give antibiotics. Fluid behind the eardrum is a common reason for the misuse of antibiotics. This is very common after a cold or a bacterial ear infection. In fact, half of children still have fluid behind the eardrum one month after appropriate treatment with antibiotics. If the child’s symptoms have improved, there is no reason to give more antibiotics. Children with an ear infection should be examined after three months. At this time all the fluid should be gone. If it is not, this might lead to hearing problems!

Some children have many ear infections over a short period of time. These children might benefit from having small tubes (myringotomy) put in their ears surgically. Because of the problem with antibiotic resistance, it is not recommended to give antibiotics on a regular basis for long periods to prevent further infections.
At all times children with earaches should be given adequate pain medicine (acetaminophen, ibuprofen).

Sinus infections

The sinuses are air-filled spaces around the nose and the eyes. Sinusitis is an inflammation of these sinuses and can occur when fluid builds up in this area. Both bacteria and viruses can cause sinusitis, but viruses are up to 200 times more common.

Sinusitis most often occurs after a cold, but most colds do not lead to sinusitis. The symptoms of sinusitis are more severe and last longer than a cold. A yellow or green runny nose within a few days of a cold is normal. If this discharge continues for more than 10 days, this may be a sign of bacterial sinusitis.

Unfortunately, sinus x-rays are not helpful in diagnosing bacterial sinusitis. X-rays cannot tell the difference between the fluid that builds-up with a viral infection and the problems of a bacterial infection.

Decongestants may help to relieve symptoms but do not shorten the illness. If cold symptoms reoccur and are associated with a clear discharge, this indicates another cold, not sinusitis.

Coughs

The majority of coughs in otherwise healthy children and adults are due to viruses. Bronchitis, often called a chest cold, occurs when the lining of the bronchi (the large airways that go to the lungs) become inflamed. In people with chronic lung diseases, bronchitis may sometimes be due to bacterial infections.

Many people put up with a cough for a few days but often seek medical advice if they start coughing up yellow or green sputum or if the cough is prolonged. Like the yellow or green runny nose of a cold, the discoloured sputum associated with bronchitis shows that the body is fighting the infection. It does not mean it is a bacterial infection.

It is important to be patient with a cough. Viral infections can cause a lot of irritation to the lining of the airways, resulting in discomfort and coughing. However, some coughs are associated with pneumonia. Pneumonia is a serious infection of the lungs which may also be caused by bacteria. These people are usually much sicker and often have had their symptoms for a shorter time. If pneumonia is suspected, a chest x-ray should be done to confirm the diagnosis. Antibiotics are usually prescribed.

Forty-five percent of people with bronchitis still have a cough two weeks after the start of their symptoms. At three weeks, 25 per cent still have a cough. Cough suppressants, such as dextromethorphan (DM), may help to relieve a cough.

Resources

Breaking the antibiotic habit: a parent’s guide to coughs, colds, ear infections, and sore throats. April 1999; Wiley Publishing, Offit PA,
Fass-Offit B, Bell L.

www.dobugsneeddrugs.org

Not All Bugs Need Drugs

Respiratory tract infections are the most common infections for which antibiotics are prescribed. Many of these antibiotics are not necessary as the majority of these infections are due to viruses.

Giving antibiotics for viral infections adds to the problem of antibiotic resistance. Most respiratory tract infections will get better with fluids and rest. Pneumonia is the one respiratory infection where antibiotics can make a difference.

Get tough on germs; wash your hands! Hand washing with regular soap is the best way to stop the spread of respiratory infections. This simple habit may be the most important key to reduce the use of antibiotics and ensure that antibiotics continue to save lives in the future.

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FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written
with the assistance of
The College of Family Physicans of Canada
Alberta College of Family Physicians
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