Australia: Schweppes Lemon Lime & Bitters recalled

Schweppes Lemon Lime & Bitters in 300ml x 4 glass bottles and 1.25L PET (plastic) bottles

with best buy dates  Before 25 Mar 15 and 26 Mar 15 for the 300ml bottle and Best Before 23 Oct 14 on the 1.25L bottle

The contained Quinine contamination, therefore quinine is not declared on the label. Quinine is an ingredient used in tonic water. Consumers who have a quinine sensitivity should not consume this product and may have a reaction if the product is consumed.

The product was sold in Australian Capital Territory,New South Wales, and Queensland by Coles, Woolworths, Aldi, IGA and many other smaller retailers including take-away stores, liquor stores and service stations. The supplier was Schweppes Australia P/L.

Consumers who have a quinine sensitivity should not consume this product and may have a reaction if the product is consumed. The products can be returned to the place of purchase for a full refund.

For more information contact Schweppes Australia P/L on ph:1800 244 054.

A New Way to Treat Tuberculosis

In a new study published in Nature, scientists describe a new type of tuberculosis (TB) treatment that involves manipulating the body’s response to TB bacteria rather than targeting the bacteria themselves, a concept called host-directed therapy. TB remains a major cause of disability and death worldwide as an estimated 8.6 million people fell ill with TB and 1.3 million people died from the disease in 2012, according to the World Health Organization.

Although TB is curable, adherence to therapy is difficult as treatment requires taking antibiotic drugs for at least six months and sometimes up to two years. Poor adherence to medication and other factors have resulted in drug-resistant strains, and currently no effective TB vaccine exists.

To address the need for alternative interventions, scientists from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, demonstrated proof-of-concept for a host-directed strategy to treat tuberculosis. They found that interleukin-1, a type of protein that regulates the body’s immune response to infection, can help protect the body from TB infection. Their studies in cells and in mice and human patients infected with TB bacteria demonstrated that interleukin-1 induces a mediator, prostaglandin E2 (PGE2), that limits the production of type-I interferons, which are associated with increased TB disease severity.

The scientists found that host-directed immunotherapy using PGE2 and zileuton, a clinically-approved drug typically used to treat asthma, prevented death in TB-infected mice. This strategy could be of particular benefit to people infected with drug-resistant TB strains who have limited options for effective antibiotics because the treatment increased bacterial control and limited disease even in the absence of TB chemotherapy. In principle, this approach is compatible with standard antibiotic regimens, according to the authors. In future studies, NIAID scientists will test adjunct host-directed therapies in TB-infected individuals.

Risks of Decorative Contact Lenses

With the end of the school year come parties, summer camp, vacations—all reasons why teens and young adults may want a new look. Requests for decorative contact lenses could be coming your way—or worse, your kids may just go out and buy them on their own.

Beware, says Dr. Helene Clayton-Jeter, an optometrist and health programs coordinator at the Food and Drug Administration (FDA). Decorative contact lenses can cause serious eye damage if not fitted by an optometrist or ophthalmologist.

That’s one of the messages of a joint campaign by the FDA, the American Optometric Association (AOA), and the Entertainment Industries Council (EIC). They want to inform consumers—and especially teens and young adults—how to use them safely, and of the dangers of decorative contact lenses when not used correctly. One of the greatest risks from these lenses is the possibility of an infection that could lead to blindness.

In this first-of-its-kind collaboration, these three organizations are joining forces to produce and distribute two public service videos that are specially designed to capture the attention and interest of young people.

American Horror Story Helps Deliver Safety Message

The video, first screened June 25, 2014 at AOA’s Annual Conference, uses dramatic clips from the popular television show “American Horror Story,” and includes interviews with professional makeup artists and optometrists. They emphasize that before an actor (or a teenager) can wear the lenses, he or she needs an eye exam, valid contact lens prescription, and decorative contact lenses purchased from a reputable source.

FDA, AOA, and EIC all believe that the unique genre and American Horror Story clips will draw in teens and young adults who might not be interested in a ‘plain vanilla’ public service announcement, says Clayton-Jeter.

“Our intent is that when young people see the lengths professional makeup artists go to to make sure actors get and use the lenses safely, they’ll take the message to heart,” she adds.

Marie Gallo Dyak from EIC says, “The entertainment industry has a unique opportunity to help deliver a message to teens and young adults through the characters and shows with which they identify and in the digital spaces where they spend their time.”

FDA Tips for Safe Use

Below are several tips the campaign uses to reinforce the message that teens and young adults need to use decorative contact lenses safely:

• Get an eye exam from a licensed eye doctor (ophthalmologist or optometrist), even if you think your vision is perfect.
• Get a valid prescription that includes the brand name, lens measurements, and an expiration date. But don’t expect your eye doctor to prescribe anime, or circle, lenses. These bigger-than-normal lenses that give the wearer a wide-eyed, doll-like look have not been approved by FDA.
• Buy the lenses from a seller that requires you to provide a prescription, whether you shop in person or online.
• Follow directions for cleaning, disinfecting, and wearing the lenses, and visit your eye doctor for follow-up eye exams.
• See your eye doctor right away if you have signs of possible eye infection, such as redness, eye pain that doesn’t go away after a short time, or a decrease in vision.

In the video Scott Smiledge of Eye Inc FX, a supplier of hand-painted contact lenses for professional production in the film and television industry, sums up his message like this: “I think if I were to leave anybody with a piece of advice on contact lenses, it would be yeah, they’re fun. They can be fantastic ... Just make sure you do it the right way. Make sure that you’re buying from a place that is following the rules and you’re buying lenses that have been handled properly. And that your eye doctor knows about and approves of it.”

Do Teething Babies Need Medicine on Their Gums? No

There are more theories about teething and "treating" a baby's sore gums than there are teeth in a child's mouth. One thing doctors and other healthcare professionals agree on is that teething is a normal part of childhood that can be treated without prescription or over-the-counter (OTC) medications.

Too often well-meaning parents, grandparents and caregivers want to soothe a teething baby by rubbing numbing medications on the tot's gums, using potentially harmful drugs instead of safer, non-toxic alternatives.

That's why the Food and Drug Administration (FDA) is warning parents that prescription drugs such as viscous lidocaine are not safe for treating teething in infants or young children, and that they have hurt some children who used those products.

FDA has previously recommended that parents and caregivers not use benzocaine products for children younger than 2 years, except under the advice and supervision of a health care professional. Benzocaine—which, like viscous lidocaine, is a local anesthetic—can be found in such OTC products as Anbesol, Hurricaine, Orajel, Baby Orajel, and Orabase.

The use of benzocaine gels and liquids for mouth and gum pain can lead to a rare but serious—and sometimes fatal—condition called methemoglobinemia, a disorder in which the amount of oxygen carried through the blood stream is greatly reduced. And children under 2 years old appear to be at particular risk.

Parents Have Safer Alternatives

On average, children get one new tooth every month from 6 months of age to about age 3, for a total of 20 "baby teeth."

According to the American Academy of Pediatrics (AAP), occasional symptoms of teething include mild irritability, a low-level fever, drooling and an urge to chew on something hard.

Because teething happens during a time of much change in a baby's life, it is often wrongly blamed for sleep disturbances, decreased appetite, congestion, coughing, vomiting and diarrhea.

If your child's gums are swollen and tender,

• gently rub or massage the gums with your finger, and
• give your child a cool teething ring or a clean, wet, cool washcloth to chew on.

Chill the teething ring or washcloth in the refrigerator for a short time, making sure it's cool—not cold like an ice cube. If the object is too cold, it can hurt the gums and your child. The coolness soothes the gums by dulling the nerves, which transmit pain.

"The cool object acts like a very mild local anesthetic," says Hari Cheryl Sachs, M.D., a pediatrician at FDA. "This is a great relief for children for a short time."

Parents should supervise their children so they don't accidentally choke on the teething ring or wash cloth.

back to top

Avoid Local Anesthetics

For teething, avoid local anesthetics such as viscous lidocaine or benzocaine-containing teething products except under the advice and supervision of a health care professional.

Viscous lidocaine is a prescription medication, a local anesthetic in a gel-like syrup. Doctors may prescribe it for chemotherapy patients (children and adults) who are unable to eat because of mouth ulcers that can occur with chemotherapy. Dentists may use it to reduce the gag reflex in children during dental X-rays and impressions.

Parents may have viscous lidocaine on hand if it has been prescribed to treat another family member for pain relief from conditions such as mouth or throat ulcers. But it should never be used to comfort a teething baby.

The Institute for Safe Medication Practices (ISMP)—a nonprofit organization dedicated to preventing medication errors—has received reports of teething babies suffering overdoses of viscous lidocaine. Symptoms include jitteriness, confusion, vision problems, vomiting, falling asleep too easily, shaking and seizures.

The drug also "can make swallowing difficult and can increase the risk of choking or breathing in food. It can lead to drug toxicity and affect the heart and nervous system," says Michael R. Cohen, RPh, MS, ISMP president.

Parents have been known to repeatedly apply viscous lidocaine if a baby keeps fussing, says Cohen. They have also been known to put liquid gel forms of a topical anesthetic into a baby's formula or even soak a pacifier or a cloth in it, then put that in their baby's mouth. How much the baby gets is not measured, so it may be too much, he says. For all these reasons, FDA recommends viscous lidocaine not be used to treat the pain associated with teething.

"Teething is a normal phenomenon; all babies teethe," says Ethan Hausman, M.D., a pediatrician and pathologist at FDA. "FDA does not recommend any sort of drug, herbal or homeopathic medication or therapy for teething in children."

Canada: More Goat Cheese Recalled

The food recall warning issued on June 20, 2014 has been updated to include additional product information. This additional information was identified during the Canadian Food Inspection Agency's (CFIA) food safety investigation.

Choices Markets is recalling Le Moutier Goat Cheese from the marketplace because it may contain the toxin produced byStaphylococcus bacteria. Consumers should not consume the recalled product described below.

Recalled products

Common Name	Code(s) on Product	UPC
Le Moutier Goat Cheese	Best before dates up to and including 2014SE19	Beginning with 235881

What you should do

Check to see if you have recalled product in your home. Recalled product should be thrown out or returned to the store where it was purchased

Food contaminated with Staphylococcus toxin may not look or smell spoiled. The toxin produced by Staphylococcus bacteria is not easily destroyed at normal cooking temperatures. Common symptoms of Staphylococcus poisoning are nausea, vomiting, abdominal cramping and fever. In severe cases of illness, headache, muscle cramping and changes in blood pressure and pulse rate may occur.

Canada: Tahina Recalled Salmonella

The food recall warning issued on June 18, 2014 has been updated to include an additional product. The additional product was identified during the Canadian Food Inspection Agency's (CFIA) food safety investigation.

Sesameco is recalling Al Koura brand Tahina Extra from the marketplace due to possible Salmonella contamination. Consumers should not consume the recalled product described below.

Recalled products

Brand Name	Common Name	Size	Code(s) on Product	UPC
Al Koura	Tahina Extra	907 g (2 lb)	Production date: 10 APRIL 2014 Expiration date: 10-04-2016	0 69467 06631 8

What you should do

Check to see if you have recalled product in your home. Recalled product should be thrown out or returned to the store where it was purchased.

Food contaminated with Salmonella may not look or smell spoiled but can still make you sick. Young children, pregnant women, the elderly and people with weakened immune systems may contract serious and sometimes deadly infections. Healthy people may experience short-term symptoms such as fever, headache, vomiting, nausea, abdominal cramps and diarrhea. Long-term complications may include severe arthritis.

Telemedicine Catches Blinding Disease in Premature Babies

Telemedicine is an effective strategy to screen for the potentially blinding disease known as retinopathy of prematurity (ROP), according to a study funded by the National Eye Institute (NEI). The investigators say that the approach, if adopted broadly, could help ease the strain on hospitals with limited access to ophthalmologists and lead to better care for infants in underserved areas of the country. NEI is a part of the National Institutes of Health.

The telemedicine strategy consisted of electronically sending photos of babies’ eyes to a distant image reading center for evaluation. Staff at the image reading center, who were trained to recognize signs of severe ROP, identified whether infants should be referred to an ophthalmologist for evaluation and potential treatment. The study tested how accurately the telemedicine approach reproduced the conclusions of ophthalmologists who examined the babies onsite.

“This study provides validation for a telemedicine approach to ROP screening and could help save thousands of infants from going blind,” said Graham E. Quinn, M.D., professor of ophthalmology at the Children's Hospital of Philadelphia and the lead investigator for the study, which is reported today in JAMA Ophthalmology. The study was conducted by the e-ROP Cooperative Group, a collaboration that includes 12 clinics in the United States and one in Canada.

Some degree of ROP appears in more than half of all infants born at 30 weeks pregnancy or younger — a full-term pregnancy is 40 weeks — but only about 5 to 8 percent of cases become severe enough to require treatment. In ROP, blood vessels in the tissue in the back of the eye called the retina begin to grow abnormally, which can lead to scarring and detachment of the retina. Treatment involves destroying the abnormal blood vessels with lasers or freezing them using a technique called cryoablation. Early diagnosis and prompt treatment is the best prevention for vision loss from ROP, which is why the American Academy of Ophthalmology recommends routine screening for all babies who are born at gestational age 30 weeks or younger or who weigh less than 3.3 pounds at birth.

All babies born before 31 weeks of pregnancy need monitoring for retinopathy of prematurity. c. Photo credit: National Eye Institute

The study evaluated telemedicine for ROP screening during the usual care of 1,257 premature infants who were born, on average, 13 weeks early. About every nine days, each infant underwent screening by an ophthalmologist, who assessed whether referral for treatment was warranted. Those who were referred were designated as having referral-warranted ROP (RW-ROP). Either immediately before or after the exam, a non-physician staff member in the neonatal intensive care unit (NICU) took images of the infant’s retinas and uploaded them to a secure server at the University of Oklahoma, Oklahoma City. Trained non-physician image readers at the University of Pennsylvania, Philadelphia, then downloaded the photos, independently evaluated them following a standard protocol, and reported the presence or absence of RW-ROP.

Through the telemedicine approach, non-physician image readers correctly identified 90 percent of the infants deemed to have RW-ROP based on examination by an ophthalmologist. And they were correct 87 percent of the time when presented with images from infants who lacked RW-ROP. The examining ophthalmologists documented 244 infants with RW-ROP on exam. After referral, 162 infants were treated. Of these, non-physician image readers identified RW-ROP in all but three infants (98 percent).

“This is the first large clinical investigation of telemedicine to test the ability of non-physicians to recognize ROP at high risk of causing vision loss,” said Eleanor Schron, Ph.D., group leader of NEI Clinical Applications. “The results suggest that telemedicine could improve detection and treatment of ROP for millions of at-risk babies worldwide who lack immediate in-person access to an ophthalmologist,” she said.

About 450,000 (12 percent) of the 3.9 million babies born each year in the United States are premature. The number of preterm infants who survive has surged in middle income countries in Latin America, Asia, and Eastern Europe. In these parts of the world, rates of childhood blindness from ROP are estimated at 15 to 30 percent — compared to 13 percent in the United States.

NICU care providers take photos of a premature baby's retinas in the NEI-funded e-ROP study of telemedicine for retinopathy of prematurity. Photo credit: Children’s Hospital of Philadelphia

One advantage of telemedicine ROP screening is that it can be done more frequently than screening by an ophthalmologist. “It’s much easier to examine the retina when not dealing with a wiggling baby,” said Dr. Quinn. “If a baby is too fussy or otherwise unavailable when the ophthalmologist visits the NICU, the exam may be delayed until the ophthalmologist returns — sometimes up to a week later.”

Weekly ROP screening — or even more frequently for high-risk babies — is a realistic goal for telemedicine and could help catch all cases needing treatment, according to the report. In the study, imaging was restricted to occasions when an ophthalmologist examined the baby. In practice, hospital staff could implement an imaging schedule based on the baby’s weight, age at birth, and other risk factors. “With telemedicine, NICU staff can take photos at the convenience of the baby,” said Dr. Quinn.

Telemedicine for evaluating ROP offers several other advantages.

Telemedicine may help detect RW-ROP earlier. In the study, about 43 percent of advanced ROP cases were identified by telemedicine before they were detected by an ophthalmologist — on average, about 15 days earlier.

Telemedicine could save babies and their families the hardship and hazards of being unnecessarily transferred to larger nurseries with greater resources and more on-site ophthalmologists. “Telemedicine potentially gives every hospital access to excellent ROP screening,” Dr. Quinn said.

Telemedicine might also bring down the costs of routine ROP screening by reducing the demands on ophthalmologists, whose time is better allocated to babies who need their attention and expertise. In a separate analysis, the study found that non-physicians and physicians had similar success in assessing photos for RW-ROP. Three physicians evaluated image sets from a random sample of 200 babies (100 with RW-ROP based on the eye exam findings; 100 without) using the standard grading protocol. On average, the physicians correctly identified about 86 percent of RW-ROP cases; the non-physicians were correct 91 percent of the time. The physicians correctly identified about 57 percent of babies without RW-ROP; non-physicians were correct 73 percent of the time.

The cost of establishing a telemedicine ROP screening program includes acquisition of a special camera for taking pictures of the retina, training of NICU personnel to take and transmit quality photos, and establishment and maintenance of an image reading center. “As we move along this road, advances in imaging and grading of images may streamline the process even more,” Dr. Quinn said.