Tuesday, May 31, 2011
FUN FACTS
* Porsche also builds tractors. *
* The lifespan of a squirrel is 9 years. *
* Emus can't walk backwards. *
* African elephants only have 4 teeth. *
* The study of insects is called entomology. *
* The lifespan of a squirrel is 9 years. *
* Emus can't walk backwards. *
* African elephants only have 4 teeth. *
* The study of insects is called entomology. *
The natural way to beat inflammation
Inflammation has gone from a condition you should worry about to a marketing buzzword used to sell everything from drugs to juice to cereal.
Well, at least they got it half right: You should worry about inflammation, and do what you can to bring your own levels down.
But forget the drugs, juice and cereal--because none of those things will ever beat the anti-inflammatory powers of plain old fish oil, and the latest research proves it again.
A new look at data on 702 patients who took part in one of 11 clinical trials finds that people who take fish oil supplements have lower blood levels of homocysteine, an inflammation marker linked to everything from heart risk to dementia to bone breaks, according to the study in Nutrition.
Other studies have also found that fish oil can put the hurtin' on homocysteine.
One published in 2009 found that omega-3 supplements reduced levels of the inflammation marker by 22 percent in diabetics--versus just one percent among those who took a placebo.
And that's really only the beginning of the benefits.
Studies have found that healthy omega-3 fatty acids can help protect your heart, eyes, and gums while raising levels of HDL ("good") cholesterol and lowering levels of deadly triglycerides.
Fish oil can also help boost the mood and beat depression--especially among seniors.
The best sources of these omega-3s are fatty fish such as salmon, tuna, trout and herring--and the highest concentrations are often in the one part of the fish you're probably not eating: the liver.
Researchers looked at a dozen fish commonly eaten in Spain and found all had livers rich in the long-chain polyunsaturated fatty acids you need for good health.
And if you like anchovies, good news: The livers of these famously oily little fish had some of the highest omega-3 levels of all.
But why stick to the liver when you can eat anchovies whole?
OK, I know that's not for everyone--but if you don't like anchovies, fish livers or even fish itself, there's a simple solution: a high-quality fish oil supplement from a company you trust.
Some can leave a fishy aftertaste or, even worse, a case of the "fish burps," but don't give up--refrigerate your capsules instead.
And if that doesn't work, try a different brand until you find one that leaves you with all the benefits... but none of the burps.
Well, at least they got it half right: You should worry about inflammation, and do what you can to bring your own levels down.
But forget the drugs, juice and cereal--because none of those things will ever beat the anti-inflammatory powers of plain old fish oil, and the latest research proves it again.
A new look at data on 702 patients who took part in one of 11 clinical trials finds that people who take fish oil supplements have lower blood levels of homocysteine, an inflammation marker linked to everything from heart risk to dementia to bone breaks, according to the study in Nutrition.
Other studies have also found that fish oil can put the hurtin' on homocysteine.
One published in 2009 found that omega-3 supplements reduced levels of the inflammation marker by 22 percent in diabetics--versus just one percent among those who took a placebo.
And that's really only the beginning of the benefits.
Studies have found that healthy omega-3 fatty acids can help protect your heart, eyes, and gums while raising levels of HDL ("good") cholesterol and lowering levels of deadly triglycerides.
Fish oil can also help boost the mood and beat depression--especially among seniors.
The best sources of these omega-3s are fatty fish such as salmon, tuna, trout and herring--and the highest concentrations are often in the one part of the fish you're probably not eating: the liver.
Researchers looked at a dozen fish commonly eaten in Spain and found all had livers rich in the long-chain polyunsaturated fatty acids you need for good health.
And if you like anchovies, good news: The livers of these famously oily little fish had some of the highest omega-3 levels of all.
But why stick to the liver when you can eat anchovies whole?
OK, I know that's not for everyone--but if you don't like anchovies, fish livers or even fish itself, there's a simple solution: a high-quality fish oil supplement from a company you trust.
Some can leave a fishy aftertaste or, even worse, a case of the "fish burps," but don't give up--refrigerate your capsules instead.
And if that doesn't work, try a different brand until you find one that leaves you with all the benefits... but none of the burps.
Better Than Beef Jerky
Want a snack you can take on the go? Love beef jerky but looking for something a little healthier? Give turkey jerky a try!
Turkey jerky is high in protein and low in fat—though it can also be high in sodium, so check the nutritional info before buying. But at 60 calories and 0 grams of fat per ounce, this is one jerky you won't mind having around!
Turkey jerky is high in protein and low in fat—though it can also be high in sodium, so check the nutritional info before buying. But at 60 calories and 0 grams of fat per ounce, this is one jerky you won't mind having around!
Mix Up Your Cardio For Your Health & Fitness Work Outs
Running is a great form of exercise, but you don't want to get stuck in a rut of hopping on the treadmill every time you go to work out. Make a pact with yourself to include at least three different types of cardio throughout your week. Run on Mondays, swim on Tuesdays, run on Wednesday, play a friend in a tennis match on Thursday, jog around the park on Friday, and Saturday or Sunday go for a bike ride. There are so many ways you can move your body, and not only will mixing up your cardio help prevent injury, but you'll end up becoming stronger overall.
Play With Your Sequencing
You may have learned a certain group of strength-training exercises and are in the habit of doing them in the same sequence every time so you don't leave one out. If you're always doing your exercises in the same order, your muscles will become efficient at doing them, and you'll be more likely to reach a plateau. You'll get more out of your strength-training sessions if you mix the sequence up, because it'll fatigue your muscles in a different order and help you to become stronger.
Play With Your Sequencing
You may have learned a certain group of strength-training exercises and are in the habit of doing them in the same sequence every time so you don't leave one out. If you're always doing your exercises in the same order, your muscles will become efficient at doing them, and you'll be more likely to reach a plateau. You'll get more out of your strength-training sessions if you mix the sequence up, because it'll fatigue your muscles in a different order and help you to become stronger.
One Woman’s Fight Against Alzheimer’s Disease
Many with early-stage Alzheimer’s disease are finding ways to maintain their quality of life in spite of the progressive brain disorder. One of them is former college professor Lydia Panero, who had to give up her career because of the disease, but found fulfillment in performing onstage. Read on to learn how she’s coping with her diagnosis and how she stays positive…
Lydia Panero of Mamaroneck, N.Y., taught literature for 40 years at Manhattan College. So when her language skills started to deteriorate in 2006, she knew something was amiss.
At age 67, Panero was diagnosed with Alzheimer’s disease, a form of dementia marked by memory problems, confusion, learning deficits and personality changes.
“In class with my students, the first thing I noticed was that I was losing my nouns,” Panero says.
It’s not that she didn’t know what objects were. Rather, “she just couldn’t find the words that identified the objects and ideas she was trying to talk about with her students,” says 80-year-old Harry Grier, her caregiver and husband of 46 years.
At first, she coped by teaching fewer classes.
“Eventually, that became overwhelming,” Panero says. “I said to Harry, ‘I don’t think I can do this anymore.’”
She left the career she loved.
But Panero now has turned her sadness into a determination to fight Alzheimer’s disease, advocate for research funding and live a rich and joyful life.
In this exclusive Lifescript interview, the couple discusses Panero’s early-stage diagnosis and the steps they’re taking to combat Alzheimer’s disease.
How soon after your symptoms surfaced did you receive an Alzheimer’s diagnosis?
Panero: It took about a year. I first went to my general practitioner, who referred me to a neurologist. The [specialist] told me that forgetting the names of objects was all part of getting older.
[But] when things didn’t get better, the neurologist did more testing and diagnosed me with frontotemporal dementia [which affects the brain’s frontal and temporal lobes, areas that govern personality, behavior and language].
Grier: That doctor suggested Lydia get a second opinion from [neurologist] Karen Marder, M.D., at the Taub Institute at the Columbia University Medical Center in New York City. Marder conducted more tests that revealed Lydia had Alzheimer’s.
How did you feel about the diagnosis process?
Grier: It was very frustrating. Diagnosing Alzheimer’s disease [is] like reading tea leaves.
Panero: It’s sad that doctors don’t know the full story until an Alzheimer’s patient dies and then they examine that person’s brain. When I die, scientists will get my brain to examine.
How did you first feel about the diagnosis?
Panero: I was devastated.
Grier: Lydia loved teaching poetry, plays and fiction to her students, so she was understandably devastated when she had to give up her lifelong career and passion.
What brought you out of your initial depression after the diagnosis?
Panero: What turned me around was participating in a play about what it’s like to have Alzheimer’s, called To Whom I May Concern.
The play was created by Maureen Matthews (a psychiatric nurse researcher and coordinator of the early memory loss program at the Stamford, Conn., Counseling Center). Five of us read aloud letters we wrote to friends explaining what it’s like to have Alzheimer’s disease.
I used parts of the letter I wrote to my dean explaining why I had to give up my teaching post at Manhattan College. I started doing the plays in 2007 and have been acting in several showings each year.
What medications and supplements do you take to control the symptoms of dementia?
Panero: When I was first diagnosed with Alzheimer’s, my doctor prescribed Razadyne, a medication that’s similar to Aricept [donepezil, a cholinesterase inhibitor that improves mental function – such as memory, attention, social interaction, reasoning and language abilities, and the ability to perform daily activities – by increasing acetylcholine, a naturally occurring substance in the brain]. Recently, my doctor [also] started me on Namenda [memantine, which reduces abnormal activity in the brain].
So far, so good. My symptoms haven’t gotten much worse since I was first diagnosed with Alzheimer’s about five years ago.
Grier: Lydia’s short-term memory is still good. Her long-term isn’t as good.
Panero: I try not to think about it, but probably my Alzheimer’s disease will get worse.
What other steps do you take to ward off depression and avoid the pitfalls?
Panero: We love music, so we go to lots of concerts. We also love to read. I walk outside or go on my stationary bike for 30 minutes each day.
Grier: We walk through a nearby conservancy, where we see deer and turkeys. One year ago, we went to China and had a wonderful time. We’ve also traveled throughout Europe and have been to Mexico and Costa Rica.
Lydia still likes to cook and I like to make salads, so we enjoying making a meal together.
She also likes to read the daily newspaper out loud so she can hold onto her vocabulary, and to debate the rules of grammar with me, so she stays sharp.
Do you also participate in support groups?
Grier: Lydia participates in two support groups. One is run by the local Alzheimer’s Association and another one is sponsored by the Taub Institute.
I’m also a member of a caregiver support group run by the local Alzheimer’s Association.
You two are advocates for funding Alzheimer’s research. What lobbying activities do you participate in?
Panero: Every year, we travel to Albany [New York’s capital] to talk with state representatives about the need for more funding for Alzheimer’s research. We also participate in the annual Walk for Alzheimer’s put on by the local branch of the Alzheimer’s Association.
I also participated in one drug trial – and I’m always on the lookout for another study to become part of in the hopes that a medication that actually stops the disease, and doesn't just control the symptoms, will be found.
Grier: We also just returned from a three-day forum in Washington, D.C., [which] was a great success. We visited legislators and their staffs and found them very receptive to hearing about the scope of the Alzheimer’s disease crisis. We also talked with them about new and pending legislation, including the National Alzheimer’s Project Act (NAPA), which recently passed unanimously in both houses of Congress.
This act directs the Secretary of Health and Human Services to create a plan to research Alzheimer’s disease and establish a protocol for caring for patients.
The 600 advocates who attended the forum also heard about two acts that will soon be voted on: The Hope for Alzheimer’s Act would utilize Medicare to expand the diagnosis of Alzheimer’s and mandate care-planning by physicians.
And the Alzheimer’s Breakthrough Act would make Alzheimer’s disease a priority for the National Institutes of Health (NIH) and require NIH scientists to submit annual reports to Congress [about] the progress of their studies.
Are there any silver linings to having Alzheimer’s?
Panero: The upside is my friendships with people who have Alzheimer’s. They’re great.
Grier: Lydia enjoyed introducing her friends and members of her support groups to some of her favorite female authors – Gwendolyn Brooks, Joyce Carol Oates, Adrienne Rich and Zorah Neale Hurston.
She also loved performing in the play To Whom I May Concern.
What is your big hope for Alzheimer’s disease?
Panero: That scientists find a cure for Alzheimer’s. Wouldn’t that be great!
For more information, visit our new Alzheimer's Disease Health Center.
How Much Do You Know About Alzheimer’s?
More than 5 million Americans have Alzheimer’s disease, and that number could climb to 16 million by 2050. Women face a higher risk of developing it than men, and are also more likely to become caregivers.
Lydia Panero of Mamaroneck, N.Y., taught literature for 40 years at Manhattan College. So when her language skills started to deteriorate in 2006, she knew something was amiss.
At age 67, Panero was diagnosed with Alzheimer’s disease, a form of dementia marked by memory problems, confusion, learning deficits and personality changes.
“In class with my students, the first thing I noticed was that I was losing my nouns,” Panero says.
It’s not that she didn’t know what objects were. Rather, “she just couldn’t find the words that identified the objects and ideas she was trying to talk about with her students,” says 80-year-old Harry Grier, her caregiver and husband of 46 years.
At first, she coped by teaching fewer classes.
“Eventually, that became overwhelming,” Panero says. “I said to Harry, ‘I don’t think I can do this anymore.’”
She left the career she loved.
But Panero now has turned her sadness into a determination to fight Alzheimer’s disease, advocate for research funding and live a rich and joyful life.
In this exclusive Lifescript interview, the couple discusses Panero’s early-stage diagnosis and the steps they’re taking to combat Alzheimer’s disease.
How soon after your symptoms surfaced did you receive an Alzheimer’s diagnosis?
Panero: It took about a year. I first went to my general practitioner, who referred me to a neurologist. The [specialist] told me that forgetting the names of objects was all part of getting older.
[But] when things didn’t get better, the neurologist did more testing and diagnosed me with frontotemporal dementia [which affects the brain’s frontal and temporal lobes, areas that govern personality, behavior and language].
Grier: That doctor suggested Lydia get a second opinion from [neurologist] Karen Marder, M.D., at the Taub Institute at the Columbia University Medical Center in New York City. Marder conducted more tests that revealed Lydia had Alzheimer’s.
How did you feel about the diagnosis process?
Grier: It was very frustrating. Diagnosing Alzheimer’s disease [is] like reading tea leaves.
Panero: It’s sad that doctors don’t know the full story until an Alzheimer’s patient dies and then they examine that person’s brain. When I die, scientists will get my brain to examine.
How did you first feel about the diagnosis?
Panero: I was devastated.
Grier: Lydia loved teaching poetry, plays and fiction to her students, so she was understandably devastated when she had to give up her lifelong career and passion.
What brought you out of your initial depression after the diagnosis?
Panero: What turned me around was participating in a play about what it’s like to have Alzheimer’s, called To Whom I May Concern.
The play was created by Maureen Matthews (a psychiatric nurse researcher and coordinator of the early memory loss program at the Stamford, Conn., Counseling Center). Five of us read aloud letters we wrote to friends explaining what it’s like to have Alzheimer’s disease.
I used parts of the letter I wrote to my dean explaining why I had to give up my teaching post at Manhattan College. I started doing the plays in 2007 and have been acting in several showings each year.
What medications and supplements do you take to control the symptoms of dementia?
Panero: When I was first diagnosed with Alzheimer’s, my doctor prescribed Razadyne, a medication that’s similar to Aricept [donepezil, a cholinesterase inhibitor that improves mental function – such as memory, attention, social interaction, reasoning and language abilities, and the ability to perform daily activities – by increasing acetylcholine, a naturally occurring substance in the brain]. Recently, my doctor [also] started me on Namenda [memantine, which reduces abnormal activity in the brain].
So far, so good. My symptoms haven’t gotten much worse since I was first diagnosed with Alzheimer’s about five years ago.
Grier: Lydia’s short-term memory is still good. Her long-term isn’t as good.
Panero: I try not to think about it, but probably my Alzheimer’s disease will get worse.
What other steps do you take to ward off depression and avoid the pitfalls?
Panero: We love music, so we go to lots of concerts. We also love to read. I walk outside or go on my stationary bike for 30 minutes each day.
Grier: We walk through a nearby conservancy, where we see deer and turkeys. One year ago, we went to China and had a wonderful time. We’ve also traveled throughout Europe and have been to Mexico and Costa Rica.
Lydia still likes to cook and I like to make salads, so we enjoying making a meal together.
She also likes to read the daily newspaper out loud so she can hold onto her vocabulary, and to debate the rules of grammar with me, so she stays sharp.
Do you also participate in support groups?
Grier: Lydia participates in two support groups. One is run by the local Alzheimer’s Association and another one is sponsored by the Taub Institute.
I’m also a member of a caregiver support group run by the local Alzheimer’s Association.
You two are advocates for funding Alzheimer’s research. What lobbying activities do you participate in?
Panero: Every year, we travel to Albany [New York’s capital] to talk with state representatives about the need for more funding for Alzheimer’s research. We also participate in the annual Walk for Alzheimer’s put on by the local branch of the Alzheimer’s Association.
I also participated in one drug trial – and I’m always on the lookout for another study to become part of in the hopes that a medication that actually stops the disease, and doesn't just control the symptoms, will be found.
Grier: We also just returned from a three-day forum in Washington, D.C., [which] was a great success. We visited legislators and their staffs and found them very receptive to hearing about the scope of the Alzheimer’s disease crisis. We also talked with them about new and pending legislation, including the National Alzheimer’s Project Act (NAPA), which recently passed unanimously in both houses of Congress.
This act directs the Secretary of Health and Human Services to create a plan to research Alzheimer’s disease and establish a protocol for caring for patients.
The 600 advocates who attended the forum also heard about two acts that will soon be voted on: The Hope for Alzheimer’s Act would utilize Medicare to expand the diagnosis of Alzheimer’s and mandate care-planning by physicians.
And the Alzheimer’s Breakthrough Act would make Alzheimer’s disease a priority for the National Institutes of Health (NIH) and require NIH scientists to submit annual reports to Congress [about] the progress of their studies.
Are there any silver linings to having Alzheimer’s?
Panero: The upside is my friendships with people who have Alzheimer’s. They’re great.
Grier: Lydia enjoyed introducing her friends and members of her support groups to some of her favorite female authors – Gwendolyn Brooks, Joyce Carol Oates, Adrienne Rich and Zorah Neale Hurston.
She also loved performing in the play To Whom I May Concern.
What is your big hope for Alzheimer’s disease?
Panero: That scientists find a cure for Alzheimer’s. Wouldn’t that be great!
For more information, visit our new Alzheimer's Disease Health Center.
How Much Do You Know About Alzheimer’s?
More than 5 million Americans have Alzheimer’s disease, and that number could climb to 16 million by 2050. Women face a higher risk of developing it than men, and are also more likely to become caregivers.
More U.S. women using medications during pregnancy
NEW YORK (Reuters Health) - Most pregnant women in the U.S. use at least one prescription or over-the-counter medication -- even though the safety of those drugs during pregnancy is not always clear, a new study finds.
Looking at data from two long-running studies, researchers found that by 2008, more than 80 percent of pregnant women used at least one prescription or over-the-counter medication at some point.
What's more, half used a drug during the first trimester -- the point of pregnancy where there is the greatest concern about the potential effects of medications on birth defect risk.
Those numbers, the study found, represent a large shift from 30 years earlier, when about 30 percent of women used some type of medication during the first trimester.
The concern, researchers say, is that with many drugs, the safety of using them during pregnancy is not yet clear.
So the findings underscore a need to keep studying the safety of individual medications, according to lead researcher Dr. Allen A. Mitchell, of the Boston University Schools of Public Health and Medicine.
"That's not to say that these drugs are dangerous," Mitchell told Reuters Health. "But we just don't have enough information on them."
The difficulty is that medications are almost never tested in pregnant women before they come to market because it is considered unethical to expose a pregnant woman to a drug with unknown effects.
So usually the only way to uncover safety concerns is with post-marketing surveillance studies.
And those studies need to be large, Mitchell explained, in order to detect whether an individual medication is linked to any one birth defect. It's usually the case that a drug would cause only certain birth defects, as opposed to a broad spectrum of problems.
In general, the risk of having a baby with any birth defect is between 2 and 3 percent. So individual birth defects are relatively infrequent.
The current findings, which appear in the American Journal of Obstetrics & Gynecology, are based on data from two long-term studies on birth defects. More than 30,000 U.S. women were interviewed about their prenatal medication use.
Over time, the number of women using a prescription or over-the-counter drug rose, as did the percentage using four or more medications. By 2008, 28 percent of women said they'd used four or more drugs in the first trimester, up from 10 percent 30 years earlier.
Among the most common prescription drugs used were various antibiotics, asthma and allergy medications, and antidepressants.
The safety of those drugs during pregnancy is not entirely clear.
On the other hand, if a woman is taking a drug for a chronic medical condition, such as asthma, epilepsy or major depression, there could be risks to stopping the medication during pregnancy.
Mitchell pointed to the example of asthma. "Untreated asthma is not good for the mother or for the baby," he said.
These findings, he added, "should not discourage women from taking the medications they need for chronic conditions."
Instead, Mitchell suggested, these women should talk with their doctors about the risks and benefits of those drugs during pregnancy. Depending on the condition, there may be a particular drug that is recommended above others for pregnant women.
Women should also be aware that the safety of over-the-counter drugs during pregnancy is not completely clear either.
Again, Mitchell said, that's not to say that those medications are necessarily dangerous. But if a pregnant woman can find other ways to manage a stuffy nose or other minor symptom, then she might want to go that route.
"If you don't feel that you need the medication," Mitchell said, "then you might want to err on the side of caution."
SOURCE: http://bit.ly/iQZqTu American Journal of Obstetrics & Gynecology, online April 25, 2011.
Looking at data from two long-running studies, researchers found that by 2008, more than 80 percent of pregnant women used at least one prescription or over-the-counter medication at some point.
What's more, half used a drug during the first trimester -- the point of pregnancy where there is the greatest concern about the potential effects of medications on birth defect risk.
Those numbers, the study found, represent a large shift from 30 years earlier, when about 30 percent of women used some type of medication during the first trimester.
The concern, researchers say, is that with many drugs, the safety of using them during pregnancy is not yet clear.
So the findings underscore a need to keep studying the safety of individual medications, according to lead researcher Dr. Allen A. Mitchell, of the Boston University Schools of Public Health and Medicine.
"That's not to say that these drugs are dangerous," Mitchell told Reuters Health. "But we just don't have enough information on them."
The difficulty is that medications are almost never tested in pregnant women before they come to market because it is considered unethical to expose a pregnant woman to a drug with unknown effects.
So usually the only way to uncover safety concerns is with post-marketing surveillance studies.
And those studies need to be large, Mitchell explained, in order to detect whether an individual medication is linked to any one birth defect. It's usually the case that a drug would cause only certain birth defects, as opposed to a broad spectrum of problems.
In general, the risk of having a baby with any birth defect is between 2 and 3 percent. So individual birth defects are relatively infrequent.
The current findings, which appear in the American Journal of Obstetrics & Gynecology, are based on data from two long-term studies on birth defects. More than 30,000 U.S. women were interviewed about their prenatal medication use.
Over time, the number of women using a prescription or over-the-counter drug rose, as did the percentage using four or more medications. By 2008, 28 percent of women said they'd used four or more drugs in the first trimester, up from 10 percent 30 years earlier.
Among the most common prescription drugs used were various antibiotics, asthma and allergy medications, and antidepressants.
The safety of those drugs during pregnancy is not entirely clear.
On the other hand, if a woman is taking a drug for a chronic medical condition, such as asthma, epilepsy or major depression, there could be risks to stopping the medication during pregnancy.
Mitchell pointed to the example of asthma. "Untreated asthma is not good for the mother or for the baby," he said.
These findings, he added, "should not discourage women from taking the medications they need for chronic conditions."
Instead, Mitchell suggested, these women should talk with their doctors about the risks and benefits of those drugs during pregnancy. Depending on the condition, there may be a particular drug that is recommended above others for pregnant women.
Women should also be aware that the safety of over-the-counter drugs during pregnancy is not completely clear either.
Again, Mitchell said, that's not to say that those medications are necessarily dangerous. But if a pregnant woman can find other ways to manage a stuffy nose or other minor symptom, then she might want to go that route.
"If you don't feel that you need the medication," Mitchell said, "then you might want to err on the side of caution."
SOURCE: http://bit.ly/iQZqTu American Journal of Obstetrics & Gynecology, online April 25, 2011.
Monday, May 30, 2011
THOUGHT FOR THE DAY ....
We are all here for some special reason. Stop being a prisoner of your past. Become the architect of your future.
FUN FACTS
* Bill Gates is worth enough money to send every single 18 year old in the country to a 4 year college *
* Worldwide, bats are the most important natural enemies of night-flying insects. *
* The 20 million Mexican free-tail bats from Bracken Cave, Texas, eat 250 tons of insects nightly. *
* A tiny biting midge, or "no-seeum," Forcipomyia, beats its hairy wings 62,760 times a minute. *
* The smallest breed of pig is the Mini Maialino. Pigs of this breed average only 20 lbs at maturity. *
* Worldwide, bats are the most important natural enemies of night-flying insects. *
* The 20 million Mexican free-tail bats from Bracken Cave, Texas, eat 250 tons of insects nightly. *
* A tiny biting midge, or "no-seeum," Forcipomyia, beats its hairy wings 62,760 times a minute. *
* The smallest breed of pig is the Mini Maialino. Pigs of this breed average only 20 lbs at maturity. *
Pregnancy possible soon after giving birth
NEW YORK (Reuters Health) -- Just had a baby, and not ready for another one quite yet?
To be safe, you should consider using contraception as soon as 3 weeks after birth, according to a new review published in Obstetrics & Gynecology.
Women who are breastfeeding are very unlikely to conceive, and most women who aren't breastfeeding won't start ovulating again until 6 weeks after giving birth. Still, it's possible in less time, say the authors.
"For women with a new baby, contraception may not be at the top of their list of concerns," Dr. Emily Jackson, one of the study's authors, from the World Health Organization (WHO), told Reuters Health in an email.
"It is really important that people who provide care to postpartum women bring up the subject of contraceptives, alert women to the fact that they may become fertile soon after having a baby, and make sure that women have their chosen method before they become fertile again," said Jackson, also a family doctor in Los Angeles.
Using some kinds of contraceptive pills right after pregnancy is dangerous because both the estrogen in pills and post-pregnancy hormones increase a woman's risk of blood clots. That risk drops off over time.
The aim of the current study was to help determine at what point after a woman gives birth the benefits of using contraceptive pills again begin to outweigh the risks.
Jackson and her colleague Dr. Anna Glasier reviewed four studies that have examined when non-breastfeeding women begin to ovulate again after giving birth, and whether women had a good chance of getting pregnant during those first ovulations.
In all of the studies combined, ovulation started, on average, between 45 and 94 days after a woman gave birth. However, in two studies women started ovulating as early as 25 and 27 days after giving birth.
The studies also found that most of those first ovulations probably wouldn't result in pregnancy.
Based on these results, and on data regarding the likelihood of blood clots, the WHO determined that the benefits of starting contraceptive pills containing both estrogen and progestin probably outweigh any risks starting at 3 weeks after birth.
After 6 weeks, WHO researchers said that there should be no restrictions on new mothers taking contraceptive pills.
Contraceptive pills that contain progestin only are thought to be safe right away after a woman gives birth, and so these could be an option for women, said Dr. Kavita Nanda, a researcher at Family Health International who was not involved in the current study.
The study's recommendations only apply to women who are not regularly breastfeeding.
In addition, doctors don't recommend that mothers who are breastfeeding take contraceptive pills with estrogen, because of a controversial potential risk that those could slow infants' growth.
Jackson also said it's important that doctors speak to all women, including women who are breastfeeding, about their options for contraception.
"Breastfeeding can be a lot of work, and women may have a break in breastfeeding that they don't plan for or stop breastfeeding earlier than they thought they would, potentially putting them at higher risk for pregnancy unexpectedly," Jackson said.
"It would be great if we could make sure that all women were prepared in advance to address their return to fertility postpartum."
SOURCE: http://bit.ly/hqlHLT Obstetrics & Gynecology, March 2011.
To be safe, you should consider using contraception as soon as 3 weeks after birth, according to a new review published in Obstetrics & Gynecology.
Women who are breastfeeding are very unlikely to conceive, and most women who aren't breastfeeding won't start ovulating again until 6 weeks after giving birth. Still, it's possible in less time, say the authors.
"For women with a new baby, contraception may not be at the top of their list of concerns," Dr. Emily Jackson, one of the study's authors, from the World Health Organization (WHO), told Reuters Health in an email.
"It is really important that people who provide care to postpartum women bring up the subject of contraceptives, alert women to the fact that they may become fertile soon after having a baby, and make sure that women have their chosen method before they become fertile again," said Jackson, also a family doctor in Los Angeles.
Using some kinds of contraceptive pills right after pregnancy is dangerous because both the estrogen in pills and post-pregnancy hormones increase a woman's risk of blood clots. That risk drops off over time.
The aim of the current study was to help determine at what point after a woman gives birth the benefits of using contraceptive pills again begin to outweigh the risks.
Jackson and her colleague Dr. Anna Glasier reviewed four studies that have examined when non-breastfeeding women begin to ovulate again after giving birth, and whether women had a good chance of getting pregnant during those first ovulations.
In all of the studies combined, ovulation started, on average, between 45 and 94 days after a woman gave birth. However, in two studies women started ovulating as early as 25 and 27 days after giving birth.
The studies also found that most of those first ovulations probably wouldn't result in pregnancy.
Based on these results, and on data regarding the likelihood of blood clots, the WHO determined that the benefits of starting contraceptive pills containing both estrogen and progestin probably outweigh any risks starting at 3 weeks after birth.
After 6 weeks, WHO researchers said that there should be no restrictions on new mothers taking contraceptive pills.
Contraceptive pills that contain progestin only are thought to be safe right away after a woman gives birth, and so these could be an option for women, said Dr. Kavita Nanda, a researcher at Family Health International who was not involved in the current study.
The study's recommendations only apply to women who are not regularly breastfeeding.
In addition, doctors don't recommend that mothers who are breastfeeding take contraceptive pills with estrogen, because of a controversial potential risk that those could slow infants' growth.
Jackson also said it's important that doctors speak to all women, including women who are breastfeeding, about their options for contraception.
"Breastfeeding can be a lot of work, and women may have a break in breastfeeding that they don't plan for or stop breastfeeding earlier than they thought they would, potentially putting them at higher risk for pregnancy unexpectedly," Jackson said.
"It would be great if we could make sure that all women were prepared in advance to address their return to fertility postpartum."
SOURCE: http://bit.ly/hqlHLT Obstetrics & Gynecology, March 2011.
Sedentary Jobs Help Drive Obesity Rates
A drop in workplace physical activity over the past half century has helped propel rates of U.S. obesity to among the highest in the world, a study said.
Less than 20 percent of jobs now require at least moderate exertion, a drop from almost half of all private-industry jobs five decades ago, according to research published Wednesday in the journal PLOS One. The change in job-related daily physical effort matched the actual change in weight for some.
“Over the last 50 years in the United States there has been a progressive decrease in the percent of individuals employed in occupations that require moderate intensity physical activity,” the study said. The reduction in energy expenditure “accounts for a significant portion of the increase in mean U.S. body weight for women and men over the last five decades.”
More than a third of U.S. adults, or over 72 million people, are obese, according to the Centers for Disease Control and Prevention in Atlanta. The obesity rate has doubled for adults since 1980. Obesity increases the risk of Type-2 diabetes, heart disease, and some cancers, according to the CDC.
The researchers analyzed occupational data from the U.S. Bureau of Labor Statistics and compared it with mean body weights from the U.S. National Health and Nutrition Examination Surveys. They found that predicted weights based on change in occupational-related daily energy expenditure since 1960 closely matched the actual change in weight for 40- to 50-year-old men and women.
The number of calories expended by U.S. workers had dropped on average by more than 100 in the period, said the researchers, led by Timothy S. Church and Claude Bouchard at Louisiana State University in Baton Rouge.
Service occupations, which are less strenuous than manufacturing and agriculture, now account for 43 percent of U.S. private-sector jobs, compared with 20 percent in the early 1960s. The study didn’t factor in technological changes that make manufacturing and agriculture easier, meaning that the study may be underestimating the trend, the researchers said.
Less than 20 percent of jobs now require at least moderate exertion, a drop from almost half of all private-industry jobs five decades ago, according to research published Wednesday in the journal PLOS One. The change in job-related daily physical effort matched the actual change in weight for some.
“Over the last 50 years in the United States there has been a progressive decrease in the percent of individuals employed in occupations that require moderate intensity physical activity,” the study said. The reduction in energy expenditure “accounts for a significant portion of the increase in mean U.S. body weight for women and men over the last five decades.”
More than a third of U.S. adults, or over 72 million people, are obese, according to the Centers for Disease Control and Prevention in Atlanta. The obesity rate has doubled for adults since 1980. Obesity increases the risk of Type-2 diabetes, heart disease, and some cancers, according to the CDC.
The researchers analyzed occupational data from the U.S. Bureau of Labor Statistics and compared it with mean body weights from the U.S. National Health and Nutrition Examination Surveys. They found that predicted weights based on change in occupational-related daily energy expenditure since 1960 closely matched the actual change in weight for 40- to 50-year-old men and women.
The number of calories expended by U.S. workers had dropped on average by more than 100 in the period, said the researchers, led by Timothy S. Church and Claude Bouchard at Louisiana State University in Baton Rouge.
Service occupations, which are less strenuous than manufacturing and agriculture, now account for 43 percent of U.S. private-sector jobs, compared with 20 percent in the early 1960s. The study didn’t factor in technological changes that make manufacturing and agriculture easier, meaning that the study may be underestimating the trend, the researchers said.
Help for Under-Eye Circles
One of the most frequently read and viewed articles from the Journal of Dermatologic Surgery discusses the causes and treatments of dark under-eye circles.
Basically, they divided the reasons for these into three categories: pigment in the skin, blood vessels, and hollow troughs under the eyes.
Some of these are easily corrected while others are more difficult. Treatments ranges from topical medications and topical cosmeceutical products (such as Scientificskin.com eye cream) to lasers and soft tissue augmentation product such as Restylane and Juvederm.
Pigment in the epidermis is usually formed after minor irritation, hormones, or after procedures. This pigment is melanin and it can be treated with medications known as hydroquinones. Many of these are produced in concentrations of 4 percent and will gradually help the pigment dissipate.
Stronger products can be custom formulated and for many of my patients I order them to help promote more rapid lightening. A prescription product called TriLuma combines this bleaching agent with hydrocortisone and a vitamin A derivative. When used correctly, it works beautifully to lighten the dark circles caused by melanin.
Hollow spaces under the eye cause shadows that appear as dark circles. In some patients, they can be easily filled using soft tissue fillers. To correct these tear troughs, I use injections of clear fillers to lift the skin and fill the hollow. Although this can result in bruising, patients treated with these fillers often have results that correct the dark circles.
The correction typically lasts for six to eight months and can easily be repeated. Some of the complications that can occur with this treatment include lumps and bumps, therefore the injections should be performed by very experienced injectors.
The last category that causes dark circles are related to blood vessels. When the vessels are near the skin or congested, they can make the area look dark. Allergies can make this situation worse and be alleviated by antihistamines. Lasers can help treat blood vessels that are near the surface.
Treatments require several visits and are typically not covered by insurance. Other laser treatments that can lighten the skin (and tighten wrinkles in this area as well) include the Fraxel and CO-2 lasers. In my practice, I employ them for patients who have fine lines with pigment in the area around the eyes.
People with dark circles around the eyes should ask their dermatologist or plastic surgeon about their specific cause and what treatments are available to them. For most patients in my practice, I design a program that makes the circles much less noticeable. No matter what the cause, there are treatments available to help.
Basically, they divided the reasons for these into three categories: pigment in the skin, blood vessels, and hollow troughs under the eyes.
Some of these are easily corrected while others are more difficult. Treatments ranges from topical medications and topical cosmeceutical products (such as Scientificskin.com eye cream) to lasers and soft tissue augmentation product such as Restylane and Juvederm.
Pigment in the epidermis is usually formed after minor irritation, hormones, or after procedures. This pigment is melanin and it can be treated with medications known as hydroquinones. Many of these are produced in concentrations of 4 percent and will gradually help the pigment dissipate.
Stronger products can be custom formulated and for many of my patients I order them to help promote more rapid lightening. A prescription product called TriLuma combines this bleaching agent with hydrocortisone and a vitamin A derivative. When used correctly, it works beautifully to lighten the dark circles caused by melanin.
Hollow spaces under the eye cause shadows that appear as dark circles. In some patients, they can be easily filled using soft tissue fillers. To correct these tear troughs, I use injections of clear fillers to lift the skin and fill the hollow. Although this can result in bruising, patients treated with these fillers often have results that correct the dark circles.
The correction typically lasts for six to eight months and can easily be repeated. Some of the complications that can occur with this treatment include lumps and bumps, therefore the injections should be performed by very experienced injectors.
The last category that causes dark circles are related to blood vessels. When the vessels are near the skin or congested, they can make the area look dark. Allergies can make this situation worse and be alleviated by antihistamines. Lasers can help treat blood vessels that are near the surface.
Treatments require several visits and are typically not covered by insurance. Other laser treatments that can lighten the skin (and tighten wrinkles in this area as well) include the Fraxel and CO-2 lasers. In my practice, I employ them for patients who have fine lines with pigment in the area around the eyes.
People with dark circles around the eyes should ask their dermatologist or plastic surgeon about their specific cause and what treatments are available to them. For most patients in my practice, I design a program that makes the circles much less noticeable. No matter what the cause, there are treatments available to help.
NIH Halts Niacin Study After Disappointing Heart Findings
A drug that boosts people's good cholesterol didn't go on to prevent heart attacks or strokes, leading U.S. officials to abruptly halt a major study Thursday.
The disappointing findings involve super-strength niacin, a type of B vitamin that many doctors already prescribe as potential heart protection. The failed study marks the latest setback in the quest to harness good cholesterol to fight the bad kind.
"This sends us a bit back to the drawing board," said Dr. Susan Shurin, cardiovascular chief at the National Institutes of Health.
The bad kind of cholesterol, called LDL, is the main source of artery clogs. Popular statin drugs, sold under such names as Zocor and Lipitor, plus generic forms, are mainstays in lowering LDL. Yet many statin users still have heart attacks, because LDL isn't the whole story.
HDL cholesterol, the good kind, helps fight artery build-up by carrying fats to the liver to be disposed of. That's one reason that people with too little HDL also are at risk of heart disease. So scientists are testing whether giving HDL-boosting drugs in addition to statins could offer heart patients extra protection.
The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements. The drug has been sold for years, and previous studies have shown it does boost HDL levels. But no one knew if that translated into fewer heart attacks.
Researchers enrolled more than 3,400 statin users in the United States and Canada who had stable heart disease and well-controlled LDL, but were at risk because of low HDL levels and too much of a different bad fat, triglycerides. They were given either Niaspan or a dummy pill to add to their daily medicine.
As expected, the Niaspan users saw their HDL levels rise and their levels of risky triglycerides drop more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes, or the need for artery-clearing procedures such as angioplasty, the NIH said.
That finding "is unexpected and a striking contrast to the results of previous trials," said Dr. Jeffrey Probstfield of the University of Washington, who helped lead the study.
But it led the NIH to stop the study 18 months ahead of schedule.
Adding to the decision was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan, compared with 12 among the 1,696 placebo users. The NIH said it wasn't clear if that small difference was merely a coincidence; previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug.
What's the message for heart patients?
Statin users who have very low LDL levels, like those in this study, don't need an extra prescription for niacin, said Dr. Robert Eckel, a University of Colorado cardiologist and American Heart Association spokesman who wasn't involved with the study.
But it's not clear if niacin would have any effect on people at higher risk or those who don't have a diagnosis of heart disease yet but take niacin as a preventive, said study co-leader Dr. William Boden of the University at Buffalo.
"We can't generalize these findings ... to patients that we didn't study," he said.
Eckel said it's "really hard to envision exactly what's going to happen in physicians' offices" in coming weeks as they discuss niacin with patients. The NIH urged people not to stop high-dose niacin without consulting a doctor.
Nor do the findings end hope that raising HDL eventually will pan out, Eckel said. While two other drugs have failed as well, he is closely watching some much stronger HDL-boosters, including a Merck & Co. drug named anacetrapib, that are under development.
The disappointing findings involve super-strength niacin, a type of B vitamin that many doctors already prescribe as potential heart protection. The failed study marks the latest setback in the quest to harness good cholesterol to fight the bad kind.
"This sends us a bit back to the drawing board," said Dr. Susan Shurin, cardiovascular chief at the National Institutes of Health.
The bad kind of cholesterol, called LDL, is the main source of artery clogs. Popular statin drugs, sold under such names as Zocor and Lipitor, plus generic forms, are mainstays in lowering LDL. Yet many statin users still have heart attacks, because LDL isn't the whole story.
HDL cholesterol, the good kind, helps fight artery build-up by carrying fats to the liver to be disposed of. That's one reason that people with too little HDL also are at risk of heart disease. So scientists are testing whether giving HDL-boosting drugs in addition to statins could offer heart patients extra protection.
The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements. The drug has been sold for years, and previous studies have shown it does boost HDL levels. But no one knew if that translated into fewer heart attacks.
Researchers enrolled more than 3,400 statin users in the United States and Canada who had stable heart disease and well-controlled LDL, but were at risk because of low HDL levels and too much of a different bad fat, triglycerides. They were given either Niaspan or a dummy pill to add to their daily medicine.
As expected, the Niaspan users saw their HDL levels rise and their levels of risky triglycerides drop more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes, or the need for artery-clearing procedures such as angioplasty, the NIH said.
That finding "is unexpected and a striking contrast to the results of previous trials," said Dr. Jeffrey Probstfield of the University of Washington, who helped lead the study.
But it led the NIH to stop the study 18 months ahead of schedule.
Adding to the decision was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan, compared with 12 among the 1,696 placebo users. The NIH said it wasn't clear if that small difference was merely a coincidence; previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug.
What's the message for heart patients?
Statin users who have very low LDL levels, like those in this study, don't need an extra prescription for niacin, said Dr. Robert Eckel, a University of Colorado cardiologist and American Heart Association spokesman who wasn't involved with the study.
But it's not clear if niacin would have any effect on people at higher risk or those who don't have a diagnosis of heart disease yet but take niacin as a preventive, said study co-leader Dr. William Boden of the University at Buffalo.
"We can't generalize these findings ... to patients that we didn't study," he said.
Eckel said it's "really hard to envision exactly what's going to happen in physicians' offices" in coming weeks as they discuss niacin with patients. The NIH urged people not to stop high-dose niacin without consulting a doctor.
Nor do the findings end hope that raising HDL eventually will pan out, Eckel said. While two other drugs have failed as well, he is closely watching some much stronger HDL-boosters, including a Merck & Co. drug named anacetrapib, that are under development.
Men, Looking for a Woman? Don't Smile
Guys, want to look sexy and get the girl? Don't smile too much. Look brooding or show a bit of shame instead. Women, ignore that advice.
Women find happy men less sexually attractive than those with expressions that show pride or hint that they have done wrong and know it, according to Canadian researchers.
The study published online Tuesday in the American Psychological Association journal Emotion showed pictures of the opposite sex to both men and women. Participants were then asked for their initial reactions on sexual attractiveness based the expressions they saw.
"Men who smile were considered fairly unattractive by women," said Jessica Tracy, a University of British Columbia psychology professor who directed the study.
"So to the extent that men think that smiling is a good thing to do if they want to be found sexually attractive our findings suggest that's not the case," Tracy said.
The men's reaction was just the opposite.
"Women who smile are absolutely very attractive. That was by far the most attractive expression women showed," Tracy said in an interview.
The researchers admit they are not sure why men and women reacted differently to smiles. In a man, a big smile may make him appear too feminine or more desperate for sex.
The study also adds fuel to the notion that women are attracted to bad boys.
"Women are attracted to guys like James Dean, Edward the vampire. The guys who are flawed, but who know it and are tortured by it," Tracy said.
A slightly downcast expression of shame is an appeasement gesture that hints at a need for sympathy.
Men also found sexual attractiveness in women whose expressions and body language hinted at shame.
The researchers stressed they looked only at initial reactions of sexual attractiveness, and were not recommending men adopt a no-smile policy for a long-term relationship.
"When people want a long-term relationship they take much more into account than sexual attractiveness. How nice a person is, is a big thing," Tracy said.
"So we're not saying, don't be a nice guy," she said.
Women find happy men less sexually attractive than those with expressions that show pride or hint that they have done wrong and know it, according to Canadian researchers.
The study published online Tuesday in the American Psychological Association journal Emotion showed pictures of the opposite sex to both men and women. Participants were then asked for their initial reactions on sexual attractiveness based the expressions they saw.
"Men who smile were considered fairly unattractive by women," said Jessica Tracy, a University of British Columbia psychology professor who directed the study.
"So to the extent that men think that smiling is a good thing to do if they want to be found sexually attractive our findings suggest that's not the case," Tracy said.
The men's reaction was just the opposite.
"Women who smile are absolutely very attractive. That was by far the most attractive expression women showed," Tracy said in an interview.
The researchers admit they are not sure why men and women reacted differently to smiles. In a man, a big smile may make him appear too feminine or more desperate for sex.
The study also adds fuel to the notion that women are attracted to bad boys.
"Women are attracted to guys like James Dean, Edward the vampire. The guys who are flawed, but who know it and are tortured by it," Tracy said.
A slightly downcast expression of shame is an appeasement gesture that hints at a need for sympathy.
Men also found sexual attractiveness in women whose expressions and body language hinted at shame.
The researchers stressed they looked only at initial reactions of sexual attractiveness, and were not recommending men adopt a no-smile policy for a long-term relationship.
"When people want a long-term relationship they take much more into account than sexual attractiveness. How nice a person is, is a big thing," Tracy said.
"So we're not saying, don't be a nice guy," she said.
Sunday, May 29, 2011
FUN FACTS
* Honey bees must fly over 55,000 miles to produce one pound of honey. *
* A worker honey bee makes only 1/12 teaspoon of honey in her life time. *
* Kangaroos live up to 20 years in captivity, but only six in the wild. *
* Male kangaroos do not have pouches. *
* The Sooty Tern remains continually aloft for 3 to 10 years as a sub adult before returning to land to breed? IT NEVER LANDS during this time! It eats, drinks, and even sleeps on the wing. *
* A worker honey bee makes only 1/12 teaspoon of honey in her life time. *
* Kangaroos live up to 20 years in captivity, but only six in the wild. *
* Male kangaroos do not have pouches. *
* The Sooty Tern remains continually aloft for 3 to 10 years as a sub adult before returning to land to breed? IT NEVER LANDS during this time! It eats, drinks, and even sleeps on the wing. *
Menopause age related to when mom went through it
NEW YORK (Reuters Health) - The age at which women go through menopause depends a lot on when their relatives did, according to new study findings.
Specifically, women whose mothers or sisters experienced menopause by age 45 were roughly 6 times more likely to do the same. Women who underwent menopause at a relatively late age - 54 or older - were also 6 times more likely to have seen the same thing happen to their mothers, and twice as likely to see it in their sisters.
But age of menopause is not entirely inherited, the authors found - a significant component also depends on so-called environmental factors.
"Genes have an important effect on age at menopause, but lifestyle also matters, and so women can affect their age at menopause by their behaviors," study author Danielle Morris at the Institute of Cancer Research in the UK told Reuters Health.
Scientists know that certain aspects of a woman's environment directly impact her age at menopause, Morris explained - for instance, women who smoke tend to undergo menopause roughly 1-2 years earlier than former or non-smokers. Women who have never given birth also experience menopause earlier, she said.
Age at menopause is an essential aspect of fertility, Morris and her team write in the journal Menopause, since a woman's ability to conceive ends roughly 10 years before she experiences menopause. Previous research has also found that women who experience menopause relatively late in life have a higher risk of breast and endometrial cancers, and a lower risk of cardiovascular disease.
According to the National Institute on Aging, 51 is the average age at which a woman reaches menopause, or has her last period. But some women have their last period in their 40s and some have it later in their 50s.
To investigate how much of a woman's age at menopause is inherited, Morris and her team compared women who were more or less related, reasoning that different relatives will share different amounts of genes and their environment.
"For example, if identical twins have more similar menopausal ages than non-identical twins, then this suggests that genes are important because identical twins have more genes in common than non-identical twins," said Morris in an email.
"Similarly, if sisters have more similar menopausal ages than mothers and daughters, then this (suggests) that environment is important, because sisters have the same amount of genes in common as mothers and daughters do, but sisters tend to have more similar lifestyles than mothers and daughters."
The sample came from a large study designed to investigate the causes of breast cancer among women living in the UK. Among those participants, the researchers selected 2,060 women between the ages of 31 and 90 who had a first-degree relative who was also participating in the same study.
Both early and late menopause appeared to run in families, the authors found - but so did usual-age menopause, they note. Specifically, women whose sisters and mothers underwent menopause during a typical age were between 2 and 7 times more likely to do the same.
SOURCE: http://bit.ly/ilCV4B Menopause, online April 18, 2011.
Specifically, women whose mothers or sisters experienced menopause by age 45 were roughly 6 times more likely to do the same. Women who underwent menopause at a relatively late age - 54 or older - were also 6 times more likely to have seen the same thing happen to their mothers, and twice as likely to see it in their sisters.
But age of menopause is not entirely inherited, the authors found - a significant component also depends on so-called environmental factors.
"Genes have an important effect on age at menopause, but lifestyle also matters, and so women can affect their age at menopause by their behaviors," study author Danielle Morris at the Institute of Cancer Research in the UK told Reuters Health.
Scientists know that certain aspects of a woman's environment directly impact her age at menopause, Morris explained - for instance, women who smoke tend to undergo menopause roughly 1-2 years earlier than former or non-smokers. Women who have never given birth also experience menopause earlier, she said.
Age at menopause is an essential aspect of fertility, Morris and her team write in the journal Menopause, since a woman's ability to conceive ends roughly 10 years before she experiences menopause. Previous research has also found that women who experience menopause relatively late in life have a higher risk of breast and endometrial cancers, and a lower risk of cardiovascular disease.
According to the National Institute on Aging, 51 is the average age at which a woman reaches menopause, or has her last period. But some women have their last period in their 40s and some have it later in their 50s.
To investigate how much of a woman's age at menopause is inherited, Morris and her team compared women who were more or less related, reasoning that different relatives will share different amounts of genes and their environment.
"For example, if identical twins have more similar menopausal ages than non-identical twins, then this suggests that genes are important because identical twins have more genes in common than non-identical twins," said Morris in an email.
"Similarly, if sisters have more similar menopausal ages than mothers and daughters, then this (suggests) that environment is important, because sisters have the same amount of genes in common as mothers and daughters do, but sisters tend to have more similar lifestyles than mothers and daughters."
The sample came from a large study designed to investigate the causes of breast cancer among women living in the UK. Among those participants, the researchers selected 2,060 women between the ages of 31 and 90 who had a first-degree relative who was also participating in the same study.
Both early and late menopause appeared to run in families, the authors found - but so did usual-age menopause, they note. Specifically, women whose sisters and mothers underwent menopause during a typical age were between 2 and 7 times more likely to do the same.
SOURCE: http://bit.ly/ilCV4B Menopause, online April 18, 2011.
People Who Cut Themselves and Why
Cutting with razors and other sharp objects is a troubling trend among women, especially teenagers. Disney starlet Demi Lovato sought treatment for the disorder earlier this year, along with bulimia and bipolar disease. Why do young women engage in such self-destructive behavior, and are these disorders connected? One of the nation’s top psychiatrists, Mark Hyman Rapaport, M.D., explains people who cut themselves and why…
Often, people who cut themselves hide their injuries out of shame and embarrassment.
But some of that stigma faded in January, when fresh-faced teen singer and actress Demi Lovato, then just 18, admitted she has wrestled with cutting and bulimia since she was 11 years old.
"It was a way of expressing my shame on my body," she told "20/20," ABC’s newsmagazine.
"There were times where my emotions were just so built up, I didn't know what to do,” she says. “[Cutting was] the only way I could get an immediate release."
While undergoing treatment last winter at an Illinois rehabilitation center, Lovato was also diagnosed with bipolar disease. Now she is speaking publically about all these issues.
We decided to dig deeper to understand why a beautiful young woman like Lovato – who seems to have it all – would engage in such self-destructive behavior. So we turned to Mark Hyman Rapaport, M.D., chairman of the department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center in Los Angeles.
In this exclusive interview, Rapaport explains self-harm and cutting and what may cause these painful disorders.
Why would someone engage in self-harm or cutting behavior?
It can be [a sign] of someone under tremendous pressure and distress. They’ve found this sort of dysfunctional behavior releases that.
It’s also a behavior that some people outgrow.
Are bipolar disorder, bulimia and cutting connected?
There are certainly adolescent people who have bipolar disorder and manifest it by a variety of different behaviors, but cutting doesn’t mean somebody has bipolar disorder. It can be a sign of a variety of different dysfunctions.
How can parents spot signs of self-harm or cutting?
The first thing is to have a good enough relationship with your children that you know they’ve got a problem. [It's] important that there’s enough trust that the child is willing to work both with the family and outside experts to get help.
That’s very difficult with adolescents – to have an open and non-judgmental relationship so they can come to you when they’re in distress.
Should parents nose around more in their children's lives?
More than nosing around, [we should develop] the best relationship we can with our children and not take things for granted.
Our lives are all so busy [that] it’s easy to say, ‘There has been a change in my child’s behavior, but since it’s not creating a problem within the family now, I don’t have time to deal with it.’
We need to address [the problem].
What are the top warning signs of people who cut themselves? What questions should parents ask?
1. Has there been a precipitate change in this person’s friends, the types of people they’re hanging out with? Have they withdrawn from them?
2. School performance and grades: Has that person also withdrawn from activities they used to enjoy and be part of? Have they gotten out of playing in the band. Are they no longer interested in participating in theater at school? Has there been a change in those activities and behaviors?
3. [Has there] been a change in their sleep-wake cycle, eating patterns [or other] day-to-day behaviors?
4. Is the child much more withdrawn, aggressive or assertive? Are we seeing more angry outbursts or tearfulness?
These are all [behaviors] that suggest that children are drifting [toward trouble] – whether it’s mood, eating or alcohol- or substance-use disorders.
Why is it so difficult for children and teens to talk about cutting?
Many times, kids, by nature, want to try and handle it on their own. They feel ashamed about it, and don’t want to be controlled by their parents at this point. They’re trying to be more independent.
That’s why open communication and acceptance is good.
What happens to people who cut themselves if you don’t deal with it head on?
Other [harmful] behaviors are experimentation with drugs and alcohol. It's a major problem [that] can begin as early as junior high school and increase in high school.
Frequently, there are issues around eating disorders, particularly with young women. That was the case [with Lovato]. She had been teased about her weight and developed eating disorders.
If teen girl has bulimia, is she more likely to practice self-harm or cutting?
One frequently sees [an array] of behaviors when someone has an eating disorder. It’s not just either binging or purging, food restriction or over exercising. It can be more basic or primitive behaviors, such as cutting.
Is peer pressure a cause?
We really don’t know how much of it is [due to] the pressure these young children are under – the pressure to grow up faster, to succeed in school [or] act more [grown up] than they may be developmentally ready to do.
How tough is it for people who cut themselves to accept their diagnosis?
For anyone to come to grips with this – let alone an adolescent whose body is changing, and who still doesn’t have the wisdom or experiences adults have had – is tough.
Healing takes a long time. A young person needs to get used to the fact that they have a chronic disease.
That is a tremendous burden to bear suddenly. Your friends don’t have a disease, but you do. You feel very different [and] stigmatized.
How can adults minimize the shame people who cut themselves feel?
It’s important to realize that these are disorders of circuitry in the brain. They’re the same types [disorders] we see in the rest of the body. They just manifest differently.
The brain is the most complex system in the body. The mind and the body are connected – that’s why God made the neck.
What sort of treatment is best for people who cut themselves?
Intervention, whether through psychotherapy, medication or a combination of those approaches.
Can doctors treat people who cut themselves without medication?
Yes, sometimes, it can be very effectively treated by psychotherapy, depending on the reasons for the cutting, because – remember – cutting is a symptom. It’s not necessarily a disorder.
What kind of psychotherapy is most effective for people who cut themselves?
[Dialectical behavioral therapy or DBT] can be a very effective treatment for these types of destructive impulses. [DBT uses cognitive-behavioral techniques and meditation to teach patients to cope with stress, regulate emotions and improve relationships.]
Have there been advances in drug and other treatments for these disorders?
We’ve made tremendous progress and will continue to make it. Not just in terms of new compounds and medications, but even more importantly, we’re beginning to understand the basic biology behind [such self-destructive behavior].
What have you learned?
We’re beginning to understand the role of stress and early-life trauma in [the development of] brain disorders later in life. We’re beginning to understand the role of chronic perceived stress in triggering events and changing the biology of people.
Through our works in genetics and epigenetics [the study of how environment and choices can influence genes], we're learning individual factors that put someone at greater risk or resilience. This will allow us eventually to better tailor treatments.
Should we be optimistic about the future of treating brain diseases?
I want to emphasize the importance of hope. Just because somebody has a symptom of something like cutting or a brain disorder, it’s not necessarily going to negatively impact the rest of their lives. Many people with brain disorders have wonderful lives.
What do people who cut themselves need to know most?
If they’re cutting, they shouldn’t be ashamed – they should realize people understand that it’s because they’re in distress. They need to know it’s OK to get help.
How Do You Deal with Difficult Emotions?
It's natural to experience anger, jealousy, hurt - even though your mother told you that "a frown doesn't suit your pretty face!" But have you ever felt overwhelmed by these emotions, or think that you spend too much energy getting over them? Everyone could use some healthy options for dealing with difficult emotions.
Often, people who cut themselves hide their injuries out of shame and embarrassment.
But some of that stigma faded in January, when fresh-faced teen singer and actress Demi Lovato, then just 18, admitted she has wrestled with cutting and bulimia since she was 11 years old.
"It was a way of expressing my shame on my body," she told "20/20," ABC’s newsmagazine.
"There were times where my emotions were just so built up, I didn't know what to do,” she says. “[Cutting was] the only way I could get an immediate release."
While undergoing treatment last winter at an Illinois rehabilitation center, Lovato was also diagnosed with bipolar disease. Now she is speaking publically about all these issues.
We decided to dig deeper to understand why a beautiful young woman like Lovato – who seems to have it all – would engage in such self-destructive behavior. So we turned to Mark Hyman Rapaport, M.D., chairman of the department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center in Los Angeles.
In this exclusive interview, Rapaport explains self-harm and cutting and what may cause these painful disorders.
Why would someone engage in self-harm or cutting behavior?
It can be [a sign] of someone under tremendous pressure and distress. They’ve found this sort of dysfunctional behavior releases that.
It’s also a behavior that some people outgrow.
Are bipolar disorder, bulimia and cutting connected?
There are certainly adolescent people who have bipolar disorder and manifest it by a variety of different behaviors, but cutting doesn’t mean somebody has bipolar disorder. It can be a sign of a variety of different dysfunctions.
How can parents spot signs of self-harm or cutting?
The first thing is to have a good enough relationship with your children that you know they’ve got a problem. [It's] important that there’s enough trust that the child is willing to work both with the family and outside experts to get help.
That’s very difficult with adolescents – to have an open and non-judgmental relationship so they can come to you when they’re in distress.
Should parents nose around more in their children's lives?
More than nosing around, [we should develop] the best relationship we can with our children and not take things for granted.
Our lives are all so busy [that] it’s easy to say, ‘There has been a change in my child’s behavior, but since it’s not creating a problem within the family now, I don’t have time to deal with it.’
We need to address [the problem].
What are the top warning signs of people who cut themselves? What questions should parents ask?
1. Has there been a precipitate change in this person’s friends, the types of people they’re hanging out with? Have they withdrawn from them?
2. School performance and grades: Has that person also withdrawn from activities they used to enjoy and be part of? Have they gotten out of playing in the band. Are they no longer interested in participating in theater at school? Has there been a change in those activities and behaviors?
3. [Has there] been a change in their sleep-wake cycle, eating patterns [or other] day-to-day behaviors?
4. Is the child much more withdrawn, aggressive or assertive? Are we seeing more angry outbursts or tearfulness?
These are all [behaviors] that suggest that children are drifting [toward trouble] – whether it’s mood, eating or alcohol- or substance-use disorders.
Why is it so difficult for children and teens to talk about cutting?
Many times, kids, by nature, want to try and handle it on their own. They feel ashamed about it, and don’t want to be controlled by their parents at this point. They’re trying to be more independent.
That’s why open communication and acceptance is good.
What happens to people who cut themselves if you don’t deal with it head on?
Other [harmful] behaviors are experimentation with drugs and alcohol. It's a major problem [that] can begin as early as junior high school and increase in high school.
Frequently, there are issues around eating disorders, particularly with young women. That was the case [with Lovato]. She had been teased about her weight and developed eating disorders.
If teen girl has bulimia, is she more likely to practice self-harm or cutting?
One frequently sees [an array] of behaviors when someone has an eating disorder. It’s not just either binging or purging, food restriction or over exercising. It can be more basic or primitive behaviors, such as cutting.
Is peer pressure a cause?
We really don’t know how much of it is [due to] the pressure these young children are under – the pressure to grow up faster, to succeed in school [or] act more [grown up] than they may be developmentally ready to do.
How tough is it for people who cut themselves to accept their diagnosis?
For anyone to come to grips with this – let alone an adolescent whose body is changing, and who still doesn’t have the wisdom or experiences adults have had – is tough.
Healing takes a long time. A young person needs to get used to the fact that they have a chronic disease.
That is a tremendous burden to bear suddenly. Your friends don’t have a disease, but you do. You feel very different [and] stigmatized.
How can adults minimize the shame people who cut themselves feel?
It’s important to realize that these are disorders of circuitry in the brain. They’re the same types [disorders] we see in the rest of the body. They just manifest differently.
The brain is the most complex system in the body. The mind and the body are connected – that’s why God made the neck.
What sort of treatment is best for people who cut themselves?
Intervention, whether through psychotherapy, medication or a combination of those approaches.
Can doctors treat people who cut themselves without medication?
Yes, sometimes, it can be very effectively treated by psychotherapy, depending on the reasons for the cutting, because – remember – cutting is a symptom. It’s not necessarily a disorder.
What kind of psychotherapy is most effective for people who cut themselves?
[Dialectical behavioral therapy or DBT] can be a very effective treatment for these types of destructive impulses. [DBT uses cognitive-behavioral techniques and meditation to teach patients to cope with stress, regulate emotions and improve relationships.]
Have there been advances in drug and other treatments for these disorders?
We’ve made tremendous progress and will continue to make it. Not just in terms of new compounds and medications, but even more importantly, we’re beginning to understand the basic biology behind [such self-destructive behavior].
What have you learned?
We’re beginning to understand the role of stress and early-life trauma in [the development of] brain disorders later in life. We’re beginning to understand the role of chronic perceived stress in triggering events and changing the biology of people.
Through our works in genetics and epigenetics [the study of how environment and choices can influence genes], we're learning individual factors that put someone at greater risk or resilience. This will allow us eventually to better tailor treatments.
Should we be optimistic about the future of treating brain diseases?
I want to emphasize the importance of hope. Just because somebody has a symptom of something like cutting or a brain disorder, it’s not necessarily going to negatively impact the rest of their lives. Many people with brain disorders have wonderful lives.
What do people who cut themselves need to know most?
If they’re cutting, they shouldn’t be ashamed – they should realize people understand that it’s because they’re in distress. They need to know it’s OK to get help.
How Do You Deal with Difficult Emotions?
It's natural to experience anger, jealousy, hurt - even though your mother told you that "a frown doesn't suit your pretty face!" But have you ever felt overwhelmed by these emotions, or think that you spend too much energy getting over them? Everyone could use some healthy options for dealing with difficult emotions.
Diabetic? Your Heart's at Risk
Diabetes and heart disease go hand in hand. A study from the University of Texas showed that people with diabetes who do not have heart disease actually have the same risk of heart attack as people already diagnosed with heart disease. This report led the American Heart Association to label diabetes “a cardiovascular disease” in 1999.
Insulin is a hormone that allows the cells of your body to absorb glucose from the blood and convert it to energy. People with insulin dysfunctions develop diabetes. When the pancreas — the gland that secretes insulin — is unable to make the hormone, the condition is called Type 1 diabetes. When the body is unable to use the insulin the pancreas makes, it’s called Type 2 diabetes.
Type 2 diabetes is also known as “insulin resistance” because the cells “resist” using the insulin that is present. Insulin resistance results in high blood sugar, high triglyceride levels, and inflammation — all of which increase the risk of heart attack and stroke.
Insulin resistance also increases inflammation in the body, which leads to plaque buildup in the arteries and a threefold or greater risk of heart attack and stroke. Symptoms of insulin resistance (Type 2 diabetes) include abdominal obesity, high cholesterol, and high blood pressure. The skin around the neck may become thickened and dark, and there can be an increased incidence of skin tags. In women, excess insulin can cause an overproduction of testosterone, which has a negative effect on women’s hearts.
The best way to avoid insulin resistance is through proper diet and supplements. The numbers you should shoot for are:
Fasting blood triglycerides, less than 100 mg/dl
Fasting blood glucose, less than 100 mg/dl
HDL cholesterol greater than 40 to 50 mg/dl for men; greater than 50 mg/dl for women
Waist measurement, less than 40 inches for men; less than 35 inches for women
To get those numbers where you want them to be and keep them there, here are some lifestyle adjustments you might make:
Emphasize low-glycemic, high-fiber foods like fresh fruits and vegetables. Limit sugar and processed foods. Choose healthy fats like olive and canola oil.
Exercise 30 to 60 minutes a day to improve your cells’ insulin sensitivity. In addition, 20 minutes of strength training twice a week greatly accelerates fat loss.
Sleep seven to eight hours a night. Chronic sleep loss impairs insulin function and results in added belly fat. If you have trouble sleeping, try a melatonin supplement at bedtime.
A good multivitamin supplement is a must, and fish oil is a good source of omega-3 fatty acids that reduce triglyceride levels. Make sure you are getting vitamin D year-round by taking supplements when you can’t get exposure to the sun. Vitamin D helps regulate blood pressure and insulin sensitivity.
Insulin is a hormone that allows the cells of your body to absorb glucose from the blood and convert it to energy. People with insulin dysfunctions develop diabetes. When the pancreas — the gland that secretes insulin — is unable to make the hormone, the condition is called Type 1 diabetes. When the body is unable to use the insulin the pancreas makes, it’s called Type 2 diabetes.
Type 2 diabetes is also known as “insulin resistance” because the cells “resist” using the insulin that is present. Insulin resistance results in high blood sugar, high triglyceride levels, and inflammation — all of which increase the risk of heart attack and stroke.
Insulin resistance also increases inflammation in the body, which leads to plaque buildup in the arteries and a threefold or greater risk of heart attack and stroke. Symptoms of insulin resistance (Type 2 diabetes) include abdominal obesity, high cholesterol, and high blood pressure. The skin around the neck may become thickened and dark, and there can be an increased incidence of skin tags. In women, excess insulin can cause an overproduction of testosterone, which has a negative effect on women’s hearts.
The best way to avoid insulin resistance is through proper diet and supplements. The numbers you should shoot for are:
Fasting blood triglycerides, less than 100 mg/dl
Fasting blood glucose, less than 100 mg/dl
HDL cholesterol greater than 40 to 50 mg/dl for men; greater than 50 mg/dl for women
Waist measurement, less than 40 inches for men; less than 35 inches for women
To get those numbers where you want them to be and keep them there, here are some lifestyle adjustments you might make:
Emphasize low-glycemic, high-fiber foods like fresh fruits and vegetables. Limit sugar and processed foods. Choose healthy fats like olive and canola oil.
Exercise 30 to 60 minutes a day to improve your cells’ insulin sensitivity. In addition, 20 minutes of strength training twice a week greatly accelerates fat loss.
Sleep seven to eight hours a night. Chronic sleep loss impairs insulin function and results in added belly fat. If you have trouble sleeping, try a melatonin supplement at bedtime.
A good multivitamin supplement is a must, and fish oil is a good source of omega-3 fatty acids that reduce triglyceride levels. Make sure you are getting vitamin D year-round by taking supplements when you can’t get exposure to the sun. Vitamin D helps regulate blood pressure and insulin sensitivity.
Health & Fitness
Weight Loss Tips!
#1: Maximize Your Muscle
Muscles are fat-burning furnaces, so be sure to do enough resistance training to build and maintain them (these fast workouts tone your whole body in 30 minutes), and follow your workout with a healthy meal or snack that contains protein, carbohydrates and fat. Building new muscle raises your Resting Metabolic Rate (RMR) so you'll burn more calories every day.
#2: Don't Forget Cardio
Cardio improves definition and burns the fat that covers your muscles, especially belly fat. Combining regular aerobic exercise with strength training will give you the slimming effect you've been going for. After all, toning without cardio is like building a house on a weak foundation. Blast calories with 20-minute cardio workouts from celebrity trainer Jackie Warner.
#1: Maximize Your Muscle
Muscles are fat-burning furnaces, so be sure to do enough resistance training to build and maintain them (these fast workouts tone your whole body in 30 minutes), and follow your workout with a healthy meal or snack that contains protein, carbohydrates and fat. Building new muscle raises your Resting Metabolic Rate (RMR) so you'll burn more calories every day.
#2: Don't Forget Cardio
Cardio improves definition and burns the fat that covers your muscles, especially belly fat. Combining regular aerobic exercise with strength training will give you the slimming effect you've been going for. After all, toning without cardio is like building a house on a weak foundation. Blast calories with 20-minute cardio workouts from celebrity trainer Jackie Warner.
NIH Halts Niacin Study After Disappointing Heart Findings
A drug that boosts people's good cholesterol didn't go on to prevent heart attacks or strokes, leading U.S. officials to abruptly halt a major study Thursday.
The disappointing findings involve super-strength niacin, a type of B vitamin that many doctors already prescribe as potential heart protection. The failed study marks the latest setback in the quest to harness good cholesterol to fight the bad kind.
"This sends us a bit back to the drawing board," said Dr. Susan Shurin, cardiovascular chief at the National Institutes of Health.
The bad kind of cholesterol, called LDL, is the main source of artery clogs. Popular statin drugs, sold under such names as Zocor and Lipitor, plus generic forms, are mainstays in lowering LDL. Yet many statin users still have heart attacks, because LDL isn't the whole story.
HDL cholesterol, the good kind, helps fight artery build-up by carrying fats to the liver to be disposed of. That's one reason that people with too little HDL also are at risk of heart disease. So scientists are testing whether giving HDL-boosting drugs in addition to statins could offer heart patients extra protection.
The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements. The drug has been sold for years, and previous studies have shown it does boost HDL levels. But no one knew if that translated into fewer heart attacks.
Researchers enrolled more than 3,400 statin users in the United States and Canada who had stable heart disease and well-controlled LDL, but were at risk because of low HDL levels and too much of a different bad fat, triglycerides. They were given either Niaspan or a dummy pill to add to their daily medicine.
As expected, the Niaspan users saw their HDL levels rise and their levels of risky triglycerides drop more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes, or the need for artery-clearing procedures such as angioplasty, the NIH said.
That finding "is unexpected and a striking contrast to the results of previous trials," said Dr. Jeffrey Probstfield of the University of Washington, who helped lead the study.
But it led the NIH to stop the study 18 months ahead of schedule.
Adding to the decision was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan, compared with 12 among the 1,696 placebo users. The NIH said it wasn't clear if that small difference was merely a coincidence; previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug.
What's the message for heart patients?
Statin users who have very low LDL levels, like those in this study, don't need an extra prescription for niacin, said Dr. Robert Eckel, a University of Colorado cardiologist and American Heart Association spokesman who wasn't involved with the study.
But it's not clear if niacin would have any effect on people at higher risk or those who don't have a diagnosis of heart disease yet but take niacin as a preventive, said study co-leader Dr. William Boden of the University at Buffalo.
"We can't generalize these findings ... to patients that we didn't study," he said.
Eckel said it's "really hard to envision exactly what's going to happen in physicians' offices" in coming weeks as they discuss niacin with patients. The NIH urged people not to stop high-dose niacin without consulting a doctor.
Nor do the findings end hope that raising HDL eventually will pan out, Eckel said. While two other drugs have failed as well, he is closely watching some much stronger HDL-boosters, including a Merck & Co. drug named anacetrapib, that are under development.
The disappointing findings involve super-strength niacin, a type of B vitamin that many doctors already prescribe as potential heart protection. The failed study marks the latest setback in the quest to harness good cholesterol to fight the bad kind.
"This sends us a bit back to the drawing board," said Dr. Susan Shurin, cardiovascular chief at the National Institutes of Health.
The bad kind of cholesterol, called LDL, is the main source of artery clogs. Popular statin drugs, sold under such names as Zocor and Lipitor, plus generic forms, are mainstays in lowering LDL. Yet many statin users still have heart attacks, because LDL isn't the whole story.
HDL cholesterol, the good kind, helps fight artery build-up by carrying fats to the liver to be disposed of. That's one reason that people with too little HDL also are at risk of heart disease. So scientists are testing whether giving HDL-boosting drugs in addition to statins could offer heart patients extra protection.
The newest study tested Abbott Laboratories' Niaspan, an extended-release form of niacin that is a far higher dose than is found in dietary supplements. The drug has been sold for years, and previous studies have shown it does boost HDL levels. But no one knew if that translated into fewer heart attacks.
Researchers enrolled more than 3,400 statin users in the United States and Canada who had stable heart disease and well-controlled LDL, but were at risk because of low HDL levels and too much of a different bad fat, triglycerides. They were given either Niaspan or a dummy pill to add to their daily medicine.
As expected, the Niaspan users saw their HDL levels rise and their levels of risky triglycerides drop more than people who took a statin alone. But the combination treatment didn't reduce heart attacks, strokes, or the need for artery-clearing procedures such as angioplasty, the NIH said.
That finding "is unexpected and a striking contrast to the results of previous trials," said Dr. Jeffrey Probstfield of the University of Washington, who helped lead the study.
But it led the NIH to stop the study 18 months ahead of schedule.
Adding to the decision was a small increase in strokes in the high-dose niacin users — 28 among those 1,718 people given Niaspan, compared with 12 among the 1,696 placebo users. The NIH said it wasn't clear if that small difference was merely a coincidence; previous studies have shown no stroke risk from niacin. In fact, some of the strokes occurred after the Niaspan users quit taking that drug.
What's the message for heart patients?
Statin users who have very low LDL levels, like those in this study, don't need an extra prescription for niacin, said Dr. Robert Eckel, a University of Colorado cardiologist and American Heart Association spokesman who wasn't involved with the study.
But it's not clear if niacin would have any effect on people at higher risk or those who don't have a diagnosis of heart disease yet but take niacin as a preventive, said study co-leader Dr. William Boden of the University at Buffalo.
"We can't generalize these findings ... to patients that we didn't study," he said.
Eckel said it's "really hard to envision exactly what's going to happen in physicians' offices" in coming weeks as they discuss niacin with patients. The NIH urged people not to stop high-dose niacin without consulting a doctor.
Nor do the findings end hope that raising HDL eventually will pan out, Eckel said. While two other drugs have failed as well, he is closely watching some much stronger HDL-boosters, including a Merck & Co. drug named anacetrapib, that are under development.
Saturday, May 28, 2011
THOUGHT FOR THE DAY ....
Everything in the world we want to do or get done, we must do with and through people.
Less bladder cancer in frequent painkiller users
NEW YORK (Reuters Health) - People who use painkillers such as ibuprofen on a regular basis may be less likely to get bladder cancer, according to a new review.
The researchers found a smaller chance of the cancer in people taking medications called non-steroidal anti-inflammatory drugs, or NSAIDs, more than twice a week. That includes drugs such as naproxen, marketed as Aleve, and ibuprofen, or Advil.
They did not find a reduced risk of bladder cancer in people who regularly took aspirin, also an anti-inflammatory.
"There's quite a lot of (research) showing that NSAIDs do protect against a variety of cancers," Dr. Daniel Djakiew, a cancer researcher at Georgetown University Medical Center in Washington, D.C., told Reuters Health.
The review, which was published in the American Journal of Epidemiology, adds support to previous studies that have suggested that people who take NSAIDs may have a smaller risk of bladder cancer as well as colon cancer and prostate cancer.
It's possible, said Djakiew, who did not participate in the current study, that "people that chronically consume ibuprofen and maybe other NSAIDs may be getting an anti-cancer benefit that they're not aware of."
Bladder cancer is the sixth most common cancer in the U.S. According to the National Cancer Institute, there were about 70,000 new cases diagnosed nationwide in 2010, and close to 15,000 deaths from the disease.
Researchers led by Dr. Sarah Daugherty from the National Institutes of Health combined data from three previous studies. The authors of each of those studies had asked participants how frequently they took different kinds of medications, including aspirin and other NSAIDs, and then tracked how many of them were diagnosed with bladder cancer over the following years.
The studies included a total of more than 500,000 people who were an average of 62 years old at the beginning of the study. Researchers followed them for an average of 7 years.
During that time, about 2,500 people were diagnosed with bladder cancer. More than 4 out of 5 of them were men.
Of people who never took NSAIDs other than aspirin, about 0.54 percent - or 1 in 185 people - developed bladder cancer. In comparison, 0.41 percent of people who took non-aspirin NSAIDs more than twice a week got bladder cancer, or 1 in 244 people.
How often people took aspirin was not linked with how likely they were to get bladder cancer.
Djakiew said there are lots of possible reasons why people who take NSAIDs regularly might be less at risk for bladder cancer. One of those possible explanations, he said, is that inflammation caused by bacteria or a virus, for example, makes the DNA mutations that lead to cancer more likely. By definition, NSAIDs cut down on inflammation, and could therefore reduce the chance of a cancer developing and spreading.
In an email to Reuters Health, Daugherty said that NSAIDs may prevent the growth of bladder cancer cells - and that anti-inflammatories other than aspirin might be better at it than aspirin.
But the study cannot prove that NSAIDs are responsible for lowering the risk of bladder cancer, and the findings don't mean that taking NSAIDs every day is the best choice for everyone. Such drugs have side effects, including ulcers.
"Based on our results, it would be premature to make recommendations to patients" to take NSAIDs, Daugherty said.
SOURCE: http://bit.ly/iklzBs American Journal of Epidemiology, online March 2, 2011.
The researchers found a smaller chance of the cancer in people taking medications called non-steroidal anti-inflammatory drugs, or NSAIDs, more than twice a week. That includes drugs such as naproxen, marketed as Aleve, and ibuprofen, or Advil.
They did not find a reduced risk of bladder cancer in people who regularly took aspirin, also an anti-inflammatory.
"There's quite a lot of (research) showing that NSAIDs do protect against a variety of cancers," Dr. Daniel Djakiew, a cancer researcher at Georgetown University Medical Center in Washington, D.C., told Reuters Health.
The review, which was published in the American Journal of Epidemiology, adds support to previous studies that have suggested that people who take NSAIDs may have a smaller risk of bladder cancer as well as colon cancer and prostate cancer.
It's possible, said Djakiew, who did not participate in the current study, that "people that chronically consume ibuprofen and maybe other NSAIDs may be getting an anti-cancer benefit that they're not aware of."
Bladder cancer is the sixth most common cancer in the U.S. According to the National Cancer Institute, there were about 70,000 new cases diagnosed nationwide in 2010, and close to 15,000 deaths from the disease.
Researchers led by Dr. Sarah Daugherty from the National Institutes of Health combined data from three previous studies. The authors of each of those studies had asked participants how frequently they took different kinds of medications, including aspirin and other NSAIDs, and then tracked how many of them were diagnosed with bladder cancer over the following years.
The studies included a total of more than 500,000 people who were an average of 62 years old at the beginning of the study. Researchers followed them for an average of 7 years.
During that time, about 2,500 people were diagnosed with bladder cancer. More than 4 out of 5 of them were men.
Of people who never took NSAIDs other than aspirin, about 0.54 percent - or 1 in 185 people - developed bladder cancer. In comparison, 0.41 percent of people who took non-aspirin NSAIDs more than twice a week got bladder cancer, or 1 in 244 people.
How often people took aspirin was not linked with how likely they were to get bladder cancer.
Djakiew said there are lots of possible reasons why people who take NSAIDs regularly might be less at risk for bladder cancer. One of those possible explanations, he said, is that inflammation caused by bacteria or a virus, for example, makes the DNA mutations that lead to cancer more likely. By definition, NSAIDs cut down on inflammation, and could therefore reduce the chance of a cancer developing and spreading.
In an email to Reuters Health, Daugherty said that NSAIDs may prevent the growth of bladder cancer cells - and that anti-inflammatories other than aspirin might be better at it than aspirin.
But the study cannot prove that NSAIDs are responsible for lowering the risk of bladder cancer, and the findings don't mean that taking NSAIDs every day is the best choice for everyone. Such drugs have side effects, including ulcers.
"Based on our results, it would be premature to make recommendations to patients" to take NSAIDs, Daugherty said.
SOURCE: http://bit.ly/iklzBs American Journal of Epidemiology, online March 2, 2011.
Short wait for breast cancer surgery seems safe
NEW YORK (Reuters Health) - Women newly diagnosed with earlier-stage breast cancer can take a few weeks to prepare for surgery without raising the odds that their tumor will progress, a new study suggests.
There are a number of reasons that a woman's surgery for breast cancer might be delayed. She might want to get a second opinion, for example, or her doctors may need to make sure any other medical conditions are under control and she's healthy enough for surgery.
But whether those short-term delays can allow a woman's tumor to progress has not been clear.
In the new study, researchers found that of 818 women treated at their center, there was no evidence that a "modest" delay before surgery gave breast tumors time to grow and spread.
"Clearly, rapid treatment is desirable," said senior researcher Dr. Funda Meric-Bernstam of M.D. Anderson Cancer Center in Houston.
"However," she told Reuters Health, "taking a few weeks to coordinate care is safe. It's very unlikely there will be tumor progression."
The findings, published in the Annals of Surgery, offer women reassurance that they do not need to rush into surgery before they are ready.
Meric-Bernstam said that patients often have questions about the safety of delaying surgery for a short time.
"Some women want to get a second opinion, but feel that they don't have time," she said.
In other cases, a woman may want to undergo breast reconstruction at the same time as the cancer surgery. But because that can delay treatment for a short time -- since different surgeons' schedules have to be coordinated -- some women forgo immediate reconstructive surgery.
There are caveats from the current study.
All of the women were having surgery for cancer that was confined to the breast and had not yet spread to nearby lymph nodes. So the findings apply only to that group of breast cancer patients.
The study was also done at a single medical center -- though, Meric-Bernstam said, it's likely that the findings can be generalized to women treated elsewhere.
Patients in the study typically had surgery three weeks after imaging tests to diagnose their cancer -- though the wait time ranged from as little as one day to about four months.
Women who underwent breast reconstruction waited somewhat longer -- typically one month, versus 19 days among other patients. And women having a total mastectomy waited longer (typically 26 days) than those only having the cancer removed (17 days).
When the researchers weighed other factors -- like the woman's age and how aggressive the cancer appeared -- they found no evidence that a longer wait for surgery raised the odds of tumor growth.
Meric-Bernstam stressed that she is not suggesting women put off surgery for any substantial amount of time.
But, she said, a "modest" delay that allows their doctors to plan and coordinate their care -- and women to prepare themselves for surgery -- could potentially improve their outcomes.
Still, it's not clear whether surgical delays affect women's ultimate breast cancer survival, either negatively or positively. Larger, longer-term studies are needed, Meric-Bernstam said.
SOURCE: http://bit.ly/kc9rxa Annals of Surgery, online April 13, 2011.
There are a number of reasons that a woman's surgery for breast cancer might be delayed. She might want to get a second opinion, for example, or her doctors may need to make sure any other medical conditions are under control and she's healthy enough for surgery.
But whether those short-term delays can allow a woman's tumor to progress has not been clear.
In the new study, researchers found that of 818 women treated at their center, there was no evidence that a "modest" delay before surgery gave breast tumors time to grow and spread.
"Clearly, rapid treatment is desirable," said senior researcher Dr. Funda Meric-Bernstam of M.D. Anderson Cancer Center in Houston.
"However," she told Reuters Health, "taking a few weeks to coordinate care is safe. It's very unlikely there will be tumor progression."
The findings, published in the Annals of Surgery, offer women reassurance that they do not need to rush into surgery before they are ready.
Meric-Bernstam said that patients often have questions about the safety of delaying surgery for a short time.
"Some women want to get a second opinion, but feel that they don't have time," she said.
In other cases, a woman may want to undergo breast reconstruction at the same time as the cancer surgery. But because that can delay treatment for a short time -- since different surgeons' schedules have to be coordinated -- some women forgo immediate reconstructive surgery.
There are caveats from the current study.
All of the women were having surgery for cancer that was confined to the breast and had not yet spread to nearby lymph nodes. So the findings apply only to that group of breast cancer patients.
The study was also done at a single medical center -- though, Meric-Bernstam said, it's likely that the findings can be generalized to women treated elsewhere.
Patients in the study typically had surgery three weeks after imaging tests to diagnose their cancer -- though the wait time ranged from as little as one day to about four months.
Women who underwent breast reconstruction waited somewhat longer -- typically one month, versus 19 days among other patients. And women having a total mastectomy waited longer (typically 26 days) than those only having the cancer removed (17 days).
When the researchers weighed other factors -- like the woman's age and how aggressive the cancer appeared -- they found no evidence that a longer wait for surgery raised the odds of tumor growth.
Meric-Bernstam stressed that she is not suggesting women put off surgery for any substantial amount of time.
But, she said, a "modest" delay that allows their doctors to plan and coordinate their care -- and women to prepare themselves for surgery -- could potentially improve their outcomes.
Still, it's not clear whether surgical delays affect women's ultimate breast cancer survival, either negatively or positively. Larger, longer-term studies are needed, Meric-Bernstam said.
SOURCE: http://bit.ly/kc9rxa Annals of Surgery, online April 13, 2011.
U.S. airport scanners find radiation OK: New tests
WASHINGTON (Reuters) - New tests of full-body scanners deployed at airports found that the radiation they emit was within acceptable levels, the Transportation Security Administration said on Tuesday after previous checks found some anomalies in results.
The machines, which have provoked health concerns about excessive radiation exposure, have been deployed at dozens of airports to thwart attacks on the U.S. aviation system which has continued to be a prime target of al Qaeda militants.
"The latest reports confirm previous testing and show that every backscatter unit currently used for passenger screening in U.S. airports is operating well within applicable national safety standards," said TSA spokesman Nicholas Kimball.
There are about 486 full-body scanners in 78 airports in the United States, of which 247 are so-called backscatter machines made by Rapiscan Systems, a unit of OSI Systems Inc. They expose a person to about 0.0025 millirem of radiation.
Test results released by TSA in March showed some anomalies, such as missing data or calculation errors unrelated to safety. The agency ordered new tests for the scanners as well as other X-ray equipment used to screen baggage that had problematic reports.
The machines cannot produce more than 0.005 millirem per scan, according to TSA. In comparison, a chest X-ray will expose someone to 10 millirem of radiation and the maximum recommended exposure to radiation from man-made sources is 100 millirem per year, according to TSA.
TSA posted the new test results on its website: http://1.usa.gov/fgMZMS
TSA has accelerated deploying full-body scanners and other machines to detect explosives after a Nigerian man tried but failed to detonate a bomb hidden in his underwear on a flight from Amsterdam as it approached Detroit on Christmas Day 2009.
The full-body scanners have also provoked a backlash among some travelers who were upset because they produce revealing body images.
The machines, which have provoked health concerns about excessive radiation exposure, have been deployed at dozens of airports to thwart attacks on the U.S. aviation system which has continued to be a prime target of al Qaeda militants.
"The latest reports confirm previous testing and show that every backscatter unit currently used for passenger screening in U.S. airports is operating well within applicable national safety standards," said TSA spokesman Nicholas Kimball.
There are about 486 full-body scanners in 78 airports in the United States, of which 247 are so-called backscatter machines made by Rapiscan Systems, a unit of OSI Systems Inc. They expose a person to about 0.0025 millirem of radiation.
Test results released by TSA in March showed some anomalies, such as missing data or calculation errors unrelated to safety. The agency ordered new tests for the scanners as well as other X-ray equipment used to screen baggage that had problematic reports.
The machines cannot produce more than 0.005 millirem per scan, according to TSA. In comparison, a chest X-ray will expose someone to 10 millirem of radiation and the maximum recommended exposure to radiation from man-made sources is 100 millirem per year, according to TSA.
TSA posted the new test results on its website: http://1.usa.gov/fgMZMS
TSA has accelerated deploying full-body scanners and other machines to detect explosives after a Nigerian man tried but failed to detonate a bomb hidden in his underwear on a flight from Amsterdam as it approached Detroit on Christmas Day 2009.
The full-body scanners have also provoked a backlash among some travelers who were upset because they produce revealing body images.
Signs of COPD? An Expert Answers Your Questions
Having trouble catching your breath? Getting winded just walking the dog? Your lungs may be sending you a signal. Get a pulmonologist’s perspective on spotting the early warning symptoms of COPD and what to do to keep your lungs healthy at any age...
Once thought of as a man’s, and even a coalminer’s, disease, chronic obstructive pulmonary disease (COPD) is now on the rise in women.
“COPD was considered a man’s disease because more men than women smoked and worked in factories,” says Stephen Mueller, M.D., a pulmonologist at Methodist Charlton Medical Center in Dallas, Texas.
“In fact,” he says, “a much larger population of women are developing COPD primarily because they’re smoking as much as men.”
According to the National Heart Lung and Blood Institute (NHLBI), more than 12 million people are living with the disease and 12 million more may not realize they have early stage COPD, which blocks airflow and makes it tough to breathe.
The best way to prevent it is to stop smoking – immediately.
But educating yourself about the warning symptoms of COPD, symptoms and treatment options could save your life or that of a loved one, Mueller says.
The best news: If COPD is diagnosed early enough, you can slow down – even stop – lung damage, says Mueller.
Here, Mueller explains symptoms of the disease, risk factors and the latest treatments for COPD.
What is COPD?
COPD describes a number of progressive chronic lung diseases, including emphysema and chronic bronchitis that slowly kill healthy lung tissue.
Emphysema causes the air sacs in the lungs to lose their flexibility, which prevents oxygen from entering the bloodstream, making it hard to breathe.
Chronic bronchitis, or ‘smoker’s cough,’ is a chronic lung disease caused by inflammation that leads to bronchial tube scarring. This produces excessive mucus that causes frequent coughing and respiratory infections.
When these conditions prevent air from flowing freely throughout the lung, parts become damaged or die. Air trapped in the dead or dying areas keeps the lungs from operating on full power, and the COPD patient has a hard time breathing.
Until we discover a way to grow or build new lung tissue, there’s no cure for the disease.
Who is at risk for COPD?
Smokers. The No. 1 contributing factor for developing COPD is smoking. At least 80% of all COPD cases are related to smoking.
What are some other risk factors?
Genetics may play a role in early symptoms of COPD development, even if a person never smokes, but it’s rare. Unfortunately, there are no genetic tests that can identify who is at risk for developing the disease.
Environmental factors, such as volatile chemicals, certain hardeners used in factories and diesel fuel fumes can injure lungs. Coal miners and those who work with asbestos or even cement increase their risk for developing symptoms of COPD.
Long-term exposure to high ozone, the main ingredient in urban smog, is thought to contribute to COPD because it deprives the lungs of fresh air.
Age is also a factor. Most people develop emphysema in their late 70s or 80s.
So, as we age, everyone is at risk for COPD?
Yes, eventually just about everyone will develop COPD simply through aging.
After age 35, you begin to lose about an ounce of lung tissue a year. It’s a slow process and isn’t noticeable in most healthy people. Smoking can quadruple the speed of the tissue loss, reducing lung capacity and increasing the likelihood of becoming oxygen dependent.
But after 40-50 years of this cumulative loss, you may get winded doing simple things, such as carrying groceries from the garage.
Patients generally don’t die of age-related COPD.
Does having asthma predispose you to COPD?
Yes and no. Untreated and uncontrolled asthma can stiffen airways and cause similar symptoms of COPD, such as difficulty in breathing.
Do men and women have similar symptoms of COPD?
Unlike heart disease, the symptoms are similar. However, the progression of the disease in women seems to be faster, especially if they continue smoking once diagnosed or are diagnosed in the later stages of the disease, or don’t take their prescribed medicines. Unfortunately, no one knows why.
What are the symptoms or warning signs of COPD?
Chronic bronchitis and coughing up clear mucous are certainly early warning signs of COPD. But its hallmark is shortness of breath. Regardless of frequency, it’s a sign of COPD you should address with your doctor.
Most patients in the early stages of COPD feel great sitting or resting. But they’re out of breath if they walk 10 feet.
If you suddenly feel winded or short of breath after normal activities, such as walking the dog, grocery shopping or riding a bike, see your physician.
Is early diagnosis important in treating or managing symptoms of COPD?
Early diagnosis may halt – or slow – its progression. Proper medication can open the airways and improve lung function, which makes it easier to breathe.
How is COPD diagnosed?
There are several non-invasive ways to test for lung disorders, such as emphysema, but only one will diagnose COPD: a lung function test.
What is that?
Called a spirometry, this two-step, non-invasive test measures the amount of air your lungs can hold and how fast you can blow the air out of your lungs.
The test can detect COPD before you have any symptoms, track the disease’s progression and monitor treatment. The optimum air-flow range depends on [several factors], such as age, weight, smoking history, etc.
If a person is diagnosed with COPD, is it too late to quit smoking?
It’s never too late to quit. Smoking destroys lung tissue continuously. Quitting now halts the accelerated destruction process, giving the lungs the opportunity to age normally.
Is COPD diagnosis an automatic death sentence?
No, COPD is an irreversible condition, but some patients have successfully managed the symptoms of this chronic lung disease for more than 20 years.
What medications are typically prescribed in the treatments of COPD?
Most COPD medications are inhaled, just like asthma drugs. They’re used to widen the airways and make it easier to breathe.
Two common drugs are Symbicort (budesonide/formoterol fumarate dihydrate) and Advair (fluticasone propionate and salmeterol). Both were initially designed for asthma treatment, but have been approved by the Food and Drug Administration (FDA) to treat COPD.
What are the side effects of those medications?
They have side effects that vary with every patient. The most common is dry mouth, which is temporary and may be managed with designated mouth rinses or by changing medicines.
Cost is a much bigger factor and deterrent for people. Many COPD medications are expensive and aren’t covered under prescription plans, insurance or Medicare.
Are there alternative remedies for COPD?
There’s insufficient scientific information to support any benefits of alternative remedies. Acupuncture may help symptoms a little, but not much.
Herbs and other treatments have not been effective in treating COPD.
Does exercise help manage symptoms of COPD?
Most definitely. Aerobic activity, such as walking or riding a stationary bike, improves lung power and capacity, and allows you to be active without getting winded.
Can surgerical treatments of COPD minimize symptoms?
The most common surgical procedure is lung volume reduction surgery, which removes about 30% of each lung to allow air to circulate more easily.
There are currently two surgical options used with this in-patient procedure. A sternotomy is a surgical incision made through the breastbone that allows the surgeon to remove the affected tissue through the chest.
The second, a thoracoscopy, is less invasive. It uses graspers and staplers inserted through small incisions on either side of the chest to remove damaged tissue and reseal the remaining lung. Both procedures require hospital stays between 5-10 days and multiple weeks of pulmonary rehabilitation.
Unfortunately, it’s a short-term solution. The disease typically recurs two to three years after surgery, which is one reason the procedure is rarely covered by insurance.
Gradually, the lung cells begin to die again, symptoms re-occur and patients again become easily winded and need oxygen.
What new treatments are on the horizon?
A new minimally-invasive procedure is being tested in the U.S. It uses umbrella-shaped valves inserted into the lungs through a bronchoscope (a flexible tube passed into the bronchial tubes through the mouth or nose) to redirect airflow from diseased portions to healthier areas.
For more information, visit our new COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.
Once thought of as a man’s, and even a coalminer’s, disease, chronic obstructive pulmonary disease (COPD) is now on the rise in women.
“COPD was considered a man’s disease because more men than women smoked and worked in factories,” says Stephen Mueller, M.D., a pulmonologist at Methodist Charlton Medical Center in Dallas, Texas.
“In fact,” he says, “a much larger population of women are developing COPD primarily because they’re smoking as much as men.”
According to the National Heart Lung and Blood Institute (NHLBI), more than 12 million people are living with the disease and 12 million more may not realize they have early stage COPD, which blocks airflow and makes it tough to breathe.
The best way to prevent it is to stop smoking – immediately.
But educating yourself about the warning symptoms of COPD, symptoms and treatment options could save your life or that of a loved one, Mueller says.
The best news: If COPD is diagnosed early enough, you can slow down – even stop – lung damage, says Mueller.
Here, Mueller explains symptoms of the disease, risk factors and the latest treatments for COPD.
What is COPD?
COPD describes a number of progressive chronic lung diseases, including emphysema and chronic bronchitis that slowly kill healthy lung tissue.
Emphysema causes the air sacs in the lungs to lose their flexibility, which prevents oxygen from entering the bloodstream, making it hard to breathe.
Chronic bronchitis, or ‘smoker’s cough,’ is a chronic lung disease caused by inflammation that leads to bronchial tube scarring. This produces excessive mucus that causes frequent coughing and respiratory infections.
When these conditions prevent air from flowing freely throughout the lung, parts become damaged or die. Air trapped in the dead or dying areas keeps the lungs from operating on full power, and the COPD patient has a hard time breathing.
Until we discover a way to grow or build new lung tissue, there’s no cure for the disease.
Who is at risk for COPD?
Smokers. The No. 1 contributing factor for developing COPD is smoking. At least 80% of all COPD cases are related to smoking.
What are some other risk factors?
Genetics may play a role in early symptoms of COPD development, even if a person never smokes, but it’s rare. Unfortunately, there are no genetic tests that can identify who is at risk for developing the disease.
Environmental factors, such as volatile chemicals, certain hardeners used in factories and diesel fuel fumes can injure lungs. Coal miners and those who work with asbestos or even cement increase their risk for developing symptoms of COPD.
Long-term exposure to high ozone, the main ingredient in urban smog, is thought to contribute to COPD because it deprives the lungs of fresh air.
Age is also a factor. Most people develop emphysema in their late 70s or 80s.
So, as we age, everyone is at risk for COPD?
Yes, eventually just about everyone will develop COPD simply through aging.
After age 35, you begin to lose about an ounce of lung tissue a year. It’s a slow process and isn’t noticeable in most healthy people. Smoking can quadruple the speed of the tissue loss, reducing lung capacity and increasing the likelihood of becoming oxygen dependent.
But after 40-50 years of this cumulative loss, you may get winded doing simple things, such as carrying groceries from the garage.
Patients generally don’t die of age-related COPD.
Does having asthma predispose you to COPD?
Yes and no. Untreated and uncontrolled asthma can stiffen airways and cause similar symptoms of COPD, such as difficulty in breathing.
Do men and women have similar symptoms of COPD?
Unlike heart disease, the symptoms are similar. However, the progression of the disease in women seems to be faster, especially if they continue smoking once diagnosed or are diagnosed in the later stages of the disease, or don’t take their prescribed medicines. Unfortunately, no one knows why.
What are the symptoms or warning signs of COPD?
Chronic bronchitis and coughing up clear mucous are certainly early warning signs of COPD. But its hallmark is shortness of breath. Regardless of frequency, it’s a sign of COPD you should address with your doctor.
Most patients in the early stages of COPD feel great sitting or resting. But they’re out of breath if they walk 10 feet.
If you suddenly feel winded or short of breath after normal activities, such as walking the dog, grocery shopping or riding a bike, see your physician.
Is early diagnosis important in treating or managing symptoms of COPD?
Early diagnosis may halt – or slow – its progression. Proper medication can open the airways and improve lung function, which makes it easier to breathe.
How is COPD diagnosed?
There are several non-invasive ways to test for lung disorders, such as emphysema, but only one will diagnose COPD: a lung function test.
What is that?
Called a spirometry, this two-step, non-invasive test measures the amount of air your lungs can hold and how fast you can blow the air out of your lungs.
The test can detect COPD before you have any symptoms, track the disease’s progression and monitor treatment. The optimum air-flow range depends on [several factors], such as age, weight, smoking history, etc.
If a person is diagnosed with COPD, is it too late to quit smoking?
It’s never too late to quit. Smoking destroys lung tissue continuously. Quitting now halts the accelerated destruction process, giving the lungs the opportunity to age normally.
Is COPD diagnosis an automatic death sentence?
No, COPD is an irreversible condition, but some patients have successfully managed the symptoms of this chronic lung disease for more than 20 years.
What medications are typically prescribed in the treatments of COPD?
Most COPD medications are inhaled, just like asthma drugs. They’re used to widen the airways and make it easier to breathe.
Two common drugs are Symbicort (budesonide/formoterol fumarate dihydrate) and Advair (fluticasone propionate and salmeterol). Both were initially designed for asthma treatment, but have been approved by the Food and Drug Administration (FDA) to treat COPD.
What are the side effects of those medications?
They have side effects that vary with every patient. The most common is dry mouth, which is temporary and may be managed with designated mouth rinses or by changing medicines.
Cost is a much bigger factor and deterrent for people. Many COPD medications are expensive and aren’t covered under prescription plans, insurance or Medicare.
Are there alternative remedies for COPD?
There’s insufficient scientific information to support any benefits of alternative remedies. Acupuncture may help symptoms a little, but not much.
Herbs and other treatments have not been effective in treating COPD.
Does exercise help manage symptoms of COPD?
Most definitely. Aerobic activity, such as walking or riding a stationary bike, improves lung power and capacity, and allows you to be active without getting winded.
Can surgerical treatments of COPD minimize symptoms?
The most common surgical procedure is lung volume reduction surgery, which removes about 30% of each lung to allow air to circulate more easily.
There are currently two surgical options used with this in-patient procedure. A sternotomy is a surgical incision made through the breastbone that allows the surgeon to remove the affected tissue through the chest.
The second, a thoracoscopy, is less invasive. It uses graspers and staplers inserted through small incisions on either side of the chest to remove damaged tissue and reseal the remaining lung. Both procedures require hospital stays between 5-10 days and multiple weeks of pulmonary rehabilitation.
Unfortunately, it’s a short-term solution. The disease typically recurs two to three years after surgery, which is one reason the procedure is rarely covered by insurance.
Gradually, the lung cells begin to die again, symptoms re-occur and patients again become easily winded and need oxygen.
What new treatments are on the horizon?
A new minimally-invasive procedure is being tested in the U.S. It uses umbrella-shaped valves inserted into the lungs through a bronchoscope (a flexible tube passed into the bronchial tubes through the mouth or nose) to redirect airflow from diseased portions to healthier areas.
For more information, visit our new COPD Health Center.
How Much Do You Know About COPD?
Chronic obstructive pulmonary disease (COPD) is on the rise, according to the National Institutes of Health. More than 12 million people in the U.S. are currently diagnosed with it, and another 12 million may have it but don’t know.
Your Fibromyalgia Gadget Guide
For women with fibromyalgia, even common tasks like cleaning the house or putting on socks can hurt. We’ve rounded up 14 tools to ease discomfort throughout your day...
Fibromyalgia can make the simplest activities painful and difficult.
A chronic condition that affects 2% of Americans, especially women, fibromyalgia is associated with muscle aches, fatigue and tender points throughout the body. At its worst, it can make chores you once took for granted suddenly seem daunting.
Fortunately, we found an array of tools to ease discomfort and lessen the burden on sore muscles. They range from pain-reducing massagers and electronic stimulators to movement-saving gadgets designed to make ordinary tasks more manageable.
We consulted physical therapist Cathy Guenthner, clinical educator at the University of Cincinnati, for the products listed below.
“They help conserve energy, so you can function without putting additional strain on your body,” she says.
We’ve suggested sources for each of the products mentioned below, but many can also be purchased from Amazon.com or local drugstores, home stores and medical-supply shops.
1. Thera Cane
What it is: This therapeutic self-massager helps you apply pressure to trigger points, knotted muscle fibers that can increase chronic pain.
Why it helps: The oddly shaped device, which resembles a wide cane with short, ball-capped branches, allows you to reach trigger points anywhere on your body.
“A trigger point is an area of hyperirritability in a muscle, common in people with fibromyalgia,” Guenthner says. “You can push the little balls on the trigger point and hold the pressure for 30-90 seconds until you feel the tension release.”
Try it: www.theracane.com
2. Handball
What it is: A regular handball, which you can buy in a sporting-goods store, provides another easy way to apply pressure to painful trigger points.
Why it helps: It’s portable and convenient. Guenthner suggests lying down, placing the ball under an irritable spot, and your body weight to apply pressure for 30-90 seconds, until you feel the trigger point release.
Try it: Official “ACE” USHA handballs, www.ushandball.org
3. Moist heating pad
What it is: A pad that relaxes your muscles with soothing heat.
Moist heating pads come in a variety of shapes and sizes, including rectangular ones for your back or oblong wraps for neck and shoulders. You can also get moist wraps for knees, ankles and elbows, and moist booties and mittens for aching feet and hands.
Electric versions heat automatically; non-electric pads have sponge liners that you wet and then heat in a microwave.
Why it helps: “Heat relaxes muscles, and moisture reduces the skin’s natural resistance to [absorbing] heat,” says Scott Glaser, M.D., an interventional pain physician in Chicago.
But be careful. “If you overuse heat, you can have permanent discoloration from increased blood flow to the skin,” Glaser says. Apply the pad to a painful spot on low heat for no more than 20 minutes at a time.
These pads can help before stretching painful muscles, observes Shannon Rock, an occupational therapist at Mercy Medical Center in Baltimore. “Moist heat increases blood flow to the area, which helps prepare the tissue for stretching,” she says.
Try it: Medibeads Neck Wrap, www.aidsforarthritis.com
4. Ice pad
What it is: Another form of temperature therapy. Like heating pads, ice pads come in many shapes, including rectangles, cervical collars and shoulder, leg and foot wraps.
Why it helps: “Ice is a great aid in controlling pain in a localized area,” Glaser says. “The signals of cold from your temperature receptors crowd out pain signals.”
Apply ice for no more than 20-30 minutes at a stretch, several times a day.
Try it: Elasto-Gel Cervical Collar Wrap, www.icewraps.net
5. TENS unit
What it is: Short for “transcutaneous electrical nerve stimulation,” it’s a device that sends harmless electrical current to sore spots.
Why it helps: “Sensations from the current crowd out input from the pain nerves,” Glaser says.
A physical therapist can recommend a home unit and teach you how to use it correctly.
Try it: LGMedSupply LG-3000 Basic TENS Unit with 3 Treatment Modes, www.lgmedsupply.com
6. Knee and head pillow
What it is: Specially curved neck-support pillows and leg wedge pillows.
Why it helps: If you’re lying on your side, placing a pillow between knees keeps legs separated, allowing the spine to stay in a more neutral, comfortable position, Guenthner says. The same is true if you’re lying on your back and place a pillow under the knees.
“It allows the joint to bend a little,” Guenthner says. “When the joint is fully extended, it puts more pressure on the joint and muscles, which increases pain.”
Try it: Knee Lift Pillow; Leg Separator Pillow; Better Neck Adjustable Memory Foam Cervical Pillow; all at makemeheal.com. While specialty pillows may be more comfortable, you can use any bed pillow, Guenthner says.
7. Lumbar support pillow
What it is: A pillow that supports your lower back when you sit.
Why it helps: “It keeps you in good spinal alignment [when you’re seated], so your back isn't too bent or arched, and your shoulders are directly over your hips,” Guenthner says. “If you slump, you put more strain on your muscles and body, which adds to muscle irritation.”
Try it: Biform Pad Lumbar Back Support Pillow, www.makemeheal.com
8. Wrist rest
What it is: A gel keyboard pad that supports the wrists.
Why it helps: If you’ve got fibromyalgia, even your wrist and arm muscles can hurt.
“Fibromyalgia patients have a higher rate of carpel tunnel syndrome,” a painful nerve condition involving tingling and numbness in the hands and wrist, usually the result of repetitive movements, says Glaser.
"A gel keyboard pad keeps wrists in a neutral position, which rests the muscles and tendons in the forearm [that extend] to the hand,” Rock says.
Try it: 3M Gel Wrist Rest for Keyboard, solutions.3m.com
9. Lumbar support belt
What it is: A wide belt that stabilizes the spine.
Why it helps: It improves posture, protects your back, and allows knees and hips to do most of the work when lifting something.
These belts can reduce back pain in people with fibromyalgia, Glaser says. But he advises wearing one no more than half the time you’re active to prevent spine muscles from weakening.
Try it: Jobri A0220X-Action Belt Lower Back Lumbar Support, www.jobri.com
10. Shower bench
What it is: A plastic bench with an arm handle and back that allows you to sit in the shower.
Why it helps: “People with fibromyalgia have fatigue and muscle aches,” Rock says. “A shower bench [conserves] energy. If you have back or leg pain, it helps to be sitting rather than standing.”
Try it: Medline Transfer Bench, www.amazon.com
11. Elevated toilet seat
What it is: This seat clamps onto your regular toilet seat, lifting you about 6 inches higher than normal. Some models also have arms you can hold on to.
Why it helps: The raised seat saves energy if you have pain in your legs.
“It definitely makes it easier to get up and down,” Guenthner says.
Try it: Medline Locking Elevated Toilet Seat With Arms, www.amazon.com
12. Sock puller
What it is: This strange-looking contraption makes it easy to put on socks without bending over. You slip a sock over it, put your foot inside and pull on the long straps.
Why it helps: “By using it, you prevent lumbar or hand strain,” Guenthner says.
Try it: Deluxe Sock Aid, Kat Health Products, www.homehealthitems.com
13. Automatic can opener
What it is: This egg-shaped beauty is fully automated – you don’t even have to hold the can. You place the gadget on a can, press a button, and the can opens. A magnet on the bottom lifts up the can’s lid.
Why it helps: “Any electric device – food choppers, jar openers, knives – helps protect the joints and conserve energy,” Rock says.
Try it: One Touch Can Opener, www.aidsforarthritis.com
14. Long-handled dustpan and broom
What it is: A lightweight dustpan and broom with oversize handles.
Why it helps: These long tools allow you to clean up a spill without squatting or bending over.
Try it: Long Handled Dust Pan and Broom, www.aidsforarthritis.com
How Much Do You Know About Fibromyalgia?
Described by Hippocrates in ancient Greece, fibromyalgia is one of the world’s oldest medical mysteries. The disease – a complex illness marked by chronic muscle, tendon and ligament pain, fatigue and multiple tender points on the body – affects about 2% percent of Americans, most of them women.
Fibromyalgia can make the simplest activities painful and difficult.
A chronic condition that affects 2% of Americans, especially women, fibromyalgia is associated with muscle aches, fatigue and tender points throughout the body. At its worst, it can make chores you once took for granted suddenly seem daunting.
Fortunately, we found an array of tools to ease discomfort and lessen the burden on sore muscles. They range from pain-reducing massagers and electronic stimulators to movement-saving gadgets designed to make ordinary tasks more manageable.
We consulted physical therapist Cathy Guenthner, clinical educator at the University of Cincinnati, for the products listed below.
“They help conserve energy, so you can function without putting additional strain on your body,” she says.
We’ve suggested sources for each of the products mentioned below, but many can also be purchased from Amazon.com or local drugstores, home stores and medical-supply shops.
1. Thera Cane
What it is: This therapeutic self-massager helps you apply pressure to trigger points, knotted muscle fibers that can increase chronic pain.
Why it helps: The oddly shaped device, which resembles a wide cane with short, ball-capped branches, allows you to reach trigger points anywhere on your body.
“A trigger point is an area of hyperirritability in a muscle, common in people with fibromyalgia,” Guenthner says. “You can push the little balls on the trigger point and hold the pressure for 30-90 seconds until you feel the tension release.”
Try it: www.theracane.com
2. Handball
What it is: A regular handball, which you can buy in a sporting-goods store, provides another easy way to apply pressure to painful trigger points.
Why it helps: It’s portable and convenient. Guenthner suggests lying down, placing the ball under an irritable spot, and your body weight to apply pressure for 30-90 seconds, until you feel the trigger point release.
Try it: Official “ACE” USHA handballs, www.ushandball.org
3. Moist heating pad
What it is: A pad that relaxes your muscles with soothing heat.
Moist heating pads come in a variety of shapes and sizes, including rectangular ones for your back or oblong wraps for neck and shoulders. You can also get moist wraps for knees, ankles and elbows, and moist booties and mittens for aching feet and hands.
Electric versions heat automatically; non-electric pads have sponge liners that you wet and then heat in a microwave.
Why it helps: “Heat relaxes muscles, and moisture reduces the skin’s natural resistance to [absorbing] heat,” says Scott Glaser, M.D., an interventional pain physician in Chicago.
But be careful. “If you overuse heat, you can have permanent discoloration from increased blood flow to the skin,” Glaser says. Apply the pad to a painful spot on low heat for no more than 20 minutes at a time.
These pads can help before stretching painful muscles, observes Shannon Rock, an occupational therapist at Mercy Medical Center in Baltimore. “Moist heat increases blood flow to the area, which helps prepare the tissue for stretching,” she says.
Try it: Medibeads Neck Wrap, www.aidsforarthritis.com
4. Ice pad
What it is: Another form of temperature therapy. Like heating pads, ice pads come in many shapes, including rectangles, cervical collars and shoulder, leg and foot wraps.
Why it helps: “Ice is a great aid in controlling pain in a localized area,” Glaser says. “The signals of cold from your temperature receptors crowd out pain signals.”
Apply ice for no more than 20-30 minutes at a stretch, several times a day.
Try it: Elasto-Gel Cervical Collar Wrap, www.icewraps.net
5. TENS unit
What it is: Short for “transcutaneous electrical nerve stimulation,” it’s a device that sends harmless electrical current to sore spots.
Why it helps: “Sensations from the current crowd out input from the pain nerves,” Glaser says.
A physical therapist can recommend a home unit and teach you how to use it correctly.
Try it: LGMedSupply LG-3000 Basic TENS Unit with 3 Treatment Modes, www.lgmedsupply.com
6. Knee and head pillow
What it is: Specially curved neck-support pillows and leg wedge pillows.
Why it helps: If you’re lying on your side, placing a pillow between knees keeps legs separated, allowing the spine to stay in a more neutral, comfortable position, Guenthner says. The same is true if you’re lying on your back and place a pillow under the knees.
“It allows the joint to bend a little,” Guenthner says. “When the joint is fully extended, it puts more pressure on the joint and muscles, which increases pain.”
Try it: Knee Lift Pillow; Leg Separator Pillow; Better Neck Adjustable Memory Foam Cervical Pillow; all at makemeheal.com. While specialty pillows may be more comfortable, you can use any bed pillow, Guenthner says.
7. Lumbar support pillow
What it is: A pillow that supports your lower back when you sit.
Why it helps: “It keeps you in good spinal alignment [when you’re seated], so your back isn't too bent or arched, and your shoulders are directly over your hips,” Guenthner says. “If you slump, you put more strain on your muscles and body, which adds to muscle irritation.”
Try it: Biform Pad Lumbar Back Support Pillow, www.makemeheal.com
8. Wrist rest
What it is: A gel keyboard pad that supports the wrists.
Why it helps: If you’ve got fibromyalgia, even your wrist and arm muscles can hurt.
“Fibromyalgia patients have a higher rate of carpel tunnel syndrome,” a painful nerve condition involving tingling and numbness in the hands and wrist, usually the result of repetitive movements, says Glaser.
"A gel keyboard pad keeps wrists in a neutral position, which rests the muscles and tendons in the forearm [that extend] to the hand,” Rock says.
Try it: 3M Gel Wrist Rest for Keyboard, solutions.3m.com
9. Lumbar support belt
What it is: A wide belt that stabilizes the spine.
Why it helps: It improves posture, protects your back, and allows knees and hips to do most of the work when lifting something.
These belts can reduce back pain in people with fibromyalgia, Glaser says. But he advises wearing one no more than half the time you’re active to prevent spine muscles from weakening.
Try it: Jobri A0220X-Action Belt Lower Back Lumbar Support, www.jobri.com
10. Shower bench
What it is: A plastic bench with an arm handle and back that allows you to sit in the shower.
Why it helps: “People with fibromyalgia have fatigue and muscle aches,” Rock says. “A shower bench [conserves] energy. If you have back or leg pain, it helps to be sitting rather than standing.”
Try it: Medline Transfer Bench, www.amazon.com
11. Elevated toilet seat
What it is: This seat clamps onto your regular toilet seat, lifting you about 6 inches higher than normal. Some models also have arms you can hold on to.
Why it helps: The raised seat saves energy if you have pain in your legs.
“It definitely makes it easier to get up and down,” Guenthner says.
Try it: Medline Locking Elevated Toilet Seat With Arms, www.amazon.com
12. Sock puller
What it is: This strange-looking contraption makes it easy to put on socks without bending over. You slip a sock over it, put your foot inside and pull on the long straps.
Why it helps: “By using it, you prevent lumbar or hand strain,” Guenthner says.
Try it: Deluxe Sock Aid, Kat Health Products, www.homehealthitems.com
13. Automatic can opener
What it is: This egg-shaped beauty is fully automated – you don’t even have to hold the can. You place the gadget on a can, press a button, and the can opens. A magnet on the bottom lifts up the can’s lid.
Why it helps: “Any electric device – food choppers, jar openers, knives – helps protect the joints and conserve energy,” Rock says.
Try it: One Touch Can Opener, www.aidsforarthritis.com
14. Long-handled dustpan and broom
What it is: A lightweight dustpan and broom with oversize handles.
Why it helps: These long tools allow you to clean up a spill without squatting or bending over.
Try it: Long Handled Dust Pan and Broom, www.aidsforarthritis.com
How Much Do You Know About Fibromyalgia?
Described by Hippocrates in ancient Greece, fibromyalgia is one of the world’s oldest medical mysteries. The disease – a complex illness marked by chronic muscle, tendon and ligament pain, fatigue and multiple tender points on the body – affects about 2% percent of Americans, most of them women.
How Can I Cure a Chronic Staph Infection?
Question: My husband has had a staph infection for six years now. He gets boils on the back of his neck and there is at least one there all of the time. He has been to doctors and they tell him the treatment would be worse than just living with it. Do you have any suggestions on how to get rid of this?
Dr. Hibberd's Answer:
Staphylococcus aureus (staph) is a skin surface dwelling bacteria that lives on the skin surface of most all of us and usually does not invade the skin surface absent some underlying condition or break in the integrity of or skin surface.
Culture swabs done on our skin whether ill or not will invariably grow out staph.
Some strains, however, are particularly hardy and do manage to invade the skin surface usually via minor sites of irritation, cuts or via infection of the sebaceous gland associated with the hair follicle.
The past 10 years have seen an increasingly resistant strain of this bacterium emerge called MRSA (which stands for methicillin resistant sphylococcus areus). MRSA is resistant to the conventional antibiotics used to treat usual staph infections, is notoriously infectious, has a tendancy to cause deep abscesses, and is very difficult to eradicate once contacted.
Risk factors for MRSA are as follows:
•Antibiotic use in the past year
•Long-term care, nursing home, or hospital residency
•Presence of permanent indwelling catheter or percutaneous medical device
•Recent hospitalization
•Exposure to athletic facilities or correctional facilities
•Patients who are immunocompromised
•Military training and/or deployment
•Poor hand hygiene in both health care and community environments
•Crowded living conditions
A carrier state for MRSA exists in the nose for most of its victims, requiring extended treatment with topical bactroban in addition to oral antibiotics to clear up infections.
Usually oral Bactrim is used, often in association with topical and intranasal bactroban and rifampin for resistant or recurrent cases.
Intravenous preparations such as Vancomycin (a toxic antibiotic) are available but have significant adverse effects limiting their use to severe life-threatening infections. Oral vancomycin is not useful here due to lack of absorption.
A new class of antibiotic has recently become available for intravenous use in severe complicated and intra-abdominal infections. Called glycylcyclines, they are related to tetracylcines and the first one available is tigecycline (marketed as Tygacil). This new antibiotic has good MRSA coverage, at least for now until resistance develops, and is for severe infections only.
I recommend you have these abscesses properly treated first and be sure to obtain a stain culture and sensitivity of the contents of one of these boils, so you understand which anti-microbial agents are going to be the most useful.
You need to differentiate whether MRSA or some other organism (such as pseudomonas or other pathogens) are responsible. Proper treatment may involve oral and/or topical antibiotic use, selective drainage of abscesses, and meticulous hand hygiene.
Be sure to treat any underlying conditions (such as diabetes mellitus, immune deficiency, chronic dermatitis, nutritional and hygiene issues) that may predispose you to infection.
Avoid tight fitting collars until well healed.
Staph is usually the culprit and is spread by direct contact, so frequent hand washing with anti-bacterial soap will be essential. Minimize recurrences with measures described above and your doctor may consider periodic use of an antiseptic solution or rinse such as hibiclens to intact skin surfaces to reduce your staph load. I agree this skin condition can and should be controlled. Request a referral to a dermatologist if you wish an alternate professional opinion.
Dr. Hibberd's Answer:
Staphylococcus aureus (staph) is a skin surface dwelling bacteria that lives on the skin surface of most all of us and usually does not invade the skin surface absent some underlying condition or break in the integrity of or skin surface.
Culture swabs done on our skin whether ill or not will invariably grow out staph.
Some strains, however, are particularly hardy and do manage to invade the skin surface usually via minor sites of irritation, cuts or via infection of the sebaceous gland associated with the hair follicle.
The past 10 years have seen an increasingly resistant strain of this bacterium emerge called MRSA (which stands for methicillin resistant sphylococcus areus). MRSA is resistant to the conventional antibiotics used to treat usual staph infections, is notoriously infectious, has a tendancy to cause deep abscesses, and is very difficult to eradicate once contacted.
Risk factors for MRSA are as follows:
•Antibiotic use in the past year
•Long-term care, nursing home, or hospital residency
•Presence of permanent indwelling catheter or percutaneous medical device
•Recent hospitalization
•Exposure to athletic facilities or correctional facilities
•Patients who are immunocompromised
•Military training and/or deployment
•Poor hand hygiene in both health care and community environments
•Crowded living conditions
A carrier state for MRSA exists in the nose for most of its victims, requiring extended treatment with topical bactroban in addition to oral antibiotics to clear up infections.
Usually oral Bactrim is used, often in association with topical and intranasal bactroban and rifampin for resistant or recurrent cases.
Intravenous preparations such as Vancomycin (a toxic antibiotic) are available but have significant adverse effects limiting their use to severe life-threatening infections. Oral vancomycin is not useful here due to lack of absorption.
A new class of antibiotic has recently become available for intravenous use in severe complicated and intra-abdominal infections. Called glycylcyclines, they are related to tetracylcines and the first one available is tigecycline (marketed as Tygacil). This new antibiotic has good MRSA coverage, at least for now until resistance develops, and is for severe infections only.
I recommend you have these abscesses properly treated first and be sure to obtain a stain culture and sensitivity of the contents of one of these boils, so you understand which anti-microbial agents are going to be the most useful.
You need to differentiate whether MRSA or some other organism (such as pseudomonas or other pathogens) are responsible. Proper treatment may involve oral and/or topical antibiotic use, selective drainage of abscesses, and meticulous hand hygiene.
Be sure to treat any underlying conditions (such as diabetes mellitus, immune deficiency, chronic dermatitis, nutritional and hygiene issues) that may predispose you to infection.
Avoid tight fitting collars until well healed.
Staph is usually the culprit and is spread by direct contact, so frequent hand washing with anti-bacterial soap will be essential. Minimize recurrences with measures described above and your doctor may consider periodic use of an antiseptic solution or rinse such as hibiclens to intact skin surfaces to reduce your staph load. I agree this skin condition can and should be controlled. Request a referral to a dermatologist if you wish an alternate professional opinion.
Friday, May 27, 2011
THOUGHT FOR THE DAY ....
A great attitude does much more than turn on the lights in our worlds;
it seems to magically connect us to all sorts of serendipitous opportunities
that were somehow absent before the change.
it seems to magically connect us to all sorts of serendipitous opportunities
that were somehow absent before the change.
Drug Combination Raises Blood Sugar
An anti-depressant and a cholesterol-lowering drug, taken together by as many as 1 million people in the United States, may cause a spike in blood sugar levels, researchers said Wednesday.
Paxil and the anti-cholesterol drug Pravachol do not have this effect when taken independently, said researchers at the Stanford University School of Medicine, Vanderbilt University, and Harvard Medical School.
The interaction was uncovered by analyzing voluntary reports of adverse events in a database maintained by the Food and Drug Administration, and comparing that to electronic medical records held by the three medical institutions.
The study used "data-mining techniques to identify patterns of associations in large populations that would not be readily apparent to physicians treating individual patients," researchers said.
While none of the patients taking the combination reported having hyperglycemia as a result, researchers found 135 patients who did not have diabetes showed an average increase of 19 milligrams per deciliter in blood glucose after starting treatment.
Among 14 people with diabetes, the effect was greater — 48 mg/dl after the drug combination was begun.
The blood sugar spikes were significant enough to possibly push a person who is pre-diabetic into full-blown diabetes, and to put diabetic patients' health in danger, according to the study published in Clinical Pharmacology and Therapeutics.
Then researchers tested the drug combination in laboratory mice who were first fed a high-fat, high-calorie diet which would put them in a state considered pre-diabetic and insulin resistant.
When these pre-diabetic mice were treated with the two drugs for three weeks, their blood glucose soared from about 128 mg/dl to 193 mg/dl. Neither drug alone has such an effect.
"These kinds of drug interactions are almost certainly occurring all of the time, but, because they are not part of the approval process by the Food and Drug Administration, we can only learn about them after the drugs are on the market," said Russ Altman, professor of medicine at Stanford.
"Understanding and mitigating the effect this pair of medications has on blood sugar could allow a person with diabetes to better control his or her glucose levels, or even prevent someone who is pre-diabetic from crossing that threshold into full-blown diabetes," said Altman.
Up to 15 million people in the United States have prescriptions for the two drugs, said the study. Paxil is also known by its generic name, paroxetine, and Pravachol is pravastatin.
The drugs do not currently carry warning against combinations that may increase blood sugar.
"By extrapolating from the electronic medical records at Stanford and elsewhere, we can predict that between 500,000 and 1 million people are taking them simultaneously," Altman said.
Paxil and the anti-cholesterol drug Pravachol do not have this effect when taken independently, said researchers at the Stanford University School of Medicine, Vanderbilt University, and Harvard Medical School.
The interaction was uncovered by analyzing voluntary reports of adverse events in a database maintained by the Food and Drug Administration, and comparing that to electronic medical records held by the three medical institutions.
The study used "data-mining techniques to identify patterns of associations in large populations that would not be readily apparent to physicians treating individual patients," researchers said.
While none of the patients taking the combination reported having hyperglycemia as a result, researchers found 135 patients who did not have diabetes showed an average increase of 19 milligrams per deciliter in blood glucose after starting treatment.
Among 14 people with diabetes, the effect was greater — 48 mg/dl after the drug combination was begun.
The blood sugar spikes were significant enough to possibly push a person who is pre-diabetic into full-blown diabetes, and to put diabetic patients' health in danger, according to the study published in Clinical Pharmacology and Therapeutics.
Then researchers tested the drug combination in laboratory mice who were first fed a high-fat, high-calorie diet which would put them in a state considered pre-diabetic and insulin resistant.
When these pre-diabetic mice were treated with the two drugs for three weeks, their blood glucose soared from about 128 mg/dl to 193 mg/dl. Neither drug alone has such an effect.
"These kinds of drug interactions are almost certainly occurring all of the time, but, because they are not part of the approval process by the Food and Drug Administration, we can only learn about them after the drugs are on the market," said Russ Altman, professor of medicine at Stanford.
"Understanding and mitigating the effect this pair of medications has on blood sugar could allow a person with diabetes to better control his or her glucose levels, or even prevent someone who is pre-diabetic from crossing that threshold into full-blown diabetes," said Altman.
Up to 15 million people in the United States have prescriptions for the two drugs, said the study. Paxil is also known by its generic name, paroxetine, and Pravachol is pravastatin.
The drugs do not currently carry warning against combinations that may increase blood sugar.
"By extrapolating from the electronic medical records at Stanford and elsewhere, we can predict that between 500,000 and 1 million people are taking them simultaneously," Altman said.
Study: Prostate Cancer Drug Extends Life
May 25, 2011 -- The newly approved prostate cancer pill Zytiga (abiraterone acetate) may extend life by up to four months in men with spreading cancer who have already been treated with chemotherapy, a study shows.
This survival gain "means quite a bit," says study researcher Howard I. Scher, MD, chief of the genitourinary oncology service at Memorial Sloan-Kettering Cancer Center in New York City. "These are a group of patients for whom there is no standard of care and it is particularly gratifying to see these results, to say the least."
The new study is published in the New England Journal of Medicine.
Prostate cancer is the most common cancer diagnosed in men besides skin cancer, according to the American Cancer Society. One out of every six men will be diagnosed with prostate cancer during his lifetime.
The new drug, which was approved by the FDA in April, inhibits a protein that helps form male hormones. The findings may help reshape the way doctors view and treat advanced prostate cancer.
The new study included 1,195 men with metastatic prostate cancer whose disease had progressed after chemotherapy. Those men who received steroid therapy along with the new pill survived for 14.8 months, on average, compared with 10.9 months seen among those who received a placebo along with steroids. This translated into a 34% reduction in risk of dying, the study shows.
This survival edge was considered so significant that men who received the placebo were permitted to switch to the new drug before the study was completed.
Men who took the new pill also saw greater responses in levels of prostate-specific antigen (PSA) than men who received placebo. Elevated levels of PSA may be a marker for prostate cancer.
The men who took Zytiga also showed improvements in disease-related symptoms and prostate cancer progression on imaging tests compared with men who received the placebo.
Zytiga side effects included fluid retention, high blood pressure, and a drop in blood potassium levels.
Drug May Have Wider Role in Treatment
This group of patients is likely the tip of the iceberg as far as the role that the new drug can play in prostate cancer treatment, Scher says.
"It absolutely will work in untreated patients as well and clearly there are studies ongoing now that are looking at this drug in combination with standard hormone therapies prior to [prostate-removal] surgery," he says.
One mainstay treatment for spreading prostate cancer is to deplete or block the action of male hormones known as androgens. This typically works initially, but the cancer eventually progresses even though levels of male hormones are low. Until recently, researchers assumed that tumors became resistant to hormonal therapies.
The opposite may be true. "These tumors may actually be hyper-sensitive to hormone therapies," Scher says. "Androgen levels are higher in the tumors than in the normal prostate."
American Cancer Society Chief Medical Officer Otis Brawley, MD, explains it this way: "Hormonally unresponsive prostate cancer is really just incredibly sensitive to hormones. We have even taken away hormones from these guys through medical or surgical castration or androgen blockers and the tumor responds, but then starts growing again."
"It may be the tumor changes, so it is very sensitive to the small amount of androgen in the man's body," Brawley says. The drug interferes with the tumor's handling of that small level of androgen that was left behind.
New Treatment Option
"There has been a lot of buzz and excitement about this drug for a while," Brawley says.
Having another option to treat these men is "incredibly important," he says. "There are clear, definite gains in survival. Yes they are small, but they are clear, definite gains. And because of the rigorous design of this trial, there is no doubt that this drug works."
Study researcher Christopher J. Logothetis, MD, chair of the department of genitourinary medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, says this study is important on several levels.
"There is a new effective drug for patients with [spreading] prostate cancer, and it's nontoxic, relieves symptoms, and prolongs survival. That is exciting," he says.
"This indicates that even among patients who have run out of all alternatives, abiraterone prolongs survival by a third," he says.
Going forward, researchers may be able to identify a subset of men who will derive an even greater survival edge with the new pill, he says.
It may also become the "foundational drug" that is added to other medications to prolong survival even further, he says, adding that such combinations are already being developed and studied.
The drug is manufactured by Centocor Ortho Biotech Inc. The company provided support for the new study, and some of the study researchers have received consulting fees from them.
This survival gain "means quite a bit," says study researcher Howard I. Scher, MD, chief of the genitourinary oncology service at Memorial Sloan-Kettering Cancer Center in New York City. "These are a group of patients for whom there is no standard of care and it is particularly gratifying to see these results, to say the least."
The new study is published in the New England Journal of Medicine.
Prostate cancer is the most common cancer diagnosed in men besides skin cancer, according to the American Cancer Society. One out of every six men will be diagnosed with prostate cancer during his lifetime.
The new drug, which was approved by the FDA in April, inhibits a protein that helps form male hormones. The findings may help reshape the way doctors view and treat advanced prostate cancer.
The new study included 1,195 men with metastatic prostate cancer whose disease had progressed after chemotherapy. Those men who received steroid therapy along with the new pill survived for 14.8 months, on average, compared with 10.9 months seen among those who received a placebo along with steroids. This translated into a 34% reduction in risk of dying, the study shows.
This survival edge was considered so significant that men who received the placebo were permitted to switch to the new drug before the study was completed.
Men who took the new pill also saw greater responses in levels of prostate-specific antigen (PSA) than men who received placebo. Elevated levels of PSA may be a marker for prostate cancer.
The men who took Zytiga also showed improvements in disease-related symptoms and prostate cancer progression on imaging tests compared with men who received the placebo.
Zytiga side effects included fluid retention, high blood pressure, and a drop in blood potassium levels.
Drug May Have Wider Role in Treatment
This group of patients is likely the tip of the iceberg as far as the role that the new drug can play in prostate cancer treatment, Scher says.
"It absolutely will work in untreated patients as well and clearly there are studies ongoing now that are looking at this drug in combination with standard hormone therapies prior to [prostate-removal] surgery," he says.
One mainstay treatment for spreading prostate cancer is to deplete or block the action of male hormones known as androgens. This typically works initially, but the cancer eventually progresses even though levels of male hormones are low. Until recently, researchers assumed that tumors became resistant to hormonal therapies.
The opposite may be true. "These tumors may actually be hyper-sensitive to hormone therapies," Scher says. "Androgen levels are higher in the tumors than in the normal prostate."
American Cancer Society Chief Medical Officer Otis Brawley, MD, explains it this way: "Hormonally unresponsive prostate cancer is really just incredibly sensitive to hormones. We have even taken away hormones from these guys through medical or surgical castration or androgen blockers and the tumor responds, but then starts growing again."
"It may be the tumor changes, so it is very sensitive to the small amount of androgen in the man's body," Brawley says. The drug interferes with the tumor's handling of that small level of androgen that was left behind.
New Treatment Option
"There has been a lot of buzz and excitement about this drug for a while," Brawley says.
Having another option to treat these men is "incredibly important," he says. "There are clear, definite gains in survival. Yes they are small, but they are clear, definite gains. And because of the rigorous design of this trial, there is no doubt that this drug works."
Study researcher Christopher J. Logothetis, MD, chair of the department of genitourinary medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, says this study is important on several levels.
"There is a new effective drug for patients with [spreading] prostate cancer, and it's nontoxic, relieves symptoms, and prolongs survival. That is exciting," he says.
"This indicates that even among patients who have run out of all alternatives, abiraterone prolongs survival by a third," he says.
Going forward, researchers may be able to identify a subset of men who will derive an even greater survival edge with the new pill, he says.
It may also become the "foundational drug" that is added to other medications to prolong survival even further, he says, adding that such combinations are already being developed and studied.
The drug is manufactured by Centocor Ortho Biotech Inc. The company provided support for the new study, and some of the study researchers have received consulting fees from them.
Health & Fitness Tip - Give Yourself A Star
Every time you exercise, whether you go for a run, a hike with a friend, or hit the gym, mark that day with a little star in your calendar. It'll give you a quick overview of how often you've been working out that month so far. It'll also serve as a visual reminder of how long it's been since you last worked out. If stars don't do it for you, then draw a big X, smiley face, heart, or a little flower. You can even use different shapes or colors to show what kind of activity you did each day. It's definitely a great feeling when you can look back in your calendar and see all those days marked off. For even more motivation, reward yourself every time you get 20 stars.
Experiment With Equipment
The gym can get painfully boring when you constantly follow the same routine each day. Mix it up by trying one new piece of equipment each week. There's a huge variety of cardio machines and weight-lifting equipment, so choose a day each week to do something new. Once you've tried everything out at least once, you'll feel more comfortable alternating them into your routines. Not only is variety the spice of life, but doing the same thing over again can cause repetitive stress injuries. You'll also only work certain muscle groups doing the same workout, so by using different equipment, you'll end up targeting more parts of your body, becoming stronger and burning more calories.
Experiment With Equipment
The gym can get painfully boring when you constantly follow the same routine each day. Mix it up by trying one new piece of equipment each week. There's a huge variety of cardio machines and weight-lifting equipment, so choose a day each week to do something new. Once you've tried everything out at least once, you'll feel more comfortable alternating them into your routines. Not only is variety the spice of life, but doing the same thing over again can cause repetitive stress injuries. You'll also only work certain muscle groups doing the same workout, so by using different equipment, you'll end up targeting more parts of your body, becoming stronger and burning more calories.
FUN FACTS
* There are over 10 trillion living cells in the human body. *
* It takes a plastic container over 50,000 years to start decomposing. *
* A group of foxes is called a skulk. *
* The Great Pyramid at Giza in Egypt holds a constant temperature of 68 degrees Fahrenheit. *
* Cabbage is 91% water. *
* It takes a plastic container over 50,000 years to start decomposing. *
* A group of foxes is called a skulk. *
* The Great Pyramid at Giza in Egypt holds a constant temperature of 68 degrees Fahrenheit. *
* Cabbage is 91% water. *
Probiotic yogurt no help for kids' constipation
NEW YORK (Reuters Health) - A yogurt aimed at easing digestion with the help of "good" bacteria may not be much help for children's chronic constipation, a new study suggests.
The study, of 159 children with persistent constipation, looked at whether an Activia-brand yogurt could help make the kids more "regular."
Activia yogurts and other cultured dairy products contain a strain of friendly bacteria, or probiotic, called Bifidobacterium lactis, which is thought to help regulate the digestive system. Some studies of adults have found the products to help ease chronic constipation.
But in the new study, researchers found that the probiotic yogurt was no better than a non-cultured dairy product without probiotics in easing kids' constipation.
Over three weeks, children who were randomly assigned to eat the probiotic yogurt each day did start to have more bowel movements, on average. But so did children in the comparison group.
In both groups, children went from having fewer than two bowel movements per week, on average, to about four per week.
It's not clear why both groups improved to a similar degree, according to the researchers.
But based on the findings, the probiotic cannot be recommended for children's constipation, lead researcher Dr. Merit M. Tabbers told Reuters Health in an email.
Some parents may still want to try it or other probiotic products, noted Tabbers, a pediatric gastroenterologist at Emma Children's Hospital in Amsterdam. And it's possible, the researcher said, that for certain kids, probiotics will help.
But for now, Tabbers said, "there is not sufficient evidence to support a general recommendation about the use of probiotics in the treatment of childhood constipation."
The study, which appears in the journal Pediatrics, was funded by Paris-based Danone (Dannon in the U.S.), which makes Activia. Two co-researchers on the study work for the company.
The findings are based on 159 children who were 7 years old, on average, and had been suffering from constipation for at least two months.
They were randomly assigned to have two servings of either the probiotic yogurt or the non-probiotic every day for three weeks. In the end, both groups showed similar improvements.
Tabbers said that children in the comparison group did better than expected. One reason might be the general attention that kids in both study groups received, the researcher explained.
All of the children were told, for example, they should try to go to the bathroom after each meal.
In general, less-than-ideal bathroom habits -- like trying to "hold" it in -- are thought to underlie many cases of constipation in children.
That and other differences between children's constipation and adults' might help explain why the probiotic appears to have different effects in kids and adults, according to Tabbers.
Typically, Tabbers said, the first step in easing children's constipation includes teaching them better bathroom habits and making diet changes, like adding more fiber-rich foods such as fruits and vegetables.
If that fails, a doctor might prescribe laxatives.
If parents want to try a probiotic, Tabbers said, they still can. But if there's no improvement within a few weeks, they should move on, according to the researcher.
One theory on why probiotics might help with constipation is that the products help restore any imbalances in the natural, friendly bacteria dwelling in the gut. However, Tabbers said, researchers don't know whether the gut bacteria in healthy children differ from those of children with constipation.
"Further research should therefore also focus on the composition of the microbiota in healthy and constipated children," Tabbers said.
SOURCE: http://bit.ly/jL7FF8 Pediatrics, online May 23, 2011.
The study, of 159 children with persistent constipation, looked at whether an Activia-brand yogurt could help make the kids more "regular."
Activia yogurts and other cultured dairy products contain a strain of friendly bacteria, or probiotic, called Bifidobacterium lactis, which is thought to help regulate the digestive system. Some studies of adults have found the products to help ease chronic constipation.
But in the new study, researchers found that the probiotic yogurt was no better than a non-cultured dairy product without probiotics in easing kids' constipation.
Over three weeks, children who were randomly assigned to eat the probiotic yogurt each day did start to have more bowel movements, on average. But so did children in the comparison group.
In both groups, children went from having fewer than two bowel movements per week, on average, to about four per week.
It's not clear why both groups improved to a similar degree, according to the researchers.
But based on the findings, the probiotic cannot be recommended for children's constipation, lead researcher Dr. Merit M. Tabbers told Reuters Health in an email.
Some parents may still want to try it or other probiotic products, noted Tabbers, a pediatric gastroenterologist at Emma Children's Hospital in Amsterdam. And it's possible, the researcher said, that for certain kids, probiotics will help.
But for now, Tabbers said, "there is not sufficient evidence to support a general recommendation about the use of probiotics in the treatment of childhood constipation."
The study, which appears in the journal Pediatrics, was funded by Paris-based Danone (Dannon in the U.S.), which makes Activia. Two co-researchers on the study work for the company.
The findings are based on 159 children who were 7 years old, on average, and had been suffering from constipation for at least two months.
They were randomly assigned to have two servings of either the probiotic yogurt or the non-probiotic every day for three weeks. In the end, both groups showed similar improvements.
Tabbers said that children in the comparison group did better than expected. One reason might be the general attention that kids in both study groups received, the researcher explained.
All of the children were told, for example, they should try to go to the bathroom after each meal.
In general, less-than-ideal bathroom habits -- like trying to "hold" it in -- are thought to underlie many cases of constipation in children.
That and other differences between children's constipation and adults' might help explain why the probiotic appears to have different effects in kids and adults, according to Tabbers.
Typically, Tabbers said, the first step in easing children's constipation includes teaching them better bathroom habits and making diet changes, like adding more fiber-rich foods such as fruits and vegetables.
If that fails, a doctor might prescribe laxatives.
If parents want to try a probiotic, Tabbers said, they still can. But if there's no improvement within a few weeks, they should move on, according to the researcher.
One theory on why probiotics might help with constipation is that the products help restore any imbalances in the natural, friendly bacteria dwelling in the gut. However, Tabbers said, researchers don't know whether the gut bacteria in healthy children differ from those of children with constipation.
"Further research should therefore also focus on the composition of the microbiota in healthy and constipated children," Tabbers said.
SOURCE: http://bit.ly/jL7FF8 Pediatrics, online May 23, 2011.
How to Attract Whatever You Want
Learn how to attract anything you want in your life. It is simple to understand but somewhat challenging to put into practice.
Instructions:
1
The first step in attracting whatever you want is to change your old ways of thinking. Remember, if you want to experience something different--you must do something different! Change your mind and change your world. Let's face it, thus far, has your way of thinking gotten you everything you want from life? Probably not.
2
How many times have you continuously worried yourself sick over an upcoming event, for example, and that event turned out to be a complete nightmare. Guess what? You get what you ask for. I know, it sounds silly; however, your thoughts are power and those thoughts were focused on the event going wrong! If you could only harness the energy that went into negative thoughts and placed it into positive thoughts, you could have anything you desire. Go ahead, try it. Imagine something you want and focus on it.
3
Now, imagine yourself already having that wish you want. Concentrate fully upon your wishes. If negative thoughts try to creap in, simply block them out--change your thoughts. You are creating what you will have right now and don't even realize it. If you are constantly thinking negatively, that is what you will attract into your world. If you want to attract positive things--think positively.
Instructions:
1
The first step in attracting whatever you want is to change your old ways of thinking. Remember, if you want to experience something different--you must do something different! Change your mind and change your world. Let's face it, thus far, has your way of thinking gotten you everything you want from life? Probably not.
2
How many times have you continuously worried yourself sick over an upcoming event, for example, and that event turned out to be a complete nightmare. Guess what? You get what you ask for. I know, it sounds silly; however, your thoughts are power and those thoughts were focused on the event going wrong! If you could only harness the energy that went into negative thoughts and placed it into positive thoughts, you could have anything you desire. Go ahead, try it. Imagine something you want and focus on it.
3
Now, imagine yourself already having that wish you want. Concentrate fully upon your wishes. If negative thoughts try to creap in, simply block them out--change your thoughts. You are creating what you will have right now and don't even realize it. If you are constantly thinking negatively, that is what you will attract into your world. If you want to attract positive things--think positively.
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