warning vs. Shopwise Supercenter branch
which was at Harrison Plaza mall, A. Mabini St., Cor. M. Adriatico St., Malate, Manila and which was identified as owned & Operated by Rustan Supercenters, Inc. Donny Tantoco was identified as the head of Shopwise Supercenters. On February 11, 2010, the guard at the said Shopwise Supercenter branch, closest to the Abenson store, didn’t inspect/subject to scanning my luggage which was large enough to contain deadly weapons. Said guard allowed me to bring said luggage into said store. Then, said store sold me, among others, what was identified as a picnic basket, swedish cinnamon bread, Kettle chips. Said picnic basket didn’t bear a visible (to unaided eye) name and address of the manufacturer/distributor of said product. Said swedish bread didn’t bear a visible, to unaided eye, address of the supplier of said product. Said chips, which were identified as an imported product, didn’t bear a visible, to unaided eye, name and address of the importer of said product.Proof of said sale is sales invoice SI No. 71 issued to me on February 11, 2010 by said store.While I was at said store, there was no visible, to unaided eye, express lane for senior citizens and while I was talking to a person at what was identified as the baggage counter of said store, said person attended to another person. I believe the implementing rules and regulations of the Expanded Senior Citizens Act of 2003 was violated. Said person issued to me a piece of plastic with a number and the name of said store but without the word “Harrison Plaza" or “Manila” on said piece of plastic. Since, as of said date, there were several branches of Shopwise in the Philippines, without the word “Manila” on said piece of plastic, I would have a hard time proving that said goods were sold by said branch. When I asked said Shopwise employee to replace said piece of plastic with one with the word “Manila” on it, he replaced it with another piece of plastic also without the word “Manila”. Said issuance of claim tags at said store without the word “Manila” or “Harrison Plaza” on said tags occurred previously and I reported said wrongdoing to the Department of Trade and Industry. Based on evidence, said DTI wrote to said Shopwise branch regarding said wrongdoing and for a time said branch did not commit said wrongdoing. Apparently, said branch has resumed commiting said wrongdoing.



http://www.bfad.gov.ph/default.cfm?CFID=113093&CFTOKEN=39965483
News and Announcements

FDA Advisory 2010-003: Zhen De Shou Fat Loss Capsule and Zhen De Shou Fat Loss Tea

FDA Advisory 2010-002: Jiaoli Miraculuous Cream (Jiaoli); Jiaoli Huichusu Special Cut Genuine (Jiaoli Huichusu); and Jiaoli 2+1 7 days Clearing Facial Spots Suit (Jiaoli) Cosmetic Products
Paunawa Mula sa DOH - FDA Blg. 2010-001: Babala sa publiko tungkol sa Food Supplements

Travelers' Diarrhea
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/travelersdiarrhea_g.htm
Frequently Asked Questions:
Who gets travelers' diarrhea?
What are common symptoms of travelers' diarrhea?
What causes travelers' diarrhea?
What preventative measures are effective for travelers' diarrhea?
Is prophylaxis of travelers' diarrhea recommended?
What treatment measures are effective for travelers' diarrhea?
When should antimotility agents not be used to treat travelers' diarrhea?
What is CDC doing to prevent travelers' diarrhea?
How can I learn more about travelers' diarrhea?


Who gets travelers' diarrhea?

Travelers' diarrhea (TD) is the most common illness affecting travelers. Each year between 20%-50% of international travelers, an estimated 10 million persons, develop diarrhea. The onset of TD usually occurs within the first week of travel but may occur at any time while traveling, and even after returning home. The most important determinant of risk is the traveler's destination. High-risk destinations are the developing countries of Latin America, Africa, the Middle East, and Asia. Persons at particular high-risk include young adults, immunosuppressed persons, persons with inflammatory-bowel disease or diabetes, and persons taking H-2 blockers or antacids. Attack rates are similar for men and women. The primary source of infection is ingestion of fecally contaminated food or water.



What are common symptoms of travelers' diarrhea?

Most TD cases begin abruptly. The illness usually results in increased frequency, volume, and weight of stool. Altered stool consistency also is common. Typically, a traveler experiences four to five loose or watery bowel movements each day. Other commonly associated symptoms are nausea, vomiting, diarrhea, abdominal cramping, bloating, fever, urgency, and malaise. Most cases are benign and resolve in 1-2 days without treatment. TD is rarely life-threatening. The natural history of TD is that 90% of cases resolve within 1 week, and 98% resolve within 1 month.



What causes travelers' diarrhea?

Infectious agents are the primary cause of TD. Bacterial enteropathogens cause approximately 80% of TD cases. The most common causative agent isolated in countries surveyed has been enterotoxigenic Escherichia coli (ETEC). ETEC produce watery diarrhea with associated cramps and low-grade or no fever. Besides ETEC and other bacterial pathogens, a variety of viral and parasitic enteric pathogens also are potential causative agents.

What preventive measures are effective for travelers' diarrhea?

Travelers can minimize their risk for TD by practicing the following effective preventive measures:
"" "" Avoid eating foods or drinking beverages purchased from street vendors or other establishments where unhygienic conditions are present
"" Avoid eating raw or undercooked meat and seafood
"" Avoid eating raw fruits (e.g., oranges, bananas, avocados) and vegetables unless the traveler peels them.

If handled properly well-cooked and packaged foods usually are safe. Tap water, ice, unpasteurized milk, and dairy products are associated with increased risk for TD. Safe beverages include bottled carbonated beverages, hot tea or coffee, beer, wine, and water boiled or appropriately treated with iodine or chlorine.



Is prophylaxis of travelers' diarrhea recommended?

CDC does not recommend antimicrobial drugs to prevent TD. Studies show a decrease in the incidence of TD with use of bismuth subsalicylate and with use of antimicrobial chemoprophylaxis. Several studies show that bismuth subsalicylate taken as either 2 tablets 4 times daily or 2 fluid ounces 4 times daily reduces the incidence of travelers' diarrhea. The mechanism of action appears to be both antibacterial and antisecretory. Use of bismuth subsalicylate should be avoided by persons who are allergic to aspirin, during pregnancy, and by persons taking certain other medications (e.g., anticoagulants, probenecid, or methotrexate). In addition, persons should be informed about potential side effects, in particular about temporary blackening of the tongue and stool, and rarely ringing in the ears. Because of potential adverse side effects, prophylactic bismuth subsalicylate should not be used for more than 3 weeks.

Some antibiotics administered in a once-a-day dose are 90% effective at preventing travelers' diarrhea; however, antibiotics are not recommended as prophylaxis. Routine antimicrobial prophylaxis increases the traveler's risk for adverse reactions and for infections with resistant organisms. Because antimicrobials can increase a traveler 's susceptibility to resistant bacterial pathogens and provide no protection against either viral or parasitic pathogens, they can give travelers a false sense of security. As a result, strict adherence to preventive measures is encouraged, and bismuth subsalicylate should be used as an adjunct if prophylaxis is needed.



What treatment measures are effective for travelers' diarrhea?

TD usually is a self-limited disorder and often resolves without specific treatment; however, oral rehydration is often beneficial to replace lost fluids and electrolytes. Clear liquids are routinely recommended for adults. Travelers who develop three or more loose stools in an 8-hour period---especially if associated with nausea, vomiting, abdominal cramps, fever, or blood in stools---may benefit from antimicrobial therapy. Antibiotics usually are given for 3-5 days. Currently, fluoroquinolones are the drugs of choice. Commonly prescribed regimens are 500 mg of ciprofloxacin twice a day or 400 mg of norfloxacin twice a day for 3-5 days. Trimethoprim-sulfamethoxazole and doxycycline are no longer recommended because of the high level of resistance to these agents. Bismuth subsalicylate also may be used as treatment: 1 fluid ounce or 2 262 mg tablets every 30 minutes for up to eight doses in a 24-hour period, which can be repeated on a second day. If diarrhea persists despite therapy, travelers should be evaluated by a doctor and treated for possible parasitic infection.



When should antimotility agents not be used to treat travelers' diarrhea?

Antimotility agents (loperamide, diphenoxylate, and paregoric) primarily reduce diarrhea by slowing transit time in the gut, and, thus, allows more time for absorption. Some persons believe diarrhea is the body's defense mechanism to minimize contact time between gut pathogens and intestinal mucosa. In several studies, antimotility agents have been useful in treating travelers' diarrhea by decreasing the duration of diarrhea. However, these agents should not be used by travelers with fever or bloody diarrhea, because they can increase the severity of disease by delaying clearance of causative organisms. Because antimotility agents are now available over the counter, their injudicious use is of concern. Adverse complications (toxic megacolon, sepsis, and disseminated intravascular coagulation) have been reported as a result of using these medications to treat diarrhea.



What is CDC doing to prevent travelers' diarrhea?

CDC, in collaboration with the World Health Organization and several Ministries of Health, is working to improve food and water safety around the world. CDC also investigates risk factors associated with acquisition of TD, to assist in identifying more effective preventive measures. CDC continues to monitor antimicrobial resistance in other countries and in the United States. In addition, CDC, in collaboration with international agencies, is working to improve sanitary conditions in foreign accommodations (e.g., tourist resorts) and frequently consults with travel medicine specialists and local and state health departments. CDC is responsible for evaluating sanitation on cruise ships docking in US ports.

Please visit CDC's Traveler's Health site
http://www.cdc.gov/travel/cruiships.htm
for more information about the vessel sanitation program and for a summary of recent vessel inspections.


How can I learn more about travelers' diarrhea?

Potential travelers should consult with a doctor or a travel medicine specialist before departing on a trip abroad. Information about TD is available from your local or state health departments or the World Health Organization (WHO).

Other information that may be of interest to travelers can be found at the CDC Travelers' Health homepage at http://www.cdc.gov/travel.




Date: Novemberr 21, 2006
Content source: National Center for Immunization and Respiratory Diseases: Division of Bacterial Diseases
Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging
http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/ucm199904.htm
Like all medical procedures, computed tomography (CT), fluoroscopy, and nuclear medicine imaging exams present both benefits and risks. These types of imaging procedures have led to improvements in the diagnosis and treatment of numerous medical conditions. At the same time, these types of exams expose patients to ionizing radiation, which may elevate a person’s lifetime risk of developing cancer. As part of a balanced public health approach, the U.S. Food and Drug Administration (FDA) seeks to support the benefits of these medical imaging exams while minimizing the risks.

Through the Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging1, FDA is advocating the universal adoption of two principles of radiation protection: appropriate justification for ordering each procedure, and careful optimization of the radiation dose used during each procedure. Each patient should get the right imaging exam, at the right time, with the right radiation dose.

In support of this goal, FDA will use our regulatory authority and also collaborate with others in the Federal government and the healthcare professional community to:

1. Promote safe use of medical imaging devices;
2. Support informed clinical decision making; and
3. Increase patient awareness.

By coordinating these efforts, we can optimize patient exposure to radiation from certain types of medical imaging exams, and thereby reduce related risks while maximizing the benefits of these studies.

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Related Information

* White Paper: Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging2
* Questions & Answers: Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging3
* FDA Unveils Initiative to Reduce Unnecessary Radiation Exposure from Medical Imaging4
* Medical Imaging5

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Other Resources

* Safety Investigation of CT Brain Perfusion Scans: Update 12/8/20096
* FDA Makes Interim Recommendations to Address Concern of Excess Radiation Exposure during CT Perfusion Imaging7

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Links on this page:

1. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/ucm199994.htm
2. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/ucm199994.htm
3. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/RadiationDoseReduction/ucm199996.htm
4. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm200085.htm
5. http://www.fda.gov/Radiation-EmittingProducts/RadiationEmittingProductsandProcedures/MedicalImaging/default.htm
6. http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm185898.htm
7. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2009/ucm193190.htm

Page Last Updated: 02/09/2010