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About Circumcision Rates Too Low

"There's a good case to be made that circumcisions can protect our children," said study author Arleen A. Leibowitz, a professor of public policy at the University of California, Los Angeles. "If you can alleviate the cost of the procedure, then people are more likely to adopt it."

Circumcision rates have been dropping since the 1980s amid controversy about whether the procedure is necessary or desirable. More states, meanwhile, have stopped paying for the procedure through Medicaid, including 10 in this decade alone. If all states covered circumcision, the percentage of male babies who get the procedure would rise from 56 percent to 62 percent, Leibowitz estimated.

Critics say circumcision is brutal and robs males of sexual sensation, but many in the medical community point to research that suggests circumcision reduces the risk of sexually transmitted diseases such as AIDS and the virus that can cause cervical cancer.

Currently, 16 states don't cover circumcision through their Medicaid programs, according to the new study. The procedure for an infant can cost $250 to $300, Leibowitz said.

Circumcision rates among Latinos are especially low, even if the government pays for the procedure, Leibowitz said. She added that rates are about equal among whites and blacks.

The study authors looked at a national sample of 417,282 newborn boys from 2004. The researchers examined the statistics with an eye toward whether the states where the boys were born covered circumcision.

The findings were published in the January issue of the American Journal of Public Health.

According to Leibowitz, the states that don't cover the procedure are: Arizona, California, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, Utah and Washington.

The researchers adjusted the numbers to account for factors such as the number of days that infants spent in the hospital. According to Leibowitz, it's difficult to fit in a circumcision if the baby is just there for a day.

Even with the adjustments, circumcision rates were significantly lower in states that didn't pay for the procedure through Medicaid, she said, adding that "not covering it under Medicaid sends a signal to recipients that this not a valuable procedure."

Robert C. Bailey, a professor of epidemiology at the University of Illinois at Chicago, said the poor are robbed of a chance to make a choice about circumcision because of the lack of funding.

"It's another way in which our health system is increasing inequality across the population," he said. "People who can't afford good health care are essentially being discriminated against by this policy."

SOURCES: Arleen A. Leibowitz, Ph.D., professor, public policy, University of California, Los Angeles; Robert C. Bailey, Ph.D., professor, epidemiology, University of Illinois at Chicago; January 2009, American Journal of Public Health.

Info about CDC Warns of Drug-Resistant Flu Bug

Flu is a dangerous and sometimes deadly disease. But the Tamiflu-resistant strain isn't any more or less dangerous than other flu strains.

The Tamiflu-resistant virus is the flu bug most commonly seen so far this year. It's been detected in 12 states so far, mostly in Hawaii and Texas.

Tamiflu resistance wasn't unexpected. What was surprising was the rapid rise of Tamiflu resistance in this particular flu bug. Last year, about 11% of type A H1N1 flu bugs were resistant. So far this year, 49 out of 50 H1N1 viruses have been resistant.

Even so, it's still very early in the flu season. There's no way to know whether the Tamiflu-resistant flu bug will be this year's predominant cause of flu.

"There is no crystal ball here," CDC Director Julie Gerberding, MD, tells WebMD. "We can't predict if this strain will end up being the most important one this year. It could fizzle out. ... We're giving a 'heads-up' to the clinicians, but we are not making drastic changes in our treatment and prevention recommendations."

Three different flu bugs are in circulation among humans. The resistant bug is the type A H1N1 strain. There's also the type A H3N2 strain, and one type B strain.

The current flu vaccine protects against all three of these viruses -- and the current flu vaccine is an excellent match for the drug-resistant bug, Gerberding says.

Fortunately, the Tamiflu-resistant flu bug is still sensitive to Relenza, an alternative flu drug of the same basic type as Tamiflu. And the bug may also be sensitive to the older flu drugs Flumadine and Symmetrel, although resistance to these drugs has been steadily increasing among type A flu bugs.

Flu drugs can be used both to treat and to prevent the flu:

  • Treatment with flu drugs must begin no later than two days after symptoms appear. The earlier that treatment begins, the shorter and less severe the illness.
  • Prevention with flu drugs is used in households, hospitals, or facilities (such as nursing homes) where people have been exposed to someone who has the flu.

Tamiflu has been the most attractive treatment because it is taken in pill form and can be given to children as young as 1 year old.

Relenza comes in an inhaler. Children younger than 7 can't use it for treatment, and those younger than 5 can't use it for prevention. Moreover, Relenza sometimes causes lung spasms, so it can't be used by people with lung problems.

Ironically, the CDC's Tamiflu warning is not going to make a huge difference in how patients are treated because too few people get treated with flu drugs, says Joseph S. Bresee, MD, chief of the epidemiology and prevention branch of the CDC's flu division.

"Even among hospital patients with the flu, more than half do not receive antiviral therapy," Bresee tells WebMD. "[Tamiflu] and [Relenza] are relatively underused at this point."

Bresee suggests that the current warning might actually increase use of flu drugs by making doctors more aware of how to use them.

Here's what the CDC now recommends:

  • Doctors should keep track of the subtypes of flu virus circulating in their areas. The CDC offers weekly updates based on reports from local and state health agencies.
  • When testing patients for the flu, doctors should consider using tests that can tell type A flu from type B flu.
  • Use Tamiflu alone only if the main flu bugs in the area are type A H3N2 or type B.
  • If drug-resistant virus is circulating in the area, use Relenza. In patients unable to take Relenza, doctors may use a combination of Tamiflu and Flumadine (or Symmetrel if Flumadine isn't available).

But here's the best advice: It's not too late to get a flu shot (or sniff, via the inhaled FluMist vaccine). Flu season rarely peaks before February -- and lots of people come down with the flu as late as March or April. So if you've been putting off getting your flu shot, now is the time to act.

SOURCES: CDC Health Advisory, Dec. 19, 2008. Julie Gerberding, MD, MPH, director, CDC. Timothy M. Uyeki, MD, medical epidemiologist, influenza branch, CDC. Joseph S. Bresee, MD, chief of epidemiology and prevention, influenza branch, CDC.

Info Even a Little Overweight, Inactivity Hurts the Heart

Even a few extra pounds and just a little inactivity increased the risk of heart failure in a major study of American doctors.

"What this study shows is that even overweight men who are not obese have an increase in heart failure risk," said Dr. Satish Kenchaiah, lead author of a report on the finding in the Dec. 23 issue of Circulation.

As for exercise, "even a little amount of physical activity appears to decrease the risk of heart failure," said Kenchaiah, who did the research as a epidemiologist at Brigham and Women's Hospital in Boston and is now at the U.S. National Heart, Lung, and Blood Institute.

The study has followed more than 21,000 doctors for two decades, measuring among other factors the influence of overweight and physical activity on development of heart failure, the progressive loss of ability to pump blood, which is often a prelude to major coronary events.

Outright obesity, defined as a body-mass index of 30 or over, has long been known as a risk factor for heart failure. The new report concentrated on men who were borderline overweight, with a body-mass index of 25 to 29.9.

About 5 percent of the doctors were obese, and 40 percent were overweight, when the study began. Adjusting for other risk factors such as high blood pressure and high cholesterol, the study found a 49 percent increased incidence of heart failure in overweight men compared to those with a body-mass index of 25 or less. Incidence of heart failure was 180 percent for the obese men compared to the leaner ones.

It was the same story for physical activity. "Men who engaged in physical activity anywhere from one to three times a month had an 18 percent reduction in heart failure risk," Kenchaiah said. "For those who were active five to seven times a week, the reduction was 36 percent. The more you exercise, the more reduction you achieve."

The association of even minimal physical activity with reduced risk could be explained as an indicator of good habits in general, he said. "It is possible that they have a healthier lifestyle in general," Kenchaiah said.

The study found that doctors who rarely or never exercised were older, smoked cigarettes more often, and were more likely to have high blood pressure or diabetes.

"This new report reinforces what we've said in the past," said Dr. Gerald Fletcher, a preventive cardiologist at the Mayo Clinic in Jacksonville, Fla. "Not being obese but being overweight is definitely a risk factor for heart failure."

While Fletcher said he would have liked a more definitive indicator of physical activity -- the report described it as simply breaking a sweat -- he said the study showed again that "vigorous exercise makes the difference. The more you do, the better it is for you."

Two-thirds of Americans have excess body weight, and only about 30 percent exercise regularly, Kenchaiah said from medicinenet.com. About 660,000 new cases of heart failure are diagnosed each year in the United States, he said, and 80 percent of the men and 75 percent of the women aged 65 and older who are diagnosed with heart failure die within eight years.

SOURCES: Satish Kenchaiah, M.D., U.S. National Heart, Lung, and Blood Institute, Bethesda, Md.; Gerald Fletcher, M.D., preventive cardiologist, Mayo Clinic, Jacksonville, Fla.; Dec. 23, 2008, Circulation

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Info Phenols in Quality Olive Oil Suppress Breast Cancer Gene

Extra-virgin olive oil, which is produced by pressing olives without the use of heat or chemical treatments, contains phytochemicals that are otherwise lost in the refining process. The Spanish researchers separated extra-virgin olive oil into fractions and tested these against breast cancer cells in the lab. They found that all the fractions that contained major extra-virgin phytochemical polyphenols (lignans and secoiridoids) effectively inhibited the breast cancer gene HER2.

The study was published in current issue of BMC Cancer.

Spanish researchers have identified anti-cancer chemicals in extra-virgin olive oil that may help explain the apparent link between eating an olive oil-rich Mediterranean diet and a reduced risk of breast cancer.

Our findings reveal for the first time that all major complex phenols present in extra-virgin olive oil drastically suppress overexpression of the cancer gene HER2 in human breast cancer cells," Javier Menendez, of the Catalan Institute of Oncology, said in a BioMed Central news release.

While the study results offer new insights into how extra-virgin olive oil may help reduce HER2 breast cancer risk, the findings must be viewed with caution.

"The active phytochemicals [i.e. lignans and secoiridoids] exhibited tumoricidal effects against cultured breast cancer cells at concentrations that are unlikely to be achieved in real life by consuming olive oil," the researchers noted.

However, they also said their findings, "together with the fact that humans have safely been ingesting significant amounts of lignans and secoiridoids as long as they have been consuming olives and extra-virgin oil, strongly suggest that these polyphenols might provide an excellent and safe platform for the design of new anti-breast cancer drugs."

-- Robert Preidt

SOURCE: BioMed Central, news release, Dec. 17, 2008

Info Hot Fitness Trends for 2009

Today i read article from medicinenet.com The group is out with its top 10 fitness trends for the upcoming year, after surveying personal trainers, group fitness professionals, and lifestyle and weight management consultants.

For the second year in a row, boot camp-style workouts are predicted to be the top fitness trend for 2009. Boot camps, group classes that aim to strengthen large muscle groups with pushups, squats, and lunges, can burn up to 600 calories during one session.

Another trend? Getting more for the money, says ACE Chief Science Officer Cedric X. Bryant, PhD, in a news release. "The overarching theme for fitness in 2009 is getting more bang for the buck."

Bryant says, "Consumers will engage in workouts that provide multiple benefits due to time and economic limitations. We will also see continued trends from 2008 including boot-camp style workouts, technology-based workouts, out-of-the-box programming, and an increased interest in fitness for those who are over 50 years old."

Here's the ACE's top trend rundown:

  1. Boot camp-style fitness programs.
  2. Workout plans that are less expensive.
  3. Specialty classes like Zumba, Bollywood, Afro-Cuban, and ballroom dancing. These classes are set to rhythmic music and aim to increase cardiovascular fitness while folks have fun.
  4. The basics. Fitness professionals believe that people will want to return to basic fitness programs.
  5. Circuit training. Circuit training blends strength training and cardiovascular activity at different intensities. Another plus: gyms can set up their own circuit for members to follow.
  6. Kettlebell training. These iron weights, traditionally used in Russia, aim to develop whole body fitness and core strength.
  7. Boomer fitness. A focus on fitness led by people 50 and older.
  8. Technology-based fitness. Using high-tech gadgets like iPods to help keep workouts engaging, plus an increase in interactive fitness video games.
  9. Event or sports-specific exercises. A focus on the simple things, like basketball or volleyball games, or day bike rides.
  10. Mixing it up. Low-intensity cardio or weight training on one day, followed by a high-intensity workout on another day.

SOURCES: News release, American Council on Exercise.

Info about Diabetic Eye Disease Rates Soaring

Diabetic retinopathy, which is damage to the small blood vessels in the retina, is the leading cause of blindness among working-age adults in the United States. In 2004, about $500 million was spent on direct medical costs for diabetic retinopathy, according to background information in the study.

The number of Americans with diabetic retinopathy is expected to increase from 5.5 million to 16 million by the year 2050, according to a U.S. Centers for Disease Control and Prevention study.

"People with diabetes mellitus also have a higher prevalence of other eye diseases, such as cataracts and glaucoma, than the general population," the researchers wrote. medicinenet.com "Vision loss related to eye disease among people with diabetes is an important disability that threatens independence and can lead to depression, reduced mobility and reduced quality of life."

For their study, Dr. Jinan B Saaddine and colleagues analyzed data from the 2004 National Health Interview Survey and the U.S. Census Bureau to predict the number of Americans with diabetes who will have diabetic retinopathy, vision threatening diabetic retinopathy, glaucoma and cataracts in 2050, when the country's population is expected to be 402 million.

Along with the increase in diabetic retinopathy cases from 5.5 million to 16 million, the researchers also projected that:

  • The number of cases of vision threatening diabetic retinopathy will increase from 1.2 million to 3.4 million.
  • Among Americans 65 and older, the number of cases of diabetic retinopathy will rise from 2.5 million to 9.9 million, and the number of cases of vision threatening diabetic retinopathy will increase from 500,000 to 1.9 million.
  • Cataract cases among whites and blacks age 40 or older with diabetes will increase 235%.
  • Cataract cases among people age 75 and older with diabetes will increase 637% for black women and 677% for black men.
  • Glaucoma cases among Hispanics age 65 and older with diabetes will increase 12-fold.

"In summary, our projections have shown higher numbers than previously estimated for diabetic retinopathy, vision threatening diabetic retinopathy, cataracts, and glaucoma among Americans with diabetes. Efforts to prevent diabetes and to optimally manage diabetes and its complications are needed," the researchers concluded.

The study was published in the December issue of the journal Archives of Ophthalmology.

-- Robert Preidt

SOURCE: JAMA/Archives journals, news release, Dec. 8, 2008

Info Too Little Vitamin D Puts Heart at Risk

New Info Getting too little vitamin D may be an underappreciated heart disease risk factor that's actually easy to fix.

Researchers say a growing body of evidence suggests that vitamin D deficiency increases the risk of heart disease and is linked to other, well-known heart disease risk factors such as high blood pressure, obesity, and diabetes.

For example, several large studies have shown that people with low vitamin D levels were twice as likely to have a heart attack, stroke, or other heart-related event during follow-up, compared with those with higher vitamin D levels.

"Vitamin D deficiency is an unrecognized, emerging cardiovascular risk factor, which should be screened for and treated," says researcher James H. O'Keefe, MD, director of preventive cardiology at the Mid America Heart Institute in Kansas City, Mo., in a news release. "Vitamin D is easy to assess, and supplementation is simple, safe and inexpensive."

Most of the body's vitamin D requirements are met by the skin in response to sun exposure. Other less potent sources of vitamin D include foods such as salmon, sardines, cod liver oil, and vitamin D-fortified foods like milk and some cereals. Vitamin D can also be obtained through supplements.

Vitamin D Deficiency on the Rise

Vitamin D deficiency is traditionally associated with bone and muscle weakness, but in recent years a number of studies have shown that low levels of the vitamin may predispose the body to high blood pressure, congestive heart failure, and chronic blood vessel inflammation (associated with hardening of the arteries). It also alters hormone levels to increase insulin resistance, which raises the risk of diabetes.

In a review article published in the Journal of the American College of Cardiology, researchers surveyed recent studies on the link between vitamin D deficiency and heart disease to come up with practical advice on screening and treatment.

They concluded that vitamin D deficiency is much more common than previously thought, affecting up to half of adults and apparently healthy children in the U.S.

Researchers say higher rates of vitamin D deficiency may be due in part to people spending more time indoors and efforts to minimize sun exposure through the use of sunscreens. Sunscreen with a sun protection factor (SPF) of 15 blocks approximately 99% of vitamin D synthesis by the skin.

"We are outside less than we used to be, and older adults and people who are overweight or obese are less efficient at making vitamin D in response to sunlight," says O'Keefe. "A little bit of sunshine is a good thing, but the use of sunscreen to guard against skin cancer is important if you plan to be outside for more than 15 to 30 minutes of intense sunlight exposure."

Testing for Vitamin D Deficiency

Vitamin D levels can be measured with a blood test that looks at a specific form of vitamin D called 25-hydroxy vitamin D (25(OH)D). Vitamin D deficiency is defined as a blood 25(OH)D level below 20 ng/dL. Normal levels are considered to be above 30 ng/dL.

Researchers recommend 25(OH)D screening for those with known risk factors for vitamin D deficiency including:

  • Older age
  • Darkly pigmented skin
  • Reduced sun exposure due to seasonal variation or living far from the equator
  • Smoking
  • Obesity
  • Kidney or liver disease

The U.S. government's current recommended daily allowance (RDA) for vitamin D is 200 international units (IU) per day for individuals under age 50. For those between 50 and 70, 400 IU per day is recommended, and for those over age 70, the RDA is 600 IU. Most experts believe these doses are too low, and that somewhere between 1,000 and 2,000 IU of vitamin D per day is necessary to maintain adequate vitamin D levels. The safe upper limit of vitamin D consumption is 10,000 IU per day.

Vitamin D supplements are available in two different forms: Vitamin D2 and Vitamin D3. Although both appear effective in raising vitamin D blood levels, Vitamin D3 supplements appear to result in a longer-lasting boost.

Although there are no current guidelines for restoring and maintaining healthy vitamin D levels in people at risk for heart disease, for those who are vitamin D deficient, the researchers recommend initial treatment with 50,000 IU of vitamin D2or D3 once a week for eight to 12 weeks, followed by maintenance with one of the following strategies:

  • 50,000 IU vitamin D2or D3 every 2 weeks
  • 1,000 to 2,000 IU vitamin D3 daily
  • Sunlight exposure for 10 minutes for white patients (longer for people with increased skin pigmentation) between the hours of 10 a.m. and 3 p.m.

Once maintenance therapy has been initiated, rechecking 25(OH)D blood levels is recommended after three to six months of ongoing supplementation.

"Restoring vitamin D levels to normal is important in maintaining good musculoskeletal health, and it may also improve heart health and prognosis," says O'Keefe. "We need large, randomized, controlled trials to determine whether or not vitamin D supplementation can actually reduce future heart disease and deaths." from medicinenet.com

SOURCES: Lee, J. Journal of the American College of Cardiology, Dec. 9, 2008; vol 52: pp 1949-1956. News release, American College of Cardiology.

Info about Soft Plastic Toys Are Health Risk

A consumer watchdog group is urging parents to avoid buying soft plastic toys this holiday season because of a risk that the toys may contain toxic chemicals.

Toys containing the chemicals, called phthalates, can no longer be manufactured or imported after February 2009, according to a product safety law that passed Congress over the summer.

But the group says the Consumer Product Safety Commission is allowing the toy industry to circumvent the law. The agency wrote a letter last week telling manufacturers they can still sell their existing stocks of phthalate-containing toys even after the ban takes effect in February.

"They're giving the industry a loophole," says Liz Hitchcock, a public health advocate for the U.S. Public Interest Research Group (U.S. PIRG).

Phthalates are a group of chemicals used to soften vinyl and other plastics. Congress banned use of the chemicals in toys because of evidence they can have health effects including early puberty, reproductive defects, and lower sperm counts in boys.

U.S. PIRG offered the following tips for avoiding unsafe toys:

  • Don't buy soft toys made of "PVC" (polyvinyl chloride) plastic. Many of these contain phthalates and may not be labeled.
  • Avoid play cosmetics with xylene or toluene or phthalates.
  • Avoid cheap metal play jewelry, key chains, and similar products. Many of these products contain lead.
  • Avoid toys with small parts that can pose a choking hazard to young children. Bring along a toilet paper tube on your shopping trip. Any toys or parts that fit inside the tube are too small for children aged 3 and under.

The new law stands to increase the budget and personnel at the Consumer Product Safety Commission and give the agency tougher recall authority.

The agency's move on phthalates sparked angry reactions from several Democratic members of Congress, who accused the Bush Administration of avoiding the intent of the new law.

Julie Vallese, a Consumer Products Safety Commission spokeswoman, says that the agency was not trying to give toy makers a way out of meeting new rules on phthalates. She said the wording of the law sets new standards for phthalates but does not automatically ban their sale in toys.

"Where U.S. PIRG's criticism should be is on Congress. If they don't like the language that they used, Congress has the authority to fix it," Vallese tells WebMD.

Joan Lawrence, vice president for safety standards and regulatory affairs for the Toy Industry Association, defends the industry's safety record. "The industry has been massively inspecting and testing toys since last year and government has too," she says. "The fact is, there are just far fewer issues. There's strong science that says phthalates are safe as used in toys."

Lawrence is critical of advice to avoid purchasing soft plastic toys. "I don't know that that's helpful for parents," she says. "Many soft toys don't contain pthalates, so parents will be avoiding a lot of toys for no reason." medicinenet.com

SOURCES: Trouble in Toyland, the 23rd Annual Survey of Toy Safety, U.S. Public Interest Research Group. Nov. 25, 2008. Liz Hitchcock, public health advocate, U.S. PIRG. Sen. Barbara Boxer, D-Calif., letter to CPSC general counsel, Nov. 21, 2008. Julie Vallese, spokeswoman, Consumer Product Safety Commission. Joan Lawrence, vice president for safety standards and regulatory affairs, Toy Industry Association.

New Gout Drug Info

Today i read article about medicine Uloric should be the first new gout drug to be approved in over 40 years, an FDA expert panel recommends.

Currently, allopurinol (trade name, Zyloprim) is the only FDA-approved drug that prevents formation of the uric acid crystals that cause gout. However, side effects -- including potentially fatal reactions -- limit the amount of allopurinol that can be tolerated. Most gout patients do not receive fully effective doses of allopurinol.

In clinical trials sponsored by Takeda, Uloric's manufacturer, an 80-milligram dose of Uloric worked better than allopurinol; a 40-milligram dose worked at least as well as allopurinol.

Unlike allopurinol, very little Uloric is excreted through the urine, making Uloric safe for patients with kidney problems. Gout patients with impaired kidney function have to take very low doses of allopurinol, making the drug even less effective for these patients.

In 2005, the FDA refused to approve Uloric because there were slightly more deaths and heart problems in patients taking the drug than in patients taking allopurinol. As people with gout problems already are at higher risk of heart disease, the FDA issued an "approvable" letter, noting that Uloric could be approved if this safety question were addressed.

Takeda then performed a large new phase 3 clinical trial that enrolled more gout patients than the two previous phase 3 trials combined. The new study found no more deaths and no more heart problems in patients taking Uloric than in patients taking allopurinol.from .medicinenet.com

Based on the safety and efficacy data, the FDA panel recommended by a 12-0 vote that the FDA approve Uloric at both the 40-milligram and 80-milligram doses. Takeda suggests the higher dose is more effective in subjects with more severe gout.

Takeda has offered to continue studying Uloric after FDA approval. A phase 4 clinical trial would compare Uloric to allopurinol for the reduction of gout flare-ups.

And because drugs with the same mechanism of action as Uloric and allopurinol may affect theophylline bronchodilators, Takeda has agreed to conduct a postmarketing phase 1 study of Uloric's interactions with theophylline.

Gout occurs when blood levels of uric acid rise. At blood levels above 7 mg/dL -- and above 6 mg/dL in the extremities -- uric acid forms crystals that lodge in the joints and other body tissues. These crystal deposits provoke an immune response that results in extremely painful swelling and in inflammatory arthritis that can permanently destroy the joints.

About 1.4% of men and 0.6% of women have gout. But prevalence rises with age. After age 80, about 9% of men and 6% of women develop gout.

The body converts a chemical called xanthine into uric acid via an enzyme called xanthine oxidase or XO. Allopurine and Uloric each inhibit XO and prevent the formation of uric acid.

Allopurinol is approved in doses up to 800 milligrams. However, it's rarely dosed above 300 milligrams per day and is often ineffective. Allopurinol side effects include upset stomach, headache, diarrhea, and rash. Although rare, allopurinol hypersensitivity syndrome can develop. It's fatal 20% to 30% of the time.

The most common side effects seen in patients taking Uloric during clinical trials were upper respiratory tract infections, muscle and connective-tissue symptoms, and diarrhea. The drug was well tolerated, and these side effects did not increase over long-term use.

SOURCES: FDA, "Briefing Document for the Arthritis Advisory Committee Meeting, Uloric/febuxostat," Nov. 24, 2008. Takeda Pharmaceuticals North America Inc., "Briefing Document for Advisory Committee, Division of Anesthesia, Analgesia, and Rheumatology Products," Nov. 24, 2008.

Alternative to Fall Babies at Higher Risk for Asthma

When it comes to babies and asthma, timing is everything.

A new study shows that babies born four months before the peak of winter virus season are more likely to develop childhood asthma than babies born at any other time of year; that's because the timing increases the chance of a viral respiratory infection during infancy, which in turn increases the risk of childhood asthma. The date that winter virus season peaks can vary from year to year.

The study is published in American Journal of Respiratory and Critical Care Medicine.

Asthma is an increasingly important health concern. The prevalence of asthma increased 100% worldwide between 1985 and 2001, according to background information in the study. About 300 million people have asthma. Deaths from asthma are expected to increase 20% during the next decade.

Researchers looked at medical records of 95,310 children born between 1995 and 2000 and followed their health status until 2005. The children were all born in Tennessee and enrolled in the state's Medicaid program, called TennCare.

Scientists have known for some time that there is a link between infant viral respiratory infections and childhood asthma. However, they did not know whether viral respiratory infections cause asthma or whether the infections are simply a sign that a child is genetically predisposed to develop asthma. This study offers evidence that the former is true.

The researchers found that babies born four months prior to the peak of winter virus season had a 29% increased risk of developing childhood asthma compared to babies born one year before the winter virus peak.

Even armed with the new findings, preventing the infant respiratory infections that lead to childhood asthma is no easy task. It is hard to shield babies from such infections. About 70% of babies develop RSV (respiratory syncytial virus) during the first year of life.

However, the researchers argue that there may be a need for prevention strategies, such as vaccines, for babies at high risk for asthma.

"Prospective trials with antiviral strategies, including potential new vaccines targeting [respiratory viruses] in selected populations at risk should give us better understanding of the role of viral infections in early life in the causation of childhood asthma," writes Renato T. Stein, MD, PhD, of the Pontifícia Universidade Catolica in Porto Alegre, Brazil, in an editorial published with the study.

SOURCES: Wu, P. American Journal of Respiratory and Critical Care Medicine, 2008; vol 178: pp 1123-1129. News release, American Thoracic Society.

Info About Post-Workout Snack May Hamper Weight Loss

Today I read article from www.medicinenet.com about Elite athletes are advised to "fill the tank" with an energy bar or sports drink soon after a workout.

But for mere mortals -- folks who are simply trying to keep their weight in check or stave off heart disease -- adding calories right after burning them up could negate the benefits of the sweat, researchers say.

"If people are going to go out and exercise to benefit their health, they should not be eating back the calories immediately upon finishing, or within a couple of hours of finishing," said Barry S. Braun, director of the Energy Metabolism Laboratory at the University of Massachusetts Amherst. "In order to maintain the benefits, you need to be in this calorie deficit."

"Athletes are always advised to do exactly the opposite," he continued. "That's great for athletes, but for the other 99.9% of the world, that's probably the wrong thing."

Braun is co-author of two papers appearing in the Journal of Applied Physiology, Nutrition and Metabolism and one paper published in the Journal of Applied Physiology that detail the findings.

Ten young, overweight men and women participated in each experiment.

For the first study, volunteers were asked to walk on a treadmill for an hour a day, burning about 500 calories each time. Half of the group were given a high-calorie carbohydrate drink immediately after their workout while the other half abstained.

Exercise increased insulin efficiency by 40% in those who did not eat afterwards. But the benefit was completely wiped out for those who had a high-carb drink after sweating.

These results had the researchers wondering if the type of calorie would make any difference.

For the second study, volunteers cycled for 75 minutes. Immediately after exercising, half of the participants ate a meal high in carbohydrates while the other half ate a meal low in carbohydrates but containing the same number of calories.

The ability of insulin to clear sugar from the blood was greater among people who ate the low-carb meal, the researchers found.

"It seems as though giving people back carbohydrates blunts or diminishes this exercise benefit," Braun said.

The third study was all about timing. Participants were given identical meals before, immediately after or three hours after cycling for 75 minutes.

The effectiveness of insulin was about the same no matter what the time, the study revealed.

"That really didn't make a whole lot of difference, which surprised us," Braun stated. "What did seem to matter was whether you ate back calories, and whether those calories were mostly carbohydrates."

SOURCES: Barry S. Braun, Ph.D., associate professor, kinesiology, and director, Energy Metabolism Laboratory, University of Massachusetts, Amherst; Jim White, R.D., personal trainer, registered dietitian and national spokesman, American Dietetic Association, Virginia Beach, Va.; 2008 and December 2005 Journal of Applied Physiology; 2007 Journal of Applied Physiology, Nutrition and Metabolism

Diabetes: Aspirin Heart Perk Questioned Info

Taking low-dose aspirin may not prevent diabetes patients from experiencing heart "events," new research shows.

Those findings come from a new study published in The Journal of the American Medical Association and another study published last month in BMJ. Those two studies don't question the heart benefits of low-dose aspirin in people who already have heart disease. Instead, the new studies are about aspirin's effects on people with diabetes who have no history of heart disease.

The researchers aren't closing the door on aspirin for diabetes patients, but "the decision to prescribe aspirin should be made on an individual patient basis," states an editorial published in The Journal of the American Medical Association.

Aspirin, Diabetes, and Heart Disease

Diabetes makes heart disease more likely. So the two new studies tested whether taking low-dose aspirin helped prevent heart attacks and other cardiovascular events (strokes, death from heart disease, etc.) in diabetes patients without a history of heart disease.

One of the studies, published in The Journal of the American Medical Association, took place in Japan and included 2,539 adults with type 2 diabetes who typically stayed in the study for about four years.

The other study, published last month in BMJ's "Online First" edition, took place in Scotland and included 1,276 adults with type 1 or type 2 diabetes who were followed for about six years.

The studies were designed differently. The Japanese study didn't use a placebo, and half of the patients in the Scottish study also got antioxidant supplements.

But in both studies, the bottom line was the same: There was no sign that taking low-dose aspirin lessened the patients' odds of having their first cardiovascular event.

Still, that may not be the final word on the topic.

For instance, the Japanese study had fewer cardiovascular events than expected, which might have made it harder to trace aspirin's effects. And in the Scottish study, the researchers note that "small effects may be shown with larger trials continued for a longer time." from http://www.medicinenet.com/

Editorialists Weigh In

In BMJ, editorialist William Hiatt, MD, a professor of medicine at the University of Colorado Denver School of Medicine, writes that "although aspirin is cheap and universally available," it should only be prescribed for patients "with established symptomatic cardiovascular disease."

But in The Journal of the American Medical Association, editorialist Antonio Nicolucci, MD, of Italy's Consorzio Mario Negri Sud encourages doctors and diabetes patients to weigh the pros and cons of low-dose aspirin on a case-by-case basis until further research is available.

Information about Whole Grains Lower Risk of Heart Failure

today I read article about health about Keep eating whole grains and reduce your consumption of eggs and high-fat dairy food to improve your odds against suffering heart failure, a new long-term study shows.

The study, which looked at more than 14,000 people over 13 years, found that participants had a 7% lower risk of heart failure (HF) per one-serving increase in whole grain consumption. The risk increased by 8% per one-serving increase in high-fat dairy intake and by 23% per one-serving increase in egg consumption. Other food groups did not appear to directly affect risk of heart failure.

The findings were published in the November issue of the Journal of the American Dietetic Association.

"The totality of literature in this area suggests it would be prudent to recommend that those at high risk of HF increase their intake of whole grains and reduce intake of high-fat dairy and eggs, along with following other healthful dietary practices consistent with those recommended by the American Heart Association," article co-author Jennifer A. Nettleton, an assistant professor in the Division of Epidemiology and Disease Control at the University of Texas Health Sciences Center at Houston, said in an association news release.

-- Kevin McKeever

SOURCE: American Dietetic Association, news release, Oct. 27, 2008

Obama Wins: What It Means for Health Care info

Today i read article about election of Democrat Barack Obama ushers in a new administration that is all but certain to include some level of health care reform. Less clear is how extensive that reform will be and when it will come.

The Illinois senator has proposed sweeping changes in the health care system designed to provide health coverage to millions of uninsured Americans.

But experts tell WebMD that the current financial crisis makes sweeping change unlikely any time soon.

"I have no inside track, but I would bet that in this economic climate it is far more likely that changes will be phased in over time," says Karen Davis, president of the health policy and research group Commonwealth Fund.

University of Michigan health economist Thomas Buckmueller, PhD, agrees that the economic climate is likely to slow reform. "I am not extremely optimistic that major reform will happen, but this seems to be the best chance we have had in a long time."

Obama's Health Plan

Obama spoke often during the campaign about his mother's battle with ovarian cancer to illustrate his commitment to changing the health care system.

He told of her final days, spent battling insurance company bureaucrats who did not want to pay for her cancer treatments. "I know what it's like to see a loved one suffer, not just because they are sick, but because of a broken health care system," he said at a rally last week and at countless campaign stops before that.

His plan would extend health coverage by expanding existing private and public programs with the help of federal subsidies and mandates.

He has repeatedly claimed the reforms will lower the average family's health insurance premiums by about $2,500 a year.

These reforms include:

  • Requiring employers, except small businesses, to provide health insurance to their employees or contribute to the cost.
  • Requiring that all children have health insurance.
  • Expanding Medicaid and the State Children's Health Insurance Program (SCHIP).
  • Creating a National Health Insurance Exchange to pool risk and give people the choice of competing private or public health plans.

According to the Tax Policy Center, a nonpartisan tax analysis group, the president-elect's plan, if fully implemented, would reduce the number of uninsured Americans from a projected 67 million to 33 million over the next decade at a cost of $1.6 trillion.

Obama has said he would pay for his plan by rolling back President Bush's tax cuts on people making more than $250,000 a year and keeping the estate tax at 2009 levels, but he has not been more specific. He has not provided a timetable for seeking his proposed reforms and has not said if he would present a comprehensive health care reform package or try for incremental change.

Expansion Likely for State Children's Health Insurance Program

Experts interviewed by WebMD agreed that expansion of the children's insurance program SCHIP is likely to be the first of the proposed reforms to be considered.

Last December, Democrats in Congress lost a yearlong fight to boost federal spending that would have expanded the program after two separate vetoes by Bush.

The program will be up for congressional review next March, and experts say it will probably be the Obama administration's first chance to make good on a health care promise.

"SCHIP is one of the big success stories in health policy over the last 20 years," Buckmueller says. "It has succeeded in getting kids the preventive care they need to keep them out of the ERs."

Medicare Reform More Problematic

Many of Obama's other proposals -- from the expansion of Medicare to his National Health Insurance Exchange -- will be much harder to win support for, even with a largely friendly Congress behind him.

Buckmueller believes the best chance for major reform lies in seeking bipartisan support for his proposals.

He says a key reason for the failure of President Clinton's 1993 health care reform effort is that his administration did not reach across the isle. "Assuming that Obama has learned from the Clinton debacle, I think he would be wise to say, 'Here are the basic principles of my plan. You work out the details, get bipartisan support, and I'll sign it.'"

Health Spending 'Not Sustainable'

While sweeping reform may not come soon, experts contacted by WebMD agreed that the nation's broken health care system must be addressed and that this must happen sooner rather than later.

The statistics bear this out:

  • 45 million Americans have no health insurance.
  • 25 million more have health plans but are considered underinsured because their policies offer only minimal coverage, according to the Commonwealth Fund.
  • 42% of U.S. adults under age 65 are uninsured or underinsured, up from 33% in 2003.

Total spending on health care represented around 16% of the gross domestic product in 2007, and the Congressional Budget Office says spending will rise to a quarter of gross domestic product by 2025.

"We are not going to reduce health care spending," says former Congressional Budget Office Director Alice Rivlin, PhD, who is now a scholar with the Brookings Institution. "The best we can do is reduce the rate of health care spending growth. That should be the No. 1 priority of any health care reform."

If jobs are the next thing to go in the current economic crisis, as many economists are predicting, the number of American's without health insurance will quickly increase beyond projections.

"Something has to happen over the next few years, because the cost of doing nothing is too great," Rivlin says.

Davis echoes the thought. "We can't afford to stay on the path we are on with regard to total health spending," she says. "Employers can't afford it, the government can't afford it, and individuals can't afford it. It is just not sustainable."

SOURCES: Karen Davis, president, Commonwealth Fund. Thomas Buckmueller, PhD, professor of business economics and public policy, Ross School of Business, University of Michigan, Ann Arbor. Alice Rivlin, director, Greater Washington Research project, Brookings Institution. Tax Policy Center: "Presidential Candidates Tax Plans," Sept. 12, 2008. Congressional Budget Office, health care spending, 2007.

10 Lifestyle Tips for Cancer Prevention

Today i read article from medicinenet.com about Looking for ways to cut your risk of developing cancer? Here's a list of 10 diet and activity recommendations highlighted this week in Chicago at the annual meeting of the American Dietetic Association (ADA).

  • Be as lean as possible without becoming underweight.
  • Be physically active for at least 30 minutes every day.
  • Avoid sugary drinks, and limit consumption of high-calorie foods, especially those low in fiber and rich in fat or added sugar.
  • Eat more of a variety of vegetables, fruits, whole grains, and legumes (such as beans).
  • Limit consumption of red meats (including beef, pork, and lamb) and avoid processed meats.
  • If you drink alcohol, limit your daily intake to two drinks for men and one drink for women.
  • Limit consumption of salty foods and food processed with salt (sodium).
  • Don't use supplements to try to protect against cancer.
  • It's best for mothers to exclusively breastfeed their babies for up to six months and then add other liquids and foods.
  • After treatment, cancer survivors should follow the recommendations for cancer prevention.

Why These Cancer Recommendations?

Walter Willett, MD, DrPH, an epidemiology professor who leads the nutrition department the Harvard School of Public Health, was on the international team of scientists that wrote the recommendations.

At the ADA meeting, Willett said the first recommendation -- to be as lean as possible within the healthy weight range -- is "the most important, by far."

But there is one recommendation that Willett says may be a "mistake" -- the one about not taking supplements. Vitamin D supplements may lower risk of colorectal cancer and perhaps other cancers, notes Willett. He predicts that that recommendation will be a top priority for review.

How to Follow the Recommendations

Karen Collins, MS, RD, CDN, is the nutritional advisor for the American Institute for Cancer Research. She reviewed the recommendations before they were issued last year, and she joined Willett in talking to ADA members.

Collins provides these tips for each of the recommendations:

  • Be as lean as possible without becoming underweight: Don't just look at the scale; check your waist measurement as a crude measurement of your abdominal fat, Collins says. She recommends that men's waists be no larger than 37 inches and women's waists be 31.5 inches or less.
  • Be physically active for at least 30 minutes every day: You can break that into 10- to 15-minute blocks, and even more activity may be better, notes Collins.
  • Avoid sugary drinks and limit consumption of energy-dense foods: It's not that those foods directly cause cancer, but they could blow your calorie budget if you often overindulge, notes Collins, who suggests filling up on fruits, vegetables, and whole grains.
  • Eat more of a variety of vegetables, fruits, whole grains, and legumes such as beans: Go for a variety of colors (like deep greens of spinach, deep blues of blueberries, whites of onions and garlic, and so on). Most Americans, says Collins, are stuck in a rut of eating the same three vegetables over and over.
  • If consumed at all, limit alcoholic drinks to two for men and one for women per day: Watch your portion size; drinks are often poured liberally, notes Collins. Willett adds that the pros and cons of moderate drinking is something that women may particularly need to consider, weighing the heart benefits and increased breast cancer risk from drinking.
  • Limit red meats (beef, pork, lamb) and avoid processed meats: Limit red meats to 18 ounces per week, says Collins, who suggests using chicken, seafood, or legumes in place of red meat. Collins isn't saying to never eat red meat, just do so in moderation.
  • Limit consumption of salty foods and foods processed with sodium: Don't go over 2,400 milligrams per day, and use herbs and spices instead, says Collins. She adds that processed foods account for most sodium intake nowadays -- not salt you add when cooking or eating.
  • Don't use supplements to protect against cancer: It's not that supplements are bad -- they may be "valuable" apart from cancer prevention, but there isn't evidence that they protect against cancer, except for vitamin D, says Collins.
  • It's best for mothers to breastfeed babies exclusively for up to six months and then add other foods and liquids: Hospitals could encourage this more, Collins says.
  • After treatment, cancer survivors should follow the recommendations for cancer prevention. Survivors include people undergoing cancer treatment, as well as people who have finished their cancer treatment.

Making Cancer Prevention Simpler

Overwhelmed? Collins boiled the 10 recommendations down to these three:

  • Choose mostly plant foods. Limit red meat and avoid processed meat.
  • Be physically active every day in any way for 30 minutes or more.
  • Aim to be a healthy weight throughout life.

Keep in mind that these tips are about reducing -- but not eliminating -- cancer risk. Many factors, including genes and environmental factors, affect cancer risk; diet and exercise aren't the whole story, but they're within your power to change.

Doctor's Visit a Pain for Overweight Women Info

i read article from www.medicinenet.com Overweight women have a message for doctors and nurses: If you want us to feel good about coming to see you, treat us well.

That means having gowns that fit, armless chairs in the waiting room, and a respectful attitude - not a demeaning lecture, eight overweight women report in October's Journal of Advanced Nursing.

Those women live in western Texas, but overweight and obese women elsewhere can probably relate, note associate professor Emily Merrill, PhD, RN, FNP, of Texas Tech University's School of Nursing in Lubbock, Texas, and assistant professor Jane Grassley, PhD, RN, of the College of Nursing at Texas Women's University in Denton, Texas.

Merrill and Grassley interviewed the women at length about their experiences in the health care system. The women told stories of feeling dismissed by doctors and nurses, of literally not fitting in at doctors' offices, feeling stigmatized for their weight, and yet refusing to give up on their care.

Poor Treatment at Doctors' Offices

Those stories included a woman whose care was delayed as a nurse "was running around the office [saying], 'We need a bigger [blood pressure] cuff. She can't fit the other."

Another woman recalled that when she gave birth to her son, she weighed 215 pounds. She said she felt hurt when the doctor told her to "just relax and envision yourself on a beach like a big ol' whale beached."

Then there was the chiropractor who told a 230-pound woman seeking arthritis relief that "all you need to do is lose weight," without taking X-rays or completing the exam. The women also said they felt that they weren't believed when they said they had tried to lose weight.

It's not that all doctors and nurses were unwelcoming. In general, the women felt comfortable with their primary care doctors, but several said they dreaded going to see specialists for the first time.

The women indicated that they wouldn't give up on getting medical care. But other overweight women may not be so persistent in the face of discouraging experiences, according to the report.

Merrill and Grassley urge nurses to "use their influence ... to provide appropriate space, furniture, equipment, and supplies including examination gowns, blood pressure cuffs, examination tables, and adequate scales for weighing," and to understand how overweight women may feel about how they're treated.

How many of Doctors Prescribe Placebos

More than half of doctors offer fake prescriptions to make patients feel better and that's OK, most doctors say. This artcle source www.medicenenet.com you can get information.

The findings come from a survey of 679 internists and rheumatologists. Doctors in these specialties often see patients with chronic illnesses or chronic pains that are difficult, if not impossible, to cure. Sometimes fake medicine -- placebos -- make such patients feel better.

Fake drugs can have very real benefits. It's called the placebo effect. In clinical trials, many patients who receive placebos do better than real-world patients who get no treatment at all, notes study researcher Jon C. Tilburt, MD.

"Twenty to thirty percent of the benefit seen in rheumatism drug studies are due to the placebo effect. Real changes in health go along with the belief that patients will get better," Tilburt tells WebMD.

Tilburt and colleagues asked the doctors a series of questions, each a bit more blunt than the last:

  • If a clinical trial showed a sugar pill was better than no treatment for fibromyalgia, would you recommend sugar pills to fibromyalgia patients? Yes, 58% of the doctors said.
  • Do you ever actually recommend treatments primarily to enhance a patient's expectations? Yes, 80% of the doctors said.
  • In the last year, did you recommend a placebo treatment to a patient? Yes, 55% of the doctors said.

What did the doctors actually tell their patients? Over two-thirds of those who prescribed placebos told patients they were getting "medicine not typically used for your condition but which might benefit you."

Is it "appropriate" to fool patients this way? Yes, 62% of the doctors said.

"I don't think doctors have anything but the patients' best interest in mind when they give a placebo prescription," says Tilburt. "They are thinking about both the physical and psychological well-being of the patient."

The hard-to-accept truth is that doctors don't have proven treatments for many of the ills that plague their patients.

"With untreatable conditions or chronic conditions when we have run out of treatments, doctors are willing to try virtually anything -- if they are convinced it is safe -- to make the patient feel better, even if the mechanism is a psychological mechanism," Tilburt says.

Placebo Prescriptions: Right or Wrong?

Is it right for doctors to prescribe treatments they believe are not biochemically effective?

Here's the official policy of the American Medical Association:

  • Use of a placebo without the patient's knowledge may undermine trust, compromise the patient-physician relationship, and result in medical harm to the patient.
  • A placebo must not be given merely to mollify a difficult patient, because doing so serves the convenience of the physician more than it promotes the patient's welfare.
  • Physicians may use placebos for diagnosis or treatment only if the patient is informed of and agrees to its use.

That last point seems tricky. How can a fake drug work if a patient knows it is fake?

The AMA policy says doctors should explain to patients that they can better understand their condition if they try different medicines, including a placebo. If the patient agrees to this, the doctor does not have to identify which medicine is fake, nor does the doctor have to get the patient's specific consent before giving the patient the fake treatment.

There's nothing wrong with this approach, says medical ethicist Arthur Caplan, PhD, professor of bioethics at the University of Pennsylvania, Philadelphia.

"It is ethical to use treatments that are low risk and have few side effects if you can relieve people's symptoms," Caplan tells WebMD. "Placebos are especially useful in the treatment of the psychological aspects of disease. Most doctors will tell you they have used placebos."

But doctors do often prescribe placebos the wrong way. In today's world, a doctor can't write a prescription for a sugar pill. The doctor has to prescribe something -- and every active medicine carries some risk of side effects.

"What you can use as a placebo is complicated. I have seen people dispensing antibiotics as placebo for mothers who want something for their kids' flu," Caplan says. "Not only does this not help, but it does build up drug resistance and may have some serious side effects for the child."

Most doctors use relatively harmless drugs, such as baby aspirin, as placebos. Clearly, great care must be taken to ensure that the placebo drug's risk is less than the benefit of the hoped-for placebo effect.

"We know it is wrong when doctors give potentially harmful medicines in a manner that may not be warranted," Tilburt says. "If I think it will actually have only a placebo effect, I should not give a patient a sedative. The compulsion by doctors to benevolently promote patient expectations can play out in a way harmful to patients."

In the end, Tilburt suggests, the effectiveness of a placebo treatment may well hinge on the trust patients have in their doctors.

"Maybe it isn't about taking a pill at all," he says. "Maybe it is the relationship between the doctor and the patient that makes the real difference."

Tilburt, formerly with the bioethics department of the National Institutes of Health, is now assistant professor of medicine at the Mayo Clinic, Rochester, Minn. The study appears in the Oct. 24 online first edition of the journal BMJ.

SOURCES: Tilburt, J.C. BMJ, online first edition, Oct. 24, 2008. American Medical Association: "Placebo Use in Clinical Practice," policy H-140.869. Jon Tilburt, MD, assistant professor of medicine, Mayo Clinic, Rochester, Minn. Arthur Caplan, PhD, professor of bioethics, University of Pennsylvania, Philadelphia.

Go to Pain Management

What about pain management? How get info pain management? I read article From information that full him from the website www.medicinenet.co, this article so give basic information for you.

Introduction to pain management

Pain management can be simple or complex, depending on the cause of the pain. An example of pain that is typically less complex would be nerve root irritation from a herniated disc with pain radiating down the leg. This condition can often be alleviated with an epidural steroid injection and physical therapy. Sometimes, however, the pain does not go away. This can require a wide variety of skills and techniques to treat the pain. These skills and techniques include:

All of these skills and services are necessary because pain can involve many aspects of a person's daily life.

How is pain treatment guided?

The treatment of pain is guided by the history of the pain, its intensity, duration, aggravating and relieving conditions, and structures involved in causing the pain. In order for a structure to cause pain, it must have a nerve supply, be susceptible to injury, and stimulation of the structure should cause pain. The concept behind most interventional procedures for treating pain is that there is a specific structure in the body with nerves of sensation that is generating the pain. Pain management has a role in identifying the precise source of the problem and isolating the optimal treatment.

Fluoroscopy is an X-ray guided viewing method. Fluoroscopy is often used to assist the doctor in precisely locating the injection so that the medication reaches the appropriate spot and only the appropriate spot.

New Drug May Boost Weight Loss Efforts Info

I read information from www.medicinenet.com, An experimental diet drug may prove to be twice as effective as currently available weight loss medications if results from an early study are confirmed.

Researchers did not compare the drug tesofensine head-to-head with currently approved weight loss medications. But researcher Arne Astrup, MD, of the University of Copenhagen tells WebMD that the weight loss in the study was roughly double that reported in trials of these drugs.

Danish biopharmaceutical company Neurosearch A/S, which hopes to market tesofensine as a weight loss drug, paid for the study.

"Normally the drugs now on the market give you at best a weight loss of 5 kilograms (11 pounds) with diet and exercise," Astrup says. "In this study we doubled that weight loss."

Tesofensine Targets Appetite Centers

Astrup says the drug works on three different appetite regulatory centers of the brain -- the neurotransmitters noradrenaline, dopamine, and serotonin.

The phase II study, reported today in The Lancet, included 203 obese patients whose average weight was about 220 pounds.

All the participants were placed on a calorie-restricted diet and all were asked to increase their physical activity to between 30 minutes to an hour a day.

Participants were treated with either a placebo, 0.25 milligrams of tesofensine, 0.5 milligrams of the drug, or 1 milligram of the drug daily.

In all, 161 of the participants completed the six-month study, with average weight loss ranging from a low of around 5 pounds in the placebo group to 28 pounds among patients taking the highest dose of the tesofensine.

But patients on the highest dose of the experimental drug also showed significant increases in blood pressure.

Because of this, patients who participate in a planned phase III study of the drug will be treated with the 0.5 milligram dose, which rivaled the higher dose in terms of weight loss in the phase II trial but elicited only a slight increase in pressure over placebo.

A spokeswoman for Neurosearch A/S tells WebMD that the phase III trials are planned for both the U.S. and Europe. Assuming the trials are positive, the company hopes to have the drug on the market within four years.

Carier Job, Education May Buffer Against Dementia

The participants' memory and cognitive skills were tested, and their brains were scanned to look for changes and damage. They were then followed for an average of 14 months, during which time 21 of those with mild cognitive impairment developed Alzheimer's disease.

Among people with the same level of memory impairment, those with more education and more mentally demanding jobs had significantly fewer brain changes and damage than those with less education and less mentally demanding occupations.

It included 242 people with Alzheimer's, 72 with mild cognitive impairment, and 144 with no memory problems. People with mild cognitive impairment have memory problems beyond what's normal for their age but not the serious memory problems associated with Alzheimer's disease.

This was true in both those with Alzheimer's and those with mild cognitive impairment who developed Alzheimer's, which suggests the cognitive reserve is already in effect during the mild cognitive impairment that precedes Alzheimer's.

"The theory is that education and demanding jobs create a buffer against the effects of dementia in the brain, or a cognitive reserve," study author Dr. Valentina Garibotto, of the San Raffaele University and Scientific Institute and the National Institute of Neuroscience in Milan, said in an American Academy of Neurology news release.

"Their brains are able to compensate for the damage and allow them to maintain functioning in spite of damage. There are two possible explanations. The brain could be made stronger through education and occupational challenges. Or, genetic factors that enabled people to achieve higher education and occupational achievement might determine the amount of brain reserve. It isn't possible to determine which accounts for our findings," Garibotto said.

The study was published in the Oct. 21 issue of Neurology.

-- Robert Preidt

Two Deaths Spur Delta Crib Recall Information

Delta Enterprise Corp. of New York is recalling nearly 1.6 million drop side cribs after two babies suffocated when the cribs' drop side detached.

That news comes from the Consumer Product Safety Commission.

The Delta crib recall includes 985,000 cribs with Delta's "Crib Trigger Lock with Safety Peg" drop side hardware and about 600,000 cribs with Delta's "Crib Trigger Lock with Spring Peg" drop side hardware.

If you have a Delta crib, check the model number, which is located on top of the mattress support board.

Here are the model numbers for the recalled Delta cribs with the "Crib Trigger Lock with Safety Peg" drop side hardware, which were sold between 1995 and December 2005: 4320, 4340, 4500, 4520, 4530, 4532, 4540, 4542, 4550, 4551, 4580, 4600, 4620, 4624 (production dates 01/06 through 11/07), 4640, 4660, 4720, 4735, 4742, 4750 (production dates 01/95 through 12/00), 4760, 4770, 4780, 4790, 4820, 4840, 4850, 4860, 4880, 4890, 4892, 4900, 4910, 4920, 4925-2, 4925-6, 4930, 4940, 4943, 4944, 4947, 4948, 4949, 4950, 4958, 4963, 4968, 4969, and 4980.

Here are the model numbers for the recalled Delta cribs with the "Crib Trigger Lock with Spring Peg" drop side hardware, which were sold from January 2000 through January 2007: 4340, 4343, 4520, 4600, 4620, 4624, 4625, 4629, 4660, 4665, 4720, 4750, 4751, 4850, 4855, 4857, 4880, 4920, 4925-2, 4925-2B, 4925-6, 4980, and 8605.

None of the recalled cribs are currently in stores.

Free Delta Crib Repair Kits

Delta is providing free kits to repair the recalled cribs. For more information, call Delta's recall hotline at 800-816-5304 after 5 p.m. today or visit Delta's crib recall web site.

Meanwhile, the CPSC urges parents with the recalled cribs to find a safe, alternative sleep environment for their child.

Even if you don't have a recalled crib, the CPSC has these tips for parents:

  • Make sure to tighten the crib's hardware from time to time to keep the crib sturdy.
  • When using a drop side crib, make sure the drop side or any other moving part operates smoothly.
  • Always check all sides and corners of the crib for disengagement. Any disengagement can create a gap and entrap a child.
  • Don't try to repair any side of the crib, especially with tape, wire, or rope.

Menu from Spices, Herbs Boost Health for Diabetics

Spices may do more than flavor your food: New research suggests a shake of this and a pinch of that could also boost the health of diabetics.

Researchers bought 24 herbs and spices and found that many appear to have the power to inhibit tissue damage and inflammation brought on by high blood-sugar levels in the body.

The study didn't examine the direct effects of spices on diabetics. Also, spices are typically used in small amounts, making it unclear if those who eat them would get much benefit.

Still, "this gives people a tool to work with in terms of keeping their health as they want it to be," said study co-author James Hargrove, an associate professor at the University of Georgia.

Hargrove and his colleagues were intrigued by spices because they're rich in antioxidants, which are thought to protect cells from damage. "One can put a lot of antioxidant power into meals by using spices" without making people fatter, he said. "Because of the way they're prepared, herbs and spices tend to have low calorie contents."

In addition, spices are cheaper than many other food products, he said.

The researchers decided to look into the anti-inflammatory properties of spices. "We said, 'Let's just go to Wal-Mart, get all the McCormick brand spices we can find, and check those. That was as complicated as our study design was."

The findings appear in a recent issue of the Journal of Medicinal Food.

In laboratory tests, the researchers found that many of the spices and extracts appeared to inhibit a process known as glycation, which has been linked to inflammation and tissue damage in diabetics.

The spices that seemed most likely to help diabetics included cloves, cinnamon (previously pegged as a possible blood-sugar reducer), allspice, apple pie spice and pumpkin pie spice, Hargrove said. Top herbs included marjoram, sage and thyme.

Other spices and herbs were "still rich compared to other foods" when it comes to the effect, he said.

Lona Sandon, national spokesperson for the American Dietetic Association, said that while research does suggest that spices are high in antioxidants and may reduce blood-sugar levels, it's difficult to make recommendations about how much to use.

Even so, "I say add as much herbs and spices as your taste buds and tummy can take," she said. "They add flavor and fun to foods without adding calories or fat. Their potential for promoting health outweighs any risks, unless, of course, you have an allergy to a particular spice."

SOURCES: James Hargrove, Ph.D., associate professor, Department of Foods and Nutrition, The University of Georgia, Athens; Lona Sandon, ME.d., R.D., assistant professor, University of Texas Southwestern, Dallas, and national spokeswoman, American Dietetic Association, Dallas; June 2008, Journal of Medicinal Food

The Female Condom Will Circulate in Balikpapan Sumatra Indonesia

Balikpapan, on Saturday — the National Office of the Family Planning Co-ordination (K3BN) Balikpapan would menyosialisasikan the new contraception implement, femdom (female condom), the condom for the woman. "His plan would disosialisasikan in the Harapan Baru Valley compound (LHB) KM 17, the" headword "of" K3BN" Yusuf Wahab in Balikpapan, on Saturday (18/10). In 2008 K3BN budget for for the contraception implement like the spiral (IUD), the implant (implan), suntik, the pill, the condom, and femdom of Rp 200 million. "In the meantime, the budget" of the "whole, as paying the official and for the socialisation agenda, of Rp 4.2 billion," he revealed. Yusuf explained, for the number of socialisation whole of the use femdom, in fact the use figure of the condom in Balikpapan was still low.


From the use data in 2007, only 241 participants in prepared FAMILY PLANNING used the condom, the contraception implement that most of his users were suntik totalling 5,735 participants and the pill totalling 2,561 participants.


The socialisation target of the contraception implement not only to the fertile age couples, but also the commercial sex workers. "Because, apart from to prevent pregnancy, the contraception implement could also avoid the spread" of the "venereal disease," said Yusuf. Femdom that currently circulates in Balikpapan was the product from DKT Indonesia..


The condom have material the foundation of the latex was imported directly from India and had the foam or the sponge that was closed to absorb sperm. It was long that this condom 17 cm with the diameter 6,6-7 cm and to prevent nested him the illness, the same condom had the area of the elastic and flexible triangle.