The desire for plastic surgery, and in particular nose jobs, may be a tell tale sign of a mental illness called dysmorphic disorder (BDD), which is basically is an unnatural preoccupation with slight or imagined defects in appearance. A person with BDD historically tends to have cosmetic surgery, and even if the surgeries are successful, does not think they are and is unhappy with the outcomes.
A new study released this week demonstrates a high rate of body dysmorphic disorder relation, up to one in three among nose job patients. Previous studies have shown that about 10% of patients seeking plastic surgery suffer from the condition and thus an increase is now present.
David B. Sarwer, associate professor of psychology at the Center for Human Appearance at the Perelman School of Medicine at the University of Pennsylvania explains:
"We know body image dissatisfaction falls on a continuum, and there has to be some degree of dissatisfaction that leads us to see a plastic surgeon in the first place. It's when it begins to interfere with daily functioning. Patients with more severe BDD struggle to maintain social relationships and have difficulty getting to work or staying employed. Almost all of us will get up in the morning and look in the mirror and see something in our appearance we may not like or wish looked different. But for patients with B.D.D., that thought never leaves their mind. They are chronically thinking about their nose, checking in the mirror or a reflective surface, or they avoid situations where people can see their profile. You can see that is a distraction and can make it hard to focus on jobs or studies or family."
The published report is based on a study of 266 patients evaluated by plastic surgeons in Belgium over a 16 month period. The patients made appointments to discuss a rhinoplasty procedure and were given a questionnaire to assess their symptoms of body dysmorphic disorder. Among those seeking the procedure for strict medical reasons only 2% of patients exhibited symptoms of the disorder.
However on the flip side, among patients seeking to change their noses for cosmetic reasons only, 43% showed signs of the disorder, expressing an unreasonable preoccupation and distress about their bodies despite having noses that were relatively normal.
It is important to note that researchers found no relationship between the level of body dysmorphic disorder and the level of abnormality in the nose, meaning that the perception of a faulty nose shape or size matches a clinical poor self esteem issue.
Dr. Phillip Haeck, a Seattle plastic surgeon and president of the American Society of Plastic Surgeons speaks from his personal professional experience in the field:
"The biggest mistake is to offer to operate on them, because the chances that they will be satisfied afterward, no matter how good the shape of the nose may be, are very low. Often patients who have this can't stop looking at themselves. When I've encountered cases like this, I've found it difficult to make eye contact. They tend to stand in the mirror in the examination room and look at themselves throughout the exam."
Sunday, July 31, 2011
Stave Off Diabetes Insulin Resistance With Muscle Mass Training
It seems that hitting the gym and resistance training may not only keep you fit and looking smart, but also will lower your risk of type 2 diabetes. People who are overweight are more likely to have insulin resistance, because fat interferes with the body's ability to use insulin.
Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.
Researchers tapped into data from the National Health and Nutrition Examination Survey III on 13,644 adults who were not pregnant and had a body mass index (BMI) of at least 16.5. The researchers wanted to see how mass affects insulin resistance, a precursor to diabetes muscle.
For each 10% increase in the skeletal muscle index (ratio of muscle mass to total body weight), there is an 11% reduction in insulin resistance and a 12% reduction in prediabetes. Prediabetes is a condition in which a person's blood sugar is higher than normal, but not high enough to be diabetes. These relationships held even after the researchers took into account other factors affecting risk for insulin resistance and/or pre-diabetes.
Resistance exercise may also have a role in helping people with type 2 diabetes better use the insulin that they do produce.
Arun S. Karlamangla, PhD, MD, an associate professor of medicine in the division of geriatrics at the University of California, Los Angeles explains:
"It's not just weight that matters, but what proportion of your weight is muscle mass. If you start an exercise program, and don't lose weight, you should not give up hope because your fat is getting converted to muscle. If you lose fat, you gain muscle. So even if the weight is the same, the balance shifts. It's not too late if you already have type 2."
John Buse, MD, PhD, chief of endocrinology at the University of North Carolina, Chapel Hill, says that muscle is one of the major insulin-sensitive tissues in the body. Insulin is a hormone that helps your body regulate blood sugar (glucose) levels. Left unchecked, high glucose levels can wreak havoc on the body and cause many diabetes-related complications.
Buse says:
"The more muscle mass you have, the more glucose you can dispose of in response to insulin. Fitness trumps fatness. If you are a little heavy but fit you are probably well. If you are heavy and not fit, your risk of diabetes is higher."
Francesco Rubino, MD, chief of gastrointestinal metabolic surgery and director of the Diabetes Surgery Center at New York-Presbyterian in New York City adds that muscle mass can improve your metabolic efficiency and reduce risk of insulin resistance.
"The exercise that we always used to consider appropriate for reducing cardiovascular risk, aerobic exercise, may not be enough. Sedentary lifestyle also decreases muscle mass."
Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.
When you have type 2 diabetes, the body does not respond correctly to insulin. This is called insulin resistance. Insulin resistance means that fat, liver, and muscle cells do not respond normally to insulin. As a result blood sugar does not get into cells to be stored for energy.
Type 2 diabetes usually occurs gradually. Most people with the disease are overweight at the time of diagnosis. However, type 2 diabetes can also develop in those who are thin, especially the elderly.
Researchers tapped into data from the National Health and Nutrition Examination Survey III on 13,644 adults who were not pregnant and had a body mass index (BMI) of at least 16.5. The researchers wanted to see how mass affects insulin resistance, a precursor to diabetes muscle.
For each 10% increase in the skeletal muscle index (ratio of muscle mass to total body weight), there is an 11% reduction in insulin resistance and a 12% reduction in prediabetes. Prediabetes is a condition in which a person's blood sugar is higher than normal, but not high enough to be diabetes. These relationships held even after the researchers took into account other factors affecting risk for insulin resistance and/or pre-diabetes.
Resistance exercise may also have a role in helping people with type 2 diabetes better use the insulin that they do produce.
Arun S. Karlamangla, PhD, MD, an associate professor of medicine in the division of geriatrics at the University of California, Los Angeles explains:
"It's not just weight that matters, but what proportion of your weight is muscle mass. If you start an exercise program, and don't lose weight, you should not give up hope because your fat is getting converted to muscle. If you lose fat, you gain muscle. So even if the weight is the same, the balance shifts. It's not too late if you already have type 2."
John Buse, MD, PhD, chief of endocrinology at the University of North Carolina, Chapel Hill, says that muscle is one of the major insulin-sensitive tissues in the body. Insulin is a hormone that helps your body regulate blood sugar (glucose) levels. Left unchecked, high glucose levels can wreak havoc on the body and cause many diabetes-related complications.
Buse says:
"The more muscle mass you have, the more glucose you can dispose of in response to insulin. Fitness trumps fatness. If you are a little heavy but fit you are probably well. If you are heavy and not fit, your risk of diabetes is higher."
Francesco Rubino, MD, chief of gastrointestinal metabolic surgery and director of the Diabetes Surgery Center at New York-Presbyterian in New York City adds that muscle mass can improve your metabolic efficiency and reduce risk of insulin resistance.
"The exercise that we always used to consider appropriate for reducing cardiovascular risk, aerobic exercise, may not be enough. Sedentary lifestyle also decreases muscle mass."
Diabetes is caused by a problem in the way your body makes or uses insulin. Insulin is needed to move blood sugar (glucose) into cells, where it is stored and later used for energy.
When you have type 2 diabetes, the body does not respond correctly to insulin. This is called insulin resistance. Insulin resistance means that fat, liver, and muscle cells do not respond normally to insulin. As a result blood sugar does not get into cells to be stored for energy.
Universal Influenza Vaccine In Reach Targeting Key Common Proteins
Almost a quarter million people are hospitalized with the flu every year, and an estimated 3,000 to 49,000 die, making the flu one of the chief causes of preventable death in the USA. However, a universal flu vaccine that protects against all strains may be within reach in the next five years that will make yearly shots a thing of the past according to experts.
A traditional flu vaccine uses the external proteins on a flu virus (the H and N on strains such as H1N1 and H3N2) to prompt the body's immune system to create antibodies. These proteins, however, are different across different strains and they are liable to mutate, making immune responses from vaccines limited.
However, there are two proteins inside the flu virus that are much more similar across strains and less liable to change over time. Nucleoprotein and matrix protein 1 are more than 90% identical in all strains of influenza A.
Sarah Gilbert from the Jenner Institute in the United Kingdom explains:
"In the nucleoprotein is wrapped around the viral RNA, there's quite a lot of it in flu virus and infected cells. It's essential for the virus because, if it doesn't have the nucleoprotein, its genome isn't stable. It can't do without it and it can't change it very much because it has a particular function and, if it mutates, it won't work. Matrix protein 1 is a structural protein which is part of the inside of the shell around the virus."
If used widely a universal flu vaccine could prevent pandemics, such as the swine flu outbreaks of recent years, and end the need for a seasonal flu jab as mentioned.
Flu viruses mutate yearly, making annual vaccines obsolete after a flu season is over. Frank Collins, Director of the National Institutes of Health commented:
"There are parts of the viral coat that don't change. If you designed a vaccine to go after the constant part of the virus, you'd be protected against all strains. A few years ago such a vaccine seemed completely out of reach."
Adrian Hill, director of the Jenner Institute adds:
"The problem with flu is that you've got lots of different strains and they keep changing. Occasionally one comes out of wildfowl or pigs and we're not immune to it. We need new vaccines and we can't make them fast enough."
Scientists at the National Institute of Allergy and Infectious Diseases (NIAID) are working to develop a universal influenza vaccine, and report that in recent experiments with mice, ferrets and monkeys, researchers at NIAID's Vaccine Research Center used a two-step immunization approach to elicit antibodies that attacked a variety of influenza virus strains.
NIAID Director Anthony S. Fauci, M.D. concludes:
"Generating broadly neutralizing antibodies to multiple strains of influenza in animals through vaccination is an important milestone in the quest for a universal influenza vaccine. This significant advance lays the groundwork for the development of a vaccine to provide long-lasting protection against any strain of influenza. A durable and effective universal influenza vaccine would have enormous ramifications for the control of influenza, a disease that claims an estimated 250,000 to 500,000 lives annually, including an average of 36,000 in the United States."
A traditional flu vaccine uses the external proteins on a flu virus (the H and N on strains such as H1N1 and H3N2) to prompt the body's immune system to create antibodies. These proteins, however, are different across different strains and they are liable to mutate, making immune responses from vaccines limited.
However, there are two proteins inside the flu virus that are much more similar across strains and less liable to change over time. Nucleoprotein and matrix protein 1 are more than 90% identical in all strains of influenza A.
Sarah Gilbert from the Jenner Institute in the United Kingdom explains:
"In the nucleoprotein is wrapped around the viral RNA, there's quite a lot of it in flu virus and infected cells. It's essential for the virus because, if it doesn't have the nucleoprotein, its genome isn't stable. It can't do without it and it can't change it very much because it has a particular function and, if it mutates, it won't work. Matrix protein 1 is a structural protein which is part of the inside of the shell around the virus."
If used widely a universal flu vaccine could prevent pandemics, such as the swine flu outbreaks of recent years, and end the need for a seasonal flu jab as mentioned.
Flu viruses mutate yearly, making annual vaccines obsolete after a flu season is over. Frank Collins, Director of the National Institutes of Health commented:
"There are parts of the viral coat that don't change. If you designed a vaccine to go after the constant part of the virus, you'd be protected against all strains. A few years ago such a vaccine seemed completely out of reach."
Adrian Hill, director of the Jenner Institute adds:
"The problem with flu is that you've got lots of different strains and they keep changing. Occasionally one comes out of wildfowl or pigs and we're not immune to it. We need new vaccines and we can't make them fast enough."
Scientists at the National Institute of Allergy and Infectious Diseases (NIAID) are working to develop a universal influenza vaccine, and report that in recent experiments with mice, ferrets and monkeys, researchers at NIAID's Vaccine Research Center used a two-step immunization approach to elicit antibodies that attacked a variety of influenza virus strains.
NIAID Director Anthony S. Fauci, M.D. concludes:
"Generating broadly neutralizing antibodies to multiple strains of influenza in animals through vaccination is an important milestone in the quest for a universal influenza vaccine. This significant advance lays the groundwork for the development of a vaccine to provide long-lasting protection against any strain of influenza. A durable and effective universal influenza vaccine would have enormous ramifications for the control of influenza, a disease that claims an estimated 250,000 to 500,000 lives annually, including an average of 36,000 in the United States."
Smallest med school in U.S. to open with 8 students
A Kansas college hopes young doctors will be more willing to practice in small towns if they go to a medical school in a rural area. The University of Kansas will have what it says is the smallest four-year medical education site in the country when eight students begin taking classes on Monday on a satellite campus in Salina, Kansas. The move is in response to a shortage of rural doctors in the United States.
"By training physicians in a nonmetropolitan area, we are showing young medical students that life can be good, and practice can be stimulating, outside of the big city," said Dr. William Cathcart-Rake, the physician who directs the University of Kansas School of Medicine-Salina.
Students will get some course work via tele-video and podcasts from the school's other campuses, but they will also train through visits to doctors' offices in small communities and at the hospital in Salina, school officials said.
"It's a bold and innovative move," said Dr. Roland Goertz, president of the American Academy of Family Physicians. He said students at rural clinics will be exposed to a potential medical career they wouldn't see in urban hospital settings.
Cathcart-Rake said six of the eight students being taught at Salina, as part of their scholarships, have committed to practicing in a rural area. Seven of the eight students are from rural areas to begin with, he said.
"They see the value of living in wide open spaces and going back to where their friends are," Cathcart-Rake said. Attending medical school in a place such as Salina reduces chances they will change their minds, which could happen if they went to a big-city school, he said.
Salina, with 46,000 residents, is about 175 miles west of the Kansas City metropolitan region where the university's main medical school is located.
Small-town America has become increasingly under-served by doctors. About 21 percent of U.S. residents live in rural regions but only about 10 percent of physicians practice there, according to data cited by the family physicians group.
In Kansas, 12 counties don't have a full-time doctor at all, said Barbara Atkinson, executive dean of the University of Kansas School of Medicine.
Several factors are often cited for a shortage of rural doctors.
Rural doctors tend to be paid less, partly because they are more likely to treat patients on Medicare and Medicaid, which reimburses at rates below standard insurance. General practitioners make up the largest share of rural doctors, but until recent years fewer medical students were going into general medicine, putting a strain on rural care.
Older doctors who practice in small towns and retire are sometimes not replaced because younger doctors may prefer the greater cultural amenities urban regions tend to offer.
Recent changes in federal healthcare laws are intended to make rural practice more acceptable to doctors. Doctors who practice in certain underserved areas will get bonuses beyond the 10 percent boost in Medicare reimbursements they were already receiving, Goertz said.
He said another reason why there are fewer rural doctors is that the large majority of medical students come from urban areas, where medical schools are usually located, making them less like to consider rural medicine.
"You tend to gravitate to where you grew up," Goertz said.
Cathcart-Rake is optimistic that the Salina medical school will be a success and that in future years admissions may grow from eight to 12 students.
"By training physicians in a nonmetropolitan area, we are showing young medical students that life can be good, and practice can be stimulating, outside of the big city," said Dr. William Cathcart-Rake, the physician who directs the University of Kansas School of Medicine-Salina.
Students will get some course work via tele-video and podcasts from the school's other campuses, but they will also train through visits to doctors' offices in small communities and at the hospital in Salina, school officials said.
"It's a bold and innovative move," said Dr. Roland Goertz, president of the American Academy of Family Physicians. He said students at rural clinics will be exposed to a potential medical career they wouldn't see in urban hospital settings.
Cathcart-Rake said six of the eight students being taught at Salina, as part of their scholarships, have committed to practicing in a rural area. Seven of the eight students are from rural areas to begin with, he said.
"They see the value of living in wide open spaces and going back to where their friends are," Cathcart-Rake said. Attending medical school in a place such as Salina reduces chances they will change their minds, which could happen if they went to a big-city school, he said.
Salina, with 46,000 residents, is about 175 miles west of the Kansas City metropolitan region where the university's main medical school is located.
Small-town America has become increasingly under-served by doctors. About 21 percent of U.S. residents live in rural regions but only about 10 percent of physicians practice there, according to data cited by the family physicians group.
In Kansas, 12 counties don't have a full-time doctor at all, said Barbara Atkinson, executive dean of the University of Kansas School of Medicine.
Several factors are often cited for a shortage of rural doctors.
Rural doctors tend to be paid less, partly because they are more likely to treat patients on Medicare and Medicaid, which reimburses at rates below standard insurance. General practitioners make up the largest share of rural doctors, but until recent years fewer medical students were going into general medicine, putting a strain on rural care.
Older doctors who practice in small towns and retire are sometimes not replaced because younger doctors may prefer the greater cultural amenities urban regions tend to offer.
Recent changes in federal healthcare laws are intended to make rural practice more acceptable to doctors. Doctors who practice in certain underserved areas will get bonuses beyond the 10 percent boost in Medicare reimbursements they were already receiving, Goertz said.
He said another reason why there are fewer rural doctors is that the large majority of medical students come from urban areas, where medical schools are usually located, making them less like to consider rural medicine.
"You tend to gravitate to where you grew up," Goertz said.
Cathcart-Rake is optimistic that the Salina medical school will be a success and that in future years admissions may grow from eight to 12 students.
Gene Variant Associated With Asthma Risk in Blacks
A gene variant associated with asthma in black Americans has been pinpointed by a team of researchers working together in a new national collaboration called the EVE Consortium.
The PYHIN1 gene variant was not present in European Americans and may be the first asthma susceptibility gene variant to be identified in black Americans.
The researchers' analysis of data from nine independent research groups also confirmed findings published last year that linked four other gene variants with increased asthma risk across all ethnicities.
The new study
offers a promising first step in efforts to determine the genetic causes of asthma, according to the researchers.
"We now have a really good handle on at least five genes that anyone would be comfortable saying are asthma risk loci," senior author Carole Ober, co-chair of the EVE Consortium and a professor of human genetics and obstetrics/gynecology at the University of Chicago, said in a news release from the university's medical center. "I think it's an exciting time in asthma genetics."
Asthma rates in the United States have been rising in recent years, with the greatest increase among black Americans, according to Dr. Susan B. Shurin, acting director of the National Heart, Lung, and Blood Institute.
"Understanding these genetic links is an important first step towards our goal of relieving the increased burden of asthma in this population," she said.
See how walk-in baths can prevent age related injuries
No matter what kind of medications you take for joint pain or arthritis, one of the ways to help manage the pain and discomfort has been around for centuries: a soak in a nice, hot tub.
Research has shown it works wonders for all kinds of musculoskeletal complaints, including fibromyalgia, arthritis and lower back pain. Submersing yourself in a warm bath soothes sore joints by reducing the force of gravity, offering support for sore limbs, increasing circulation and decreasing inflammation.
Unfortunately, depending on your medical condition, getting in and out of a tub in your house can not only be challenging, but dangerous. You may fear using the bathroom, especially when it comes to getting in the bath, slipping or falling, and not having the strength to get yourself out of the bath once you are in.
No matter what size tub or shower you currently have, it can be replaced by a Premier Care walk-in bath. A walk-in bath allows people with strength or mobility issues to bathe in a safe, easy access tub with a contoured seat for comfort and the ability to bathe alone or with an assistant.
Premier Care has been helping customers for 25 years with bathtubs produced to the highest safety and quality standards to ensure comfort, safety and independence. Premier will assess your bathroom and your mobility needs to find the right walk-in bathtub for your home. They will install your new tub and leave your bathroom in perfect condition.
No matter the size of your bathroom, if you're looking to add to your home to accommodate an elderly parent or relative, Premier Care has options to fit your space constraints.
Research has shown it works wonders for all kinds of musculoskeletal complaints, including fibromyalgia, arthritis and lower back pain. Submersing yourself in a warm bath soothes sore joints by reducing the force of gravity, offering support for sore limbs, increasing circulation and decreasing inflammation.
Unfortunately, depending on your medical condition, getting in and out of a tub in your house can not only be challenging, but dangerous. You may fear using the bathroom, especially when it comes to getting in the bath, slipping or falling, and not having the strength to get yourself out of the bath once you are in.
No matter what size tub or shower you currently have, it can be replaced by a Premier Care walk-in bath. A walk-in bath allows people with strength or mobility issues to bathe in a safe, easy access tub with a contoured seat for comfort and the ability to bathe alone or with an assistant.
Premier Care has been helping customers for 25 years with bathtubs produced to the highest safety and quality standards to ensure comfort, safety and independence. Premier will assess your bathroom and your mobility needs to find the right walk-in bathtub for your home. They will install your new tub and leave your bathroom in perfect condition.
No matter the size of your bathroom, if you're looking to add to your home to accommodate an elderly parent or relative, Premier Care has options to fit your space constraints.
Sleep research leads to a simple snoring solution
Do you feel tired all day, even if you slept a full 8 hours? Do you suffer from unexplained headaches, high blood pressure, cardiac problems and excessive daytime sleepiness? Believe it or not, all your problems could stem from snoring.
Snoring is more than just bothersome, it can be hazardous to your health. That's because snoring is the most common symptom of obstructive sleep apnea (OSA), a condition that literally causes you to stop breathing a multitude of times at night. And you often aren't even aware it's happening.
People suffering from OSA stop breathing at night when their jaw, throat and tongue muscles relax, which causes the airway to become obstructed. Snoring is a symptom that the obstruction is occurring. OSA has been linked to a host of health problems, including:
Heart attack
High blood pressure
Heart disease
Stroke
Depression
Diabetes
Diagnosing and treating OSA can be a costly affair. A full sleep study to diagnose the problem can cost up to $5,000 or more, must be done at a certified sleep center and involves an overnight stay. Prescribed treatments may include losing weight, wearing a costly and uncomfortable continuous positive airway pressure (CPAP) device that forces air through your nose and mouth to keep your airways open, or even surgery.
The My Snoring Solution chinstrap can help for just $119.97
There is a more cost-effective, simpler alternative. Recent studies have shown that wearing a jaw supporter while sleeping can effectively treat snoring and sleep apnea. Recently, a clinical trial conducted at the Kochi Hospital in Japan demonstrated how a chinstrap alone improved obstructive sleep apnea and snoring. A strap can reposition the jaw and tongue, preventing obstruction from occurring.
The news comes as no surprise to Stephen Matthews, inventor of the My Snoring Solution chinstrap. Matthews himself suffered from OSA until a flash of inspiration prompted him to wear a makeshift chinstrap to sleep. Years later, the My Snoring Solution chinstrap has helped thousands of wearers relieve snoring symptoms, sleep better and feel healthier.
Snoring is more than just bothersome, it can be hazardous to your health. That's because snoring is the most common symptom of obstructive sleep apnea (OSA), a condition that literally causes you to stop breathing a multitude of times at night. And you often aren't even aware it's happening.
People suffering from OSA stop breathing at night when their jaw, throat and tongue muscles relax, which causes the airway to become obstructed. Snoring is a symptom that the obstruction is occurring. OSA has been linked to a host of health problems, including:
Heart attack
High blood pressure
Heart disease
Stroke
Depression
Diabetes
Diagnosing and treating OSA can be a costly affair. A full sleep study to diagnose the problem can cost up to $5,000 or more, must be done at a certified sleep center and involves an overnight stay. Prescribed treatments may include losing weight, wearing a costly and uncomfortable continuous positive airway pressure (CPAP) device that forces air through your nose and mouth to keep your airways open, or even surgery.
The My Snoring Solution chinstrap can help for just $119.97
There is a more cost-effective, simpler alternative. Recent studies have shown that wearing a jaw supporter while sleeping can effectively treat snoring and sleep apnea. Recently, a clinical trial conducted at the Kochi Hospital in Japan demonstrated how a chinstrap alone improved obstructive sleep apnea and snoring. A strap can reposition the jaw and tongue, preventing obstruction from occurring.
The news comes as no surprise to Stephen Matthews, inventor of the My Snoring Solution chinstrap. Matthews himself suffered from OSA until a flash of inspiration prompted him to wear a makeshift chinstrap to sleep. Years later, the My Snoring Solution chinstrap has helped thousands of wearers relieve snoring symptoms, sleep better and feel healthier.
The Asian secret to strong, lush hair
If you think the art of luxurious hair comes from the world's top fashion cities like Paris and Milan, you're incorrect. You might be surprised to discover the best methods for adding volume, thickness and shine come from Asian cities like Tokyo, Hong Kong and Seoul.
Why might this be? The Asian obsession with luxurious hair might be attributed to the average Asian hair strand being 5 times thicker than the average Western strand. With thicker hair, there is higher demand for products that provide fluid movement and manageability.
Beautiful hair without the salon expense
One system of hair products that is renowned in Asia and is being touted by American celebrities is OOKISA . This line of products blends proven ingredients into special, highly effective formulas. Key Asian botanicals create hair like you've never experienced before. Here is a sample of the key natural ingredients:
Kaou (White Peony Tea) - soothes and conditions the scalp.
Yuzu (Japanese Citrus Extract) - promotes lasting shine and radiance.
Tsubaki (Camellia Oil) - legendary for advanced moisturizing and fortifying with increased length and volume.
Niiro Cha (Rooibos Red Tea) - Middle Asian tea leaf stimulates circulation to scalp and hair follicles for enhanced brilliance.
Yuri (Water Lily) - centuries-old Asian remedy calms and soothes the scalp, especially with irritation due to hair styling products.
Unique 3-dimensional approach
1) Fortifying shampoo powerfully cleans away clogging residue from hair styling products and nourishes each hair strand, follicle and cuticle so that thick hair can emerge.
2) Replenishing conditioner helps repair dried, frayed and thinning hair by restoring hair strand flexibility, elasticity and essential protein content.
3) Nighttime Follicle Renewing Serum is a specialized serum that you put on your hair and leave in overnight. While you sleep, key nutrients help anchor hair to the scalp to prevent thinning and splitting, while revitalizing hair's youthful body and bounce.
Why might this be? The Asian obsession with luxurious hair might be attributed to the average Asian hair strand being 5 times thicker than the average Western strand. With thicker hair, there is higher demand for products that provide fluid movement and manageability.
Beautiful hair without the salon expense
One system of hair products that is renowned in Asia and is being touted by American celebrities is OOKISA . This line of products blends proven ingredients into special, highly effective formulas. Key Asian botanicals create hair like you've never experienced before. Here is a sample of the key natural ingredients:
Kaou (White Peony Tea) - soothes and conditions the scalp.
Yuzu (Japanese Citrus Extract) - promotes lasting shine and radiance.
Tsubaki (Camellia Oil) - legendary for advanced moisturizing and fortifying with increased length and volume.
Niiro Cha (Rooibos Red Tea) - Middle Asian tea leaf stimulates circulation to scalp and hair follicles for enhanced brilliance.
Yuri (Water Lily) - centuries-old Asian remedy calms and soothes the scalp, especially with irritation due to hair styling products.
Unique 3-dimensional approach
1) Fortifying shampoo powerfully cleans away clogging residue from hair styling products and nourishes each hair strand, follicle and cuticle so that thick hair can emerge.
2) Replenishing conditioner helps repair dried, frayed and thinning hair by restoring hair strand flexibility, elasticity and essential protein content.
3) Nighttime Follicle Renewing Serum is a specialized serum that you put on your hair and leave in overnight. While you sleep, key nutrients help anchor hair to the scalp to prevent thinning and splitting, while revitalizing hair's youthful body and bounce.
Talk frankly with aging parents about health care
It's 3 a.m., and your phone startles you out of a sound sleep.
Your 70-year-old mother has suffered a stroke. You rush to her house nearby to take her to the hospital.
But you're not prepared. She's incoherent. You forget the name of her primary care doctor and don't know what medications she's taking.
This may be an all-too-common scenario, as adult children struggle to take care of aging parents, and sometimes grandparents, and their often- complex medical needs.
Being a caregiver, even if it's only part time or for emergencies, is challenging. When do you step in? How do you offer advice without being bossy? What can you do to help prevent emergencies? How do you best handle them when they happen?
"Preparing in advance really helps because it helps you to stay calm," said Tamara Wolske, director of the Center for Aging and Community at the University of Indianapolis. "The more you prepare, the easier it will be to make things simple for yourself and your loved one in a crisis."
Two years ago, Steve Carley's aging mother didn't share with him that she wasn't feeling well. Sara Carley, then 94, ended up in the hospital and rehab for a couple of weeks and then a nursing home -- which none of them wanted.
The answer for them was hiring a caregiver with Home Instead Senior Care, a national firm that provides services to seniors to help them remain home.
A caregiver comes every morning and returns in late afternoon. The caregiver cooks, cleans, handles personal care and makes sure Sara Carley takes her medications, which Steve's brother sets out weekly. The caregiver logs the elderly woman's daily activities and physical condition and keeps her medical information up to date.
"It has worked very well for us," Steve said. "If she has a medical problem, they alert my brother and I, and we get her care."
The Carleys were able to find a solution, but ideally it is best to have regular, frank conversations with a parent about medical issues before an emergency occurs.
Adult children should be aware of key medical information and know how to access it quickly. They need to have a list of the parent's prescriptions, allergies, physicians and contact information and the parent's pharmacy.
"A lot of the information is very critical to their immediate care," said Georgette Smith, franchise owner of Home Instead Senior Care.
The challenge, says Christopher Callahan, director of the Indiana University Center for Aging and Research, is keeping information updated because medications and health-care providers, for example, change frequently.
Key information, such as medications and doctors' names, can be kept on the refrigerator door or the back of the front door -- where ambulance personnel can easily see it. Adult children should collect the information from parents.
Callahan suggests asking them broad questions about their goals of care, such as if they would undergo certain emergency procedures, and their advance directives in case of life-threatening conditions.
The right time to broach medical issues varies, depending on the aging parent's health.
"We usually say when the child reaches age 40 or the parent reaches 70, whichever one happens first, that's a good time to talk about what the senior's wishes are and to get an emergency kit in place," Smith said. If a senior is in poor health, she said, it could be done when he or she is in his or her 50s or 60s.
Seniors are usually willing to share such information, but not always.
Callahan advises that adult children say they need to know family medical history so they can get cancer screenings. Then they can ease into conversations about the parent's medical issues.
Adult children also need to make clear they're asking questions and collecting information because they care about their parents' well-being and want to handle emergencies well and try to prevent them.
The tone, though, needs to be conversational, says Wolske. It shouldn't sound like an interrogation.
Your 70-year-old mother has suffered a stroke. You rush to her house nearby to take her to the hospital.
But you're not prepared. She's incoherent. You forget the name of her primary care doctor and don't know what medications she's taking.
This may be an all-too-common scenario, as adult children struggle to take care of aging parents, and sometimes grandparents, and their often- complex medical needs.
Being a caregiver, even if it's only part time or for emergencies, is challenging. When do you step in? How do you offer advice without being bossy? What can you do to help prevent emergencies? How do you best handle them when they happen?
"Preparing in advance really helps because it helps you to stay calm," said Tamara Wolske, director of the Center for Aging and Community at the University of Indianapolis. "The more you prepare, the easier it will be to make things simple for yourself and your loved one in a crisis."
Two years ago, Steve Carley's aging mother didn't share with him that she wasn't feeling well. Sara Carley, then 94, ended up in the hospital and rehab for a couple of weeks and then a nursing home -- which none of them wanted.
The answer for them was hiring a caregiver with Home Instead Senior Care, a national firm that provides services to seniors to help them remain home.
A caregiver comes every morning and returns in late afternoon. The caregiver cooks, cleans, handles personal care and makes sure Sara Carley takes her medications, which Steve's brother sets out weekly. The caregiver logs the elderly woman's daily activities and physical condition and keeps her medical information up to date.
"It has worked very well for us," Steve said. "If she has a medical problem, they alert my brother and I, and we get her care."
The Carleys were able to find a solution, but ideally it is best to have regular, frank conversations with a parent about medical issues before an emergency occurs.
Adult children should be aware of key medical information and know how to access it quickly. They need to have a list of the parent's prescriptions, allergies, physicians and contact information and the parent's pharmacy.
"A lot of the information is very critical to their immediate care," said Georgette Smith, franchise owner of Home Instead Senior Care.
The challenge, says Christopher Callahan, director of the Indiana University Center for Aging and Research, is keeping information updated because medications and health-care providers, for example, change frequently.
Key information, such as medications and doctors' names, can be kept on the refrigerator door or the back of the front door -- where ambulance personnel can easily see it. Adult children should collect the information from parents.
Callahan suggests asking them broad questions about their goals of care, such as if they would undergo certain emergency procedures, and their advance directives in case of life-threatening conditions.
The right time to broach medical issues varies, depending on the aging parent's health.
"We usually say when the child reaches age 40 or the parent reaches 70, whichever one happens first, that's a good time to talk about what the senior's wishes are and to get an emergency kit in place," Smith said. If a senior is in poor health, she said, it could be done when he or she is in his or her 50s or 60s.
Seniors are usually willing to share such information, but not always.
Callahan advises that adult children say they need to know family medical history so they can get cancer screenings. Then they can ease into conversations about the parent's medical issues.
Adult children also need to make clear they're asking questions and collecting information because they care about their parents' well-being and want to handle emergencies well and try to prevent them.
The tone, though, needs to be conversational, says Wolske. It shouldn't sound like an interrogation.
Move Over Stroke Belt; Meet The Sepsis Belt
You've heard of the Stroke Belt. Stretching across the American Southeast, it spans 11 states from Louisiana to Virginia, where death from stroke is much higher than in other regions of the country.
The term Sepsis Belt might be a new one, though. Sepsis, a severe illness in which the bloodstream is overwhelmed by bacteria, also appears to have a belt of its own. According to University of Alabama at Birmingham emergency physician Henry Wang, M.D., the death rate for sepsis is much higher in one geographic region of the United States the same region in which stroke is most prevalent.
"In 2010, we examined death rates from sepsis across the United States," said Wang, associate professor and vice chair for research in the UAB Department of Emergency Medicine. "Laying it out on a map, we saw that the states with highest sepsis mortality formed a cluster in the Southeast United States, closely mirroring the appearance of the Stroke Belt."
Wang says sepsis is responsible for 750,000 hospitalizations and some 200,000 deaths in the United States each year, about the same as for heart attack and breast cancer. Sepsis is triggered by infections such as meningitis or bacterial pneumonia, and can lead to shock, organ failure and death.
Wang has just received a five-year, $2.7 million grant from the National Institute of Nursing Research, one of the National Institutes of Health, to examine the risk factors for sepsis and potential reasons for the cluster.
"There are a host of possible causes for this geographic cluster," said Wang. "Possibilities include pre-existing medical conditions, health behaviors, diet, genetics and even the environment and air pollution."
Wang will use data from REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, a large, long-term study of the Stroke Belt, funded by the federal government and based at UAB.
"We'll be able to make extensive use of the REGARDS infrastructure, with access to information from the more than 30,000 people enrolled in that project," said Wang. "With that wealth of information, we will be able to identify the characteristics of persons most likely to be hospitalized for sepsis. This information may lead to strategies to prevent its onset."
"Sepsis treatment is complex, dealing with disruption of blood flow, organs shutting down and shock," he said. "Our current best course of action is to prevent sepsis from occurring in the first place. We hope our new research endeavor will lead to novel ways to prevent this disease and its effects."
The term Sepsis Belt might be a new one, though. Sepsis, a severe illness in which the bloodstream is overwhelmed by bacteria, also appears to have a belt of its own. According to University of Alabama at Birmingham emergency physician Henry Wang, M.D., the death rate for sepsis is much higher in one geographic region of the United States the same region in which stroke is most prevalent.
"In 2010, we examined death rates from sepsis across the United States," said Wang, associate professor and vice chair for research in the UAB Department of Emergency Medicine. "Laying it out on a map, we saw that the states with highest sepsis mortality formed a cluster in the Southeast United States, closely mirroring the appearance of the Stroke Belt."
Wang says sepsis is responsible for 750,000 hospitalizations and some 200,000 deaths in the United States each year, about the same as for heart attack and breast cancer. Sepsis is triggered by infections such as meningitis or bacterial pneumonia, and can lead to shock, organ failure and death.
Wang has just received a five-year, $2.7 million grant from the National Institute of Nursing Research, one of the National Institutes of Health, to examine the risk factors for sepsis and potential reasons for the cluster.
"There are a host of possible causes for this geographic cluster," said Wang. "Possibilities include pre-existing medical conditions, health behaviors, diet, genetics and even the environment and air pollution."
Wang will use data from REGARDS (Reasons for Geographic and Racial Differences in Stroke) study, a large, long-term study of the Stroke Belt, funded by the federal government and based at UAB.
"We'll be able to make extensive use of the REGARDS infrastructure, with access to information from the more than 30,000 people enrolled in that project," said Wang. "With that wealth of information, we will be able to identify the characteristics of persons most likely to be hospitalized for sepsis. This information may lead to strategies to prevent its onset."
"Sepsis treatment is complex, dealing with disruption of blood flow, organs shutting down and shock," he said. "Our current best course of action is to prevent sepsis from occurring in the first place. We hope our new research endeavor will lead to novel ways to prevent this disease and its effects."
Prisoners Need Greater Awareness Of Voluntary Services To Aid Their Resettlement
New research from the Third Sector Research Centre (TSRC) highlights the need to make prisoners more aware of voluntary organisations that could help them towards resettlement. The report shows that despite the relatively high number of third sector organisations working within prisons, many are not known by prisoners.
TSRC researchers from the University of Southampton conducted a survey across eight prisons nationally to investigate prisoners' experiences of third sector organisations (TSOs). The number of TSOs that each prison claimed was active in their establishment ranged from 15 to 31. However, on average, respondents reported having heard of just four.
Engagement with third sector organisations was also low, with only 5 per cent of prisoners having engaged with at least one. Where prisoners had heard of an organisation, but not engaged with them, the main reasons given were that they knew nothing about them or did not feel they could help.
The researchers looked specifically at prisoners' experiences of organisations operating within seven different areas or 'pathways' of resettlement. They found that TSOs working on drug and alcohol issues had the most consistent representation and use within prisons.
Within other pathways there was a discrepancy between the representation of organisations and awareness of these by prisoners. While each prison had a number of organisations which provided housing, for example only 20 - 25 per cent of respondents were aware of these and nearly 10 per cent of respondents identified accommodation as a key area where supply did not fit demand. Similar problems were noted within employment, education and training, and finance and debt.
Certain groups of offenders were also more likely to engage with different services. Women respondents and those from non-British Black, Asian and mixed ethnic (BAME) backgrounds reported significantly less engagement with housing TSOs despite equal levels of awareness. Young adult and juvenile respondents reported less awareness and involvement with accommodation TSOs. This is backed up by previous TSRC research, which illustrated under-representation of housing organisations offering services to women offenders, young offenders and offenders from BAME backgrounds.
In open-ended questions, 25 per cent of respondents said that more organisations are needed to provide employment, training and work placements for prisoners in the community. This was especially the case among young adult and juvenile offenders, as well as in open prisons where the number of TSOs operating in this area was low.
Dina Gojkovic, TSRC researcher at the University of Southampton, says: "Our ongoing research within the criminal justice system has highlighted a proven need for the work of TSOs and the benefits they can provide. While our survey did not measure engagement with statutory services, the identified need for more of some services shows that prisoners are not necessarily getting these from elsewhere. It certainly seems that improving the communication between TSOs and prisoners could help more people to benefit from them."
TSRC researchers from the University of Southampton conducted a survey across eight prisons nationally to investigate prisoners' experiences of third sector organisations (TSOs). The number of TSOs that each prison claimed was active in their establishment ranged from 15 to 31. However, on average, respondents reported having heard of just four.
Engagement with third sector organisations was also low, with only 5 per cent of prisoners having engaged with at least one. Where prisoners had heard of an organisation, but not engaged with them, the main reasons given were that they knew nothing about them or did not feel they could help.
The researchers looked specifically at prisoners' experiences of organisations operating within seven different areas or 'pathways' of resettlement. They found that TSOs working on drug and alcohol issues had the most consistent representation and use within prisons.
Within other pathways there was a discrepancy between the representation of organisations and awareness of these by prisoners. While each prison had a number of organisations which provided housing, for example only 20 - 25 per cent of respondents were aware of these and nearly 10 per cent of respondents identified accommodation as a key area where supply did not fit demand. Similar problems were noted within employment, education and training, and finance and debt.
Certain groups of offenders were also more likely to engage with different services. Women respondents and those from non-British Black, Asian and mixed ethnic (BAME) backgrounds reported significantly less engagement with housing TSOs despite equal levels of awareness. Young adult and juvenile respondents reported less awareness and involvement with accommodation TSOs. This is backed up by previous TSRC research, which illustrated under-representation of housing organisations offering services to women offenders, young offenders and offenders from BAME backgrounds.
In open-ended questions, 25 per cent of respondents said that more organisations are needed to provide employment, training and work placements for prisoners in the community. This was especially the case among young adult and juvenile offenders, as well as in open prisons where the number of TSOs operating in this area was low.
Dina Gojkovic, TSRC researcher at the University of Southampton, says: "Our ongoing research within the criminal justice system has highlighted a proven need for the work of TSOs and the benefits they can provide. While our survey did not measure engagement with statutory services, the identified need for more of some services shows that prisoners are not necessarily getting these from elsewhere. It certainly seems that improving the communication between TSOs and prisoners could help more people to benefit from them."
USDA issues alert after 77 become ill from ground turkey
A public health alert has gone out from the U.S. Dept. of Agriculture due to ground turkey from an unnamed producer that has been implicated in an estimated 77 illnesses in 26 states. USDA's Food Safety and Inspection Service issued the alert Friday night because of concerns about illnesses caused by a salmonella type called salmonella Heidelberg.
The agency acted because of "continuous medical reports, ongoing investigations and testing conducted by various departments of health across the nation" that found an association between people eating ground turkey products and the illnesses.
The investigation is being conducted by the Centers for Disease Control and Prevention and state health departments, USDA says.
So far neither USDA nor CDC have been able to determine the producer of the ground turkey that has been causing the illnesses, but the investigation continues.
Food contaminated with salmonella can cause salmonellosis. Symptoms include diarrhea, abdominal cramps, and fever within eight to 72 hours of eating the tainted food, in addition to chills, headache, nausea and vomiting that can last up to seven days. In the very young, the elderly and people with weakened immune systems, salmonella can be life-threatening.
The agency called for consumers to be aware "of the critical importance of following package cooking instructions for frozen or fresh ground turkey products," and to always allow ground turkey to reach an internal temperature of 165 degrees.
The agency acted because of "continuous medical reports, ongoing investigations and testing conducted by various departments of health across the nation" that found an association between people eating ground turkey products and the illnesses.
The investigation is being conducted by the Centers for Disease Control and Prevention and state health departments, USDA says.
So far neither USDA nor CDC have been able to determine the producer of the ground turkey that has been causing the illnesses, but the investigation continues.
Food contaminated with salmonella can cause salmonellosis. Symptoms include diarrhea, abdominal cramps, and fever within eight to 72 hours of eating the tainted food, in addition to chills, headache, nausea and vomiting that can last up to seven days. In the very young, the elderly and people with weakened immune systems, salmonella can be life-threatening.
The agency called for consumers to be aware "of the critical importance of following package cooking instructions for frozen or fresh ground turkey products," and to always allow ground turkey to reach an internal temperature of 165 degrees.
Fatty 'comfort' foods may alter brain's response to sadness
New research suggests that fatty foods do more than satisfy our stomachs. They may also soothe our psyche, literally serving as comfort foods.
"Eating fat seems to make us less vulnerable to sad emotions, even if we don't know we're eating fat," said psychiatrist Dr. Lukas Van Oudenhove, co-author of a study that tracked people's responses to sad and neutral experiences while fatty acids were inserted into their stomach. The food appeared to cause emotional and physical changes.
Anyone who's ever dipped into a pint of premium ice cream after a breakup knows that certain foods feel emotionally healing. But is it all in the mind -- a connection to, say, childhood comforts? Or are there signals that go from mouth or stomach to the brain?
Researchers previously have tackled these questions by focusing on how the smell, taste and appearance of food affect emotions, said Van Oudenhove, a postdoctoral researcher at the University of Leuven in Belgium. But this new study is a first, he said, because "we bypassed sensory stimulation by infusing fatty acids directly into the stomach, without the subjects knowing whether they were getting fat or saline."
the researchers recruited 12 non-obese, healthy volunteers who received fatty acids or a saline solution through a feeding tube. Using functional MRI, the researchers also scanned the volunteers' brain waves as they were exposed to sad and neutral music, and sad and neutral facial expressions.
One might assume they would already be a bit sad because of the medical procedure, but Van Oudenhove said they weren't particularly uncomfortable.
On its own, the efforts to induce sadness -- through music and images of frowns -- caused people's moods to fall by 2.5 points out of 10, Van Oudenhove said. But the fatty acids helped reduce the dip to about 1 point.
In the brain itself, researchers found that induced sadness produced a change of about 3 to 4 percent, "which is quite a lot," Van Oudenhove said. But the level of change shrank to less than 1 percent once the subjects got a dose of fatty acids, at least in most regions of the brain that were analyzed.
It's not clear if other ingredients in food would have a similar effect. Van Oudenhove said more research is needed to determine whether the findings may have any value in treatment of obesity, depression or eating disorders.
The authors of an accompanying journal editorial pointed out several limitations of the study, including the small number of participants and the absence of an obese cohort. Still, they said the findings may help further the understanding of obesity.
"The next step would be to test the effects of food that contain both high-fat and high-sugar," said Sonja Yokum, a research associate at the Oregon Research Institute in Eugene, who's familiar with the study findings. "It would be interesting to test if fat, sugar or the combination decreases negative mood and for how long."
Also of interest, she said, would be a study involving both "emotional eaters" (people who use food as solace) and successful dieters.
Ultimately, it would be "very helpful" to find a way to prevent people from craving high-fat and high-sugar foods when they're depressed, Yokum said.
"Eating fat seems to make us less vulnerable to sad emotions, even if we don't know we're eating fat," said psychiatrist Dr. Lukas Van Oudenhove, co-author of a study that tracked people's responses to sad and neutral experiences while fatty acids were inserted into their stomach. The food appeared to cause emotional and physical changes.
Anyone who's ever dipped into a pint of premium ice cream after a breakup knows that certain foods feel emotionally healing. But is it all in the mind -- a connection to, say, childhood comforts? Or are there signals that go from mouth or stomach to the brain?
Researchers previously have tackled these questions by focusing on how the smell, taste and appearance of food affect emotions, said Van Oudenhove, a postdoctoral researcher at the University of Leuven in Belgium. But this new study is a first, he said, because "we bypassed sensory stimulation by infusing fatty acids directly into the stomach, without the subjects knowing whether they were getting fat or saline."
the researchers recruited 12 non-obese, healthy volunteers who received fatty acids or a saline solution through a feeding tube. Using functional MRI, the researchers also scanned the volunteers' brain waves as they were exposed to sad and neutral music, and sad and neutral facial expressions.
One might assume they would already be a bit sad because of the medical procedure, but Van Oudenhove said they weren't particularly uncomfortable.
On its own, the efforts to induce sadness -- through music and images of frowns -- caused people's moods to fall by 2.5 points out of 10, Van Oudenhove said. But the fatty acids helped reduce the dip to about 1 point.
In the brain itself, researchers found that induced sadness produced a change of about 3 to 4 percent, "which is quite a lot," Van Oudenhove said. But the level of change shrank to less than 1 percent once the subjects got a dose of fatty acids, at least in most regions of the brain that were analyzed.
It's not clear if other ingredients in food would have a similar effect. Van Oudenhove said more research is needed to determine whether the findings may have any value in treatment of obesity, depression or eating disorders.
The authors of an accompanying journal editorial pointed out several limitations of the study, including the small number of participants and the absence of an obese cohort. Still, they said the findings may help further the understanding of obesity.
"The next step would be to test the effects of food that contain both high-fat and high-sugar," said Sonja Yokum, a research associate at the Oregon Research Institute in Eugene, who's familiar with the study findings. "It would be interesting to test if fat, sugar or the combination decreases negative mood and for how long."
Also of interest, she said, would be a study involving both "emotional eaters" (people who use food as solace) and successful dieters.
Ultimately, it would be "very helpful" to find a way to prevent people from craving high-fat and high-sugar foods when they're depressed, Yokum said.
Doctors group says hot dogs as dangerous as cigarettes
Instead of grouping hot dogs with Mom and apple pie, a national medical group wants you to consider them as bad for your health as cigarettes.
The Physicians Committee for Responsible Medicine, a Washington, D.C., group that promotes preventive medicine and a vegan diet, unveiled a billboard Monday near the Indianapolis Motor Speedway with the advisory: "Warning: Hot dogs can wreck your health."
The billboard features a picture of hot dogs in a cigarette pack inscribed with skull and crossbones. It aims to increase awareness of a link between colorectal cancer and hot dogs.
Hot dogs, like cigarettes, should come with a "warning label that helps racing fans and other consumers understand the health risk," said Susan Levin, the committee's nutrition education director.
Other health experts disagree.
Although hot dogs are certainly not health food, neither are they toxic, if consumed in moderation, they say.
"It is not necessary to eliminate consumption of red or processed meat; rather the message is that these foods should not be the mainstay of your diet," American Cancer Society guidelines state.
About twice a month, Kimberly Hunt indulges. She harbors no illusions that hot dogs are good for her, but she's not worried about the risks.
"Not any more than any other processed foods that we eat," said Hunt, as she finished off lunch in downtown Indianapolis. "There's a lot of things that are going to cause cancer. Are hot dogs on the top of my list? No."
Hot dogs are low in nutritional value, said Dr. Jesse Spear, an internal medicine physician with St. Vincent Medical Group in Fishers, Ind. They're high in salt, which can lead to hypertension and heart disease.
Should we avoid them at all costs?
That's not what Spear tells patients. Instead, he advises them to eat a generally healthy diet -- more fruits and vegetables, less processed meats.
"I don't personally tell people never to eat hot dogs, because I guess I'm just realistic enough to know that people will still consume them to some degree," he said.
But there's something about a car race that encourages hot dog consumption. Last year, more than 1.1 million hot dogs were sold during the Indianapolis 500.
So this year, the Physicians Committee decided to target another Speedway event, Sunday's Brickyard 400, with its $2,750 billboard.
The strong warning is needed to make people think twice about eating hot dogs and all processed meats, Levin said. That includes deli meats, ham, sausage, bacon and pepperoni.
"A hot dog a day could send you to an early grave," said Levin, a registered dietitian. "People think feeding their kids these foods (is) safe, but (it's) not."
The research linking colorectal cancer and processed meat is convincing, says a 2007 report by the World Cancer Research Fund and American Institute for Cancer Research.
Just one 50-gram serving of processed meat -- about the amount in one hot dog -- a day increases the risk of colorectal cancer, on average, by 21 percent, the study found.
George Hanlin has his consumption down to one or two a month, as part of a plan to eat healthier. Monday, he contemplated the data linking hot dogs to health risks.
"Will it keep me from never eating hot dogs? No," Hanlin said. "But there's no question I will try to limit it a lot more."
The Physicians Committee for Responsible Medicine, a Washington, D.C., group that promotes preventive medicine and a vegan diet, unveiled a billboard Monday near the Indianapolis Motor Speedway with the advisory: "Warning: Hot dogs can wreck your health."
The billboard features a picture of hot dogs in a cigarette pack inscribed with skull and crossbones. It aims to increase awareness of a link between colorectal cancer and hot dogs.
Hot dogs, like cigarettes, should come with a "warning label that helps racing fans and other consumers understand the health risk," said Susan Levin, the committee's nutrition education director.
Other health experts disagree.
Although hot dogs are certainly not health food, neither are they toxic, if consumed in moderation, they say.
"It is not necessary to eliminate consumption of red or processed meat; rather the message is that these foods should not be the mainstay of your diet," American Cancer Society guidelines state.
About twice a month, Kimberly Hunt indulges. She harbors no illusions that hot dogs are good for her, but she's not worried about the risks.
"Not any more than any other processed foods that we eat," said Hunt, as she finished off lunch in downtown Indianapolis. "There's a lot of things that are going to cause cancer. Are hot dogs on the top of my list? No."
Hot dogs are low in nutritional value, said Dr. Jesse Spear, an internal medicine physician with St. Vincent Medical Group in Fishers, Ind. They're high in salt, which can lead to hypertension and heart disease.
Should we avoid them at all costs?
That's not what Spear tells patients. Instead, he advises them to eat a generally healthy diet -- more fruits and vegetables, less processed meats.
"I don't personally tell people never to eat hot dogs, because I guess I'm just realistic enough to know that people will still consume them to some degree," he said.
But there's something about a car race that encourages hot dog consumption. Last year, more than 1.1 million hot dogs were sold during the Indianapolis 500.
So this year, the Physicians Committee decided to target another Speedway event, Sunday's Brickyard 400, with its $2,750 billboard.
The strong warning is needed to make people think twice about eating hot dogs and all processed meats, Levin said. That includes deli meats, ham, sausage, bacon and pepperoni.
"A hot dog a day could send you to an early grave," said Levin, a registered dietitian. "People think feeding their kids these foods (is) safe, but (it's) not."
The research linking colorectal cancer and processed meat is convincing, says a 2007 report by the World Cancer Research Fund and American Institute for Cancer Research.
Just one 50-gram serving of processed meat -- about the amount in one hot dog -- a day increases the risk of colorectal cancer, on average, by 21 percent, the study found.
George Hanlin has his consumption down to one or two a month, as part of a plan to eat healthier. Monday, he contemplated the data linking hot dogs to health risks.
"Will it keep me from never eating hot dogs? No," Hanlin said. "But there's no question I will try to limit it a lot more."
FDA criticized over the way they regulate medical devices.
The government should abandon a 35-year-old system for approving most medical devices in the U.S. because it offers little to no assurance of safety for patients, a panel of medical experts concludes in a report Friday.
The surprise recommendation from the Institute of Medicine panel calls for a massive reworking of how the government regulates medical devices, a $350 billion industry that encompasses everything from pacemakers to X-ray scanners to contact lenses.
The 12-member group's advice, commissioned by the Food and Drug Administration, is not binding. And there were immediate signs that the report would face tough headwinds in Washington, as both the FDA and device manufacturers disagreed with its conclusions.
Still, the stinging critique could eventually bring about tighter standards for medical device companies, which have long benefited from less safety scrutiny than their peers in the drug industry.
FDA requires that most new prescription drugs go through clinical trials to prove that patients fare better after receiving medication. Most devices only have to show that they are similar to devices already on the market. Only a handful of truly new devices must undergo extensive testing to prove they are safe and effective.
The FDA said Friday that it disagreed with the group's recommendations, but would hold a public meeting to discuss them. The FDA has been working for more than a year to make the 510(k) process more predictable and less bureaucratic, efforts that would go to waste if the system is abandoned.
"FDA believes that the 510(k) process should not be eliminated but we are open to additional proposals and approaches," said FDA's device director Jeffrey Shuren, in a statement.
The report arrives as the FDA fends off pointed criticism from manufacturers who say the agency has become too slow and bureaucratic in clearing new devices, driving up costs for companies and forcing some out of business. Despite the relative speed of the 510(k) process, they point out that some devices still get tied up in red tape, ultimately reaching the U.S. market two years after launching overseas. In the past year, companies have taken their arguments to Capitol Hill, where lawmakers have grilled FDA officials over device reviews.
The device industry's chief lobbying group immediately dismissed the proposal.
"The report's conclusions do not deserve serious consideration from the Congress or the Administration," said Stephen Ubl, president of the Advanced Medical Technology Association. "It proposes abandoning efforts to address the serious problems with the administration of the current program by replacing it at some unknown date with an untried, unproven and unspecified new legal structure."
Latham & Watkins attorney John Manthei, who represents device manufacturers, said it would be a mistake to pronounce the report "dead on arrival." Even if the FDA doesn't adopt its recommendations, he said members of Congress will likely use the findings to pressure both companies and the FDA.
"For those who feel like the 510(k) process is inadequate, this report definitely gives those folks ammunition," said Manthei.
The Institute of Medicine panelists, mostly doctors and researchers, appear to have overwhelmingly sided with public safety advocates who have argued for years that devices used to treat and detect illnesses must undergo real testing.
The FDA sought the group's advice as it updates the system used to clear more than 90 percent of devices in the U.S. The so-called 510(k) system was created by Congress in 1976 to grant speedy approval to devices that are similar to products already on the market. The pathway was originally intended as a temporary method to grandfather in devices that had been used for decades. Instead it has become the standard tool to launch new medical implants.
The IOM generally recommends ways to improve or modify government programs, but instead the panel said the 510(k) system is "flawed" and should be eliminated completely.
"A system was put in place 35 years ago that does not really assess safety and effectiveness," said panel chair David Challoner, former vice president of health affairs at University of Florida. "We need something different for the next 35 years. We're dealing with a whole new world: new technology, new materials and new data."
Challoner and the other panelists recommend the FDA develop a new system based on safety metrics and tracking device failure rates in the real world. He said better tracking of device complications could take the place of premarket testing, which would be unfeasible for all new devices.
The group stressed that medical devices cleared through the pathway are not inherently unsafe — most probably are safe — but the approval system itself provides little assurance to doctors and patients.
The 510(k) system is popular among manufacturers because it is a faster path to market than the review process for first-of-a-kind devices, which must undergo rigorous medical testing. Hip replacements, CT scanners and drug pumps are among the devices cleared by 510(k).
As generations of devices have been cleared year after year, FDA critics say dangerous devices have slipped through because they vaguely resemble products approved decades ago.
"Originally there was this idea that the 510k would wither away and over time more and more new devices would go through the more onerous path. But instead there are more devices cleared this way than ever," Dr. Diana Zuckerman, director of the nonprofit National Research Center for Women & Families, said in an interview Thursday.
Earlier this month Zuckerman and other safety advocates seized on new reports of painful complications with pelvic surgical mesh as the latest example of the shortcomings of the abbreviated review system. Reports of pain, bleeding and infection are up 500 percent since 2008 among women who've had surgery to support the pelvic wall. The FDA cleared the device for that use in 2002 via 510(k).
About 4,000 devices are cleared every year under the 510(k) system, while just 50 devices are approved under the more stringent system that requires human testing. It costs the FDA roughly $800,000 per device when utilizing the more rigorous system.
The IOM is a nonpolitical group of experts that advises the federal government on medical issues.
For months, medical device lobbyists and executives have downplayed the legitimacy of the IOM panel, pointing out that none of them have experience working in the device sector.
Dr. Jeffrey Lerner, who has studied medical technology for over 25 years, said device makers are still coming to grips with a new regulatory environment that demands greater safety — often at the expense of profits.
"The bottom line is that everybody has got to make adjustments in an era in which technology is changing and public expectations are changing," said Lerner, who is president of the Emergency Care Research Institute.
The surprise recommendation from the Institute of Medicine panel calls for a massive reworking of how the government regulates medical devices, a $350 billion industry that encompasses everything from pacemakers to X-ray scanners to contact lenses.
The 12-member group's advice, commissioned by the Food and Drug Administration, is not binding. And there were immediate signs that the report would face tough headwinds in Washington, as both the FDA and device manufacturers disagreed with its conclusions.
Still, the stinging critique could eventually bring about tighter standards for medical device companies, which have long benefited from less safety scrutiny than their peers in the drug industry.
FDA requires that most new prescription drugs go through clinical trials to prove that patients fare better after receiving medication. Most devices only have to show that they are similar to devices already on the market. Only a handful of truly new devices must undergo extensive testing to prove they are safe and effective.
The FDA said Friday that it disagreed with the group's recommendations, but would hold a public meeting to discuss them. The FDA has been working for more than a year to make the 510(k) process more predictable and less bureaucratic, efforts that would go to waste if the system is abandoned.
"FDA believes that the 510(k) process should not be eliminated but we are open to additional proposals and approaches," said FDA's device director Jeffrey Shuren, in a statement.
The report arrives as the FDA fends off pointed criticism from manufacturers who say the agency has become too slow and bureaucratic in clearing new devices, driving up costs for companies and forcing some out of business. Despite the relative speed of the 510(k) process, they point out that some devices still get tied up in red tape, ultimately reaching the U.S. market two years after launching overseas. In the past year, companies have taken their arguments to Capitol Hill, where lawmakers have grilled FDA officials over device reviews.
The device industry's chief lobbying group immediately dismissed the proposal.
"The report's conclusions do not deserve serious consideration from the Congress or the Administration," said Stephen Ubl, president of the Advanced Medical Technology Association. "It proposes abandoning efforts to address the serious problems with the administration of the current program by replacing it at some unknown date with an untried, unproven and unspecified new legal structure."
Latham & Watkins attorney John Manthei, who represents device manufacturers, said it would be a mistake to pronounce the report "dead on arrival." Even if the FDA doesn't adopt its recommendations, he said members of Congress will likely use the findings to pressure both companies and the FDA.
"For those who feel like the 510(k) process is inadequate, this report definitely gives those folks ammunition," said Manthei.
The Institute of Medicine panelists, mostly doctors and researchers, appear to have overwhelmingly sided with public safety advocates who have argued for years that devices used to treat and detect illnesses must undergo real testing.
The FDA sought the group's advice as it updates the system used to clear more than 90 percent of devices in the U.S. The so-called 510(k) system was created by Congress in 1976 to grant speedy approval to devices that are similar to products already on the market. The pathway was originally intended as a temporary method to grandfather in devices that had been used for decades. Instead it has become the standard tool to launch new medical implants.
The IOM generally recommends ways to improve or modify government programs, but instead the panel said the 510(k) system is "flawed" and should be eliminated completely.
"A system was put in place 35 years ago that does not really assess safety and effectiveness," said panel chair David Challoner, former vice president of health affairs at University of Florida. "We need something different for the next 35 years. We're dealing with a whole new world: new technology, new materials and new data."
Challoner and the other panelists recommend the FDA develop a new system based on safety metrics and tracking device failure rates in the real world. He said better tracking of device complications could take the place of premarket testing, which would be unfeasible for all new devices.
The group stressed that medical devices cleared through the pathway are not inherently unsafe — most probably are safe — but the approval system itself provides little assurance to doctors and patients.
The 510(k) system is popular among manufacturers because it is a faster path to market than the review process for first-of-a-kind devices, which must undergo rigorous medical testing. Hip replacements, CT scanners and drug pumps are among the devices cleared by 510(k).
As generations of devices have been cleared year after year, FDA critics say dangerous devices have slipped through because they vaguely resemble products approved decades ago.
"Originally there was this idea that the 510k would wither away and over time more and more new devices would go through the more onerous path. But instead there are more devices cleared this way than ever," Dr. Diana Zuckerman, director of the nonprofit National Research Center for Women & Families, said in an interview Thursday.
Earlier this month Zuckerman and other safety advocates seized on new reports of painful complications with pelvic surgical mesh as the latest example of the shortcomings of the abbreviated review system. Reports of pain, bleeding and infection are up 500 percent since 2008 among women who've had surgery to support the pelvic wall. The FDA cleared the device for that use in 2002 via 510(k).
About 4,000 devices are cleared every year under the 510(k) system, while just 50 devices are approved under the more stringent system that requires human testing. It costs the FDA roughly $800,000 per device when utilizing the more rigorous system.
The IOM is a nonpolitical group of experts that advises the federal government on medical issues.
For months, medical device lobbyists and executives have downplayed the legitimacy of the IOM panel, pointing out that none of them have experience working in the device sector.
Dr. Jeffrey Lerner, who has studied medical technology for over 25 years, said device makers are still coming to grips with a new regulatory environment that demands greater safety — often at the expense of profits.
"The bottom line is that everybody has got to make adjustments in an era in which technology is changing and public expectations are changing," said Lerner, who is president of the Emergency Care Research Institute.
Federal court upholds patenting on human genes
A federal court said Friday that human genes can be patented, reversing a lower court's ruling that involved a test for breast cancer but which could have had big implications for biotechnology and pharmaceutical companies.
Judge Alan Lourie's ruling says the genes can be patented because the isolated DNA has a "markedly different chemical structure" from DNA within the body. The U.S. Patent and Trademark Office has been awarding patents on genes for almost 30 years.
"The ability to visualize a DNA molecule through a microscope, or by any other means, when it is bonded to other genetic material, is worlds apart from possessing an isolated DNA molecule that is in hand and usable," Lourie wrote for a 2-to-1 majority. "It is the difference between knowledge of nature and reducing a portion of nature to concrete form, the latter activity being what the patent laws seek to encourage and protect."
The lawsuit concerned two patents held by Myriad Genetics Inc. of Salt Lake City. Myriad's BRACAnalysis test looks at gene sequences linked to increased risk of breast and ovarian cancer. The American Civil Liberties Union argued that genes couldn't be patented, and in March 2010, a New York district court agreed.
"Today's ruling is a blow to the idea that patent law cannot impede the free flow of ideas in scientific research," said Chris Hansen, a staff attorney with the ACLU Speech, Privacy and Technology Project.
ACLU Attorney Sandra Park said the ACLU will consult with its clients in deciding whether to appeal or seek another remedy. The plaintiffs include geneticists who said they were not able to continue their work because of Myriad's patents, along with breast cancer and women's health groups, patients, and groups of researchers, pathologists, and laboratory professionals.
Myriad was able to continue selling the BRACAnalysis test despite the previous ruling from Judge Robert Sweet of the U.S. District Court for the Southern District of New York.
Lourie ruled against Myriad on five claims, saying the company cannot patent comparisons and analysis of DNA sequences. The company said it still holds 237 claims that are not affected by the decision. The company's shares rose 2.3 percent in aftermarket trading.
Judge Alan Lourie's ruling says the genes can be patented because the isolated DNA has a "markedly different chemical structure" from DNA within the body. The U.S. Patent and Trademark Office has been awarding patents on genes for almost 30 years.
"The ability to visualize a DNA molecule through a microscope, or by any other means, when it is bonded to other genetic material, is worlds apart from possessing an isolated DNA molecule that is in hand and usable," Lourie wrote for a 2-to-1 majority. "It is the difference between knowledge of nature and reducing a portion of nature to concrete form, the latter activity being what the patent laws seek to encourage and protect."
The lawsuit concerned two patents held by Myriad Genetics Inc. of Salt Lake City. Myriad's BRACAnalysis test looks at gene sequences linked to increased risk of breast and ovarian cancer. The American Civil Liberties Union argued that genes couldn't be patented, and in March 2010, a New York district court agreed.
"Today's ruling is a blow to the idea that patent law cannot impede the free flow of ideas in scientific research," said Chris Hansen, a staff attorney with the ACLU Speech, Privacy and Technology Project.
ACLU Attorney Sandra Park said the ACLU will consult with its clients in deciding whether to appeal or seek another remedy. The plaintiffs include geneticists who said they were not able to continue their work because of Myriad's patents, along with breast cancer and women's health groups, patients, and groups of researchers, pathologists, and laboratory professionals.
Myriad was able to continue selling the BRACAnalysis test despite the previous ruling from Judge Robert Sweet of the U.S. District Court for the Southern District of New York.
Lourie ruled against Myriad on five claims, saying the company cannot patent comparisons and analysis of DNA sequences. The company said it still holds 237 claims that are not affected by the decision. The company's shares rose 2.3 percent in aftermarket trading.
Heat-linked illnesses strike thousands each year
Summer is a time to be out and about, but it's also a time when high temperatures can take a big toll on health.
Experts at the U.S. Centers for Disease Control and Prevention (CDC) say that from 2001 to 2009, almost 6,000 people annually were seen in emergency rooms for heat-related illness caused while playing sports or engaged in other outdoor activities."Because heat-related illness is a preventable illness, any number is too high," said lead researcher Ellen E. Yard, an Epidemic Intelligence Service Officer at the CDC
.
Their concerns are especially timely as many areas in the nation are suffering through record heat waves, with probably more blistering temperatures to come before fall arrives.
"You need to be proactive in protecting yourself from heat illness," Yard said. "If heat illness does occur, recognize it right away and treat it appropriately."
Yard said there are things that can be done to prevent heat-related illness, particularly for active people. First, drink lots of water when you are outside. In addition, try to limit activity to the coolest parts of the day -- early morning and late evening, she said.
"It's really important to pace yourself. Especially when it first starts getting warm, your body is not going to be used to that," she said. "You really want to slowly increase the intensity and frequency of your activity over one to two weeks."
In the study, the most common activities linked to heat illnesses were football and exercise. Most of the illnesses -- about 73 percent -- occurred among males. One-third of the illnesses were in teenagers.
Among women, the most common activities causing heat illness were baseball and softball for those aged 14 and younger, track and field for those 15 to 19 years, and exercise for women 20 and older, the researchers found.
Heat illness includes a range of symptoms, usually starting with mild dehydration and quickly progressing to heat exhaustion and possibly to heat stroke, Yard said. Heat stroke is rarer, but can be potentially fatal.
Signs of possible heat illness include heavy sweating, feeling weak, headache, nausea or vomiting. These are signs of heat exhaustion, Yard said.
"That's a sign that you need to get these people immediately out of the heat and into air conditioning or an ice bath," she said. "That's why it is important to have an exercise partner or teammates or coaches who can recognize the signs of heat illness and get you the prompt attention that it needs," she added.
If a person starts to show signs of mental confusion it could be heat stroke, Yard noted. "That's a medical emergency that needs immediate emergency attention," she said.
According to Dr. Lisandro Irizarry, chair of the emergency department at The Brooklyn Hospital Center in New York City, the most common heat-related illness sending people to the emergency room is heat exhaustion.
"It's rare to see someone in heat stroke," Irizarry said. "Usually the person you see who has heat stroke is an elderly person on multiple medications that restrict the person's ability to sweat," he explained.
However, there are times when heat illness should be treated in an emergency room, he added. "If you are significantly confused you should go to the emergency department," he said.
"In addition, if you have symptoms of another illness you have, like heart disease with chest pain or shortness of breath, that's another reason to go to the hospital," Irizarry continued. Also, feeling faint is another reason to go to the hospital, he said.
For most people who are active outside during heat waves, Irizarry recommends limiting the time spent exercising and keep drinking water. "Know your limitations," he said.
Irizarry also suggests exercising indoors where it is air conditioned. "If you're a runner, get to the gym and run on a treadmill," he said.
Insomnia: treating a disease not a symptom
There has never been a better time to have a sleep disorder.
Awareness of clinical sleep disorders and clinical sleep medicine expertise is growing. We can see this in the increasing efforts to develop new treatments, and the expanding specialty training programs. We can also sense the growing importance of sleep because of intensified advertising on TV which encourages viewers to seek attention for sleep dissatisfaction – often for the first time. Americans today are both sleep-deprived and sleep-disordered.
There are many kinds of sleep disorders. Most of them you may not have come across in your reading. They include:
Parasomnias: behaviors coming out of sleep like sleep walking and sleep eating
Hypersomnias: conditions like obstructive sleep apnea and narcolepsy which are often characterized by excessive sleepiness in daytime
Movement disorders: while strictly disorders of wakefulness, they can impact sleep (Restless Leg Syndrome is perhaps the best known)
But insomnia remains the commonest sleep disorder affecting Americans and most likely to require sleep medications. More than 30% of Americans report sleep complaints, and of those, nearly half report chronic insomnia.
Patients often come to me at their wits' end for help with insomnia, fearful of becoming dependent on sleep medicines and often admitting that they have borrowed medicines from a family member in their desperation to sleep well. One of the first interventions I make is to tell these patients that there is indeed a healthy and safe place for supervised medications to help them sleep better. Quite honestly, the risks of not treating insomnia far outweigh the risks of sleep aids over the long term.
Sleep medicine is finally embracing a new philosophy to approaching patients: Insomnia is a chronic disorder that needs to be managed with careful and often long-term pharmacotherapy, among other treatments, rather than relegated as a troublesome symptom that needs to be palliated over the short term.
This decision to finally understand insomnia as a legitimate disorder and not a symptom was made in a National Institute of Health (NIH) State of the Science Panel in June 2005. This decision completely changed the practices and attitudes of many physicians to treating sleeplessness though certainly some colleagues do need to catch up with the new outlook. As a result of the NIH defining insomnia as a disease, drug companies could carefully test new sleep medicines over long-term use and find that they are in fact safe. This sea change has lead to newer FDA approvals for long-term prescriptions of the hypnotic class of sleep medications.
I tell my patients these changing attitudes contribute greatly to encouraging both patients and their doctors. Stigma over seeking treatment for insomnia continues to persist and certainly presents a major obstacle for finding the correct help. In the meantime, let's find out what's inside the medicine cabinet.
Awareness of clinical sleep disorders and clinical sleep medicine expertise is growing. We can see this in the increasing efforts to develop new treatments, and the expanding specialty training programs. We can also sense the growing importance of sleep because of intensified advertising on TV which encourages viewers to seek attention for sleep dissatisfaction – often for the first time. Americans today are both sleep-deprived and sleep-disordered.
There are many kinds of sleep disorders. Most of them you may not have come across in your reading. They include:
Parasomnias: behaviors coming out of sleep like sleep walking and sleep eating
Hypersomnias: conditions like obstructive sleep apnea and narcolepsy which are often characterized by excessive sleepiness in daytime
Movement disorders: while strictly disorders of wakefulness, they can impact sleep (Restless Leg Syndrome is perhaps the best known)
But insomnia remains the commonest sleep disorder affecting Americans and most likely to require sleep medications. More than 30% of Americans report sleep complaints, and of those, nearly half report chronic insomnia.
Patients often come to me at their wits' end for help with insomnia, fearful of becoming dependent on sleep medicines and often admitting that they have borrowed medicines from a family member in their desperation to sleep well. One of the first interventions I make is to tell these patients that there is indeed a healthy and safe place for supervised medications to help them sleep better. Quite honestly, the risks of not treating insomnia far outweigh the risks of sleep aids over the long term.
Sleep medicine is finally embracing a new philosophy to approaching patients: Insomnia is a chronic disorder that needs to be managed with careful and often long-term pharmacotherapy, among other treatments, rather than relegated as a troublesome symptom that needs to be palliated over the short term.
This decision to finally understand insomnia as a legitimate disorder and not a symptom was made in a National Institute of Health (NIH) State of the Science Panel in June 2005. This decision completely changed the practices and attitudes of many physicians to treating sleeplessness though certainly some colleagues do need to catch up with the new outlook. As a result of the NIH defining insomnia as a disease, drug companies could carefully test new sleep medicines over long-term use and find that they are in fact safe. This sea change has lead to newer FDA approvals for long-term prescriptions of the hypnotic class of sleep medications.
I tell my patients these changing attitudes contribute greatly to encouraging both patients and their doctors. Stigma over seeking treatment for insomnia continues to persist and certainly presents a major obstacle for finding the correct help. In the meantime, let's find out what's inside the medicine cabinet.
Tamoxifen wards off breast cancer's return for more than a decade
Women who took the cancer-suppressing drug tamoxifen for five years after a breast cancer diagnosis were nearly 40 percent less likely to have the cancer return, and that protection lasted for more than a decade after they stopped taking the drug, a new study finds.
Researchers analyzed the results of about 20 randomized controlled trials on a five-year course of tamoxifen vs. not taking the drug. The trials involved 21,000 women from a dozen countries around the world, including the United States, Europe, China and Japan.
Some 15 years after their diagnosis -- and 10 years after they stopped taking the drug -- women who took tamoxifen still had one-third lower risk of dying than women who didn't take it.
"It's a remarkable drug," said study author Dr. Christina Davies, a lead investigator with the Early Breast Cancer Trialists Collaborative Group, which was established some 25 years ago to conduct periodic reviews of research on breast cancer from around the world. "It has probably saved more lives than any other oncological drug ever."
Of 10,645 women who took tamoxifen, about 26 percent had a relapse at the 10-year-mark, compared to 40 percent who didn't take the medication. By 15 years, 33 percent of women who took the drug had their cancer return, compared to 46 percent who didn't.
The statistics were similar when it came to death rates. After a decade, about 25 percent of women who didn't take the drug had died compared to 18 percent of those who did take it; at 15 years, 33 percent who didn't take the drug died compared to 24 percent of those who took tamoxifen.
"They not only gained the benefits while they were taking the drug, but for many years afterward," Davies said.
Tamoxifen has been widely used for more than 30 years to treat the most common type of breast cancer, estrogen-receptor positive tumors.
The drug works by inhibiting the activity of estrogen, a female hormone that can drive the growth of breast cancer tumors. The drug is most often prescribed as a once-a-day pill for younger women with breast cancer.
Older, postmenopausal women are now often prescribed a newer class of drugs called aromatase inhibitors, which block estrogen released in body fat, experts said. Aromatase inhibitors are most easily used in women who no longer have ovaries that are producing estrogen, Davies said.
One reason for the switch to aromatase inhibitors: Prior research, as well as the current study, found that tamoxifen raises the risk of cancer of the lining of the uterus (endometrial cancer) and life-threatening blood clots in the lungs. The analysis found the added risk from tamoxifen to older women was small, and in younger women it was "almost non-existent," Davies said.
"The benefits greatly outweigh the risks," Davies said.
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, said studies such as this that look at death rates over the long-term are valuable.
"The study shows that tamoxifen as an adjuvant [additional] therapy for breast cancer has had a very successful track record that has been sustained over 30 years of use in the clinic, even though it's used less now," he said.
The analysis found tamoxifen worked equally well in women who underwent chemotherapy and radiation in addition to surgery, Davies noted. Another benefit: tamoxifen is inexpensive. Davies estimated a five-year course of the drug costs about $150, of particular importance in developing nations where breast cancer rates have risen dramatically, she said.
Many of the women in the analysis, she noted, failed to take the full five-year course of the drug, so it's possible the protective effect from fully taking the medication as prescribed might be even greater. The findings raise the question of whether, say, a 10-year course of tamoxifen might be even more beneficial than five years.
About half of the women worldwide diagnosed with breast cancer are pre-menopausal, she said. "For those women, tamoxifen is the main treatment option," she said.
About two-thirds of breast cancers in the United States are estrogen-positive. The drug worked even on those whose tumors are "weakly positive," she noted.
Brain injury may boost stroke risk
In the three months after a traumatic brain injury, the risk of stroke may increase 10-fold, Taiwanese researchers report.
"Traumatic brain injury has not been included among the usual stroke risk factors in the past," said Dr. Ralph Sacco, president of the American Heart Association/American Stroke Association, who is familiar with the study. "The mechanism is still not clear, but deserves further investigation."
Sacco, also chairman of the department of neurology at the University of Miami Miller School of Medicine, said it's known that patients with traumatic brain injury can have other complications, such as ruptured or torn arteries, cardiac injuries or blood clotting disturbances, that increase the risk of stroke.
In the United States, about one in 53 people has a traumatic brain injury each year, according to the U.S. Centers for Disease Control and Prevention. Because impairment following traumatic brain injury may be invisible, the researchers said the condition is sometimes described as a silent epidemic.
For the study, published in the July 28 online edition of Stroke, a team led by Herng-Ching Lin, a professor at Taipei Medical University, collected data on 23,199 people who suffered a traumatic brain injury between 2001 and 2003. They compared these patients with 69,597 patients without traumatic brain injury.
Among those with a traumatic brain injury, 2.91 percent had a stroke within the first three months after the injury, compared with 0.30 percent of those who had not experienced traumatic brain injury, the researchers found. That's a 10-fold increase, Lin's group noted.
Over time, however, the risk of stroke diminished among those with traumatic brain injuries, the researchers said. After a year, the risk was 4.6 times greater, and after five years it was 2.3 times greater for these patients than for people without traumatic brain injury.
A fractured skull significantly boosted stroke risk. Within three months of a skull fracture, the risk for stroke was 20 times higher than for brain-injured patients with no skull fracture, the researchers found.
Also, patients with a traumatic brain injury were at greater risk for bleeding in the brain, compared with people who had not experienced traumatic brain injury.
The brain-injured patients also were more likely to have high blood pressure, diabetes, coronary heart disease, atrial fibrillation and heart failure than non-traumatic brain injury patients, Lin's group said.
"Stroke is the most serious and disabling neurological disorder worldwide," Lin said in a journal news release. "Our study leads the way in identifying stroke as an additional neurological problem that may arise following traumatic brain injury."
Lin said early neuroimaging examinations, such as MRI, and intensive monitoring should be standard in the first few months and years after a traumatic brain injury.
Commenting on the study, Dr. Larry B. Goldstein, director of the Duke University Stroke Center in Durham, N.C., said the study could not adjust for major risk factors for stroke or their treatment, or prove a causal connection between traumatic brain injury and stroke.
"Those that have had traumatic brain injury may differ from those who do not, and it may be these other differences that lead to stroke rather than the trauma itself," Goldstein said.
"Even minor trauma, however, can sometimes cause a tear in an artery that can compromise blood flow to the brain and cause a stroke," he said.
Increasing muscle mass may lower type 2 diabetes risk
More muscle may reduce the odds of developing diabetes, a new study suggests.
Other research has shown that having less body fat reduces diabetes risk and that exercise can help too, but the new study by UCLA scientists suggests a link between higher muscle mass and a lower risk of diabetes.
"Our findings suggest that beyond focusing on losing weight to improve metabolic health, there may be a role for maintaining fitness and building muscle mass," says Preethi Srikanthan, an assistant professor of medicine in the division of endocrinology at UCLA's David Geffen School of Medicine.
For the study
researchers analyzed data from 13,644 adults who participated in the National Health and Nutrition Examination Survey III (NHANES III) to determine whether there was a correlation between higher levels of muscle mass and lower levels of insulin resistance, a precursor to diabetes.
After controlling for age, race and other factors, the scientists found that for each 10% increase in the skeletal muscle index — the ratio of muscle mass to total body weight — there was a corresponding 11% reduction in insulin resistance and a 12% decrease in
According to the American Diabetes Association, 79 million people in the USA have pre-diabetes, which means their blood glucose levels are higher than normal but not in the diabetes range yet.
The finding that more muscle mass is beneficial is consistent with what's already known about muscle and fat — that they do affect metabolism, says Daniel Rubin, an assistant professor of medicine in the division of Endocrinology at Temple University School of Medicine.
"Extra fat has bad effects, but more muscle has good effects. These data are also consistent with data we see on exercise, that it helps decrease diabetes risk, and that a lack of exercise and weight gain increase risk," Rubin says.
Srikanthan points out that the study was not an intervention, it was observational. In other words, the authors did not look at the effect of different kinds of muscle-building activities on diabetes.
It's difficult to know when looking at a correlational study like this one whether it's just a correlation or an effect, says Duke endocrinologist Susan Spratt.
"Are there other healthy behaviors that tag along with high muscle mass that reduce the risk of diabetes? We don't know from this study that if you increase muscle mass you will decrease insulin resistance, but we can infer that might be the case," Spratt says.
It's a welcome message for patients who have trouble shedding extra pounds, Srikanthan says: "We should consider monitoring improvements in muscle mass in addition to changes in fat."
Fertility Juices
Infertility has affected 2.1 million married couples in the US alone. With the numbers growing and limited treatments offered by the doctors, many are seeking other types of remedies to elevate their chances of conception.
Nutrition plays a vital role in fertility. This is one of the options that is often overlooked. If your body is deficient in certain nutrients, you are going to encounter biochemical imbalances. Unique bodily processes will begin to slow down and will not function normally until those imbalances are addressed.
Ensuring that the food you consume are nourishing your body is one of the most important things you can do. If you are consuming food that are full of sugar, chemicals, preservatives, artificial ingredients and unhealthy fats, you are simply undermining your efforts to become pregnant. Most people fail to realize the damaging impact this has. How could we expect our body to do the things it should when we have neglected of the tools it requires? Be aware of how powerful real, healthy foods are.
Adequate intake of nutritional elements such as Vitamins B12, Vitamin E and C, Beta-carotene, Lycopene, Iron, Zinc, and Selenium are required for both men and women. Also, nutritional drinks may also help with fertility issues.
Studies report that pomegranate juice can improve one's sperm count and motility. It is believed that the potent antioxidants found in pomegranates may protect the fatty acids in sperm from damage.
Pomegranate juice is just one of the drinks that can aid in fertility. A combination of guava and watermelon juice is also helpful. This drink has the elements needed by men to be effective in reproduction. The lycopene in guava, for example, has antioxidant properties that enhances the function of the male reproductive system.
In looking for something to gulp, men who are having problems with fertility should be choosing their drinks wisely. Retreat back to nature and start juicing today!
Health Benefits of Sauna and Massage
Are you finding it hard to achieve Rapid Eye Movement (REM) sleep? Do you often feel lethargic on most days of the week? Are you experiencing frequent chronic headaches and are always stressful due to the demands you face at work and at home?
Saunas and massages are sought after by many to ease these, enhance relaxation, and heal body pains by loosening the muscle with a certain rubbing technique.
Massage performs delicate and flexible circulatory movement on tissues, raises circulation to your muscles, improves the range of motion and flexibility, heals knots and scar tissue, reduces tension, pain and stress.
Try to opt for a sauna and massage combo at least once a month. If you can afford them for at least once a week, that would be best. It is absolutely relaxing and stress-relieving. It improves circulation, rejuvenates your energy, and conditions your skin as well.
There are a plenty of salons and spas available for men today. You can easily have massage and sauna.
Remember, on the day of your appointment, eat lightly an hour before. It is important that you do not feel bloated during these procedures. Consuming a small amount of food prevents hunger while you are on session.
Scheduling a massage and sauna combo once a month can offer both men and women with incomparable experience that can benefit a person physically, mentally, emotionally, and spiritually that can revitalize a fatigued body and mind from day-to-day stress.
Facials for Men
Are facials necessary for men? Most men would have never thought of skin care. But the fact is, men's skin is more prone to blackheads, trapped pores, and greater oil secretion.
Skin care and facials should not only be for women. Men should embrace them equally, too. Although men are not as verbal as women, skin problem can affect them emotionally just the same. Taking care of your skin, knowing your skin care range and going for regular facials do not make you any less of a man. In fact, real men take care of their skin and go for facials when needed. Lack of doing so may eventually lead to serious problems. There is a long list of celebrities who keep up their youthful look by removing facial lines thru Botox. You don't have to battle with nature but you can certainly age gracefully.
There are plenty of salons and spas available for men today. Facial massage helps firm and tone the skin. The massage helps to move the muscles and tighten them up. Another medical benefit of facial massage is that it helps relieve sinus congestion. Gently rubbing the side of the bridges of your nose helps reduce blockage.
Men are not aware of the facial expressions they make at times. Certain expressions like frowning and eyebrow raising create lines on their faces. The more often this happens, the deeper and more permanent the lines are. It helps ease the tension you might be facing from work, home or relationship, relaxes your mind, and removes tiredness off your face.
Skin care needs to work both ways, internally and externally. You have to keep up with the exercise routine and diet as well. Always maintain a great supply of vegetables. The greener the better! Take fruits and drink sufficient water every day. Remove all junk foods on your diet list.
Multi-Vitamin Supplementation
Many people don't really know their body's requirements and why there is a need for supplementation every single day. They completely rely on their meals alone, thinking these will suffice?
Multivitamins intake has been a debatable topic over the years, to date, there is not enough of awareness.Complacency still exists in the community. Many are complacent that by having the standard recommended servings of vegetables and fruits, taking multivitamins or supplements is not necessary.
But the truth is multivitamins are essential. You do not have to wait till you are unwell to consider taking them. Vitamins are for supplementing a normal meal with nutritional values that food cannot give. We need to replenish ourselves with vitamins constantly because they are not stored for long in the body. Instead, they travel through your bloodstream. This cluster of vitamins includes vitamin C, and the large group of B vitamins - B1 (thiamine), B2 (riboflavin), niacin, B6 (pyridoxine), folic acid, B12 (cobalamine), biotin, and pantothenic acid.
Herbal supplements are another nutritional enhancement. They are processed plants in capsule form. Herbal supplements have phytonutrients that exert different activities in the body to enhance biological processes. The big difference between vitamins and herbal supplements is that the latter may be used to alleviate symptoms of specific ailments or diseases. For example, Ashwagandha is widely used to help relieve stress while restoring balance in your nervous system. It improves the fighting capacity or adaptability of the body against all types of stress. Ashwagandha also deeply rejuvenates on a cellular level. It elevates stamina and endurance, maintaining enough energy throughout the day as it relieves exhaustion. Vitamins and mineral supplements are taken generally to make up for nutrients lacking in their diet. Women, who are not getting sufficient calcium diet, take calcium supplements daily to help prevent osteoporosis.
We may not realize this, but by consuming herbal supplements, we are absorbing nutrients from plants. Herbal medicine has come a long way and holds a respected history. Numerous studies have proven for a fact that the therapeutic benefits and the healing ability of several medicinal herbs are significant if they are properly administered with a healthy lifestyle.
Multivitamins intake has been a debatable topic over the years, to date, there is not enough of awareness.Complacency still exists in the community. Many are complacent that by having the standard recommended servings of vegetables and fruits, taking multivitamins or supplements is not necessary.
But the truth is multivitamins are essential. You do not have to wait till you are unwell to consider taking them. Vitamins are for supplementing a normal meal with nutritional values that food cannot give. We need to replenish ourselves with vitamins constantly because they are not stored for long in the body. Instead, they travel through your bloodstream. This cluster of vitamins includes vitamin C, and the large group of B vitamins - B1 (thiamine), B2 (riboflavin), niacin, B6 (pyridoxine), folic acid, B12 (cobalamine), biotin, and pantothenic acid.
Herbal supplements are another nutritional enhancement. They are processed plants in capsule form. Herbal supplements have phytonutrients that exert different activities in the body to enhance biological processes. The big difference between vitamins and herbal supplements is that the latter may be used to alleviate symptoms of specific ailments or diseases. For example, Ashwagandha is widely used to help relieve stress while restoring balance in your nervous system. It improves the fighting capacity or adaptability of the body against all types of stress. Ashwagandha also deeply rejuvenates on a cellular level. It elevates stamina and endurance, maintaining enough energy throughout the day as it relieves exhaustion. Vitamins and mineral supplements are taken generally to make up for nutrients lacking in their diet. Women, who are not getting sufficient calcium diet, take calcium supplements daily to help prevent osteoporosis.
We may not realize this, but by consuming herbal supplements, we are absorbing nutrients from plants. Herbal medicine has come a long way and holds a respected history. Numerous studies have proven for a fact that the therapeutic benefits and the healing ability of several medicinal herbs are significant if they are properly administered with a healthy lifestyle.
I Tried It: Paddleboarding
This past Saturday evening I found myself balanced on a paddleboard in the middle of Burlington Bay on Lake Champlain. The water was still, its depths blue-green and seemingly bottomless. As the sun sank lower, casting its golden pink rays over the Adirondack Mountains across the lake, the rhythmic splish-splash of my paddle kept time with the faint music floating across the water from a beach-side festival.
It was, in short, a little piece of heaven.
For anyone who hasn’t heard of paddleboarding (also known as paddlesurfing), it basically boils down to standing on a big surfboard while doing canoe-style strokes with a super-long paddle. I’d been longing to try it for months—why should celebs like Michelle Williams, Jennifer Aniston, and Kate Hudson have all the fun?—but Birmingham, Alabama, isn’t exactly a hotbed of aquatic activity.
So as soon as I nailed down the dates for my family’s annual summer Vermont vacation, I got in touch with Jason Starr, owner of PaddleSurf Champlain, to set up a lesson.
We started out on terra firma, practicing the three basic strokes—forward (for, well, moving forward), sweep (for gradual turns), and reverse sweep (for quick turns). Once Jason was confident I had those down, it was time to conquer the lake. Initially, he had me kneel on the board, allowing time to get used to balancing while paddling with added resistance from the water.
Once I felt relatively comfortable, I carefully got to my feet. Talk about core engagement! While the waves seemed to be as firmly on vacation as I was, I still needed to keep my whole middle section strongly engaged in order to stay upright. The muscles in my legs and feet were clenched just as tightly as I tried to balance the need for strength in my strokes with my fervent desire to not fall off the board and lose my favorite hat.
I inched forward. Jason, clearly as at home on the board as a wizened mariner at the helm of his most seaworthy vessel, stayed gamely nearby, suggesting helpful tweaks—a more circular stroke here, a straighter arm there. We had just practiced a turn back toward the shore when a motorboat passed behind us, churning up a brief series of waves. My board began to pick up speed as it rode the mini-swells, and the feeling was so delightful that I forgot I was a beginner and began to relax.
And, lo and behold, it all became easier after that. My strokes became more confident, my balance stronger, my progress smoother. I found myself gliding along, chatting easily with Jason as our boards kept pace.
How can I describe what it was like, to be out there in the middle of the bay? It felt different from being in a kayak or a canoe, like I was pulling a fast one on Mother Nature by skimming over the water as if standing on Aladdin’s flying carpet. A whole new world, indeed.
The hour passed far too quickly. As we headed back toward the beach, a seagull flew by in the opposite direction. I envied him.
It was, in short, a little piece of heaven.
For anyone who hasn’t heard of paddleboarding (also known as paddlesurfing), it basically boils down to standing on a big surfboard while doing canoe-style strokes with a super-long paddle. I’d been longing to try it for months—why should celebs like Michelle Williams, Jennifer Aniston, and Kate Hudson have all the fun?—but Birmingham, Alabama, isn’t exactly a hotbed of aquatic activity.
So as soon as I nailed down the dates for my family’s annual summer Vermont vacation, I got in touch with Jason Starr, owner of PaddleSurf Champlain, to set up a lesson.
We started out on terra firma, practicing the three basic strokes—forward (for, well, moving forward), sweep (for gradual turns), and reverse sweep (for quick turns). Once Jason was confident I had those down, it was time to conquer the lake. Initially, he had me kneel on the board, allowing time to get used to balancing while paddling with added resistance from the water.
Once I felt relatively comfortable, I carefully got to my feet. Talk about core engagement! While the waves seemed to be as firmly on vacation as I was, I still needed to keep my whole middle section strongly engaged in order to stay upright. The muscles in my legs and feet were clenched just as tightly as I tried to balance the need for strength in my strokes with my fervent desire to not fall off the board and lose my favorite hat.
I inched forward. Jason, clearly as at home on the board as a wizened mariner at the helm of his most seaworthy vessel, stayed gamely nearby, suggesting helpful tweaks—a more circular stroke here, a straighter arm there. We had just practiced a turn back toward the shore when a motorboat passed behind us, churning up a brief series of waves. My board began to pick up speed as it rode the mini-swells, and the feeling was so delightful that I forgot I was a beginner and began to relax.
And, lo and behold, it all became easier after that. My strokes became more confident, my balance stronger, my progress smoother. I found myself gliding along, chatting easily with Jason as our boards kept pace.
How can I describe what it was like, to be out there in the middle of the bay? It felt different from being in a kayak or a canoe, like I was pulling a fast one on Mother Nature by skimming over the water as if standing on Aladdin’s flying carpet. A whole new world, indeed.
The hour passed far too quickly. As we headed back toward the beach, a seagull flew by in the opposite direction. I envied him.
Shake Up Your Workout With Vibration Training
While the phrase “vibration training” might stir up long-ago visions of plump women with shimmying belts circling their rear ends, it actually refers to a legit way to get fit. Credible, journal-worthy research has been done on these shake-you-up platforms, showing that by causing your muscle fibers to contract at a super-high rate, not only can they help build strength (whether you’re doing exercises or just standing there), but also increase bone density (and, my fellow women over 30, it’s never too early to start doing that).
Until very recently, to use one you’d have to head to a gym or rehab cent
er, or expect to shell out four figures for a home version. Slowly but surely, though, more affordable models—like the Gaiam Vibe-Fit Trainer—are making their way onto the market.
The Vibe-Fit looks a lot like a fancy doctor’s scale, with a platform about the size of a newspaper folded in half. While it lacks the sturdiness of a higher-priced model (it’s a bit noisy when turned on, as I expected, but also a bit clackety-sounding), it’s a decently built machine. The handles adjust to different heights, it comes with attachable resistance bands, and the display is bright and clear. There are 12 speeds and four vibration modes to choose from, though it’s not clear from the accompanying booklet what the different modes are for or how they should be used (I stuck mostly with the first, steady mode).
A lot isn’t clear from the booklet, actually. Assembling the unit would’ve taken five minutes (instead of 25) if there had been instructions instead of just vague drawings. And while the booklet contains a selection of exercises with how-to descriptions, they’re not fashioned into a particular routine and there are no guidelines regarding sets and reps.
But I digress.
The first time I stood on the machine, it felt really odd and somewhat unsettling—like what I imagine it would be like to hold onto a low-speed jackhammer. With time, though, my body got used to being shaken like a martini, and I could definitely feel its effects. The moves I tried—squats, lunges, push-ups, triceps dips—were all noticeably more challenging. (The platform, with its hard plastic massage nubs, can be tough on your hands, though, so put a towel down for cushioning.)
While the booklet suggests limiting your use of the Vibe-Fit to no more than 20 minutes, you may want to aim for even less—say, 10 minutes max, and not every day—and stick to the lower speeds. In the science world, the jury’s still out on how much vibrating is too much, so it’s best to play it safe. (Important note: If you’re pregnant, this is not the machine for you.)
The bottom line: While a vibration trainer is far from being a necessary addition to your home gym, doing strength workouts on the platform can help build muscle faster and therefore cut down on your workout time (and if you can’t work out for some reason, just standing on it can help you get stronger). And even though the Vibe-Fit isn’t perfect, it’s worth the price if you’re in the market.
How to Work Out (Safely!) in the Heat
Here in Alabama, “summertime” usually means temperatures in the 90s (at least) plus a heapin’ helping of humidity. Even if you don’t live in the Deep South, chances are it’s getting pretty toasty outside where you live. But that doesn’t mean you have to give up your outdoor workouts. Try these keep-cool tips from Michele Olson, PhD, professor of exercise science at Auburn University, in Montgomery, Ala.
Drink up. Guzzle 8 ounces of water at least 30 minutes before you head out, then another 4 ounces every 15 to 20 minutes during your workout.
Follow the 3 L’s. Clothing-wise, go with lightweight, light-colored, and loose-fitting. And leave the cotton at home (unless you enjoy wearing the equivalent of a heavy wet rag); instead, don togs made with tech fabrics like Coolmax and Dri-Fit—they wick sweat to keep you cooler.
Protect yourself. It takes time for your skin to absorb sunscreen, so apply it at least 30 minutes pre-workout. (Cloudy? Slather it on anyway—damaging UV rays can still penetrate.) And don’t forget your hat and sunglasses.
Head for the trees. Route-wise, shady beats sunny every time.
Ease up. When it’s super-hot, you need to cut your body some slack. Keep to moderate intensity (save those vigorous sprints for the treadmill), trim 10 minutes or so off your workout time, and exercise in the morning (before the earth has absorbed the heat of the day).
Know when to stop. Taste one of those myriad beads of sweat as they dribble down your face. Super-salty? You’re probably losing too much water and sodium—and that can lead to cramping or dehydration. Head back inside pronto. Ditto if you feel nauseated, weak, or dizzy during your workout.
Think gym. If both heat and humidity are higher than you’re used to—especially if you’re planning an afternoon workout—then OK, you do need to choose treadmill (or a great DVD) over pavement pounding. Here’s why: The evaporation of your sweat is what keeps you from overheating, and in pea soup–like conditions, that can’t happen. So bite the bullet, hop on the sidewalk to nowhere, and remember: There’s always tomorrow.
How Safe Is That Salon Procedure?
When Alexandra Spunt went for a keratin hair treatment at a Los Angeles salon two years ago, she hoped to walk out with two months' worth of silky-straight locks. What she didn’t expect: two hours of burning eyes and a sore throat. "The stylist offered me goggles because my eyes stung and I couldn’t stop coughing," says Spunt, 32. She was shocked to learn that the treatment likely contained formaldehyde—deemed a possible human carcinogen by the Environmental Protection Agency (EPA).
You’ve heard that pedicure tubs are teeming with fungus. And you probably know that your waxer shouldn’t double-dip. But new dangers have been popping up at salons, and it’s hard for clients, regulators, and even salon owners to keep up. The U.S. Food and Drug Administration (FDA) has a limited ability to regulate cosmetic ingredients, says Claudia Polsky, a deputy attorney general in California’s Environment Law section. For instance, "the FDA cannot require ingredient labeling on products intended for salon use only," she says. And there’s no federal body overseeing the safety of salons, or how well-trained employees are. That means it’s up to you to get informed. Here’s what you need to know to stay safe.
Great hair can be dangerous
Walk into a salon offering a keratin treatment, and you may see stylists in masks with fans pointed their way. And with good reason: Formaldehyde has been ID’d as the key active ingredient in many hair-straightening treatments currently offered in salons. Recently, Oregon’s Occupational Health and Safety Administration found the chemical in samples of nine different products—one of which was actually labeled "formaldehyde-free."
Some epidemiological studies have linked exposure to formaldehyde over several months with certain forms of cancer, such as leukemia. In the short term, it can cause scalp rashes when it comes into contact with the head; when inhaled (whether you’re receiving the treatment or sitting next to someone who is), it can lead to burning eyes, nose, and throat, and even asthma attacks if you’re prone to them, says Julia Quint, PhD, a retired toxicologist from the California Department of Public Health. While it may be possible to get a safe keratin treatment if the salon is properly ventilated, "we’re advising that consumers steer clear altogether," says environmental scientist Alexandra Gorman Scranton, who directs science and research for Women’s Voices for the Earth, a nonprofit organization that works to eliminate toxic chemicals that have an impact on women’s health. "Formaldehyde sensitivity can vary from person to person, but you won’t know you have a problem with it until you get sick."Some side sffects can be as tough as nails
Manicures and pedicures are perhaps the most common salon treatments, but they’re not necessarily the safest. A University of Texas studypublished in the Archives of Dermatology in 2009 reported on two women who’d developed skin cancers on the backs of their hands. Both frequently used nail dryers that emit UV light.
It’s unclear how much the dryers might increase your cancer risk, since lesions take years to develop. What we do know is that they’ve become a fixture in salons everywhere. So until more research is conducted, many dermatologists advise that you slather on sunscreen before your nail tech applies polish, or stick to fan-based dryers, especially if you get your nails done weekly or monthly. "I will never use a UV light again," says Carolyn Jacob, MD, a spokeswoman for the American Academy of Dermatology and dermatologist in private practice in Chicago. "Yes, this report was only on two patients. But the UV lights drying your nails are primarily made from UVA light, which means there is potential for cell damage, wrinkling, and skin cancer. Go with the fan dryers instead."
Peels aren’t always so appealing
There’s no denying that they work: Chemical peels can brighten and lighten skin to dramatic effect, and help reduce the appearance of fine lines, wrinkles, and age spots. But some of these formulas are so powerful that they can cause burns and even scarring if handled incorrectly—and since they’re being used more frequently these days, and in more casual settings (like spas rather than a dermatologist’s office), the potential for danger is multiplied. Nia Terezakis, MD, a clinical professor of dermatology at Tulane University Medical Center and dermatologist in private practice in New Orleans, has seen patients come in with white doughnut shapes around their mouths after getting peels from inexperienced salon technicians who left the solution on for too long, permanently damaging the pigment there. "There’s nothing in the world that will put the color back in your skin after that," Dr. Terezakis says.
So if you’re at the salon or spa, stick to "light" peels (such as glycolic peels), which have an alpha-hydroxy acid content under 10 percent and pH level above 3.5, per FDA rules. "Medium or deep peels should only be performed by a dermatologist with experience in giving them," Dr. Terezakis says. But know that even a light peel can cause a bad reaction if it isn’t done properly. "Glycolic acid peels have to be neutralized after several minutes with a neutralizing solution or water," Dr. Jacob says. "If they’re left on too long, they can burn the skin, leaving blisters, scabs, and sometimes permanent redness." And even beta-hydroxy peels, which self-neutralize—eliminating the risk of keeping them on too long—can burn you if the acidic content is higher than it should be, she adds.
Consider the price of beauty
While the experts we spoke with agreed that it’s worth minimizing your exposure to salon hazards, nobody recommended going cold turkey on every spa service you love. But to stay safe, you must do your homework first. Before you try any new treatment—even if it’s just new to you—"look for any clinical studies on the active ingredients," Dr. Jacob says. Not comfortable combing through scientific research? Skin Deephas compiled thousands of reports on ingredient safety, and the FDAissues readable consumer warnings on ingredients. Ask your doctor if she’s heard any reports about the dangers of a device or product, or has any specific concerns about its safety or its effects on you. When in doubt, it can’t hurt to wait it out until more has been learned about the service in question. "Don’t be a guinea pig!" Dr. Jacob says.
And if you have made the educated decision to go in for a treatment, investigate the place you’re getting it just as carefully. "Find out if you know anyone who’s been to the salon you’re planning to visit" and can report on safety precautions it takes, Dr. Terezakis says. "Check with the Better Business Bureau to see if there have been any complaints. If you’re going to a place with a good reputation, they are going to want to conduct business in a way that’s safe." For facial treatments, "trust your dermatologist over anyone else," Dr. Jacob says. Yes, you may have to pay a few bucks more—but you’ll be glad to have someone on hand with years of medical training and experience if something does go wrong.
How safe is a medi-spa?
"Medi-spas," which promise the pampering of a spa with the expertise of a doctor’s office, have grown in number by more than 50 percent since 2006, according to SpaFinder, which reports on the global spa industry. In theory, a medi-spa offers salon fare, like facials and massages, as well as cosmetic medical procedures like superstrength peels and laser hair removal from estheticians working under an MD’s supervision. But the regulations on medi-spas vary from state to state—and aren’t always enforced. "Before you go, make sure a doctor specializing in dermatology or cosmetic surgery will be on hand," says Soram Khalsa, MD, a doctor of integrative medicine on staff at Cedars-Sinai Hospital in Los Angeles. Here, services which don’t, and do, require a physician.
See a licensed esthetician (at a medi-spa, regular spa, or salon) for: Facials, massages, microdermabrasion, mud wraps, and "light" peels, including glycolic acid and enzyme peels (which have an alpha-hydroxy acid content under 10 percent and a pH level above 3.5).
See a physician for: Botox, collagen wrinkle-fillers and other injectables, laser hair removal, and "medium" or "deep" peels.
You’ve heard that pedicure tubs are teeming with fungus. And you probably know that your waxer shouldn’t double-dip. But new dangers have been popping up at salons, and it’s hard for clients, regulators, and even salon owners to keep up. The U.S. Food and Drug Administration (FDA) has a limited ability to regulate cosmetic ingredients, says Claudia Polsky, a deputy attorney general in California’s Environment Law section. For instance, "the FDA cannot require ingredient labeling on products intended for salon use only," she says. And there’s no federal body overseeing the safety of salons, or how well-trained employees are. That means it’s up to you to get informed. Here’s what you need to know to stay safe.
Great hair can be dangerous
Walk into a salon offering a keratin treatment, and you may see stylists in masks with fans pointed their way. And with good reason: Formaldehyde has been ID’d as the key active ingredient in many hair-straightening treatments currently offered in salons. Recently, Oregon’s Occupational Health and Safety Administration found the chemical in samples of nine different products—one of which was actually labeled "formaldehyde-free."
Some epidemiological studies have linked exposure to formaldehyde over several months with certain forms of cancer, such as leukemia. In the short term, it can cause scalp rashes when it comes into contact with the head; when inhaled (whether you’re receiving the treatment or sitting next to someone who is), it can lead to burning eyes, nose, and throat, and even asthma attacks if you’re prone to them, says Julia Quint, PhD, a retired toxicologist from the California Department of Public Health. While it may be possible to get a safe keratin treatment if the salon is properly ventilated, "we’re advising that consumers steer clear altogether," says environmental scientist Alexandra Gorman Scranton, who directs science and research for Women’s Voices for the Earth, a nonprofit organization that works to eliminate toxic chemicals that have an impact on women’s health. "Formaldehyde sensitivity can vary from person to person, but you won’t know you have a problem with it until you get sick."Some side sffects can be as tough as nails
Manicures and pedicures are perhaps the most common salon treatments, but they’re not necessarily the safest. A University of Texas studypublished in the Archives of Dermatology in 2009 reported on two women who’d developed skin cancers on the backs of their hands. Both frequently used nail dryers that emit UV light.
It’s unclear how much the dryers might increase your cancer risk, since lesions take years to develop. What we do know is that they’ve become a fixture in salons everywhere. So until more research is conducted, many dermatologists advise that you slather on sunscreen before your nail tech applies polish, or stick to fan-based dryers, especially if you get your nails done weekly or monthly. "I will never use a UV light again," says Carolyn Jacob, MD, a spokeswoman for the American Academy of Dermatology and dermatologist in private practice in Chicago. "Yes, this report was only on two patients. But the UV lights drying your nails are primarily made from UVA light, which means there is potential for cell damage, wrinkling, and skin cancer. Go with the fan dryers instead."
Peels aren’t always so appealing
There’s no denying that they work: Chemical peels can brighten and lighten skin to dramatic effect, and help reduce the appearance of fine lines, wrinkles, and age spots. But some of these formulas are so powerful that they can cause burns and even scarring if handled incorrectly—and since they’re being used more frequently these days, and in more casual settings (like spas rather than a dermatologist’s office), the potential for danger is multiplied. Nia Terezakis, MD, a clinical professor of dermatology at Tulane University Medical Center and dermatologist in private practice in New Orleans, has seen patients come in with white doughnut shapes around their mouths after getting peels from inexperienced salon technicians who left the solution on for too long, permanently damaging the pigment there. "There’s nothing in the world that will put the color back in your skin after that," Dr. Terezakis says.
So if you’re at the salon or spa, stick to "light" peels (such as glycolic peels), which have an alpha-hydroxy acid content under 10 percent and pH level above 3.5, per FDA rules. "Medium or deep peels should only be performed by a dermatologist with experience in giving them," Dr. Terezakis says. But know that even a light peel can cause a bad reaction if it isn’t done properly. "Glycolic acid peels have to be neutralized after several minutes with a neutralizing solution or water," Dr. Jacob says. "If they’re left on too long, they can burn the skin, leaving blisters, scabs, and sometimes permanent redness." And even beta-hydroxy peels, which self-neutralize—eliminating the risk of keeping them on too long—can burn you if the acidic content is higher than it should be, she adds.
Consider the price of beauty
While the experts we spoke with agreed that it’s worth minimizing your exposure to salon hazards, nobody recommended going cold turkey on every spa service you love. But to stay safe, you must do your homework first. Before you try any new treatment—even if it’s just new to you—"look for any clinical studies on the active ingredients," Dr. Jacob says. Not comfortable combing through scientific research? Skin Deephas compiled thousands of reports on ingredient safety, and the FDAissues readable consumer warnings on ingredients. Ask your doctor if she’s heard any reports about the dangers of a device or product, or has any specific concerns about its safety or its effects on you. When in doubt, it can’t hurt to wait it out until more has been learned about the service in question. "Don’t be a guinea pig!" Dr. Jacob says.
And if you have made the educated decision to go in for a treatment, investigate the place you’re getting it just as carefully. "Find out if you know anyone who’s been to the salon you’re planning to visit" and can report on safety precautions it takes, Dr. Terezakis says. "Check with the Better Business Bureau to see if there have been any complaints. If you’re going to a place with a good reputation, they are going to want to conduct business in a way that’s safe." For facial treatments, "trust your dermatologist over anyone else," Dr. Jacob says. Yes, you may have to pay a few bucks more—but you’ll be glad to have someone on hand with years of medical training and experience if something does go wrong.
How safe is a medi-spa?
"Medi-spas," which promise the pampering of a spa with the expertise of a doctor’s office, have grown in number by more than 50 percent since 2006, according to SpaFinder, which reports on the global spa industry. In theory, a medi-spa offers salon fare, like facials and massages, as well as cosmetic medical procedures like superstrength peels and laser hair removal from estheticians working under an MD’s supervision. But the regulations on medi-spas vary from state to state—and aren’t always enforced. "Before you go, make sure a doctor specializing in dermatology or cosmetic surgery will be on hand," says Soram Khalsa, MD, a doctor of integrative medicine on staff at Cedars-Sinai Hospital in Los Angeles. Here, services which don’t, and do, require a physician.
See a licensed esthetician (at a medi-spa, regular spa, or salon) for: Facials, massages, microdermabrasion, mud wraps, and "light" peels, including glycolic acid and enzyme peels (which have an alpha-hydroxy acid content under 10 percent and a pH level above 3.5).
See a physician for: Botox, collagen wrinkle-fillers and other injectables, laser hair removal, and "medium" or "deep" peels.
San Francisco judge removes circumcision ban from ballot
San Francisco residents will not be voting on whether male circumcisions should be banned in the city this fall.
A Superior Court judge ordered Thursday that the proposed measure, which had initially made it onto the November 8 city ballot, be removed entirely.
The measure proposed banning male circumcisions with the penalty of jail time or a $1,000 fine. It would not have granted religious exemptions.
From the beginning, the controversial ballot measure faced strong resistance from medical, religious and civil liberties groups.
Should teens make circumcision decision?
Superior Court Judge Loretta Giorgi wrote that male circumcision is "a widely practiced medical procedure" and that medical services are left to the regulation of the state, not individual cities.
The judge's ruling was hailed by the Jewish Community Relations Council, the Anti-Defamation League and others who had sued to remove the measure from the ballot.
'Inactivists' to San Francisco: Ban circumcision
"While we are confident that the overwhelming majority of San Franciscans would have voted to defeat this extreme measure and are grateful for the outpouring of support from every sector of the community, we believe the right decision was made in the right venue," said Abby Michelson Porth, associate director of Jewish Community Relations Council.
The plaintiff's efforts were also supported by the American Civil Liberties Union and San Francisco's Medical Society. And even the San Francisco City Attorney's office expressed concerns about whether the measure was constitutional.
San Francisco's proposed circumcision ban galvanizes religious opposition
"It's unusual for a judge to order an initiative off the ballot, but the proposed circumcision ban presented that rare case where the court should block an election on an initiative," said ACLU Northern California staff attorney Margaret Crosby in a released statement. "Not only is the ban patently illegal, it also threatened family privacy and religious freedom. The court's order protects fundamental constitutional values in San Francisco."
Anti-circumcision advocates who had gathered more than 7,000 signatures to put the measure on the ballot expressed disappointment and said they would appeal.
Circumcising our son -- how do we decide?
"To remove an initiative before it comes on ballot is an extraordinarily irregular thing to do," said Lloyd Schofield, who is part of a Bay Area advocacy group that says the surgery violates human rights and likens it to "male genital mutilation."
"To go to this length to have it struck from the ballot is undemocratic," he said. "It's very, very unfortunate."
A Superior Court judge ordered Thursday that the proposed measure, which had initially made it onto the November 8 city ballot, be removed entirely.
The measure proposed banning male circumcisions with the penalty of jail time or a $1,000 fine. It would not have granted religious exemptions.
From the beginning, the controversial ballot measure faced strong resistance from medical, religious and civil liberties groups.
Should teens make circumcision decision?
Superior Court Judge Loretta Giorgi wrote that male circumcision is "a widely practiced medical procedure" and that medical services are left to the regulation of the state, not individual cities.
The judge's ruling was hailed by the Jewish Community Relations Council, the Anti-Defamation League and others who had sued to remove the measure from the ballot.
'Inactivists' to San Francisco: Ban circumcision
"While we are confident that the overwhelming majority of San Franciscans would have voted to defeat this extreme measure and are grateful for the outpouring of support from every sector of the community, we believe the right decision was made in the right venue," said Abby Michelson Porth, associate director of Jewish Community Relations Council.
The plaintiff's efforts were also supported by the American Civil Liberties Union and San Francisco's Medical Society. And even the San Francisco City Attorney's office expressed concerns about whether the measure was constitutional.
San Francisco's proposed circumcision ban galvanizes religious opposition
"It's unusual for a judge to order an initiative off the ballot, but the proposed circumcision ban presented that rare case where the court should block an election on an initiative," said ACLU Northern California staff attorney Margaret Crosby in a released statement. "Not only is the ban patently illegal, it also threatened family privacy and religious freedom. The court's order protects fundamental constitutional values in San Francisco."
Anti-circumcision advocates who had gathered more than 7,000 signatures to put the measure on the ballot expressed disappointment and said they would appeal.
Circumcising our son -- how do we decide?
"To remove an initiative before it comes on ballot is an extraordinarily irregular thing to do," said Lloyd Schofield, who is part of a Bay Area advocacy group that says the surgery violates human rights and likens it to "male genital mutilation."
"To go to this length to have it struck from the ballot is undemocratic," he said. "It's very, very unfortunate."
Am I narcissistic?
Q: I keep hearing how everyone these days is narcissistic. How do I know if I am?
The fact that you are asking probably means you don't have narcissistic personality disorder, because people who do have it generally don't have enough self-awareness to question their own behavior.
While many people occasionally exhibit "narcissistic traits" like self-absorption or arrogance, true narcissistic personality disorder takes it to another level.
People with this disorder have a very inflated image of themselves (exaggerating their talents), and expect everyone around them to admire them. They are very sensitive to criticism, believe others are jealous of them, and often have dramatic mood swings and outbursts. They also have a sense of entitlement.
Behind the arrogant front, though, they usually have a self-esteem problem.
Not surprisingly, celebrities in general and reality TV stars in particular rate super-high in narcissistic traits.West Nile Virus reported in Indianapolis
The West Nile Virus has been found in mosquitoes in Franklin and Center townships, the Marion County Public Health Department announced Friday.
The virus carrying mosquitoes were discovered in traps used to monitor the local mosquito population.
There have been no reports of illness from West Nile Virus in Marion County in 2011.
In 2010, there were three confirmed cases and no reported deaths. Since 2002, five people have died and 50 have fallen ill with the virus.
"West Nile virus is a serious public health threat, and while we are doing all we can, there are steps the public can take to lower their risk of infection," said Virginia A. Caine, M.D., director, Marion County Public Health Department.
The virus was discovered in Hamilton County earlier this week , the State Department of Health reported.
There are steps you can take to help protect yourself and neighbors from mosquito born illnesses by eliminating mosquito breeding grounds.
Mosquitoes lay eggs in standing water and even containers capable of holding small amounts of water should be regularly cleaned or covered.
The health department recommends properly disposing old tires, storing buckets upside down, cleaning out clogged gutters and regularly changing water in small pools and bird baths.
"Last year, we collected more than 13,000 discarded tires. Not only are we eliminating mosquito breeding sites, but we are improving the environment, too," said Chuck Dulla, administrator of the mosquito control program. Since 2000, the health department has collected more than 104,000 tires.
The virus carrying mosquitoes were discovered in traps used to monitor the local mosquito population.
There have been no reports of illness from West Nile Virus in Marion County in 2011.
In 2010, there were three confirmed cases and no reported deaths. Since 2002, five people have died and 50 have fallen ill with the virus.
"West Nile virus is a serious public health threat, and while we are doing all we can, there are steps the public can take to lower their risk of infection," said Virginia A. Caine, M.D., director, Marion County Public Health Department.
The virus was discovered in Hamilton County earlier this week , the State Department of Health reported.
There are steps you can take to help protect yourself and neighbors from mosquito born illnesses by eliminating mosquito breeding grounds.
Mosquitoes lay eggs in standing water and even containers capable of holding small amounts of water should be regularly cleaned or covered.
The health department recommends properly disposing old tires, storing buckets upside down, cleaning out clogged gutters and regularly changing water in small pools and bird baths.
"Last year, we collected more than 13,000 discarded tires. Not only are we eliminating mosquito breeding sites, but we are improving the environment, too," said Chuck Dulla, administrator of the mosquito control program. Since 2000, the health department has collected more than 104,000 tires.
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