Health is Wealth : Do you really mean it?

Is the Person Exposing You to Radiation Qualified?

2010-02-26T23:00:00.000-08:00

ST. PAUL, Minn., Feb. 27- Every day in the United States, tens of thousands of patients are exposed to ionizing radiation through radiation therapy, CT scans, x rays, mammograms, and other medical imaging and therapeutic procedures. Patients need to have confidence that the technologists caring for them have the credentials and qualifications to safely administer radiation, and that the equipment they are using is properly calibrated and maintained to deliver radiation safely and within the proper dose parameters.

These imaging procedures are key to making correct diagnoses of injuries and disease processes. Radiation therapy procedures are an important weapon in treating cancer. But, along with its life-saving capacity, ionizing radiation can cause harm to patients when used improperly. Too much radiation and the patient may suffer debilitating injury or death, as today's testimony before the U.S. House of Representatives' Energy and Commerce Committee's Subcommittee on Health has documented.

Responsibility for assuring balance between the amount of radiation used and the costs and benefits of its use lies with the physicians, the radiation oncologists, the equipment manufacturers, the radiation physicists, and the technologists who interact directly with the patients and who operate the equipment that delivers the radiation. Being fully qualified to perform their role in this team of professionals requires that the individuals have been appropriately educated in the fundamental concepts of radiation -- including its biological effects -- and how to achieve positive benefits and avoid or mitigate negative effects.

"For technologists, that means a formal educational program that covers both the underlying concepts of radiation physics and its application for medical uses," according to Michael DelVecchio, B.S., R.T.(R)(ARRT), president of the American Registry of Radiologic Technologists. "This includes both classroom work and hands-on education in clinical settings."

Completion of the educational program is followed by application for certification by a national organization specializing in medical imaging and/or radiation therapy, according to DelVecchio. Certification organizations evaluate the applicant's education (including successful completion of specified clinical competencies), compliance with ethics standards related to patient care, and passing a comprehensive examination that covers both principles of radiation and application to imaging or therapy.

"Initial certification alone, however, is not sufficient for assuring ongoing qualifications," DelVecchio notes. Although the concepts of radiation learned in the educational program may remain relevant for decades, the technology of how it is used changes rapidly. "This means that technologists must continue to update their qualifications on an ongoing basis," he adds. Continuing education relevant to their practice is an essential requirement for technologists and is a requirement for maintaining the registration of certification.

"While no medical error is acceptable," DelVecchio asserts, "they do occur. They can result from lack of knowledge and education in some cases. But errors may also result from behavior that lacks the appropriate ethical grounding, which is also essential to assuring ongoing qualifications. Measured by an appropriate standard of ethics, individuals can demonstrate that they have internalized a set of guidelines that reflect the best interests of the patient."

Answering the question -- Is the person exposing you to radiation qualified? -- is a matter of both initial and ongoing evaluation and monitoring of qualifications. Certification programs such as those administered by the American Registry of Radiologic Technologists are important elements in providing the quality of care that all patients and their loved ones should expect.

The American Registry of Radiologic Technologists promotes high standards of patient care by recognizing individuals qualified in medical imaging, interventional procedures, and radiation therapy. Headquartered in St. Paul, Minn., ARRT evaluates, certifies, and annually registers more than a quarter-of-a-million radiologic technologists across the United States.

How Much Will Your Surgery Cost? Hospitals Can't Tell You

2010-02-03T09:02:00.000-08:00

WASHINGTON, Feb. 3 - Patients are the losers in both the Democratic and Republican versions of the health care reform bills. Proposed health care reform won't help patients find out how much health care costs before they get care and many hospitals aren't set up to help.

A new research paper from The Healthcare Blue Book (healthcarebluebook.com) entitled Surgery Pricing Secrets: The Challenges Patients Face, shows that it is almost impossible to get prices ahead of time if a patient plans to have surgery in a hospital.

Healthcare Blue Book researchers found that:

-- It took three times as many phone calls and four times as long to get
pricing information from a hospital.
-- Hospitals would not provide guaranteed prices and price ranges often
varied by more than 100%.
-- ASCs were more likely to discount prices for cash customers;
regardless of the patient's financial status.
-- Facility fees are 3-4 times higher in a hospital than in an ASC.

Healthcare Blue Book researchers contacted hospitals and ambulatory care centers (ASCs) in three markets: Raleigh-Durham, NC; Denver, CO; and Portland, OR. Hospitals and ASCs were asked to provide the costs of an anterior cruciate ligament surgery of the knee for a patient without health insurance.

Queries were primarily about facility fees, but researchers also asked respondents about other fees associated with the surgery.

It's almost certain health care expenditures, which totaled about $2.5 trillion in 2009, will continue to climb by at least 6% a year. Hospital costs are 31% of the total according to the Centers for Medicare and Medicaid Services. So what are health care consumers going to do?

The Healthcare Blue Book, an Internet content provider, offers a free consumer guide to fair pricing for healthcare treatments and services for local markets at www.healthcarebluebook.com.

"One of the main tenets of successful healthcare reform will be patients taking more responsibility for finding out what their care costs as they make treatment decisions," said Dr. Jeffrey Rice, Healthcare Blue Book CEO, and white paper author. "But until hospitals are able to provide exact pricing, managing out of pocket costs for both insured and self-pay patients is almost impossible."

Peanut Butter Dipping Helps Kids Eat More Veggies

2009-10-30T12:23:00.000-07:00

WASHINGTON, Oct. 31 - This week at the Obesity Society 27th Annual Meeting, new data was presented showing that adolescents deemed "vegetable resistant," who don't eat vegetables at all, significantly increased both the amount and variety of vegetables they ate when they were served with one of America's favorite foods -- peanut butter. Raw carrots, celery, and broccoli were provided either with or without peanut butter for dipping and those not provided peanut butter, did not improve vegetable intake.

"We measured what they ate and were excited to see that even those who reported not eating vegetables, who are the most challenging group, ate a greater variety of vegetables with the peanut butter," said Dr. Craig Johnston, Instructor at the Behavioral Research Center at Baylor College of Medicine, at the USDA-ARS Children's Nutrition Research Center in Houston, Texas who conducted the study.

Vegetable intake has been shown to be beneficial against the development of many chronic diseases, but consumption in adolescents is well below recommended levels and strategies to increase intake in adolescents are limited.

Peanut butter was paired with vegetables in this study, because it is a nutrient-rich comfort food loved by kids and adults alike. In fact, it was well received and readily consumed by the students in this study all of whom are Mexican-American.

The adolescents are part of a treatment group in a successful weight loss program in schools that is funded by the United States Department of Agriculture-Agricultural Research Service (USDA-ARS). Though some believe peanut butter would be associated with increased energy intake, the study has demonstrated significant weight loss that is maintained over time.

In the United States, over two-thirds of the nuts eaten are peanuts and peanut butter. Peanut butter provides over 15 key nutrients and is offered in Women, Infant, and Children (WIC) packages because of its protein, nutrient content, and affordability. Numerous studies have also shown that peanuts and peanut butter reduce the risk of chronic disease when eaten in small amounts daily and that they can help in weight management and keeping you satisfied.

Pairing vegetables with peanut butter is an effective, simple strategy for children and adolescents, which helps build positive eating habits and increases vegetable intake. Eating more vegetables with increased variety, by providing them with healthy, nutrient-rich foods like peanut butter may contribute to healthier lifestyles and chronic disease reduction.

The Peanut Institute is a non-profit organization that supports nutrition research and develops educational programs to encourage healthful lifestyles. Learn more about peanuts and health at www.peanut-institute.org

New Survey Reveals Even After 12 Years of Living With Depression Adults Still Struggle Due to Lack of Basic Information

2009-10-14T10:28:00.000-07:00

Expert Panel Offers Three-Step Plan to Guide People Toward Recovery of Depression

INDIANAPOLIS, Oct. 14 - A new survey of 2,001 adults living with depression revealed that despite being diagnosed for an average of 12 years, many unknowingly took actions that could have sabotaged their chances of getting well.(i) Furthermore, on average, it took about six years for respondents to seek diagnosis from a health care professional, suggesting these adults may have been coping with depression for as long as 18 years.(i)

Depression, which includes a variety of symptoms,(ii) is a highly treatable illness,(iii) but it can become more difficult to treat the longer it goes undiagnosed or undertreated.(iv) The survey showed that among those who waited six months or more to be diagnosed, 69 percent reported they delayed diagnosis because they lacked knowledge about depression or lacked basic facts about available depression treatments and where to go for help.(i) Additionally, among those who wanted more information about depression treatment at the time of diagnosis, 64 percent said they wanted to know what it means to "get well."(i) Surprisingly, 91 percent have been prescribed an antidepressant for depression, but among them, just seven percent felt very knowledgeable about all basic aspects of the treatment.(i)

The survey is part of a new depression educational program called Missing Pieces, which was developed by leading mental health experts and supported by Eli Lilly and Company to help people identify the information they need to better understand depression. Overall, the survey demonstrated that many adults with depression are engaging in unhealthy behaviors that may jeopardize recovery,(i) such as:

-- Nearly three in five (57 percent) of those who delayed seeking a
diagnosis felt they could manage their own depression symptoms.(i)
-- Among respondents who had taken antidepressants for depression, nearly
half (47 percent) did not discuss when it might be necessary to change
medications with their doctor, despite the fact that they were still
experiencing depressive symptoms.(i)
-- Among those who have stopped taking antidepressants, about two in five
(41 percent) did so without telling their doctor.(i)

-- More than 70 percent (71 percent) noted that talk therapy should
always be part of a depression treatment plan, yet only 22 percent
were currently enrolled in talk therapy.(i)

"The survey strongly suggests that many people living with depression are unaware or are 'missing pieces' of vital information that may be preventing them from getting well," said Dr. Susan Kornstein, professor of psychiatry and obstetrics and gynecology at Virginia Commonwealth University. "Depression needs to be treated by a health care professional.(iii) To increase the likelihood of recovery from depression, it's important that people with depression have a comprehensive treatment plan that may include medications, psychotherapy and lifestyle changes.(iii,v) The goal is to help them to recovery."(iv)

Three-Step Action Plan

The survey revealed key areas of information that people with depression are missing. In response,

The Missing Pieces expert panel recommends three simple steps to help guide people from diagnosis to recovery of depression:

Step One: Two Week Rule for Diagnosis of Depression

Current American Psychiatric Association guidelines state that adults experiencing at least five of the symptoms of depression for two consecutive weeks, and at least one of them is depressed mood or loss of interest, they should talk to a health care professional.(ii) Additional symptoms of depression can also include feelings of guilt or worthlessness, thoughts of death or suicide, restlessness, trouble concentrating or making decisions, fatigue, lack of energy and changes in weight or sleep patterns.(ii) Additional symptoms of depression may include pain, irritability and anxiety.(ii)

Step Two: Six Week Rule for Seeing Improvement in Depression Symptoms

To get fully well, it is important to address all of the symptoms of depression.(iv,vi) Experts recommend that individuals on any type of treatment plan for depression who are unsatisfied with their level of improvement should consider consulting with their doctor about making changes to their treatment plan.

Step Three: Managing Your Depression Treatment Plan When Feeling Better

If an individual has found a depression treatment plan that is addressing many of their depression symptoms, they should continue on that treatment for at least another four to nine months to help prevent the return of their symptoms. Some individuals will also need long-term maintenance treatment to help prevent future episodes of depression.(vii,viii)

In addition to this three-step plan, Missing Pieces offers an educational Web site, found at www.MissingPiecesProgram.com, which provides more survey details and in-depth information about depression. The Missing Pieces program was driven by a multi-disciplinary expert panel that helped shape the development of all educational materials including the national survey and Web site content:

-- Dr. Susan Kornstein, professor of psychiatry and obstetrics and
gynecology at Virginia Commonwealth University
-- Dr. Sally Edwards, family practice doctor at Woodinville Primary Care
in Seattle, Washington
-- Dr. W. Clay Jackson, clinical assistant professor of psychiatry at the
University of Tennessee College of Medicine

-- Dr. Thomas Wise, professor of psychiatry, George Washington University
School of Medicine

About the Survey

The Missing Pieces survey was conducted online within the United States by Harris Interactive® on behalf of Eli Lilly and Company from April 23 to May 7, 2009 among 2,001 U.S. adults ages 18 and older who have been diagnosed with depression. Results were weighted as needed to the U.S. adult population diagnosed with depression. Propensity score weighting was also used to adjust for respondents' propensity to be online. No estimates of theoretical sampling error can be calculated. Full methodology is available through Harris Interactive. Patient input garnered from the survey played a pivotal role in shaping all Missing Pieces materials.

About Harris Interactive

Harris Interactive is a global leader in custom market research. With a long and rich history in multimodal research, powered by our science and technology, we assist clients in achieving business results. Harris Interactive serves clients globally through our North American, European and Asian offices and a network of independent market research firms. For more information, please visit www.harrisinteractive.com.

Medication Adherence: Important Factor in the Treatment of Postmenopausal Osteoporosis

2009-09-13T14:34:00.001-07:00

DENVER, Sept. 14- Amgen Inc. today announced the presentation of data highlighting the links between medication satisfaction, adherence to therapy and fracture risk reduction among women with postmenopausal osteoporosis. The data were presented at the 31st annual meeting of the American Society for Bone Mineral Research (ASBMR).

"These data enhance our understanding of why many women discontinue treatment with current osteoporosis therapies, suggesting that convenience, effectiveness and side effects are important factors," said David Macarios, executive director for Global Health Economics at Amgen. "This new research reinforces the view that poor adherence can lead to negative outcomes including fractures, more frequent hospital admissions and higher medical costs."

Impact of Treatment Satisfaction (Perceived Benefits, Convenience, Side Effects) on Persistence with Postmenopausal Osteoporosis Therapy (Abstract No. SA0317)

Data collected from the Prospective Observational Scientific Study Investigation Bone Loss Experience (POSSIBLE US(TM)) study showed that women who were less satisfied with their osteoporosis therapy were more likely to discontinue or switch their therapy compared to women who were more satisfied.(i) The prospective registry study enrolled 5,015 patients, the majority of whom were using an oral bisphosphonate at the time of study entry, and used the self-administered Treatment Satisfaction Questionnaire for Medication every six months to measure patient satisfaction with convenience, perceived effectiveness and side effects of therapy.

In this study, in which women self-reported their adherence to therapy, 25 percent (n=2402) reported discontinuation of their initial therapy within the first study year and an additional 7 percent reported that they switched from their initial therapy to another therapy. Women who were less satisfied with the convenience of their treatment were approximately 39 percent (adjusted HR 0.72) more likely to discontinue or switch their initial therapy, and women who were less satisfied with the effectiveness of their treatment were approximately 25 percent (adjusted HR 0.80) more likely to discontinue or switch. Furthermore, among women reporting moderate or severe treatment side effects, those who were less satisfied with treatment were 61 percent (adjusted HR 0.62) more likely to discontinue or switch.

Comorbidities, Bone Loss and Concomitant Medication Use in European Postmenopausal Women: POSSIBLE EU (Abstract No. MO0339)

Amgen also reported preliminary findings from a similar longitudinal cohort study, the Prospective Observational Scientific Study Investigating Bone Loss Experience in Europe (POSSIBLE EU ), designed to describe the characteristics and management of postmenopausal women (N = 3,403) receiving bone loss medication in 5 countries in the European Union (France, Germany, Italy, Spain and the UK). Data were collected via physician-completed questionnaires at study entry and at 3-month intervals for 1 year.

Interim analysis showed that at study enrollment, the majority (84 percent) of patients were receiving oral bisphosphonate therapy and the largest proportion (31 percent) of patients received 5 or more concomitant medications. Upper gastrointestinal (GI) problems were common in this population, particularly in patients who switched bone loss medication at baseline. In this European population, comorbid conditions and the use of multiple medications were common. POSSIBLE EU analyses are ongoing exploring the association between patient characteristics, treatment satisfaction and adherence.

Impact of Adherence to Osteoporosis Medication on Risk of Fracture (Abstract No. SA0368) and Association Between Adherence to Osteoporosis Medication and Inpatient Stays and Medical Services Costs (Abstract No. SU0387)

Two retrospective analyses were conducted from a study that examined the impact of medication adherence on risk of fracture, hospitalization and healthcare costs among women initiating osteoporosis medication. The two analyses used medical and pharmacy claims from 32,573 women who initiated treatment on alendronate, risedronate, teriparatide, ibandronate or raloxifene in a large U.S. health plan. One analysis showed that patients with low adherence had a 20.4 percent higher risk of fracture than did patients with high adherence (p<0.0001).(ii)

A second analysis found that patients with low adherence had a 31.2 percent higher probability of a hospital stay (p<0.001) and 11.4 percent higher mean medical costs (p=0.001) versus patients with high adherence, even after adjusting for other important patient characteristics such as comorbidities, prior fracture history, and hospitalizations.(iii) The mean monthly medical costs were significantly higher for low-adherence ($507) vs. high-adherence ($405) patients.

Fracture is one of the most common health events suffered by postmenopausal women with osteoporosis.(iv) Globally, one woman in three over 50 years of age will experience a fracture in her lifetime.(3) A woman who has broken a bone as a result of osteoporosis has more than an eight-out-of-ten chance of breaking another bone.(v) Half of women who break a hip, a life changing event, will permanently need assistance to walk.(vi)

Osteoporosis: Impact and Prevalence

Often referred to as the "silent epidemic," osteoporosis is a global problem that is increasing in significance as the population of the world both increases and ages. The World Health Organization (WHO) has recently identified osteoporosis as a priority health issue along with other major non-communicable diseases.

The economic burden of osteoporosis is comparable to that of other major chronic diseases; for example, in the U.S., the costs associated with osteoporosis-related fractures are equivalent to those of cardiovascular disease and asthma.(vii) (viii) (ix) It has been reported that osteoporosis results in more hospital bed-days than stroke, myocardial infarction or breast cancer.(x)

About Amgen

Amgen discovers, develops, manufactures and delivers innovative human therapeutics. A biotechnology pioneer since 1980, Amgen was one of the first companies to realize the new science's promise by bringing safe and effective medicines from lab, to manufacturing plant, to patient. Amgen therapeutics have changed the practice of medicine, helping millions of people around the world in the fight against cancer, kidney disease, rheumatoid arthritis, and other serious illnesses. With a deep and broad pipeline of potential new medicines, Amgen remains committed to advancing science to dramatically improve people's lives.

Home-Spun or Hard Fact?

2009-09-05T00:30:00.000-07:00

Fast-Food Family Planning May Contribute to High Levels of Unintended Pregnancies

NEWBURY, England,- Women's health experts are warning that old wives' tales and ignorance about modern contraceptive options could be fuelling Britain's high levels of unintended pregnancy, following new research into contraception myths by pollster Opinion Health.(1)

Fast-foods and store cupboard staples were often suggested as methods of contraception women had heard of.(1) Coca-cola, kebabs, chocolate bars or wrappers, crisp packets and chewing gum were proposed as contraceptives and one in five women questioned mentioned a kitchen cupboard staple as a possible option, with eating garlic or using bread, cling film or even chicken skin as a barrier method given as alternatives.(1)

These myths are compounded by a lack of general understanding of even the most popular methods of contraception. The survey revealed that half of women hold the false belief that oral contraceptive use over an extended period of time can cause infertility(1) and nearly 10 percent of women think that it always takes a number of years to regain fertility after discontinuation of The Pill.(1) In fact, no matter how long The Pill is taken for, the effects are fully reversible and it is possible to get pregnant straight away in the absence of other forms of contraception.(2)

The survey also highlighted that there is a myth that oestrogen is only present in combined oral contraceptive pills in order to disguise the taste(1) when in fact the combined pill was designed to have the combination of oestrogen and progestogen to offer protection from pregnancy and shorter lighter periods. Surprisingly, those questioned who were using oral contraception often showed a lower level of knowledge about The Pill than those not using it.

These and other myths - ranging from the ridiculous to the concerning - are held by women across all ages, according to the research.

Dr Annie Evans, Women's Health Specialist at the Bristol Sexual Health Centre, commented: "It is not surprising that this survey has uncovered how widespread contraceptive myths still are in this country, given that Britain continues to have the highest unintended pregnancy rate in Europe*,(3) with as many as 50% of births being unintended.(4) It is vital that women are made aware of the facts, using the credible sources of information available to them."

Despite the accurate information available to women online, in the media and from their healthcare professionals, over a third of women mistakenly believe that the greatest risk of getting pregnant whilst using the combined contraceptive pill is to miss a pill in the middle of the pack.(1) The truth is that missing the first and last pills of the pack pose the greatest risk of getting pregnant.(2)

Dr Anne Szarewski, Associate Specialist at the Margaret Pyke Centre commented: "Combined oral contraceptive pills are the most widely prescribed contraceptive option, but they are particularly plagued by myths. Many women are unaware that they even contain oestrogen and progestogen, both of which play different but important roles. It is vital that women of all ages are aware of the facts, to have a full understanding of their contraception and so avoid the distress of an unintended pregnancy."

Other myths exposed by the survey include:

- One in six women believed that the contraceptive pill is effective as
soon as a woman starts taking it (increasing to one in three in
the 18-20 age group).(1) Whilst this is closer to the truth than other
tales, it is only if the first pill is taken on the first day of the
menstrual cycle.

- Some believe that using combined oral contraceptives will protect them
against HIV, when in fact only condoms will protect you against HIV.

- Some believe that if a woman is not using contraception she is safe
from getting pregnant if she only has sex on her period. In fact, there
is still the possibility of becoming pregnant during your period if you
have sex without using contraception.(5)

The results from this survey also show that, contrary to popular belief, older women believe more myths than younger women. The importance of sex education is also underlined, with those women that have received it showing a better understanding of the facts about contraception, and in particular, about combined oral contraceptives.

The more credible sources of accurate information that there are made available to women, the better chance there is of dispelling these outdated myths. Balanced, factual information about a range of contraceptive options can be found on the comprehensive new website http://www.contraception.co.uk which was recently launched by leading contraception manufacturer Bayer Schering Pharma.

Children with severe Milk Allergy can Safely Drink Milk

2009-08-19T10:07:00.000-07:00

Some children with a history of severe milk allergy can safely drink milk and consume other dairy products every day, according to research led by the Johns Hopkins Children’s Center and published in Journal of Allergy and Clinical Immunology.

Investigators followed up with a subset of children who were part of an earlier Hopkins Children’s-led study published in 2008 in which patients allergic to milk were given increasingly higher doses of milk over time. For many of them, continuous exposure to milk allergens – the proteins that trigger bad reactions – slowly and gradually retrained their immune systems to better tolerate the very food that once sent those systems into overdrive.

The follow-up of 18 children ages 6 to 16 whose severe milk allergies had eased or disappeared found that all children were able to safely consume milk at home, and that reactions, while common, were generally mild and grew milder and milder over time. The follow-up varied from three to 17 months, depending on how long it took patients to increase their milk intake.

These findings also suggest that regular use of milk and dairy foods may be needed for children to maintain their tolerance.

“We now have evidence from other studies that some children once successfully treated remain allergy-free even without daily exposure, while in others the allergies return once they stop regular daily exposure to milk,” says Robert Wood, M.D., the study’s senior investigator and director of Allergy & Immunology at Hopkins Children’s. “This may mean that some patients are truly cured of their allergy, while in others the immune system adapts to regular daily exposure to milk and may, in fact, need the exposure to continue to tolerate it,” he adds.

After up to 17 months of at-home consumption, 13 of the 18 children who could tolerate increasingly higher doses were asked to return to the clinic for milk-drinking tests. Of the 13, six showed no reaction after drinking 16,000 mg (16 ounces) of milk, twice the highest tolerated dose during the initial study. Seven children had reactions at doses ranging from 3,000 mg to 16,000 mg. The reactions ranged from oral itch to hives, to sneezing to mild abdominal pain, but none was serious. One child developed cough requiring medications.

Investigators also continued to follow three children who could not tolerate doses higher than 2,540 mg (2.5 ounces) – the cutoff set by the investigators at the beginning of the follow-up – which made them ineligible to continue the at-home part of the study. All three continued to drink milk daily with minimal reactions, and two of the children were eventually able to increase their consumption beyond 2,540 mg.

Sensitivity to milk was also measured with traditional skin prick testing, which showed gradual decreases in reactions over time. Seven children had no reactions at eight to 15 months of follow-up. Blood levels of milk IgE antibodies slowly decreased over time too, another sign of better tolerance to milk. At the same time, a different type of antibody, IgG4 – one that signals immunity to a particular allergen – went up over time, a maker of improved tolerance.

Children and their parents also kept daily logs of milk and dairy consumption and recorded symptoms, such as hives, abdominal pain, sneezing and cough. During the first three months, consumption of milk triggered reactions 49 percent of the time, with some children experiencing as few as two reactions for every 100 doses of milk consumed. The figure dropped to 23 percent in the subsequent three months, and some children had no reactions at all.

Milk allergy is the most common type of food allergy. Three million U.S. children have food allergies, according to the Centers for Disease Control and Prevention.

Co-investigators in the study include Satya Narisety, Robert Hamilton and Elizabeth Matsui, of Hopkins; Justin Skripak of the Mt. Sinai School of Medicine; and Pamela Steele and A. Wesley Burks of Duke University.

The research was funded by the National Institutes of Health.

Dr. Wood receives funding support from Genentech, manufacturer of Xolair, for the treatment of allergic asthma. He serves on the advisory board of the Food Allergy and Anaphylaxis Network.

Another Reason to Eat Well: a Healthy Diet

2009-08-14T07:09:00.000-07:00

Researchers have found another reason to eat well: a healthy diet helps prevent kidney stones. Loading up on fruits, vegetables, nuts, low-fat dairy products, and whole grains, while limiting salt, red and processed meats, and sweetened beverages is an effective way to ward off kidney stones, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). Because kidney stones are linked to higher rates of hypertension, diabetes, increased body weight, and other risk factors for heart disease, the findings have considerable health implications.

Eric Taylor, MD (Maine Medical Center) and his colleagues at Brigham and Women’s Hospital conducted a large study to determine the effects of healthy eating habits on the formation of kidney stones. The investigators collected information from individuals enrolled in three clinical studies: the Health Professionals Follow-up Study (45,821 men followed for 18 years), the Nurses’ Health Study I (94,108 older women followed for 18 years), and the Nurses’ Health Study II (101,837 younger women followed for 14 years).

Dr. Taylor’s team assigned a score to each participant based on eight components of a DASH (Dietary Approaches to Stop Hypertension) style diet: high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains and low intake of salt, sweetened beverages, and red and processed meats. Individuals with higher DASH scores consumed diets that were higher in calcium, potassium, magnesium, oxalate, and vitamin C and lower in sodium.

A total of 5,645 incident kidney stones developed in the participants in the three studies. In each study, participants with the highest DASH scores were between 40% and 45% less likely to develop kidney stones than participants with the lowest DASH scores. The reductions in kidney stone risk were independent of age, body size, fluid intake, and other factors.

Because a DASH-style diet may affect the development of hypertension, diabetes, and other chronic diseases associated with kidney stones, the researchers also performed an analysis limited to study participants without hypertension or diabetes. Even among those individuals the DASH diet reduced the risk of kidney stones.

Many of the medications used to treat kidney stones have unpleasant side effects. This study indicates that adopting a DASH-style diet may be an effective alternative.

The authors report no financial disclosures. Study co-authors include Teresa Fung (Simmons College) and Gary Curhan, MD (Brigham and Women’s Hospital).

The article, entitled “DASH-Style Diet Associates with Reduced Risk for Kidney Stones,” will appear online at http://jasn.asnjournals.org/ on August 13, 2009, doi 10.1681/ASN.2009030276.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, the American Society of Nephrology (ASN) is the world’s largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

PA Department of Health Confirms the First Human Case of West Nile Virus in Pennsylvania for 2009

2009-08-11T13:04:00.000-07:00

HARRISBURG, Pa., Aug. 12- State Health Secretary Everette James today reported this year's first confirmed human case of West Nile virus in Pennsylvania. The individual is a 21-year-old woman from Luzerne County.

"The number of cases of West Nile disease has declined significantly in the past five years but this season's first case is a reminder that the disease is still out there," Secretary James said. "You can take precautions to protect yourself from this deadly disease."

James recommended these simple precautions to prevent mosquito bites, particularly for those most at risk which include the elderly and those with compromised immune systems:

Make sure screens fit tightly over doors and windows to keep mosquitoes out of your home;
When possible, reduce outdoor exposure at dawn and dusk, the times of day when the mosquitoes that transmit West Nile virus are most active, during the warmer months of the year (usually April through October);
Consider wearing long-sleeved shirts, long pants and socks when outdoors, particularly at dawn and dusk, or in areas known for having large numbers of mosquitoes;
Use insect repellents according to the manufacturer's instructions. Effective repellents contain DEET. Consult a doctor if you have concerns about the use of repellent on young children, as repellent is not recommended for children under the age of two months. Two other insect repellants, Picaridin (KBR 3023) and oil of lemon eucalyptus, a plant based repellent, were tested against mosquitoes and provided protection similar to repellents with low concentrations of DEET.

Pennsylvanians can also reduce the risk of West Nile virus by eliminating the places where mosquitoes breed.

Here are some simple steps that can be taken around the house:

Dispose of tin cans, plastic containers, ceramic pots, discarded tires, or any object on your property that could collect standing water.
Drill holes in the bottom of recycling containers left outdoors.
Have roof gutters cleaned every year, particularly if the leaves from nearby trees have a tendency to clog the drains.
Turn over plastic wading pools and wheelbarrows when not in use.
Don't let water stagnate in birdbaths.
Aerate ornamental pools or stock them with fish.
Clean and chlorinate swimming pools and remove standing water from pool covers.
Use landscaping to eliminate standing water that collects on your property.
Standing water that cannot be eliminated should be treated with Bti products, which are sold at outdoor supply, home improvement, and other stores. Bti is a naturally occurring bacterium that kills mosquito larvae but is safe for people, pets, aquatic life and plants.

West Nile virus is spread to people and animals by infected mosquitoes. Usually, the infection does not result in any illness. Older adults and persons with compromised immune systems are at greatest risk of becoming ill after a West Nile infection.

The disease can take two forms; the milder of which is known as West Nile fever. In addition to fever, people with this form of the disease may also experience headache, body aches, skin rash, and swollen lymph glands. The more severe form of West Nile infection is known as encephalitis (an inflammation of the brain). People with encephalitis may experience high fever, headache, neck stiffness, disorientation, tremors, convulsions, paralysis, and coma. Anyone with any of these symptoms should immediately contact their health care provider.

There is no specific treatment for West Nile virus. For severe cases, hospitalization is needed and illness can be associated with long-term disabilities and death.

Since West Nile was first identified in Pennsylvania in 2000, the virus has been found in all areas of the state and has returned each summer.

In 2008, there were 14 human West Nile Virus cases that resulted in one death. In 2007, there were 10 human cases and no deaths. In 2006, there were nine human cases and two deaths. In 2005, there were 25 human cases and two deaths. In 2004, there were 15 human cases and two deaths.

Workplace Yoga and Meditation Can Lower Feelings of Stress

2009-08-06T12:17:00.000-07:00

Twenty minutes per day of guided workplace meditation and yoga combined with six weekly group sessions can lower feelings of stress by more than 10 percent and improve sleep quality in sedentary office employees, a pilot study suggests.
The study offered participants a modified version of what is known as mindfulness-based stress reduction (MBSR), a program established in 1979 to help hospital patients in Massachusetts assist in their own healing that is now in wide use around the world.
In this context, mindfulness refers in part to one’s heightened awareness of an external stressor as the first step toward relaxing in a way that can minimize the effects of that stress on the body.
While the traditional MBSR program practice takes up an hour per day for eight weeks supplemented by lengthy weekly sessions and a full-day retreat, the modified version developed at Ohio State University for this study was designed for office-based workers wearing professional attire.
The results of the pilot study are published in a recent issue of the journal Health Education & Behavior.
Participants attended one-hour weekly group meetings during lunch and practiced 20 minutes of meditation and yoga per day at their desks. After six weeks, program participants reported that they were more aware of external stressors, they felt less stressed by life events, and they fell asleep more easily than did a control group that did not experience the intervention.
“Because chronic stress is associated with chronic disease, I am focusing on how to reduce stress before it has a chance to contribute to disease,” said Maryanna Klatt, lead author of the study and an assistant professor of clinical allied medicine at Ohio State.
“My interest is to see whether or not we can get people to reduce their health care utilization because they’re less stressed. I want to deliver something low cost at the work site, something practical that can be sustained, that can help reduce health care costs,” Klatt said.
Klatt and colleagues are building on these preliminary findings and continuing to study the broader impact of the intervention in various populations, such as cancer survivors, intensive-care nurses and inner-city schoolchildren. In addition to gathering self-reported data from research participants, the scientists plan to collect biological samples to determine whether the intervention can lead to lower levels of stress hormones.
For the pilot study, the researchers recruited 48 adult office workers with body mass index scores lower than 30 who exercised less than 30 minutes on most days of the week. Half were randomized to the intervention and half were wait-listed to receive the intervention later. Forty-two people completed the study.
Those who received the intervention participated in weekly one-hour group sessions during which breathing, relaxation and gentle yoga movement were designed to coax participants toward a meditative state. Participants also discussed work-related stress. As part of the pursuit of mindfulness, they were coached to contemplate a specific topic in each session that explored their response to a specific type of stress over the past week.
“It doesn’t matter what the stress is, but how you change the way you perceive the stress,” Klatt noted. “I like to describe mindfulness as changing the way you see what’s already there. It’s a tool that teaches people to become aware of their options. If they can’t change the external events in their life, they can instead change the way they view the stress, which can make a difference in how they experience their day-to-day life.”
The weekly sessions were supplemented by 20 minutes each day of movement and meditation guided by verbal cues and music provided on compact discs that Klatt designed and recorded. The entire intervention lasted six weeks.
The study analyzed participants’ responses to the intervention using data from established research questionnaires that measured perceived stress, or the degree to which situations in life are considered stressful; a number of components of sleep quality; and what is called mindful attention awareness, which refers to how often a person is paying attention to and is aware of what is occurring in the present.
All participants completed the questionnaires before and after the intervention. Twenty-two adults completed the intervention. Their pre- and post-test results were compared to those reported by the 20 control participants.
Mindful attention awareness increased significantly and perceived stress decreased significantly among the intervention group when compared to the control group’s responses. Overall sleep quality increased in both groups, but three of seven components of sleep were more affected in the intervention group.
On average, mindfulness increased by about 9.7 percent and perceived stress decreased by about 11 percent among the group that experienced the intervention. These participants also reported that it took them less time to fall asleep, they had fewer sleep disturbances and they experienced less daytime dysfunction than did members of the non-intervention group.
The researchers also took saliva samples to test for the presence of cortisol, a stress hormone, but found no significant changes in average daily levels of the hormone over time for participants in both groups. Klatt said the design of this part of the pilot study could have affected the result, and the sample collection technique will be changed in subsequent studies.
Klatt said mindfulness-based stress reduction, developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center, has been studied widely and determined to be useful in lowering symptoms ranging from depression and anxiety to chronic pain. But the time commitment required in the program makes it impractical for busy working professionals, and adding a stress-reduction class outside of work could add stress to these people, she said.
So Klatt set out to develop what she calls a “low dose” of the program that is suitable for the workplace and still offers stress-reduction benefits. She specifically scheduled weekly sessions during lunch to avoid interfering with work time or home time, and combined movement with verbal prompts and music that are cues for participants to relax.
“As I’ve been working on the program, I heard so many of the participants say they wish they had learned this earlier,” Klatt said.
Because the low-dose program remains a work-in-progress that is still under investigation, it is not available for public use, Klatt noted.
This work was supported by the National Institute of Health-funded General Clinical Research Center at Ohio State.
Co-authors of the study are Janet Buckworth of the College of Education and Human Ecology and William Malarkey of the College of Medicine, both at Ohio State.

Boomers: Tips on How to Exercise Safely

2009-06-23T13:25:00.001-07:00

As the weather gets warmer, people often get motivated to spend more time outdoors. Whether it’s working on projects around the house, playing with the grandkids at the park or out exercising, the American Academy of Orthopaedic Surgeons (AAOS) stresses important that baby boomers remember their bodies are not as young as they used to be and not overdo it.

In 2008, more than 166,000 people between the ages of 45 and 64 were treated in emergency rooms, clinics and doctors’ offices for injuries related to exercise and exercise equipment, according to the U.S. Consumer Products Safety Commission.

“Baby boomers have become increasingly active as they age and orthopaedic surgeons think this trend will continue,” says Ray Monto, MD, spokesperson for the AAOS. “One thing to keep in mind is that when you are 50, you may injure your body more easily than when you were 20. Joints, tissues and muscles may not be as flexible as they used to be. So as boomers age, they should take extra steps to protect themselves from injuries when exercising.” Dr. Monto adds, “a little extra stretching before and after exercise, for example, goes a long way.”

The AAOS offers the following tips to help boomers prevent exercise-related injuries:

• Check with your doctor before beginning any exercise program. A physician will make sure your heart is in good condition and can make recommendations based on your current fitness level. This is especially important if you have had a previous injury.

• Always warm up and stretch before exercising. Cold muscles are more likely to get injured, so warm up with some light exercise for at least three to five minutes.

• Avoid being a “weekend warrior.” Moderate exercise every day is healthier and less likely to result in injury than heavy activity only on weekends.

• Do not be afraid to take lessons. An instructor can help ensure you are using the proper form, which can prevent overuse injuries such as tendonitis and stress fractures.

• Develop a balanced fitness program. Incorporate cardio, strength training and flexibility training to get a total body workout and prevent overuse injuries. Also, make sure to introduce new exercises gradually, so you do not take on too much at once.

• Take calcium and Vitamin D supplements daily.

• Listen to your body. As you age, you may not be able to do some of the activities that you did years ago. Pay attention to your body’s needs and abilities, and modify your workout accordingly.

• Remember to rest and schedule regular days off from exercise and rest when tired.

Baby boomers who exercise regularly are less likely to experience depression, weight gain, diabetes, high blood pressure and sleep disturbances, so it’s important to incorporate physical activity into your routine at any age.

Physical Activity May Strengthen Children's Ability to Pay Attention

2009-04-01T11:31:00.000-07:00

As school districts across the nation revamped curricula to meet requirements of the federal “No Child Left Behind” Act, opportunities for children to be physically active during the school day diminished significantly.

Future mandates, however, might be better served by taking into account findings from a University of Illinois study suggesting the academic benefits of physical education classes, recess periods and after-school exercise programs. The research, led by Charles Hillman, a professor of kinesiology and community health and the director of the Neurocognitive Kinesiology Laboratory at Illinois, suggests that physical activity may increase students’ cognitive control – or ability to pay attention – and also result in better performance on academic achievement tests.

“The goal of the study was to see if a single acute bout of moderate
exercise – walking – was beneficial for cognitive function in a period of time afterward,” Hillman said. “This question has been asked before by our lab and others, in young adults and older adults, but it’s never been asked in children. That’s why it’s an important question.”

For each of three testing criteria, researchers noted a positive outcome linking physical activity, attention and academic achievement.

Study participants were 9-year-olds (eight girls, 12 boys) who performed a series of stimulus-discrimination tests known as flanker tasks, to assess their inhibitory control.

On one day, students were tested following a 20-minute resting period; on another day, after a 20-minute session walking on a treadmill. Students were shown congruent and incongruent stimuli on a screen and asked to push a button to respond to incongruencies. During the testing, students were outfitted with an electrode cap to measure electroencephalographic (EEG) activity.

“What we found is that following the acute bout of walking, children performed better on the flanker task,” Hillman said. “They had a higher rate of accuracy, especially when the task was more difficult. Along with that behavioral effect, we also found that there were changes in their event-related brain potentials (ERPs) – in these neuroelectric signals that are a covert measure of attentional resource allocation.”

One aspect of the neuroelectric activity of particular interest to researchers is a measure referred to as the P3 potential. Hillman said the amplitude of the potential relates to the allocation of attentional resources.

“What we found in this particular study is, following acute bouts of walking, children had a larger P3 amplitude, suggesting that they are better able to allocate attentional resources, and this effect is greater in the more difficult conditions of the flanker test, suggesting that when the environment is more noisy – visual noise in this case – kids are better able to gate out that noise and selectively attend to the correct stimulus and act upon it.”

In an effort to see how performance on such tests relates to actual classroom learning, researchers next administered an academic achievement test. The test measured performance in three areas: reading, spelling and math.

Again, the researchers noted better test results following exercise.

“And when we assessed it, the effect was largest in reading comprehension,” Hillman said. In fact, he said, “If you go by the guidelines set forth by the Wide Range Achievement Test, the increase in reading comprehension following exercise equated to approximately a full grade level.

“Thus, the exercise effect on achievement is not statistically significant, but a meaningful difference.”

Hillman said he’s not sure why the students’ performance on the spelling and math portions of the test didn’t show as much of an improvement as did reading comprehension, but suspects it may be related to design of the experiment. Students were tested on reading comprehension first, leading him to speculate that too much time may have elapsed between the physical activity and the testing period for those subjects.

“Future attempts will definitely look at the timing,” he said. Subsequent testing also will introduce other forms of physical-activity testing.

“Treadmills are great,” Hillman said. “But kids don’t walk on treadmills, so it’s not an externally valid form of exercise for most children. We currently have an ongoing project that is looking at treadmill walking at the same intensity relative to a Wii Fit game – which is a way in which kids really do exercise.”

Still, given the preliminary study’s positive outcomes on the flanker task, ERP data and academic testing, study co-author Darla Castelli believes these early findings could be used to inform useful curricular changes.

“Modifications are very easy to integrate,” Castelli said. For example, she recommends that schools make outside playground facilities accessible before and after school.

“If this is not feasible because of safety issues, then a school-wide assembly containing a brief bout of physical activity is a possible way to begin each day,” she said. “Some schools are using the Intranet or internal TV channels to broadcast physical activity sessions that can be completed in each classroom.”

Among Castelli’s other recommendations for school personnel interested in integrating physical activity into the curriculum:

• scheduling outdoor recess as a part of each school day;

• offering formal physical education 150 minutes per week at the elementary level, 225 minutes at the secondary level;

• encouraging classroom teachers to integrate physical activity into learning.

An example of how physical movement could be introduced into an actual lesson would be “when reading poetry (about nature or the change of seasons), students could act like falling leaves,” she said.

The U. of I. study appears in the current issue of the journal Neuroscience. Along with Castelli and Hillman, co-authors are U. of I. psychology professor Art Kramer and kinesiology and community health graduate student Mathew Pontifex and undergraduate Lauren Raine.

Operation Patient Access: Quality Surgical Care for All

2009-03-24T01:07:00.000-07:00

WASHINGTON - Surgical groups, led by the American College of Surgeons (ACS), along with other key health care stakeholders, today announced the formation of Operation Patient Access: Quality Surgical Care for All, an effort to bring into focus the urgent issues facing access to quality surgical care in the United States. With nearly 400 surgeons from around the country meeting with their elected representatives today, they will call attention to urgently needed policy changes to address gaps in the availability of quality surgical patient care.

"As policymakers examine how to reform this country's health care system in the midst of the current economic crisis, there is a growing concern that the focus on cost controls will dominate discussions and decisions to the extent that access to quality surgical care will be further compromised," said L.D. Britt, MD, FACS, Chair, ACS Board of Regents. "Operation Patient Access is designed to help policymakers understand that patient access to quality surgical care is at risk and that we want to work with them to craft workable solutions that address access problems while preserving and improving high-quality surgical care."

The shortage of general surgeons in the US has been well-documented and continues to be a major concern because these surgeons are mainstays in rural parts of the country and also staff trauma centers in urban areas. Operation Patient Access released new information today that shows that the shortage and the resulting gaps in access to care are actually getting worse:

-- The American College of Surgeons Health Policy Institute issued trend
information in a new unpublished report that highlights research
indicating the shortage of general surgeons has raised concerns about
the access to care for underserved and rapidly aging populations in
pockets of both rural and urban areas of the United States.
-- New research published in the March issue of the Journal of the
American College of Surgeons reveals shortages of qualified surgeons
in many regions of Maryland, especially in rural areas. The study
states that excessive administrative demands and an aging physician
and general population could push these shortages to critical levels
over the next 10 years.

"One of the goals of Operation Patient Access is to spur dialogue and build consensus among stakeholders on how best to tackle and solve this problem because this is about making sure patients get the right care at the right time in the right place," said Thomas Russell, MD, FACS, Executive Director, American College of Surgeons.

Among the solutions being discussed by Operation Patient Access participants are: increase the number of residency programs; expand the National Health Services Corps; establish student loan forgiveness programs; provide more funding for graduate surgical education; reduce liability cost; and implement alternative payment methods for health care.

A key reason that patient groups are coming out in support of Operation Patient Access is to make sure that there are enough well-trained surgeons available to provide quality surgical care to those who need it when they need it.

"Susan G. Komen for the Cure supports the American College of Surgeons and its Operation Patient Access program," said Diana Rowden, VP, Health Sciences, Susan G. Komen for the Cure. "Highly trained, experienced surgeons provide the treatment that is the foundation of breast cancer care, resulting in overall quality outcomes for women with breast cancer. These experts can and do provide women with the range of surgical options that are part of a comprehensive individualized treatment plan. A rigorous training program and extensive continuing education ensures that surgeons are qualified and current in their approaches to breast surgery."

Other areas of surgery in which shortages are developing include orthopaedic surgery, neurosurgery, urology, obstetrics-gynecology, and cardiothoracic surgery.

"We're facing a situation where 50 percent of the practicing cardiothoracic surgeons in this country are planning on retiring within 10 years, with more than 70 percent following within 13 years," said John Mayer, MD, FACS, past president of The Society of Thoracic Surgeons and current chair of the Council on Health Policy and Relationships for the Society. "This issue is compounded by the fact that we aren't getting enough trainees into our cardiothoracic surgery fellowship programs. Between 2002 and 2007, thoracic surgery has seen a drop of 24 percent in the number of first year trainees. This is a forbidding harbinger of things to come."

About Operation Patient Access

Operation Patient Access is a collaboration of America's surgical community, including patients, surgeons, hospitals, public health and other providers - with the ultimate goal of bringing into focus the urgent issues facing access to quality surgical care. Operation Patient Access partners include: The American College of Surgeons, American Academy of Ophthalmology, American Academy of Otolaryngology - Head and Neck Surgery, American Association of Neurological Surgeons, American Association of Orthopaedic Surgeons, American College of Osteopathic Surgeons, American Osteopathic Academy of Orthopedics, American Society of Plastic Surgeons, American Urological Association, Congress of Neurological Surgeons, New England Rural Health Round Table, The Society of Thoracic Surgeons, Society for Vascular Surgery, Texas Rural Health Association, Utah Department of Health, and the Wyoming Health Resources Network.

Web site: http://operationpatientaccess.facs.org/

10 Ways to Spend Less on Health Care in a Recession

2009-02-16T11:46:00.000-08:00

After many months of wondering, we finally have confirmation that we’re in a recession. Unfortunately, that means spending less on necessities and eliminating what we now consider to be luxuries. But during these tough economic times, the Institute for Good Medicine and the physician members of the Pennsylvania Medical Society urge you to protect your greatest asset – your health.

“Taking care of yourself or your family should never be viewed as a luxury, particularly if you have a chronic illness, or if you are unemployed or uninsured. We want to help our patients stay healthy or get healthy, regardless of their personal circumstances,” notes Daniel Glunk, MD, internal medicine physician and president of the Pennsylvania Medical Society.

The society offers these 10 ways to spend less on health care and stay (or get) healthy:

Don’t stop doing the right things
Take good care of yourself to avoid additional costs.

1. Take your medications as prescribed. If you take medications for a chronic condition such as high blood pressure, asthma, arthritis or diabetes, it can be extremely dangerous and ultimately more costly to stop taking them or alter your dose without consulting your doctor. Ask your doctor if a generic drug would be appropriate – the quality, strength and purity are the same as brand-name drugs, but they’re cheaper because the manufacturer didn’t invest millions to develop the drug. Also ask your doctor about prescription drug assistance, or visit www.RxAssist.org to see if you qualify for free and low cost medications.

2. Pay attention to early warning signs of health problems, particularly if it’s a symptom you haven’t experienced before. The longer you wait, the more costly it can be to treat. Visit your nearest clinic or doctor’s office before you head to the emergency room.

3. Keep important medical appointments. If you have a chronic illness or if your child is due for required immunizations, please keep those appointments. Worried about the cost? Visit http://findahealthcenter.hrsa.gov/ for a listing of clinics and federally qualified health centers that provide services free-of-charge or at reduced cost for those who qualify.

4. Continue self-exams and annual screenings. Take advantage of free health screenings at local clinics, hospitals, or health fairs. Sign up for periodic screening reminders from the American Cancer Society here: http://acsremindme.com/register.php?CID=206. The Pennsylvania Department of Health offers free pelvic and breast exams, pap tests, mammograms to women who qualify. Call 1-800-215-7494 for more information.

5. Fill out the online health assessments offered by the Pennsylvania Medical Society. In just a few minutes, you can find out what steps to take to improve your overall health. Visit www.myfamilywellness.org and click on “How’s Your Health?” The assessment’s personalized reports offer valuable suggestions for making positive lifestyle changes.

Do something
Continue or begin healthy habits.

6. If you smoke, quit. Nearly one quarter (23%) of Pennsylvania’s adults smoke and about 20,000 die each year from the effects of smoking. Smokers pay approximately $16,000 to $18,000 more in health care costs over their lifetime than non-smokers. If you smoke, kicking the habit will save you big bucks PLUS, it will dramatically improve your health. Contact your local American Cancer Society, American Lung Association about smoking cessation classes.
Beginning in February, the PA Department of Health is giving away a four-week supply of nicotine patches. Call 1-800-QUIT-NOW for more information.

7. Get moving. Regular exercise reduces your risk of heart disease, diabetes, stroke, high blood pressure and osteoporosis. First, if you haven’t exercised regularly in a long time, consult your doctor. Exercise also helps to control weight; contributes to healthy bones, muscles, and joints; reduces falls among older adults; helps to relieve the pain of arthritis; reduces symptoms of anxiety and depression; and is associated with fewer hospitalizations, physician visits, and medications. So, whether you take a brisk walk, climb stairs, ride a bike or lift weights, just get moving. You’ll feel better and hopefully need to visit the doctor less. Contact your local hospital about free or low cost exercise and weight-control classes.

8. Eat healthy. Try to make more meals at home. While fast-food value meals may seem like a good deal, they’re not always the healthiest choice. Instead, try cooking at home, including more fruits and vegetables in each meal. For great recipes, cooking tips and shopping lists, visit the American Caner Society’s Great American Eat Right Challenge (http://www.cancer.org/docroot/subsite/greatamericans/eat_right.asp).

9. Be more careful. The riskier your lifestyle, the more likely you are to have health problems. Take simple precautions in daily life: lift with your knees, buckle-up, and don’t take unnecessary risks. If you’re a do-it-yourselfer, make sure you know what you’re doing, or enlist the help of someone who does. Maybe now isn’t the best time to try putting on the new roof or re-wiring the house.

10. Be resourceful. If you have health care benefits, check to see if your plan includes lifestyle programs and preventive services. Take advantage of workplace wellness programs or check with your local hospital about free healthy lifestyle classes.

Avoiding Surgery for Low Back Pain

2009-02-02T12:03:00.000-08:00

The simplest method for treating low back pain may actually be the best method. A literature study published in the February 2009 issue of The Journal of the American Academy of Orthopaedic Surgeons finds that in most cases of symptomatic lumbar degenerative disk disease, a common cause of low back pain, the most effective treatment is simply a combination of physical therapy and anti-inflammatory medication.

Symptomatic lumbar degenerative disc disease occurs when a disc weakens, often due to the effects of aging, repetitive strain or injury to the disc space. The result is that the disc cannot hold the vertebrae as well as it used to, and that lack of stability can cause low back pain. In some cases, the pain is great enough that the patient may seek treatment from an orthopaedic surgeon. These treatments can include a range of noninvasive and invasive/surgical options.

According to the review findings:
1 90 percent of patients with low back pain will see their symptoms fade on their own within three months
2 Most of those patients will recover within six weeks.

Therefore, the researchers determined that, barring an emergency, the initial treatment of all patients with low back pain should be noninvasive.

“Recently, disc replacement surgery has been proposed as a cure or treatment for symptomatic lumbar disc disease,” says Luke Madigan, M.D., an attending physician at Knoxville Orthopaedic Clinic, Knoxville, TN, and the lead author of the review. “But the FDA studies on lumbar disc replacement have only so far shown equivalence to fusion for discogenic disease. Long-term outcomes are still to be published and caution should be exercised with their use.” Madigan also notes that in the past, surgical fusion was used to treat this condition, and the success rate was 50-60 percent.

Meanwhile, noninvasive treatments have brought about greater success by helping patients strengthen the injured area and prevent further strain:

1 Physical therapy that focuses on strengthening core muscle groups in the abdominal area and the lower back has demonstrated positive effects in patients with disc-related pain.
2 Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen have been found effective for short-term relief of low back pain, and no NSAID was found to be any more effective than the others.
3 Educating patients on better body mechanics—for example, lifting with the legs instead of the back—is found to lessen the strain that is placed on the lumbar region.
4 Another recent literature review advocated mobilization or activity in the treatment of low back pain as opposed to bed rest, and exercise has been shown to improve function and decrease pain in adult patients with chronic low back pain.
5 Braces have not been found to be effective in treating low back pain, although whether patients actually wear the brace in the prescribed manner may be a factor.

Invasive treatment should only be explored if these and other noninvasive treatments have not been effective.

“Surgery should be the last option, but too often patients think of surgery as a cure all and are eager to embark on it,” Madigan says. “Also, surgeons should pay close attention to the list of contraindications, and recommend surgery only for those patients who are truly likely to benefit from it.”

HeartSaving Solutions Offers Free CPR Course for Parents

2009-01-21T09:08:00.000-08:00

The economic meltdown has taken its toll; family budgets are being slashed as belts tighten. But Seattle-based CPR training firm HeartSaving Solutions (http://www.onlinebabycpr.com) believes all parents should have the right to learn how to save their children’s lives in the event of an emergency. To that end, the company has made its online infant and child CPR course completely free of charge.

Available to parents, grandparents, older siblings and anyone else who would like to learn infant and child CPR from the comfort of their own homes, Online Baby CPR used to cost $13.95 per person. HeartSaving Solutions founder Keith Weaver, however, decided to provide the infant and child CPR training for free when he realized that in spite of its importance, many parents just can’t afford to take any CPR course right now.

“I’m a dad myself. I know parents have limited time and, these days, even more limited money. But at the same time, we at HeartSaving Solutions are alarmed that thousands of babies and children die each year as a result of choking, suffocation and drowning — three situations in which CPR can literally be a lifesaver,” Weaver explained. “So Online Baby CPR is dedicated to giving parents and parents-to-be a way to learn those vital skills at home, at their pace, for free. In this one area, we’re able to remove the barrier the recession had presented to parents.”

The Online Baby CPR course is designed for parents and is a complete CPR training class. Proceeding through the course on their own time, participants will learn child and infant CPR, choking and drowning prevention, automated external defibrillator (AED) use, and how to help a child or baby who is already choking. There is no software required and nothing to download. Although parents will thoroughly learn the basics of CPR, the free course does not offer a CPR certification, making it for personal use only.

Those wondering whether they can really learn CPR online needn’t worry. Online Baby CPR uses industry best practices to teach the lifesaving concepts of CPR through video, images, audio, text and quizzes; students can ask questions at the OnlineBabyCPR.com forums, where certified CPR trainers are on hand to provide answers.

“We hope parents, grandparents and primary caregivers will take this free, convenient opportunity to learn how to save their children’s lives through CPR,” Weaver said. “With Online Baby CPR, it’s easier than ever before to make your home a safer place.”

About HeartSaving Solutions

HeartSaving Solutions is a certified CPR, AED and First Aid training provider. The company provides outstanding on-site training to businesses and has been chosen by one of the largest AED manufacturers to provide training to many of its customers in the Northwest. To learn more about HeartSaving Solutions, visit the company at http://www.heartsaving.net; more information about the Online Baby CPR course is available at http://www.onlinebabycpr.com.

No More Dry Eyes -- Tips to Get the Grit Out

2009-01-21T08:59:00.000-08:00

Dry eyes can be a nuisance. But when severe cases are not treated, the condition becomes more than an irritation. The surface of the eye is susceptible to infection and scarring. The January issue of Mayo Clinic Health Letter covers the causes of dry eyes and treatment options.

Healthy eyes are continuously covered by layers of fluids. The outermost layer includes fatty acids that smooth the tear surface and slow evaporation of the thicker, middle layer, which is mostly water. Mucus makes up the innermost layer, which allows tears to be evenly spread over the eye surface. Dry eyes happen when any of these three components is out of balance.

For example, dry eyes occur when tear glands don’t produce enough fluids or when problems with blinking hamper tear distribution. Also, several commonly used medications, including diuretics, pain relievers, sleep medications and antidepressants, can cause dry eyes.

Most people with dry eyes don’t develop long-term complications, but they can happen. Treatments are designed to both increase comfort and reduce the possibility of complications. The best treatment depends on what is causing dry eyes.

If the irritant is lack of tears, using nonprescription artificial tears is the mainstay treatment. Generally, it’s best to avoid drops such as Clear Eyes and Visine, which reduce redness but may aggravate dry eyes. Some products have a thicker consistency, and their effects last longer, but they can blur vision. Others such as Refresh Dry Eye Therapy use an oil-based component to help prevent evaporation. Another option, Optive, lubricates the eye surface and keeps the eye healthy.

For severe dry eyes, a physician may recommend tear conservation methods such as blocking tear drainage with tiny silicone plugs or cauterizing the tissues of the tear drainage area so scarring closes the tear ducts.

Other options are prescription cyclosporine (Restasis) drops and corticosteroid drops or contact lenses that cover the white of the eye to help retain moisture. For impaired blinking, surgery may be needed.

At home, using eyedrops before eyes become irritated is helpful. Protecting eyes from blowing air, for example with wraparound sunglasses, can reduce eye irritation. So can avoiding smoke and not rubbing the eyes. A humidifier can help when the air inside the home is dry.

Mood Disorders, Migraines Might Be Connected

2009-01-21T08:55:00.000-08:00

Migraine headaches can precede the onset of mental disorders, according to a growing body of knowledge that includes a new study in the January-February 2009 issue of General Hospital Psychiatry.

“Together, migraine and mental disorders cause more impairment than alone,” said lead study author Gregory Ratcliffe. “Patients who have one condition should be assessed for the other so they can be treated holistically. Although it is important to know that both are present, treating one will have an effect on the other.”

Ratcliffe is with the department of psychiatry at the University of Manitoba in Canada. He and his colleagues analyzed data on 4,181 participants in the German National Health Interview and Examination Survey. Migraines were diagnosed by a physician and trained interviewers evaluated participants for mental disorders.

Researchers found that 11 percent of participants had migraines. Participants had a variety of disorders: major depression, general anxiety disorder, dysthymia, bipolar disorder, panic attacks, panic disorder, substance abuse disorders, agoraphobia and simple phobia.

The authors considered two theories that might explain the relationship between migraine and mental disorders. The first theory is that a common factor influences both conditions, such as low activity of enzymes that deactivate certain chemical messages sent to the brain. They also considered a causal relationship: This study and others found that anxiety often precedes migraine, which often precedes depression.

Frederick Taylor, M.D., director of the Park Nicollet Headache Clinic in St. Louis Park, Minn., said that migraine co-morbidities — depression, anxiety and other disorders — affect 83 percent of migraineurs and explain 65 percent of their inability to function in life, more than the pain itself.

According to MAGNUM, a national migraine awareness group, 30 million Americans suffer from migraines and another 8 million are genetically susceptible. Those who suffer from the most disabling type of migraine, intractable migraine, can find it a struggle to function in the workplace.

General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, M.D., at (206) 543-7177.

Ratcliffe GE, et al. The relationship between migraine and mental disorders in a population-based sample. General Hosp Psychiatry, 31(1), 2009.

Simple Steps for a Healthier You

2008-12-27T03:56:00.000-08:00

Quit Smoking. Lose weight. Get more exercise. These are popular New Year’s resolutions, but they are undoubtedly a chore. A third of resolutions, however well motivated, are broken within a week.

If better health is your aim, there are many other simple, less obvious things you can do – without a great deal of effort. Here are a few recommended by physicians at Rush University Medical Center.

Have fun to help de-stress. Experts recommend regular exercise, meditation and breathing techniques to reduce stress, but even something as simple as listening to soothing music, reading a good book, soaking in a hot tub or playing with your pet can help you relax. “Spending just 30 minutes a day doing something you enjoy can go a long way toward beating the stressors of everyday life,” says cardiologist Dr. Annabelle Volgman, director of the Rush Heart Center for Women. That’s advice you should take to heart because prolonged stress can cause or exacerbate a number of health problems — some serious — including heart disease, stroke, hypertension, depression, ulcers, irritable bowel syndrome, migraines and obesity.

Practice good oral hygiene. Spend a minimum of two minutes to brush your teeth twice a day — and don’t forget the dental floss. Daily flossing and brushing of teeth not only help prevent cavities but may keep other diseases at bay as well. Experts suspect that bacteria-producing dental plaque, which leads to gum inflammation, can result in or exacerbate heart disease. Although the exact mechanism of why this occurs is not clear, a connection has also been found between poor periodontal health and stroke, diabetes, premature births and low birth weights. “It’s also a good idea to take a three-hour break between eating foods that contain sugar,” says Dr. Joel Augustin, a family medicine physician at Rush.

Do a crossword puzzle. Researchers at Rush have found that mentally challenging activities, such as reading and playing chess, may have a protective effect on your brain. “Regularly engaging your mind may help lower your risk for the dementia associated with Alzheimer’s disease,” Dr. Augustin says.

A little red wine is fine. Recent studies have shown that the powerful antioxidants found in red wine protect against heart disease, colon cancer, anxiety and depression. So unless there is a medical reason why you shouldn’t imbibe, go ahead and enjoy that glass of merlot with your nightly meal — you can even toast to your good health.

But don’t drink excessively. Just as a small amount of red wine has health benefits, too much alcohol — even red wine — can cause a variety of health problems, including liver and kidney disease and cancer. Women, in particular, need to be careful about alcohol consumption. “Women are at higher overall risk of liver problems than men, so they are more likely to experience liver problems from smaller amounts of alcohol,” says Dr. Carline Quander, a gastroenterologist at Rush. “They simply shouldn’t drink as much as men.” For a healthy man, two drinks a day is not likely to do harm; women, on the other hand, should limit themselves to one daily drink.

Stop the snore cycle. When half of a couple snores, the other person loses sleep. The snorer is frequently tired too because people who snore loudly often have sleep apnea. In the most common form of this condition, the airway is blocked, causing the person to stop breathing and wake up repeatedly. Physicians at the Sleep Disorders Service and Research Center at Rush found that treating the snorer with continuous positive airway pressure, which keeps the airway open, results in better sleep for both people.

Don’t skip the seatbelt — ever. Even if you’re driving only a short distance or are in a parking lot, take a few seconds to fasten your safety belt, which prevents you from being tossed around the car or thrown from it in the event of a crash. Most cars these days are equipped with air bags, but these lifesaving features are designed to work with safety belts. According to National Highway Traffic Safety Administration, air bags alone are only 42 percent effective in providing protection.

Check your ergonomics. If you work at a computer, look at the ergonomics of your workstation — how you fit and move in your environment. You can start by visiting the Division of Occupational Health and Safety at http://dohs.ors.od.nih.gov. “An ergonomics review can help you avoid neck, back and eye strain,” Dr. Augustin says.

Even small steps toward better health can yield surprising rewards.

Menarcheal Age Affects Bone Density

2008-12-27T03:53:00.000-08:00

A South Dakota State University study showed that women who began menstruating at an earlier age had a higher percentage of body fat as adults than women who began menstruating later.

But women who began menstruating earlier also had higher bone mineral density in the hip as adult women. They also had greater bone mass and bone density in the femoral neck region of the hip, a common site for hip fracture.

These are among the findings in a study by assistant professor Teresa Binkley at SDSU’s Ethel Austin Martin Program in Human Nutrition. Binkley worked on the project with Courtney Grimsrud, an undergraduate research assistant at the time, and professor Bonny Specker, director of the Ethel Austin Martin Program.

The SDSU researchers published the results of their study in 2008 in the American Journal of Human Biology. The study looked at the effect of menarcheal age on body size and bone measures in adult women.

“ ‘Menarcheal age’ refers to the age at which a female first begins menstruation,” Binkley explained.

“If the age at which a female starts menstruating, or her menarcheal age, is early, then she has an increased exposure to estrogen compared to a female with a later menarcheal age.”

Estrogen exposure leads to growth plate closure, or the stage at which bones stop growing in length, as well as to mineral packing in bone. Studies have associated early menarcheal age with increased bone density. Some research has also associated early menarcheal age with shorter stature and greater percent body fat as an adult, while later menarcheal age is associated with taller stature and leaner body composition.

The purpose of the SDSU study was to determine in adult women the effect of menarcheal age on weight, body fat, height, limb length and bone measurements.

To measure bones, the study used two technologies. Dual energy X-ray absorptiometry, or DXA, is used routinely in hospitals and clinics to measure bone density of the spine or hip. Peripheral quantitative computed tomography, or pQCT, is a method that measures density, size and shape of the arm or leg bones and is used for research purposes.

“Our hypotheses were that women with young menarcheal ages compared to those with higher menarcheal ages would have higher adult percent body fat and higher adult weight, shorter height and limb length, and greater bone mass and bone mineral density.”

The subjects were a subset of South Dakota Rural Bone Health Study, 260 women with regular menstrual cycles from two ethnic groups (140 were Hutterite, 120 were non-Hutterite). They ranged from 20 to 40 years old.

The study measured weight, standing height, sitting height (defined as the length from the stool seat to the top of the head), leg length (standing height minus the sitting height), and forearm length.

The study assessed menarcheal age by asking women in the study when they began menstruating. Fifty percent of the study participants said that was before age 13; the other 50 percent said it was at age 13 or after.

“Although it wasn’t in our hypothesis, we did find a trend in menarcheal age,” Binkley noted. “Women born in 1960 tended to have an older average menarcheal age than women born toward the 1980s,” Binkley said.

“Although it was not statistically significant, it is interesting that in this population, the trend over the 20-year-age-range was 2.3 months per decade.”

In line with their hypothesis, SDSU researchers found that women with younger menarcheal ages had on average a higher percent body fat as adults than women with later menarcheal ages. They also weighed more.

However, the study found no associations between menarcheal age and height, sitting height or limb lengths.

Interestingly, women with an early menarcheal age had a smaller bone size at the distal radius, the end of the arm bone near the wrist, than women with a later menarcheal age.

“Women with a later menarcheal age have more time for the adolescent growth spurt, and their bones probably grow bigger,” Binkley said.

The Ethel Austin Martin Program in Human Nutrition at SDSU and a grant from the National Institutes of Health supported the research.

Assistant professor Teresa Binkley at SDSU’s Ethel Austin Martin Program in Human Nutrition studied menarcheal age as a factor in body size and bone measurements in adult women.

Alzheimer: Women Affected More Often than Men

2008-12-19T12:46:00.000-08:00

Nearly 4.5 million people suffer from Alzheimer’s disease (AD) in our country, and more than half of them are women, according to the National Institute on Aging in Bethesda, Md. As the general population continues to age, this number is expected to increase significantly over the next few decades.

Alzheimer’s disease is the most common form of dementia, a group of brain disorders that interferes with a person’s ability to carry out daily activities. In AD, areas of the brain change and deteriorate, which causes a decline in cognition and memory functioning. In some patients, the deficits are large enough to get in the way of performing normal, everyday tasks.

There is evidence that AD affects women differently than men. “Many studies of gender differences in cognition have pointed to greater language deficits in women with Alzheimer’s disease as compared to men,” explains Michael S. Rafii, M.D., Ph.D., director of the Memory Disorders Clinic and an attending neurologist at the Shiley-Marcos Alzheimer Disease Research Center at the University of California, San Diego. “Naming and word-recognition skills have been reported to be more adversely affected in female patients with AD than in male patients, and the differences have been shown to be sustained over time.”

Notable sex and gender differences in behavior among Alzheimer patients have been observed as well. “Male patients exhibit greater problems than female patients in wandering, abusiveness and social impropriety, particularly in the more advanced stages of the disorder,” Rafii points out. In fact, major tranquilizers and behavior management programs are used more frequently on male patients.

While there is currently no cure for AD, researchers continue to make progress. More drugs are being studied, and researchers have identified several genes associated with the disease. “Recent work has been focused on identifying the molecule that may be causing AD symptoms,” says Rafii. Researchers from the University of Minnesota and Johns Hopkins University “discovered a protein complex in the brain that appears to impair memory.”

Combined with sophisticated imaging techniques, this discovery is enabling scientists to take a clear picture of the protein deposits in the brain. According to Rafii, “This could lead to accurate diagnosis of AD at very early stages.

Previously, a definitive diagnosis of the disease could only be made through an autopsy after the patient's death, typically at a very late stage of the illness.”

Diagnosing AD can be tricky, especially because many people are under the assumption that forgetfulness is a normal part of the aging process. But patients with AD suffer from much more than simple memory lapses. Here are a few common signs and symptoms of the disease:

• Persistent forgetfulness or memory loss
• Disorientation
• Problems performing routine tasks
• Inability to express thoughts coherently or finish sentences
• Loss of judgment
• Changes in personality

As in other diseases, early diagnosis is very important for patients with AD. Certain medications have been found to be useful in the earlier stages of the disease, so the sooner the diagnosis is made, the better.

Source: National Institute on Aging: www.nia.nih.gov

Surgeons Predict Foot Pain Will Increase in January

2008-12-17T08:33:00.001-08:00

You've signed up for the gym membership. You've bought new workout clothes and shoes. You've made a promise to yourself to stick to your New Year's resolution to exercise and lose weight.

You hit the gym, you work out hard for a week, then you wake up one morning and pain is shooting through your heel. Exercise now hurts so much that you stay home on the couch watching the new season of American Idol.

Soon after the last gulp of New Year's champagne, foot and ankle surgeons see the annual influx of patients with foot pain caused by exercise. Doctors interviewed by the American College of Foot and Ankle Surgeons (ACFAS) say the most common problems are heel pain, pinched nerves and sore Achilles tendons. They shared tips for preventing and treating these conditions.

Heel pain

Most heel pain cases are caused by plantar fasciitis. Foot and ankle surgeons recommend athletic shoes that support the arch and cushion the heel. Buy shoes designed for the sport. Over-the-counter orthotics may help some people.

To treat heel pain, first trying icing the bottom of the foot before bed.

Performing stretching exercises two to three times a day can also help. Sit on the floor barefoot with the knees straight. Hook a towel around the toes of the foot. Pull back on the towel, count to 10, then relax. Repeat several times.

Pinched nerves

Have your feet measured before you buy athletic shoes. Foot and ankle surgeons say many people wear shoes that are a half-size too tight. Exercising in tight shoes can cause a neuroma, or a pinched nerve. Patients with this condition say they feel pain in the ball of their foot and tingling in their third and fourth toes.

Achilles tendon pain

Instead of going from couch potato to a high intensity workout, doctors recommend easing into a new exercise routine. Try to alternate a hard workout one day with an easy workout the next.

New Year's exercisers who ignore this advice risk Achilles tendonitis. The back of the foot becomes tender and painful.

When Achilles tendon pain occurs, foot and ankle surgeons recommend first using RICE therapy (Rest, Ice, Compression, Elevation).

Additional advice

Consult a physician or trainer before starting a new exercise routine.

Foot pain doesn't have to sabotage New Year's resolutions to exercise. Listen to your body. If pain in the foot or ankle lasts five to seven days in a row, see a foot and ankle surgeon. They'll be expecting you.

For more information on foot and ankle pain, visit http://FootPhysicians.com.

Lighting Tips for Low Vision

2008-12-12T12:32:00.000-08:00

Eyesight can fade over time because of aging or an eye disease. The December issue of Mayo Clinic Health Letter offers tips to help compensate for low vision:

Around the house:

-- Reduce differences in brightness -- Equalize indoor and outdoor light sources by leaving some house lights on during bright sunny days.

-- Reduce glare -- Cover shiny surfaces, such as a polished table, with a cloth. Dark-colored place mats can help at mealtime. Opt for furnishings with a flat or matte finish.

-- Light up dark spots -- Install lighting in dark areas, such as inside closets. Keep a pocket flashlight handy for dark areas.

For better close-up vision:

-- Use bright, direct lighting -- Position an adjustable lamp about four to eight inches from reading material or a close-up task. Keep the lamp slightly to one side to reduce glare. If possible, position the light over the shoulder on the side of the better-seeing eye.

-- Use daylight -- To take advantage of natural light, position yourself so that windows are to the side or behind you.

-- Use a dark background -- When reading, reduce glare by using a piece of dark construction paper to cover areas of text you’re not reading at that moment.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 800-333-9037 (toll-free), extension 9771, or visit www.HealthLetter.MayoClinic.com.

Great Depression Spurred Great Creativity

2008-12-04T12:11:00.000-08:00

“If it’s true that adversity and hardship can bring out creativity,” said Miles Orvell, professor of English and American studies at Temple University, “then the Great Depression was one of the great creative periods of our time.”

The Great Depression is currently all the rage, with New Yorkers hosting Depression parties, peasant skirts and newsboy caps making a return on the runways, and Netflix rentals of The Grapes of Wrath on the rise. But that 1939 Steinbeck novel is not the only Depression-era work worth taking a second (or a first) look at from our current perspective in what some are calling the New Depression.

Common themes found in the literature of the period are despair, poverty, corruption, strife between labor and management, and the need to work together, noted Orvell. Does any of that sound familiar?

“The period also birthed several new genres, such as the melodrama, which laid the foundation for today’s soap opera, and it brought the detective novel to fulfillment, with the heroic detective stoically dealing with corruption and the underside of life in cities like New York, Los Angles and San Francisco,” he said.

“The literature of the Depression has been largely dismissed from the cultural record,” explained Orvell. “By the post WWII era, the anti-communist and neo-conservative movements looked back at the depression and anything from the left as the work of the ‘communist devil.’ And that has carried over into our own day” he added.

According to Orvell, a current standard survey textbook of American literature devotes just three pages out of 1500 to Depression Era literature. “Yet, the literature of the Depression reflects a critical period in our history and one that had a lasting impact by bringing us social security, roads, post-offices, and banking regulations,” he noted.

Two-Drug Blood Pressure Therapy Reduces Heart Attacks

2008-12-04T12:10:00.000-08:00

While doctors are urged to start with a diuretic-based strategy to control patients’ high blood pressure, an international blood pressure study shows a different single-pill drug combination is more effective at preventing heart-related events such as heart attacks and strokes. The findings challenge the way blood pressure is usually treated worldwide.

The randomized study led by a University of Michigan Health System researcher compared two drug combinations. The results, which appear in today’s New England Journal of Medicine, were so significant that the trial was stopped early.

Both single-pill combination drugs helped more than 75 percent of people who had high blood pressure and other cardiovascular risk factors get their blood pressure down. But even more important, patients in the study taking the combination that included a calcium channel blocker had 20 percent fewer heart-related events than the patients taking the other combination.

In all, 11,506 study participants took a single tablet that includes two medications. One group received a tablet containing benazepril, which is a type of drug called an ACE inhibitor, and amlodipine, which belongs to a class of drugs known as calcium channel blockers or CCBs. The other pill combined benazepril and hydrochloro-thiazide, a type of diuretic or “water pill.” The 20 percent reduction in cardiovascular events was observed with the ACE/CCB combination tablet.

Cardiovascular events were defined as cardiovascular deaths, heart attacks, strokes, hospitalizations for unstable angina and treatments to re-open blocked heart arteries.

Currently, national guidelines for the treatment of high blood pressure (also called hypertension) call for patients who need medication to start out on a single pill, usually a diuretic, or water pill, and to add other drugs only as needed to bring pressure down. But the new results may signal a need to change those guidelines.

The ACCOMPLISH study suggests physicians no longer give diuretics preferred status in treating patients.

“This robust study showed us that switching patients to a single-pill combination meant that twice as many patients got to their blood pressure goal, regardless of previous therapy,” says University of Michigan Health System’s Kenneth Jamerson, M.D., the leader of the study.

“The significant reduction in cardiovascular events we observed in patients will, I hope, show physicians that earlier use of a combination medication, especially with amlodipine, may be in the best interest of patients,” he says.

Jamerson is a professor of internal medicine at the University of Michigan Medical School and a member of the U-M Cardiovascular Center.

Results from the ACCOMPLISH trial show that just six months of treatment with either drug combination was enough to bring the blood pressure of 73 percent of
patients into an acceptable range – despite the fact that two-thirds were already taking some other medication before they entered the study. At the beginning of the trial, only 37 percent had blood pressure below 140/90.

However, by the end of the three-year trial blood pressure control rates were 80 percent, with average systolic blood pressure less than 130 mmHg. This represents exceptional blood pressure control when contrasted to the current control rate of about 30 percent in the United States.

Participants from five countries – the United States, Sweden, Norway, Denmark and Finland – were part of the trial, and all patients were at risk for cardiovascular events.

Many studies have already shown that reducing blood pressure can reduce the risk of stroke, heart attack, heart failure and other conditions, but many people have a very difficult time achieving blood pressure control.

As many as 73 million Americans have high blood pressure. But because high blood pressure doesn’t cause symptoms, most people who have it, don’t know it.

Over time, uncontrolled blood pressure affects the blood vessel walls, encouraging the growth of weak spots called aneurysms and the formation of narrowed and inflamed areas that can lead to clots that can break off and cause heart attacks and strokes.

Fortunately, once the condition is diagnosed, doctors have a broad range of medicines to choose from to try to get it under control, including many inexpensive generic medicines.

But studies have found that patients often have trouble taking the multiple medications they need. As a result, many companies have developed combination pills.

The study was funded by Novartis, which is among the companies that offer two-drug combination tablets for blood pressure treatment.
ACCOMPLISH stands for Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension.

No Drop in I.Q. After Bypass for Child Heart Surgery

2008-11-13T05:42:00.000-08:00

The use of cardiopulmonary bypass does not cause short-term neurological problems in children and teenagers after surgery for less complex heart defects, according to pediatric researchers. The new finding contrasts favorably with previous studies that showed adverse neurological effects after newborn surgery for more complex heart conditions.

“This is good news for school-aged children who receive surgery for these less complex heart defects,” said study leader Michael D. Quartermain, M.D., a pediatric cardiologist at The Children’s Hospital of Philadelphia. Quartermain presented the study group’s results at the American Heart Association’s Scientific Sessions today in New Orleans.

The research, conducted at the Cardiac Center of Children’s Hospital, studied 41 patients, aged five to 18, who underwent heart surgery at the hospital while a heart-lung machine circulated their blood (under cardiopulmonary bypass, or CPB). All the patients had milder forms of congenital heart disease usually characterized by an abnormal heart valve or by a hole between the heart’s chambers.

Such defects, while present from birth, are often not detected until a patient is school age or even older. Patients do not show obvious symptoms and are otherwise healthy, but surgical intervention is often recommended to prevent complications later in life. In contrast, more complex congenital heart defects, such as hypoplastic left heart syndrome, a severely underdeveloped ventricle, are life-threatening in infancy, and require urgent surgical repair.

Previous studies of survivors of more complex heart surgery have found neurological problems, such as impaired motor development, lower I.Q. scores and reduced language skills. As medical regimens and surgical techniques have advanced, more recent studies have found milder neurological problems or normal neurological outcomes, but long-term outcomes remain a concern. Likewise, adults with acquired heart disease have sometimes suffered adverse neurological outcomes after surgery with CPB.

In the current study, researchers compared 41 pediatric heart patients who underwent CPB to a control group receiving non-heart-related surgery without CPB. Neurological and developmental testing were performed two weeks before and six months after surgery in both groups. When controlling for the effects of hospitalization and anxiety, the researchers found no significant difference between the two groups in I.Q. scores and tests of memory, motor skills or attention. Neither of the surgical groups showed a decline in neuropsychological scores after surgery.

Regarding the implications of the study, Quartermain said, “It is often challenging for the cardiologist to determine the optimal time to refer a child without symptoms to the operating room for repair of an underlying congenital heart defect. It is now clear that the potential neurodevelopmental sequelae of cardiopulmonary bypass in this group of school-aged patients should not be a major factor in this important decision.”

About The Children’s Hospital of Philadelphia: The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu.

A Growing Problem for Veterans -- Domestic Violence

2008-11-07T11:16:00.000-08:00

"The increasing number of veterans with posttraumatic stress disorder (PTSD) raises the risk of domestic violence and its consequences on families and children in communities across the United States," says Monica Matthieu, Ph.D., an expert on veteran mental health and an assistant professor of social work at Washington University in St. Louis.

"Treatments for domestic violence are very different than those for PTSD. The Department of Veterans Affairs (VA) has mental health services and treatments for PTSD, yet these services need to be combined with the specialized domestic violence intervention programs offered by community agencies for those veterans engaging in battering behavior against intimate partners and families."

Matthieu and Peter Hovmand, Ph.D., domestic violence expert and assistant professor of social work at Washington University, are merging their research interests and are working to design community prevention strategies to address this emerging public health problem.

"The increasing prevalence of traumatic brain injury and substance use disorders along with PTSD among veterans poses some unique challenges to existing community responses to domestic violence" says Hovmand.

"Community responses to domestic violence must be adapted to respond to the increasing number of veterans with PTSD. This includes veterans with young families and older veterans with chronic mental health issues."

Even as the demographic of the veteran population changes as World War II veterans reach their 80s and 90s and young veterans completing tours of duty in Iraq and Afghanistan, the numbers of living veterans who have served in the United States military is staggering. Current estimates indicate that there are 23,816,000 veterans.

Matthieu says there are evidence-based psychological treatment programs that can be a great resource for clinicians to learn how to identify and treat PTSD symptoms. However, identifying battering behaviors among veterans with active PTSD symptoms may be difficult and may require consultation and referral to domestic violence experts.

Research in the VA shows that male veterans with PTSD are two to three times more likely than veterans without PTSD to engage in intimate partner violence and more likely to be involved in the legal system.

"Community violence prevention agencies and services need to be included in a veteran's treatment plan to address the battering behaviors," says Hovmand.

"Veterans need to have multiple providers coordinating the care that is available to them, with each provider working on one treatment goal. Coordinated community response efforts such as this bring together law enforcement, the courts, social service agencies, community activists and advocates for women to address the problem of domestic violence. These efforts increase victim safety and offender accountability by encouraging interorganizational exchanges and communication.

"Veterans Day is an excellent reminder that we need to coordinate the services offered by the VA and in the community to ensure that our veterans and their families get the services they need when they need it," Matthieu and Hovmand say.

New Vaccines for Adults: Which Do You Need?

2008-11-05T23:06:00.000-08:00

Most adults are not up to date on their vaccinations, says a new report from Harvard Medical School. The report, Viruses and Infectious Diseases, describes how fast-adapting viruses pose an advancing threat to human health and urges adults to seek out new vaccines and renew their old ones.

The new report explains how viruses and other infections affect the body, and what adults should do to protect themselves. It warns adults not to assume that the vaccines they received as children will protect them for life. Here are some of the reasons adults need vaccination:

• Some adults were never vaccinated as children.

• Newer vaccines were not available when today’s adults were children.

• Immunity can begin to fade over time.

• As you age, you become more susceptible to serious disease caused by common infections.

• You may travel to areas where infectious diseases that are rare where you live are much more common.

• You may come in contact with people who have been exposed to unusual infectious diseases.

The FDA is understandably cautious and very demanding before it will license a new vaccine. But it has recently licensed several vaccines against important infectious agents: HPV (human papillomavirus, which causes cervical cancer), varicella-zoster virus (which causes chickenpox and shingles), and meningococcus (which causes bacterial meningitis). The FDA has also approved a preliminary bird flu vaccine to keep stockpiled in case of a bird flu pandemic. Find out about these and other new vaccines in the Special Section of Viruses and Infectious Diseases, "The newer vaccines: Do you need them?"

Viruses and Infectious Diseases, a 49-page Special Health Report edited by Michael N. Starnbach, Ph.D., Professor of Microbiology, Harvard Medical School, also covers such topics as these:

• Infectious disease in the 21st century

• Transmission of infectious disease

• Common and not-so-common viruses

Simple Blood Test Predicts Obesity

2008-11-01T13:52:00.000-07:00

According to new research from the Monell Center, the degree of change in blood triglyceride levels following a fatty meal may indicate susceptibility to diet-induced obesity. The findings open doors to new methods of identifying people, including children, who are at risk for becoming obese.

Triglycerides are a form of fat that is transported in the blood and stored in the body’s fat tissues. They are found in foods and also are manufactured by the body.

“These findings suggest we may someday be able to use a simple blood test to identify those at risk for obesity,” said senior author Mark Friedman, PhD, a behavioral physiologist at Monell. “The ability to identify more susceptible individuals would make it possible to target obesity-prevention resources on those who need them most.”

The global obesity epidemic is thought to be caused in part by consumption of a diet high in fat and carbohydrates, which promotes weight gain. This propensity to gain weight and become obese when consuming a high-fat diet is at least partially controlled by genes, with some individuals gaining more than others while eating the same diet.

In the study, published in the International Journal of Obesity, Friedman and lead author Hong Ji, PhD, screened rats for vulnerability to diet-induced obesity by measuring the increase in blood triglyceride levels following a single high-fat meal. They then fed the rats a diet high in fat over the next four weeks.

The researchers were able to predict which animals would become obese over the four-week period by examining the earlier metabolic response to the high-fat meal: the smaller the triglyceride change, the greater the weight gain.

There currently are no simple biomarkers for predicting susceptibility to diet-induced obesity, and thus no clinical tests that assist physicians in identifying those at risk for becoming obese. The current findings suggest that a change in blood triglyceride levels may someday be used as such a tool.

Future studies will entail a thorough investigation of the mechanism behind differences in the change in blood triglycerides.

“The differences in weight gain associated with high-fat diets indicate that genetically-determined factors contribute to obesity,” notes Friedman. “We have shown that these genetic factors are related to the body’s ability to burn fat. We now need a better understanding of how this relates to blood triglyceride levels.”

Longer term, Friedman, who received a 2008 Guggenheim Fellowship to pursue his studies on diet and obesity, hopes to determine whether such a blood test is predictive of future weight gain in humans.

The Monell Chemical Senses Center is a nonprofit basic research institute based in Philadelphia, Pennsylvania. For 40 years, Monell has been the nation’s leading research center focused on understanding the senses of smell and taste: how they function and affect lives from before birth through old age. Using a multidisciplinary approach, scientists collaborate in the areas of: sensation and perception, neuroscience and molecular biology, environmental and occupational health, nutrition and appetite, health and well being, and chemical ecology and communication. For more information about Monell, visit www.monell.org.

If You Have Rheumatoid Arthritis and You Smoke, Listen Up

2008-10-27T13:19:00.000-07:00

Tossing your cigarettes may help control your rheumatoid arthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.

Rheumatoid arthritis is a chronic disease that causes pain, stiffness, swelling, and limitation in the motion and function of multiple joints. Though joints are the principal body parts affected by RA, inflammation can develop in other organs as well. An estimated 1.3 million Americans have RA, and the disease typically affects women twice as often as men.

Smoking is known to increase the risk and severity of RA. Smoking cessation has been shown to have a positive impact in slowing the progression of other diseases such as coronary disease and emphysema.

Researchers recently evaluated 14,847 patients with RA based on their smoking status. Of those, 65.4 percent were non-smokers, 22.1 percent were former smokers, and 12.5 percent were active smokers. Smoking cessation was defined as patient-reported cessation over two consecutive physician office visits, and independent variables in the study included patient age, gender, ethnicity, rheumatoid factor status, and use of different therapies for treating RA.

Researchers primarily monitored change in Clinical Disease Activity Index—a composite measure of disease activity in people with RA that assesses change over time— as well as other measures of disease activity including tender and swollen joint counts and laboratory tests.

Among 1,405 patients who smoked at enrollment into the registry, 21.1 percent successfully stopped smoking. In comparing this group to patients who continued to smoked, researchers found no significant differences in disease duration, rheumatoid factor or CCP status, non-biologic DMARD or biologic use. However, at the last follow-up visit, Clinical Disease Activity Index was higher among active smokers than among patients who had stopped smoking. Individual measures of active disease including swollen and tender joint counts and C-reactive protein were all lower in the patients who had stopped smoking.

These results suggest that stopping smoking can lessen RA disease activity over and above current medical treatment.

"While these results are preliminary, it seems that quitting smoking, which would have many other health benefits, also may benefit patients with rheumatoid arthritis,” explains Mark C. Fisher, MD, MPH; Research Fellow, NYU Medical Center; Hospital for Joint Disease, New York, N.Y. “RA patients who stop smoking may see an improvement in the number of joints that hurt them every day and in how they feel overall,” he says, noting that further research is necessary to confirm these early findings.

The ACR is an organization of and for physicians, health professionals, and scientists that advances rheumatology through programs of education, research, advocacy and practice support that foster excellence in the care of people with or at risk for arthritis and rheumatic and musculoskeletal diseases. For more information on the ACR’s annual meeting, see www.rheumatology.org/annual.

Men Who Never Smoke Live Longer, Better Lives Than Heavy Smokers

2008-10-14T12:54:00.000-07:00

Health-related quality of life appears to deteriorate as the number of cigarettes smoked per day increases, even in individuals who subsequently quit smoking, according to a report in the October 13 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Smoking has been shown to shorten men’s lives between seven and 10 years, according to background information in the article. It also has been linked to factors that may reduce quality of life, including poor nutrition and lower socioeconomic status.

Arto Y. Strandberg, M.D., of the University of Helsinki, and colleagues followed 1,658 white men born between 1919 and 1934 who were healthy at their first assessment, conducted in 1974. Participants were mailed follow-up questionnaires in 2000 that assessed their current smoking status, health and quality of life. Deaths were tracked through Finnish national registers.

During the 26-year follow-up period, 372 (22.4 percent) of the men died. Those who had never smoked lived an average of 10 years longer than heavy smokers (more than 20 cigarettes per day). Non-smokers also had the best scores on all health-related quality of life measures, especially those associated with physical functioning. Physical health deteriorated at an increasing rate as the number of cigarettes smoked per day increased, with heavy smokers experiencing a decline equivalent to 10 years of aging.

“Although many smokers had quit smoking between the baseline investigation in 1974 and the follow-up examination in 2000, the effect of baseline smoking status on mortality and the quality of life in old age remained strong,” the authors write. “In all, the results presented here are troubling for those who were smoking more than 20 cigarettes daily 26 years earlier; in spite of the 68.9 percent cessation rate during follow-up, 44.1 percent of the originally heavy smokers had died, and those who survived to the mean [average] age of 73 years had a significantly lower physical health-related quality of life than never-smokers.”

The findings may add to the view of smoking as a burden on society and might also encourage individual smokers to quit, the authors note. “The argument of better quality of life may be especially meaningful for the aging smoker but, as our results show, for the best health-related quality of life, the habit should not be started at all,” they write. “The highly addictive nature of nicotine is revealed by the persistence of the smoking habit in spite of the declining health-related quality of life among older heavy smokers. For those not able to quit smoking, reduction may also be beneficial because mortality [death] and health-related quality of life showed a dose-dependent trend according to the number of cigarettes smoked daily.”

Additional papers related to smoking in the October 13 issue found that:

Offering smoking cessation counseling to hospitalized smokers appears to be effective as long as supportive contacts are offered for more than one month after discharge. Nancy A. Rigotti, M.D., of Massachusetts General Hospital and Harvard Medical School, Boston, and colleagues reviewed 33 trials of smoking cessation interventions that began during hospitalizations. Programs that offered telephone or in-person support lasting longer than one month improved smoking cessation rates six to 12 months after discharge. “Adding nicotine replacement therapy to counseling may further increase smoking cessation rates and should be offered when clinically indicated, especially to hospitalized smokers with nicotine withdrawal symptoms,” the authors write.

Hospital-based smoking cessation programs, along with referrals to cardiac rehabilitation, also appear to be associated with increased rates of quitting smoking following heart attack. Nazeera Dawood, M.D., M.P.H., at Emory University School of Medicine, Atlanta, and colleagues studied 639 patients who smoked at the time of their hospitalization for myocardial infarction (heart attack). Six months later, 297 (46 percent) had quit smoking. The odds of quitting were greater among patients who received discharge recommendations for cardiac rehabilitation and those who were treated at a facility offering an inpatient smoking cessation program; however, individual counseling was not associated with quit rates.

A pay-for-performance program may increase referrals to tobacco quitline services, particularly among clinics who have not previously participated in quality improvement activities. Lawrence C. An, M.D., of the University of Minnesota, Minneapolis, and colleagues randomly assigned 24 primary care clinics to participate in a program offering $5,000 for 50 quitline referrals. Between Sept. 1, 2005, and June 31, 2006, these clinics referred 11.4 percent of eligible smokers, compared with 4.2 percent among 25 clinics offering usual care. “Quitlines are widely available, and application of pay-for-performance strategies to encourage health care provider referral should be strongly considered by health care organizations seeking to reduce the health and economic burden of tobacco-related disease,” the authors write.

“Smoking remains the largest avoidable cause of death and disability in the United States, but it is a problem against which we are making steady albeit far too slow progress,” writes David M. Burns, M.D., Del Mar, Calif., in an accompanying editorial. “Smoking cessation is one of the most important changes needed to achieve the goal so often articulated by Dr. Ernst Wynder, one of the founders of the field of preventive medicine: die young as late in life as possible.”

Why Do Women Get More Cavities than Men?

2008-10-14T12:51:00.000-07:00

Reproduction pressures and rising fertility explain why women suffered a more rapid decline in dental health than did men as humans transitioned from hunter-and-gatherers to farmers and more sedentary pursuits, says a University of Oregon anthropologist.

The conclusion follows a comprehensive review of records of the frequencies of dental cavities in both prehistoric and living human populations from research done around the world. A driving factor was dramatic changes in female-specific hormones, reports John R. Lukacs, a professor of anthropology who specializes in dental, skeletal and nutritional issues.

His conclusions are outlined in the October issue of Current Anthropology. The study examined the frequency of dental caries (cavities) by sex to show that women typically experience poorer dental health than men. Among research reviewed were studies previously done by Lukacs. Two clinical dental studies published this year (one done in the Philippines, the other in Guatemala) and cited in the paper, Lukacs said, point to the same conclusions and "may provide the mechanism through which the biological differences are mediated."

A change in food production by agrarian societies has been associated with an increase in cavities. Anthropologists have attributed men-women differences to behavioral factors, including a sexual division of labor and dietary preferences. However, Lukacs said, clinical and epidemiological literature from varied ecological and cultural settings reveals a clear picture of the impacts on women's oral health.

"The role of female-specific factors has been denied by anthropologists, yet they attain considerable importance in the model proposed here, because the adoption of agriculture is associated with increased sedentism and fertility," Lukacs said. "I argue that the rise of agriculture increased demands on women’s reproductive systems, contributing to an increase in fertility that intensified the negative impact of dietary change on women’s oral health. The combined impacts of increased fertility, dietary changes and division of labor during the move into agricultural societies contributed to the widespread gender differential observed in dental caries rates today."

Lukacs' meta-analysis looked at both prehistoric anthropological and modern health records. He repeatedly found that increases in cavities go in favor of women in adulthood. Lukacs' review found that women’s higher rates of cavities are influenced by three main changes:

• Female sex hormones. Citing his own research published in 2006, he notes that these hormones and associated physiological factors can significantly impact cavity formation. A study on animals published in 1954 found that female estrogens, but not male androgens, were correlated to cavity rates. He argues for a cumulative effect of estrogens, including fluctuations at puberty and high levels during pregnancy that both promote cavities and dietary changes.

• The biochemical composition and flow rate of saliva. Women produce less saliva than do men, reducing the removal of food residue from the teeth, and that during pregnancies the chemical composition changes, reducing saliva's antimicrobial capacity.

• Food cravings, immune response and aversions during pregnancy. Lukacs points to findings that women crave high-energy, sweet foods during the third trimester, as well as an aversion to meat in first trimesters.

How the factors combine to contribute to higher risk of cavities in women as they age is not fully documented or understood, he wrote. "However, if hormonal and physiological factors work in an independent or additive manner, their impact on women's oral health could be significant. The fact that women's caries experience increases with age at a greater rate than men's in diverse ethnic groups from different ecological and cultural settings supports this interpretation."

The Alexander von Humboldt Foundation, American Institute of Indian Studies, American Philosophical Society, L.S.B. Leakey Foundation, National Geographic Society, National Science Foundation and Wenner-Gren Foundation for Anthropological Research supported the project.

Free Clinics Now Providing Healthcare Solutions to the Uninsured

2008-10-09T23:57:00.001-07:00

In over 66 communities across the country, 250,000+ retired physicians and 350,000 retired nurses are now providing a solution to the healthcare crisis. Volunteers in Medicine (VIM), an organization whose mission is to promote and guide the development of a national network of free clinics, is utilizing retired medical professionals and lay volunteers to care for the uninsured within a culture of caring.
Volunteers in Medicine (VIM) began in Hilton Head, South Carolina. In 1992, one out of three people who lived on Hilton Head Island had no access to health care. At the same time, a number of retired medical personnel (physicians, nurses, dentists) expressed an interest in finding a way to continue practicing their profession on a voluntary, part-time basis to help those without access to health care. So these two groups were brought together to create the first Volunteers in Medicine Clinic. Since then, 66 VIM free clinics have opened in 22 states across the country.

"No community can be truly healthy if a significant portion of the population is excluded from basic health care services," says Amy Hamlin, executive director of Volunteers in Medicine. "In the absence of a national health policy that includes health care for everyone, concerned citizens need to find other solutions to provide the medically under-served with the health care services they desperately need. Volunteers in Medicine delivers on such solution."

The statistics are staggering; 47 million people in this country have no medical insurance. Another 25 million are underinsured, up 60% in just four years with middle and higher income families comprising most of that increase. The impact on the infrastructure of towns and cities is equally staggering. When people are injured or sick, they can't work, effecting employers and their ability to provide goods and services. When people postpone seeking medical care, their medical conditions get worse and more costly to treat. And without adequate health insurance, emergency rooms become the default. This is particularly difficult, as emergency departments have seen cuts in reimbursements, while at the same time ER visits are at record highs across the country. This creates a cost-shift, which means higher premiums for everyone.

Even if everyone were to become insured tomorrow, there is not enough current or future primary care capacity to provide health care to all Americans. Over one-third of active physicians are over age 55 and with many choosing early retirement, there will be a deficit of primary care physicians by 2020. Faced with lower reimbursement rates, excessive work loads, and rising medical school costs, fewer graduates are choosing primary care. "Empowering retired physicians to practice the 'pure medicine' they crave without the 'business' of medicine is the common sense approach that Volunteers in Medicine provides. This is one solution to improving the long term health of our country," continued Hamlin.

Some 313,000 of the active physician population are over 55. This means that 36% of active physicians are set to retire by 2020 while at the same time there are only 105,000 physicians in residency training. Contrary to predictions in the 1980's and 1990's, there will not be a surplus of physicians in the 21st Century but rather we will face a physician shortage. "The statistics on current and projected physician numbers further support the ongoing effectiveness that the VIM model will have in improving the healthcare of our country long term," continued Hamlin.

Time Management -- Tips to Reduce Stress

2008-10-09T13:41:00.000-07:00

Many women know the overwhelmed feeling caused by too much to do and too little time. Better time management can help you do more. And it has health benefits, such as less stress and a better quality of life.

The October issue of Mayo Clinic Women’s HealthSource offers tips to improve time management. The recommendation is to try one strategy for two to four weeks to see if it helps. If it does, add another. If not, try a different one. Here’s a few to consider:

Plan each day. A schedule minimizes conflicts and last-minute rushes. Write a to-do list with the most important tasks at the top. Even if you don’t get through the list, you’ll know time was spent constructively.

Say no to nonessential tasks. Let priorities determine your schedule rather than letting guilt have the final say.

Delegate. Consider what you can eliminate or delegate from your to-do list. Be willing to let others do tasks differently from how you do them.

Take time to do a quality job. Doing something right the first time may take more time up front, but errors caused by rushing may require longer to correct.

Practice the 10-minute rule. Work on dreaded tasks for 10 minutes each day. Once a task is started, you may be able to finish it.

Evaluate how you are spending your time. Keep a diary for three days to track tasks. Look for time that could be used more wisely, freeing up time to spend exercising or with family and friends.

Get plenty of exercise and sleep. Improved focus and concentration help increase efficiency, so you can complete tasks in less time.

Take a time management course. Employers, community colleges and community education programs often offer these classes.

Take a break when needed. Too much stress can derail attempts at getting organized. When you need a break, take one. Take a walk. Do some quick stretches. Take time for a day of relaxation when you need it.

If you are too frazzled to manage your time better, and life feels out of control, ask for help. Consider discussing your situation with a doctor or mental health professional.

Mayo Clinic Women’s HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9751, or visit http://www.bookstore.mayoclinic.com.

Infants Can Tell Happy Songs from Sad

2008-10-09T13:38:00.000-07:00

A new study shows that 5-month-old babies can distinguish an upbeat tune, such as “Ode to Joy” from Beethoven’s Ninth Symphony, from a lineup of gloomier compositions.

By age 9 months, babies can do the opposite and pick out the sorrowful sound of Beethoven’s Seventh Symphony from a pack of happy pieces.

The musical experiments offer another example of how babies make sense of the world long before they can talk, says Brigham Young University psychology professor and study author Ross Flom.

“One of the first things babies understand communicatively is emotion, so for them the melody is the message,” Flom said. “Our study showed that by nine months, babies are categorizing songs as happy or sad the same way that preschoolers and adults do.”

The results of the musical study will be published in the upcoming issue of the academic journal Infant Behavior and Development.

Given the challenge of peering inside babies’ minds, the researchers designed experiments that take advantage of what babies say with their eyes.

First they displayed an emotionally-neutral face for the baby while music played. When the baby looked away from the face, the music stopped and the researchers queued up a new song from a playlist of five happy and five sad songs. For each song, observers recorded how long the baby paid attention to the face. The babies that noticed a switch from happy to sad, or vice versa, stared at the face three to four seconds longer than usual because of their heightened interest.

This method of measuring how long it takes for babies to get bored is the same principle behind a 2007 study published in the journal Science that shows 4- and 6-month-old babies from English-only households can tell different languages are being spoken simply by watching and not hearing the person speaking.

“People of all ages reveal quite a bit through what they choose to look at and how much time they spend attending to that event,” Flom said. “The only trick is to come up with the right presentation to test an idea about how and what babies learn.”

The researchers selected songs with the greatest consensus as happy or sad based on ratings by average adults and children.

BYU music professor Susan Kenney, who was not involved with the study, noted some of the technical differences between the happy and sad songs the babies heard.

“The happy songs were all in major keys with fairly short phrases or motives that repeated,” Kenney said. “The tempo and melodic rhythms were faster than any of the sad selections, and the melodies had a general upward direction. Four of the sad songs were in minor keys and all had a slower beat and long melodic rhythms. For an infant to notice those differences is fascinating.”

Flom says this period of learning about emotion in sounds is a natural step before learning to talk.

“Infants master so many things in such a short time frame,” Flom said. “I can’t think of a better line of inquiry than how infants learn so much so quickly.”

Douglas Gentile of Iowa State University and Anne Pick of the University of Minnesota are co-authors on the study.

Managing Gas Isn't Rocket Science

2008-10-08T12:21:00.000-07:00

Daily flatulence is normal and necessary. In fact, the average person passes gas about 14 times per day (the human body produces one to three liters daily). However, every body behaves differently and some experience more gas than others. If you are one of those unlucky few, follow these recommendations from gastroenterologist Patricia Raymond, MD on how to minimize it:

Rocket

Keep a gas diary - If gas has become more than just an occasional nuisance, try to determine if your gas is related to a particular food by noting the volume of gas within six hours of your last meal. It takes about a full six hours for portions of a meal to be released as gas, so if you have a particularly gassy sensation, it might not be that snack you just ate, but the meal you had earlier in the day. If you find that you are gassy, note all items in your last several meals to crosscheck against other meal periods where you experience gas.

Determine odor - Non-smelling flatulence results from swallowed air, which is symptomatic of chewing gum, drinking through straws, sucking on hard candies or nervousness, rather than something you've eaten. Foul-smelling flatulence is related to the breakdown of actual foods as they go through the intestinal tract. If nutrients are poorly absorbed, they 'feed' bacteria in the gut, which then produces the smelly flatulence.

Deactivate gas fast - Dr. Raymond suggests taking CharcoCaps® Homeopathic Formula products as a natural and safe way to relieve gas/flatulence. The activated charcoal/carbo vegetabilis in CharcoCaps is commonly used by people suffering from gas discomfort, pressure and bloating, since it serves to adsorb the gas, reducing both the gas and its smell.

Certain foods in moderation - Certain foods have a higher propensity to produce gas, since they are poorly absorbed by individuals, while others cause gas in just about everyone. They include beans, cabbage, onions, Brussels sprouts, cauliflower, broccoli, asparagus and corn; fruits such as pears, apples, prunes and peaches; whole grain products and oats; milk, ice cream and cheese; and carbonated drinks, fruit juices and alcohol.

Walk it off - Instead of keeping still after a meal, get moving: take a post-dinner stroll, do some chores around the house, or walk the dog. Not only is this a nice excuse for a bit of exercise, but it will keep your body moving and gas flowing.

Consult your doctor - If excessive or malodorous gas persists, see a doctor. What's making your belly bloat might not be gas, but a symptom of an underlying condition, such as irritable bowel syndrome (IBS), celiac disease, pancreatic insufficiency or lactose intolerance. A gastroenterologist can make these determinations and prescribe proper diet and/or medication.

You can also become friends with Gary Gasman the CharcoCaps spokesman on Facebook.

Hip Fracture: What Women Need to Know

2008-10-08T11:48:00.000-07:00

Love them or hate them, a woman’s hips are a vital part of her daily life, and keeping them healthy is important. Fracturing a hip can be incredibly serious. Only one in four women with a broken hip makes a full recovery and one out of four women over 50 who suffer a hip fracture dies within one year. Furthermore, more than 352,000 people in the U.S. suffer hip fractures each year, 90 percent as a result of a fall. Despite these statistics, awareness and concern of the risks associated with hip fracture remains low, according to Donnica Moore, M.D., president of the Sapphire Women's Health Group and nationally renowned women’s health expert.

“Having healthy hips is vitally important to anyone who wants to live a healthy, active life,” says Dr. Moore. “However, there is still room for most women to educate themselves on hip fracture and how to lower their risks.”

According to a recent survey commissioned by GlaxoSmithKline Consumer Healthcare among women aged 45 to 64, 80 percent of those polled said that they do not worry about hip fracture. Also, although 92 percent noted that hip fracture could lead to the loss of the ability to walk properly or at all, many did not realize some other serious consequences associated with it.

To help women increase their knowledge of hip health and share vital information about the condition with other women that they care about, Os-Cal has created a new online resource, www.oscal.com/bumpitup. This new Web site also helps women learn more about the risks of hip fracture and how to protect their hips, and features hip fracture facts, ways to reduce risk, questions to ask the doctor, information about calcium and vitamin D and useful tools like a calcium calculator and a fracture risk calculator. Each woman who passes along hip health information to a friend will receive a downloadable $3 coupon for any Os-Cal product, and visitors to the site can also enter a sweepstakes for a chance to win a trip to Hollywood.

Role of Calcium and Vitamin D

While about three out of four women said they consider taking care of their hips an important part of their healthcare regimen, not enough are taking the proper steps to do so. For instance, while taking a calcium and vitamin D supplement like Os-Cal is one of the best ways to keep bones strong, about a third of women 45 to 64 said they do not currently take one. Of those that do take calcium supplements, only about one out of six is taking them properly, in twice daily doses.

“Adequate calcium intake is one of the best defenses against hip fracture,” says Dr. Moore. “And while many people assume they take in enough calcium, more than 75 percent of all Americans are not getting enough in their diet.”

According to the National Institutes of Health (NIH), vitamin D is also essential for efficient calcium absorption – without it, bones can become thin and brittle. And like calcium, many people do not get enough. More than 70 percent of women 51 to 70 and almost 90 percent of women over 70 are vitamin D deficient.

"Even when women try to get enough calcium and vitamin D through diet, it's still usually not enough," says Dr. Moore. "Women can make simple choices in order to take a more active role in managing their bone health, and taking a calcium supplement like Os-Cal is a great first step."

Exercise Helps Reduce Pain, Disability After Lower Back Surgery

2008-10-08T11:42:00.000-07:00

Lumbar spine (lower back) surgery is a common treatment for a herniated or “slipped” disk, and patients need to know whether it is better to sit still or get moving during their recovery period.

An updated review from the Netherlands suggests that exercise programs starting four to six weeks after the operation could lead to more rapid pain relief and a quicker recovery from disability — without increasing the risk of additional surgery.

“Many people are operated on because of a herniated lumbar disc but there is still controversy with regard to rehabilitation,” said lead author Raymond Ostelo, Ph.D., at the VU University Medical Center in Amsterdam. “[Although] many different rehabilitation programs are available and prescribed for patients, some surgeons say that patients don’t need rehabilitation programs at all once they are discharged from the hospital.”

However, the review findings support a more active approach.

“In general, it appears that patients who participated in exercise programs recovered somewhat faster than those who received no treatment and that patients who participated in high-intensity programs reported slightly less short-term pain and disability than those in low-intensity programs,” Ostelo said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The updated review included 14 randomized controlled trials involving 1,927 participants.

There was a great deal of variation in the programs available following surgery, ranging from only stretching and strength training at home to 90 minutes of intensive aerobic, strength and stretching exercises three times a week.

The amount of support that patients received also varied widely: from a single two-hour training session to multiple visits with a team that included physiatrists, physical and massage therapists, and social workers. Because of the large differences in treatments, the authors were unable give guidance on which kind of exercise program works better.

None of the studies reported an increase in the number of patients who required additional surgery. There were also no indications that patients should restrict their activity after surgery.

“Given the ongoing controversy regarding the type — if any — and timing of rehabilitation programs, this review highlights that it seems to be a good idea to follow an exercise program and return to daily activities as soon as possible,” Ostelo said.

“It is hard to make sweeping generalizations about all the different types of back surgeries that are done,” said Joel Press, M.D., an associate professor of physical medicine and rehabilitation at Northwestern University’s Feinberg School of Medicine in Chicago. “These results show that there was no evidence suggesting that exercise programs were increasing the rates of re-operation. Sitting too long often will hurt the patient more than getting up and moving.”

Why Women's Feet Hurt More in Autumn

2008-10-01T14:12:00.000-07:00

Fall is not a fun time of year for women like Elaine Powers.

In the summer months, "like everybody else, I like to wear flip-flop sandals, open-toed shoes, a nice pedicure with good nail polish," she says.

But as autumn arrives, the 49-year-old South Carolina hospice nurse is making the annual changeover to closed-in shoe styles more appropriate to the cooler weather. It's a transition many women are making in their wardrobes. But it's more painful for women like Powers, and not because she's a slave to foot fashion. Powers has bunions.

"Even after you take your shoes off, or put your feet up, it's just a throbbing… It's almost like every time your heart beats, that bunion throbs," she says.

Women with bunions are a common sight in the waiting rooms of many foot and ankle surgeons during this time of year, according to the 6,000-member American College of Foot and Ankle Surgeons (ACFAS).

St. Louis foot and ankle surgeon Karl Collins, DPM, FACFAS, gives two additional reasons for this annual trend. One is financial. Women are closer to meeting insurance deductibles near the end of the year.

"The other thing is, people are very active in the summer," Collins says. "They're always outdoors, they're always at the pool or whatever, so they will decide to get their bunion fixed in the winter, because in their mind, they're not missing anything fun."

Powers has suffered with bunion pain for nearly 25 years. However, many women never experience pain from their bunions, even when the deformity looks severe. Shoes do not cause bunions, but they may cause bunion pain. That's why foot and ankle surgeons recommend shoe modifications to new patients. Avoiding high heeled shoes and styles that crowd the toes together can help. Collins says proper shoe selection and adjustment can go a long way.

"If they have a shoe that fits well everywhere else, but there's just a little bit of irritation at just that one spot, we may recommend that they have the shoe modified (by a shoe repair shop)," he says.

South Carolina foot and ankle surgeon Michelle L. Butterworth, DPM, FACFAS, treats a lot of teachers with back to school bunion pain. She says many women don’t understand what doctors mean about shoe width: It's the front of the shoe that needs to be wide.

"Anything that's real pointy is going to put more pressure on that (bunion) bump," she explains.

In addition to recommending shoe changes, foot and ankle surgeons may also prescribe foam- or gel-filled padding, orthotics, anti-inflammatory medications, and injections for bursitis, nerve irritation and joint irritation. While these techniques address pain, they do not stop the bunion from getting worse. Only surgery can correct the deformity.

Bunion surgery boasts a high success rate. But surgeons agree that patients need to understand what their procedure and recovery will involve.

"Probably the biggest thing is, they think surgery's not going to work and (the bunion is) going to come back," says Butterworth. "It's probably the biggest myth I dispel."

Powers is one of her patients.

"That's one of the reasons why I haven't had this surgery before now," Powers says. "A lot of people tell me once you have (bunions), you are always prone to have them, they'll come back."

Following the surgeon's instructions for recovery can significantly reduce the chances of a bunion returning.

"If wearing four-inch heels and working on your feet all day wasn't good for you before the surgery, it's certainly not going to be good for you after the surgery," notes Michael Loshigian, DPM, FACFAS, a New York City foot and ankle surgeon.

Powers hasn't made up her mind about bunion surgery. She's already tried prescription pain medication, and struggles to find comfortable shoes. This fall, Butterworth will perform bunion surgery on Powers' 19-year-old daughter, who inherited her mother's feet. Powers wants to see how that turns out. She also has to worry about finding someone to cover her 12-hour work shifts for several weeks.

But if she does choose surgery, she already knows how she'll celebrate after her recovery.

"I'm buying a pair of stiletto heels and I'm wearing them everywhere I go," she jokes.

The ACFAS provides a list of answers to frequently asked questions about bunion surgery on http://FootPhysicians.com.

One Day Could Change Your Life

2008-09-30T03:41:00.000-07:00

7.3 million American women have difficulty conceiving and need help starting a family. The numbers may be just as high among men. A woman’s fertility begins to decline in her mid 20’s and men follow ten years later. Oftentimes when a couple first finds out they’re facing these challenges they’re unaware of the options available.

The American Fertility Association brings you Family Matters NY 2008, October 5th, at Steiner Studios in the Brooklyn Navy Yard. This annual, day-long conference brings you everything you need to know about trying to conceive or wanting to adopt.

A faculty of experts has been assembled to make sure that participants receive great value for their time. Panel discussions have been added, so that participants have the opportunity to hear from and ask questions of multiple health care professionals in most of the sessions.

Family Matters NY 2008 has a limited supply of tickets and booths for sale. Thanks to a generous grant, 25 scholarships are available to cover the $40 registration fee for those who would like to attend but are having financial difficulties. To apply, submit your request to info@theafa.org or call 888.917.3777.

An exhibit hall will feature companies providing the most up-to-date information available to support your family-building journey. The day starts off with a continental breakfast and wraps up with a wine and cheese reception. This venue also gives you a unique and valuable opportunity to interact with others who are experiencing the same challenges in a beautiful setting. Steiner Studios is on the waterfront in Brooklyn and has picture windows overlooking New York City.

All those who are interested in family building - young, mature, gay, straight, single, married or partnered - are enthusiastically invited to attend. Whether you are just beginning to think about family-building or actively trying to conceive or considering adoption - Family Matters NY is for you.

For more information or to register, visit http://www.theafa.org and click on the Family Matters banner or e-mail lisav@theafa.org or corey@theafa.org. You can also call 888.917.3777.

The American Fertility Association, a 501(c)(3) non-profit organization, is a lifetime resource for fertility preservation, reproductive health and family-building. We offer services through our free membership program, including an extensive online library, weekly online chats, telephone and in-person coaching, hosted message boards and a toll-free support line. Contact us at http://www.theafa.org or 888.917.3777.

Seven Habits (To Break) Of Highly Effective People

2008-09-27T05:13:00.000-07:00

During tough financial times, many people try to demonstrate their value at work by working harder and longer. But, if you don’t also make time to take care of yourself, success may come at a hefty cost: your health.

“Many people feel like they have to push themselves to unhealthy levels in order to succeed. But high-pressure jobs and long hours take a real toll on your immediate and future health,” says George Griffing, M.D., professor of internal medicine at Saint Louis University.

Whether you’re running for president, moving up the corporate ladder or juggling your family’s activities, it’s crucial that you take a break to care for yourself, he says.

These are the seven worst habits of workaholics, according to Griffing.

1. Forgetting to relax: While some stress can be good because it keeps you alert and motivated, too much stress or chronic stress will take its toll on your body. In fact, stress can cause a wide-array of problems including: cancer, heart disease, headaches, upset stomach, sleeping problems, muscle tension, weight gain/loss, high blood pressure and chest pains.

2. Eating on the go: Between meetings, conference calls and deadlines, who has time to sit down for a healthy lunch? But a healthy, balanced meal of complex carbohydrates, protein, fruits and vegetables is exactly what you need to stay mentally sharp throughout the day. Beware of frozen meals, fast food and processed food; they can be high in sodium, calories and fat.

3. Putting off sleep for work: Even busy professionals need seven to nine hours of sleep every night. Skimping on sleep can cause irritability, difficulty concentrating, memory problems and poor judgment. It has also been linked to obesity. If you have troubles sleeping at night, avoid bringing work to bed, limit caffeine and alcohol consumption and develop a relaxing routine before bedtime, such as light reading or a warm bath. If you still cannot sleep, seek the help of an expert.

4. Not making time for exercise: Humans were not designed to sit at desks for eight hours or more a day. Getting at least 30 minutes of exercise most days is very important to your immediate and future health. In addition to reducing the risk for nearly every major disease, exercise has been shown to help fight anxiety and depression. By hitting the gym before or after work or walking during lunch, even the busiest person can find time to squeeze in exercise.

5. Working even when sick: Everyone has heard, “don’t come to work if you’re sick,” yet that’s exactly what many do. Whether you’re worried about jeopardizing your job in an unstable economy or just anxious about getting behind, there are three common sense reasons to stay home: Nobody wants your germs, you’ll be less productive and you need your rest to get better.

6. Drinking (too much): The saying “too much of a good thing” certainly applies to alcohol. Research has shown that moderate alcohol consumption can reduce your risk for everything from heart disease to rheumatoid arthritis, with “moderate” being the key word. In general, men should have no more than two drinks per day (1.5 oz. of spirits, 5 oz. of wine or 12 oz. of beer) and women who are not pregnant should limit themselves to one drink per day. Remember, the risks of excessive drinking far outweigh the benefits of alcohol consumption and can lead to alcoholism, liver disease and some forms of cancer.

Instead of drinking several cocktails to cope with stress or unwind after a busy day, try sipping herbal tea, meditation or yoga.

7. Skipping annual medical checkups: In order to detect problems early, prevent others from developing and get the best treatment if you have a condition, you need to know what’s going on in your body. Depending on your age, family history and lifestyle, consider a comprehensive medical checkup and special screenings every one to five years. Consult with your doctor for more information.

“Eventually, something’s going to give. If you keep burning the candle at both ends, the flame will burn out,” Griffing said. “But if you maintain a healthy balance, you will be happier and healthier overall.”

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.

Coming Soon: Self-guided Depression Treatment

2008-09-27T05:10:00.000-07:00

Self-guided treatment for depression could soon be only a mouse click away.

Scientists with the National Space Biomedical Research Institute (NSBRI) are developing an interactive, multi-media program that will assist astronauts in recognizing and effectively managing depression and other psychosocial problems, which can pose a substantial threat to crew safety and mission operations during long-duration spaceflights.

Even though the depression treatment is under development for NASA, project leader Dr. James Cartreine said it could be spun off for use on Earth.

“This project has great potential as a self-guided treatment for many people,” said Cartreine, a member of NSBRI’s Neurobehavioral and Psychosocial Factors Team. “Depression is the number one cause of disability days in the United States, but it’s not only about days lost. Depression also results in presenteeism -- showing up for work but not really working.”

The depression treatment is part of the Virtual Space Station, a multi-media program that addresses multiple types of potential psychosocial problems and can be used for training before, and for assistance during, missions. Other problems being addressed via the Virtual Space Station include interpersonal conflict, and stress and anxiety.

Cartreine, a Harvard Medical School research psychologist based in the Division of Clinical Informatics at Beth Israel Deaconess Medical Center in Boston, said the Virtual Space Station will make effective therapeutic depression treatment more easily accessible to astronauts aboard the International Space Station and proposed missions to the moon and Mars. Currently, astronauts have audio and video access to psychologists only when communication links are available.

Project co-investigator and former astronaut Dr. Jay Buckey said long-duration spaceflight can be tough on astronauts. “While astronauts are not particularly prone to psychological problems, the environment is very demanding,” Buckey said. “On a mission, they face a lot of challenges that could lead to depression.”

Buckey, a professor and physician at Dartmouth Medical School, said the depression module and other aspects of the Virtual Space Station are based upon proven methods. “These are unique NSBRI products that did not exist before,” Buckey said. “The Virtual Space Station is based on proven treatment programs and is a very helpful way to work on problems in general.”

The system’s multi-media approach for depression includes graphics and video featuring a psychologist who leads the user through a straightforward process called Problem-Solving Treatment. The system provides feedback based upon the information provided when answering a series of questions.

The first step of the process is to make a problem list and select a problem on which to work. The second and third steps are setting goals and brainstorming ways to reach them. The final two steps are assessing the pros and cons of possible solutions and making an action plan to implement them. The program also helps users plan and schedule enjoyable activities, which people who have depression often stop doing. Additionally, the program provides preventative and educational information on depression.

Cartreine and Buckey, who received input from 29 current and former astronauts while designing the Virtual Space Station, said some of the system’s other benefits include its portability and privacy. “It can be delivered to the International Space Station on a flash drive and run directly from that drive, so that the astronaut has complete control over his or her data,” Cartreine said. “The system is private and secure. The user is the only one who can share the information with others.”

An early version of the depression treatment system was beta-tested on research stations in Antarctica, which is used as an analog to long-duration spaceflights due to its isolation from the rest of the world, length of stay and team composition. Cartreine said feedback from that early test run has been positive, and a clinical evaluation of the latest version on 68 Boston-area volunteers is about to begin.

“We plan to study the program’s ability to treat depression,” he said. “We are looking for people who are similar to astronauts, such as people in the technology industry.”

Eventually, the researchers want to adapt the system for use in many different settings, giving people access to treatment they may not have now. For instance, people with depression often seek treatment by going to their primary care physician, so the researchers hope to adapt it for use at the doctor’s office or in a person’s home.

The system could also be beneficial in rural areas where clinical help is in short supply or nonexistent. Other possible locations for use include schools, social service offices, places of worship, military bases, prisons, commercial ships, oil rigs and underwater research stations.

The self-guided treatment project is part of the NSBRI Neurobehavioral and Psychosocial Factors Team portfolio, which includes studies on and development of countermeasures for stress, anxiety, interpersonal conflict and fatigue.

Content on stress and anxiety management for the Virtual Space Station is being developed by Dr. Raphael Rose at UCLA. Harvard Medical School and Massachusetts General Hospital researcher Dr. Gary Strangman is studying the depression treatment program’s effects on brain activity using infrared imaging.

NSBRI, funded by NASA, is a consortium of institutions studying the health risks related to long-duration spaceflight. The Institute’s science, technology and education projects take place at more than 60 institutions across the United States.

New Hernia Repair Technique Developed for Quicker Recovery and Less Pain

2008-09-25T00:06:00.000-07:00

Drawing upon his 20 years of hernia repair experience Dr. David Albin has modified the commonly used tension-free mesh hernia repair technique to provide patients with less pain and a quicker overall recovery.

The modified technique utilizes absorbable sutures in the more tender areas of the body, as well as using a larger piece of mesh. The larger mesh piece protects better against the hernia recurring while the absorbable sutures protect against post-operative hernia pain. With less tension inside the body and out, the patient experiences less pain throughout the recovery process and is able to return to their everyday activity faster and safer.

Developed as a result of being an avid triathlete competitor, five-time Ironman finisher and operating on many athletes like himself, Dr. David Albin knew there had to be a way to achieve less down-time for his patients due to pain and healing. So he modified the commonly used tension-free mesh hernia repair technique in order to provide his patients with a faster recovery time while experiencing less pain.

Another benefit of this procedure is that it is very simple to teach with a small learning curve, which Dr. Albin hopes will allow more surgeons to be open to learn and adopt so that all hernia repair patients may one day have a quicker, less painful recovery. For more information on Dr. David Albin, his new technique or the Hernia Center of Southern California, visit -

HERNIA CENTER OF SOUTHERN CALIFORNIA
800 S. FAIRMOUNT AVENUE, STE.# 419, PASADENA, CA 91105
TEL: (626) 584-6116 FAX: (626) 584-7886 - www.herniaonline.com

Psoriasis: More than Skin Deep

2008-08-22T12:52:00.000-07:00

By Jennifer Wider, M.D.

Society for Women’s Health Research

Newswise — Psoriasis is a chronic disease of the immune system that affects the skin. As many as 7.5 million Americans suffer from psoriasis, according to the National Institutes of Health. Unlike other diseases of the immune system which affect women more often than men, psoriasis occurs about equally in men and women.

Psoriasis is not contagious and cannot be spread from person to person. There are five known forms of the disease. “The most common form, plaque psoriasis, appears as raised, red patches or lesions covered with a silvery white buildup of dead skin cells called scale,” explains Bruce F. Bebo, Jr., Ph.D., director of research and medical programs at the National Psoriasis Foundation in Portland, Ore.

For some people, psoriasis can be a nuisance, for others, it can be debilitating. The symptoms vary from person to person and can include:

* Red, itchy patches of skin that are covered with silver-colored scales.

* Dry, irritated or cracked skin that can bleed when scratched.

* Disorders of the fingernails or toenails including thickened or ridged nails. The nails can become brittle and in some cases, detach from the nail beds.

Most cases of psoriasis wax and wane and include flare-ups which last for a few weeks to months. Some people will go into remission for months to years. But in most cases, the psoriasis will reappear.

Psoriasis can also lead to psoriatic arthritis, which can cause pain and swelling in the joints. Roughly one-tenth to one-third of people with psoriasis will also have psoriatic arthritis, according to the National Psoriasis Foundation. Psoriatic arthritis can lead to joint erosion and get in the way of daily functioning.

Although it affects both genders equally, recent studies show that there may be a racial or ethnic link. “It seems that psoriasis is most common in Caucasians and slightly less common in African Americans. Worldwide, psoriasis is most common in Scandinavia and other parts of northern Europe. It appears to be far less common among Asians and is rare in Native Americans,” Bebo points out.

Research has identified some differences between the sexes in psoriasis related to smoking and alcohol consumption.

Smoking increases the risk of developing psoriasis and can make the disease more severe, especially in women, but the risk goes down if you stop smoking. Alcohol appears to affect psoriasis in men more strongly than in women. Researchers don’t know why, but alcohol consumption appears to be a risk factor for psoriasis in men but not women and it may lower treatment response in men.

The cause of psoriasis isn’t fully clear. The disease is related to a malfunction in the immune system, which results in T-cells attacking healthy skin cells. What triggers the T-cell malfunction isn’t known, but many researchers cite genetic and environmental factors as possibilities. The most noteworthy risk factor for psoriasis is family history. Roughly 30 percent of people with psoriasis have a close relative with the disease.

Diagnosing psoriasis is often done in a doctor’s office. “No special blood tests or diagnostic tools exist to diagnose psoriasis. The physician or other health care provider usually examines the affected skin and decides if it is from psoriasis. Less often, the physician examines a piece of skin (biopsy) under the microscope,” explains Bebo.

There are several therapies for psoriasis available to patients, which focus on reducing skin inflammation and plaque formation. Looking to the future, there are “a number of new treatments in the psoriasis pipeline,” Bebo said, which may help reduce the burden of this chronic and disabling disease. The types of treatments in development include biologics, monoclonal antibodies and immune system modulators.

Women with psoriasis who are pregnant, may become pregnant, or are breastfeeding should discuss carefully with their doctors their treatment options, as some treatments for psoriasis may cause birth defects. There is, however, some good news for pregnant women. Research has shown that hormonal changes during pregnancy may lead to improvements in psoriasis symptoms, providing temporary relief.

You can visit the National Psoriasis Foundation online at http://www.psoriasis.org/.

Sleep Selectively Preserves Emotional Memories

2008-08-17T12:33:00.000-07:00

As poets, songwriters and authors have described, our memories range from misty water-colored recollections to vividly detailed images of the times of our lives.

Now, a study led by researchers at Beth Israel Deaconess Medical Center (BIDMC) and Boston College offers new insights into the specific components of emotional memories, suggesting that sleep plays a key role in determining what we remember – and what we forget.

Reported in the August 2008 issue of the journal Psychological Science, the findings show that a period of slumber helps the brain to selectively preserve and enhance those aspects of a memory that are of greatest emotional resonance, while at the same time diminishing the memory’s neutral background details.

“This tells us that sleep’s role in emotional memory preservation is more than just mechanistic,” says the study’s first author Jessica Payne, PhD, a Harvard University research fellow in the Division of Psychiatry at BIDMC. “In order to preserve what it deems most important, the brain makes a tradeoff, strengthening the memory’s emotional core and obscuring its neutral background.”

Previous studies have established the key role that sleep plays in procedural memory, demonstrating that the consolidation of procedural skills (such as typing or playing the piano) is greatly enhanced following a period of sleep.

But sleep’s importance in the development of episodic memories – in particular, those with emotional resonance– has been less clear.

“Emotional memories usually contain highly charged elements – for example, the car that sideswiped us on the ride home – along with other elements that are only tangentially related to the emotion, such as the name of the street we were traveling on or what store we’d just passed,” explains study author Elizabeth Kensinger, PhD, an Assistant Professor in the College of Arts and Sciences at Boston College. “We were interested in examining whether sleep would affect memory for all of these elements equally, or whether sleep might allow some of the event features to decay at a faster rate than others.”

The authors tested 88 college students. Study participants were shown scenes that depicted either neutral subjects on a neutral background (a car parked on a street in front of shops) or negatively arousing subjects on a neutral background (a badly crashed car parked on a similar street). The participants were then tested separately on their memories of both the central objects in the pictures and the backgrounds in the scenes. In this way, memory could be compared for the emotional aspects of a scene (the crashed car) versus the non-emotional aspects of the scene (the street on which the car had crashed.)

Subjects were divided into three groups. The first group underwent memory testing after 12 hours spent awake during the daytime; the second group was tested after 12 nighttime hours, including their normal period of nighttime sleep; and the third baseline group was tested 30 minutes after viewing the images, in either the morning or evening.

“Our results revealed that the study subjects who stayed awake all day largely forgot the entire negative scene [they had seen], with their memories of both the central objects and the backgrounds decaying at similar rates,” says Payne. But, she adds, among the individuals who were tested after a period of sleep, memory recall for the central negative objects (i.e. the smashed car) was preserved in detail.

“After an evening of sleep, the subjects remembered the emotional items [smashed car] as accurately as the subjects whose memories had been tested only 30 minutes after looking at the scenes,” explains Kensinger. “By contrast, sleep did little to preserve memory for the backgrounds [i.e. street scenes] and so memory for those elements reached a comparably low level after a night of sleep as it did after a day spent awake.”

“This is consistent with the possibility that the individual components of emotional scene memory become ‘unbound’ during sleep,” adds Payne, explaining that “unbinding” enables the sleeping brain to selectively preserve only that information which it calculates to be most salient and worthy of remembering. A real-world example of this tradeoff, she adds, is the “weapon focus effect” in which crime victims vividly remember an assailant’s weapon, but have little memory for other important aspects of the crime scene. Traumatic memories, such as the flashbacks experienced among individuals with post-traumatic stress disorder, can demonstrate similar disparities, with some aspects of an experience seemingly engraved in memory while other details are erased.

“Sleep is a smart, sophisticated process,” adds Payne. “You might say that sleep is actually working at night to decide what memories to hold on to and what to let go of.”

This study was supported, in part, by grants from the National Science Foundation and the National Institute of Mental Health. Coauthors include Elizabeth Kensinger, PhD, of Boston College, Robert Stickgold, PhD, of Beth Israel Deaconess Medical Center; and Kelley Swanberg of Harvard University.

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and consistently ranks among the top four in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.harvard.edu.

Protein Key to Control, Growth of Blood Cells

2008-08-17T12:31:00.000-07:00

New research sheds light on the biological events by which stem cells in the bone marrow develop into the broad variety of cells that circulate in the blood. The findings may help improve the success of bone marrow transplants and may lead to better treatments for life-threatening blood diseases.

“As we better understand the biological pathways that regulate the growth of stem cells, we may identify new approaches for treating blood disorders,” said study leader Wei Tong, Ph.D., a hematology researcher at The Children’s Hospital of Philadelphia. Her study appeared online July 10 in the Journal of Clinical Investigation.

Hematopoietic stem cells (HSCs) develop into all types of blood cells: red blood cells, platelets and immune cells. HSCs, like other stem cells, have the ability to self-renew: each can give rise to more mature, developed cells with more specific functions, as well as a new stem cell. (Everyone carries HSCs in their bone marrow, unlike embryonic stem cells, which exist only in embryos.)

In her study, conducted in mice, Tong focused on a protein called Lnk that helps control HSC expansion. When a growth factor in the blood called thrombopoietin (TPO) acts on its cell receptor, it triggers signals along a pathway that includes another protein, JAK2. JAK2, in turn, causes stem cells to increase their numbers.

Tong’s group and others previously found that Lnk is a negative regulator for HSCs, acting as a brake on stem cell expansion. In the current study, they found that mice genetically engineered to lack the Lnk protein had 10 times the normal amount of HSCs in their bone marrow. Without Lnk to directly interact with JAK2 and inhibit its activity, TPO made stem cell production go into overdrive.

However, there was an unexpected potential benefit-- the expanded population of stem cells had a higher proportion of quiescent cells, those in a resting stage in the cell cycle. Quiescent stem cells, said Tong, are more likely to succeed in a recipient when they are used in bone marrow transplantation.

Although much research remains to be done, added Tong, other researchers might build on this knowledge to manipulate HSCs for more effective bone marrow transplants for cancer patients after high-dose chemotherapy or radiotherapy. It might also improve treatments for particular blood disorders. For example, aplastic anemia, severe combined immunodeficiency disorders and hemoglobin disorders involve deficiencies of specific immune cells in the blood. Using a drug to inhibit Lnk could potentially produce larger numbers of HSCs for a successful bone marrow transplant.

Myeloproliferative disorders (MPDs), on the other hand, entail the opposite danger—a sometimes-fatal overproduction of certain bone marrow cells. Clinicians might use Tong’s research on Lnk and its associated signaling pathway to curtail stem cell production and control MPDs.

The National Cancer Institute, part of the National Institutes of Health, supported Tong’s research, with additional grant funding from the McCabe Foundation and the Institutional Development Fund at Children’s Hospital. Tong’s co-authors were Alexey Bersenev, Chao Wu, and Joanna Balcerek, all of the Division of Hematology at The Children’s Hospital of Philadelphia.

About The Children’s Hospital of Philadelphia: The Children’s Hospital of Philadelphia was founded in 1855 as the nation’s first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children’s Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu

Stress, Anxiety Can Make Allergy Attacks Even More Miserable, Last Longer

2008-08-17T12:11:00.000-07:00

A new study here shows that even slight stress and anxiety can substantially worsen a person’s allergic reaction to some routine allergens.

Moreover, the added impact of stress and anxiety seem to linger, causing the second day of a stressed person's allergy attack to be much worse.

The finding, the latest in more than three decades of study on stress and immunity, is important since allergic reactions are the fifth-most-common chronic disease in America, and medical costs to treat them can reach $3.4 billion each year.

In a report presented today (8/14) at the annual meeting of the American Psychological Association in Boston, Ohio State University researchers described recent experiments meant to gauge how psychological stress might affect allergy sufferers.

“Allergies are not minor problems,” explained Jan Kiecolt-Glaser, a professor of psychology and psychiatry at Ohio State. “A huge number of people suffer from allergies and, while hay fever, for example, is generally not life-threatening, allergy sufferers often also have asthma which can be deadly.”

Some data suggest that 38 percent of the people who suffer from allergic rhinitis also have asthma, and that 78 percent of asthma sufferers have allergic rhinitis.

Kiecolt-Glaser and Ronald Glaser, professor of molecular virology, immunology and medical genetics at Ohio State, recruited 28 men and women. All of the volunteers had a history of hay fever and seasonal allergies

The volunteers spent two half-days in a research unit at the Ohio State Medical Center. Each time, they were given the standard skin prick test several times to determine their reactions to various allergens, and blood, saliva and serum samples were taken before, after and at several times during the research project.

All of the participants were given a battery of psychological questionnaires to determine their levels of stress, anxiety, self-confidence and feelings of control over situations.

On the day that individuals were assigned to the low-stress control condition, they were given the skin prick test and then asked to read from a magazine. Then they were asked to tape themselves reading the same material aloud.

During the day that people were assigned to the experimental condition, however, they had a much tougher time.

“We used a ‘speech stressor test’ used in a lot of psychology research,” Kiecolt-Glaser said.

“Basically the participants each appeared before a panel of several ‘evaluators’ who supposedly were behavioral experts. Participants had to give a 10-minute speech, which was videotaped, and then are asked a series of math questions they had to solve without paper or pen.”

Afterwards, they had to watch their videotaped performance.

“The whole exercise is a nice stress experiment in the laboratory,” she said.

The researchers measured the raised “wheals” that formed on the arms of the participants before and after they were stressed, as well as the next day.

“The wheals on a person who was moderately anxious because of the experiment were 75 percent larger after the experiment, compared to that same person’s response on the day when they were not stressed,” Kiecolt-Glaser said, signifying a stronger reaction.

“But people who were highly anxious had wheals that were twice as big after they were stressed compared to their response when they were not stressed. Moreover, these same people were four times more likely to have a stronger reaction to the skin test one day later after the stress,” she said.

This next-day change – labeled a “late-phase reaction” – is important because it signals an ongoing and strengthening response to the allergens, and even suggests that sufferers may react strongly to other stimuli that previously hadn’t caused them to develop an allergic reaction.

Gailen Marshall, a co-investigator on the project and professor of medicine and pediatrics at the University of Mississippi, said that late phase, or delayed, reactions are typically unresponsive to the most common forms of allergy treatment, such as antihistimines.

“Late phase reactions also occur in allergic asthma and can, in the proper settings, be potentially life-threatening.

“The results of this study should alert practitioners and patients alike to the adverse effects of stress on allergic reactions in the nose, chest, skin and other organs that may seemingly resolve within a few minutes to hours after starting, but may reappear the nest day when least expected,” he said.

Partner Ronald Glaser, director of the University’s Institute for Behavioral Medicine Research, said that they stimulated cells taken from study participants and then measured the levels of cytokines like interleukin-6 (IL-6) that the cells produced.

Lymphocytes taken from participants during the study showed increased levels of cytokines like IL-6. High levels of IL-6 are part of the allergic response to an allergen, Glaser said. The researchers also measured levels of stress hormones called catecholamines and they were elevated as well.

He suggests that the raised levels of these compounds are to blame for the residual effects seen in the late-phase reaction.

“What’s interesting about this is that it shows that being stressed can cause a person’s allergies to worsen the next day,” she explained.

“This is clinically important for patients since most of what we do to treat allergies is to take antihistimines to control the symptoms – runny nose, watery, itchy eyes, and congestion.

“Antihistimines don’t deal with those symptoms on the next day.”

People may be setting themselves up to have more persistent problems by being stressed and anxious when allergy attacks begin,” Kiecolt-Glaser said.

The researchers estimate that Americans pay $2.3 billion for allergy medications each year and $1.1 billion for doctor visits to treat allergy attacks. Those amounts don’t include approximately 3.5 million workdays lost as well.

Working along with Kiecolt-Glaser, Glaser and Marshall on the project were William Malarkey, professor of internal medicine; Stanley Lemeshow, professor and dean of public health; Kathi Heffner from Ohio University; Kyle Porter, Cathie Atkinson and Byron Laskowski, all from Ohio State.

The research was supported in part by the National Institutes of Health.

Asthma in Boys May Be Just a Phase, But For Girls It May Be There To Stay

2008-08-17T12:10:00.000-07:00

Boys may be more apt than girls to have childhood asthma, but, when compared to girls, they are also more likely to grow out of it in adolescence and have a decreased incidence of asthma in the post-pubertal years. This indicates that there may be a buried mechanism in asthma development, according to a prospective study that analyzed airway responsiveness (AR) in more than 1,000 children with mild to moderate asthma over a period of about nine years.

“We wanted to investigate what was behind the observed sex differences in asthma rates and AR,” says lead researcher, Kelan G. Tantisira, M.D., M.P.H., of Brigham and Women’s Hospital and Harvard Medical School. “This is the first study to prospectively examine the natural history of sex differences in asthma in this manner.”

Their results appeared in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

Dr. Tantisira and colleagues used data from the ongoing Childhood Asthma Management Program (CAMP) that enrolled 1041 children from 5 to 12 years of age with mild to moderate persistent asthma and performed annual spirometric testing with methacholine challenges to quantify their AR.

After an average of 8.6 years and each individual had undergone eight to nine annual methacholine challenges, the researchers were able to identify a clear pattern: when it came to the amount of methacholine it took to provoke airway constriction, the girls’ reactivity did not change markedly over the years. In contrast, boys became increasingly tolerant over time to larger and larger doses of methacholine, suggesting a possible decrease in disease severity. By the age of 16, it took more than twice as much methacholine to provoke a 20 percent constriction in the boys’ airway on average as it did with the girls.

What’s more, by age 18, only 14 percent of the girls did not demonstrate any significant degree of airways responsiveness, compared to 27 percent of boys.

“While our results were not unexpected, they do point to intriguing potential mechanisms, to explain the gender differences in asthma incidence and severity. Especially intriguing is that the differences in gender begin at the time of transition into early puberty.” said Dr. Tantisira.

This study into the natural history and sex differences in asthma marks the beginning of what many hope will be a long investigation into the subject.

“It will be of great interest to follow these children over time to see what happens with AR and severity of asthma in adulthood,” wrote Jorrit Gerritson, M.D., Ph.D., in an accompanying editorial.

This is precisely Dr. Tantisira’s next step: Dr. Tantisira and colleagues now have 12 years of data for the cohort, and is looking into investigating the characteristics of the individuals who attained clinically “normal” AR during follow-up. “Most of the original cohort has now reached adulthood,” said Dr. Tantisira. “We are now able to perform a secondary analysis with an emphasis on those who have reached clinical ‘normalcy.’”

Hope for Patients with COPD

2008-08-17T12:06:00.000-07:00

For the first time, a drug therapy appears to reduce lung function loss in patients with moderate to severe chronic obstructive pulmonary disease (COPD), according to the results of a randomized, double-blind, placebo-controlled trial in 42 countries.

The Toward a Revolution in COPD Health (TORCH) study investigated the effects of combined salmeterol, a ß-agonist, and fluticasone propiniate, an inhaled cortical steroid, either alone or in combination, on mortality, exacerbations, health-related quality of life and rate of decline in lung function as measure by forced expiratory volume in one second (FEV1) in patients with COPD.

The results are published in the second issue for August of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

“Pharmacotherapy with salmeterol plus fluticasone propionate, or the components, reduces the rate of decline on FEV1 in patients with moderate to severe COPD, thus slowing disease progression,” wrote Bartolome R. Celli, M.D., lead author of the study and professor at Tufts University School of Medicine. “To date, smoking cessation is the only intervention that has conclusively been shown to alter the rate of decline in FEV1,” remarked Dr. Celli. This is the first demonstration of an effective pharmacothrerapy in COPD.

The TORCH study randomized more than 6,000 patients with moderate to severe COPD from 42 countries to receive either salmeterol (SAL; 50 μg), fluticasone propionate (FP; 500 μg), the two in combination (SFC; 50/500 μg), or placebo. After baseline FEV1 was recorded, patients were re-evaluated every 24 weeks to determine the rate of decline in FEV1.

“The rate of decline in FEV1 was slowest in patients on SFC and fastest in those randomized to the placebo arm,” wrote Dr. Celli. “From week 24 onward, the adjusted rate of decline in FEV1 was 39ml/year for SFC, 42 ml/year for both SAL and FP and 55 ml/year for placebo.”

Although the study was not formally powered to detect differences in rate of decline of FEV1, the results were highly significant (p<0.001.) The rate of decline in treatment groups was similar across a number of variables, including sex, age, ethnicity and body mass index. Furthermore, the slower rate of decline in FEV1 appeared to be associated with a lower risk of exacerbation.

“Although treatment did not abolish the accelerated decline in lung function [that occurs with COPD], it did ameliorate it substantially,” wrote Dr. Celli, while noting that “the mechanism responsible for the effect on rate of decline is not clear, as all treatments have potentially significant nonbronchodilator effects.” Clarifying those mechanisms is the goal of the next phase of the research, with the comparison between a long-acting bronchodilator drug and placebo with respect to FEV1 decline.

In the meantime, “the TORCH study brings some clarity to the treatment picture and provides some hopeful signs for patients with COPD,” wrote Samy Suissa, Ph.D., of McGill University, in the accompanying editorial. “This study also demonstrates that no treatment [placebo] is not an option for patients with moderate to severe COPD.”

An Apple Peel a Day Could Keep Cancer at Bay

2008-05-01T05:09:00.000-07:00

An apple peel a day might help keep cancer at bay, according to Rui Hai Liu, Cornell associate professor of food science, who has identified a dozen compounds -- triterpenoids -- in apple peel that either inhibit or kill cancer cells in laboratory cultures. Three of the compounds have not previously been described in the literature.

"We found that several compounds have potent anti-proliferative activities against human liver, colon and breast cancer cells and may be partially responsible for the anti-cancer activities of whole apples," says Liu, who is affiliated with Cornell's Institute of Comparative and Environmental Toxicology and is senior author of the study, which is online and published in the Journal of Agricultural and Food Chemistry.

In previous Cornell studies, apples had been found not only to fight cancer cells in the laboratory but also to reduce the number and size of mammary tumors in rats. The Cornell researchers now think that the triterpenoids may be doing much of the anti-cancer work.

"Some compounds were more potent and acted differently against the various cancer cell lines, but they all show very potent anti-cancer activities and should be studied further," says Liu.

With co-author Xiangjiu He, a Cornell postdoctoral researcher, Liu analyzed the peel from 230 pounds of red delicious apples from the Cornell Orchard and isolated their individual compounds. After identifying the structures of the promising compounds in the peel, the researchers tested the pure compounds against cancer cell growth in the laboratory. In the past, Liu has also identified compounds called phytochemicals -- mainly flavonoids and phenolic acids -- in apples and other foods that appear to be have anti-cancer properties as well, including inhibiting tumor growth in human breast cancer cells.

"We believe that a recommendation that consumers to eat five to 12 servings of a wide variety of fruits and vegetables daily is appropriate to reduce the risks of chronic diseases, including cancer, and to meet nutrient requirements for optimum health," said Liu.(NewsWise)

Ten Things You Can Do to Reduce Your Cancer Risk

2008-05-01T04:58:00.000-07:00

Most people assume that cancer is genetic and cannot be avoided. However, according to the American Cancer Society, healthy behaviors could prevent approximately half of cancer deaths. Below is a list of 10 lifestyle changes, all based on the latest research, which people can make to improve their odds of preventing cancer or catching it at its earliest, most curable stages.

• Don’t smoke or use any other tobacco products. Tobacco increases the risk for many cancers including those of the lung, bronchus, head and neck, colon, and bladder. If you smoke, stop. If you don’t smoke, don’t start. If you’ve tried to quit before, don’t give up – eventually something will work. Don’t be afraid to ask for help from your physician, your family and friends, your employer, and even your insurance company. There are so many benefits to reducing smoking that many companies and insurance companies provide free help for quitting smoking.

• Get screened for cancer regularly. Several tests can find cancer at a very early stage, sometimes even before a growth has turned cancerous. Finding cancer early can greatly increase your chance for a cure and reduce your risk of dying from the disease. Currently available cancer screening includes:

o Colon: Starting at age 50, all people should have a colonoscopy (or even younger if at high risk). The frequency of colon screening depends on risk. A colonoscopy every 10 years is the norm for those with no personal or family history of colon cancer or high-risk polyps. Those at high risk may need more frequent testing. Acceptable alternatives for people who are not at high risk for colon cancer include flexible sigmoidoscopy, CT scanning and a test to check for hidden blood in the stool.
o Breast: Starting at age 40, all women should get an annual mammogram (or even younger if at high risk) and a breast exam performed by a clinician. Some women may be eligible for a breast MRI and ultrasound as recommended by their physician.
o Prostate: Starting at age 50 (or younger if at high risk), all men should have an annual physical exam (including a digital-rectal exam) and a blood test to check for blood levels of prostate-specific antigen, or PSA, which when elevated can be an indication of prostate cancer.
o Cervix: Cervical-cancer screening (cervical sampling for Pap smear and human papillomavirus testing) should start as soon as a woman is sexually active and should continue throughout life with frequency depending on the woman’s risk and age.
o Skin: All adults should have a yearly skin exam by their primary care doctor. Those at high risk should have annual skin-cancer screening performed by a dermatologist. Persons at high risk for melanoma or other skin cancer should examine their own skin monthly.

• Keep your alcohol consumption low. This means no more than two drinks per day for men and one drink per day for women. Alcohol use increases risk for several cancers including those of the breast, esophagus, colon, pancreas, and head and neck. Keeping your alcohol intake to the minimum daily level doesn’t mean that you can “save up” all your drinks for a week and binge on Friday night with your weekly “allotment.” This type of binge drinking is dangerous because it reduces your ability to make rational decisions, and it increases your risk of injury and of acute heart failure.

• Protect your skin from the sun. Use sunscreen every time you go outdoors (preferably one with an SPF of 30 or higher that protects against both UVA and UVB rays). Keep covered with a broad hat and sunglasses, keep the amount of exposed skin to a minimum and limit time in the sun when it is the strongest (usually 10 a.m. to 4 p.m.) Remember that sun rays penetrate car and other windows, so you should use sunscreen any time you’ll be getting sun exposure through a window. Never use a tanning bed, as they are as dangerous as sun exposure. If you want a tan without going outdoors, use a self-tanner, as such products do not cause skin cancer or other skin damage.

• Keep a physically active lifestyle. Research suggests that exercising three to four hours per week at moderate or vigorous levels reduces the risk of several cancers by 30 percent to 50 percent. Many studies have shown that regular exercise lowers risk for breast and colon cancers, and studies now suggest that risks for endometrial and lung cancer may also be lower in people who exercise regularly. You don’t need to be an athlete to get the benefit of exercise. Activities like brisk walking, biking, dancing, or any exercise that raises your heart rate and makes you sweat will be beneficial.

• Keep your weight in the normal range for your height. That means keeping to a body mass index (BMI) of 25 or less. (You can calculate you BMI with online calculators). People who are overweight or obese have increased risk of developing several cancers including those of the colon, breast, pancreas, liver, kidney and endometrium, and perhaps leukemia and lymphoma. There is also evidence that men who are obese are more likely to develop a deadly form of prostate cancer if they develop the disease. Keep your weight steady; don’t gain pounds over time. Try to stay within 5 to 10 pounds of what you weighed at age 18. The best way to avoid weight gain and avoid overweight or obesity is to eat a diet high in vegetables and fresh fruit and low in high-calorie foods like sugared drinks, refined carbohydrates and fatty foods.

• Avoid taking menopausal hormone therapy. Menopausal hormone-replacement therapy increases risk for breast, endometrial and, possibly, ovarian cancer. If you have menopausal symptoms, try to handle them without hormone therapy including estrogens, progesterone, and testosterone. If you need to take hormones, limit your use to less than five years.

• Consider taking medications for reducing cancer risk. There are several medications that have been tested and found effective for reducing risk for cancer. Anyone considering using such medications should talk with their doctor about the pros and cons of these medications given their risk for the disease. These include:

o Breast: Tamoxifen and raloxifene both reduce the chance of developing breast cancer by half in women at increased risk for the disease. Women at increased risk include those over age 60, and women who have certain family histories of breast cancer or who have had certain types of benign breast disease.
o Prostate: Finasteride has been shown to reduce the risk of developing prostate cancer by 25 percent. However, it increases risk for some types of advanced prostate cancer.

• Avoid exposures to cancer-causing substances. Radiation exposures and some chemicals are known to cause cancer. Make sure that any physician who orders an X-ray for you, especially high-dose ones like CT scans, knows how many previous X-rays you have had. If it is not an emergency medical situation, ask whether there is an alternative examination that would work for you, such as ultrasound or MRI, which do not have radiation. Limiting X-ray exposure is especially important for children and teens. If you work in an industry or occupation where you are exposed to radiation or chemicals, be very careful to follow the regulations of your company and the U.S. Occupational Safety and Health Administration.

• Eat a cancer-risk-reducing diet. The role of diet in cancer is far from established, but research suggests that a plant-based diet is associated with reduced risks for several cancers, especially for colon cancer. Some general dietary guidelines for reducing cancer risk are:
o Keep your intake of red meat to a minimum. This means no more than 4 ounces of red meat per day on average. Four ounces of red meat is about as big as a deck of cards.
o Avoid processed meats such as sausages and bologna. The chemicals used to process such meats have been found to cause several kinds of cancer.
o Eat a variety of non-starchy vegetables and fruits every day. The National Cancer Institute recommends eating at least five servings of vegetables and fruit per day, but most experts on cancer and diet recommend at least double that amount. Experts further recommend that you eat a variety of brightly colored vegetables and fruits, as these contain the highest concentrations of vitamins. You can increase your intake of vegetables by putting them into your breakfast omelet, by snacking on carrots, and by mixing them into casseroles for dinner.
o Minimize your intake of high-calorie foods such as sugared drinks, juices, desserts and candies, refined breads and bagels, and chips. By lowering intake of these high-calorie foods and increasing your intake of non-starchy vegetables, you will be better able to keep your weight to a normal level and avoid gaining weight.
o Eat foods with high calcium and vitamin D levels such as fortified low- or nonfat milk and yogurt. If you don’t get enough through your diet, you may want to take calcium and vitamin D supplements. Check with your doctor, who may want to check your blood level of vitamin D, because many Americans have been found to have a deficiency in this vitamin.

Games and Play All Part of Care When Nursing Children with Cancer

2008-05-01T04:38:00.000-07:00

“Cancer is a very scary word for children,” says nursing researcher Dr. Roberta Woodgate of the University of Manitoba in Winnipeg, Canada. “We want to help them deal with the subject in a way that is most appropriate to them, and at their level.”

Woodgate is involved in several research projects that focus on children or teenagers and illness. In one study, she is conducting an ethnographic study of adolescents' conceptualization of cancer and its prevention with a goal of gaining insight into how they frame cancer within the context of their own life-situations. With the trends in incidence and mortality for cancer increasing, Woodgate is developing cancer prevention programs encouraging adolescents to practice healthy behaviors that extend into adulthood. She is also looking to understand how youth frame health within the context of their life-situations.

“Before programs can effectively target adolescents, a detailed understanding of their beliefs about health and cancer prevention is necessary,” she notes.

Woodgate is also helping to create an online “virtual world” in which children with cancer can talk with others about their illness and manage symptoms caused by cancer and other chronic diseases. Her study of children’s perceptions of their cancer symptoms may lead to methods for assessing symptoms and evaluation of the effectiveness of interventions.

“In addition to helping children take their minds off their illness, they can ‘act’ and ‘react’ in a safe and comfortable environment,” she says.

Woodgate believes gaming will teach children with chronic diseases how to recognize and manage real-life symptom experiences such as fatigue and pain. The interactive game will represent symptoms in a non-violent story such as travelling through a jungle or a haunted house and encountering challenges, or symptom experiences, and the opportunity and means to meet the challenges. Interviews with seven to 17 year olds will help determine content in separate games for children and teenagers.

“I hope that gaming as an intervention will improve children’s symptom assessment and management, and their quality of life. What we learn may improve the experiences of families and professionals,” Woodgate says..
In her career as a nurse, professor and researcher, Woodgate has been called many things: a pioneer, an academic, a “kids nurse,” a mentor to Masters and PhD students and an expert on the health and illness experiences of children and youth. And in February 2008, she was named a “nurse to know” by Canada’s Prime Minister Stephen Harper at a Canadian Nurses’ Association ceremony in Toronto.

Woodgate is also researching the concept of transition in childhood illness and death, and parents' and children's decisions and experiences in childhood clinical research.

“I have always recognized how necessary research is to improving the quality of life for children and their families,” says Woodgate.

The Magnificence of Exercise: Choose Movement Over Medication

2008-04-07T13:38:00.000-07:00

Psychotherapist Bob Livingstone writes about the benefits of exercise in his new book "The Body Mind Soul Solution: Healing Emotional Pain through Exercise" (Pegasus Books). He feels that the program in his book that combines exercise, self-questioning, journaling and listening to music is a healthy alternative to medication.

There is increasing evidence that exercise is just as effective as or more beneficial than medication for the depressed. One Duke University study titled "Effects of exercise training on older patients with major depression" determined that exercise was just as effective as medication in reducing Major Depressive Disorder in older patients without the adverse side effects of the drugs.

Another Duke University study found that continued exercise greatly reduces the possibility that depression will return, and a study that took place at The University of University of Texas Southwest Medical Center at Dallas also indicates that exercise alone would greatly reduce the symptoms of depression.

In celebration of the book selling out its first printing, a special EBook giveaway is being offered: Purchase "The Body Mind Soul Solution: Healing Emotional Pain through Exercise" on Amazon.com and then send the Amazon receipt to bobl@boblivingstone.com. You will then be sent a new EBook titled "The Miracle of Exercise: Letting Go of Anger, Hurt and Loss," which will be priced at $10.99. And if you act right now, you will also obtain another EBook titled "From Marriage to Mortality: How to Face Life's Challenges," which will be priced at $8.99. Right now they both are FREE!

Both EBooks contain a collection of articles that teach strategies on how to identify, face and resolve emotional pain.

Check out the rave reviews for "The Body Mind Soul Solution":
New York Times bestselling author of "The Fat Flush Diet," Ann Louise Gittleman, calls the book "Ground Breaking."

The prestigious Library Journal Review says that the book is "Highly Recommended."

The Miami Herald states, "Run through your anger and bike through your anguish with 'The Body Mind Soul Solution: Healing Emotional Pain through Exercise.' It explores different kinds of emotional pain and helps you search for the source so your mind and body can work in concert to resolve painful emotional issues."
Click on the book cover on http://www.boblivingstone.com to order from Amazon and then submit your receipt to bobl@boblivingstone.com to obtain his two new EBooks at no charge! This promotion is for a limited time only, so why not buy the book today?

Bob Livingstone has been featured in The San Francisco Chronicle, The Miami Herald, The Dallas Morning News, The Hartford Courant, Natural Health Magazine, The Library Journal, Grand Magazine, and Lee's Summit Journal.

He is a featured contributor to DrLaura.com, Beliefnet.com, Ediets.com, Selfgrowth.com and SheKnows.com. He is the author of the critically acclaimed book "The Body Mind Soul Solution: Healing Emotional Pain through Exercise" (Pegasus Books, Sept. 2007). For more emotional healing visit http://www.boblivingstone.com.

More Women Choosing Dermal Fillers as a Nonsurgical Alternative to Facelifts

2008-04-02T12:01:00.000-07:00

Though not as durable as a facelift, dermal fillers have become popular among women seeking a younger look and offer yet another alternative to cosmetic surgery, reports the April 2008 issue of Harvard Women’s Health Watch.

Dermal fillers are substances injected into the skin of the face to fill in deep folds and wrinkles. They are used mainly for “static” facial lines and folds, the ones that don’t come and go as you change your expression. They work chiefly as a substitute for lost collagen and fat under the skin. Their results may vary in different areas of the face, as does the duration of their effect.

The dermal filler field is booming because the effects are immediate, the procedure doesn’t involve real surgery, and costs are reasonable with very few side effects, says Harvard Women’s Health Watch.

Fillers are used mainly in the lower two-thirds of the face. Vertical frown lines between the eyes and “tear troughs” below the eyes can also be treated, but complications are more common in these areas. The greatest danger is inadvertently injecting a filler into a blood vessel near an eye, causing a lack of circulation that results in blindness in that eye.

Harvard Women’s Health Watch suggests that before you decide to use a dermal filler, you should schedule a consultation with a practitioner you trust. Success depends greatly on the skill of the practitioner, so look for someone who has plenty of experience with different fillers. She or he should be very familiar with the anatomy of the area, adept at choosing and applying the filler, and able to manage any complications that may arise.

Also in this issue:
• The controversy over bio-identical hormones
• Exercises for neck pain
• Cranberries for urinary tract infections
• By the way, doctor: Should I get Life Line Screening?

Harvard Women’s Health Watch is available from Harvard Health Publications, the publishing division of Harvard Medical School, for $24 per year. Subscribe at www.health.harvard.edu/women or by calling 877-649-9457 (toll-free).

Red Wine, Tea, May Help Regulate Blood Sugar in Type 2 Diabetics

2008-04-02T11:59:00.000-07:00

Red wine has been shown to protect people from heart disease, even when they follow a diet high in saturated fat, and the healing powers of tea are becoming the stuff of legend. Now, researchers at the University of Massachusetts Amherst have shown that these beverages may hold promise for regulating the blood sugar of people with type 2 diabetes.

Results have been published in the Journal of Food Biochemistry. Researchers include food scientists Kalidas Shetty, Young-In Kwon and Emmanouil Apostolidis.

“Levels of blood sugar, or blood glucose, rise sharply in patients with type 2 diabetes immediately following a meal,” says Shetty. “Red wine and tea contain natural antioxidants that may slow the passage of glucose through the small intestine and eventually into the bloodstream and prevent this spike, which is an important step in managing this disease.”

One of the main challenges in managing diabetes is keeping blood sugar levels as normal as possible with few major fluctuations, which can prevent the disease from contributing to heart disease and high blood pressure as well as damaging the eyes, kidneys, nerves and blood vessels.

Both red and white wines were tested in the laboratory using in vitro enzyme studies to determine how well they could inhibit the activity of a target enzyme called alpha-glucosidase, responsible for triggering the absorption of glucose by the small intestine. Red wine was the winner, able to inhibit the enzyme by nearly 100 percent. Values for white wine hovered around 20 percent.

This was clearly related to the amount of a specific type of antioxidants, called polyphenolics, found in the wines. “Our testing showed that red wine contains roughly ten times more polyphenolics than white wine,” says Shetty. “Laboratory results suggest that these compounds, found in many plant-based foods, may play a role in inhibiting alpha-glucosidase and slowing the passage of carbohydrates into the bloodstream.”

Alpha-glucosidase is the target for current drugs used to treat type 2 diabetes and the development of new drugs.

The team also tested four kinds of tea, including black, oolong, white and green teas. Water extracts of black tea had the highest effect on inhibiting the activity of
alpha-glucosidase, followed by white tea and oolong tea.

Wine and tea had no effect on a pancreatic enzyme called alpha-amylase that breaks down starch, which could help patients avoid the side effects of medications used to control blood sugar.

“A major drawback of medications that control both enzymes is the bacterial fermentation of undigested carbohydrates, especially starch, in the colon, which can lead to side effects such as flatulence, bloating and diarrhea,” says Shetty. “Tea and wine had no effect on the breakdown of starch by alpha-amylase, which could potentially help patients avoid these side effects.”

Another benefit is that the polyphenolics in wine and tea could also help in protecting the rest of the body from the additional complications of diabetes such as high blood pressure and heart disease. Diabetes places a stress on the entire body by increasing the production of free radicals, including molecules that react with oxygen, which degrade cellular function. Both red wine and tea contain antioxidants with proven health benefits, and have the potential to manage heart disease, high blood pressure and perhaps contribute to the prevention of cancer, which are all linked to free radicals.

“These results provide strong evidence for further studying the use of wine and tea to manage some stages of type 2 diabetes using animal models and clinical studies, and point to the importance of an antioxidant-rich diet as part of an overall management strategy,” says Shetty. “This concept is not new, but we are finding clear cellular targets for the functions of dietary polyphenolics. Using specific beverage combinations could generate a whole food profile that has the potential to manage type 2 diabetes and its complications, especially in the early stages.”

(NewsWise)

Proper Seatbelt Use by Pregnant Women Would Save 200 Fetuses/Year

2008-04-02T11:56:00.000-07:00

A new study could have a profound effect on fetal deaths and injuries caused by car accidents.

The study, by researchers at the University of Michigan, found that about 200 fetuses each year would not be lost if pregnant women properly buckled their seatbelts every time they were in an automobile.

“It’s very clear, based on this study, that pregnant women should buckle up every single time they’re in a vehicle,” says senior author Mark D. Pearlman, M.D., vice-chair in the Department of Obstetrics and Gynecology at the U-M Health System. “Our study strongly suggests that about 200 fetuses each year would not lose their lives if women simply buckled up each time.” An estimated 370 fetuses die as a result of car crashes each year in the United States.

The research debunks a long-standing myth that wearing a seatbelt is not safe for pregnant women, says Pearlman, the S. Jan Behrman Professor of Reproductive Medicine.

“Some women are very concerned because the lap belt overlies their fetus. This study shows that the opposite is true, that seatbelts clearly protect the fetus,” he notes. The study appears in the new issue of the American Journal of Obstetrics & Gynecology.

The study results have led Pearlman to initiate a campaign called Safe Babi (Seatbelts Are For Everyone – Buckle All Babies In).

Pearlman teamed up with researchers from the U-M Transportation Research Institute (UMTRI), the Department of Emergency Medicine and the College of Engineering to study data from 57 severe automobile crashes involving pregnant women. The study, the first of its kind, performed detailed crash analysis, including accurate estimates of the crash severity, restraint usage and pregnancy outcome. Among the six improperly restrained women, three (50 percent) resulted in fetal death or major fetal complications. Among the 10 unbelted women, eight (80 percent) of the instances resulted in fetal death or major complications. Among the properly restrained women, 29 percent of instances resulted in death or complications.

“Given that there are seatbelts in virtually every car in America, the cost effectiveness of a project like this is truly extraordinary,” says lead author Kathleen DeSantis Klinich, Ph.D., assistant research scientist with UMTRI.

The study states that:

• The routine use of seatbelts by pregnant women will prevent 84 percent of serious fetal adverse outcomes (injuries and deaths) due to car accidents.
• If all women simply wore their seatbelts during pregnancy, approximately 200 fetal lives would be saved. (The 200 lives saved don't include the number of prevented extreme preterm births, placental abruptions that result in brain injury, etc.)
• There are more fetal deaths due to car impacts than there are deaths of children due to bicycle accidents, or deaths of children due to car accidents in the first year of life.
• Women who are in car crashes resulting in serious fetal adverse outcomes are unbelted 62 percent of the time.
• About 6 percent to 7 percent of women who are pregnant are involved in a car crash during their pregnancy. That translates to about 170,000 car crashes a year involving pregnant women.

Other published research by Pearlman shows that women whose prenatal care provider says anything at all about seatbelt use during prenatal visits are much more likely to wear their seatbelts (92 percent if the physician or nurse mentioned it versus 71 percent if they didn't), according to Pearlman. He encourages health care providers to remind all of their pregnant patients about the importance of using seatbelts.

In addition to Pearlman and Klinich, authors of the study were Carol A.C. Flannagan, Ph.D., and Jonathan D. Rupp, Ph.D., both of UMTRI; Mark Sochor, M.D., of UMTRI and the U-M Department of Emergency Medicine; and Lawrence W. Schneider, Ph.D., of UMTRI and the U-M College of Engineering’s Department of Biomedical Engineering.

Financial support for the initial research described in the paper was provided by General Motors, pursuant to an agreement between GM and the U.S. Department of Transportation. The UMTRI crash database is sponsored by the Alliance of Automobile Manufacturers. Additional data collection by the Crash Injury Research and Engineering Network program was sponsored by the National Highway Traffic Safety Administration.

A Clearer Picture of Cloudy Eyes

2008-03-24T11:30:00.000-07:00

A new study appearing in JBC provides more insight into cataracts, the leading cause of vision loss and blindness in the elderly, finding that small pieces of a perfectly normal protein become toxic during the aging process.

A cataract results from deterioration in the highly ordered assembly of crystallin proteins in the eye lens. Normally, the ordered structure keeps lenses clear and able to efficiently transmit light. However, crystallins gradually break down during aging, causing the lens to become opaque and scatter light instead. Besides age, other risk factors such as diabetes, ultraviolet radiation, or drugs like corticosteroids can also contribute to cataracts.

Like cataracts themselves, the exact mechanisms governing their formation are cloudy, but Krishna Sharma and colleagues found that tiny bits of crystallin greatly contribute to this process.

They compared a range of human donor lenses and found that aged and cataract lenses accumulated about four times as many short (~10-20 amino acids) crystallin fragments compared to young lenses. These fragments could readily bind full-length crystallins, which disrupted their natural shape and organization and caused them to become insoluble.

Ironically, these tiny fragments are a by-product of the eye’s efforts to stay healthy; when a crystallin becomes damaged, other proteins chew it up to remove it; but occasionally the process is incomplete, leaving tiny pieces that can cause greater damage. (Newswise)

Study Provides Clues to Prevent Spread of Ovarian Cancer

2008-03-15T06:57:00.000-07:00

A drug that blocks production of an enzyme that enables ovarian cancer to gain a foothold in a new site can slow the spread of the disease and prolong survival in mice, according to a study by researchers from the University of Chicago Medical Center, but only if the drug is given early in the disease process.

In the April issue of the Journal of Clinical Investigation, the researchers show that an enzyme known as MMP-2 is necessary for ovarian cancer to attach itself to the sites where it tends to spread. Several drugs known as MMP inhibitors (for example, marimastat or prinomastat) inhibit the enzyme, dramatically reducing the tumor's ability to establish itself at sites beyond the ovary. But such MMP inhibitors, which were abandoned after they failed to extend survival in earlier clinical trials, have to be given before the cancer has spread.

"Our study suggests that MMP-2 inhibitors could have a significant impact on ovarian cancer but only if administered quite early, before the cancer has advanced beyond the ovary," said Ernst Lengyel, assistant professor of obstetrics and gynecology at the University of Chicago.

This approach could help women who receive surgical treatment while the disease is still limited to the ovary as well as those who have successful surgery to remove all evidence of local spread of the disease. In the earlier trial, marimastat was given to women with late-stage disease that had already spread.

The fifth leading cause of cancer death in women, ovarian cancer -- unlike breast, colon or lung cancer -- tends to spread within the abdominal cavity and not to distant organs. Carried by fluid, it most often spreads throughout the peritoneal cavity and to the omentum, a large fat pad draped over the small bowel.

Lengyel and colleagues wanted to understand the many steps required for ovarian cancer to dislodge from its original site and establish itself elsewhere in the peritoneal cavity. They found that one of the key steps was production of MMP-2 by cancer cells that came in contact with the cells that line the peritoneal cavity.

When ovarian cancer cells make contact with the cells that line this internal cavity, they produce MMP-2 (an acronym for matrix metalloproteinase-2). MMP-2 alters two proteins--vitronectin and fibronectin--found on the surface of the cells that line the cavity. These alterations change those proteins in a way that enables the cancer cells to latch on to them better. Once attached, the cancer cells can multiply rapidly and invade.

By inhibiting MMP-2 activity early in the disease course, Lengyel and colleagues were able to prevent injected ovarian cancer cells from attaching to their target tissues in the peritoneum and omentum. This reduced the growth of new tumors by 68 percent, when measured four weeks after treatment.

The inhibitor nearly doubled survival time in mice that were injected with ovarian cancer cells. Those who received it survived an average of 63 days, compared to untreated mice, who survived only 36 days.

Brief and early intraperitoneal treatment with an MMP inhibitor, the authors conclude, may reduce peritoneal attachment, reduce metastases and significantly prolong survival.

The treatment has much less impact, however, once cancerous cells have attached and formed colonies. In several earlier trials, marimastat, an oral MMP inhibitor, was given for a prolonged period of time to women with late-stage disease that had already spread.

"MMP-inhibitors were given at the wrong time for too long, causing side effects," Lengyel said. Attachment is the first step for metastatic spread. MMP-2, the target of MMP inhibitors, plays a role in early cancer spread.

"Our study examines the initial step of ovarian cancer metastasis," the authors note, when cancer cells meet unprepared target cells. Other steps in this process, they suggest, may also provide additional treatment targets.

The National Institutes of Health, the Department of Defense, the Ovarian Cancer Research Fund, the Gynecologic Cancer Foundation and the Illinois Department of Health funded the research. Additional authors include Hilary Kenny and Swayamjot Kaur of the University of Chicago and Lisa Coussens of the University of California San Francisco.

Tags - OVARIAN CANCER, METASTASIS, MMP-2, MARIMASTAT, OMENTUM

Parkinson’s Disease Drug Might Work in Cancer Patients

2008-03-15T06:54:00.000-07:00

A study published in the March 13 online issue of The Journal of Clinical Investigation shows that dopamine, a drug currently used to treat Parkinson’s disease and other illnesses, also might work in cancer patients. The study, which was done in mouse and laboratory models, shows that dopamine could possibly prevent new blood vessels from growing and as a result, slow cancer progression.

Dopamine is a neurotransmitter in the brain that regulates movement and affects behavior. In its synthetic form, dopamine is used to treat heart attack victims, Parkinson’s disease and pituitary tumors. But it wasn’t known until now that dopamine worked by blocking the growth of new blood vessels (a process called angiogenesis).

“Researchers now can test this concept in solid tumors where angiogenesis plays a critical role in the growth and progression of these cancers,” says Sujit Basu, M.D., Ph.D., a Mayo Clinic scientist who conducted this study with Partha Sarathi Dasgupta, Ph.D., a scientist with the Chittaranjan National Cancer Institute (CNCI) in Calcutta, India.; and, Debanjan Chakroborty, Ph.D., a postdoctoral fellow in biochemistry at Mayo Clinic and CNCI.

“Sometimes new drugs may not be the answer. We looked instead at a novel use for an established product and have found very promising results,” Dr. Basu says.

The study has not been replicated in humans, but the results are encouraging, he says.

Dr. Basu has been studying the role of dopamine in cancer for years, and was credited with the initial discovery that dopamine can block new blood vessel growth. His current study is based on mouse and laboratory models of sarcoma -- a malignant tumor affecting soft tissues. The research is the first report that dopamine has a role in cancer’s use of endothelial progenitor cells to provide a supply line of nourishing blood, Dr. Basu says. These cells, a form of stem cells, are released by bone marrow into the blood system in response to the vascular endothelial growth factor-A (VEGF-A), which is a protein that is secreted by oxygen-deprived cancer cells. The endothelial progenitor cells then help form new blood vessels to feed the cancer.

Researchers discovered that dopamine stops the transfer of endothelial progenitor cells from the bone marrow into the circulatory system by binding to a specific receptor on the surface of the progenitor cells. This binding suppresses the activity of matrix metallopeptidase 9 (MMP-9), an enzyme that enables these cells to move out of bone marrow.

In their experiments, they found that treatment with dopamine significantly decreased mobilation of the progenitor cells from the bone marrow, and it also decreased MMP-9 expression.

“This is the first time it has been shown that an important neurotransmitter like dopamine is regulating the mobilization of these progenitor cells from the bone marrow. This is very important and represents why these findings are so unique,” Dr. Basu says.

Other authors include: Chandrani Sarkar, Ph.D., of both CNCI and Mayo Clinic; Uttio Roy Chowdhury, Ph.D., and Rathindranath Baral, Ph.D., both of CNCI.

This research was supported by grants from the Department of Biotechnology, the Government of India; the National Institutes of Health; and the U.S. Department of Defense.

Tags - DOPAMINE, CANCER PROGRESSION

Breast Cancer More Aggressive Among Obese Women

2008-03-15T06:52:00.000-07:00

Women with breast cancer have more aggressive disease and lower survival rates if they are overweight or obese, according to findings published in the March 15 issue of Clinical Cancer Research, a journal of the American Association for Cancer Research.

“The more obese a patient is, the more aggressive the disease,” said Massimo Cristofanilli, MD, associate professor of medicine in the Department of Breast Medical Oncology at The University of Texas M.D. Anderson Cancer Center. “We are learning that the fat tissue may increase inflammation that leads to more aggressive disease.”

Cristofanilli and colleagues observed 606 women with locally advanced breast cancer. These women were classified by body mass index into the following three groups: normal/underweight (24.9 or below), overweight (at least 25 but less than 30) or obese (more than 30). Body mass index is calculated by dividing a person’s weight by their height.

At five years, overall survival was 56.8 percent among obese women, 56.3 percent among overweight women and 67.4 percent among normal weight women. The 10-year survival rate was 42.7 percent among obese women, 41.8 percent among overweight women and 56.5 percent among normal weight women.

The rate of inflammatory breast cancer, previously shown to have worse outcomes than non-inflammatory breast cancer, among obese women was 45 percent compared with 30 percent in overweight women and only 15 percent in women considered normal weight, researchers found.

Risk of breast cancer recurrence was also higher in obese or overweight women. By five years, 50.8 percent of obese women reported a recurrence compared with 38.5 percent of normal weight women. By 10 years, the rate of recurrence was 58 percent among obese women and 45.4 percent among normal weight women.

“Obesity goes far beyond just how a person looks or any physical strain from carrying around extra weight. Particular attention should be paid to our overweight patients,” Cristofanilli said.

Cristofanilli said physicians need to pay close attention to breast cancer patients because commonly used drugs, such as tamoxifen, tend to increase weight gain during treatment.

“We have actually become quite good at managing acute side effects such as nausea in our chemotherapy patients and it goes away within a couple of days,” Cristofanilli said.

“Following the nausea, our patients tend to overeat, which further increases their risk of weight gain. We need to implement lifestyle modifications interventions and develop better methods to follow these patients closely.”

The study was funded by the Susan G. Komen Foundation, the Nellie B. Connally Fund for Breast Cancer Research and the Inflammatory Breast Cancer Research Group.

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes nearly 27,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment, and patient care. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication and its sixth major journal, Cancer Prevention Research, is the only journal worldwide dedicated exclusively to cancer prevention, from preclinical research to clinical trials. The AACR also publishes CR, a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. CR provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship, and advocacy.

Tags - BREAST CANCER, OBESITY, RESEARCH, CANCER

Snoring May Be Chronic Despite Surgery

2008-03-15T06:42:00.000-07:00

Especially for African-American Children and Children with Rapid Weight Gain

Children who gain weight rapidly after having their tonsils and adenoids removed to treat sleep-disordered breathing (SDB) may improve in the short-term, but over time they may relapse or even worsen. African-American children also tend to relapse, according to new research from Cincinnati Children’s Hospital Medical Center.

Adenotonsillectomy is the most commonly performed surgery in children, ranging from about 19 per 10,000 in Canada to 115 per 10,000 in the Netherlands. In the U.S., the rate is about 50 per 10,000. It is the first line of treatment for SDB in children. For many kids, undergoing this major surgery provides only temporary relief.

“The high rate of recurrence we observed in both obese and non-obese children indicates that SDB is a chronic condition,” said Raouf Amin, M.D., director of pulmonary medicine at the hospital.

The results were published in the second issue for March of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society.

The researchers recruited 40 healthy children between seven and 13 whose parents and otolaryngologists had jointly agreed upon adenotonsillectomy surgery to treat nightly snoring. The investigators also recruited 30 sex- and age-matched children who were not undergoing adenotonsillectomy as a control group. They performed polysomnographies on each child at time of recruitment, and again at six weeks, six months, and a year following surgery. Children in the control group had polysomnographies at the same intervals.

While the majority of children with SDB showed significant improvement in their AHI scores six weeks after surgery, the rate of relapse one year later had no correlation with the six-week score. Children who relapsed were more likely to be more obese, have worse SDB at baseline, have an accelerated body mass index (BMI) gain, and to be African-American.

“Most post-adenotonsillectomy outcome studies have focused on the assessment of SDB six to 16 weeks after surgery. Resolution of SDB during this window was usually interpreted as a cure for the disorder,” noted Dr. Amin. “We report[ed] for the first time the longitudinal outcome of adenotonsillectomy in healthy children, the important influence of BMI gain velocity and African-American race on recurrence of SDB.”

Half of the non-obese children, and two-thirds of the obese children had an AHI score of greater than 3 prior to surgery. A year later, 27 percent of the non-obese children and 79 percent of obese children had AHI score of greater than 3, indicating that the surgery was significantly more effective at a year in non-obese children.

While children who were obese at the baseline were more likely to relapse than their no-obese peers, accelerated BMI gain was also an independent risk factor for relapse.

“These results highlight the differential disease mechanisms between those due to obesity and those due to the rapid change in body composition associated with accelerated BMI gain,” explained Dr. Amin.

Furthermore, children who relapsed had significantly higher blood pressure at follow up than children who didn’t.

“SDB appears to be a chronic disorder that is clearly linked to other medical problems. Given the rate of relapse, we advocate long-term follow up of children with SDB, monitoring of BMI gain, and reevaluation of children who demonstrate rapid BMI gain, especially those who are African-American,” the researchers concluded.

TAGS - SLEEP DISORDERED BREATHING, PEDIATRICS, SNORING, ADENOTONSILLECTOMY, TONSILLECTOMY

New Supplemental Blend Treats TMJ Pain Naturally

2008-01-23T09:56:00.000-08:00

Natural TMJ Relief provides effective alternative to surgery

Most everyone has heard of TMJ ... the popular acronym for the "temporomandibular joint," and the jaw pain and dysfunction associated with it. What they don't know is that TMJ is so common that approximately 50 percent of the population will experience this condition at some point in their lives. At any given time, 10 to 15 million people are walking around with the aching, muscle spasms and even headaches that are all attributable to TMJ, according to Dr. Jeffrey B. Wheaton, a Santa Fe, N.M.-based oral and maxillofacial surgeon.

"Unfortunately, many people don't realize they have TMJ or that there are easy, non-invasive ways to manage and even treat this disorder," Wheaton says. "What this means is that people are suffering needlessly."

In treating TMJ patients, Wheaton prescribes medications, such as painkillers, and offers surgery when it's absolutely necessary. More recently, however, he's been moving toward a less-invasive, more holistic approach to TMJ treatment options. What's more, Wheaton is officially unveiling an all-natural supplement that he has personally developed: Natural TMJ Relief(TM) (http://www.naturaltmjrelief.com).

"There are many naturally occurring substances that produce a calming effect and therefore reduce the muscle spasms and inflammation that contribute to TMJ disorders," Wheaton says. "The first product of its kind in the marketplace, Natural TMJ Relief(TM) is the perfect blend of the vitamins and herbs needed for a healthy temporomandibular joint system. It's not harmful to patients, and it provides the nutrients that sooth TMJ pain and discomfort."

Factors contributing to TMJ include bite problems and trauma to the joint. However, stress - typically manifested as clenching or grinding of the teeth - is the number-one cause of TMJ. In such cases, eliminating or reducing stress is the long-term goal. Meanwhile, taking Natural TMJ Relief(TM), using a bite-guard, and doing physical therapy to relax and strengthen the muscles may also eliminate TMJ symptoms.

"Nowadays, supplements are very respected and have even gone mainstream," Wheaton says. "With so many people suffering from this prolific condition, the demand for Natural TMJ Relief(TM) is very real. And in general, people taking Natural TMJ Relief(TM) are less likely to undergo surgery or take prescription drugs - the main reason I developed this unique product and launched an educational website to promote it as well as address issues related to TMJ."

For more information, visit: http://www.naturaltmjrelief.com

About Natural TMJ Relief

Natural TMJ Relief(TM) is an all-natural supplement for Temporomandibular Joint Disorder. It was developed by Dr. Jeffery B. Wheaton, a board-certified oral and maxillofacial surgeon with experience treating TMJ and based in Santa Fe, N.M. Natural TMJ Relief(TM) is the only product in the marketplace specifically designed to target all TMJ aspects including: joint pain and inflammation; muscle spasm; cartilage damage; and anxiety, tension and stress. Natural TMJ Relief is available online at http://www.naturaltmjrelief.com.

Calcium Supplements May Increase Heart Attacks in Older Women

2008-01-16T23:42:00.000-08:00

New research suggests that calcium supplements may increase the risk of heart attack in healthy postmenopausal women.

Calcium supplementation is commonly prescribed to postmenopausal women to maintain bone health, and some data suggest that it might protect against vascular disease by lowering levels of bad cholesterol in the blood.

But evidence for this theory is lacking, so researchers at the University of Auckland investigated the effect of calcium supplementation on heart attack (myocardial infarction), stroke, and sudden death.

Their analysis involved 1,471 healthy postmenopausal women aged 55 years or over who had previously taken part in a study to assess the effects of calcium on bone density and fracture rates.

The women were randomly allocated to a daily calcium supplement or placebo. Dietary calcium intake was assessed and women were seen every six months over five years.

Adverse events were recorded at each visit. Heart attacks were more commonly reported in the calcium group. The occurrence of any three vascular events (heart attack, stroke or sudden death) was also more common in this group.

Because of the potential importance of these findings, the authors checked hospital admissions and reviewed all death certificates for study participants to identify any unreported events.

With these added events, heart attacks remained more common in the calcium group (36 events in 31 women versus 22 events in 21 women on placebo). Rates for heart attack, stroke or sudden death were also increased in this group (76 events in 60 women versus 54 events in 50 women on placebo) although these event rates were of borderline significance.

These findings are not conclusive, but suggest that high calcium intakes might have an adverse effect on vascular health and are concerning, say the authors. If confirmed by other studies, this effect could outweigh any beneficial effects of calcium on bone.

In the meantime, this potentially detrimental effect should be balanced against the likely benefits of calcium on bone, particularly in elderly women, they conclude.

(Newswise)

Stressed, Can't Sleep?

2008-01-14T10:19:00.000-08:00

New 'Quick2Sleep' All Natural, Fast Acting, Dissolving Strip Works Miraculously

Tossing, turning? Is the stress of being back to work keeping you up at night? Need help to get to sleep quickly? When you don't have 8 hours or cannot take a prescription sleep aid there's a revolutionary all natural sleep aid available in a fast dissolving strip that allows you to get to sleep almost instantly. Quick2Sleep is the revolutionary natural sleep aid delivered via a fast acting dissolving strip that instantly melts in your mouth. A proprietary blend of all natural ingredients quickly enters the blood stream and induces a safe sound sleep within 15 minutes. This unique formula and revolutionary delivery method is a true breakthrough in sleep aid treatment that insomnia sufferers have been searching for. Most importantly it's safe, non-habit forming, and it works!

Nature's Healthy Supplements is excited to announce the immediate availability of a revolutionary new Sleep Aid product, Quick2Sleep at http://www.quick2sleep.com. Quick2Sleep is a 100% natural Sleep aid that is non-narcotic, non-addictive, non-habit forming, works quickly, and let's you wake rested and not groggy. Now you have a great natural alternative to harsh prescription medications.

The oral strips that induce sleep, similar to breath fresheners are designed to dissolve on the tongue. They are intended for use by adults who, have difficulty falling asleep, don't or cannot take prescription sleep medications, or want fast acting results. You do not even need a glass of water. It's great for the business travelers who need to get to sleep in-flight and arrive refreshed without being groggy. Many people do not have 8 hours when they go to bed and are afraid to take a prescription sleep aid due to the morning side effects - now if you awaken in the night - there's Quick2Sleep to help you get the rest you need.

Oral thin film products are a relatively new delivery technology that provides a quick way to ingest medicinal or dietary supplements and the benefits are realized almost instantaneously. "Consumers have become accustomed to using film technology in breath fresheners. It just makes sense to use this delivery form for supplements and particularly our natural sleep aid product, Quick2Sleep(TM), said the company. "It's what consumers are looking for; safe, fast acting, easy to take, 100% natural alternative to prescription sleeping drugs at an affordable price."

Quick2Sleep fast dissolving sleep aid strips are available at the company's website, http://www.quick2sleep.com for the introductory price of $12.95 for 24 strip package or call the toll-free hotline at (888) 768-3836.

Nature's Healthy Supplements, Inc. gives you the choice and access to dietary supplements that are safe, effective and relied upon by the rest of the world. We would encourage you to visit Nature's Healthy Supplement's product websites: http://www.quick2sleep.com and http://www.bestprostate.com.

Women and Heart Disease: Something to Talk About

2008-01-11T11:06:00.000-08:00

Description

Dr. Blanchard of the UCSD Medical Center, and Susan Iliff, a retired nurse discuss the symptoms of heart attack in women.

Eight million women in the United States suffer from cardiovascular disease. It is their number one cause of death. The disease often exhibits itself with symptoms such as back or arm pain, indigestion, and shortness of breath. The most common way women respond to the early signs? They ignore them.

“When I had my first angina attack in my 50s, I was working on a TV commercial about stroke awareness,” said Susan Iliff, 59, a retired UC San Diego Medical Center nurse. “I didn’t feel quite right. I was a little short of breath which I attributed to a hectic work schedule. Later, I felt some heaviness in my chest which I thought was bronchitis.”

Two days later Iliff’s life changed forever.

“I was sitting at my desk on a Friday when suddenly I had a shooting pain in my jaw. I knew immediately it was my heart. By Monday, I had bypass surgery.”

Iliff’s story is common among many women. The symptoms they feel are not the popularized symptoms of heart attack.

“Women often do not experience the crushing pain that men feel from a heart attack,” said Denise Barnard, M.D., director of the Women’s Cardiovascular Health Program at UCSD Medical Center. “Women’s symptoms of heart attack are sometimes more subtle and often dangerously dismissed for less serious ailments.”

For women, the most common signs of heart attack are chest or mid-back or shoulder pain, deep aching in one or both arms, breathlessness, clamminess, dizziness, and anxiousness. Other symptoms may be swelling of the ankles or lower legs, a fluttering heart, gastric upset, or a feeling of heaviness in the chest. All these symptoms should be reported to a doctor.

Iliff, a single mother of three who also cared for her aging parents, one with chronic pulmonary disease, and the other a paraplegic, found that simple conversation was key to significantly relieving stress and keeping her own health on track.

“Having a heart attack is really scary. Going back to managing your family, excelling at work, attending to your home and investments, in addition to caring for your own heart can be even scarier. You need help. You need others to look out for you,” said Iliff.

To help women connect with other female heart patients, Iliff decided to start a support group. She is now a trained group support leader for WomenHeart: the National Coalition for Women with Heart Disease, a national advocacy organization for women heart patients.

“Somehow we have this idea in our head that we’re desperately needed by everyone around us—except ourselves. Yes, our kids need us. But more importantly, they need us to take care of our own health so that we can be there for them,” said Iliff. “Believe me, it’s easier to treat the early signs of heart disease than it is to wait and have a heart attack.”

The first WomenHeart support group meeting will take place at UCSD Thornton Hospital on February 19, 2008. The group will meet on the third Tuesday of every month from noon until 1:00 p.m. During each meeting, women talk about their personal experiences, listen to speakers, and share tips and information on their own treatments. The meeting is free and open to all women in the community. Similar groups are offered by WomenHeart in 50 U.S. cities.

Communication extends outside the support group in the form of daily emails, phone calls and personal visits. If any one participant undergoes a medical procedure or operation, fellow members visit and offer support where needed. As a sign of solidarity, the women wear a bright red scarf as reminder to take care of themselves.

“Every new member at UCSD receives a beautiful red knitted scarf,” said Iliff. “Just as each woman in the group is different, no two scarves are alike. The scarf travels with us to our medical appointments and on those days we need to remember that we are not alone and that we are loved.”

The Sulpizio Family Cardiovascular Center at the University of California, San Diego developed the Women’s Cardiovascular Health Program to directly combat cardiovascular disease (CVD) in women. The program is led by a group of leading female physicians dedicated to helping women understand, prevent and treat the disease. Risk screening evaluations are available for women who think they may be at risk for heart disease or stroke. For those women with diagnosed CVD, the program provides the tools needed to manage the disease.

Experts Examine Blood Clots, Angiogenesis in Women

2008-01-11T11:02:00.000-08:00

Description

Drs. Mary Cushman and Matthew Watkins are established leaders in the field of cardiovascular research. Their efforts have uncovered new information about women's cardiovascular risk and potential new therapies for angina in women.

University of Vermont cardiovascular physician-scientists Mary Cushman, M.D., and Matthew Watkins, M.D., are conducting cutting-edge research on the number-one killer of men and women in the United States -- cardiovascular disease.

NEW FINDINGS ABOUT HORMONES AND BLOOD CLOT RISK
In early December 2007, Cushman presented preliminary data from two Women’s Health Initiative trials that assessed factors that indicate increased risk of venous thromboembolism (VTE) with postmenopausal hormone therapy. VTE refers to a blood clot that forms in the veins, usually in the legs. These clots can become fatal if they travel through the veins to the lung. According to the American Heart Association, more than 200,000 cases of VTE occur each year and 30 percent of these people die within three days. It is known that postmenopausal hormone treatments can double the risk of developing VTE, and in recent years hormone prescriptions have declined, partly as a result of this.

“If these findings are confirmed, measurement of some of these factors might assist women with decision-making about whether or not to take estrogen or estrogen plus progestin for treatment of postmenopausal symptoms," said Cushman. "This becomes very important since hormones remain a very effective treatment for menopausal symptoms."

WOMEN WITH ANGINA BETTER CANDIDATES FOR ANGIOGENIC THERAPY
A reported 8.9 million people in the United States, including 4.6 million women, live with chronic angina, the debilitating chest pain, squeezing or pressure experienced by people with coronary heart disease. However, women with heart disease have been largely underrepresented in cardiovascular clinical trials. A recent study article co-authored by Matthew Watkins, M.D., professor of medicine at the University of Vermont College of Medicine, indicates that an experimental treatment designed to promote blood vessel growth and improve cardiovascular blood flow in patients with angina may have a positive treatment effect in women as opposed to men.

The AGENT (Angiogenic Gene Therapy) studies (1 through 4) have to date involved 663 patients at more than one hundred U.S., European and other international medical centers. The experimental therapy under examination in the AGENT trials is Generx™ (alferminogene tadenovec, Ad5FGF-4), a gene product in a new class of cardiovascular biologics that when administered by intracoronary injection, promotes angiogenesis – the process of blood vessel growth in the heart. For their September 11, 2006 Journal of American College of Cardiology article, Watkins and his colleagues analyzed pooled original data from the AGENT -3 and -4 trials to determine treatment effects in two subgroups, gender and older patients with severe angina.

The study used exercise tolerance testing time to track any changes from baseline at 4 weeks, 12 weeks and 6 months among three groups – placebo, low-dose Ad5FGF-4 and high-dose Ad5FGF-4. At 12 weeks, there was significant improvement in women at both doses, but not in men.

Based on these findings, a Phase 3 clinical trial titled AWARE (Angiogenesis in Women with Angina pectoris who are not candidates for Revascularization) was launched in August 2007. UVM is one of more than two dozen centers in the country currently participating in this trial, which aims to enroll approximately 300 women with chronic angina who are not candidates for conventional bypass surgery or angioplasty in order to more closely examine the effects of angiogenic therapy on this population of patients.

Strict surveillance at work 'can affect' health of employees

2008-01-09T03:37:00.000-08:00

London, Jan 9 - Employers, please note -- don't
keep your staff members under surveillance in office all the
time as it might affect their health.
A study has found that employees are being put under
increasing strain when their bosses use monitoring equipment
to keep track of how hard they're working.
In fact, the constant surveillance leaves the staff
members feeling exhausted and anxious, according to British
researchers who carried out the study for the Economic and
Social Research Council.
"Computers and IT systems are bringing surveillance
to most workplaces. Now for the first time we can see how this
development is damaging employees' well-being," according to
lead researcher Dr Michael White.
Dr White, who co-directed the study with Dr Patrick
McGovern of the London School of Economics, came to the
conclusion after analysing a survey -- they questioned 2,132
employees and 2,000 employers across all industry sectors.
The researchers found that in workplaces checked by
computer, reports of work-related strain rose by 7.5 per cent.
Evidence of added stress was particularly striking
among administrative and white-collar staff in offices such
as call centres, where it rose by 10 per cent if staff were
monitored constantly.

A growing number of employers also admitted to
monitoring their staff's Internet use to ensure they were not
wasting time on social networking sites, the study found.
Those in lower-ranking office jobs, rather than those
in professional and managerial roles, tended to suffer the
worst effects of monitoring.
Dr McGovern said many employees felt as if they had
simply become "an appendage of a machine".
"People are having to register every piece of work
they do. Where your work is routinely recorded electronically,
then there's a sense that you are becoming an appendage of a
machine. The people who work under this sort of monitoring
were more likely to report work strains like feeling exhausted
at the end of the day," he said.
Dr McGovern said the research, covering changes in
the British workplace from 1984 to 2004, showed the trend in
monitoring had spread very quickly, but he expected it to
continue.

Nutrition Trends of 2008

2008-01-04T11:35:00.000-08:00

With 2008 here, we all are looking for that magic pill that will make us look and feel better. You will find out that the magic pill is no longer a pill, and nutrition trends of 2008 will put you on the right path. "Nutrition can be confusing if you listen to all the hype," said Dr. Clive R. Spray, a biochemist and leader in nutrition research for the past 11 years.

How can we improve the health of our family and ourselves?

Here are 7 predictions from our list of 15 that will put you on track in 2008:

1. With all the superbugs going around, like strep, MRSA, bird flu, etc. ... What can we do? The best defense is to build a strong and healthy immune system. You already know you need a good multiple as well as supplementation with vitamin C and zinc. Research is starting to lean towards herbs that support the immune system. The top 3 herbs are Echinacea, garlic and goldenseal. They're best when you can find them all in one formulation.

2. With this New Year, our bulges around our waists are getting larger. We are all tired of years and years of fad diets. The nutritional approach to weight loss finally begins to gain a foothold with the American population. Research continues to support the fact that obesity is linked to dietary deficiency rather than purely overeating. Providing the body the nutrients it needs to sustain daily activities leads to a marked reduction in overeating and obesity. You need to find a nutritional program that hits the 5 keys to weight loss (deficiency, caloric intake, acid factor, immune, and activity). The diet must include protein, vitamins, and minerals which effectively curb the appetite while maintaining optimum health.

3. Keep an eye out for the new "super-nutrient" to emerge in 2008. It will be vitamin D. Throughout 2007 we regularly read about emerging research on this nutrient, and this will continue into 2008. We fully expect government guidelines on the intake of vitamin D to be changed early in the year. Deficiency of vitamin D is common in the United States and worldwide. It is known to be important in bone mineral metabolism, but now we have information that it does much more. For example: good intake of vitamin D can reduce both hip fractures and other non-vertebral fractures; it can improve symptoms of leg weakness; it can improve lower extremity strength and improve walking for seniors; and it has even been shown to significantly diminish occurrence of certain cancers. Other metabolic disorders that may benefit from vitamin D include type 1 diabetes, hypertension, cardiovascular disease, possibly type 2 diabetes, and multiple sclerosis.

4. More emphasis will be placed on bringing the body into balance. Extensive medical research will emerge supporting the view that too much of a single nutrient can be as damaging as too little, leading some nutritional companies to reformulate products and use the synergistic approach to nutrition.

-- Multiple (takes care of dietary deficiency)
-- Colloidal Minerals (takes care of dietary deficiency)
-- C + Zinc (builds a healthy immune system)
-- B12 (energizer)

These four products provide the nutrients the human body needs on a daily basis, with useful, usable doses that are easy on the body (and, of course, represent value for money).

5. The most significant trend in the nutritional industry was a novelty about 25 years ago when it was first introduced by Vitamist.com. Now accepted in the medical arena, it will start having acceptance and understanding as a delivery system for your nutrition. One medicine that is already being sprayed is nitroglycerin. This is a great example because it is being used to save lives throughout the country by EMT's - spray delivery is used because of purity, improved effectiveness, ease, and instant delivery. With all that background, vitamin sprays will grab the country's attention as being the best way to take supplements.

6. The USA continues to lead the world in deaths from heart disease, despite what is largely regarded as the most advanced (if not the most available) health care system in the world. In addition, the availability of doctors, drugs, and hospitals, all specializing in heart health, is regarded as among the best in the world. Public awareness of this growing problem helps to drive a trend towards the "natural" approach to circulatory health. A simple amino acid, L-arginine, leads this trend. Nobel Prize-winning work demonstrated that L-arginine is a major factor for vascular protection, together with L-citrulline.

7. The number one factor inducing health problems is STRESS!! The use of B-complex vitamins as an antidote to the effects of stress continues to gain in acceptance. During periods of extreme stress the body will deplete its reserves of B-vitamins and will also become susceptible to infection and disease.

It has been shown that good nutrition is a major key to good health and a longer life. Use these predicted trends to change your life for the better in 2008. For the rest of the predicted trends by Dr. Clive R. Spray, you can go to his web site - http://www.drspray.com

Women Who Smoke at Increased Risk of Lung Disease

2008-01-04T04:38:00.000-08:00

Description

Here’s another reason not to smoke, especially for women: chronic obstructive pulmonary disease (COPD).

Here’s another reason not to smoke, especially for women: chronic obstructive pulmonary disease (COPD).

This disabling breathing disorder is increasingly becoming a problem for women, according to the January issue of Mayo Clinic Women’s HealthSource. The most important risk factor for COPD is long-term cigarette smoking.

Chronic obstructive pulmonary disease is a broad term that describes any of a group of illnesses that block airflow through the lungs. The most common are emphysema and chronic bronchitis. Signs and symptoms of COPD -- persistent cough, increased mucus production, shortness of breath and frequent colds and respiratory problems -- often develop gradually, and people don’t realize they have the disease until it’s advanced.

Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States. The COPD death rate for women rose much faster between 1980 and 2000 than it did for men. In 2000, the number of women dying of COPD surpassed men for the first time. According to recent research, women with the disease experience more breathlessness, higher rates of depression and lower quality of life than men with the disease -- even those women reported fewer years of smoking than men.

The increase in female rates of COPD likely reflects the increase in the number of female smokers since the 1940s, when advertisers began promoting smoking as a symbol of independence for women.

Chronic obstructive pulmonary disease can be treated, but not cured. The most important treatment is to stop smoking. For smokers with COPD, quitting smoking reduces subsequent loss of lung function by half and cuts the death rate by nearly half. And some better news for women is that those who quit smoking receive twice as great an improvement in lung function as men. (Newswise)

Moderate Exercise Yields Big Benefits

2008-01-04T04:35:00.000-08:00

Description

What’s the key to looking and feeling better and enhancing your health? Exercise.

What’s the key to looking and feeling better and enhancing your health? Exercise.

Moderately strenuous exercise, about 30 minutes a day, can lead to enormous benefits in terms of your mood, health, weight and the ability to live an independent and fulfilling life. The exercise doesn’t need to be athletic or difficult. Studies have shown that simply walking at a brisk pace for 30 minutes or more on most days can lead to significant health improvements. Add simple strengthening exercises two or three times a week and the benefits are even greater.

The January issue of Mayo Clinic Health Letter lists some of the benefits of 30 minutes of exercise a day:

Lower blood pressure: A reduction of 5 to 10 millimeters of mercury (mm Hg) is possible. In some cases, that’s enough to prevent or reduce the need for blood pressure medications.

Improve cholesterol: Exercise often increases the concentration of high-density lipoprotein (HDL or “good” cholesterol in the blood), especially when accompanied by weight loss. Exercise also helps reduce triglyceride levels.

Prevent or manage type 2 diabetes: Exercise helps insulin work better, lowering blood sugar.

Manage weight: Coupling exercise with a healthy diet is the best way to shed fat and maintain a healthier body composition.

Prevent osteoporosis: Exercise may increase bone density and protect against bone mass decline, especially if weight-bearing activities are involved.

Prevent cancer: Exercise has been shown to strengthen the immune system, improve circulation, reduce body fat and speed digestion. Each has a role in preventing cancer, particularly cancers of the colon, prostate, uterine lining and breast.

Maintain mental well-being: Exercise may help reduce stress, improve mild-to-moderate depression and anxiety, improve sleep and boost moods.

Increase energy and stamina: A lack of energy often results from inactivity, not age.

Herbal tea for body weight maintenance

2008-01-03T22:28:00.000-08:00

Garcinia atroviridis known in Malaysia as Asam Gelugor is a big-size perennial fruit tree, which is endemic to Peninsular Malaysia. The fruits are bright orange in colour when ripe. The dried sliced fruit is known locally as Asam Keping, and it is popularly used as seasoning in curries, sour relish and also for fish dressing.

Garcinia atroviridis fruits contain fruiting acids such as citric acid, tartaric acid, malic acid and ascorbic acid and hydroxycitric acid (HCA). Hydroxycitric acid (HCA) found in Garcinia spp. has been studied extensively in the animal model.

HCA was found to suppress fatty acid, cholesterol synthesis and reduce appetite. Studies have shown that HCA decreases weight by inhibiting lipogenesis, the metabolic process that changes carbohydrate into fat.

HCA also lowers blood lipid levels. Body weight maintenance nutraceutical products have been developed from fruit extract of Garcinia atroviridis. The fresh raw material for the above nutraceutical product is not readily available as the fruiting is seasonal and can only be harvested during certain period of the year. Moreover the fresh ripe Garcinia atroviridis fruits are facing storage problems as they are easily infected with fungus.

Our studies showed that HCA is detected in Garcinia atroviridis leaves. The level (w/v) of HCA in the leaves is comparable to the fruits. Based on bioactivity studies, chemistry studies, safety evaluation, processing and formulation studies that had been conducted, a body weight maintenance herbal tea was developed from Garcinia atroviridis leaves.

contact-

Zamree M.S. , Ong B.K., Hada Masayu I., Noor Rasyila M.N., Abdull Rashih A, Mohd Shahidan M. A., Pin K.Y, Mohd Radzi A., Mohd Faizal K. and Rasadah M.A.
Forest Research Institute Malaysia (FRIM), 52109 Kepong, Selangor
E-mail: zamree@frim.gov.my

Plastic Surgery: Truth Is in Style

2008-01-03T09:34:00.000-08:00

DALLAS, Jan. 3, 2008 -- According to a recent Yale University study published on an MSNBC website, "79 percent of patients who underwent plastic surgery were influenced by television and media."

That means roughly 4 out of 5 patients are relying on TV and other media for education.

With so much controversy and misunderstanding surrounding plastic surgery and other elective procedures, the launch of new television show Modern Beauty couldn't have better timing.

With a mission to "empower those seeking cosmetic procedures," Modern Beauty goes against the grain of plastic surgery reality shows to inform and educate its audience.

What does board certification really mean? What is the Gummy Bear? What is the reality of tummy tuck recovery? These, and other, questions are answered by several of the nation's best doctors, and through the real experiences of their patients.

"Television audiences are sophisticated. We know they want high-quality HD video, great sound, and entertaining storylines. Modern Beauty accomplishes this while communicating an accurate portrayal of elective surgical procedures," said the show's executive producer.

Featured physicians include Dr. Grant Stevens, Dr. David Stoker and Dr. Carson Liu of Los Angeles, Dr. Jay Burns of Dallas, Dr. Lior Heller and Dr. Thomas P. McHugh of Houston, and Dr. Robert Cohen of Scottsdale.

Beginning January 6th, Modern Beauty airs nationally from 5-5:30 AM Sunday mornings on the Style Network. All televised segments will be made available on http://www.modernbeauty.tv as free, on-demand streaming video.

Modern Beauty is produced by Hacienda Nocturna Productions, LLC.

Link Between Childhood Obesity and Adult Discrimination

2008-01-02T12:09:00.000-08:00

COLORADO SPRINGS, Colo., Jan. 2, 2008 -- The U.S. Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity sites that there is a 70% chance of overweight adolescents becoming overweight or obese adults. The chances increase to 80% if one or more of the parents are overweight or obese. This strong association between childhood obesity and subsequent adult obesity creates an obvious need to focus attention on habit change, nutrition, and exercise during childhood (when habits are being formed and are easier to correct).

There are many serious health risks associated with being overweight or obese including heart disease, diabetes, high blood pressure, stroke, certain cancers, arthritis, and sleep apnea. The health risks are well researched and documented. However, very few studies have addressed the social and personal economic impact of being overweight or obese.

Dr. Rebecca Puhl and Dr. Kelly Brownell of Yale University have conducted a review of discriminatory behaviors and negative attitudes that people have towards overweight and obese adults. The review was published in the professional journal Obesity Research. Their study suggests that discrimination towards overweight and obese adults is widespread and includes the following findings:
-- There is significant negative hiring prejudice for
overweight and obese adults particularly for women,
sales positions, and managerial positions.
-- There is a significant wage penalty for being obese.
-- Obese adults have lower promotion prospects due to
discrimination.
-- Many health care workers have negative attitudes
regarding obese patients.
-- Many educators also have a prejudice against overweight
and obese students.

One method to combat adult obesity is to modify the nutrition and exercise habits of "at risk" children. Shawn McCance, Founder of the Thriving Child Corporation is launching the Aqua Fitness and Nutrition Program in Colorado Springs, Colorado. This eight-week program will combine family (both parent and child-level) nutrition education with swimming games and basic swimming stroke instruction (three days a week). The goal is to modify life-long behavior through habit change, incorporating both physical fitness and improved nutrition. Nutrition sessions will be taught by highly qualified Registered Dietitians. Swimming sessions (taught by skilled swim coaches) are focused on having "fun in the water". The goal is learn (or re-learn) that exercise can be truly enjoyable. For more information, please visit http://www.thrivingchild.com or call 800-719-6756.

If you would like more information about this topic (or wish to schedule a meeting) please email Shawn McCance at sm@thrivingswimmers.com or call (719) 322-3048.

Bring in the New Year with a New Fitness Routine

2008-01-01T11:55:00.000-08:00

Description

Joining a gym is easy. What’s hard is sticking with an exercise routine for more than a few weeks into the new year. To start and stick with a new workout plan through 2008, a University of Michigan Health System fitness expert offers advice for setting reasonable fitness goals, and staying motivated at the gym.

It’s that time of year again – you have had your final glass of eggnog and your last bite of pumpkin pie. Now you are ready to start the year off right with a new exercise plan – and to keep it up throughout the year so that fitness becomes a routine rather than just another resolution.

Colleen Greene, wellness coordinator with MFit, the University of Michigan Health System’s health promotion division, says that in order for a workout plan to succeed a person must realize that pounds won’t come off within the first clutch of a dumbbell. Instead, exercise must become part of a regular routine rather than be thought of as a short-term solution.

“The number one New Year resolution people have is to lose weight, and it is really not that difficult. But many expect it to be done overnight, and they lose their motivation when that doesn’t happen,” says Greene. “You didn’t gain weight overnight, so you’re not going to lose it overnight either.”

One main way people jump into a fitness routine is by joining a gym. But often the motivation disappears only weeks after a new membership. Greene offers several tips on how to start and stick with a new workout plan.

1. Join a fitness center that is convenient to your lifestyle. “It’s great if you see that a fitness center across town is all new and sparkly, but if you have to fight cross-town traffic to get there it’s probably not a good choice,” advises Greene. It is also important to make sure the center’s hours mesh with your schedule, if it offers child care or other programs you may need and that it has a qualified staff.

2. Ask questions. Don’t be shy about learning all that the fitness center has to offer, says Greene. Most gyms have specialists and personal trainers that can help you navigate equipment and devise the best plan for your fitness needs. You should also get the OK from your doctor as you begin a new workout routine, and ask any questions that you may have about your health.

3. Try things you’ve never done before. “If you think Pilates is something for dancers only or if you think yoga means standing on your head, most gyms will have some sort of special drop-in rate for either the first week or first few sessions of a class,” says Greene. “Go ahead and try it! You may find that you like it.”

4. Aim to meet your goals gradually. Greene notes that the most common mistake people make when they join a gym is coming in and doing everything at once. Instead, work toward your goals at a steady pace so that you can sustain your new fitness routine.

5. Schedule time to exercise into your calendar. “Sometimes people burn out because other things happen; they have this or that responsibility. Remember that you have a responsibility to yourself too,” says Greene. Incorporate exercise into your daily routine so that it becomes part of your day and not something you can easily blow off.

6. Get a support system. Find people you can count on, whether it is an exercise buddy or someone taking care of your responsibilities at home or on the job, so you have time to work out.

7. Make your exercises fun! Working out does not have to be drudgery. Many fitness centers have intramural leagues and an assortment of classes. Also add a variety of workouts to your routine to prevent boredom. “Find out what you like and switch it up every so often,” Greene suggests.

As the winter months roll along, you may begin to feel less motivated. But Greene notes that there is one thing to always remember: “Fitness is a time for you and a time to take care of yourself,” she says. “You will end up feeling good because you’ll be getting fit and feeling better.”
(Newswise)

Top Five Women’s Health Stories of 2007

2007-12-24T12:10:00.000-08:00

Description

The Society for Women's Health Research announced its top five women’s health stories of 2007 today. The list covers advances of particular interest to women and new sex-specific treatments.

The Society for Women's Health Research announced its top five women’s health stories of 2007 today. The list covers advances of particular interest to women and new sex-specific treatments.

“The medical news in 2007 show how important it is that researchers continue to focus on women’s health and sex differences,” said Phyllis Greenberger, M.S.W, president and CEO of the Society for Women's Health Research, a Washington, D.C., based advocacy organization. “We applaud the Gynecologic Cancer Foundation for forging a national consensus on ovarian cancer symptoms. And we commend cardiologists working to answer questions about sex differences in heart disease. We look forward to more advances in 2008.”

The top women’s health stories of 2007 as determined by the Society for Women's Health Research are:

1. First Consensus on Ovarian Cancer Symptoms
The Gynecologic Cancer Foundation (GCF) announced in June the first national consensus on ovarian cancer symptoms. Ovarian cancer has been long considered a silent killer because of the perceived lack of warning signs. According to GCF, ovarian cancer is the fifth deadliest cancer among U.S. women killing 15,000 annually. There is a 90 percent cure rate when women are diagnosed in Stage I of the disease. The announcement and promotion of the consensus statement should lead to earlier diagnosis and earlier intervention for many women.

2. Technology Advances Aid Fight against Breast Cancer
The FDA approved in February a molecular test that determines the likelihood of breast cancer returning within five to 10 years after a woman’s initial cancer. In August, research was published noting that magnetic resonance imaging enables radiologists to better identify tumors missed by mammography and ultrasound in women at high-risk for breast cancer. These developments underscore the growing role advanced medical technology is playing in the fight against breast cancer.

3. Mounting Evidence of Sex Differences in Cardiovascular Disease
Women with heart disease are 50 percent more likely to die from it than men with the disease. More women than men suffer from small vessel heart disease. More women than men are having a stroke in middle life. Women have a poorer quality of life after a stroke than men. These are just a few of the headlines from 2007 that confirm great differences in cardiovascular disease between the sexes. Scientists are just now beginning to understand these differences and treatments to account for them have generally not yet been developed, underscoring the need for greater research support.

4. Improved Model Predicts Breast Cancer Risk in African-American Women
National Cancer Institute researchers have developed a new model for calculating invasive breast cancer risk that has been found to give better estimates of the number of breast cancers that would develop in African American women 50 to 79 years of age than an earlier model which was based primarily on data from white women. This is a great advance because earlier models likely underestimated breast cancer risk in African American women. As a result they might not have received counseling about actions they could take to reduce their risk. The new model, called the CARE model, was unveiled in November.

5. Young Girls’ Obesity Rates Rising
Four-year-old girls are six times more likely to have a body mass index (BMI) of 30 or more than they were 20 years ago, according to research published in April. A BMI of 30 and over is considered obese by the National Institutes of Health. The findings point to recent changes in children’s environment and lifestyles, which merits monitoring, further research and action, given the health risks associated with adulthood obesity such as increased risks for cardiovascular disease and type-2 diabetes. (Newswise)

Winter Is Here: Tips to Prevent Dry Skin 'Blues'

2007-12-21T08:03:00.000-08:00

Medical Director Offers Time-Tested Suggestions to Prevent Dry Skin in Winter

DES PLAINES, Ill., Dec. 20, 2007 -- When the calendar says it's December, better start preparing for the "Dry Skin Season." Whether you suffer from dry skin only in winter or year-round, you can take some simple steps to keep your skin soft, healthy, and pain-free. "An ounce of prevention will help you beat the discomfort and pain caused by dry irritated skin," says Dr. Paul R. Kasdan, medical director of OurHealthNetwork.com

While every inch of our skin is affected by the cold outdoors and low humidity created indoors by heating furnaces, our hands and feet suffer the most. Natural oils produced by the glands in the skin help the skin retain moisture. But our hands and feet lack the oil glands that are present on all other skin surfaces. If our palms were covered by oil, just think of all of the things that would slip out of our hands! The same goes for the soles of our feet: we would slip and slide with every step!

Without this oil, the skin on the hands and feet suffer most when exposed to excessively cold outdoor temperatures, dry indoor heat, and wearing socks and gloves made of wool or other materials that can irritate the skin.

To help avoid winter weather's skin irritations, painful cracks, and unsightly appearances, Dr. Kasdan says, "Getting a head-start on winter's assault is the best thing you can do for your skin." Dr. Kasdan recommends starting the following good skin habits immediately:
-- Moisturize, moisturize, and moisturize again. This is especially true after bathing or hand-washing. Make sure you pat your skin "almost dry." While the skin is still damp, apply a moisturizer to hold the water in, and keep the skin from drying.

-- Add oil to your bath. The oil will soothe dry skin and help "lock in" moisture.

-- Exfoliate patches of dry skin as soon as they appear. This helps to prevent the skin from breaking down and cracking. For calluses and dry cuticles, something stronger may be needed. Callex Ointment is uniquely effective in thinning and softening calluses and cuticles.

-- Wear clothes - especially gloves and socks - made of natural and comfortable fibers. Cotton is more soothing to the skin than nylon, wool, and rubber. Cotton will help the skin keep natural fluids in, while absorbing excessive perspiration that can cause drying.
Dr. Kasdan believes most dry skin problems would disappear if everyone followed this advice. At http://www.OurHealthNetwork.com/news/DrySkinInWinter.asp, Dr. Kasdan shares the recipe for his favorite exfoliative scrub you can make yourself. For those who do not respond to "preventive measures," Dr. Kasdan also lists additional tips for caring for dry, cracked skin.

Spine Surgeon First to Use AxiaLIF Spine Surgery in Manhattan

2007-12-18T11:38:00.000-08:00

Description

More than one million spine surgery procedures are performed annually, with medical costs to treat back pain approaching $24 billion per year. With age and injury, discs located between the vertebrae in the spine might eventually wear-down -- a process termed degenerative disc disease. Due to the lack of padding, vertebrae bones slip and rub together. This leads to excruciating and disabling pain, and may cause sciatica (leg pain) due to pressure on the sciatic nerve -- resulting in cramping, pain and numbness along the lower back and back of the thigh.

Each year, 40 to 60 percent of American adults suffer from chronic back pain. More than one million spine surgery procedures are performed annually, with medical costs to treat back pain approaching $24 billion per year.

With age and injury, discs located between the vertebrae in the spine might eventually wear-down -- a process termed degenerative disc disease. Due to the lack of padding, vertebrae bones slip and rub together. This leads to excruciating and disabling pain, and may cause sciatica (leg pain) due to pressure on the sciatic nerve -- resulting in cramping, pain and numbness along the lower back and back of the thigh.

Now, Dr. Roger Härtl, director of the spine program at NewYork-Presbyterian Hospital/Weill Cornell Medical Center and assistant professor of neurological surgery at Weill Cornell Medical College, is using a new and less-invasive procedure, developed by TranS1 Inc., to help patients recover faster and with a better quality of life. The procedure, called AxiaLIF, involves only a single small incision near the tailbone.

"AxiaLIF offers another option for minimally invasive procedures for spine-surgery and opens up avenues to give surgeons a new way to perform a procedure in a less invasive fashion," says Dr. Härtl, who is currently the only spine surgeon in Manhattan using the procedure.

To correct degenerative disc disease, spine surgeons fuse together two or more vertebrae and replace the worn disc -- naturally composed of mostly cartilage and various proteins -- with synthetic replacement material. However, the invasive nature of this surgery often leads to a long and painful recovery for the patient.

Now, using AxiaLIF, patients are usually released from the hospital within 24 hours following the surgery, and are able to return to their daily routines and work within two to three weeks.

The surgery takes only 45 to 60 minutes with minimal blood loss, compared to the traditional four-hour procedure. And because there is only a small incision, there is less pain for the patient, because the area has fewer pain receptors.

More traditional surgeries call for large incisions in the back or abdomen. These invasive techniques often require complicated dissection of muscles, nerves and even organs, so that the surgeon can navigate to the affected area. Additional vascular surgeons are called in to perform this part of the procedure, which can take hours, even before a spine surgeon begins.

Because of these invasive measures, patients are at a much higher risk for greater blood loss, and nerve and muscle injury, which means more time in recovery with physical therapists to get back to doing normal-day activities. There are also other concerns for patients.

In males, for instance, surgery in the abdomen risks damage to the nerves controlling sexual function, which may lead to premature ejaculation, explains Dr. Härtl. But risks like these are now avoidable.

"With the less invasive technique, I can do the same surgery, but access the area with less trauma to muscles, nerves and surrounding tissue," says Dr. Härtl.

To perform the surgery, a one-inch incision is made at the tailbone. Under X-ray guidance, Dr. Härtl locates and removes the damaged portion of the disc -- most often affected is the lumbar region, between the sacral (S1) and lumbar (L5) vertebrae -- and then injects synthetic material to rebuild the disc. A screw is then inserted to distract and stabilize the vertebrae, and, finally, the incision is closed. Dr. Härtl cautions that, depending on the injury, this surgery may not be right for each patient, but may be combined with other techniques to reach a better outcome.

The AxiaLIF procedure is estimated to be less costly than open surgeries. The main savings are in the dramatic decrease in operating-room time, length of stay, less need for post-surgical pain medication and more rapid rehabilitation.

"With this new surgery, spine surgeons can offer patients more options," says Dr. Härtl. "We used to have only one or two surgeries to choose from, but now we have a variety of techniques to tailor the treatment for each person."

For more information, patients may call (866) NYP-NEWS.

NewYork-Presbyterian Hospital/Weill Cornell Medical Center
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine, and is committed to excellence in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances -- from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and, most recently, the world’s first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the first U.S. medical college to offer a medical degree overseas and maintains a strong global presence in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. (Newswise)

Constipation Most Common Cause of Children's Abdominal Pain

2007-12-18T11:34:00.000-08:00

Description

Acute and chronic constipation together accounted for nearly half of all cases of acute abdominal pain in children treated at one hospital. The study suggests that physicians should do a simple rectal examination for constipation when trying to determine the cause of abdominal pain in children.

A new study led by a University of Iowa researcher showed that acute and chronic constipation together accounted for nearly half of all cases of acute abdominal pain in children treated at one hospital.

The study also suggests that physicians should do a simple rectal examination for constipation when trying to determine the cause of abdominal pain in children. The findings, which were based on medical records of 962 children ages 4 to nearly 18, appear in the December issue of the Journal of Pediatrics.

Earlier studies have shown that constipation can contribute to abdominal pain in children, but no specific recommendations for diagnosing this contributing factor were made, said Vera Loening-Baucke, M.D., professor of pediatrics at the UI Roy J. and Lucille A. Carver College of Medicine and the study's lead investigator.

"Constipation can be overlooked as the cause of severe or intermittent abdominal pain, as a reporting of symptoms alone does not always establish that a child has constipation," she said. "Our study helps to show that constipation frequently causes acute abdominal pain and that a physician should not just ask the parent if the child is constipated because the parent may have not been able to see all the signs of this condition."

Constipation signs include fewer than three bowel movements per week, one or more episodes of stool incontinence per week, passing of stools so large that they obstruct the toilet, retentive posturing (withholding behavior) and painful defecation.

"The doctor should perform an abdominal examination and a rectal examination to see if the child is retaining stool," said Loening, who sees patients at UI Children's Hospital.

Loening said that some doctors shy away from the rectal examination, which involves digitally checking for impacted stool in the lower colon, because they believe it may cause a child mental or physical discomfort. However, the test can be performed safely and explained to children so that they understand its purpose.

"It's important for doctors to do a thorough evaluation for abdominal pain, as there are many causes. In addition to constipation, having a cold or sore throat can also cause abdominal pain, for example," Loening-Baucke said.

The study found that 83 (9 percent) of 962 children who had received at least one "well-child" visit during a six-month period in 2004 at UI Children's Hospital or UI Hospitals and Clinics reported acute abdominal pain at that visit or another clinic or emergency visit. Significantly more girls (12 percent of the 962) reported such pain, compared to only 5 percent of boys.

Of the 83 children with acute abdominal pain, 72 were seen in a primary care clinic and 11 were examined after hours in the emergency department. Together, acute constipation (lasting eight or fewer weeks) and chronic constipation (lasting eight or more weeks) accounted for 48 percent of the cases (40 children), making it the most common cause of the pain.

Only 2 percent of the children with pain had a surgical condition such as appendicitis. In addition, doctors could not determine causes for 19 percent of the patients with pain.

While most of the patients reviewed in the study were Caucasian, individuals from all other races were included.

In addition to Loening-Baucke, the study team included Alexander Swidsinski, M.D., Ph.D., a faculty member at Charite Hospital and Humdboldt University in Berlin, Germany. Loening-Baucke is now investigating the role of constipation in chronic abdominal pain.(Newswise)

For Heart-defect Babies, Busier Hospital = Lower Death Risk

2007-12-17T11:58:00.000-08:00

Image Gallery

Dr. Jennifer Hirsch, pediatric cardiac surgeon at the University of Michigan Health System.

Description

Though the odds for infants with heart defects are much better now than they were even 10 years ago, a new study suggests a way to give them a better chance at survival: Get them to hospitals that are the most experienced at handling such cases. It’s the first national study of this issue, and lends support to the creation of regional congenital heart centers.

Each year, thousands of babies are born with severe heart defects that must be operated on within days or weeks of their birth. And though the odds for these infants are much better now than they were even 10 years ago, a new study suggests that there may be a way to give them an even better chance at living: Get them to the hospitals that are the most experienced at handling such cases.

In the first national study of this issue, a team of University of Michigan researchers found that infants with specific complex heart defects are much less likely to die before leaving the hospital if they are treated at the centers that treat the largest numbers of these patients. This relationship between hospital volume and mortality has been seen in adult heart operations, but the new study suggests it holds true for infants as well. The study is published online in the journal Pediatric Cardiology.

“A generation ago, we were just happy when these patients lived, but that’s not good enough anymore,” says lead author Jennifer Hirsch, M.D., a U-M pediatric cardiac surgeon and member of the Michigan Congenital Heart Center. “Although mortality rates are much lower, there is still a significant variation between centers. This study indicates that it may be time to selectively regionalize these patients’ care, to give them the best chance at a good outcome.”

Hirsch and her colleagues based their study on data from the 2003 Kids’ Inpatient Database, a national database sponsored by the Agency for Healthcare Research and Quality that includes information on children hospitalized in 36 states.

They analyzed data for two of the most severe congenital heart defects: transposition of the great arteries (TGA), in which the major blood vessels leading between the heart and lungs are switched, and hypoplastic left heart syndrome (HLHS), in which the left side of the heart does not develop properly.

Both defects are lethal if not treated within a few weeks of birth, with operations called the arterial switch operation for TGA and the Norwood procedure for HLHS. Infants may need additional operations later in life, but these initial open-heart procedures are critical for their survival.

The study shows that an infant’s risk of dying in the hospital during or after their operation varied greatly depending on the number of each procedure performed that year at the hospital where they were treated. Mortality rates ranged from more than 10 percent to less than 1 percent for the arterial switch operation, and from more than 35 percent to around 10 percent for the Norwood procedure.

“The relationship between hospital volume and risk of dying was significant across the spectrum for both defects, though in the case of arterial switch operations the difference dwindled among hospitals that performed about 15 or more in a year,” says Hirsch, a Lecturer in the Section of Cardiac Surgery at the U-M Medical School who performs operations at the U-M C.S. Mott Children’s Hospital. “For the Norwood, the trend to decreased mortality did not level off.”

The researchers chose the two conditions for their study not because the operations themselves vary in difficulty — both require skilled surgeons and operating room teams — but because of differences in the difficulty of pre- and post-surgical care. TGA care is considered somewhat less tricky than HLHS care. Even after the Norwood operation, babies with HLHS will still need at least two more operations in their first years of life to palliate their defect.

“All of the surgeons who operate on congenital heart defects are incredibly well trained,” says Hirsch, noting that pediatric cardiac surgeons must complete more than 10 years of surgical training after four years of college and four years of medical school to operate on the tiny hearts of infants and children. “It’s a matter of exposure to these complex cases not just for the surgeon, but also for the anesthesiologist, the surgical nurses and perfusionists, the intensive care unit staff, and the social workers and floor nurses who help prepare parents to take care of these children at home.”

The new results suggest that for these most rare and complex of cases, infants have the best outcomes when treated at hospitals whose teams are accustomed to caring for TGA and HLHS babies. The Michigan Congenital Heart Center, for example, handles more than 60 Norwood cases and 20 arterial switch cases each year, along with hundreds of other children with lesser defects.

Selectively regionalizing the care of these more severely ill infants, the researchers conclude, may be warranted based on the difference in mortality seen in the new study. But making sure that babies get to the most experienced centers in time for their operation will require commitments of resources and logistics, and a commitment by smaller congenital heart programs to refer the most complex patients early.

More research is also needed on the factors that influence a baby’s likelihood of dying after being discharged from the hospital following a Norwood procedure, but before he or she has the second- or third-stage operations for HLHS. Currently, this inter-stage mortality is estimated at 15 percent. The U-M has launched a new effort — the Michigan Congenital Heart Outcomes Research & Discovery program — that will allow researchers to collect and analyze much more detailed data about U-M congenital heart patients than ever before, to help answer these questions and more.

The newly published study differs in several major ways from previous studies that examined the relationship between in-hospital mortality and hospital volume for congenital heart patients. Other United States studies, performed in the 1990s when congenital heart operations and post-surgical care were still evolving at a rapid pace, used data for all heart conditions in one or two states.

Although these studies found a relationship between the number of infants treated and their risk of dying, the major thresholds were seen at the 100- to 200-patient level. Hirsch and her colleagues note that these studies included data from patients with much less severe heart defects, who had operations that carry a much lower risk of death during and after surgery.

“For the more routine congenital heart surgery, outcomes are excellent everywhere,” says Hirsch. “But when it comes to a child with a complex defect, it’s important to send him or her to a center of excellence. And the parents of these children are often so overwhelmed by their sudden situation, it will be important to develop the systems and support that will help them get to the right place.”

In addition to Hirsch, the paper’s authors are pediatric heart surgeon Richard G. Ohye, M.D., and James Gurney, Ph.D. and Janet Donohue, MPH of the U-M Child Health Evaluation and Research Unit. (Newswise)

More information on the Michigan Congenital Heart Center is at http://www.med.umich.edu/cvc/mchc.

Age-old Remedy Cuts Kids’ Coughs

2007-12-17T11:50:00.000-08:00

Image Gallery

Photo by Neil Brake
Claire Hendry, 5, of Franklin, Tenn., watches as her mother pours a spoonful of honey before bedtime.

Description

According to experts at the Monroe Carell Jr. Children's Hospital at Vanderbilt, a recent study may have discovered an intriguing option to help quiet children's coughs.

According to experts at the Monroe Carell Jr. Children's Hospital at Vanderbilt, a recent study may have discovered an intriguing option to help quiet children's coughs.

The study, from Pennsylvania State University researcher, Ian Paul, M.D., showed that honey has some benefit in reducing cough symptoms.

Michael Warren, M.D., a clinical fellow in the Division of General Pediatrics, along with Division colleagues, reviewed the research and wrote an Evidence-Based Journal Club review which appeared alongside the Penn State study in the December issue of Archives of Pediatrics and Adolescent Medicine.

“Dr. Paul's study represents a welcome addition to the literature on cough medications in children,” said Warren.

“During the cough and cold season, pediatricians are bombarded with questions from parents who want to know what they can to do to relieve their child’s cold symptoms.”

Warren and his colleagues combed through the Penn State article and found it was well-designed and that the results could be considered reliable.

The results were that children who are given honey at bedtime had a 47.3 percent reduction in cough symptoms, while a honey-flavored syrup containing a common over-the-counter cough suppressant, dextromethorphan (DM), had just slightly more effect than no treatment at all.

“We found there are some lingering questions,” Warren said. “It is unclear whether the benefits of honey are variety-specific. This study used buckwheat honey; the authors note that darker honeys (such as buckwheat honey) consist of more phenolic compounds than other varieties and that the associated antioxidant effect might have contributed to the improvement seen in those children treated with this kind of honey.”

Upper respiratory infections are the most common complaint at pediatric offices this time of the year.

Since an FDA panel reviewed the safety and efficacy of over-the-counter cough medications earlier this year and determined they pose more risk than benefit to children under age 6, parents have been anxious to hear about other things to try.

“When children have a cold, everyone is miserable —the cough bothers the child, the child can't sleep, and the parents can't sleep.

“Parents are often desperate for the 'magic bullet' that will make the symptoms go away. Supportive care like nasal saline sprays/drops, bulb suctioning, cool mist humidifiers, fever-reducing medications, fluids, and rest are the mainstays of therapy for children with cough and cold symptoms,” Warren said.

At least, Warren says, this new research shows that when desperation sets in, it’s reasonable to try a teaspoon of honey.(Newswise)

Keeping New Year’s Resolutions

2007-12-17T11:45:00.000-08:00

Description

Health-related New Year’s resolutions top the list of promises American adults make to themselves every year. An expert offers tips on how to succesfully keep resolutions.

Jennifer Wider, M.D.
Society for Women’s Health Research

As the New Year quickly approaches, vows to adopt a healthier lifestyle abound. Health-related New Year’s resolutions top the list of promises American adults make to themselves as the calendar turns every year.

For lots of women, taking on new habits and maintaining a healthy lifestyle may be difficult, especially during the holiday season into the New Year. During the holidays, when entertaining and visiting with extended families are custom, women often take on most of the added workload, which can add up to a lot of stress. Add promises to change old, unhealthy lifestyle habits into the mix and new behaviors may be difficult to uphold.

“Sometimes we take on too many changes and create too many goals all at one time,” explains Erica Wright, a licensed clinical social worker and psychotherapist who practices in New York City and Fairfield, Conn. “Instead of being able to maintain these new habits, we fail because we become overwhelmed.”

But keeping health-related New Year’s resolutions can make a big difference when it comes to long-term health. For women who are overweight or obese, shedding those extra pounds can be life saving. Obesity has been linked to an increase risk of heart disease, breast cancer and type 2 diabetes. Studies have shown that losing weight through diet and exercise can lower the risk of these and other diseases.

“Every year, it’s the same thing,” says Kate Reynolds, a thirty-five year old stay-at-home mom in Connecticut. “I vow to lose weight, but somehow it doesn’t happen.” Reynolds has tried a host of different options from diet programs to fitness classes at a local gym. “I start off strong in January but I get frustrated if I don’t achieve my desired weight loss.”

Reynolds isn’t alone. Many women complain that they are unable to keep their resolutions. “We fall into the rhythm of life and into our old patterns,” says Wright, “forgetting some of these major life goals.”

So what can we do to keep our healthy resolutions and avoid falling into the same pitfalls?

Wright suggests streamlining your resolutions: “Pick one thing versus taking on so many things. For example, quitting smoking is a massive life change that has so many health benefits to it, but choosing to lose weight on top of that is way too much to handle all at once.”

Enacting small and feasible changes may make it easier to incorporate into in already busy lifestyle. Focus on one change at a time. For example, if you want to exercise more, try to work that into your routine before taking on any more challenges. Even if you walk briskly to work, take the stairs instead of the elevator or get to the gym once a week, it can make a difference.

“Perhaps incorporate other goals throughout the year,” says Wright. “It doesn’t necessarily have to get done by January 1st.” (Newswise)

Another “Smart” Cancer Drug Can Have Toxic Effects on the Heart

2007-12-15T12:57:00.000-08:00

Description

Another FDA-approved targeted cancer drug, sunitinib (SutentTM, Pfizer), may be associated with cardiac toxicity, report researchers at Children’s Hospital Boston, Dana-Farber Cancer Institute, and Thomas Jefferson University. Sunitinib is one of several new “smart” cancer drugs called tyrosine kinase inhibitors that targets specific signaling molecules inside cancer cells that aid cancer spread.

Another FDA-approved targeted cancer drug, sunitinib (SutentTM, Pfizer), may be associated with cardiac toxicity, report researchers at Children’s Hospital Boston, Dana-Farber Cancer Institute (Boston), and Thomas Jefferson University (Philadelphia). Their collaborative study, led by Ming Hui Chen, MD, MMSc, a cardiologist at Children’s who specializes in the cardiac health of cancer patients, appears in the December 15 issue of The Lancet, accompanied by an editorial.

Sunitinib is one of several new “smart” cancer drugs called tyrosine kinase inhibitors that targets specific signaling molecules inside cancer cells that aid cancer spread. Another “targeted” cancer therapy, imatinib (GleevecTM, Novartis Pharmaceuticals), was reported last year in Nature Medicine to be associated with heart failure in patients with chronic myelogenous leukemia.

Sunitinib was originally thought to be relatively free of cardiac side effects. However, a new retrospective analysis, focused on cardiovascular events, revealed a risk for heart failure, myocardial infarction and hypertension in 75 adult patients with imatinib-resistant, gastrointestinal stromal tumor (GIST) receiving multiple cycles of sunitinib in a phase I/II trial at Dana-Farber.

Of the 75, six (8 percent) developed symptoms consistent with moderate-to-severe congestive heart failure, and two had heart attacks. In all, eight (11 percent) had some kind of cardiovascular event while receiving sunitinib at FDA-approved or lower doses. Patients with preexisting coronary artery disease were more likely to develop cardiac problems. Nineteen percent of the 36 patients receiving the FDA-approved dose had decreases in left ventricular ejection fraction, a measure of the heart’s pumping ability.

In addition, 47 percent (35 of 75) developed hypertension. “Hypertension is a common side effect with certain cancer drugs, but the degree of hypertension – both the percentage of affected patients and the magnitude of increase in systolic blood-pressure – was notable,” says Chen, who is also affiliated with Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School.

Two patient biopsies revealed abnormalities in the heart cells’ mitochondria (the structures responsible for energy production). Further studies, led by Maria Rupnick, MD, of the Children’s Hospital Boston Vascular Biology Program, and Thomas Force, MD, from the Center for Translational Medicine and Division of Cardiology at Jefferson, examined heart-muscle cells from mice who had received the equivalent of a human dosage of sunitinib alone, and found direct evidence of cardiotoxicity.

“Early identification of cardiac side effects is an important part of keeping patients on life-saving cancer therapy over the long-term,” says Chen. “In this study, the cardiac dysfunction and hypertension were usually medically manageable. Most importantly, patients were most often able to resume sunitinib therapy following temporary withholding of drug, addition of cardiac medications and/or dose adjustment.”

“This sunitinib study highlights potential concerns with agents that are ‘multi-targeted,’ meaning they inhibit multiple factors involved in cancer progression,” adds Force, who led the study of imatinib patients published in Nature Medicine last year. “Some of these factors may also play important roles in maintenance of proper heart function, and their inhibition by cancer drugs could have adverse effects on the heart.”

“The most important element of this new work is the close, creative collaboration between our medical oncology and cardiology teams,” says George Demetri, MD, a co-author on the paper and director of the Ludwig Center at Dana-Farber Cancer Institute and Harvard Medical School. “As our molecular targeting involves more pathways, we can inform one another’s fields and identify side effects early by working together across traditional disciplinary boundaries.”

“We are hopeful,” Chen concludes, “that this type of multidisciplinary approach, from the patient’s bedside to the basic cell biology laboratory, will lead to further pharmaceutical advances that will make these ‘smart’ cancer drugs even smarter.”

Children’s has a long history of researching the cardiovascular effects of cancer drugs. In children, such side effects are especially important to manage so they can survive the cancer in good health well into adulthood. In 1991, for example, Children’s cardiologists published the seminal finding that doxorubicin therapy for childhood leukemia can lead to clinically important heart disease.

Supporters of the sunitinib cardiovascular study included the Department of Cardiology, Children’s Hospital Boston; the Translational Research Fund for Cancer and Cardiology at Children’s Hospital Boston; a Long-Term Survivorship Grant from the Dana-Farber Cancer Institute; the National Heart, Lung and Blood Institute; the Finnish Heart Foundation; and the American Heart Association.

Children’s Hospital Boston is home to the world’s largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 500 scientists, including eight members of the National Academy of Sciences, 11 members of the Institute of Medicine and 12 members of the Howard Hughes Medical Institute comprise Children’s research community. Founded as a 20-bed hospital for children, Children’s Hospital Boston today is a 377-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Children’s also is the primary pediatric teaching affiliate of Harvard Medical School.(Newswise)

Amazing Treatment Relieves Serious Back Pain

2007-12-14T11:33:00.000-08:00

Amazing Treatment Relieves Serious Back Pain Without Dangerous Drugs, Injections or Surgery!

CHICAGO, Dec. 14, 2007- Non-surgical, spinal decompression is probably the last back pain treatment you will ever need. And you can forget about popping toxic pills, struggling through exercise programs ... and ... unnecessary and risky injections and surgery ... because with this amazing technology - for most people - they are a thing of the past.

Dr. Thea Flock is Chicagoland's most respected authority on relieving severe back and leg pain. Dr. Flock says, "I enable people to live longer using non-invasive techniques without the use of drugs, injections or surgery."

Dr. Flock has treated many Chicagoland residents offering them a solution to their severe low back and leg pain. Patients from Florida to California and as far away as Lima, Peru have sought out her treatment programs and have found relief.

Dr. Flock is a powerful, and educational interview. She will tell your audience:
-- Why most medications often fail
-- 8 causes of low back pain
-- The worst and best things you can do for low back
pain at home
-- 6 warning signs of severe back and leg pain that
everyone must know
-- How you can have diminished pain and increased
function in less than 5 weeks
-- How can Dr. Flock guarantee diminished pain
(No other doctor I know of is willing to make a guarantee)

Dr. Flock has been featured in many local newspapers and publications including the M.D. News. Flock lectures to many different groups educating people on severe low back pain and the treatments available. Dr. Flock offers a free report entitled "The Severe Back, Sciatica, and Disc Pain Guide" and her website, http://www.flockspinal.com is a great educational resource to learn more about severe back pain.

Flock states, "I am thrilled to be able to provide relief to my patients who haven't responded to other treatments. Often times these are patients who have given up hope of ever being pain free. I believe this treatment will become as common in the treatment of back pain as laser eye surgery has become as a treatment for nearsightedness."

For further information contact: Dr. Thea Flock, 630-771-9662

Are Muramyl Peptides the Magic Bullet in Probiotics?

2007-12-12T11:33:00.000-08:00

Magazines like Time, Newsweek, and U.S. World and News are all buzzing about the latest health trend, probiotics. Researchers have found compelling evidence that these friendly bacteria are an important key to digestive and immune health, but Eastern Europeans have been savvy to the health benefits of probiotics, found in fermented foods such as yogurt, for centuries. While Western medicine is beginning to tout probiotic benefits, Russian scientists have been aware of these characteristics for decades, and took investigations further by deconstructing the friendly bacteria to study cell components.

In fact, Russian and Ukrainian researchers used special strains of probiotics as raw materials for high-powered immune-support supplements during the Cold War period up until the mid-1980s. Soviet Scientists, responding to directives from their government, found that cell pieces of specific strains of probiotics, or lactobacillus bacteria, had a powerful protective action against bio-warfare agents. The researchers also discovered the probiotic cell pieces helped protect cancer patients against the effects of radiation and chemotherapy, were safe, and had no side-effects.

The Russian scientists discovered one key to these results are muramyl peptides, part of the complex sugars that become available when probiotic cells are fractured in the "lysing" process, which digests the cell wall. Eastern European researchers have been using the lysing technique for several decades, but the laboratory technique is barely on biotech manufacturing radar in the U.S.

"Comparing a live probiotic and a lysed one, in terms of immune system support, is like comparing a match to a blowtorch," said Dr. Elin Ritchie of Taos, N.M. Dr. Ritchie has been using a lysed lactobacillus product, Del-Immune V, for the last five years in cases including colds and flu. Ritchie has also had success with cancer patients. "I have given the product to hundreds of patients. The product is safe and has no contra-indications with drugs or other supplements," she said. Dr. Ritchie added that teachers are the product's biggest fans, as it helps them avoid the worst of the winter crud.

Other doctors are using the lysed cell product as well. "I have been recommending this product (Del-Immune V) for many patients. When I began using it, I couldn't believe its effectiveness in a variety of immune issues," said Dr. Ted Hayashida of Gardiner, Calif.

Research shows the striking effects of lysed probiotics are due to muramyl peptides in the cell fragments. "European doctors went deeper to understand the healthy role of probiotics decades ago, and used the bacteria as a jumping-off point for a new bio-technology. In simple terms, muramyl peptides regulate the correlation between different branches of the human immune system. When probiotics are lysed, the muramyl peptides become bio-available. The muramyl peptides organize an immune response to foreign invaders and environmental pathogens," said Dr. Luba Shynkarenko, former dean of the Institute of Biotechnology, National Technical University, Kiev, Ukraine.

During the 1980s, Shynkarenko worked as a Soviet microbiologist, and saw her research on lysed probiotics develop into products used for everything from adjunctive cancer therapies to radiation protection after the Chernobyl accident. Now living in the Boulder, Colo., she said she would like to see deeper probiotic research in the West. Shynkarenko is not surprised to see Del-Immune V, the grandchild of her original research, gaining popularity among patients and doctors, even though it is a nutritional supplement. "Healthy flora bacteria are the answer to a multitude of health issues - discovery in the West has really just begun," she said. For information, visit http://www.delimmune.com.

Top Five: Tips for a Stress-free Holiday with Family

2007-12-07T08:00:00.000-08:00

Description

Busy holiday preparations, driving or flying to faraway places for family gatherings and spending time in close quarters with extended family can add up to a tension-filled holiday. Patricia Daza, PhD, a psychologist with The Menninger Clinic’s Hope Program, offers tips to better enjoy the holidays with your family.

Busy holiday preparations, driving or flying to faraway places for family gatherings and spending time in close quarters with extended family can add up to a tension-filled holiday.

“Most people, regardless if they are family members or not, will begin having conflicts when they are with each other 24/7,” says Patricia Daza, PhD, a psychologist with The Menninger Clinic’s Hope Program. Dr. Daza offers the following tips to better enjoy the holidays with your family:

1. Plan ahead.
Recognize stress and arguments will arise and put a game plan in place for how you will handle it. Dr. Daza suggests repeating coping self-statements to yourself (I am a good cook, good mother, good father, etc.), deep breathing and praising yourself for the work you are doing to make the day go well.

2. Be realistic about the time you spend together.
Do you feel comfortable spending eight hours together or would you rather schedule dinner one night and meet up the next day to see a movie? “At times families are not aware of their limits with each other,” Dr. Daza says. “They would rather avoid the meeting altogether rather than spend small amounts of quality time with each other.”

3. Involve family in an activity.
When in the presence of their family members, many persons revert to established roles in the family they have outgrown, which can cause tension. Activities such as playing a board game or going for a walk together allow an opportunity for cooperation and fun versus arguing or discussing problems in the relationships.

4. Consider staying in a hotel when visiting family.
Staying in a hotel can give you some extra breathing room and is a good option if family members are visiting and you are pressed for space. To avoid hurt feelings, reassure family members that you still intend to spend time with them.

“It can also be helpful to talk to family members about hotels as a way to accommodate different family patterns,” Dr. Daza says. “Some family members are ‘early birds’ and get up early to work out or shower. Others may want the quiet to sleep late. Also discuss how hotels add to the vacation experience, for example, the benefits of having someone make your bed, having breakfast in bed or taking advantage of the massage services at the hotel.”

5. Treat yourself after the holidays.
Make a plan for “me time” when you return home--such as attending a yoga class, getting a massage, seeing a movie or participating in other enjoyable activity. Having something to look forward to will make any tough times with your family a little easier.

The Menninger Clinic is an international specialty psychiatric center, providing treatment, research and education. Founded in 1925 in Kansas, Menninger relocated to Houston in 2003 and is affiliated with Baylor College of Medicine and The Methodist Hospital. For 17 consecutive years, Menninger has been named among the leading psychiatric hospitals in U.S. News & World Report’s annual ranking of America’s Best Hospitals.

Parkinson's-Specific Exercise Plan Restoring Lives

2007-12-07T07:40:00.000-08:00

Since the spring release of his new book and instructional DVD, Delay the Disease - Exercise and Parkinson's Disease, David Zid delights in the positive response from participants whose lives are enhanced thanks to following his daily fitness program. Participants worldwide are thrilled that their Parkinson's symptoms have been minimized. "It might be overly dramatic to say exercise saved my life, but it certainly saved the quality of my life," boasts program participant Kathy Cooper.

Zid, an ACE, APG certified trainer, designed the Parkinson's-specific program to exercise all parts of the body, focusing on balance, flexibility, strength and coordination. Nearly two years after being diagnosed, Kathy Cooper began the Delay the Disease exercise program. "I've noticed improvements in the way I walk and maintain my balance," explains Cooper. "I now take bigger steps and no longer seem to shuffle or limp. I smile 'normally' and my relaxed facial expression has improved."

Participants are enthusiastic about the practical nature of the routine. Emphasis is placed on activities of daily living that frequently become a challenge to those with Parkinson's, such as rising from a chair, moving about in crowds, and getting in and out of the car. "The program has really helped me stand up from a seated position by using the 'nose over toes' technique," reports program participant Jerry Timmons.

According to Zid, the most rewarding stories are the individuals who associate an improved mindset with the Delay the Disease fitness program. Though Cooper attributes multiple physical improvements since beginning the routine, "The biggest change is my mental outlook," she gloats. "My demeanor has improved so much that my overall reaction to this affliction has become almost dismissive. My small voice has been replaced with a stronger one and overall, I feel as good, or better, than my pre-afflicted self."

Parkinson's professionals and those affected by the disease are grateful for the simplicity, organization and comprehensiveness of the exercise manual and DVD. The program empowers the patient to participate in their healing and cope with the difficult Parkinson's diagnosis. Marjorie Johnston, a clinical exercise specialist in Naples, Florida, has been conducting Parkinson's fitness classes for over ten years and is responsible for reviewing exercise programs for recommendation to her Parkinson's association. "The Delay the Disease program is the first program that I feel I can enthusiastically recommend to my organization and participants. The exercise inventory is excellent." The National Parkinson's Foundation Center of Excellence at Indiana University recently used a portion of their funding for a bulk purchase of books and DVDs to distribute to their patients to encourage daily exercise.

Author David Zid leads a weekly class based on this fitness routine where Parkinson's participants discover fun, fitness and camaraderie. A portion of Delay the Disease proceeds is used to support Parkinson's research and development. The book and DVD are available for purchase at http://www.amazon.com or http://www.delaythedisease.com.