“Anyone can get monkeypox. In Africa, most cases are among children under 15 years old. Outside of Africa, the disease appears to be more common in men who have sex with men, but there are numerous cases in people who don’t fall into that category.

Monkeypox is usually a self-limited disease with symptoms lasting from two weeks to four weeks. Most people with monkeypox get better on their own without treatment. Following diagnosis, your healthcare provider will monitor your condition and try to relieve your symptoms, prevent dehydration and give you antibiotics to treat secondary bacterial infections if they develop.

There’s currently not an approved antiviral treatment for monkeypox. Antiviral drugs may help, but they haven’t been studied as a treatment for monkeypox. Several investigational antivirals with activity against monkeypox are available, but only as part of a research study.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/22371-monkeypox)

“The Schnitzler syndrome is a rare and underdiagnosed entity which is considered today as being a paradigm of an acquired/late onset auto-inflammatory disease. It associates a chronic urticarial skin rash, corresponding from the clinico-pathological viewpoint to a neutrophilic urticarial dermatosis, a monoclonal IgM component and at least 2 of the following signs: fever, joint and/or bone pain, enlarged lymph nodes, spleen and/or liver, increased ESR, increased neutrophil count, abnormal bone imaging findings. It is a chronic disease with only one known case of spontaneous remission. Except of the severe alteration of quality of life related mainly to the rash, fever and pain, complications include severe inflammatory anemia and AA amyloidosis. About 20% of patients will develop a lymphoproliferative disorder, mainly Waldenström disease and lymphoma, a percentage close to other patients with IgM MGUS. It was exceedingly difficult to treat patients with this syndrome until the IL-1 receptor antagonist anakinra became available. ”

National Library of Medicine-NIH  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018454/)

Schnitzler syndrome is considered to be a rare disorder characterized by a monoclonal IgM protein and chronic urticaria that is associated with considerable morbidity. We hypothesized that the syndrome may be under-recognized and patients may be deprived of highly effective therapy in the form of anakinra (an interleukin-1 receptor antagonist=inhibits interleukin 1).  This treatment controls the condition but does not cure it. Around 15% of people develop complications, but the condition generally does not shorten life

Schnitzler is a rare disease characterised by onset around middle age of chronic hives (urticaria) and periodic fever, bone pain and joint pain (sometimes with joint inflammation), weight loss, malaise, fatigue, swollen lymph glands and enlarged spleen and liver.

How its Diagnosed:

–Blood tests show a high concentration of specific gamma-globulins (monoclonal gammopathy) of the IgM type. It almost always has light chains of the κ-type. A variant in which IgG is raised has been described, which appears to be one-tenth as common.

–CBC, this could show signs of inflammation are often present: these include an increased white blood cell count (leukocytosis) and a raised erythrocyte sedimentation rate=we would see this in what we call a simple Complete Blood Count(CBC) and C-reactive protein blood test.

-There can be anemia of chronic disease showing low red blood count again in a simple CBC.

-Bone abnormalities can be seen on radiological imaging (often increased density or osteosclerosis)

-Biopsy

-What we call the Lipsker criteria require hives, the presence of monoclonal IgM, and at least 2 of the following: fever, joint pain or arthritis, bone pain, swollen lymph nodes, enlarged spleen or liver, elevated erythrocyte sedimentation rate, high levels of white blood cells, and findings of problems in bone imaging.

-What we call the Strasbourg criteria, the person must have hives and the presence of monoclonal IgM or IgG. Schnitzler’s is diagnosed if the person has IgM and two of the following, or IgG and three of the following: recurrent fevers, abnormalities in bone imaging, with or without bone pain, findings of neutrophil infiltration in a skin biopsy, high levels of white blood cells or C-reactive protein.

Other conditions which can cause periodic fevers, paraproteins or chronic hives that should be ruled out, include (and are not limited to) autoimmune or autoinflammatory disorders such as adult-onset Still’s disease, angioedema, hematological disorders such as lymphoma or monoclonal gammopathy of undetermined significance (MGUS), other causes of hives, cryoglobulinemia, mastocytosis, chronic neonatal onset multisystem inflammatory disease or Muckle–Wells syndrome.

Treatment:

As of 2017 no drug was approved to treat Schnitzlers. Drugs that inhibit interleukin 1 activity have been the preferred treatment since they emerged in 2005; since 2012 a consensus guideline has recommended treatment with anakinra. Immunosuppressant drugs such as corticosteroids, cyclooxygenase inhibitors, interferon alpha may be effective.

“Antimicrobial resistance (AMR) is a threat to humans, animals, plants and the environment. It affects us all. This is why this year’s theme calls for collaboration across sectors to preserve the efficacy of these critical medicines. Fighting AMR is a truly global endeavour and must be addressed through a One Health approach.

To curb it effectively, all sectors must join forces and encourage the prudent use of antimicrobials, as well as preventive measures. Strengthening infection prevention and control in health care facilities, farms and food industry premises, ensuring access to vaccines, clean water, sanitation and hygiene, implementing best practices in food and agriculture production, and guaranteeing the sound management of waste and wastewater from key sectors are critical to reducing the need for antimicrobials and minimizing the emergence and transmission of AMR.”

UN environment programme (https://www.unep.org/events/unep-event/world-antimicrobial-awareness-week-2022)

In the lead-up to World Antibiotic Awareness Week, the Food and Agriculture Organization of the United Nations (FAO), the World Health Organization (WHO) and the World Organisation for Animal Health (OIE) are together calling for responsible use of antibiotics in humans and animals to reduce the emergence of antibiotic resistance.

Antibiotic resistance is rising to dangerously high levels in all parts of the world and threatening our ability to treat common infectious diseases. Infections affecting people – including pneumonia, tuberculosis, blood poisoning and gonorrhoea – and animals alike are becoming harder, and sometimes impossible, to treat as antibiotics become less effective.

Antibiotics are often overprescribed by physicians and veterinarians and overused by the public. Where they can be bought for human or animal use without a prescription, the emergence and spread of resistance is made worse. Examples of misuse include taking antibiotics for viral infections like colds and flu, and using them as animal growth promoters on farms or in aquaculture.

To tackle these problems, WHO, FAO and OIE are leveraging their expertise and working together in a ‘One Health’ approach to promote best practices to reduce the emergence and spread of antibiotic-resistant microbes in both humans and animals.

“Antibiotic resistance is a global crisis that we cannot ignore,” says Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “If we don’t tackle this threat with strong, coordinated action, antimicrobial resistance will take us back to a time when people feared common infections and risked their lives from minor surgery.”

“The overuse of antimicrobials blunts their effectiveness, and we must reduce their misuse in food systems,” says José Graziano da Silva, Director-General of FAO. “Antimicrobial veterinary medicines are a crucial tool for animal health and welfare and safe food production, but they are by no means the only tool.”

“Like in human health, veterinary medicine has tremendously progressed thanks to antibiotics. Preserving their efficacy and availability through their responsible use associated with good husbandry and prevention practices, is therefore essential to preserve animal health and welfare,” highlights Dr Monique Eloit, Director-General of OIE.

“Do not weigh yourself the day after Thanksgiving. The extra sodium and carbs may cause your weight to temporarily jump up 3 pounds. Wait at least 3 days.  If you end up eating a lot more than you planned, don’t beat yourself up. Tell yourself it was one day and get back on track the next day.  If you are in someone’s home for the weekend and are surrounded by leftovers, focus on the healthier ones like turkey and veggies.  If you are really tempted, allow yourself one “treat” a day for the rest of the weekend. Maybe a dessert one day or a portion of stuffing and gravy.  If you are home for the holiday, make sure you plan activities for the day after Thanksgiving as well as the weekend. This will get you out of the house and away from the leftovers.”

Martha  McKittrick – a RN, registered dietitian,  and a certified diabetes educator.  (http://marthamckittricknutrition.com)

How to stop the eating motion and go back a step back into healthy eating after a parting day or weekend with on top leftovers. Thanks to RN NETWORK.com they have words of wisdom to offer and here they are:

“Turkey, stuffing and pie, oh my! Thanksgiving can be a stressful time for people looking to manage their weight because it is a holiday that:

1) Primarily focuses on food

2) Signifies the start of the holiday season which is full of parties, celebrations and special family meals. And unfortunately, most of these celebrations are not serving huge platters of veggies, grilled chicken, hummus and whole wheat pita with fruit for dessert!

While an all-day eating holiday like Thanksgiving can wreak havoc on otherwise good eating habits, one non-ideal meal (or day) does not lead to pounds of weight gain. The big issue for many is how to deal with the days following Thanksgiving when we have lots of temptations to keep the celebration going on. Friday (all those leftovers) and Saturday (well I’ve already gone overboard so may as well enjoy myself) and Sunday (I’ll start fresh on Monday) and Monday (I wanted to eat better but my coworkers brought in pie/cake and leftovers!) and . . . you get the idea.

To successfully tackle Black Friday, use the following three tactics:

• Have a “Leftovers” Plan: We tend to run into trouble when we open the fridge the day after Thanksgiving and see tons of tempting foods staring back at us. Creating a way to control leftovers will make sure that we can indulge on our terms, not on our refrigerator’s terms (i.e. I’ve got to eat this pie and half a turkey or it will go bad). The adage still applies, “Out of sight, out of mind, out of stomach.” So if you’re hosting Thanksgiving dinner, send your guests home with care packages containing pie and casseroles.  If you didn’t then send some out to neighbors, close family, bring to work or even to church to homeless.  You can figure it out.

• Keep Active: Nothing like falling asleep in front of the football game on TV after Thanksgiving dinner to get our weekend started on the less active foot. A great way to help our bodies deal with extra food is to keep our metabolism high throughout the weekend. Consider a bike ride, jog or workout the day after Thanksgiving into this weekend to keep you motivated to continue exercising throughout the entire holiday season. Check out the 1 hour-tip below for another activity that will let you kill two birds (pun intended) with one stone.

• Preventing “Holiday Mode”: As previously mentioned, most of the issues with Thanksgiving and the holidays are when we let our celebratory meals spill into the next day, and the day after that. Many people have the the day after Thanksgiving  off of work and we often are busy focusing on other activities like holiday shopping so we just go for whatever food is around: usually leftovers or eating out. Being mindful that the food-related Thanksgiving holiday ends on Thursday if not Post day is the first crucial step to setting yourself up for success over the rest of the weekend.Have 1 Minute? Give away unwanted leftovers.Have 5 Minutes? Plan a healthy Black Friday weekend.Have 15 Minutes? Portion your leftovers.Have 60 Minutes? Work out by cleaning up.
• After breakfast on this weekend, get your workout in while taking care of one of the most dreaded post-Thanksgiving activities by setting aside an hour to do some vigorous cleaning all around the house if not already done. By increasing the intensity of your cleaning (a little bit faster, more elbow grease) you will clean more and burn a few hundred calories per hour.”
• Sometimes the issue is not about what the leftovers are, but more how much of them are left. Spend some time Thursday night or the night after or this weekend putting the left over thanksgiving food in portion leftovers  for  future balanced meals for Friday and the rest of the weekend so you do not become tempted to take extra-large helpings or only eat lots of your favorite food. Freeze some leftovers too so you can enjoy them throughout the holiday season and not feel pressured to eat them all within a few days.
• Plan a healthy day of eating for this weekend by writing down what you ate, from breakfast to your after-dinner snack. This will reduce that chance that you miss a meal or become tempted to eat something that is out of your routine. If you normally eat breakfast, do not skip it on Friday. Remember some of the keys to balanced meals: lean protein, complex carbs, plenty of fruits and veggies and healthy fats (avocado, olive oil, nuts, salmon, etc.). Consistency is key: make sure you eat on Friday the same way you ate the month, week and day before Thanksgiving.
• Create a leftover delegation list with each family or person coming to Thanksgiving and the associated foods you will send them home with. Ask guests to bring their containers with them or make sure you have enough that you don’t mind parting with.

About the author: Jason Machowsky, MS, RD, CSCS is a registered dietitian, certified personal trainer.

Wishing all a Happy Thanksgiving!

“While the holiday season is certainly merry and sentimental, these festive months carry the added risk of holiday weight gain. If you’re looking for ways to cut down on the calories this Thanksgiving, take note of these 10 ways to watch your waistline.
1. Choose Healthy Thanksgiving Dishes
2. Watch Your Alcohol Intake
3. Don’t Forget About Exercising
4. Make Only One Thanksgiving Dessert
5. Eat Before the Main Event-If you can’t trust yourself and your appetite around a table full of delicious Thanksgiving delicacies, aim to eat an hour or so before the main meal. Eating before Thanksgiving will help you to not pile your plate with too much food as you’ll already been pretty full.
6. Be Social-Aside from being a prerequisite on special family occasions, socializing will help you stay away from the chips, dip and celebratory snacks. Mix and mingle around the room or the table and you’ll find you’ve forgotten all about the temptation to eat the unhealthy snacks on offer.
7. Get Out of the House-Why not troop the whole family out of the house after the big meal? This can be a great adventure if there’s kids involved.
8. Less is More
9. Use a Smaller Plate
10. Avoid the Leftovers”

FITDAY (https://www.fitday.com/fitness-articles/nutrition/10-tips-to-have-a-healthier-thanksgiving.html)