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New Test Predicts Heart Attacks

A new test can detect a person’s likelihood of having a heart attack, researchers report in the Journal of the American Medical Association.

Levels of the chemical troponin are detected in the muscle tissue via a highly sensitive procedure, leaving doctors with the information they need to determine whether someone’s going to have a heart attack, according to the article. High troponin levels equate to a higher risk.

“Early identification of individuals at high and intermediate risk for myocardial ischemia [insufficient blood flow to the heart muscle] is crucial because they benefit the most from early and aggressive treatment,” according to the article. “Highly sensitive troponin assays [tests] have been developed recently that reliably assess troponin levels in more than 50 percent of the general population.”

The research was conducted at the University Heart Center Hamburg, Germany, where the new test was compared with a less-sensitive troponin test.

More than 1,800 cardiac patients participated — 413 of whom had acute myocardial ischemia. Researchers found the new test to be superior in detecting coronary disease in the higher-risk population, while the less-sensitive test was more effective in patients with signs of a heart attack.

“The shortcoming of conventional troponin assays with low sensitivity within the first hours after chest-pain onset led to the evaluation of various so-called early biomarkers in the diagnosis of MI,” the article said. “In our study, the diagnostic information (of the new test) was superior to all other evaluated biomarkers alone.”

Avastin Offers Little Help Against Ovarian Cancer

Avastin, the blockbuster drug that just lost approval for treating breast cancer, now looks disappointing against ovarian cancer, too. Two studies found it did not improve survival for most of these patients and kept their disease from worsening for only a few months, with more side effects.

The Genentech drug won approval in Europe last week for advanced ovarian cancer. But its maker has no immediate plans to seek the same approval in the United States. After talking with the Food and Drug Administration, "we do not believe the data will support approval" although no final decision has been made, said Charlotte Arnold, a spokeswoman for Genentech, part of the Swiss company Roche.

Results of the studies are in Thursday's New England Journal of Medicine.

In November, the FDA revoked Avastin's approval for breast cancer because it did not meaningfully extend life and can have serious side effects. Without approval, doctors can prescribe the drug but insurers may not pay. Treatment with it can cost $100,000 a year.

Avastin can still be sold for some colon, lung, kidney, and brain cancers. The new research was aimed at adding ovarian cancer to the list.

One study, led by Dr. Robert Burger of Fox Chase Cancer Center in Philadelphia, involved nearly 1,900 women with advanced ovarian cancer given one of three treatment combinations. The time until the disease got worse was a median of 10 months in those given just chemotherapy; adding Avastin improved that by just one to four months for the other two groups.

Survival was similar among the groups, and side effects were higher among those on Avastin — mostly high blood pressure but also some stomach and gut problems that needed treatment.

In the other study, led by researchers from England, more than 1,500 ovarian cancer patients were given chemo with or without Avastin. The drug kept cancer at bay just one to two months longer than chemo alone did, with more cases of high blood pressure. There was a trend toward improved survival for those on Avastin, but the difference was too small to say the drug was responsible.

Genentech helped pay for the studies and some of the researchers consult for the company.

Dr. Gary Lyman, a Duke University researcher who was on the FDA advisory panel that recommended revoking Avastin's approval for breast cancer, wrote in an email that he agreed with the company's decision not to seek approval for ovarian cancer.

"The situation is very similar" to the results in breast cancer, and approval is unlikely unless a biological marker or test can show which patients might benefit, he wrote.

About 220,000 new cases of ovarian cancer are diagnosed each year around the world, and it causes 140,000 deaths. In the United States, the National Cancer Institute estimates 22,000 new cases and 15,000 deaths each year.

Skin Lumps? Strange Bumps? - Identifing Cysts, Warts and More on Your Body

Discovering a lump anywhere on your body is scary, and it’s difficult not to assume the worst. From bumps on our breasts and feet to our head and eye, could they be serious? To cut the worry, check out our guide to bumps women can get and learn when you should see a doctor...

You’re soaping up in the shower when your hand rubs over a new lump in your breast. That’s strange, you think. Could it be cancer?

Relax. Most bumps and lumps on your body are harmless, says Mary Jane Minkin, M.D., a board-certified obstetrician-gynecologist and clinical professor at Yale University School of Medicine in New Haven, Conn. As long as it’s not causing a lot of pain, watch a bump for several days to see if it vanishes on its own, she advises.

“Cancer doesn't disappear,” she says, “so if it goes away, it was nothing worrisome.”

Still, when women find a bump, they assume the worst. Here’s a guide to when to worry and not.

Breasts
Most women who feel a lump in their breast automatically assume it’s the Big C.

“The vast majority of lumps aren’t breast cancer,” says Debbie Saslow, Ph.D., director of Breast and Gynecologic cancers for the American Cancer Society.

Most are abnormal growths that aren’t life-threatening, Saslow says.
Fibroadenoma: These round, hard noncancerous lumps usually occur near the nipple and feel smooth and solid like a marble – and move like one too. Their cause isn’t known, but they’re common in teenagers and young women, says Saslow.

If you’re young, fibroadenomas are usually left alone. “But in middle-age and older women, they’re often surgically removed just to make sure there's no cancer there,” she says.

Cysts: Among the most common causes of breast lumps, these harmless, fluid-filled sacks typically occur in women 30-50 years old. They can come and go with your period and usually aren’t dangerous.

“When close to the breast’s surface, cysts feel smooth on the outside and liquid on the inside,” Saslow explains. “[Deep] cysts will feel hard.”

They’re often diagnosed by ultrasound and/or by fine needle aspiration. During the outpatient procedure, a thin needle is inserted into the lump to remove fluid for testing.

Intraductal papilloma: These small, difficult-to-feel but harmless growths are found inside milk ducts. They frequently occur near the areola (the darkened skin around the nipple) in women 35-55 years old. In some cases, their only symptom is a watery, pink or bloody discharge from the nipple, which is why you should see a doctor.

“Nipple discharge [is also] a sign of breast cancer,” Saslow says. “The evaluation may be just imaging, but usually includes a biopsy.”

Cancer: Most cancerous lumps occur in women over 40. Although the disease can strike any part of the breast, it often lodges in its upper quarter, including near the armpit.

In rare cases, other symptoms – redness or dimpling of the skin, an inward-turning nipple or discharge – indicate inflammatory breast cancer, a rare but fast-growing cancer, says Saslow.
If you have these symptoms, see a physician quickly.

If you spot a new or old lump that has grown or shrunk, tell a doctor right away. They’ll probably give you a breast exam and may recommend diagnostic tests, such as a mammogram, ultrasound or fine-needle biopsy.

When to worry: See a doctor if you feel a single, dominant lump, unless it’s a cyst that comes and goes with menstrual cycles, says Saslow.

“These are usually the size of a grape and are distinct from the rest of the breast tissue.”

Feet
One of the most stressed parts of a woman’s body is a prime spot for skin lumps.

Bunions: Blame killer shoes for these large, bony growths that are common to women. They develop at the outer base of the big toe, causing it to slant in and the joint to jut out.

You can keep them from getting worse – and painful – by wearing roomy, cushioned shoes and orthotics (inserts that relieve pain). A podiatrist also may prescribe stretching exercises and a bunion splint to be worn at night. In severe cases, a surgeon can shave them down.

Bone spurs (osteophytes): These often develop at a joint, like the ankle, but the bony bump can also appear on heels.

Your body commonly creates them to stabilize a joint, or they can be caused by osteoarthritis, a condition in which the cartilage cushioning your bones wears down.

Bone spurs can trigger corns and calluses, your body’s reaction to reduce friction. They usually don’t require treatment unless they’re painful. Then over-the-counter anti-inflammatory medications or cortisone injections can help.

If it's a severe, painful lump, it can be surgically removed.
Plantar warts: These skin growths typically form beneath the pressure points on your feet – the heels or balls – but they can also appear on the side of your heel or bottom of a toe.

These skin lumps feel like hardened skin and sometimes have small clotted blood vessels that look like dark pinpoints.

They’re caused by certain strains of the human papilloma virus (HPV) – not the kind responsible for cervical cancer – and spread by contact with the virus (for example by walking barefoot in moist, public places like the gym shower room).

An over-the-counter (OTC) wart remover with 40% salicylic acid can remove them.

“To get the best results, apply salicylic acid every day for several weeks,” says Howard Sobel M.D., a clinical attending physician in dermatology and dermatologic surgery at Lenox Hill Hospital and Beth Israel Medical Center in Manhattan. It will vanish in 7-12 days.

OTC wart-freezing remedies are effective for one or two warts, says Sobel. “But if you have multiple warts or those that don’t respond to OTC medicine or you’re not sure it’s a wart, see a dermatologist,” he says.

A doctor can quickly remove them by freezing with liquid nitrogen or by cutting them out.

When to worry: If it’s painful and limits daily activities, head to a podiatrist.

Hands and Fingers
Like your feet, your hands work hard and can be beset by mysterious protrusions.
Ganglion cysts: These common bumps form near tendons or joints. They can be round, hard or soft, and filled with a thick liquid, a joint lubricator (not pus) that has leaked. The (mostly) painless cyst is a protective swelling that forms around the liquid.

Don’t pop a ganglion cyst – it can trigger an infection – and the body will eventually reabsorb the fluid. Instead, take an OTC anti-inflammatory such as aspirin or ibuprofen.

When to worry: When signs of infection, such as swelling or redness, appear.

Head
Most head bumps are harmless and go away on their own, says Sobel.

Sebaceous cyst: A painless, smooth lump, this is caused when glands producing sebum (an oily substance secreted with sweat to protect skin) get clogged.

Typically, they’re no larger than 5 centimeters and are harmless. These skin lumps are surgically removed or drained only when they interfere with daily activities, such as brushing your hair, or if they become infected, Sobel says.

When to worry: If you have pain, which can signal an infection or cancer.

“Approximately 20% of melanomas originate on the head and neck, so have this often-overlooked area checked if you have any bumps or lumps,” Sobel says.

Neck
“Normally, the nodes under your neck – right near your jaw – are about the size of fingernails,” Sobel says. “With an infection, they can swell to 2-3 times their usual size."

That’s normal – it’s your body’s reaction to the invaders.
But if the nodes change shape, it could mean an inflammatory disease or even cancer, Sobel says.

A lump in the front of the neck is a symptom of an overactive thyroid (called hyperthyroidism), in which the gland produces too much thyroid hormone. It’s usually accompanied by other symptoms, such as sudden weight loss and a rapid or irregular heartbeat. A blood test can diagnose it.

When to worry: If the swollen lymph node grows more than 1 inch or remains larger than a half-inch for more than a month, see a doctor.

Call a doctor immediately if:

It grows more tender

It gets red streaks

You develop a rash or high fever

The node’s size impairs movement, breathing, or swallowing.

These signal a range of diseases, including strep throat and viral mononucleosis, Sobel says.

Your Bottom
Painless lumps in your nether regions are often harmless, says Minkin. They range from annoying to painful to – in the case of herpes – contagious.
Ingrown hairs: They’re caused by strands that break off from shaving with a dull razor or waxing. They can lead to large, red, painful bumps that can turn into boils – infections involving entire hair follicles and nearby skin tissue.

The best way to treat an ingrown hair or boil is to apply heat on the spot with a washcloth soaked in hot water.

“Heat increases circulation to the area, allowing the body to better fight off the infection,” Sobel says.

It also softens the skin around the trapped hair, allowing the hair shaft to break free and stop irritating the skin.

If you have a large boil, a doctor will need to drain or lance it.

Acne: It’s often caused by skin glands that produce too much oil and clog pores. Other culprits include heat and humidity, tight pants and laundry detergent.

If the bottom breakouts are painful or irritated, see a dermatologist, who can prescribe an acne medication or wash.

Hemorrhoids: These are swollen veins in the lower portion of the rectum or anus and they’re often caused by pregnancy, pushing down during bowel movements or excess weight.

Hemorrhoids itch and ache, especially when you’re sitting. And you may notice bleeding when using the bathroom.

If you have blood in your stool, even if it’s caused by hemorrhoids, tell your doctor. Rectal bleeding is a sign of colon cancer.

Hemorrhoids can be treated with OTC corticosteroid cream. If the condition is severely painful, they can be surgically removed.

To prevent them: Drink more water, eat more fibrous foods and avoid straining during bowel movements.
Bartholin’s cysts: These painless lumps are caused when the glands that lie on each side of the vaginal opening to lubricate the vagina become clogged and swollen.

To treat them, soak in a warm bath a couple of times a day for a few days.

“The cysts may spontaneously drain that way,” Minkin says. “If they persist and are painful, you may need to have them drained, which can usually be done in a doctor’s office.”

If the cyst is infected, your doctor may prescribe antibiotics.

Herpes: This serious viral infection requires medical attention. The virus enters your body through small breaks in the skin or the mucous membranes found around the vagina and anus, and it’s usually transmitted from sexual contact.

Look for painful lumps, red, itching blisters or clusters that look like a tiny cauliflower on your genitals.

“The one thing that usually differentiates herpes [from other bumps] is that it really hurts,” Minkin says.

A blood test can confirm herpes. There’s no cure for this recurring infection, but you can control outbreaks through prescription antiviral medication, such as acyclovir.

When to worry: If you suspect a herpes outbreak, see your physician immediately. Herpes is contagious – and dangerous if you’re pregnant.

“Genital herpes can cause potentially fatal infections in infants as well as neonatal complications and premature birth,” Sobel says.

Eye
A lump that develops near the eye is usually a stye or a chalazion.

Stye: An infection, this causes a tender red lump that resembles a pimple around the edges of the eyelid.
Chalazion: This hard lump crops up on the upper or lower eyelid when oil in a gland becomes too thick and clogs, Sobel says.

It may be painful, or you might notice the eyelid is red. In rare cases, the bump can be cancerous.

To treat a stye or chalazion, apply a hot towel compress to the bump 3-6 times a day for 3-4 days to help open up the blockage. Most of the time, they’ll disappear in a few days.

Don’t squeeze or pierce them. If they don’t improve with home treatment, a prescription antibiotic eye ointment or drops may help.

When to worry: See a physician if the lump doesn't respond to care or if your vision changes.

Women’s Health: How Much Do You Know?
There's no substitute for good health, and when it's gone, it's often gone for good. Don't let it pass you by.

9 Tips to Treat Restless Legs Syndrome - There Are Ways to Get Relief from RLS Symptoms

Restless legs syndrome can be debilitating - taxing your job, health and relationships. Here are some tips to reduce RLS symptoms and take back your downtime...

Do friends or family members roll their eyes when you can’t still long enough to watch your favorite TV show, enjoy dinner or take in a movie or play?

“Don’t be dissuaded by people who think that restless legs syndrome is ‘all in your head,’” advises Donald Watenpaugh, Ph.D., director of Sleep Consultants in Fort Worth, Texas, and a restless legs syndrome sufferer.

It’s a real disease with recognizable features and an underlying biological basis, agrees David Rye, M.D., Ph.D., professor of neurology at Emory University School of Medicine in Atlanta, director of the Emory Healthcare Program in Sleep and co-author of a 2007 landmark study that isolated a gene believed to dramatically increase the risk of restless legs syndrome.

About 10% of women suffer from restless legs syndrome (RLS), a neurological sleep and movement disorder that causes painful, crawling sensations in the legs and an irresistible urge to move them.

According to the National Institutes of Health, 2%-3% of adults, or more than 5 million people, have reported moderate to severe RLS symptoms.

Although RLS isn’t curable, you can take many steps to calm symptoms.

“To isolate things that may trigger symptoms, record eating, exercise, medication and sleep habits in a diary and watch for patterns,” says Jacci Bainbridge, Pharm.D., president of the Restless Legs Syndrome Foundation board and a professor of pharmacology and neurology at the University of Colorado in Denver. (For a seven-day diary, visit www.rls.org.)

Read on for 9 ways to tame RLS symptoms.

1. Beware of high blood pressure.
The higher your blood pressure, the worse your RLS symptoms are likely to be, especially if you're middle-aged, according to a 2011 Harvard study of 98,000 women.

Taming hypertension can help reduce RLS symptoms, the study found.

To lower blood pressure, “eat a healthy diet, engage in regular physical activity and maintain a healthy weight,” advises lead researcher Xiang Gao, M.D., Ph.D., assistant professor of medicine at Harvard Medical School and author of several studies on restless legs syndrome.

2. Lose the ab flab.
Obese women with excess belly fat may be more likely to develop restless legs syndrome than those who maintain a healthy weight, according to a 2009 Harvard study conducted on more than 80,000 overweight people with restless legs syndrome.

In the study, women with a body mass index (BMI) of 30 or more were 42% more likely to have RLS than those who were at normal weight or underweight (BMI of less than 23).

The underlying culprit could be decreased dopamine levels in the brains of obese people, says Gao, lead study author.

“Since decreased dopamine function is believed to play a critical role in restless legs syndrome as well, this could be the link between the two,” he says.
To lose weight and blast belly fat, eat a fat-burning diet with 30% protein, 40% carbohydrates and 30% fat, suggests David Edelson, M.D., a New York-based internist and bariatric surgeon and assistant clinical professor of medicine at Albert Einstein College of Medicine in New York.

That's basically a Mediterranean diet, he says. (For examples of these dishes, read 10 Mediterranean Recipes.)

Add weight training, and you’ll burn more calories and lose more pounds than women who rely solely on diet, according to a 2010 study at the University of Missouri.

But be cautious at the gym, says Michelle Bommarito, an American College of Exercise (ACE)-certified fitness instructor and personal trainer who works with women who have restless legs syndrome.

“Women with restless legs syndrome should avoid weight machines that overstress their legs, such as leg presses, treadmills and elliptical trainers and focus on machines that work their arms, shoulders and abdominal muscles, such as abdominal crunch machines, chest press machines and bicep curl machines,” she says.

(To start, try these 8 Easy Exercises for women.)

3. Find the right amount of exercise.
Engaging in aerobic and lower-body resistance training three times weekly will help decrease RLS symptoms, according to a 2011 study conducted by Brigham Young University in Utah.

In fact, if you avoid exercise completely, your symptoms may increase, according to a 2007 study conducted at the University of Kentucky College of Medicine.

But strike a happy medium.

“Overly strenuous exercise, especially if you’ve never done it before, can also aggravate symptoms by irritating and inflaming leg tissues,” Watenpaugh says.

Stick to low-impact exercises such as walking, low-impact aerobics classes and water aerobics and avoid high-impact activities such as running and long-distance running, Bommarito says.

(Here are some easy workout ideas with pictures from our new Diet & Fitness channel)

4. Step up your sex life.
“Although it’s not clear why, some women with restless legs syndrome find prolonged relief after having an orgasm, whether through sexual intimacy or masturbation,” says Mark Buchfuhrer, M.D., an internist and pulmonary specialist at SomnoMedix Sleep Disorders Center in the Los Angeles area and co-author of Restless Legs Syndrome: Coping With your Sleepless Nights (Demos Medical Publishing).

Having sex at bedtime could help relieve bothersome RLS symptoms that otherwise would keep you awake, he says.

But to avoid triggering symptoms, use positions that don’t overstress your legs and don't get too strenuous during sex, he says.

5. Consume enough iron and folate.
Patients with restless legs syndrome had decreased iron levels in their cerebrospinal fluid, according to a 2007 review of studies of more than 35,000 patients by Durango Natural Medicine in Colorado.

An iron deficiency in central brain neurons is believed to disrupt the brain’s dopamine levels, triggering RLS symptoms, says Rebecca Gray, M.D., an OB-GYN with Baylor Medical Center in Irving, Texas.

About 90% of American women are iron-deficient, the Durango study found.

Folate, a vitamin, is also crucial because it's needed to make red blood cells and prevent iron-deficiency anemia.
To find out if you're deficient in iron, get annual tests that detect levels of the metal in your blood, says midwife Jennifer Hensley, R.N., coordinator of nurse-wifery at the University of Colorado College of Nursing in Denver, and part of the International Restless Legs Syndrome Study Group, which is setting guidelines for treating restless legs syndrome during pregnancy.

To help prevent iron deficiency, eat iron-rich foods, for example, dark green vegetables, liver, wheat germ, kidney beans and lean beef.

To help your body absorb iron, also consume foods high in vitamin C, such as citrus fruits, and fortified cereals and grains, Hensley adds.

Also, get plenty of folic acid, or folate, by eating lentils, leafy greens like spinach, kale and collard greens and asparagus.

6. Distract yourself.
Daytime boredom and inactivity can trigger a restless legs syndrome attack, Buchfuhrer says.

“Activities that increase alertness often improve symptoms [for a few hours] by changing the mental state and activating the body’s motor system (and increasing dopamine levels),” he explains.

Do something to get your mind absorbed in a game or hobby. For example, play a video game, do a crossword puzzle or needlework, play cards or read an interesting book, Buchfuhrer says.

7. Get help for depression.
“Restless legs syndrome can lead to depression, which in turn can interrupt sleep and make symptoms even worse,” says Pam Santamaria, M.D., a neurologist at the Nebraska Medical Center in Omaha.

If you’re depressed, antidepressants that don’t trigger symptoms (Wellbutrin, Norpramin, Pamelor) may help relieve anxiety and improve sleep, Buchfuhrer says.

8. Zone out.
Patients with restless legs syndrome who pray, meditate or listen to relaxing music regularly enjoy a temporary reduction in symptoms, according to a 2008 study at Tottori University in Japan.

Practicing a calming ritual known as “progressive muscle relaxation” can also be therapeutic, according to the Restless Legs Syndrome Foundation. Here’s how to do it:

1. Breathe deeply for a few minutes and then tense the muscles in your feet. Hold the tension for a few seconds and then relax.

2. Next, tense your calf muscles. Hold and relax.

3. Do the same with your thigh muscles.

4. Repeat the tensing-and-relaxing pattern, working all the way up your body to your neck and face muscles.

If that technique seems like too much work, get a rub-down.

Patients with restless legs syndrome who received Swedish massage with special attention to their legs twice a week for three weeks enjoyed relief from symptoms for two weeks after treatment, according to a 2011 Brigham Young University study.

9. Ask your doctor about medication.
“If lifestyle changes don’t help reduce RLS symptoms, you may need medication,” Buchfuhrer says.

Medications used to treat restless legs syndrome include:

Horizant: Similar to an epilepsy drug, Horizant received FDA approval in April 2011 for treating moderate to severe restless legs syndrome.

Requip: A drug that replaces dopamine, Requip received FDA approval in 2006 for treating moderate to severe restless legs syndrome.

Benzodiazepines (Valium, Dalmane, Xanax) treat anxiety and insomnia associated with restless legs syndrome.

Nonbenzodiazepine hypnotics (Ambien, Lunesta, Sonata) treat associated insomnia.

Narcotics (codeine, morphine, oxycodone) treat associated pain.

Take your medication as prescribed to avoid triggering symptoms, Buchfuhrer says.

For more information, visit our Restless Legs Syndrome Health Center.
What’s Your Restless Legs Syndrome IQ?
Restless legs syndrome (RLS) might sound like a simple case of someone feeling on edge. After all, many people shake their legs when they’re antsy, bored or nervous. But there’s more to RLS than restless legs.

How to Combat Compulsive Hoarding - Tips for Clutter Control and More

Do you know someone who blames a messy home on being too busy or sentimental? She could have a more serious condition. Experts from A&E’s “Hoarders” offer tips to spot the warning signs of compulsive hoarding. Plus, get their clutter control tips for pack rats…

Teri, a busy 47-year-old registered nurse, doesn’t fit the stereotype of a hoarder. She’s not a loner, adores her two children (ages 12 and 8) and doesn’t have a yard full of clutter.

But inside Teri’s home, it’s a different story.

Piles of children’s clothing, toys and books stretch to the ceiling. The kitchen lies buried under boxes and used cat litter. And cartons of 3-year-old milk curdle in the refrigerator.

“We’re just messy,” she says.

Many people are too busy to clean, and we all squirrel away items in closets and rooms we hope our friends and relatives won’t see. Even when we have everything we need, our consumer-driven culture rewards us for shopping with coupons and discounts – so we buy even more.
What makes Teri different is that she’s a secret hoarder, just like 1 in 20 Americans, according to the International Obsessive Compulsive Disorder Foundation (IOCDF). Her compulsion is to shop and collect items, leaving her family in danger of being buried by her belongings.

People with the disorder “acquire [so much], they can’t use things as they’re intended,” explains Robin Zasio, Psy. D., LCSW, who counsels Teri and others like her on the A&E documentary series “Hoarders."

Besides helping hoarders understand their need for possessions, treatment often involves purging their homes of belongings that are creating a health hazard.

Professional organizer Geralin Thomas also appears on “Hoarders” and works with clients in the Raleigh-Durham, N.C., area. She helps both hoarders and busy moms decide which items to keep and which to toss.

“I’m a mom of two, so I know how that feels,” Thomas says. “You’re attaching symbolism and meaning to these things. When you still have your son’s smocked baby clothes and he’s now 6'4", you just need permission to let things go.”
So how do you know the difference between sentimentality and dysfunction? Here are 6 telltale signs:

1. Hoarders have difficulty or are unable to get rid of furniture, clothing, toys or other items.
“They're scared,” Zasio explains. “They think, What if I give this up and can't get it back? What if I need this? What if I can't tolerate the anxiety?”

2. Large amounts of clutter in the office or at home make it difficult to use furniture or appliances, or move around easily.
Hoarders often can’t get to their kitchen counters or beds because of overflowing piles of stuff, and will even choose an extreme alternative – sleeping in a recliner because the bed is covered with papers.

3. Hoarders consistently lose important items like money, school permission slips or medical forms.
“Papers don’t get signed and go back to school,” Thomas says. “Kids’ vaccinations don’t get done. There’s no grocery list, and coupons are expired.”

4. They feel overwhelmed by possessions that have “taken over” the house or workspace.
“They might have 16 bottles of ketchup and all of them are rotten or expired,” Thomas says. Or they drop items wherever it’s most convenient, leaving food on the coffee table or in the bathroom.

5. Hoarders excuse their purchases by saying they’re buying things because they’re a bargain or to stock up.
There’s a difference between getting a good deal at a two-for-one sale and hoarding items you don’t need.

A hoarder might think, Oh my gosh, I only need one pair of gloves, but four for $10 is a better deal, according to Zasio.

"The reality is you're buying four pairs of gloves. Are you really going to use them all? Most people aren’t.”

6. They avoid inviting family or friends home due to shame or embarrassment.
Hoarders don’t believe they can get their belongings under control but are aware enough of their problem not to let others into their homes, Zasio says.

Profile of a Hoarder
It might be easy to label a hoarder as lazy or sloppy, but Thomas and Zasio stress that the condition isn’t an indication of how caring, clean or attentive a person is.

“Compulsive hoarding doesn't discriminate,” Zasio says. “You've got people who are doing fine in their work and can have relationships. I went to a client’s home two days ago and she looks great, does well in her job, but [her house stank of cat feces].”
A lot of them, in fact, are perfectionists, Zasio says.

“They think of themselves as collectors and want to have every piece.”

And they not only focus on their own wants, Thomas adds.

“They buy gifts but never give them away,” she says.

Objects they find attractive hold a particular appeal, according to Thomas. She had a client who collected Tiffany shopping bags with the goal of creating a Tiffany-themed guest bedroom. Instead, the bags languished in a pile and were soiled by the family’s cat.

What You Can Do
If someone you know has a hoarding problem, encourage them to seek treatment from a licensed therapist.

If you need help persuading them, suggest they visit the IOCDF’s hoarding website and fill out the online questionnaires.

In treatment, which can take anywhere from six months to a year, hoarders are taught techniques to manage their impulses.

They’re also given homework assignments to learn how to clear out their homes, “such as removing six items out of the fridge every day until I see them next,” Zasio says.

The IOCDF also offers ways friends and family can help:

Show respect. Acknowledge that the person has a right to make decisions at his or her own pace.

Have sympathy. Understand that everyone has some attachment to things they own. Try to understand the importance of the items.

Encourage. Come up with ideas to make the home safer, such as moving clutter from doorways and halls.
Team-build. Don’t argue about whether to keep or discard an item; instead, find out what will help motivate the person to discard or organize.

Reflect. Help the person recognize that hoarding interferes with goals or values they might hold. For example, by de-cluttering a home, the person may host social gatherings and have a richer personal life.

Ask. To develop trust, never throw anything away without asking permission.

Organizing Techniques
Without proper therapy, it’s hard for hoarders to establish a cleaning routine. But whether you’re a hoarder in treatment or just overwhelmed by your belongings, here are techniques Thomas recommends to control clutter:

The 30-day rule: Make an agreement with your family that over the next 30 days, you won't bring anything new into the house except food.

Clean in sections: When straightening up, imagine the room divided by the numbers on a clock. Start at the top, and clear each section in 5- or 15-minute increments, then move on to the next.

Pick a theme: Each day, select something you have strewn around the house – such as clothes hangers or coffee mugs – and collect as many of those items as you can in a container. When you’re done, clean them and either put them away or box them for donation.

The timeliness test: When cleaning out a closet, ask yourself: If I were going shopping today, would I put this on my shopping list? If the answer is no, get rid of it.

Stick to your current style: When going through old clothes, ask yourself, Does this represent the person I am today? Or invite a friend over and ask, “If I walked in wearing this, what would you say?” If the answer is negative, get rid of the item.

For more on Geralin Thomas, visit her website, Metropolitan Organizing.

For more on A&E’s “Hoarders,” visit www.aetv.com/hoarders.

Are You a Pack Rat?
Collecting things can be a harmless habit, but compulsive hoarding is a serious disorder.

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Study: Diet Can Boost Brain Power

Elderly people with higher levels of certain vitamins and omega-3 fatty acids in their blood score better on mental acuity tests than those who eat junk food, a study released Wednesday showed.

The study published in Neurology, the journal of the American Academy of Neurology, also showed that eating better could help reduce the brain shrinkage commonly associated with Alzheimer's disease.

"This approach clearly shows the biological and neurological activity that's associated with actual nutrient levels, both good and bad," said Maret Traber, a principal investigator at the Linus Pauling Institute and study co-author.

Researchers at the institute at Oregon State University conducted the study, one of the first of its kind, along with scientists at the Oregon Health and Science University in Portland.

The study, carried out among 104 people at an average age of 87, specifically measured a wide range of blood nutrient levels instead of basing results on food questionnaires, which are less precise and less reliable.

"The vitamins and nutrients you get from eating a wide range of fruits, vegetables, and fish can be measured in blood biomarkers," Traber said.

"I'm a firm believer these nutrients have strong potential to protect your brain and make it work better."

Researchers noted the positive effects of high levels of vitamins B, C, D, and E, as well as the healthy oils most commonly found in fish, on mental quickness and brain size.

Those with a higher intake of trans-fats — commonly found in fried foods, fast foods, and other less healthy diet options -- did not perform as well on cognitive tests.

Researchers found that while age and education affected performance on the cognitive tests, nutrient status accounted for 17 percent of the variation in scores, and 37 percent of the differences in brain volume.

Of those who took part in the study, 7 percent showed a vitamin B12 deficiency, and 25 percent did not have enough vitamin D in their systems.

Scientists tested 30 different nutrient biomarkers. In addition, 42 participants had MRI scans to measure their brain volume.

"These findings are based on average people eating average American diets," Traber said.

"If anyone right now is considering a New Year's resolution to improve their diet, this would certainly give them another reason to eat more fruits and vegetables."

Study co-author Gene Bowman of the Oregon Health and Science University added while results needed to be confirmed, "it is very exciting to think that people could potentially stop their brains from shrinking and keep them sharp by adjusting their diet."

Red Meat Lovers Get More Kidney Cancer

People who eat lots of red meat may have a higher risk of some types of kidney cancer, suggests a large U.S. study.

Researchers found that middle-aged adults who ate the most red meat were 19 percent more likely to be diagnosed with kidney cancer than those who ate the least. A higher intake of chemicals found in grilled or barbecued meat was also linked to increased risk of the disease, they reported in the American Journal of Clinical Nutrition.

"Red meat is an important source for iron (and) it has protein," said Dr. Mohammed El-Faramawi, an epidemiologist from the University of North Texas Health Science Center in Fort Worth, who has studied diet and kidney cancer risks but wasn't involved in the new study.

"You should not stop eating red meat because there is an association between red meat and renal cancer," he told Reuters Health. Instead, eating a limited amount of meat while following dietary recommendations is a good idea, he said.

U.S. guidelines call for limiting high-fat foods including processed meat, and instead eating more lean meat and poultry, seafood, and nuts.

Eating red meat in large amounts — even if it doesn't necessarily lead to kidney cancer — increases the risk of a host of health problems, such as plaque buildup in the arteries, El-Faramawi added.

Previous studies examining the link between red meat and kidney cancer arrived at mixed conclusions, according to Carrie Daniel, from the National Cancer Institute in Rockville, Maryland, and her colleagues.

To try to clear up that picture, they used data from a study of close to 500,000 U.S. adults age 50 and older, who were surveyed on their dietary habits, including meat consumption, and then followed for an average of nine years to track any new cancer diagnoses.

During that time, about 1,800 of them — less than half a percent — were diagnosed with kidney cancer.

On average, men in the study ate two or three ounces of red meat per day, compared to one or two ounces among women. Participants with the highest consumption of red meat — about four ounces per day — were 19 percent more likely to be diagnosed with kidney cancer than those who ate the smallest amount, less than one ounce per day.

That was after accounting for other aspects of diet and lifestyle that could have influenced cancer risks, such as age, race, fruit and vegetable consumption, smoking and drinking, and other medical conditions including high blood pressure and diabetes.

When the researchers looked at the most common types of kidney cancers, they found that the association between red meat and cancer was stronger for so-called papillary cancers, but there was no effect for clear-cell kidney cancers.

People who ate the most well-done grilled and barbecued meat — and therefore had the highest exposure to carcinogenic chemicals that come out of the cooking process — also had an extra risk of kidney cancer compared to those who didn't cook much meat that way.

The study doesn't prove that eating red meat, or cooking it a certain way, causes kidney cancer. And, El-Faramawi pointed out, some people who eat lots of red meat won't develop cancer, while others that hardly eat any will.

Daniel and her colleagues said more research is needed to figure out why red meat may be linked to some types of kidney cancers but not others.

But for now, meat-related cooking chemicals "can be reduced by avoiding direct exposure of meat to an open flame or a hot metal surface, reducing the cooking time, and using a microwave oven to partially cook meat before exposing it to high temperatures," Daniel told Reuters Health in an email.

"Our findings," she concluded, "support the dietary recommendations for cancer prevention currently put forth by the American Cancer Society — limit intake of red and processed meats and prepare meat by cooking methods such as baking and broiling."

Enjoy a Hangover-Free Holiday

It’s a tradition to ring in New Year’s with a glass of bubbly. And if you’re attending a party this weekend, chances are you’ll enjoy a favorite cocktail, glass of wine, or bottle of beer.

But the truth is, while you might like the taste of a full-bodied red or a smooth whiskey, drink too much of it and your body will react, or more like rebel.

“It’s really viewed as a poison by the body, so the body tries to get rid of it,” explains Roberta H. Anding, spokesperson for the Academy of Nutrition and Dietetics.

A good way to avoid overindulging is to consume no more than one standard-size drink per hour, she says. That means four or five ounces of wine, a 12-ounce bottle of beer, and a mixed drink with no more than one ounce of alcohol.

Any more than that and you’ll likely engage in embarrassing behavior — a big no-no if you’re socializing with colleagues. And come morning your head will pound, your stomach will be sour, and you’ll feel exhausted. In other words, you’ll have a hangover.

If you’re female, alcohol’s effects will hit you faster because women have less alcohol dehydrogenase, a liver enzyme that helps the body metabolize booze. Women also tend to have a higher percentage of body fat than men, which leaves their bodies with less water to help dilute alcohol, explains Anding, an adjunct instructor of nutrition at Rice University in Houston.

“So it’s really not being sexist when we say that women can’t drink as much as men,” she says. “It’s not sexist, it’s physiology.”

In addition to gender, genetics can play a role in alcohol’s effects. For example, Asian women make less alcohol dehydrogenase than white women, so their tolerance is even lower. And there also is the question of how your body reacts to other ingredients in alcoholic beverages, such as congeners — byproducts of fermentation that are more highly concentrated in darker colored alcohol, such as bourbon, whiskey, red wine, brandy, and tequila. Darker colored alcohol is typically known to cause worse hangover symptoms than white or clear alcohol like vodka, which has fewer congeners.

“You individually may not tolerate something or tolerate it differently from friends,” Anding says.

The best way to avoid these unpleasant aftereffects — short of abstaining — is to alternate drinks with glasses of water to stay hydrated, Anding says. Also, taking control of your glass, especially if you are drinking wine, is key. When your host comes with a refill, have the glass in your hand or put your napkin over the top to prevent an automatic re-pour, she advises.

“You can easily lose track of how much you’ve had to drink when someone else is pouring for you,” she says.

You also can simply refrain from drinking after that first glass or toast.

“People always notice the first glass you take but not the ones after,” she says. “Have the first glass of champagne and no one is going to know if you have sparkling water after.”

Anding’s other tips include:

Eat a half a turkey sandwich before the party. The combination of protein and carbohydrates provides a buffer for your stomach lining, which becomes easily irritated from absorbing alcohol. Snack on non-greasy foods like pretzels with your drink, too.

Go for quality vs. quantity. Splurge on that $12 glass of wine. You’re more likely to sip it and less likely to drink four or five of them.

Don’t mix booze with medication. Be particularly careful about not drinking if you take antidepressants. Alcohol is a drug, a depressant that also affects the central nervous system.

Because the exact cause of the hangover remains elusive, so does a surefire remedy, Anding says. “There is no magic cure here,” she says, and feeling better takes time. However, there are some things you can do to help yourself.

Sip water. Be sure to drink, but don’t gulp, which can further nauseate you. Rehydrating is important because alcohol is dehydrating. If you have vomited, sip a sports drink to replace lost electrolytes.

Avoid greasy food. This will further irritate your angry stomach. Instead, eat crackers, rice, a bagel, dry cereal, or similar bland food.

Take aspirin or other pain reliever. Headaches are one of the most common hangover symptoms. Experts are at odds over what exactly causes them, Anding says. It could be dehydration, a compromise in immune function, congeners, or alcohol metabolites. Remedies like Alka-Seltzer and the new Blowfish, which contain sodium bicarbonate and aspirin, may also help, but Anding advises going easy on the aspirin, a known stomach irritant.

Could Injections Relieve Osteoarthritis Symptoms? - When to Choose Steroids or Joint Fluid to Combat Pain and Stiffness

If over-the-counter medicines aren’t relieving your osteoarthritis pain and stiffness, but you aren’t ready for joint surgery, there’s a middle ground: injections of steroids or a joint-fluid component directly into the affected area.

Could this be the right osteoarthritis treatment for you?

Read on to learn about the benefits and drawbacks of these treatments for easing osteoarthritis symptoms...

When osteoarthritis gets severe, the pain can be debilitating. So what can you do about this degenerative joint condition, generally brought on by aging or overuse of the joints?

You may take over-the-counter pain medications like acetaminophen (Tylenol) or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve) to relieve your osteoarthritis symptoms.

But they may not provide total relief – and as you increase NSAID doses, you may also be facing other health risks.
“Non-steroidal anti-inflammatories are good first-line treatments for osteoarthritis symptoms,” says Patrick McCulloch, M.D., an orthopedic surgeon at the Methodist Center for Sports Medicine in Houston. “The problem is that [eventually] they can contribute to gastrointestinal ulcers and bleeding, as well as high blood pressure, kidney damage, heart problems and stroke.”

That’s one reason an injected osteoarthritis treatment – either corticosteroids to reduce inflammation or hyaluronic acid to cushion joints – is an increasingly attractive osteoarthritis treatment option.

Not only do they help relieve pain and stiffness, but they may allow some patients to postpone joint-replacement surgery.

If medications aren’t helping your osteoarthritis symptoms – or if they’re causing harmful side effects – ask your doctor whether injections could help. Here’s the lowdown on each of the two options:

Osteoarthritis treatment #1: Corticosteroids
These steroid hormones relieve inflammation when injected into a painful joint.

Although inflammation isn’t part of the osteoarthritis disease process (as it is with rheumatoid arthritis), it can still be a factor that triggers pain, says Robert Salk, D.P.M., a podiatrist at Northern California Foot and Ankle Center in San Francisco who has researched the use of injections for osteoarthritis symptoms.
When osteoarthritis creates bony growths, called bone spurs or osteophytes, inflammation can occur around the joint, Salk explains.

Sometimes spurs break off, causing a bone fracture that also leads to inflammation.

How do they work?
By reducing inflammation and the number of inflammatory cells and decreasing temperature (another sign of joint inflammation), McCulloch says.

When do doctors recommend them?
They’re generally preferred if NSAIDs no longer relieve pain at a safe dose, and if you have only one or two painful spots – such as knees or ankles.

Physicians inject the medication directly into the painful area, says McCullough. That way, it relieves osteoarthritis pain without distributing the medicine throughout your body, which would increase the risk of side effects.

Are they an effective osteoarthritis treatment?
They’re very good at decreasing osteoarthritis pain and increasing joint function, says family and sports physician Jamie F. Peters, M.D., medical director of Fairview Sports and Orthopedic Care in Eden Prairie, Minn.
“They can allow increased function for 3-4 months, even if you have significant damage,” he says.

But not everyone gets long-term benefits, says McCulloch.

“If someone gets six months [of pain] relief, then an injection once or twice a year is a reasonable treatment,” he says. “But if you only get six weeks’ relief, it doesn’t make sense to inject corticosteroids again.”

Do they prevent the need for surgery?
“If injections help, then it’s reasonable to delay surgery,” McCulloch says.

They may also be an effective remedy for elderly patients when joint surgery isn’t an option.

What are the side effects?
“Steroids can weaken ligaments or tendons,” Salk says. “That’s why doctors usually do no more than three injections a year.”

And some forms can leave crystals in the joint, injuring it further.
But with occasional use, most side effects are rare, says McCulloch. The skin at the injection site may become lighter or irritated for 24 hours – “but that’s in less than 1% of patients,” he says.

Some people may also experience a short flushing sensation, which means some of the medicine has passed into the bloodstream. Also, diabetics may have a small increase in blood sugar levels.

To help minimize these effects, avoid strenuous activities for 48 hours after an injection, advises Salk.

“The ligaments and tendons can develop tears and the activity could make the cortisone dissipate – you want to keep it localized,” he says.

How do corticosteroids compare to hyaluronic acid injections?
Recent studies suggest that corticosteroids are best short term.

When injected into a knee, they were more effective for osteoarthritis pain than hyaluronic acid during weeks 1-4; by week 4, the two were equally effective; and after week 8, hyaluronic acid proved the winner, according to a 2009 Tufts University analysis of seven trials involving 606 people.
Osteoarthritis treatment #2: Hyaluronic Acid (HA)
HA is a thick, gooey fluid produced in every joint. The form that’s injected is made from rooster combs.

How does it work?
It’s a natural joint lubricant, providing a cushion that helps absorb stresses.

Injecting HA into the joint offers even more cushioning, says Salk.

“If you look at the joint fluid in someone with osteoarthritis symptoms, it’s very thin and watery,” he says. “When you inject hyaluronic acid, it replenishes the normal fluid.”

Supplementing HA also seems to trigger more of your body’s natural production.

“After 3-5 injections, you may have a year or more of relief, even though the medication [itself] is out of the body within a few days,” Salk says. “That’s why we theorize that it stimulates the growth of new hyaluronic acid.”
When do doctors recommend it?
If NSAIDs and corticosteroids don’t offer enough relief, your doctor may prescribe it.

“It works best for mild to moderate osteoarthritis,” Salk says.

In later stages, there’s little space and natural fluid left at the joints – so HA may be less effective, he says.

Is it an effective osteoarthritis treatment?
“Two out of three patients get relief [from osteoarthritis symptoms] and feel it was worthwhile,” McCulloch says.

Most patients feel less osteoarthritis pain by the end of a series of three or more injections given weekly (dosing varies by manufacturer). A single-injection product is available, but it’s not yet clear if it’s as effective as a series, McCulloch says.

If someone feels relief for a year, it might be worth getting another series of shots, says Peters.“But if you only get a month’s relief, I wouldn’t give it again.”

Does it prevent the need for surgery?
HA doesn’t stop cartilage deterioration, but it can relieve pain and stiffness and make moving around easier. And it can delay an operation as long as osteoarthritis hasn’t worn away all the cartilage, leaving bone on bone, says Peters.
“Then, even hyaluronic acid injections don’t buy a lot of time,” he says.

What are the side effects?
HA injections are generally safe, though they’ll occasionally produce an allergic reaction, says Peters.

You also can have some pain and swelling around the injection site, especially if the needle is injected into tissue instead of joint space, says McCulloch.

When receiving injections, you have to rest the joint and avoid strenuous activities. For example, no running or jumping, Peters advises.

Is it approved only for the knee?
The Food and Drug Administration (FDA) approved it for knee osteoarthritis symptoms in 1997, says Salk, who participated in the first study of HA ankle injections in 2006.

But “osteoarthritis is osteoarthritis, whether it’s in the knee, shoulder, hip or ankle,” he says. “Many doctors use hyaluronic acid on multiple joints as an off-label application.”

“The FDA [might] approve it for multiple joints in the next few years,” he adds.
How does HA compare with corticosteroids?
Several studies indicate that the effects of HA injections last longer than corticosteroids, although the latter provides faster relief.

HA injections were effective after four weeks, reaching their peak by week 8, with some residual effect at 24 weeks, according to a 2011 Tufts University analysis of 54 study trials involving 7,545 people with knee osteoarthritis symptoms.

Their effect was greater than that of acetaminophen and NSAIDs, the study found.

HA is also available as a nutritional supplement, but its effectiveness as an osteoarthritis treatment hasn’t been well-studied.

“I think one day we’ll ingest hyaluronic acid in a pill in our 20s or 30s with proven benefits for joints,” Salk says.

To learn more, visit our Osteoarthritis Health Center.

5 Anti-Aging Supplements Worth Taking - Nature's Way to Keep You Looking Younger

No one stays young forever, but some nutritional supplements promise to add some time to your life – or at least make you healthier now. We examined the claims and found 5 anti-aging supplements worth considering...

In a culture that puts a premium on youth, it’s easy to see why we’re always looking for anti-aging remedies. But can nutritional supplements really slow the process?

The answer lies in looking at scientific studies and separating truth from hype, which isn’t always easy. Still, there are some supplements for which the evidence is promising.

Since most of us already live more than 70 years, it’s difficult to test the effects of these products on people. As a result, most anti-aging research is done on animals – from mice, which typically live 1-3 years, to fruit flies, which only live about two weeks.

And if a supplement does effectively slow some aspects of human aging, it might work so gradually you wouldn’t notice, says naturopath Alan C. Logan, N.D., author of The Brain Diet (Cumberland House).

“It many cases, it may be the opposite of the way fast food accelerates aging,” he says. “Usually, people can consume fast food over time, not really aware of its toll on the body. The reverse is generally true of supplements purported to slow aging.”
For now, subjective changes may be your best measure of whether a supplement has benefits.

Ask yourself: Does it make you feel good? Keep you energetic? Combat fuzzy memory?

“It should make a difference in mood and energy levels over 3-6 months,” Logan says.

Here are 5 products worth trying. Remember, any supplement may interact negatively with certain drugs or health conditions, so consult your doctor before taking them.

Coenzyme Q-10
Our bodies naturally make CoQ10 (also known as ubiquinone), a nutrient necessary for basic cell function. It enters the mitochondria (our cells’ “energy centers”), where it helps transform fats and sugars into energy. As we age, CoQ10 levels naturally decline.

Test-tube and animal studies show that CoQ10 acts as a protective antioxidant in mitochondrial membranes and may prevent cognitive decline.

“But we still need human data,” Logan says.

When taken with other antioxidants – selenium and vitamins C and E – CoQ10 may also improve arterial elasticity, making you less vulnerable to the hardening of the arteries that leads to heart disease, according to a 2010 study published in Nutrition & Metabolism.

Recommended dose: 30-200 mg per day, according to the University of Maryland’s program in complementary medicine. CoQ10 may be especially helpful if you’re taking statins to lower cholesterol levels or beta blockers for irregular heartbeats, because they reduce CoQ10 levels.

Resveratrol
Known as the “red wine” chemical, resveratrol is a polyphenol found in the skin of grapes and berries.

Some researchers believe it’s partially responsible for the “French paradox,” in which people who drink wine have fewer health problems from eating fatty foods.

Animal research has shown that resveratrol increases the lifespan of worms, fruit flies and fish. In mice, it raises insulin sensitivity, decreases glucose levels and improves cardiac health, which suggests it may help prevent type 2 diabetes, heart disease and cancer.

Resveratrol also may influence sirtuins, proteins that keep cells healthy, and the Sir T1 gene, a gene that governs cellular longevity, says Leonard Guarente, Ph.D., an anti-aging specialist and MIT biology professor.

A 2006 Harvard study compared mice fed a standard diet, a high-calorie diet, or a high-calorie diet with resveratrol. Mice given resveratrol survived longer than both other groups, the researchers found.

Recommended dose: Most resveratrol supplements come from polygonum cuspidatum, a giant knotweed grown mainly in China and Japan. The actual resveratrol content varies from 50%-99%, depending on how it’s processed.

Guarente recommends taking between 100 mg and 1 gram per day. But much smaller amounts may also be good for you, since red wine has less than 2 mg per glass.

Because of the publicity surrounding resveratrol products, they’re vulnerable to scams. Buy from a company you trust, and avoid any that claim celebrity endorsements or offer a dubious “free trial.”
Blueberry Extract
Blueberries have proven to be incredibly healthy – for animals. Rats fed blueberries navigated mazes better. Mice fed blueberry supplements avoided behavioral problems associated with Alzheimer’s disease. Studies have also found that the fruit may extend lifespan in worms.

But human research is sparse. A small 2010 study published in the Journal of Agricultural and Food Chemistry found that older adults who drank wild-blueberry juice every day improved their memory.

Exactly what makes blueberries good for you isn’t clear. Research suggests it’s their healthful anthocyanins, pigments that give berries – and other blue and red plants – their color, says Robert Krikorian, Ph.D., lead author of the juice study and a University of Cincinnati Health Center researcher.

Recommended dose: Eat 1/2-1 cup of blueberries a day, fresh or frozen. Juice is good, too, though high in sugar. (Make sure it isn’t adulterated with other juices.)

If you want a blueberry-extract supplement, take one that’s made from the whole fruit and minimally processed. Too much heat and exposure to moisture during processing can reduce the amount of micronutrients, Krikorian says.
Turmeric
The ancient Indian spice that gives curry its yellow color is an anti-inflammatory and protective antioxidant. A member of the ginger family, it has been found to help shield against a variety of age-related conditions.

A 2010 University of California-Irvine study found that turmeric’s active ingredient, curcumin, extended the lifespan of fruit flies by up to 20% by influencing genes associated with aging. University of Arizona research in 2010 suggested that the extract can help prevent arthritis and bone loss in aging women.

But you don’t have to be a curry fanatic to reap its health benefits. Older adults who reported having curry “occasionally” scored better on mental-health tests than those who “never or rarely” consumed the dish, according to a 2006 study in Singapore.

Recommended dose: Currently, there’s no suggested dose for turmeric, but ongoing human studies use 1-gram supplements daily, Logan says. Look for one that’s standardized for high curcumin content. And be careful – very high doses can cause indigestion.

If you like Indian and Southeast Asian foods, include turmeric in your diet. Add it to yogurt for a great vegetable dip, suggests Christine Gerbstadt, M.D., R.D., a spokeswoman for the American Dietetic Association.
Multivitamins
Nearly everyone knows that a daily multivitamin can make up for nutritional deficits in your diet. Now, new research suggests that it could lead to a longer life.

Women who took multivitamins regularly had longer telomeres, the protective caps at the end of chromosomes that grow shorter with age, according to a 2009 National Institutes of Health study. Longer telomeres are associated with youth and health, shorter ones with aging and disease.

The study also found a link between longer telomeres and higher intake of vitamins C and E from food.

But another reason may be vitamin D, which increases telomere length in women, according to a 2007 study at the London School of Medicine.

“Vitamin D is a real winner,” says Fred Pescatore, M.D., a New York physician and author of Thin for Good (Wiley). “It does everything from cancer protection and lowering blood pressure to strengthening bones.”
How to take it: With so many multivitamin formulas on store shelves, choosing the right one may be difficult.

Here are some tips:

Women of childbearing age need a multi folic acid, a B vitamin that guards against neural tube defects in unborn children.

All women should take a multivitamin with calcium and vitamin D, a potent combination that helps prevent osteoporosis. Recommendations vary, but Pescatore suggests 2,000 IU of vitamin D and 750 mg of calcium per day.

Women also need biotin and boron, two micronutrients important for balancing estrogen and progesterone, Pescatore says

And don’t just grab for your husband’s multivitamin – men’s formulas may not have enough calcium, folic acid and iron.

What’s Your Supplement IQ?
Beyond the world of basic nutrition, there's a different solar system of weird, wacky and wonderful facts about vitamins, minerals and herbs.

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* Fidgeting can burn about 350 calories a day. *

* It is possible for you to survive even after the removal of the spleen, the stomach, one kidney, one lung, 75% of the liver, 80% of the intestines, and almost every organ from the pelvic and groin area. *

* 20 minutes after smoking a cigarette, blood pressure drops to normal. *
__________________________________________________________________________

* FOR A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT PLEASE GO TO WWW.GOKIVIA.COM - IT IS THE BEST COMPANY TO BE INVOLVED WITH AND THERE ARE FANTASTIC PRODUCTS AND THE BEST PEOPLE IN THE WORLD TO WORK WITH!! IT HAS THE BEST MARKETING PLAN THAT I'VE EVER SEEN AND YOU WILL BE VERY HAPPY!! WHAT A GREAT WAY TO MAKE MONEY AND SHOP FOR CHRISTMAS GIFTS AT THE SAME TIME!! I CAN'T BEGIN TO EXPLAIN HOW WONDERFUL THE PRODUCTS ARE, I'VE NEVER USED BETTER!! IF YOUR INTERESTED AND I HOPE YOU'LL TRY IT, CALL ME TO GET INVOLVED AT 310-326-3633 - Home - 310-986-7777 - Cell -, email: HereForYou@sbcglobal.net, THANK YOU AND BEST REGARDS, Catrina DeMicelli *
________________________________________________________________________

WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"


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MP3 Players Damage Hearing

New research announced last week finds that nine out of 10 urban dwellers are exposed to enough loud noise to damage their hearing. But rather than noisy construction sites and roaring buses and subways, the main culprits are MP3 players and stereos, according to the findings.

In a study of 4,500 New York City residents, researchers at the University of Michigan found that noise from MP3 players and stereos has eclipsed loud work environments as the primary risk factor, said Rick Neitzel, assistant professor and researcher, in a statement from the university.

Still, work-related noise and loud public transit did account for some of the damaging noise levels: the study shows that one in 10 people who use public transit were exposed to noises that go above the recommended limits, just from taking public transit alone.

Yet 90 percent of public transit users and 87 percent of non-transit users are exposed to damaging noise levels mainly from using their MP3 players or stereos.

"I do think it's a serious problem, there aren't really any other experiences where we would tolerate having nine out of 10 people exposed at a level we know is hazardous," added Neitzel. "We certainly wouldn't tolerate this with another agent, such as something that caused cancer or chronic disease. Yet for some reason we do for noise."

A study published this year found that nearly one in five U.S. teens has lost a bit of their hearing — and the problem has increased substantially in recent years. A 2010 Australian study linked use of personal listening devices with a 70 percent increased risk of hearing loss in children.

Another study of 200 New York university students found that more than half listened to their digital music players at 85 decibels or louder — about as loud as a vacuum cleaner. "Habitual listening at those levels can turn microscopic hair cells in the inner ear into scar tissue," one of the researchers told MSNBC.

As a comparison, speaking level is 60 decibels, a bustling street corner is 80 decibels, a circular saw is 90 decibels, a crying baby is 115 decibels, and a noise level that induces pain is 125 decibels, according to the University of Michigan researchers.

Study: Beer, Martinis as Good as Red Wine For Health

The healthful benefits derived from alcohol may be the same no matter the source, be it a glass of red wine or a bottle of beer, according to a new analysis that casts doubts on studies that have suggested wine is most beneficial.

The study, published in the January issue of The Journal of Studies on Alcohol and Drugs, suggests that wine was singled out in past studies because those who prefer it over other alcohol tend to be healthier.

The study looked at 802 individuals ages 55 to 65 over the course of 20 years, 345 of whom were not drinkers, and the rest of whom comprised a mix of moderate drinkers broken down into high-wine and low-wine consumption. It found that the drinkers who had one to two drinks per day outlived the abstainers. When certain factors were controlled, the study showed negligible mortality differences between low-wine and high-wine drinkers.

Lead author Charles Holahan confirmed that moderate drinking by older individuals, no matter the alcohol source, is beneficial. He cautioned, however, that the analysis “does not encourage initiating wine consumption as a pathway to better health.”

Heartburn Drug Sales Soar in Bad Economy

If you think the economy is giving you heartburn, you may not be alone.

Use of acid reflux medications showed a 93 percent correlation with the U.S. unemployment rate over the last five years, according to a study by Bloomberg Rankings. Drugs for high blood pressure and antidepressants had correlation rates of 92 percent and 85 percent respectively, the data show.

Unemployment in the United States declined to 8.6 percent as of Nov. 30, from a high of 10.1 percent in October 2009. Patients taking drugs for high blood pressure, including ACE inhibitors like Pfizer (PFE)’s Accupril and AstraZeneca (AZN)’s Zestril, or antidepressants such as Eli Lilly & Co. (LLY)’s Cymbalta have found ways to keep paying for them through economic doldrums, said Andrew Berens of Bloomberg Industries.

“The demand for drugs, especially in those classes, appears to be independent of major macro indicators, suggesting that people will find a way to pay for them,” said Berens, a senior health-care analyst based in Skillman, N. J., in a telephone interview. “Especially the ones that alleviate anxiety, depression, and maybe hypertension, which can be related to anxiety, too.”

To be sure, “correlation does not mean causation,” said Les Funtleyder, a health-care strategist and portfolio manager at Miller Tabak & Co. in New York.

“Just because a number is high and positive doesn’t mean the two are related,” Berens said. “It just means in that time period they traveled in the same direction.”

The study examined medicines for pain, cholesterol and erectile dysfunction as well, showing correlation rates with unemployment of 87 percent, 93 percent and 68 percent, respectively.

Ulcer Bacteria May Protect Against Diarrhea

People who harbor ulcer-causing bacteria in their stomachs may be protected against some diarrheal diseases, according to an Israeli study.

Some previous studies had suggested that being infected with the bacterium, Helicobacter pylori, increases the risk of diarrhea, while others have reported finding the opposite, said researchers from Tel Aviv University.

"Our findings suggest an active role of H. pylori in the protection against diarrheal diseases," wrote lead author Dani Cohen in the journal Clinical Infectious Diseases.

The bacterium is especially common throughout the developing world, but only causes symptoms in a minority of those it infects. People with chronic H. pylori infections are known to have an increased risk of stomach cancer and related diseases.

Cohen's team studied 595 male Israeli soldiers, close to one-third of whom visited a base clinic for diarrhea during their field training.

All of the soldiers had their blood taken before the start of training, which researchers used to determine which men were chronically infected with H. pylori.

It turned out that between 32 and 36 percent of soldiers who had diarrhea due to different types of bacteria than H. pylori, or from unknown causes, had been infected with H. pylori before training.

By contrast, up to 56 percent of soldiers who had been infected with H. pylori before training reported no diarrhea.

The researchers calculated that being infected with H. pylori meant solders were about 60 percent less likely to get diarrhea from Shigella bacteria.

They also had a lower chance of having diarrhea caused by Escherichia coli bacteria — although statistically, that particular finding could be due to chance.

An H. Pylori infection may affect how acidic the gut is, and high acidity is known to keep disease-causing bacteria from settling there, Cohen said in an email.

Having an immune system in overdrive due to chronic H. pylori infection may also keep other bacteria in the digestive system at bay, the researchers wrote.

6 Almost-Free Beauty Treatments - Beauty Recipes You Can Make Yourself

Relief from parched, oily or irritated skin is as close as the fridge. Ingredients that nourish your body can soothe complexions too. Try beauty expert Rona Berg’s easy, affordable home spa treatments for skin woes, from rough feet to "bacne"...

Every beauty expert keeps a well-stocked cupboard, and mine is overflowing with yummy scrubs, sweet-smelling oils and scrumptious masks for summer.

So is my kitchen pantry – and chances are yours is too.

It’s easy to dip into your fridge or cupboard, pull out fresh, healthy ingredients and make your own natural home spa treatments to soothe summer skin woes.

Here are 7 of my favorite recipes.

They cost less than $3, smell great and are good enough to eat!
1. Tropical Treat for Feet
There’s no time like sandal season to indulge tired feet. In just a few minutes, mix an easy, effective, all-natural foot mask that will pamper and prettify those barking dogs.

Luscious papaya contains papain, a natural exfoliant that smoothes rough, scaly skin. Yogurt absorbs excess oil and cools skin. Honey is an antibacterial, mint reduces inflammation and relaxes tired muscles, while grapeseed oil is a light antioxidant moisturizer that’s easily absorbed into skin.

Ingredients
1/2 papaya, mashed
1/2 cup plain yogurt
1 teaspoon honey
1 teaspoon grapeseed oil (you can substitute vegetable oil or olive oil)
1 sprig fresh mint, leaves torn into small pieces

Preparation
1. Mix all ingredients by hand or in a blender.

2. Massage all over feet.

3. Slip each foot into a small plastic bag. After 10 minutes, rinse with cool water. Apply your favorite foot or body cream. Tropical Treat lasts about 5 days in the fridge.

Cost: $1.40

Tip: This mask can also be used to smooth and soften hands and face.
2. Aloe Skin Soother
In the Southwest, many people keep an aloe plant because the gel from the leaves soothes dry, irritated, or burned skin.

Aloe gel is an anti-inflammatory, rich in vitamins, minerals and enzymes. It has more than 99% water, which is why it’s so soothing.

Aloe is also a temporary skin-tightener, which makes this a great “mini-mask” when you’re prepping for a party or after a day at the beach, especially if you’ve had too much sun.

The optional lavender oil also soothes burns. Chamomile oil calms inflamed skin.

Ingredients
1/4 cup aloe gel (available at health food stores)
2 vitamin E capsules
1/2 teaspoon chamomile or lavender essential oil (optional)

Preparation
1. Keep aloe gel chilled in the refrigerator – where it’ll last about 4 weeks – because cold makes it more effective. When you’re ready to apply the mask, cut open the vitamin E capsules and mix contents with the aloe gel and essential oil.

2. Apply to a clean face and leave on for 10 minutes. Rinse with cool water and moisturize.

Cost: $1.05

Tip: Aloe also reduces puffiness beneath eyes. Lie down for 5 minutes and gently pat back and forth on the under-eye area with your fourth finger. (It exerts the least pressure.)

3. Tuscan Face Glow
Olive oil isn’t only for eating. Since ancient Rome, it has been used in soaps, moisturizers, hair conditioners and body treatments.

“Liquid gold,” as it’s known in Italy, is loaded with antioxidants and oleic acid, which helps regenerate skin cells. It’s gentle enough for sensitive skin and so light that it won’t clog pores – even if your complexion is oily.

The orange (like other citrus fruit) contains citric acid, an exfoliant that loosens bonds between surface skin cells. Baking soda is a gentle scrub. Your skin will glow like you’re living La Dolce Vita!

Ingredients
1 small orange
1/4 cup cold-pressed extra-virgin olive oil (cold-pressing retains more nutrients)
1 tablespoon baking soda (optional)

Preparation
1. Finely grate the zest of the orange (avoid the white pith). Combine with olive oil in a small glass, ceramic or stainless-steel bowl. Cut the orange in half and squeeze the juice into the olive oil mixture. Blend in the baking soda, if you like.

2. Gently massage in circular motion on clean skin, and rinse with cool water. Store this for 2 weeks at room temperature.

Cost: $1.32

Tip: To make your tresses soft and shiny, massage a dime-sized dab of olive oil into your palms and very lightly scrunch through your hair – especially on dry ends. Give hair a light blast with the blow-dryer to help the oil penetrate.
4. Nutty Sesame Body Scrub
Sesame is one of the most deeply penetrating and richly emollient oils. In India, it’s massaged into the scalp because it’s believed to prevent hair loss.

The salt in this recipe helps slough off dry, flaky skin, while the oil softens and nourishes dry, sun-parched skin. This recipe is modeled after a spice paste, a traditional cooking rub common in many cultures, including India, China and Mexico.

Ingredients
1 cup sesame seeds
1 cup sea or kosher salt
1/2-3/4 cup sesame oil (or sweet almond oil)

Preparation
1. Toast the sesame seeds at 350˚ for 2 minutes to release the oil and make your scrub more fragrant. Using a mortar and pestle, crush the seeds with salt. Add oil.

2. Gently massage into your skin, from the neck down. Rinse off in the shower. Store it for up to six months out of direct sunlight.

Cost: $1.15

Tip: To revitalize skin and re-energize your body, massage the scrub as the pros do – from the tips of your fingers and toes toward the heart, to stimulate blood flow and increase circulation.
5. Egg-on-Your-Face Oily Skin Mask
There’s nothing as refreshing as the tart scent of lemon in the summer heat! This mask will cleanse and help clear oily skin.

The fruit’s citric acid is an alpha-hydroxy acid, which is a great exfoliant. The egg tightens and tones.

Citrus oils (grapefruit, lemon, orange, bergamot and neroli)) can make your skin more vulnerable to UV rays, so avoid the sun after applying them. Use this mask at night, before you sleep.

Ingredients
1 lemon
1 egg

Preparation
1. Slice the lemon in half. Scoop out enough pulp from one half to fit the egg yolk inside. Refrigerate the lemon-egg yolk overnight.

2. Apply the lemon-infused egg yolk to clean, dry skin, avoiding the eye area. Leave on for 15 minutes. Rinse with warm water. Store this for 2-3 days in the refrigerator.

Cost: 36¢

Tip: To exfoliate flaky elbows, prepare both halves of the lemon as directed above. After you’ve used the yolk on your face, tuck an elbow in each half for five minutes, gently massage salt into the area, then rinse.

6. Sage Bath ‘Bacne’ Buster
When zits blossom on your back, wearing a bathing suit is embarrassing.

Sage is your go-to "bacne" buster. The herb’s antiseptic oil kills bacteria that cause acne; it also disinfects cuts, soothes skin irritations and controls excess oil secretion.

Ingredients
1 cup oatmeal
1/4 cup fresh or dried sage leaves
Muslin bag or cheesecloth square with a piece of string

Preparation
1. Fill the bag or place ingredients in the middle of the cheesecloth square.

2. Tie it closed with string and hang it under the faucet while warm bathwater fills the tub. (This softens oatmeal and releases the sage oils.)

3. Soak in the bath for 5-10 minutes, then remove the bag and gently press it against your back. Make a batch to store for up to 6 months.

Cost: $1.24

Tip: You can use this poultice to help control oil on the face or chest too.
7. Cool-as-a-Cuke Toner
Cucumber is a beauty classic. It cools and refreshes irritated skin and reduces mild swelling. It's also a great toner, gentle enough for all skin types.

Ingredients
1/2 cucumber (don’t peel) *
3 tablespoons distilled water
3 tablespoons witch hazel

Preparation
1. Put ingredients in the blender and pulse until smooth. Strain through cheesecloth to separate solid ingredients and pour the liquid into a container with a tight-fitting lid. Dab on to skin with a clean, soft cloth or cotton ball. Keep it in the fridge for up to 2 weeks.

*You can replace the cucumber with pomegranate juice. The fruit is a powerful antioxidant that slows down skin damage from sun or pollution and helps regenerate cells. It’s gentle enough for all skin types. If using pomegranate juice, simply pour all ingredients into a bottle or jar and shake well to combine.

Cost: 45¢ (with cucumber)

Tip: To soothe irritated or puffy eyes, cut two slices of cucumber, and lie down with a slice over each eye for five minutes.
Best-selling author and beauty expert Rona Berg has written two books: Beauty: The New Basics and Fast Beauty: 1,000 Quick Fixes (Workman). You can reach her at www.ronaberg.com.

THOUGHT FOR THE DAY...

If we keep our little flame alive, our first feeling of enthusiasm of who we are, without the influence or intervention of others, we will prevail.

FUN FACTS - AND A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT - AND - CHECK OUT " WWW.MELODY'SHAPPYWORLD.COM " FOR A FREE WAY TO BRING HAPPINESS, LOVE AND HOPE TO THE WORLD WE LIVE IN!!

* Microsoft made $16,005 in revenue in its first year of operation. *

* Duracell, the battery-maker, built parts of its new international headquarters using materials from its own waste. *

* Women have a better sense of smell than men *.

* The human brain has the capacity to store everything that you experience in life *.

* Sex burns about 360 calories per hour. *

* When you take a step, you are using up to 200 muscles. *
__________________________________________________________________________

* FOR A GREAT WAY TO MAKE EXTRA INCOME AND LOTS OF IT PLEASE GO TO WWW.GOKIVIA.COM - IT IS THE BEST COMPANY TO BE INVOLVED WITH AND THERE ARE FANTASTIC PRODUCTS AND THE BEST PEOPLE IN THE WORLD TO WORK WITH!! IT HAS THE BEST MARKETING PLAN THAT I'VE EVER SEEN AND YOU WILL BE VERY HAPPY!! WHAT A GREAT WAY TO MAKE MONEY AND SHOP FOR CHRISTMAS GIFTS AT THE SAME TIME!! I CAN'T BEGIN TO EXPLAIN HOW WONDERFUL THE PRODUCTS ARE, I'VE NEVER USED BETTER!! IF YOUR INTERESTED AND I HOPE YOU'LL TRY IT, CALL ME TO GET INVOLVED AT 310-326-3633 - Home - 310-986-7777 - Cell -, email: HereForYou@sbcglobal.net, THANK YOU AND BEST REGARDS, Catrina DeMicelli *
________________________________________________________________________

WWW.MELODYSHAPPYWORLD.COM - "True happiness is not looking back with regret, but looking forward to the future and creating your own exciting, magnificent destiny and masterpiece, YOUR LIFE!"


MELODY JENSEN IS THE MOST WONDERFUL PERSON AND THE GREATEST HUMANITARIAN I KNOW. CHECK OUT MELODY'S HAPPY WORLD, IT'S FREE!!


ASSOCIATIONS:
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1 in 6 Stent Patients Rehospitalized

A New York State study of 40,000 patients getting stents inserted to open up blocked arteries found that almost one in six of them were readmitted to the hospital within a month of the procedure, often for heart conditions and chest pain.

That's higher than the rehospitalization rate of one in 10 stent patients reported at a single Minnesota hospital in a study published last month.

Regardless of the exact number, those figures are troubling, researchers said.

"In general, all the studies have shown that readmission rates after (stent procedures) are higher than what we would expect. It points to a national problem in general regarding readmission after a hospitalization," said Dr. Adrian Hernandez, a cardiologist at the Duke University School of Medicine in Durham, North Carolina, who wasn't involved in the research.

Rehospitalizations are costly to patients and the healthcare system, and experts believe many may be preventable if heart patients are treated properly the first time around and sent home with the resources to keep them out of trouble.

The new study suggests that most of the factors that put patients at higher risk of readmission — such as being older, or having more underlying diseases — can't be changed by better care.

But researchers said that cardiologists treating those patients can be aware of their extra risks, and take special precautions to make sure that when they leave the hospital, it's for good.

Data for the new study came from just more than 40,000 stent procedures done on patients in New York in 2007. Within the 30 days after they were discharged from the hospital, about 16 percent of patients were readmitted. The majority of those were unplanned return trips, while in one-fifth of the cases doctors had planned a second procedure later in the month.

Patients were most often hospitalized again for heart disease, heart failure, or chest pain. One in every three readmissions resulted in a repeat of the stent procedure.

Researchers led by Edward Hannan of the University at Albany, State University of New York, found that being older or a woman, having underlying diseases like diabetes and kidney failure, and having a longer original procedure or one with complications were all linked to a higher chance of being rehospitalized.

"The majority of the factors are not modifiable. For instance, you can't change someone's age, you can't change someone's gender," Hernandez told Reuters Health.

But cardiologist Dr. Joseph Cacchione from the Cleveland Clinic, who wrote a commentary published with the study in JACC: Cardiovascular Interventions, said that knowing those risk factors is important for predicting — and preventing — repeat hospital stays.

For patients at risk, he said, "You could keep them a little longer (or) depending on the circumstances you could have more aggressive care coordination or home care."

Keeping a patient in the hospital for an extra day the first time around is much cheaper than readmitting them, and rehospitalization often comes with more intense and expensive procedures, Cacchione told Reuters Health.

Patients are also better off, and less likely to need further hospital stays, when they go home with all of their medications and an explanation of how to take care of themselves and what warning signs to be on the lookout for, researchers said.

Talking to your doctor on the phone a few days after the stent procedure and coming in for a check-up about a week later will also help ward off any problems serious enough to require readmission, Hernandez said.

But the goal is not to eliminate all return hospital trips — some patients will always have emergencies not related to the procedure, or complications that aren't totally preventable, which need to be treated in that setting.

"Not all readmissions are evil," Cacchione said. "Patients have to understand that occasionally the treatments that we do are not perfect and the way their bodies or them as individuals respond to them aren't perfect."

But, he said, "The majority of patients, when we send them home, shouldn't come back."

New Painkiller Alarms Addiction Experts

Drug companies are working to develop a pure, more powerful version of the nation's second most-abused medicine, which has addiction experts worried that it could spur a new wave of abuse.

The new pills contain the highly addictive painkiller hydrocodone, packing up to 10 times the amount of the drug as existing medications such as Vicodin. Four companies have begun patient testing, and one of them — Zogenix of San Diego — plans to apply early next year to begin marketing its product, Zohydro.

If approved, it would mark the first time patients could legally buy pure hydrocodone. Existing products combine the drug with nonaddictive painkillers such as acetaminophen.

Critics say they are especially worried about Zohydro, a timed-release drug meant for managing moderate to severe pain, because abusers could crush it to release an intense, immediate high.

"I have a big concern that this could be the next OxyContin," said April Rovero, president of the National Coalition Against Prescription Drug Abuse. "We just don't need this on the market."

OxyContin, introduced in 1995 by Purdue Pharma of Stamford, Conn., was designed to manage pain with a formula that dribbled one dose of oxycodone over many hours.

Abusers quickly discovered they could defeat the timed-release feature by crushing the pills. Purdue Pharma changed the formula to make OxyContin more tamper-resistant, but addicts have moved onto generic oxycodone and other drugs that do not have a timed-release feature.

Oxycodone is now the most abused medicine in the United States, with hydrocodone second, according to the Drug Enforcement Administration's annual count of drug seizures sent to police drug labs for analysis.

The latest drug tests come as more pharmaceutical companies are getting into the $10 billion-a-year legal market for powerful — and addictive — opiate narcotics.

"It's like the wild west," said Peter Jackson, co-founder of Advocates for the Reform of Prescription Opioids. "The whole supply-side system is set up to perpetuate this massive unloading of opioid narcotics on the American public."

The pharmaceutical firms say the new hydrocodone drugs give doctors another tool to try on patients in legitimate pain, part of a constant search for better painkillers to treat the aging U.S. population.

"Sometimes you circulate a patient between various opioids, and some may have a better effect than others," said Karsten Lindhardt, chief executive of Denmark-based Egalet, which is testing its own pure hydrocodone product.

The companies say a pure hydrocodone pill would avoid liver problems linked to high doses of acetaminophen, an ingredient in products like Vicodin. They also say patients will be more closely supervised because, by law, they will have to return to their doctors each time they need more pills. Prescriptions for the weaker, hydrocodone-acetaminophen products now on the market can be refilled up to five times.

Zogenix has completed three rounds of patient testing, and last week it announced it had held a final meeting with Food and Drug Administration officials to talk about its upcoming drug application. It plans to file the application in early 2012 and have Zohydro on the market by early 2013.

Purdue Pharma and Cephalon, a Frazer, Pa.-based unit of Israel-based Teva Pharmaceuticals, are conducting late-stage trials of their own hydrocodone drugs, according to documents filed with federal regulators. In May, Purdue Pharma received a patent applying extended-release technology to hydrocodone. Neither company would comment on its plans.

Meanwhile, Egalet has finished the most preliminary stages of testing aimed at determining the basic safety of a drug. The firm could have a product on the market as early as 2015 but wants to see how the other companies fare with the FDA before deciding whether to move forward, Lindhardt said.

Critics say they are troubled because of the dark side that has accompanied the boom in sales of narcotic painkillers: murders, pharmacy robberies, and millions of dollars lost by hospitals that must treat overdose victims.

Thousands of legitimate pain patients are becoming addicted to powerful prescription painkillers, they say, in addition to the thousands more who abuse the drugs.

Prescription painkillers led to the deaths of almost 15,000 people in 2008, more than triple the 4,000 deaths in 1999, the Centers for Disease Control and Prevention reported last month.

Emergency room visits related to hydrocodone abuse have shot from 19,221 in 2000 to 86,258 in 2009, according to data compiled by the Drug Enforcement Administration. In Florida alone, hydrocodone caused 910 deaths and contributed to 1,803 others between 2003 and 2007.

Hydrocodone belongs to family of drugs known as opiates or opioids because they are chemically similar to opium. They include morphine, heroin, oxycodone, codeine, methadone, and hydromorphone.

Opiates block pain but also unleash intense feelings of well-being and can create physical dependence. The withdrawal symptoms are also intense, with users complaining of cramps, diarrhea, muddled thinking, nausea, and vomiting.

After a while, opiates stop working, forcing users to take stronger doses or to try slightly different chemicals.

"You've got a person on your product for life, and a doctor's got a patient who's never going to miss an appointment, because if they did and they didn't get their prescription, they would feel very sick," said Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing. "It's a terrific business model, and that's what these companies want to get in on."

Under pressure from the government, Purdue Pharma last year debuted a new OxyContin pill formula that "squishes" instead of crumbling when someone tries to crush it.

But Zogenix, whose drug is time-released but crushable, says there is not enough evidence to show that such tamper-resistant reformulations thwart abuse.

"Provided sufficient effort, all formulations currently available can be overcome," Zogenix said in a written response to questions by The Associated Press.

At a conference for investors New York on Nov. 29, Zogenix chief executive Roger Hawley said the FDA was not pressuring Zogenix to put an abuse deterrent in Zohydro.

"We would certainly consider later launching an abuse-deterrent form, but right now we believe the priority of safer hydrocodone — that is, without acetaminophen — is a key priority for the FDA," Hawley said.

FDA spokeswoman Erica Jefferson said the agency would not comment on its discussions with drug companies, citing the need to protect trade secrets.

Drug control advocates say they're worried the U.S. government is too lax about controlling addictive pain medications. The United States consumes 99 percent of the world's hydrocodone and 83 percent of its oxycodone, according to a 2008 study by the International Narcotics Control Board.

One 41-year-old loophole in particular has fed the current problem with hydrocodone abuse, critics say. The federal Controlled Substances Act, passed in 1970, puts fewer controls on combination pills containing hydrocodone and another painkiller than it does on the equivalent oxycodone products.

A Vicodin prescription can be refilled five times, for example, while a Percocet prescription can only be filled once.

The Drug Enforcement Administration and Food and Drug Administration have been studying whether to close this loophole since 1999 but have made no decision. Congress is now considering a bill that would force the agencies to tighten the controls.

"This is a problem that is fundamentally an oversupply problem," said Jackson, the drug-control advocate. "The FDA has kind of opened the floodgates, and they refuse to recognize the mistakes made in the past."

Pure hydrocodone falls into the stricter drug-control category than hydrocodone-acetaminophen medications, meaning patients would have to go to their doctors for a new prescription each time they needed more pills. But Jackson said that's no guarantee against abuse, noting that dozens of unscrupulous doctors have been caught churning out prescriptions in so-called "pill mills."

The Drug Enforcement Administration, which enforces controls on medicines along with the FDA, said it could not comment on drugs that have not yet been approved for sale.

However, Zogenix has acknowledged the abuse issue could become a liability.

"Illicit use and abuse of hydrocodone is well documented," it said in a filing with the Securities and Exchange Commission in September. "Thus, the regulatory approval process and the marketing of Zohydro may generate public controversy that may adversely affect regulatory approval and market acceptance of Zohydro."