Blue and Broke for the Holidays

Economic woes ratchet up mental health problems already more common this time of year... Read more

Health Tip: Why You May Have Erectile Dysfunction

(HealthDay News) -- Erectile dysfunction occurs when a man can't achieve or maintain an erection during sex.

The American Academy of Family Physicians says the condition doesn't have to be a natural part of getting older. ED often is attributed to physical or psychological causes. Physical reasons may include:

• Having a side effect of surgery on the prostate or bladder, or radiation therapy to the testicles.
• Having low testosterone levels, kidney failure, liver failure, multiple sclerosis or Parkinson's disease.
• Having chronic conditions such as diabetes, high blood pressure, or hardening of the arteries.
• Having had a stroke or an injury to the brain or spinal cord.
• Using too much tobacco or alcohol.
• Being tired.

Prevent Bone Loss and Osteoporosis With Sodium and Potassium Bicarbonate

Eating and drinking an alkaline diet of fresh fruit and vegetables can reduce calcium excretion and boost bone health, says a new study.

Diets high in acidic protein and cereal grain produce an excess of acid residue in the body, which can increase calcium excretion, according to results to be published in the January issue of the Journal of Clinical Endocrinology & Metabolism.

"When it comes to dietary concerns regarding bone health, calcium and vitamin D have received the most attention, but there is increasing evidence that the acid/base balance of the diet is also important," said lead author Bess Dawson-Hughes from Tufts University in Boston.

Bone health is becoming a major segment of the supplements and functional foods market, as ageing populations and the additional strain from acid caused obesity swell the numbers affected by the symptom of osteoporosis. Already the lifetime risk for a woman to have an osteoporotic fracture is 30-40 per cent and in men the risk is about 13 per cent.

"As adults age they become less able to excrete the acid produced via environment, diet, and metabolism," states Dr. Robert O. Young, Director of the pH Miracle Living Center.

"Reacting to the increasing levels of dietary and metabolic acid, the body counters this by bone resorption, a process by which bones are broken down, releasing minerals such as calcium, phosphates, and alkaline (basic) salts into the blood to keep it alkaline at 7.364. Bone resorption weakens the bones and increases the risk of fracture," states Dr. Young.

Tufts researchers, in collaboration with scientists from Northeastern University in Boston, recruited 171 men and women aged 50 or older and randomly assigned them to receive supplements of potassium bicarbonate, sodium bicarbonate, potassium chloride or placebo for three months.

Dawson-Hughes and her co-workers report that only bicarbonate-receiving volunteers had significant reductions in calcium excretion, which indicated a reduction in bone resorption.

"When fruit and vegetables are metabolized they add bicarbonate, an alkaline compound, to the body," said Dr. Dawson Hughes. "Our study found that bicarbonate had a favorable effect on bone resorption and calcium excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults."

"Achieving alkali-producing diets would require drastic changes in food choices and be challenging in older people who tend to have long-established dietary patterns," wrote the researchers.

"Should it be shown to be beneficial, an alternative approach may be to administer bicarbonate in supplement form or to lower the acid-producing capacity of selected foods through alkali fortification," they added.

"I created the nutritional supplement, pHour salts to help maintain the alkaline design of the body and to protect the bones and muscles from the acidic affects of an acidic lifestyle and diet. pHour salts is a combination of sodium, magnesium, potassium and calcium bicarbonate mineral salts. These four mineral salts are powerful alkalizing compounds in the body. The alkali affect in the blood and tissues will show up when you test your urine. The urine pH will show over 8 which indicates an alkaline state of the body tissues. Keeping the body alkaline is the best way to slow down aging and prevent dis-ease, including bone loss and the condition of osteoporosis," states Dr. Young.

Rule would protect right of conscience

A new federal regulation is aimed at protecting the rights of health-care providers who refuse to participate in a procedure such as abortion because of their moral or religious beliefs. full story

Health Tip: Anticipating Acupuncture

(HealthDay News) -- If you've decided to try acupuncture to help treat pain or another health condition, the first step is to find a qualified, licensed acupuncturist.

Once you've accomplished that, the National Center for Complementary and Alternative Medicine offers this explanation of what to expect during your treatment.

• At your initial visit, the acupuncturist should ask you about your health history, medications you are taking, and your lifestyle.
• The metal needles used are extremely thin -- approximately the thickness of a human hair.
• Most people feel very little or no pain as the needles are inserted into the skin.
• The way you feel after the experience may vary. Some people have more energy, while others feel more relaxed.
• Treatments may last several weeks or longer.

Experimental Weight-Loss Pill Passes Early Test

(HealthDay News) -- Researchers are hoping that an experimental new weight-loss drug will prove to be a valuable new weapon in the crusade against obesity.

In recently released phase 2 trials, the drug, known as lorcaserin, resulted in substantial weight loss in obese men and women.




"Lorcaserin is a completely novel mechanism and we think it can bring very robust weight loss. But, also, the safety profile of the compound is excellent," said Dominic P. Behan, co-founder and chief scientific officer of Arena Pharmaceuticals in San Diego, which makes the drug and sponsored a study published in the Dec. 4 issue of the journal Obesity.

"We demonstrated a highly statistically significant, progressive weight loss. This study involved no diet or exercise and the weight loss was rapid and we saw the weight loss in as little as two weeks," he added.

A phase 3 trial is under way and, if all goes well, Arena Pharmaceuticals may file a new drug application with the U.S. Food and Drug Administration at the end of 2009, Behan said.

With some two-thirds of Americans either overweight or obese, the need for an effective weight loss tool is tremendous. Excess weight can lead to a variety of health problems, including heart disease, stroke, cancer, arthritis and type 2 diabetes.

"Obesity is an epidemic," said Dr. Stuart Weiss, a clinical assistant professor of medicine at New York University's Langone Medical Center in New York City. "Diabetes trails behind obesity by a short few years and the numbers of patients that are developing diabetes is staggering."

Diet and exercise are proven antidotes for excess weight, but few people are able to sustain such changes and, even if they lose weight, will regain it.

Some weight-loss drugs are already on the market -- such as Xenical and Meridia -- but have certain side effects.

The drug Fen-phen, a combination of fenfluramine and dexfenfluramine, worked for many but was withdrawn from the market in 1997 when it was linked with increased rates of heart valve problems in patients.

Fen-phen acted on serotonin receptors both in the brain and in the heart and therein lay the problem, Behan said.

"The challenge was to design a compound that was purely selective for the receptor involved, namely the 2c receptor [located in the hypothalamus region of the brain and involved in weight loss] and avoiding the 2b receptor [located in the heart]," Behan said.

The result was lorcaserin, which targets the 5-HT2C serotonin receptor only.

For the phase 2 trial, 469 men and women with a body mass index ranging from 30 to 45 were randomly assigned to one of four groups: 10 milligrams (mg) of lorcaserin once a day, 15 mg once a day, 10 mg twice a day, or a placebo.

Participants taking lorcaserin at 10 mg, 15 mg and 20 mg a day lost 4 pounds, 5.7 pounds and 7.9 pounds, respectively, over the 12-week period. Those in the placebo group lost less than a pound.

In the 10 mg, 15 mg and 20 mg groups, respectively, 12.8 percent, 19.5 percent and 31.2 percent of participants lost 5 percent or more of their starting body weight, versus only 2.3 percent of patients on the placebo.

Participants taking the two higher doses of lorcaserin also shaved inches off their waist and dropped their cholesterol levels.

Also, their echocardiograms -- ultrasound images of the heart -- were normal.

"It [lorcaserin] certainly looks a bit better [than other weight-loss medications]," Weiss said. "We don't have much out there. They're really just modest medications and they don't do much at all."

More information
Visit the U.S. Centers for Disease Control and Prevention for more on overweight and obesity.

Cancer Deaths Take Heavy Financial Toll

(HealthDay News) -- In pure economic terms of productivity lost and the expense of care-giving, cancer deaths cost the United States $232.4 billion in 2000 and will cost $308 billion in 2020, a new report finds.

But another way of measuring that toll includes the human element of years of life lost -- and that model placed the cost of cancer mortality at $960.7 billion in 2000 and projects it to reach $1.472 trillion in 2020.

Those two estimates appear in side-by-side papers published online Dec. 9 in the Journal of the National Cancer Institute. While the numbers differ widely, they are alike in one major respect, said Cathy J. Bradley, a professor of health administration at Virginia Commonwealth University and the Massey Cancer Center in Richmond, Va., and lead author of one of the reports.

"In both cases, the percentage of cost caused by lung cancer was about the same," Bradley said. "Lung cancer accounts for between a quarter and a third of the value of life lost."

The assessment made by Bradley and her colleagues used what is called the human capital approach, which looks strictly at money not earned or money spent because of cancer deaths. Lost productivity cost the country $115.8 billion in 2000. Adding in the cost of care-giving and lost household duties, as well as the loss of regular wage-earning jobs, more than doubled the total of that reckoning.

Robin Yabroff, an epidemiologist at the U.S. National Cancer Institute, and lead author of the second paper, said her "calculation was based on willingness to pay. How much would an individual be willing to pay for an extra year of life?"

Estimates of that figure can vary, depending on the country. The Canadian government, for instance, has set the value of an added year of life at $50,000, a figure it uses to determine whether the national health program will pay for drug treatment, Bradley said. Her report used previous U.S. studies to set the value of an added year of life at $150,000. That estimate led to the $960.7 billion cost for the year 2000.

"Both of these methods are used in the medical literature," Yabroff said. "We thought it would be useful to compare them."

Large as the costs are, they reflect a decrease in the incidence of cancer in the United States. A report issued earlier this month said the rate for all cancers among men and women had dropped 0.8 percent a year between 1999 and 2005 -- a 1.8 percent a year decline for men and a 0.6 percent annual decline for women.

The human capital approach places a higher value on some people than others, Bradley added. For example, "Certain diseases inflict a lower cost because they affect older people more," she said. "Men tend to be valued higher than women, men in their middle years higher than men at the beginning of their career."

The findings could be used to affect cancer spending priorities, Bradley said.

"Policy makers have to decide if we focus on working-age individuals, if we focus on prevention or treatment," she said. "If you get people to stop smoking, 40 years later you see the cost of lung cancer come down. Or perhaps right now you would want to make an impact on treatment."



The assessment of cost is important because "it puts a dollar value on the fact that many people die of cancer at a younger age," Yabroff said.

"But," Bradley added, "you can argue that people are worth more than the wages they earn."

More information
The American Cancer Society has statistics on U.S. cancer deaths.

How the Body Works : The Digestive System

Starting at the mouth, the digestive system helps provide the energy your body needs to perform its many functions. Upon entry into a person's mouth, the teeth cut, tear, crush and grind food. In the mouth, salivary glands respond to the thought or presence of food by producing a fluid containing mucus and the enzymes amylase and maltase. The tongue then mixes the food and rolls it into a soft ball, called the bolus, which is pushed toward the esophagus. Passing through the esophagus the bolus is dropped into the stomach where gastric glands, one secreting digestive enzymes and the other secreting hydrochloric acid, begin to break the food down into smaller pieces. The stomach wall discharges mucus during this phase to protect itself against the action of the gastric acid. From there the food passes into the small intestine through the phylorus, a sphincter muscle that controls the flow of food. It is in the small intestine where a major part of digestion and absorption occurs. The intestinal wall releases enzymes which digest proteins, fats and carbohydrates. Blood and lymph vessels, which supply the small intestine, take away the final products of digestion. The lymphatics transport the fats around the body and finally release them into the bloodstream. Blood takes sugars and amino acids to the liver via the portal vein. The pancreas, like the small intestine, secretes enzymes in an alkaline juice to digest proteins, fats and carbohydrates. It also manufactures hormones which regulate the blood sugar level. From the small intestine, the digested food is received by the liver, which manufactures bile for the gall bladder. The gall bladder stores and discharges the bile, which helps to break down fats into minute droplets. Undigested food from the small intestine is then passed into the large intestine. There blood vessels supplying the large intestine carry away water extracted from the undigested waste. After passing through to the large intestine the ileocecal valve prevents digested food from returning to the small intestine. Undigested food is eliminated from the system through the anus.

How the Body Works : The Mouth

The mouth is the beginning of the digestive system. It is here that the first stages of food breakdown begin. When food enters the mouth, saliva, a fluid containing the digestive enzyme ptyalin and mucus, is secreted by the salivary glands. Saliva not only lubricates the food and begins its chemical digestion, but it also helps to keep the mouth cavity moist and clean. The teeth function mechanically to break up the food into smaller, more readily swallowed and digestible pieces. The tongue and the muscular walls of the mouth shape the food into a moist ball, the bolus, which is pushed to the back of the mouth and into the pharynx to be swallowed.

Do I Need to Use Mouthwash?

Are mouthwashes necessary for good oral health? And if so, what types are the best?"... Read more

Scans Show Sound-Processing Deficits in Autistic Kids

(HealthDay News) -- Children with autism spectrum disorder process sounds a fraction of a second slower than other children, an abnormality that offers insight into listening and language issues linked to the condition, a new study says.

Researchers used magnetoencephalography (MEG), which records minute magnetic fields associated with electrical brain activity, to detect the slight delay in autistic children who were exposed to beeps, tones in pairs, vowels and sentences at different speeds, tones and frequencies.

The findings were expected to be presented Monday at the annual meeting of the Radiological Society of North America (RSNA), in Chicago.

"This delay in processing certain types and streams of sound may underpin the subsequent language processing and communication impairment seen in autistic children," researcher Timothy Roberts, vice chair of research in the department of radiology at Children's Hospital of Philadelphia, said in a news release issued by the RSNA.

This signature of autism found in brain activity may eventually become a biomarker to improve classification of the disorder and aid in treatment and therapy planning, he added.

"We hope that in the future, these signatures will also be revealed in the infant brain to help diagnose autism and allow earlier intervention," he said.

Autism inhibits the brain functions that govern the development of social and communication skills. About one in every 150 American children, mostly boys, is affected by the condition, according to the Autism Society of America.

More information
The U.S. National Library of Medicine has more about hearing problems in children.

FDA finds more traces of toxics in formula

Several samples of infant formula have tested positive for trace amounts of the toxic contaminant melamine or a related compound, the Food and Drug Administration said Thursday. full story

Tooth Replacement Options

A: Tooth replacement options are now more accessible than ever. By "permanent tooth replacement," I assume you mean a non-removable restoration. Some of your choices include dental implants, permanent fixed bridges, acid-etched bridges (Maryland splints), and chairside bonded bridges.... Read more

Texting Food Diaries Helps Kids Stick With Diets

(HealthDay News) -- Experts hope that letting kids have their fingers do the texting will increase compliance with the food diaries that are such a critical part of successful dieting.

As a first proof that such a method might work, a new University of North Carolina study shows that kids aged 5 to 13 are almost twice as likely to text daily records of their food intake, exercise and screen time as those using the old-fashioned kinds of diaries. The research was published in the November/December issue of the Journal of Nutrition Education and Behavior.

Previous studies have shown that dieters who keep these types of records are more likely to lose weight and to keep it off, according to study author Jennifer Shapiro, an assistant professor in the department of psychiatry.

"What we're looking for is a fun way for people, particularly children," to keep these diaries, Shapiro said. "If people enjoy doing it, they're more likely to do it and more likely to lose weight."



The eight-week study following 31 families with children aged 5 to 13 showed that those kids who used text messaging were almost twice as likely to comply with the program than kids who used paper and pencil.

The popularity of this approach was demonstrated by the fact 100 percent of the participating children and parents initially said they hoped they would be selected for the text-messaging group.

In the study, an immediate text message responded to the children's report on how well they met their goals. Children who used the paper-and-pencil diaries had to wait a week to report to their nutritionist for a response to their progress.

"Feedback is very important," Shapiro explained. "It makes them feel like there is someone on the other line paying attention, and they need to be more accountable."

The study's goal was to measure adherence to the dieting diary process and did not measure weight loss, Shapiro said. Because it was such a small study, the results did not reach statistical significance, but the researchers hope to repeat the study with a larger population and for a longer time.

"The idea of text messaging is really interesting, particularly to communicate with a new generation," added Dorothy Teegarden, a professor in the department of foods and nutrition at Purdue University.

But Teegarden agreed further research needs to be done on the effectiveness of this approach, given the wide gap in the age range and the fact that parents also were involved. She explained that some research shows that it's easier to modify behavior within the context of a family environment. "So, just that part of the study might have contributed to better compliance," she added.

The fact that all of the kids wanted to be part of the text-messaging group also may have biased the study, said Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas. The children who were assigned the paper-and-pencil diary might not have been as compliant, because they didn't get the tool they wanted, she explained.

Research has shown that 19 percent of kids aged 6 to 11 are overweight, and 80 percent of those kids become obese adults, according to the study.

More information
For more on children and obesity, go to the U.S. National Institutes of Health.

Alternative Medicine - Videos

From yoga techniques to acupuncture to herbal supplements, learn all about alternative therapies, medicines and nutrition.... Read more

Peppermint Oil, Fiber Can Fight Irritable Bowel

(HealthDay News) -- For some patients, the best therapy for irritable bowel syndrome (IBS) may be older, cheaper drugs such as fiber, antispasmodics and peppermint oil, a new study finds.
According to researchers, these simple treatments have fallen out of favor because of the availability of newer (and more expensive) drugs, some of which have been taken off the market due to safety concerns.

But more traditional therapies should become first-line treatments in guidelines for the treatment of IBS, the experts say.

"IBS can be difficult for physicians to treat," noted lead researcher Dr. Alex Ford, from McMaster University, Health Sciences Centre in Ontario, Canada.

"New drugs are always being developed, but recent ones such as alosetron and tegaserod have been withdrawn, and are now only available on a restricted basis, and renzapride has not been shown to be effective," he said. On the other hand "older drugs, which are cheap, safe, and in some cases available over the counter, appear to be effective in IBS."

The report is published in the Nov. 14 online edition of the BMJ.

As many as 45 million Americans may have IBS, the International Foundation for Functional Gastrointestinal Disorders reports. Between 60 percent and 65 percent of IBS sufferers are women.

In addition to pain and discomfort, people with IBS experience chronic or recurrent constipation or diarrhea -- or bouts of both. While the exact cause of the condition isn't known, symptoms seem to result from a disturbance in the interaction of the gut, brain and nervous system, according to the foundation.

For the study, Ford's team reviewed trials that compared IBS treatment with fiber antispasmodics and peppermint oil to a placebo or no treatment. The trials included more than 2,500 IBS patients.

The researchers found that fiber, antispasmodics and peppermint oil were effective treatments for IBS. Specifically, that meant that to prevent IBS symptoms in one patient, 11 needed to be treated with fiber, five with antispasmodics, and 2.5 with peppermint oil.

There were no serious side effects associated with any of these treatments, the researchers note.

Peppermint oil appeared to be the most effective therapy of those reviewed, the researchers found.

In trials comparing fiber with placebo, insoluble fiber such as bran was not effective. Instead, only soluble fiber, such as ispaghula husk, reduced symptoms. For antispasmodics, the most effective was hyoscine. This should be used first among antispasmodics, Ford's group advised.

"Physicians, particularly those in primary care, who are being asked to take increasing responsibility for the management of IBS, should consider the use of these agents as first-line therapies for IBS," Ford said.

Dr. Roger Jones, from Kings College London and author of an accompanying journal editorial, welcomed the study.

"These treatments might be slightly more effective than recently thought and they are worth trying," Jones said.

For some patients with pain and diarrhea the antispasmodics may be useful. Patients with constipation should try fiber and for other patients, peppermint oil may be helpful, Jones said.

"If you have IBS which is not under reasonably good control or you are not happy with your symptom profile, you should see your primary-care doc or gastroenterologist for review and perhaps remind them that there is new evidence about the effectiveness of these traditional medicines and you would like to give it a go," Jones said.

"Alternatively, if you feel sufficiently well-informed and confident, you can go do it yourself and get these treatments at the pharmacy," Jones added.

More information
For more information on IBS, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

Beta Blocker Use Questioned in Non-Heart Surgery

(HealthDay News) -- An analysis of 33 studies on drugs known as beta blockers has concluded that they are not useful in any surgical procedure other than heart surgery. In fact, using beta blockers for non-coronary surgery may actually increase the risk of stroke, the scientists say.

The researchers who conducted the study -- known as a meta-analysis -- recommend that the guidelines committees of both the American College of Cardiology and the American Heart Association "soften" their recommendations that beta blockers be used to prevent surgical complications in non-coronary operations.

"Our study says that if you look at the overall picture, do a meta-analysis, studies that are not particularly well-done come to the conclusion that they are useful," said Dr. Franz Messerli, professor of medicine at Columbia University and an author of a report published online by The Lancet to coincide with the annual heart meeting now underway. "But if you look at the high-quality studies, there are distinctly more strokes with beta blockers." Beta blockers are drugs that inhibit adrenaline and slow the nerve impulses to the heart. They can also be used to treat irregular heartbeat, known as arrhythmia.

The meta-analysis did show a 35 percent reduced risk of heart attacks and a 64 percent reduction in less serious heart artery blockages among the more than 12,000 participants in all the studies where beta blockers were prescribed before surgery. But there was no overall reduction in total deaths, heart failure or deaths due to heart disease, and a doubled risk of nonfatal stroke.

Beta blocker usage was also associated with a high risk of bradycardia, low heart rate requiring medical treatment, which occurred in 1 of every 22 people getting beta blockers, and of lower blood pressure dangerous enough to require treatment.

In September 2008, researchers writing in the Journal of the American College of Cardiology concluded that beta blocker drugs don't prevent development of heart failure in people with high blood pressure and should not be used as first-line treatment for hypertension.

The increased risk of stroke, occurring in 1 of every 293 beta blocker recipients, is especially important, Messerli said. "Stroke is one of the most devastating complications of cardiovascular disease," he said. "For that reason, we would be very reluctant to use beta blockers in noncomplicated patients."

There is a presurgical role for beta blockers in many cases, Messerli said. "If a patient has coronary artery disease, he or she should certainly be on beta blockers," he said. "If they are on beta blockers already, they should remain on beta blockers. But if there is no particular cardiovascular risk, beta blockers should not be prescribed for noncardiac procedures."

Existing recommendations that call for routine use of beta blockers before surgery should be revised, Messerli said. "This is regarded as a quality measure for physicians," he said. "If they don't prescribe a beta blocker, it is considered to be falling short of a quality measure. Since the data are relatively soft, it certainly should not be a quality measure."

But an argument for use of beta blockers before surgery was made in an accompanying comment to the study by Dr. Don Poldermans, professor of medicine at Erasmus Medical Center in Rotterdam, the Netherlands. One major problem with studies showing difficulties when beta blockers were prescribed was that the doses were too high, Poldermans said.

"A low dose is safe, so why not use it?" Poldermans said, citing a study that he presented to the American Heart Association's annual scientific sessions, in New Orleans.

The study of 1,066 people who underwent surgery and were classified as being of intermediate risk of cardiovascular complications found that 2.1 percent of those getting a moderate daily dose of bisoprolol, a widely used beta blocker, suffered heart attacks or died of heart disease, compared to 6 percent of those not getting the beta blocker, Poldermans reported.

What might help decide the issue would be "a study to clarify dose and regimen" of beta blockers before surgery, he said. But such a study might be difficult to do, because the dangers of high-dose beta blockers are clear, Poldermans said.

"I would be very careful with high doses of beta blockers," he said. "There could be an increased risk of stroke. But a low dose is safe, so why take a high dose?"

More information
Learn why and how beta blockers are used from the Texas Heart Institute.

Statin Might Help More People Fight Heart Disease Than Thought

(HealthDay News) -- A widely used cholesterol-lowering drug appears to protect against heart attacks, stroke and other adverse outcomes in people who do not have high cholesterol.

The patients receiving the drug, Crestor (rosuvastatin), did have high levels of C-reactive protein (CRP), a marker for the inflammation process which is implicated in hardening of the arteries.

The study, sponsored by drug maker AstraZeneca and conducted by researchers at Brigham and Women's Hospital in Boston and colleagues, was presented Sunday at the American Heart Association's annual scientific sessions, in New Orleans. It will also be published in the Nov. 20 issue of the New England Journal of Medicine.

Dr. Howard Weintraub, clinical director of the Center for the Prevention of Cardiovascular Disease at New York University's Langone Medical Center, believes these results will change practice and will expand the universe of people who can benefit from the drug.

"This article conveys clearly that if all you do is use LDL cholesterol as a discriminator for cardiovascular risk, you are going to underestimate cardiovascular risk substantially," he said. "Individuals even with modest LDL can have considerable cardiovascular risk when other factors are present."

One of the study authors agreed. "This shifts the paradigm for evaluating risk and treatment," said Dr. Antonio M. Gotto Jr., dean of Weill Cornell Medical College in New York City.

In a statement, Dr. Elizabeth G. Nabel, director of the U.S. National Heart, Lung, and Blood Institute (NHLBI), acknowledged this study and two others concerning CRP.

"New results from three studies being presented at the American Heart Association (AHA) Scientific Sessions in New Orleans and published in scientific journals today provide the strongest evidence to date that a simple blood test for high-sensitivity C-reactive protein (hsCRP) is a useful marker for cardiovascular disease," she said.

But other experts urged caution.

"We have to really not lose sight of traditional guidelines," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City. "This is very interesting, but I think we have to wait and see."

According to the NHLBI, about 450,000 Americans will die of coronary heart disease, which is the leading cause of death for both men and women.

People with increased levels of CRP, a marker of inflammation, have a higher risk for cardiovascular events. And about half of all heart attacks and strokes occur in apparently healthy people with lower LDL levels.

Statins are known to lower CRP levels, in addition to cholesterol levels.

The JUPITER trial randomized almost 18,000 men and women with LDL cholesterol levels less than 130 milligrams per deciliter (130 is considered "borderline high") and CRP levels of 2 milligrams per liter or higher (considered average risk) to take 20 milligrams of Crestor daily or a placebo.

Men were 50 years or older, while women were 60 or older, with no history of cardiovascular disease, no diabetes and no uncontrolled hypertension.

"These people would not have been candidates for statins," Weintraub said. "The use of statins right now is entirely related to LDL cholesterol."

The trial was halted after only two of four planned years of follow-up, when researchers noted a significant reduction (44 percent) in the primary endpoint -- a composite of cardiovascular events including heart attack, stroke and death.

Crestor reduced LDL levels by 50 percent and CRP levels by 37 percent.

"We estimate that the application of this simple screening and treatment strategy, when used over a five-year period, would prevent more than 250,000 heart attacks, strokes, revascularizations and cardiovascular deaths in the U.S. alone," said study author Dr. Paul Ridker.

However, one expert was more cautious.

"We cannot say cannot say CRP is a risk factor nor a causal mediator," said Dr. Andrew Tonkin, head of the cardiovascular research unit at Monash University in Melbourne, Australia. "I don't think we would screen everyone, not at all at this time. We need to know the absolute risk reductions."

The findings do indicate that women could be taking statins for primary prevention, Gotto said. But the specific age group these findings relate to needs to be kept in mind.

Weintraub doubted that the benefit would be seen with all drugs in the class of statins. "There are features in each of the drugs that makes it better or not as good an anti-inflammatory agent," he said.

More information
The American Heart Association has more on C-reactive protein.

Five steps to getting a second opinion online

Not sure your doctor's got it right? Get a second opinion without ever leaving your living room. In this week's Empowered Patient, CNN Medical Correspondent Elizabeth Cohen tells you how to get a second opinion from one of the nation's top doctors. full story

6 Simple Ways a Woman Can Be Healthy Every Day

6 Simple Ways a Woman Can Be Healthy Every Day - By cutting down on the number of calories taken in and being physically active , women can reduce their chances of becoming overweight or overweight or obese.... Read more

Family Halloween Safety Can Be Fiendishly Simple

(HealthDay News) -- With Halloween right around the corner, many parents are wondering how they can help keep their kids safe.

According to Meridith Sonnett, director of pediatric emergency services at Morgan Stanley Children's Hospital of New York-Presbyterian, taking a few precautions can help make Halloween a happy and safe occasion for everyone.

She particularly recommends limiting trick-or-treating to familiar neighborhoods and neighbors.

Here are more tips parents should keep in mind for Halloween:

• Accompany your children when they go trick-or-treating.
• Examine all candy before letting your children eat it
• Have your children discard any unwrapped foods.
• Make sure your children's costumes are non-flammable and short enough so that they don't trip.
• Make sure the eye holes in masks are the right size and in the right place for clear vision.
• If your children are old enough to trick-or-treat without a parent, have them go in groups.
• At night, make sure your children wear costumes that are bright in color, or have them wear reflectors.
• If the streets are dark, have your children take a flashlight.
• Accompany your children in apartment buildings.
• Have your children use proper street-crossing safety.
• Do not allow your children to enter a stranger's home; have them ask for treats and wait outside the door.

More information

The U.S. Food and Drug Administration has more about Halloween safety.

3 Nice Things I’m Going to Do for My Boobs Today

By Anne Krueger

1. I’m going to join the army. The Army of Women, that is. It’s a partnership between Avon and the Dr. Susan Love Research Foundation, designed to help women and scientists unite to find ways to prevent and cure breast cancer.

“Over and over I’ve heard scientists lament how difficult it is for them to find the volunteers they need for research studies. By responding to this need, the Army of Women will change the face of breast cancer research,” says founder Susan Love, MD.

I love this idea because it gives me a chance to help beyond just sending in a tax-deductible donation. I’ll fill out a questionnaire, and if the Army needs me to be part of a study on healthy women, they’ll let me know. I may be called upon to contribute a blood or urine sample, or fill out a survey. My volunteering will help researchers learn more about how cancer starts and how to prevent it. Read More

Purple Tomato Extended Lives of Cancer-Prone Mice

(HealthDay News) -- Tomatoes genetically modified to be rich in antioxidants called anthocyanins appeared to extend the life spans of cancer-prone mice, a European study finds.

The modified tomatoes were created by adding two genes (Delila and Rosea1) from the snapdragon flower. The anthocyanins, which belong to the flavonoid class of antioxidants, gave the tomatoes a peculiar purple color.

"The two genes we have isolated are responsible for flower pigmentation and, when introduced in other plants, turned out to be the perfect combination to produce anthocyanins, the same phytochemical found in blueberries," study author Eugenio Butelli, of the FLORA project, said in a news release.

Chemical tests revealed that the "purple tomato has a very high antioxidant activity, almost tripled in comparison to the natural fruit," making it very useful to study the effect of anthocyanins, Butelli said.

The researchers fed a powder obtained from the purple tomatoes to mice that lacked the p53 gene, which helps protect against cancer. These mice had an average life span of 182 days compared to 142 days for p53-deficient mice fed a standard diet.

The findings were published in the Oct. 26 issue of Nature Biotechnology.

The study authors emphasized this is a preliminary study, and much more research needs to be done before there's any possibility of human trials.

More information
The American Dietetic Association has more about antioxidants.

Depression During Pregnancy May Cause Premature Birth

(HealthDay News) -- Women who are depressed early in their pregnancy run a higher risk of preterm delivery, the leading cause of infant mortality, a new study suggests.

For the study, researchers interviewed 791 San Francisco-area women near their 10th week of pregnancy. Forty-one percent reported "significant" symptoms of depression, and 22 percent reported "severe" symptoms.

Those women with severe symptoms had almost twice the risk of an early birth, defined as before 37 weeks' gestation. Those with significant symptoms had a 60 percent risk of early birth, the study found.

Women who were likelier to report depressive symptoms tended to be younger than 25, unmarried, less educated, poorer, black, and have a history of preterm delivery.

Discovering a possible cause of preterm birth, about which little is known, makes the findings significant, said study lead author Dr. De-Kun Li, a perinatal epidemiologist and senior research scientist at Kaiser Permanente's Division of Research in Oakland, Calif.

Scientists have been researching for the causes of high rates of infant mortality in the United States, Li said, but, "we don't know what is going on. If we can find something as obvious as depression that can be treated during pregnancy, that is very, very significant."

The findings were published online Oct. 23 in the journal Human Reproduction.

Dr. Shari I. Lusskin, director of reproductive psychiatry at New York University Medical Center, said she doesn't think the study establishes a link between depression in early pregnancy and preterm delivery. She said the women in the study weren't clinically diagnosed with depression but had scored high on a screening test.

"We don't know if the depression at 10 weeks is a marker for something that happens later in pregnancy, which is the real culprit," she said.

Li hopes the study's findings will make "ante-natal depression" as widely recognized as postpartum depression has become. Until now, depression during pregnancy has been "under-estimated and under-treated," he said, "not just by women, but also by their doctors."

One reason for this lack of attention is that there hasn't been strong evidence of a connection between depression in pregnant women and harm to the fetus, Li said.

Women may not readily report depressed feelings when they are pregnant because of the societal expectation that having a baby should be a joyous occasion, said Dr. Jennifer Wu, an obstetrician and gynecologist at Lenox Hill Hospital in New York City.

"I think many patients are very stressed about pregnancy and worried about the pregnancy and not sure about its impact on their lives," Wu said.

Lusskin tries to spread the word about the dangers of depression during pregnancy.

"The more we know about postpartum depression, the more we realize that half the cases started in pregnancy," Lusskin said. Ante-natal depression also carries the risk of noncompliance with prenatal care, poor nutrition, inadequate sleep, self-medication with drugs and alcohol, and suicide, she explained.

And, Lusskin added, "Ante-natal depression interferes with bonding with the baby both during pregnancy and post-partum."

The take-home lesson from the Kaiser study, Lusskin said, "is that ante-natal depression and ante-natal depression symptoms have some effect on pregnancy, and they should be treated, even though we don't know how that mood is translated into the biochemistry of that pregnancy."

She added that she is "a proponent of maintaining a good mood throughout pregnancy and breast-feeding, and doing what you have to do to do that. If a patient requires medication, she should do that. Then, it's a matter of finding the drugs that are best studied and most effective for the patient."

More information
To learn more about pregnancy and depression, visit the American Pregnancy Association.

Colon Cancer Drug Won't Help Those With Certain Gene Mutation

(HealthDay News) -- A new study suggests that people with advanced colon cancer who have a particular gene mutation won't benefit from the medication cetuximab (Erbitux).

While the drug can add months to the lives of people without a mutation in a gene called K-ras, those who have the mutation won't see any benefit from this additional therapy, reports the study, which is published in the Oct. 23 issue of the New England Journal of Medicine.

"We believe that, in the context of pre-treated advanced bowel cancer, the K-ras mutation status of the cancer should be determined before using cetuximab, and cetuximab should only be given to patients with tumors that do not have the mutation," said study author Dr. Christos S. Karapetis, a senior consultant medical oncologist and director of clinical research in the department of medical oncology at Flinders Medical Centre in Australia.

Karapetis said that about four in 10 people with colon cancer have the K-ras mutation.

Erbitux works by interrupting cell growth and division. It does this by binding to a receptor known as epidermal growth factor receptor (EGFR). A mutation in the K-ras gene is believed to interfere with cetuximab's ability to disrupt EGFR, according to the study.

For the study, 572 people with advanced colorectal cancer were randomly assigned to receive either weekly treatment with cetuximab and supportive care (287 people) or supportive care alone (285 people). All had undergone other treatment options without success.

Almost 400 tumor specimens from the study volunteers were tested for K-ras mutations (198 from the cetuximab group and 196 from the supportive care group). Just over 42 percent of the tumors evaluated were found to have mutations in the K-ras gene.

Even with cetuximab treatment, people with K-ras mutations had no significant changes in overall survival or in progression-free survival. Those without the mutations, on the other hand, appeared to benefit significantly from the therapy.

People with no K-ras mutations who were treated with cetuximab had nearly twice the overall survival rate compared to the supportive care group -- 9.5 months versus 4.8 months. And, the time of progression-free survival was also nearly doubled for those treated with cetuximab -- 3.7 months versus 1.9 months in the supportive care group.

"Patients with a colorectal tumor bearing mutated K-ras did not benefit from cetuximab," the researchers concluded.

"This study suggests that if someone has this particular mutation, they won't respond to this drug," said Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society. "The bottom line is that this study is important and really has the potential to impact how we treat patients with colorectal cancer with this very expensive drug."

He added that other researchers have noted similar results for K-ras mutations in earlier-stage colorectal cancer.

"This is one more refinement on personalized medicine, and we're moving into an age of molecular markers that eventually will guide treatment. If someone has a cancer in the future, that cancer will be analyzed for what kind of cancer it is, and then we'll know what the best treatments are for that cancer," Lichtenfeld said.

Another important molecular marker that guides treatment is already in use for breast cancer treatment, according to Lichtenfeld. Breast cancers are tested for a type of receptor called HER2. Those with this molecular marker are likely to have a more aggressive type cancer, but also a type of cancer that responds to treatment with the drug trastuzumab (Herceptin), he said.

"I'm excited about the future, and this study shows we can be more targeted with our targeted therapies," said Lichtenfeld.

More information
To learn more about colon cancer treatment options, visit the National Cancer Institute.

Cholesterol-Lowering Drugs Will Wreck Your Muscles

Cholesterol-lowering “statin” drugs often come with side effects. The most frequently reported consequence is fatigue, and about 9 percent of patients report statin-related pain.

The results of a new study show that statins at higher doses may also affect the ability of the skeletal muscles -- which allow your body to move -- to repair and regenerate themselves.

The study examined the proliferative capacity of human satellite cells when exposed to the statin simvastatin. They found that higher end concentrations of the drug led to reduced proliferation, which would likely negatively affect the muscle's ability to heal and repair itself.

Sources:
Eurekalert September 25, 2008

Health Tip: Choose Meats Wisely

(HealthDay News) -- Love to eat meat? As with any food group, there are good choices and bad.

The U.S. Department of Agriculture offers these suggestions on which meats to choose, and how:

• Select for low-fat meats and chicken, and avoid eating high-fat ground beef or chicken with the skin.


• Don't forget to count the fat and calories in cooking additives. For example, if you cook chicken in shortening, add the extra calories to your count.


• Include fish in your diet, especially those high in omega-3 fatty acids, such as salmon, trout and herring.


• Avoid organ meats such as liver, which are high in cholesterol.


• Also avoid processed meats such as hot dogs, ham, sausage and lunch meats, which can be very high in sodium and other additives.

Nation's Teachers Battle Sleep Problems

(HealthDay News) -- That snoring in the classroom may be from the teacher, not the students, a new study suggests.

Nearly a fourth of U.S. teachers say they are so sleep-deprived that their teaching skills are significantly impacted, according to a survey of teachers, administrators and support staff conducted by Ball State University researchers.

"Sleepy teachers are at a higher risk of providing insufficient supervision and inferior classroom instruction," researcher Denise Amschler, a Ball State health science professor, said in a university news release. "They also report more mood swings, and are at a higher risk of serious personal health problems."

The study found that about 43 percent slept an average of six hours or less each night, and 64 percent said they felt drowsy during the school day. Only a third of all school personnel said they got a good night's sleep most of the time.

The study also found female respondents tended to have sleep disturbances, drowsiness and sleep problems more often.

Long work days caused not only by grading papers and preparing assignments may be the cause. Nearly 45 percent of respondents also worked part-time jobs.

"Many teachers are forced to coach, farm, run a family business, or work a second job just to pay the bills," Amschler said. "When you factor in the responsibilities of raising a family, it is easy to see why teachers sleep so little. There is very little time."

Amschler said the study shows that more assistance is needed to reduce teacher stress and workloads through a variety of programs, including the new federally mandated wellness policies for schools.

More information
The University of Maryland has more about getting a good night's sleep.

Autumn Sees More Women With Bunion Problems

(HealthDay News) -- With the transition from summer to fall, doctors note an increase in bunions among their female patients, according to the American College of Foot and Ankle Surgeons.

Experts say this may have to do with the transition from open-toed shoes and sandals to winter footwear.

In the summer, "like everybody else, I like to wear flip-flop sandals, open-toed shoes, a nice pedicure with good nail polish," Elaine Power, a 49-year-old South Carolina hospice nurse who has bunions, said in an ACFAS news release.

But, when fall arrives, Powers and many others begin wearing closed-in shoe styles, which can be painful.

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

In addition to changes in footwear, Dr. Karl Collins, a foot and ankle surgeon in St. Louis, said there may be two other reasons for the annual trend of more women with bunion problems.

First, women are closer to meeting their insurance deductibles at the end of the year. Second, people are more active in the summer and may be waiting until fall to address their foot problems.

"People are very active in the summer," Collins said in the news release. "They're always outdoors, they're always at the pool or whatever, so they will decide to get their bunion fixed in the winter, because in their mind, they're not missing anything fun."

Many people with bunions do not experience any pain. But for those who do, shoe changes, foam- or gel-filled shoe padding, orthotics, anti-inflammatory medications, and injections for bursitis, nerve irritation, or joint irritation may be prescribed to address the pain.

As for shoe changes, avoiding high heels and styles that crowd the toes together can help. Also, shoes can be adjusted to better fit the foot.

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

While shoe adjustment and other techniques may be able to help relieve pain, only surgery can truly correct a bunion, according to the college news release.

More information
The American College of Foot and Ankle Surgeons has more about bunions.

Oregon's Assisted Suicide Law May Overlook Depressed Patients

(HealthDay News) -- Oregon's physician-assisted suicide law may not adequately protect the one in four terminally ill patients with clinical depression , a new study says.

The Death with Dignity Act was passed by the state in 1997, and there's been intense debate about the extent to which potentially treatable psychiatric disorders may influence a patient's decision to hasten death, according to a news release about the study, published online Oct. 8 by the British Medical Journal.

The act does contain several safeguards to ensure patients are competent to make the decision to end their life, including referral to a psychologist or psychiatrist, if there's concern that a mental illness may be impairing a patient's judgment. However, depression is often overlooked in mentally ill patients.

In 2007, none of the 46 people in Oregon who used physician-assisted suicide were evaluated by a psychologist or psychiatrist, the news release said.

For the new study, researchers at Oregon Health and Sciences University checked for depression or anxiety in 58 terminally ill patients who'd requested physician-assisted suicide or had contacted an assisted death organization. Fifteen of the patients met the criteria for depression and 13 for anxiety.

By the end of the study, 42 patients had died. Of those, 18 received a prescription for a lethal medication, and nine died by lethal ingestion. Of those who received a prescription for a lethal medication, three met the criteria for depression. All three died by lethal ingestion within two months of being assessed by researchers.

While most patients who request physician-assisted suicide do not have a depressive disorder, the study authors suggested that "the current practice of Death with Dignity Act may not adequately protect all mentally ill patients." The authors called for "increased vigilance and systematic examination for depression among patients who may access legalized aid in dying."

While it's important to protect vulnerable patients, it can be difficult to determine if depression is impairing the judgment of terminally ill patients, Dr. Marije van der Lee, of the Helen Dowling Institute in the Netherlands, wrote in an accompanying editorial.

Depression doesn't necessarily impair judgment, van der Lee said. "We should focus on trying to 'protect' patients from becoming depressed in the first place, rather than focus on protecting patients from assisted suicide," she wrote.

More information
The U.S. National Cancer Institute has information about end-of-life issues.

Obesity, Insulin Level Impact Prostate Cancer Survival

(HealthDay News) -- Men who are overweight and who have high insulin levels when they are diagnosed with prostate cancer may be more likely to die from the disease, research shows.

This striking finding, published early online and expected to be in the November issue of The Lancet Oncology, is yet more reason to continue fighting the battle of the bulge, experts say.

"I don't want to be sensationalist, but obesity effects and the insulin effects are so big that I think if you had to choose between being thin and having a low insulin level or having access to the best chemotherapy, you would be more likely to survive without chemotherapy," said study senior author Dr. Michael Pollak, professor of oncology at McGill University in Montreal, Quebec, Canada.

"Tens of thousands of men are taking chemotherapy for prostate cancer -- as they should, because it is a good treatment. Doing so is actually helping," he said. "But potentially, dealing with insulin, obesity may one day be of more benefit."

The findings also have scientific import, giving researchers a clue that could lead to new prevention and treatment strategies.

Experts have long known that androgens, or male hormones, play a critical role in spurring prostate cancer.

In fact, these cancers are often treated with approaches that deprive the tumors of testosterone.

Smaller reports have suggested that obese patients with prostate cancer have a worse prognosis than patients of regular weight, though weight hasn't been related to actually developing a malignancy.

"We found in a large sample that obesity has a very important influence on prostate cancer outcome," Pollak said. "Then the question becomes, why would obesity make the outcome worse?"

Pollak and his colleagues looked at information on more than 2,500 men who had been followed for 24 years as part of the Physicians' Health Study. Information on body mass index (BMI) was available for all of these men, while information on C-peptide concentration (a marker of insulin levels in the blood) was available for 827 men.

Overweight men (those with a BMI of 25 to 29) had a 47 percent higher risk of dying from prostate cancer, while obese men (BMI of 30 or over) were more than two-and-a-half times more likely to die of the disease, compared with men of healthy weight (BMI under 25).

Men with the highest C-peptide concentrations also had more than double the risk of dying from their cancer compared with men with the lowest levels, the study found.

Finally, men who had a BMI of more than 25 and high C-peptide concentrations had quadruple the risk of dying from their cancer compared with men who had lower BMIs and lower C-peptide levels, the researchers reported.

"This suggests that there may be a whole new story to tell, whereby not just androgens have something to do with cancer behavior, but also insulin," Pollak said.

The insulin hormone may be latching onto insulin receptors located on prostate cancer cells, he speculated.

Some pharmaceutical companies are already testing drug candidates that target insulin signaling, Pollak added.

And the findings could have broader implications for other cancers, said study lead author Dr. Jing Ma, of Harvard University's Channing Laboratory.

"The simple things are still the important things. Don't drink, don't smoke, exercise, and eat well," said Dr. Ganesh Palapattu, assistant professor of urology, pathology and oncology at the University of Rochester School of Medicine. "This is yet another piece of evidence suggesting that obesity is not a good thing for many reasons."

"Obesity is the second leading cause of cancer death in this country next to tobacco," emphasized Dr. Jay Brooks, chief of hematology/oncology at Ochsner Health System in Baton Rouge, La. "Two years ago, I would never have told my patients that obesity is increasing their risk of death from cancer. Today, I do."

More information
There's more on prostate cancer at the U.S. National Cancer Institute.

Fixing Fibromyalgia

Learn how in recent clinical trials, intravenous micronutrient therapy (IVMT) has provided pain relief for patients with fibromyalgia.

Don’t Get Slimed: The Slippery Web Promotion of an Anti-Aging “Breakthrough”

By Scott Mowbray

The weird case of Caracol Cream offers a glimpse into the sometimes slimy but lucrative world of anti-aging product hype, in which an $80 cream is promoted vigorously by an allegedly scam-busting association that probably doesn’t exist based on tests in a laboratory that also probably doesn’t exist.

Who knew that the goo from Helix aspersa, your garden-variety brown snail, is rich in skin-nourishing compounds? (It was a brave woman who first daubed snail on her skin.) But yes: Caracol Cream is also known as crema de baba de caracol, which translates—on some websites—as cream of snail slobber. The extract hails from Chile where, according to one account, a farmer who couldn’t sell the snails for food decided to sell their slime instead. Read More

Link Between Vaccine and MS Unproven

(HealthDay News) -- Children vaccinated against hepatitis B probably are not at an increased risk of developing multiple sclerosis (MS) unless they were inoculated with a particular brand of the vaccine, according to a new study.

The French study found that children with MS were almost twice as likely to have received the vaccine called Engerix B three or more years before the disease's onset. Further studies will need to be done to determine whether the vaccine is a direct cause of the development of MS.

The study, which involved 349 children with MS and 2,941 children without the disease, is to be published in the Oct. 8 online issue of Neurology.

More information
The U.S. Centers for Disease Control and Prevention has more about vaccinations.

Fall Sports Peak Time for Lower Leg Damage

(HealthDay News) -- People who play football and other fall sports are at increased risk for lower extremity injuries and need to take precautions to protect themselves, says the American Podiatric Medical Association (APMA).

"Stress fractures of the foot, ankle sprains and ligament injuries are all, unfortunately, quite common in popular fall sports such as football," Dr. David Davidson, podiatric medical consultant for the Buffalo Bills of the National Football League, said in an APMA news release. "From maintaining proper conditioning to wearing sport-specific footwear, athletes can function at peak performance much more often when constantly maintaining high levels of footwear safety."

Sprains, fractures and turf toe are among the most common acute injuries suffered by people playing fall sports.

Sprains (stretched or torn ligaments) can be caused by hard sprinting. Prevention includes doing proper warm-up exercises before and after workouts, practices and games. Spend five to 10 minutes stretching, holding and relaxing muscles. Sprains that don't show improvement in three days should be looked at by a doctor. Treatment may include casting, immobilization and a rehabilitation program, the APMA said.

Casting, and sometimes surgery, is required to properly immobilize fractures and set breaks. It usually takes 10 to 12 weeks to recover. You can reduce your risk of stress fractures (incomplete fractures in bones typically caused by overuse) by wearing sport-specific footwear that contains extra padding.

Turf toe is a painful hyperextension of the big toe joint. Competing on artificial turf is the leading cause of this condition, but it can also occur on grass and other natural surfaces, the APMA said. Customized foot orthotics can help protect against turf toe and wearing a stiffer shoe can prevent further aggravation of the condition. Treatment of turf toe usually includes rest, ice, compression and elevation (RICE).

More information
The American Academy of Orthopaedic Surgeons has more about foot and ankle injuries.

Boomers Should Add Muscle Before It's Too Late

(HealthDay News) -- Strength training can help people build muscle mass to assist in the fight against the debilitating effects of old age until they reach 80, a new study says.

After that, not so much, according to the authors.

The Ball State University study, sponsored by a grant from the U.S. National Institutes of Health, found that while six men in their 80s did get somewhat stronger, their whole muscle size and fiber size did not grow during a 12-week training regime.

"We know that there is accelerated muscle loss as we get older," Scott Trappe, director of Ball State's Human Performance Laboratory, said in a university news release. "The best way to keep our muscles from shrinking is through resistance training, which allows our body to maintain muscle size and strength as we go through our 60s and 70s."

Trappe said aging eventually causes the loss of "fast-twitch" muscle fibers, reducing the ability to produce the explosive movements that allow us to move our feet and arms to keep from falling. The concurrent loss of slow-twitch muscles, the large ones found in the legs, thighs, trunk, back and hips, weakens posture as well. Together, these losses make it harder to balance and maintain an independent life.

"At this point," he said, "I would advise people to actively engage in some sort of resistance training once they hit their 60s. From our study, once you hit the threshold of 80, that may not be possible."

A 2003 study published in the Journal of the American Geriatrics Society, estimated U.S. health care costs directly attributed to sarcopenia, the degenerative loss of skeletal muscle mass and strength, exceeds $26 billion. Indirectly, sarcopenia has contributed to a doubling of home health care and nursing home expenditures to $132 billion annually.

More information
The U.S. Centers for Disease Control and Prevention has more about healthy living for older adults.

Shorter-Course Radiation for Breast Cancer Safe, Effective

(HealthDay News) -- A more intense but briefer course of radiation therapy is equally effective as the traditional longer course for certain breast cancer patients, Canadian researchers report.

The new findings reflect a longer term follow-up than those presented five years ago, noted Dr. Timothy Whelan, lead author and a radiation oncologist at the Juravinski Cancer Centre, McMaster University, in Hamilton, Ontario.

His team was expected to present the findings Monday at the American Society for Therapeutic Radiology and Oncology (ASTRO) meeting in Boston.

"We first presented our results five years ago, but many oncologists were reluctant to adopt this," said Whelan, referring to the briefer but more intense radiation treatments. "They were concerned about long-term effects."

In the new study, Whelan's group followed the women for 12 years, comparing the results in 1,234 women with early-stage breast cancer who had a lumpectomy and then were randomly assigned to receive standard whole breast radiation for five weeks, to women who received "accelerated" whole breast radiation for three weeks.

At the 10-year mark, cancer returned locally in 6.2 percent of those who got the briefer therapy, compared with 6.7 percent of those who got traditional therapy. Cosmetic results were similar in both groups. The researchers noted no differences between the two groups in terms of radiation-linked side effects.

In a second study, also expected to be presented Monday at the ASTRO conference, Dr. Peter Beitsch, a surgical oncologist at Medical City Dallas Hospital, Dallas, said that radiation "seed" implants work well as an alternative to standard whole breast radiation. He used a type of accelerated partial breast irradiation (APBI) that involves a radiation seed implant, called balloon brachytherapy.

After the tumor is surgically removed, the doctor inserts a small balloon into the cavity, attaches a catheter to the balloon, and delivers a high radiation dose by way of tiny radioactive seeds.

Beitsch used the Mammosite Radiation Therapy System, approved by the FDA in 2002. The manufacturer, which funded the study, wanted to conduct a post-approval study, he said.

Beitsch reported on 400 women (of more than 1,400 total) now followed up for almost four years. He found that the rate of early complications, such as pockets of accumulated fluid, were similar to those of patients receiving standard therapy. Cosmetic results were similar, too.

The researchers reported 28 breast tumor recurrences (about 2 percent). "The range of recurrences for whole breast radiation is nearly zero to 5 percent," Beitsch said, so these results are comparable.

The best candidates for the seed therapy, he said, are women age 45 years or older, with tumors of three centimeters or less and a diagnosis of ductal cancer or ductal cancer in situ (DCIS). About 40 percent of women diagnosed with breast cancer would probably be candidates, Beitsch estimated.

In a third study presented at the meeting, a form of external beam radiation therapy called proton therapy reduced the risk of cancer patients developing a secondary malignancy by twofold, compared to traditional radiation therapy using photons.

Proton therapy is a more targeted radiation that delivers less radiation to surrounding areas than does photon radiation. However, during the delivery of proton therapy, neutrons are produced and scattered, and some experts fear this scatter radiation may boost the chances of a secondary cancer.

Researchers compared 503 patients with a variety of cancers -- including brain tumors, sarcomas and prostate cancer -- who had proton therapy against 1,600 who had photon therapy. After a one year or more of follow-up, 6.4 percent of those who had proton therapy got a second cancer, compared to 12.8 percent of those who got traditional photon therapy. The median followup (half were longer, half shorter) was 7.7 years for the proton group and 6.1 years for the photon patients.

The results suggest that fears about scatter radiation may not be justified, said Dr. Albert Blumberg, M.D., vice chairman, radiation oncology, Greater Baltimore Medical Center, Md., and chairman of the American College of Radiology's Commission on Radiation Oncology, who reviewed the studies for HealthDay.

Blumberg is not so sure, however, that the briefer radiation course touted in Whelan's study will catch on. Among his concerns: "The cosmetic result in larger women may not be comparable," Blumberg said.

And while the seed therapy described in Beitsch's study may be more convenient than traditional treatments, Blumberg worries about longer-term results. "I disagree with his [Beitsch's] blanket assessments that recurrence is not a concern," he said. While the study's follow-up was nearly four years, "most researchers look at five-year follow-up," Blumberg noted. With time, he said, more recurrences could appear.

More information
To learn more about radiation therapy, visit the American Society for Therapeutic Radiology and Oncology.

The Anti-Inflammatory Diet: 14 Ingredients to Avoid

An important step in creating a healthy kitchen is to read and understand food labels. When you begin restocking your pantry, food labels are your best resource to assess what to keep and what to toss Find Out What Ingredients To Avoid

Obesity Surgery: Less Successful for Diabetics?

By Theresa Tamkins

A gastric bypass is a radical operation for desperate people. But a new study shows that this dramatic procedure—during which surgeons fashion a tiny new pouch that bypasses the old, larger stomach and part of the small intestine—isn’t always a weight-loss home run.

Certain patients—5% to 15%—lose some, but not all, of their excess weight after surgery. The new research, published today in Archives of Surgery, shows that people with type 2 diabetes diabetes are three times as likely as those without diabetes to fall into this group. Read More

Later Use of Clot-Buster After Stroke Possible: Study

(HealthDay News) -- European researchers who showed that the clot-dissolving drug tPA could safely be used within three hours after a stroke now say the limit can be extended to four-and-a-half hours.

"We now have a three-hour limit mandated by authorities," said Dr. Nils Wahlgren, a neurology professor at the Karolinska Institute in Sweden and leader of an international group reporting Sunday in the online version of The Lancet. "Our data indicate that it is safe to extend that from three hours to four-and-a-half hours. The risk of hemorrhagic complications is not significantly different from the earlier time limit."

Tissue plasminogen activator (tPA), also known as the drug alteplase, is the approved treatment for the most common kind of stroke, in which a blood clot blocks a brain artery. The three-hour post-stroke time limit has been set because of fears that use of the clot-dissolving drug beyond that period might cause dangerous bleeding or other complications.

The new report is the latest from a study requested by European authorities after doubts arose about the safety of tPA in stroke treatment, which was approved in 1996 by the U.S. Food and Drug Administration. It was approved in 2002 in Europe.

The study compared the outcomes of 664 people who were given tPA between three and four-and-a-half hours after a stroke against almost 12,000 who received the drug within three hours of an attack.

The study found a death rate of 12.7 percent in the following three months for the three-hour group and 12.2 percent for those getting tPA later. In the early group, 58 percent achieved the ability of independent action, compared to 56.3 percent in the later-administration group.

"We recorded no significant differences between the 3- to 4.5-hour cohort and the within 3-hour cohort for any outcome measure," the researchers reported.

The bottom line, according to Wahlgren: "if patient treatment has been delayed, it is still safe to treat a patient beyond the time limit of three hours."

The results were expected to be presented at an international meeting in Stockholm in November, "when we will recommend a change in the guidelines," Wahlgren said. "I expect it would be accepted by the international community, both in the United States and Europe, and in the rest of the world."

But the new results do not necessarily mean an end to the three-hour limit, cautioned Dr. Larry Goldstein, professor of neurology at Duke University and director of the Duke Stroke Center in Durham, N.C.

"They are consistent with a combined analysis done some time ago that suggested we might be able to treat beyond three hours," Goldstein said. "But those were observational studies, as was this one. Controlled trials done to test that belief have not shown benefit."

It will take a change in the current guidelines to alter the three-hour limit, he said, and the overall benefit of tPA is greater when it is given earlier. "The sooner you get blood to the brain, the better," Goldstein said.

More information
There's more on tPA at the American Heart Association.

Study Probes Why Smokers Find It Hard to Quit

(HealthDay News) -- If you're not craving a hit of nicotine the moment you declare you are quitting smoking, your battle just got a little tougher, say researchers at the University of Pittsburgh and Carnegie Mellon University.

"We have observed previously that the idea of smoking a cigarette becomes increasingly attractive to smokers while they are craving," lead investigator Michael Sayette, a University of Pittsburgh professor of psychology, said in a university news release. "This study suggests that when smokers are not craving, they fail to appreciate just how powerful their cravings will be. This lack of insight while not craving may lead them to make decisions -- such as choosing to attend a party where there will be lots of smoking -- that they may come to regret."

The study, published in the September issue of Psychological Science, examines the "cold-to-hot empathy gap" -- that is, the tendency for people in a "cold" state (one not influenced by visceral factors such as hunger or fatigue) to improperly predict their own behavior when in a "hot" state (hungry, fatigued). This is, in part, because those in the cold state can't recall the intensity of their past cravings.

The researchers gathered 98 smokers for two experimental sessions. Those put in a "hot" state were asked to not smoke for 12 hours prior to the first session, then were induced to crave a cigarette by holding but not smoking a lit one. Those in a "cold" state smoked up until the first session but did not hold a lit cigarette. A comparison group skipped the first session completely.

During the first session, "hot" and "cold" participants were asked how much money they would need to delay smoking for five minutes in the second session, a time when all participants would be in a "hot" state. Smokers in all three groups had to abstain from smoking for 12 hours before the second session started, and were asked to hold -- but not smoke -- a lit cigarette during the session.

When asked the money question in the second session, the "cold" smokers from the first session asked for significantly more money to delay smoking for just five minutes while those originally in a "hot" state did not request an increase.

Those from the "cold" group were also much less likely to accurately predict how much money they would need to delay lighting up. Almost half of the "cold" smokers requested more money than what they had initially predicted, while only 25 percent of the "hot" group did the same.

"These findings suggest that smokers are likely to underpredict their own future desire to smoke when they're not craving a cigarette," study co-author George Loewenstein, the Herbert A. Simon Professor of Economics and Psychology at Carnegie Mellon, said in the news release. "The research not only has implications for helping smokers quit, but it also enlightens us on how nonsmokers may pick up the habit. If smokers can't appreciate the intensity of their need to smoke when they aren't currently craving, what's the likelihood that people who have never smoked can do so?"

More information
The American Cancer Society has more about how to quit smoking.