(HealthDay News) -- Multiple sclerosis patients may benefit from a form of vitamin B3, a new study finds.
Multiple sclerosis (MS) results in damage to nerve fibers, causing fatigue, difficulty walking, pain and other problems. Most people with MS eventually enter a chronic progressive phase of the disease for which there is currently no good treatment.
New research published in the Sept. 20 issue of the Journal of Neuroscience studied the effects of injecting nicotinamide -- a form of vitamin B3 -- under the skin of mice that had an MS-like disease.
The researchers, from the Neurobiology Program in Children's Hospital Boston, found the injections protected nerve fibers in the mice from degeneration -- even in the nerve cells that had already been damaged.
The higher the dose of nicotinamide, the more protective the effect, the study found.
On a scale of one to five, with one indicating the least nerve damage and five indicating the most, the mice receiving the highest doses of nicotinamide had neurologic scores of one to two, and those receiving no nicotinamide had scores between three and four.
Even the mice in which treatment was delayed until 10 days after the onset of their disease benefited.
"The earlier therapy was started, the better the effect, but we hope nicotinamide can help patients who are already in the chronic state," Shinjiro Kaneko, a research fellow at Children's, said in a prepared statement.
Researchers believe nicotinamide works by increasing the levels of a compound known as nicotinamide adenine dinucleotide (NAD), which has been shown to directly prevent nerve degeneration.
More information
The National Institute of Neurological Disorders and Stroke has more about multiple sclerosis.
Wednesday, September 20, 2006
Brand-Name Drug Prices Still Rise Faster Than Inflation
(HealthDay News) -- The prices of the brand-name prescription drugs most used by older Americans continue to increase faster than the rate of inflation, a new report finds.
But, the prices of the 75 generic drugs commonly used by older Americans remain unchanged, according to the AARP's quarterly Rx Watchdog Report, released Tuesday.
In the survey of almost 200 brand-name prescription drugs, AARP found that prices rose 6.3 percent during the 12 months ending with the second quarter of June 2006. This increase exceeded the rate of inflation, which was 3.8 percent over the same period, the group said.
The biggest year-to-date increases were Adventis' Ambien, a sleep aid, 5 milligram (13.3 percent); Boehringer Ingelheim's Combivent, a bronchodilator aerosol (12 percent); Pfizer's Atrovent Inhaler (12 percent); Adventis' Ambien 10 mg. (9.9 percent); and GlaxoSmithKline's Wellbutrin, an antidepressant, 150 mg. (9.4 percent), according to the report.
Aventis had the biggest average six-month price increases, up 7.7 percent. The lowest price increases were for the drug companies Monarch and Takeda (0.0 percent) and Lilly (2.5 percent).
The rate of price increases is the same as it has been in recent years, said report author Susan Raetzman, associate director of the AARP Public Policy Institute. "When you look at how that translates to the cost of the drug to people, it's an increase of over $70 a year for a drug that's taken on a regular basis," she said. "And that's quite a bit higher than it has been in the past."
The typical increase in drug costs for older Americans equals $300 a year, according to the report.
Drug companies keep raising prices because they can, Raetzman said. "There really aren't market forces at work," she said. "They don't have competitors."
Efforts by HealthDay to reach the Pharmaceutical Research and Manufacturers of America, a trade group, for comment were unsuccessful.
Raetzman noted that not only were drug prices increasing for consumers who aren't in prescription drug plans, prices are likely to go up for those in Medicare Part D plans as cost increases get passed along to members. Although these plans purchase drugs at below-retail cost, there is no legal requirement that they pass the savings on to their members, Raetzman said.
To help ease rising drug costs, AARP is supporting a bill in Congress to allow Americans to import drugs from Canada and other western nations.
"We've never been this close to getting meaningful relief from rising prescription drug costs," David Sloane, AARP's senior managing director of government relations, said in a prepared statement. "For the first time, a bill that would allow safe and legal importation of medications has widespread bipartisan support."
Sharon Treat is executive director of the National Legislative Association on Prescription Drug Prices, a nonpartisan, nonprofit group founded by state legislators to make prescription drugs more affordable and accessible to Americans. She said the price increases aren't justifiable, economically or socially.
"I think it's outrageous," Treat said. "The drugs that they sell the most of are the ones that have the biggest increases, which implies it has nothing to do with normal economic theory. People are being ripped off, our government is being ripped off, and people's health is being affected as a result."
In addition, Treat said, it's clear that the Medicare Part D prescription drug plan for seniors that took effect Jan. 1 did nothing to reduce prices. "In fact, prices have now zoomed up more than they had before Part D was passed," she said.
Treat noted that under Part D, the federal government cannot negotiate drug costs. "The government has ceded over to the private sector all the negotiation and has divided up the pool of enrollees, which reduces purchasing power. The end result is that there is no strong push to reduce prices."
Calls by HealthDay to Medicare for comment were not returned.
More information
Visit AARP to view the full report.
But, the prices of the 75 generic drugs commonly used by older Americans remain unchanged, according to the AARP's quarterly Rx Watchdog Report, released Tuesday.
In the survey of almost 200 brand-name prescription drugs, AARP found that prices rose 6.3 percent during the 12 months ending with the second quarter of June 2006. This increase exceeded the rate of inflation, which was 3.8 percent over the same period, the group said.
The biggest year-to-date increases were Adventis' Ambien, a sleep aid, 5 milligram (13.3 percent); Boehringer Ingelheim's Combivent, a bronchodilator aerosol (12 percent); Pfizer's Atrovent Inhaler (12 percent); Adventis' Ambien 10 mg. (9.9 percent); and GlaxoSmithKline's Wellbutrin, an antidepressant, 150 mg. (9.4 percent), according to the report.
Aventis had the biggest average six-month price increases, up 7.7 percent. The lowest price increases were for the drug companies Monarch and Takeda (0.0 percent) and Lilly (2.5 percent).
The rate of price increases is the same as it has been in recent years, said report author Susan Raetzman, associate director of the AARP Public Policy Institute. "When you look at how that translates to the cost of the drug to people, it's an increase of over $70 a year for a drug that's taken on a regular basis," she said. "And that's quite a bit higher than it has been in the past."
The typical increase in drug costs for older Americans equals $300 a year, according to the report.
Drug companies keep raising prices because they can, Raetzman said. "There really aren't market forces at work," she said. "They don't have competitors."
Efforts by HealthDay to reach the Pharmaceutical Research and Manufacturers of America, a trade group, for comment were unsuccessful.
Raetzman noted that not only were drug prices increasing for consumers who aren't in prescription drug plans, prices are likely to go up for those in Medicare Part D plans as cost increases get passed along to members. Although these plans purchase drugs at below-retail cost, there is no legal requirement that they pass the savings on to their members, Raetzman said.
To help ease rising drug costs, AARP is supporting a bill in Congress to allow Americans to import drugs from Canada and other western nations.
"We've never been this close to getting meaningful relief from rising prescription drug costs," David Sloane, AARP's senior managing director of government relations, said in a prepared statement. "For the first time, a bill that would allow safe and legal importation of medications has widespread bipartisan support."
Sharon Treat is executive director of the National Legislative Association on Prescription Drug Prices, a nonpartisan, nonprofit group founded by state legislators to make prescription drugs more affordable and accessible to Americans. She said the price increases aren't justifiable, economically or socially.
"I think it's outrageous," Treat said. "The drugs that they sell the most of are the ones that have the biggest increases, which implies it has nothing to do with normal economic theory. People are being ripped off, our government is being ripped off, and people's health is being affected as a result."
In addition, Treat said, it's clear that the Medicare Part D prescription drug plan for seniors that took effect Jan. 1 did nothing to reduce prices. "In fact, prices have now zoomed up more than they had before Part D was passed," she said.
Treat noted that under Part D, the federal government cannot negotiate drug costs. "The government has ceded over to the private sector all the negotiation and has divided up the pool of enrollees, which reduces purchasing power. The end result is that there is no strong push to reduce prices."
Calls by HealthDay to Medicare for comment were not returned.
More information
Visit AARP to view the full report.
Early Memory Lapses Could Warn of Alzheimer's
(HealthDay News) -- Older adults who complained of recurrent memory loss had brain changes that mirrored those of very early Alzheimer's -- even when standard cognitive tests came up normal, a new study reports.
Based on these findings, "cognitive complaints should be taken very seriously -- these are not necessarily just the 'worried-well,'" said researcher Andrew Saykin, a professor of psychiatry and radiology at Dartmouth Medical School, in Lebanon, N.H. "Those with significant cognitive complaints and concerns should talk with their physicians and get a thorough evaluation."
The findings were published in the September issue of Neurology.
Saykin's team studied 120 adults aged 60 to 90 to determine whether gray matter changes in the brain's medial temporal lobe were similar to those seen in patients with Alzheimer's disease and mild cognitive impairment (very early Alzheimer's).
The study included 40 participants with "cognitive complaints" -- including occasional but troublesome forgetfulness -- who tested as normal on standard neuropsychological tests. The researchers compared these participants' brain changes to those of 40 patients with mild cognitive impairment and 40 healthy controls, using high-tech MRI brain scans.
The cognitive-complaint and mild-cognitive-impairment groups had similar patterns of decreased gray matter in their brains, Saykin said. The degree of gray matter loss was associated with the extent of memory complaints and performance deficits, he added.
One expert said the study is interesting because it could point to the early detection of Alzheimer's disease.
"I'm excited (about the study) because this is the kind of early diagnostic method that is badly needed. Everything we're doing now says the therapy works better earlier," said Greg M. Cole, associate director of the University of California, Los Angeles' Alzheimer's Disease Research Center.
He said the study provides further evidence that there's a continuum of Alzheimer's-type physical changes in the brain.
The findings echo those of another study of older adults, published in Neurology in June. In that research, a team at Rush University, Chicago, found that episodic memory failure corresponded with signs of early, undiagnosed Alzheimer's in brain tissues examined post-mortem.
Although the findings do point to memory lapses as perhaps indicative of very early Alzheimer's disease, "I wouldn't necessarily look at it as something to be extremely concerned about," Dr. Sam Gandy, chairman of the Alzheimer's Association's Medical and Scientific Council told HealthDay at the time. He said the results of the Rush study suggest potential new avenues for early diagnosis and treatment.
Cole noted that occasional "cognitive complaints" -- forgetting keys, or failing to remember PIN codes at the bank -- do occur, of course, and can be a cause for worry. But age-related forgetfulness can be caused by a variety of conditions, including non-Alzheimer's-related vascular disease, he pointed out.
"This study took a comprehensive look and defined a subset of people who have essentially episodic problems yet do well on tests," Cole said. In other words, their forgetfulness occurred frequently and was noted by loved ones, yet the usual tests showed no obvious problem.
Here, however, "the researchers verified the gray matter changes that indicate disease prior to minimal cognitive impairment," Cole said. "They're clicking back the ability to detect incipient Alzheimer's disease with some better confidence that it's truly Alzheimer's disease."
That could lead to the use of neuro-protective agents five, 10 or 20 years before people meet the diagnostic criteria for Alzheimer's, the experts said, to help delay symptoms.
"What needs to be proven is whether they are really catching incipient Alzheimer's disease by then confirming these individuals go on to develop Alzheimer's disease," Cole explained.
Any drug aimed at Alzheimer's disease will need to help delay the illness in its earliest stages, Cole said.
Another study, this time in the September Archives of Neurology, found that accelerated weight loss may be another sign of very early Alzheimer's disease.
Researchers at Washington State University School of Medicine, St. Louis, tracked the weight of 449 adults without Alzheimer's or related dementia when the study began.
Six years on, the 125 participants who did develop the illness were found to have weighed approximately 8 pounds less upon study entry than participants who remained free of Alzheimer's. Weight loss increased as Alzheimer's symptoms appeared, the researchers noted.
If the findings are supported in other studies, early weight loss may be a factor in spotting people at risk for Alzheimer's, the St. Louis team said.
Saykin said early detection may someday be key to a cure, as new treatment breakthroughs emerge over time.
"There is an incredible amount of new information about molecule biology that's been uncovered in recent years. For example, the chemical composition of tangles in the brain are becoming better understood, and vaccines to dissolve the causative agent, beta amyloid, are in clinical trials," he said.
More information
There's more on Alzheimer's disease at the U.S. National Institute on Aging.
Based on these findings, "cognitive complaints should be taken very seriously -- these are not necessarily just the 'worried-well,'" said researcher Andrew Saykin, a professor of psychiatry and radiology at Dartmouth Medical School, in Lebanon, N.H. "Those with significant cognitive complaints and concerns should talk with their physicians and get a thorough evaluation."
The findings were published in the September issue of Neurology.
Saykin's team studied 120 adults aged 60 to 90 to determine whether gray matter changes in the brain's medial temporal lobe were similar to those seen in patients with Alzheimer's disease and mild cognitive impairment (very early Alzheimer's).
The study included 40 participants with "cognitive complaints" -- including occasional but troublesome forgetfulness -- who tested as normal on standard neuropsychological tests. The researchers compared these participants' brain changes to those of 40 patients with mild cognitive impairment and 40 healthy controls, using high-tech MRI brain scans.
The cognitive-complaint and mild-cognitive-impairment groups had similar patterns of decreased gray matter in their brains, Saykin said. The degree of gray matter loss was associated with the extent of memory complaints and performance deficits, he added.
One expert said the study is interesting because it could point to the early detection of Alzheimer's disease.
"I'm excited (about the study) because this is the kind of early diagnostic method that is badly needed. Everything we're doing now says the therapy works better earlier," said Greg M. Cole, associate director of the University of California, Los Angeles' Alzheimer's Disease Research Center.
He said the study provides further evidence that there's a continuum of Alzheimer's-type physical changes in the brain.
The findings echo those of another study of older adults, published in Neurology in June. In that research, a team at Rush University, Chicago, found that episodic memory failure corresponded with signs of early, undiagnosed Alzheimer's in brain tissues examined post-mortem.
Although the findings do point to memory lapses as perhaps indicative of very early Alzheimer's disease, "I wouldn't necessarily look at it as something to be extremely concerned about," Dr. Sam Gandy, chairman of the Alzheimer's Association's Medical and Scientific Council told HealthDay at the time. He said the results of the Rush study suggest potential new avenues for early diagnosis and treatment.
Cole noted that occasional "cognitive complaints" -- forgetting keys, or failing to remember PIN codes at the bank -- do occur, of course, and can be a cause for worry. But age-related forgetfulness can be caused by a variety of conditions, including non-Alzheimer's-related vascular disease, he pointed out.
"This study took a comprehensive look and defined a subset of people who have essentially episodic problems yet do well on tests," Cole said. In other words, their forgetfulness occurred frequently and was noted by loved ones, yet the usual tests showed no obvious problem.
Here, however, "the researchers verified the gray matter changes that indicate disease prior to minimal cognitive impairment," Cole said. "They're clicking back the ability to detect incipient Alzheimer's disease with some better confidence that it's truly Alzheimer's disease."
That could lead to the use of neuro-protective agents five, 10 or 20 years before people meet the diagnostic criteria for Alzheimer's, the experts said, to help delay symptoms.
"What needs to be proven is whether they are really catching incipient Alzheimer's disease by then confirming these individuals go on to develop Alzheimer's disease," Cole explained.
Any drug aimed at Alzheimer's disease will need to help delay the illness in its earliest stages, Cole said.
Another study, this time in the September Archives of Neurology, found that accelerated weight loss may be another sign of very early Alzheimer's disease.
Researchers at Washington State University School of Medicine, St. Louis, tracked the weight of 449 adults without Alzheimer's or related dementia when the study began.
Six years on, the 125 participants who did develop the illness were found to have weighed approximately 8 pounds less upon study entry than participants who remained free of Alzheimer's. Weight loss increased as Alzheimer's symptoms appeared, the researchers noted.
If the findings are supported in other studies, early weight loss may be a factor in spotting people at risk for Alzheimer's, the St. Louis team said.
Saykin said early detection may someday be key to a cure, as new treatment breakthroughs emerge over time.
"There is an incredible amount of new information about molecule biology that's been uncovered in recent years. For example, the chemical composition of tangles in the brain are becoming better understood, and vaccines to dissolve the causative agent, beta amyloid, are in clinical trials," he said.
More information
There's more on Alzheimer's disease at the U.S. National Institute on Aging.
Alzheimer's Symptoms May Arise From Mutant Genes
(HealthDay News) -- Scientists may have found a new cause of Alzheimer's disease symptoms.Researchers at the University of Texas Southwestern Medical Center at Dallas and colleagues have been studying genes known as "presenilins," known to be mutated in people with an inherited form of Alzheimer's disease.
Until now, presenilins have been primarily known for their role in forming the plaques that riddle the brains of Alzheimer's patients. But this new study, published in the Sept. 8 issue of Cell, found that presenilins may also control the balance of calcium within cells.
Calcium serves as a signaling molecule and affects functions such as learning and memory. Mutant forms of presenilin lose their ability to control calcium balance, and cells become "overloaded" with calcium.
More research is needed to determine whether the disruption of calcium balance actually causes Alzheimer's disease symptoms, but this study raises the possibility of new treatments for people with Alzheimer's disease, the research team said.
Since the heightened calcium signal was reversed in mutant cells when the scientists restored normal presenilin, drugs targeted at restoring normal calcium levels might be useful for treating Alzheimer's disease, the Texas team added.
More information
The U.S. National Institute on Aging has more about Alzheimer's disease.
Sunday, September 17, 2006
Health Tip: What's Sleep Apnea?
(HealthDay News) -- Sleep apnea is a disorder that causes a person to stop breathing while asleep, sometimes for up to 30 seconds at a time.The condition typically causes a person to wake up many times during the night when breathing stops, resulting in lack of sleep.
Most people suffer from a type called obstructive sleep apnea, in which something in the throat blocks the airway and interrupts breathing.
The American Academy of Family Physicians says most often the blockage is caused by the tonsils, tongue or uvula at the back of the throat. A less common type is called central sleep apnea, which is caused by an abnormality in the central nervous system that leads to inconsistent breathing.
Symptoms of sleep apnea may include heavy snoring, fatigue, and even dangerous instances of falling asleep during the day -- such as while driving.
Sleep apnea can be treated with lifestyle changes, including avoiding alcohol and smoking, and losing weight. Or special devices can be prescribed to help make breathing easier during sleep.
Health Tip: Prevent Yeast Infections
(HealthDay News) -- Vaginal yeast infections are caused by a fungus that thrives when a woman's body changes because of a period, pregnancy or medication she may be taking.Here are suggestions to prevent these infections, courtesy of the American Academy of Family Physicians:
· Avoid underwear and pants that are made of synthetic fibers. Stick to all-cotton underwear.
· Wear loose-fitting clothing.
· Avoid wearing pantyhose daily.
· Remove wet swimsuits, clothing, or underwear immediately.
· Avoid artificially fragranced or colored products such as sprays, tampons, pads, douches, or bubble baths, as they can affect the area's acid balance, which can promote symptoms of a yeast infection.
Kids Don't Benefit From Calcium Supplementation
(HealthDay News) -- While calcium supplements have been touted to prevent broken bones in adults, providing them to children may not help prevent fractures as they age, Australian researchers report."At two of the areas where we worry about fractures in later life -- the spine and the hip -- the giving of calcium supplements had no effect on bone health in children," said study lead author Dr. Tania Winzenberg, a musculoskeletal epidemiologist at the Menzies Research Institute, in Tasmania.
"It had been thought that calcium supplements would be more helpful than that in children," she said. "So, giving calcium supplements to children has little effect on fractures, and fractures is what we worry about."
Her team's report is published in the Sept. 16 edition of the British Medical Journal.
In their review, the researchers analyzed data collected from 19 different studies. The studies included nearly 2,900 children between three and 18 years of age, and focused on the benefits of calcium supplementation lasting at least three months. The studies tracked bone outcomes after at least six months of follow-up.
Winzenberg's team found only a small effect of supplementation on total-body bone mineral content and upper arm bone density. Children taking the supplements only had 1.7 percent better bone density in their upper arms compared to kids not taking the supplements.
The team also found no effect on the rate of fractures seen later in life among people given calcium supplements as children. This was particularly true for common fracture sites, such as the hip and lumbar spine.
Based on the findings, Winzenberg's group recommends other approaches to improving kids' bone health, especially increasing vitamin D intake and eating more fruit and vegetables. Vitamin D is sourced mainly from exposure to sunlight, and is essential to the intestinal absorption of calcium.
The findings don't apply to children who may have significant problems with their bones or who can't eat dairy products, Winzenberg said. For healthy children, calcium remains an important part of the diet, she noted.
One expert agreed that calcium supplementation probably doesn't benefit healthy children.
"Healthy children, with an adequate diet, may have all the calcium they need to build bone," said Dr. David L. Katz, an associate professor of public health and director of the Prevention Research Center at Yale University School of Medicine. "Growing bone might need a combination of materials, such as calcium combined with vitamin D, to grow stronger," he said.
This study does not exclude a possible benefit of calcium supplementation for children with low intake of dietary calcium, or children with certain health problems, Katz said.
"But it does indicate that calcium supplementation in healthy children is a questionable practice," he said. "For now, the tried-and-true approach to the early prevention of osteoporosis remains a healthful, balanced diet, and plenty of exercise," Katz said.
More information
There's more on calcium intake at the U.S. National Institutes of Health.
Friday, September 15, 2006
Pomegranates for the Prostate?
Pomegranates for the Prostate?
Q: Is it true that pomegranate juice protects against prostate cancer?
A: Pomegranate juice may turn out to be very useful in the treatment of prostate cancer and, perhaps, its prevention, as well. Here’s the story: in 2005, researchers at the University of Wisconsin tested various doses of pomegranate extract on human prostate cancer cells in the lab. The higher the dose of the extract, the more cancer cells died.
Then, in tests with mice that were injected with human prostate cancer cells, the animals that received the highest concentration of pomegranate extract had the least progression of prostate cancer and declining levels of prostate specific antigen (PSA), a marker for prostate cancer in humans. In a comparison group of mice that received only water instead of pomegranate extract, tumors grew much faster.
And now it appears that pomegranate juice also helps humans. Researchers at the University of California at Los Angeles (UCLA) tested it on a group of 46 men whose PSA levels were rising after treatment for prostate cancer – usually a bad sign. While surgery or radiation cures two out of every three cases of early prostate cancer, the disease lingers among patients in the other third, and within 15 years, may progress to deadly metastatic cancer.
Patients with detectable PSA levels after surgery or radiation usually are treated with hormone therapy to remove testosterone from the system. This can bring on severe side effects including hot flashes, osteoporosis, fatigue, depression and muscle wasting, as well as loss of libido or erectile dysfunction. Instead, the men participating in the UCLA study drank eight ounces of pomegranate juice daily. Of the 46 patients, PSA levels declined in 16 and, in four of them, dropped by half. The researchers reported that some of the men in the study have continued drinking pomegranate juice and their PSA levels have remained stable for more than three years.
It’s little wonder pomegranate juice shows such remarkable effects. It is anti-inflammatory and rich in antioxidants. It contains some of the same polyphenols found in tea, as well as isoflavones found in soy, plus ellagic acid found in berries, which is believed to play a role in cancer cell death.
Pomegranate juice didn’t work on everyone in the study and certainly isn’t a cure, but the results were sufficiently striking to prompt the launch of a larger clinical trial to be conducted at 10 medical centers around the country. The hope is that the juice will turn out to be powerful enough to keep prostate cancer in check. As a result, the researchers said, prostate cancer patients between the ages of 65 and 70 may be able to avoid both hormonal treatment and chemotherapy and still have normal life expectancy. The UCLA study was published in the July 1, 2006, issue of Clinical Cancer Research.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Q: Is it true that pomegranate juice protects against prostate cancer?
A: Pomegranate juice may turn out to be very useful in the treatment of prostate cancer and, perhaps, its prevention, as well. Here’s the story: in 2005, researchers at the University of Wisconsin tested various doses of pomegranate extract on human prostate cancer cells in the lab. The higher the dose of the extract, the more cancer cells died.
Then, in tests with mice that were injected with human prostate cancer cells, the animals that received the highest concentration of pomegranate extract had the least progression of prostate cancer and declining levels of prostate specific antigen (PSA), a marker for prostate cancer in humans. In a comparison group of mice that received only water instead of pomegranate extract, tumors grew much faster.
And now it appears that pomegranate juice also helps humans. Researchers at the University of California at Los Angeles (UCLA) tested it on a group of 46 men whose PSA levels were rising after treatment for prostate cancer – usually a bad sign. While surgery or radiation cures two out of every three cases of early prostate cancer, the disease lingers among patients in the other third, and within 15 years, may progress to deadly metastatic cancer.
Patients with detectable PSA levels after surgery or radiation usually are treated with hormone therapy to remove testosterone from the system. This can bring on severe side effects including hot flashes, osteoporosis, fatigue, depression and muscle wasting, as well as loss of libido or erectile dysfunction. Instead, the men participating in the UCLA study drank eight ounces of pomegranate juice daily. Of the 46 patients, PSA levels declined in 16 and, in four of them, dropped by half. The researchers reported that some of the men in the study have continued drinking pomegranate juice and their PSA levels have remained stable for more than three years.
It’s little wonder pomegranate juice shows such remarkable effects. It is anti-inflammatory and rich in antioxidants. It contains some of the same polyphenols found in tea, as well as isoflavones found in soy, plus ellagic acid found in berries, which is believed to play a role in cancer cell death.
Pomegranate juice didn’t work on everyone in the study and certainly isn’t a cure, but the results were sufficiently striking to prompt the launch of a larger clinical trial to be conducted at 10 medical centers around the country. The hope is that the juice will turn out to be powerful enough to keep prostate cancer in check. As a result, the researchers said, prostate cancer patients between the ages of 65 and 70 may be able to avoid both hormonal treatment and chemotherapy and still have normal life expectancy. The UCLA study was published in the July 1, 2006, issue of Clinical Cancer Research.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Citronella: Convincing Mosquitoes to Buzz Off?
Citronella: Convincing Mosquitoes to Buzz Off?
Q: How effective is citronella as an insect repellent? Will burning the candles really keep mosquitoes away?
A: Citronella, extracted from the leaves of a tropical Asian grass related to lemon grass, has a worldwide reputation as an insect repellent, but I’m not sure that it’s all its cracked up to be. Citronella oil goes into candles, lotions, sprays, soaps, and other products designed to banish pesky bugs. Although it's considered quite safe, the undiluted oil can cause skin irritation, and may increase heart rate in some people.
Does it keep insects away? A study published in the New England Journal of Medicine in 2002 found that products containing citronella oil protected against mosquito bites for under 20 minutes compared to more than five hours for products containing highly concentrated DEET, an effective repellent that I consider toxic and nasty. The least concentrated citronella products didn’t do as good a job as Skin So Soft Bath Oil (a skin moisturizing product that consumers have come to believe has significant repellent effects), which gave a mean of just 9.6 minutes of protection. Incidentally, the researchers also tested wrist bands impregnated with DEET and citronella. None of them worked.
Burning citronella candles may be a better idea than using citronella insect repellents, but I wouldn’t depend on them to keep you bite-free. A Canadian study published in the June, 1996, issue of the Journal of the American Mosquito Control Association compared using three percent citronella candles, five percent citronella incense, an unscented candle and no candle at all in the woodlands of Ontario during several July and August evenings. Those near the citronella candles and incense received fewer bites than those near the unscented candle or in the area with no candle. The reduction attributed to citronella was 42.3 percent and 24.2 percent, respectively. That still leaves a lot of bitten people.
Natural insect repellents containing geraniol appear to be more effective and are my first choice. Neem oil and eucalyptus oil may also work better than citronella. Otherwise, your best bet is to stay indoors at dusk when mosquitoes are feeding, and make sure the screens don’t have any holes.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Q: How effective is citronella as an insect repellent? Will burning the candles really keep mosquitoes away?
A: Citronella, extracted from the leaves of a tropical Asian grass related to lemon grass, has a worldwide reputation as an insect repellent, but I’m not sure that it’s all its cracked up to be. Citronella oil goes into candles, lotions, sprays, soaps, and other products designed to banish pesky bugs. Although it's considered quite safe, the undiluted oil can cause skin irritation, and may increase heart rate in some people.
Does it keep insects away? A study published in the New England Journal of Medicine in 2002 found that products containing citronella oil protected against mosquito bites for under 20 minutes compared to more than five hours for products containing highly concentrated DEET, an effective repellent that I consider toxic and nasty. The least concentrated citronella products didn’t do as good a job as Skin So Soft Bath Oil (a skin moisturizing product that consumers have come to believe has significant repellent effects), which gave a mean of just 9.6 minutes of protection. Incidentally, the researchers also tested wrist bands impregnated with DEET and citronella. None of them worked.
Burning citronella candles may be a better idea than using citronella insect repellents, but I wouldn’t depend on them to keep you bite-free. A Canadian study published in the June, 1996, issue of the Journal of the American Mosquito Control Association compared using three percent citronella candles, five percent citronella incense, an unscented candle and no candle at all in the woodlands of Ontario during several July and August evenings. Those near the citronella candles and incense received fewer bites than those near the unscented candle or in the area with no candle. The reduction attributed to citronella was 42.3 percent and 24.2 percent, respectively. That still leaves a lot of bitten people.
Natural insect repellents containing geraniol appear to be more effective and are my first choice. Neem oil and eucalyptus oil may also work better than citronella. Otherwise, your best bet is to stay indoors at dusk when mosquitoes are feeding, and make sure the screens don’t have any holes.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Antioxidants and Cancer Treatment?
Antioxidants and Cancer Treatment?
Q: Is it advisable or not to supplement with antioxidant therapy during combined chemotherapy and radiation therapy? If so, which antioxidants do you recommend and are there any that should definitely be avoided?
A: You've asked a difficult question. This issue has been generating a heated controversy, especially among cancer specialists (oncologists) who also practice integrative medicine.
One camp holds that taking antioxidants during cancer treatment could interfere with the way chemo and radiation work and diminish their benefits to the patient. This is because radiation and some chemotherapy agents work by generating free radicals, which then kill rapidly dividing cancer cells. Since antioxidants scavenge free radicals, they might interfere with the therapeutic effects of these treatments.
The opposing argument is that oxidation supports the proliferation of malignant cells and may itself interfere with treatment. People who hold this view maintain that antioxidants may counter the harmful effects of oxidation in the malignant process and thereby increase the effects of drugs or radiation therapy to the benefit of the patient. Moreover, they note that some evidence suggests that antioxidant supplements offer patients protection from the toxic effects of therapy.
As things now stand, we need more research before we can confidently advise patients one way or another. However, I posed your question to Donald Abrams, M.D., an integrative oncologist at the University of San Francisco and a graduate of the associate fellowship at the Program on Integrative Medicine here at the University of Arizona. Dr. Abrams told me that questions about antioxidants are the most frequent ones he gets. In the absence of strong evidence, he now advises patients as follows:
For those being treated for a possible cure (meaning that their tumors have been removed and that the goal of chemotherapy or radiation is to destroy any remaining cancer cells): Don't take antioxidant supplements on the day before, the day of, and the day after chemotherapy. Otherwise, it is okay to take supplements.
For patients undergoing radiation therapy: no antioxidant supplements throughout the course of treatment.
For patients with advanced cancer who are being treated in order to prolong survival and relieve symptoms: it is okay to take antioxidant supplements. Because chemotherapy agents differ in their mode of action, it would be helpful to know whether the particular drugs being used work by an oxidative (free-radical-generating) mechanism. Ask the medical oncologist treating you for that information.
By the way, there is no justification for telling patients undergoing chemotherapy or radiation therapy to avoid antioxidant-rich foods.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Q: Is it advisable or not to supplement with antioxidant therapy during combined chemotherapy and radiation therapy? If so, which antioxidants do you recommend and are there any that should definitely be avoided?
A: You've asked a difficult question. This issue has been generating a heated controversy, especially among cancer specialists (oncologists) who also practice integrative medicine.
One camp holds that taking antioxidants during cancer treatment could interfere with the way chemo and radiation work and diminish their benefits to the patient. This is because radiation and some chemotherapy agents work by generating free radicals, which then kill rapidly dividing cancer cells. Since antioxidants scavenge free radicals, they might interfere with the therapeutic effects of these treatments.
The opposing argument is that oxidation supports the proliferation of malignant cells and may itself interfere with treatment. People who hold this view maintain that antioxidants may counter the harmful effects of oxidation in the malignant process and thereby increase the effects of drugs or radiation therapy to the benefit of the patient. Moreover, they note that some evidence suggests that antioxidant supplements offer patients protection from the toxic effects of therapy.
As things now stand, we need more research before we can confidently advise patients one way or another. However, I posed your question to Donald Abrams, M.D., an integrative oncologist at the University of San Francisco and a graduate of the associate fellowship at the Program on Integrative Medicine here at the University of Arizona. Dr. Abrams told me that questions about antioxidants are the most frequent ones he gets. In the absence of strong evidence, he now advises patients as follows:
For those being treated for a possible cure (meaning that their tumors have been removed and that the goal of chemotherapy or radiation is to destroy any remaining cancer cells): Don't take antioxidant supplements on the day before, the day of, and the day after chemotherapy. Otherwise, it is okay to take supplements.
For patients undergoing radiation therapy: no antioxidant supplements throughout the course of treatment.
For patients with advanced cancer who are being treated in order to prolong survival and relieve symptoms: it is okay to take antioxidant supplements. Because chemotherapy agents differ in their mode of action, it would be helpful to know whether the particular drugs being used work by an oxidative (free-radical-generating) mechanism. Ask the medical oncologist treating you for that information.
By the way, there is no justification for telling patients undergoing chemotherapy or radiation therapy to avoid antioxidant-rich foods.
Andrew Weil, M.D.
–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Bacopa: A Better Memory Booster?
Bacopa: A Better Memory Booster?Q: What you can tell me about bacopa? I first read about it as a treatment for memory problems. Do you know anything about its effectiveness in treating memory problems or what the recommended dosage should be?
A: Bacopa (Bacopa monnieri) is an herb native to India that has been used traditionally in Ayurvedic medicine to enhance memory, learning and concentration and also to treat anxiety, heart problems, digestive disorders, asthma, and bronchitis. Most of the research on bacopa has been in animals, but a few small studies on humans have also been done.
A: Bacopa (Bacopa monnieri) is an herb native to India that has been used traditionally in Ayurvedic medicine to enhance memory, learning and concentration and also to treat anxiety, heart problems, digestive disorders, asthma, and bronchitis. Most of the research on bacopa has been in animals, but a few small studies on humans have also been done.
The single study I've been able to find on bacopa's effect on memory was a small, double-blind, placebo-controlled 12-week trial conducted in Australia with 46 volunteers between the ages of 18 and 60, divided into two groups.
The volunteers in one group were given 300 milligrams of bacopa daily, and the others received a placebo. Prior to the study, the researchers tested all the volunteers to assess their verbal learning abilities, memory and speed of information processing. The tests were repeated five and 12 weeks after the study began. The researchers noted a significant improvement among the volunteers in the bacopa group compared to those in the placebo group.
A review article of some 38 scientific studies of bacopa was published in the March, 2004, issue of the journal Alternative Medicine Review, and noted two small studies that demonstrated an improvement in cognitive function in children as a result of taking bacopa. A single small-scale human study also found a decrease in anxiety symptoms among patients treated with bacopa.
Bacopa is now being widely promoted as a treatment for memory problems, but I would recommend more proven protective strategies.
Keep your mind active by reading newspapers and books, doing crossword puzzles, playing musical instruments, participating in ongoing education, and learning a new language. As far as supplements to enhance memory are concerned, the ones listed below have been studied more thoroughly than bacopa:
Ginkgo biloba. This well-studied botanical remedy increases blood flow to the head, has a reputation as a memory-enhancing agent and may slow the progression of dementia in early onset Alzheimer's disease. You probably won't notice any effects for six to eight weeks. (Look for products standardized to 24 percent ginkgo flavone glycosides and 6 percent terpene lactones; the dose is 60 to 120 milligrams twice a day with food.) Ginkgo has low toxicity, although it may cause mild stomach irritation.
Ginkgo biloba. This well-studied botanical remedy increases blood flow to the head, has a reputation as a memory-enhancing agent and may slow the progression of dementia in early onset Alzheimer's disease. You probably won't notice any effects for six to eight weeks. (Look for products standardized to 24 percent ginkgo flavone glycosides and 6 percent terpene lactones; the dose is 60 to 120 milligrams twice a day with food.) Ginkgo has low toxicity, although it may cause mild stomach irritation.
Acetyl-L-carnitine (also called ALC or ALCAR) is an amino acid derivative. Human clinical studies of this compound are currently underway, and the early evidence from animal trials is encouraging. Many people take ALC as a cognitive enhancer.
The dose is 500-1,000 milligrams twice a day on an empty stomach. It is nontoxic, but this is an expensive regimen.
Phosphatidyl serine, or PS. A naturally occurring lipid that is a component of cell membranes, PS is considered a brain-cell nutrient. Human studies have reported positive effects on memory and concentration; PS may improve cognitive function in normal adults and may help reverse age-related cognitive decline.
The supplement form, derived from soybeans, is readily available, but fairly expensive. The starting dose is 100 milligrams two or three times a day; if this produces positive benefits after a month or more, it may be possible to go on a lower maintenance dose. It is nontoxic.
Andrew Weil, M.D.–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Andrew Weil, M.D.–Author of:
Eight Weeks to Optimum Health
Spontaneous Healing
The Natural Mind
The Marriage of the Sun and Moon
Health and Healing
Natural Health, Natural Medicine
From Chocolate to Morphine (with Winifred Rosen)
Monday, September 11, 2006
Should You 'Go Green' When You Clean?
(HealthDay News) -- For consumers concerned about the environment and their own health, household cleaning products that promise to be "all natural" or "organic" have understandable appeal.
They promise to help you polish, buff or scrub without worrying about polluting the earth, having an allergic reaction or breathing in the organic chemicals widely used in conventional cleaning products. The makers of "green" cleaning products say they are made with "earth-friendly" ingredients and plant-derived essential oils, and they are touted as having the same cleaning power as conventional products filled with chemicals.
But how can consumers really be sure when they buy these products whether they are organic or not? Right now, natural cleaning products aren't regulated by the government, said Craig Minowa, a spokesman for the Organic Consumers Association, based in Finland, Minn., which promotes food safety and organic farming.
Jackie Dizdul, a spokeswoman for the U.S. Federal Trade Commission agreed that at the present time, "There are no specific Federal Trade Commission regulations about use of the words 'natural,' 'all-natural' or 'organic' when describing cleaning products. But all claims need to be truthful, non-misleading, substantiated."
Claims for natural products offered by Caldrea and Mrs. Meyer's Clean Day, for instance, are substantiated, according to Monica Nassif, founder and president of both companies. "We make claims that they are earth-friendly, biodegradable, have no phosphate, no chloride, no solvents and are plant-derived, and not tested on animals," she said.
She said household cleaners made by Caldrea include plant-derived ingredients and essential oils. Prices are higher than conventional cleaning products. Caldrea liquid dish soap, available in high-end specialty stores, costs $8 for 16 ounces, for instance, while Mrs. Meyer's brand, sold in natural food markets, is $4.99 for 16 ounces. A similar-sized bottle of regular dishwashing liquid found in conventional groceries typically sells for $2 or $3, Nassif said.
Part of the higher price is due to the cost of the ingredients, which Nassif said cost more than those used in conventional products. "We buy the fragrances in the Caldrea line from sophisticated perfume fragrance houses," she said.
Do they work as well? Green-clean products do have their critics, but Nassif said her companies' cleaners perform just as well as their mainstream competitors.
"All our products are sent out to independent laboratories which test [them] for performance," she said. "There are industry standards for performance." The results for her products, she said, "have to be on par or better with the leader in the mass [conventional product] category."
"There's definitely benefit," said Minowa, referring to organic or all-natural cleaning products. "If you find a natural cleaning product, it's way better than conventional," he said. "You don't have the negative health and environmental effect."
According to the U.S. Environmental Protection Agency, potentially hazardous chemicals are widely used in conventional household products. Cleaning and disinfection products as well as paints and varnishes all contain chemicals called organic solvents. The compounds can be released into the air during use and even when stored, according to the EPA.
Among the potential health effects with exposure are headaches; irritation to the eyes, nose and throat; and central nervous system damage. Some of these compounds have been found to cause cancer in animals, according to the EPA, and some are suspected of raising risks in people, as well.
Environmentally keen and health-conscious consumers are driving the move to "green clean" products. Nassif cited recent statistics that found the U.S. market for "natural" cleaning products now tops $100 million a year.
It's still a small part of the overall market, but sales growth has continued to rise by 18 percent to 25 percent each year for the past five years, according to WorldWatch Institute, an environmentally conscious organization.
However, Minowa pointed out that consumers don't always have to choose between mass-market brands and pricey, "green" alternatives.
Instead, you can fall back on old-fashioned remedies -- things your grandparents or parents may have used: Vinegar instead of Windex, for example, or baking soda rather than Comet.
One more suggestion? "Boil a big pot of water, add baking soda and vinegar," Minowa said. "Clean out the drain [with that] instead of drain cleaner."
More information
To learn more about volatile organic compounds, visit the U.S. Environmental Protection Agency.
They promise to help you polish, buff or scrub without worrying about polluting the earth, having an allergic reaction or breathing in the organic chemicals widely used in conventional cleaning products. The makers of "green" cleaning products say they are made with "earth-friendly" ingredients and plant-derived essential oils, and they are touted as having the same cleaning power as conventional products filled with chemicals.
But how can consumers really be sure when they buy these products whether they are organic or not? Right now, natural cleaning products aren't regulated by the government, said Craig Minowa, a spokesman for the Organic Consumers Association, based in Finland, Minn., which promotes food safety and organic farming.
Jackie Dizdul, a spokeswoman for the U.S. Federal Trade Commission agreed that at the present time, "There are no specific Federal Trade Commission regulations about use of the words 'natural,' 'all-natural' or 'organic' when describing cleaning products. But all claims need to be truthful, non-misleading, substantiated."
Claims for natural products offered by Caldrea and Mrs. Meyer's Clean Day, for instance, are substantiated, according to Monica Nassif, founder and president of both companies. "We make claims that they are earth-friendly, biodegradable, have no phosphate, no chloride, no solvents and are plant-derived, and not tested on animals," she said.
She said household cleaners made by Caldrea include plant-derived ingredients and essential oils. Prices are higher than conventional cleaning products. Caldrea liquid dish soap, available in high-end specialty stores, costs $8 for 16 ounces, for instance, while Mrs. Meyer's brand, sold in natural food markets, is $4.99 for 16 ounces. A similar-sized bottle of regular dishwashing liquid found in conventional groceries typically sells for $2 or $3, Nassif said.
Part of the higher price is due to the cost of the ingredients, which Nassif said cost more than those used in conventional products. "We buy the fragrances in the Caldrea line from sophisticated perfume fragrance houses," she said.
Do they work as well? Green-clean products do have their critics, but Nassif said her companies' cleaners perform just as well as their mainstream competitors.
"All our products are sent out to independent laboratories which test [them] for performance," she said. "There are industry standards for performance." The results for her products, she said, "have to be on par or better with the leader in the mass [conventional product] category."
"There's definitely benefit," said Minowa, referring to organic or all-natural cleaning products. "If you find a natural cleaning product, it's way better than conventional," he said. "You don't have the negative health and environmental effect."
According to the U.S. Environmental Protection Agency, potentially hazardous chemicals are widely used in conventional household products. Cleaning and disinfection products as well as paints and varnishes all contain chemicals called organic solvents. The compounds can be released into the air during use and even when stored, according to the EPA.
Among the potential health effects with exposure are headaches; irritation to the eyes, nose and throat; and central nervous system damage. Some of these compounds have been found to cause cancer in animals, according to the EPA, and some are suspected of raising risks in people, as well.
Environmentally keen and health-conscious consumers are driving the move to "green clean" products. Nassif cited recent statistics that found the U.S. market for "natural" cleaning products now tops $100 million a year.
It's still a small part of the overall market, but sales growth has continued to rise by 18 percent to 25 percent each year for the past five years, according to WorldWatch Institute, an environmentally conscious organization.
However, Minowa pointed out that consumers don't always have to choose between mass-market brands and pricey, "green" alternatives.
Instead, you can fall back on old-fashioned remedies -- things your grandparents or parents may have used: Vinegar instead of Windex, for example, or baking soda rather than Comet.
One more suggestion? "Boil a big pot of water, add baking soda and vinegar," Minowa said. "Clean out the drain [with that] instead of drain cleaner."
More information
To learn more about volatile organic compounds, visit the U.S. Environmental Protection Agency.
Stopovers May Ease Jet Lag
(HealthDay News) -- If you suffer from severe jet leg, it may be because your body overshoots as it attempts to adjust to large leaps forward in time, new research shows.
In order to help the body more easily adjust to time changes, travelers shouldn't advance more than four hours at a time, says a team from the University of Massachusetts in Amherst.
Based on their study of the circadian rhythms of rats, they say this approach enables the body's clock to advance smoothly and nudges the entire system in the right time direction.
"Jet lag isn't a horrible thing that we have to conquer -- and our clock is a very important regulator at a basic level," researcher Hava Siegelmann said in a prepared statement. "Medications to target the clock may be counter-productive if they affect future oscillatory behavior," she said.
"Instead, take a stopover if you are traveling for more than six hours -- relax for a day and then continue. Understand and go with your body's natural oscillations," Siegelmann advised.
The research also has implications for rotational shift workers, such as airline attendants and nurses, because the body has more difficulty adjusting to some shifts than others.
The study was published in the current issue of the Journal of Biological Rhythms.
More information
The National Sleep Foundation has more about jet lag.
In order to help the body more easily adjust to time changes, travelers shouldn't advance more than four hours at a time, says a team from the University of Massachusetts in Amherst.
Based on their study of the circadian rhythms of rats, they say this approach enables the body's clock to advance smoothly and nudges the entire system in the right time direction.
"Jet lag isn't a horrible thing that we have to conquer -- and our clock is a very important regulator at a basic level," researcher Hava Siegelmann said in a prepared statement. "Medications to target the clock may be counter-productive if they affect future oscillatory behavior," she said.
"Instead, take a stopover if you are traveling for more than six hours -- relax for a day and then continue. Understand and go with your body's natural oscillations," Siegelmann advised.
The research also has implications for rotational shift workers, such as airline attendants and nurses, because the body has more difficulty adjusting to some shifts than others.
The study was published in the current issue of the Journal of Biological Rhythms.
More information
The National Sleep Foundation has more about jet lag.
'Blackberry Thumb' Proves a Sour Fruit of Modern Labor
(HealthDay News) -- You can now add "BlackBerry Thumb" to the list of workplace maladies, says the American Physical Therapy Association (APTA).
BlackBerry Thumb refers to an increasingly common, repetitive-stress injury stemming from use of the popular handheld electronic devices. This stress injury causes pain and/or numbness in the thumbs and joints of the hands.
The condition is caused by spending too much time on these devices -- checking and composing e-mails, instant messaging, and accessing the Internet.
"The use of PDAs (personal digital assistants) is no longer limited to the eight hours spent in the workplace," Margot Miller, president of the APTA's Occupational Health Special Interest Group, said in a prepared statement.
"More and more, people are depending on these devices to stay in touch with friends and family before and after the work day and on the weekends, as well as having access to work when they leave the office; that is where the heart of the problem lies," Miller said.
Many PDA users are middle-aged and overuse of the handheld devices can aggravate underlying arthritis.
"Because the keyboard of the PDA is so small, and because the thumb, which is the least dexterous part of the hand, is overtaxed (for faster typing), the risk of injury just skyrockets," Miller said.
The APTA offers the following tips on how to avoid BlackBerry Thumb:
· Take frequent breaks from your PDA. Don't type for more than a few minutes at a time.
· Write fewer and shorter messages. Learn to abbreviate your responses.
· Try to avoid thumb-typing. Use your other fingers to type.
· If possible, place a support in your lap when using a PDA, so that your wrists are in a more upright position and not flexed or bent.
The APTA also recommends the following simple exercises:
· Tap each finger with the thumb of the same hand. Repeat five times.
· Alternate tapping the palm of your hand and the back of your hand against your thigh as quickly as you can. Repeat 20 times.
· Open your hands and spread your fingers as far apart as possible. Hold for 10 seconds and repeat eight times.
· Fold your hands together, and turn your palms away from your body as you extend your arms forward. You should only feel a gentle stretch. Hold for 10 seconds and repeat eight times.
· Fold your hands together, turn your palms away from your body, and extend your arms overhead. You should feel the stretch in your upper torso and shoulders to hand. Hold for 10 seconds and repeat eight times.
More information
The U.S. National Institute of Neurological Disorders and Stroke has more about repetitive motion disorders.
BlackBerry Thumb refers to an increasingly common, repetitive-stress injury stemming from use of the popular handheld electronic devices. This stress injury causes pain and/or numbness in the thumbs and joints of the hands.
The condition is caused by spending too much time on these devices -- checking and composing e-mails, instant messaging, and accessing the Internet.
"The use of PDAs (personal digital assistants) is no longer limited to the eight hours spent in the workplace," Margot Miller, president of the APTA's Occupational Health Special Interest Group, said in a prepared statement.
"More and more, people are depending on these devices to stay in touch with friends and family before and after the work day and on the weekends, as well as having access to work when they leave the office; that is where the heart of the problem lies," Miller said.
Many PDA users are middle-aged and overuse of the handheld devices can aggravate underlying arthritis.
"Because the keyboard of the PDA is so small, and because the thumb, which is the least dexterous part of the hand, is overtaxed (for faster typing), the risk of injury just skyrockets," Miller said.
The APTA offers the following tips on how to avoid BlackBerry Thumb:
· Take frequent breaks from your PDA. Don't type for more than a few minutes at a time.
· Write fewer and shorter messages. Learn to abbreviate your responses.
· Try to avoid thumb-typing. Use your other fingers to type.
· If possible, place a support in your lap when using a PDA, so that your wrists are in a more upright position and not flexed or bent.
The APTA also recommends the following simple exercises:
· Tap each finger with the thumb of the same hand. Repeat five times.
· Alternate tapping the palm of your hand and the back of your hand against your thigh as quickly as you can. Repeat 20 times.
· Open your hands and spread your fingers as far apart as possible. Hold for 10 seconds and repeat eight times.
· Fold your hands together, and turn your palms away from your body as you extend your arms forward. You should only feel a gentle stretch. Hold for 10 seconds and repeat eight times.
· Fold your hands together, turn your palms away from your body, and extend your arms overhead. You should feel the stretch in your upper torso and shoulders to hand. Hold for 10 seconds and repeat eight times.
More information
The U.S. National Institute of Neurological Disorders and Stroke has more about repetitive motion disorders.
FDA Again Fines Red Cross Over Blood Collection Practices
(HealthDay News) -- Levying the largest fine to date, the U.S. Food and Drug Administration has slapped the American Red Cross once again for failure to comply with safe blood collection techniques.
The Red Cross (ARC), which gathers 45 percent of the nation's blood supply, has been under government mandate since 1993 to improve its quality control system and ensure the safety of its blood supply.
The latest fine, of $4.2 million, brings the total amount levied against the ARC for failure to comply with government requirements to $9.9 million since 2003. It came as a result of a recently completed FDA review of ARC blood recalls between 2003 and 2005, a review that found the recalls were preventable. The agency's violations include breaches of Good Manufacturing Practices, such as failure to ask appropriate donor screening questions and failure to follow manufacturer test protocols.
"The safety of the blood supply is extremely important," Margaret Glavin, the FDA's associate commissioner for regulatory affairs, said during a press conference late Friday.
"The safety of the blood supply requires a rigorous quality control system at all points along the supply chain," she added.
She noted the announcement of the fine was not a public health advisory, and there was no evidence that anyone had been harmed by any recalled blood.
But in light of these new problems, she said, the FDA is requiring the ARC to review its quality-assurance system and its implementation.
"FDA does not consider the current situation acceptable," Glavin said. "It is not acceptable that the quality system has failed in this way. We will continue to work to make sure that the quality system is improved in its design and in its implementation so that these kinds of problems do not continue to occur."
FDA officials did say that some of the blood designated for recall was released, but there appeared to be no adverse consequences.
"We are not aware of any actual contaminations or any actual health consequences from and of the released units," said Dr. Jay Epstein, the FDA's director of the Office of Blood Research and Review and the Center for Biologics Evaluation and Research.
According to the New York Times, which cited court papers unsealed earlier this year in the U.S. District Court in Washington D.C., a former Red Cross quality-control manager has accused the charity of releasing 607 pints of contaminated blood in New Jersey, even though charity officials knew that the blood had been improperly collected and exposed to air.
FDA Commissioner Dr. Mark B. McClellan added in a prepared statement, "I am hopeful that the acceptance of this agreement by ARC's new leadership reflects a new willingness to implement a management culture that expects and achieves good blood safety practices."
In response to the latest FDA action, the ARC said in a statement released Friday: "In accordance with established procedure, we will review the letter, prepare our plans to address the FDA's concerns, and respond to the agency within 20 days. The American Red Cross senior management takes it seriously and is committed to full compliance with the Amended Consent Decree and all applicable federal regulations."
More information
The FDA can tell you more about blood collection.
The Red Cross (ARC), which gathers 45 percent of the nation's blood supply, has been under government mandate since 1993 to improve its quality control system and ensure the safety of its blood supply.
The latest fine, of $4.2 million, brings the total amount levied against the ARC for failure to comply with government requirements to $9.9 million since 2003. It came as a result of a recently completed FDA review of ARC blood recalls between 2003 and 2005, a review that found the recalls were preventable. The agency's violations include breaches of Good Manufacturing Practices, such as failure to ask appropriate donor screening questions and failure to follow manufacturer test protocols.
"The safety of the blood supply is extremely important," Margaret Glavin, the FDA's associate commissioner for regulatory affairs, said during a press conference late Friday.
"The safety of the blood supply requires a rigorous quality control system at all points along the supply chain," she added.
She noted the announcement of the fine was not a public health advisory, and there was no evidence that anyone had been harmed by any recalled blood.
But in light of these new problems, she said, the FDA is requiring the ARC to review its quality-assurance system and its implementation.
"FDA does not consider the current situation acceptable," Glavin said. "It is not acceptable that the quality system has failed in this way. We will continue to work to make sure that the quality system is improved in its design and in its implementation so that these kinds of problems do not continue to occur."
FDA officials did say that some of the blood designated for recall was released, but there appeared to be no adverse consequences.
"We are not aware of any actual contaminations or any actual health consequences from and of the released units," said Dr. Jay Epstein, the FDA's director of the Office of Blood Research and Review and the Center for Biologics Evaluation and Research.
According to the New York Times, which cited court papers unsealed earlier this year in the U.S. District Court in Washington D.C., a former Red Cross quality-control manager has accused the charity of releasing 607 pints of contaminated blood in New Jersey, even though charity officials knew that the blood had been improperly collected and exposed to air.
FDA Commissioner Dr. Mark B. McClellan added in a prepared statement, "I am hopeful that the acceptance of this agreement by ARC's new leadership reflects a new willingness to implement a management culture that expects and achieves good blood safety practices."
In response to the latest FDA action, the ARC said in a statement released Friday: "In accordance with established procedure, we will review the letter, prepare our plans to address the FDA's concerns, and respond to the agency within 20 days. The American Red Cross senior management takes it seriously and is committed to full compliance with the Amended Consent Decree and all applicable federal regulations."
More information
The FDA can tell you more about blood collection.
Saturday, September 02, 2006
Age-Linked Vision Loss May Depend on Genes
(HealthDay News) -- Genetics plays a big role in age-related macular degeneration (AMD), the leading cause of vision loss in older adults, two new studies show.
"We took a very detailed look at a gene that had previously been identified as involved in AMD," explained the lead researcher for one study, Goncalo Abecasis, an associate professor of biostatistics at the University of Michigan, Ann Arbor. "We found there were many variants of the gene that could increase the risk of AMD -- some with very large effects," he added.
The reports were published in the September issue of Nature Genetics.
AMD is a degenerative disorder that affects the retina, gradually reducing vision. The risk of developing the condition increases with age and is influenced by environmental as well as genetic factors.
Earlier studies have found that a genetic variant of a protein called complement factor H (CFH) to be associated with increased risk of developing AMD. These new studies show that other variants of the CFH gene also play an important role in the risk of AMD.
In the first study, Abecasis' team examined at gene variants associated with the CFH gene. They studied these variants in 726 people with AMD and in 268 people who didn't have the condition.
They found that variants linked to CFH gene -- which do not change the protein itself -- significantly contribute to the risk of AMD. They also showed that multiple variants taken together make up a high proportion of people's risk.
What was unusual about the finding was that these variants didn't have an obvious impact on the protein, Abecasis said. This finding could give scientists a more accurate means of determining an individual's specific risk for AMD.
The discovery may also help lead to new treatments. "We would like to be able to target the gene to reduce the risk of developing AMD," Abecasis said. There are also other genes involved in AMD which need to be examined just as this one was, he noted.
The second study was led by Mark Daly, an assistant professor of medicine at Massachusetts General Hospital. His team examined the genetic causes of AMD cases and found that a common variant of CFH influenced the risk for AMD. As with Abecasis' study, this variant appeared to have no relation to the CFH protein. The Boston group studied over 1,200 people with AMD and more than 900 people without the disease.
They also confirmed links between AMD susceptibility and variations in two other genes. Together, genetic variations in these three genes accounted for a large proportion of people's increased risk for AMD, the report found.
"We identified a new gene variant that is associated with AMD," Daly said. "And we have confirmed several other findings. There is now confirmation of three genes involved in AMD," he added.
Brothers and sisters of people with AMD have a 3- to 6-fold higher risk of developing AMD compared with the general population, experts say. Daly's group now estimates that variations in these three genes account for about half of that increased risk.
With this information, researchers can start to look at people to determine their personal risk for developing AMD, Daly said.
That might help in the future, if and when effective treatments arose. However, "At this point, if there were more substantial measures in treating AMD, this would be more valuable information," Daly said. "At present, there are not really compelling ways of preventing the onset of disease."
The new findings could yield effective ways to prevent or treat AMD, Daly said.
Two other experts agreed.
"These studies confirm what has already been known, but give us a better view on the subject," said Rando Allikmets, the Acquavella associate professor in ophthalmology and director of the molecular genetics laboratory at Columbia University Medical Center in New York City.
Targeting these genes might help treat AMD by suppressing inflammation in the eye, he said.
And Michael Dean, head of the human genetics section at the U.S. National Cancer Institute, said prevention will be key.
"Now that we can identify people at risk for AMD, we need to identify them when they are young and follow them over time to see when AMD starts occurring and to see if there is a way delay or prevent the disease," he said.
More information
For more on AMD, head to the U.S. National Eye Institute.
"We took a very detailed look at a gene that had previously been identified as involved in AMD," explained the lead researcher for one study, Goncalo Abecasis, an associate professor of biostatistics at the University of Michigan, Ann Arbor. "We found there were many variants of the gene that could increase the risk of AMD -- some with very large effects," he added.
The reports were published in the September issue of Nature Genetics.
AMD is a degenerative disorder that affects the retina, gradually reducing vision. The risk of developing the condition increases with age and is influenced by environmental as well as genetic factors.
Earlier studies have found that a genetic variant of a protein called complement factor H (CFH) to be associated with increased risk of developing AMD. These new studies show that other variants of the CFH gene also play an important role in the risk of AMD.
In the first study, Abecasis' team examined at gene variants associated with the CFH gene. They studied these variants in 726 people with AMD and in 268 people who didn't have the condition.
They found that variants linked to CFH gene -- which do not change the protein itself -- significantly contribute to the risk of AMD. They also showed that multiple variants taken together make up a high proportion of people's risk.
What was unusual about the finding was that these variants didn't have an obvious impact on the protein, Abecasis said. This finding could give scientists a more accurate means of determining an individual's specific risk for AMD.
The discovery may also help lead to new treatments. "We would like to be able to target the gene to reduce the risk of developing AMD," Abecasis said. There are also other genes involved in AMD which need to be examined just as this one was, he noted.
The second study was led by Mark Daly, an assistant professor of medicine at Massachusetts General Hospital. His team examined the genetic causes of AMD cases and found that a common variant of CFH influenced the risk for AMD. As with Abecasis' study, this variant appeared to have no relation to the CFH protein. The Boston group studied over 1,200 people with AMD and more than 900 people without the disease.
They also confirmed links between AMD susceptibility and variations in two other genes. Together, genetic variations in these three genes accounted for a large proportion of people's increased risk for AMD, the report found.
"We identified a new gene variant that is associated with AMD," Daly said. "And we have confirmed several other findings. There is now confirmation of three genes involved in AMD," he added.
Brothers and sisters of people with AMD have a 3- to 6-fold higher risk of developing AMD compared with the general population, experts say. Daly's group now estimates that variations in these three genes account for about half of that increased risk.
With this information, researchers can start to look at people to determine their personal risk for developing AMD, Daly said.
That might help in the future, if and when effective treatments arose. However, "At this point, if there were more substantial measures in treating AMD, this would be more valuable information," Daly said. "At present, there are not really compelling ways of preventing the onset of disease."
The new findings could yield effective ways to prevent or treat AMD, Daly said.
Two other experts agreed.
"These studies confirm what has already been known, but give us a better view on the subject," said Rando Allikmets, the Acquavella associate professor in ophthalmology and director of the molecular genetics laboratory at Columbia University Medical Center in New York City.
Targeting these genes might help treat AMD by suppressing inflammation in the eye, he said.
And Michael Dean, head of the human genetics section at the U.S. National Cancer Institute, said prevention will be key.
"Now that we can identify people at risk for AMD, we need to identify them when they are young and follow them over time to see when AMD starts occurring and to see if there is a way delay or prevent the disease," he said.
More information
For more on AMD, head to the U.S. National Eye Institute.
Daily Aspirin Helps Prevent Enlarged Prostate
(HealthDay News) -- Older men who regularly take aspirin or a similar painkiller may help keep prostate enlargement at bay, a new study finds.
The common condition, called benign prostatic hyperplasia, typically affects one of every four men ages 40 to 50 and almost half of those over 70, experts say. Enlarged prostate can lead to frequent urination and other bothersome effects.
However, men who regularly took a non-steroidal anti-inflammatory drug (NSAID) "had a reduction of 50 percent in enlargement and a 35 percent reduction in moderate to severe urinary problems," said Jenny St. Sauver, a Mayo Clinic epidemiologist who led the study, which was reported in the American Journal of Epidemiology.
It didn't matter which NSAID a man was taking: aspirin, ibuprofen, naproxen (Aleve) or a more expensive cox-2 inhibitor such as Celebrex, St. Sauver said. "Eighty percent were taking daily aspirin," she said. "We did look at the other drugs, but the differences were not statistically significant."
The study was prompted by several earlier studies that suggested a decreased risk of prostate cancer for men who took NSAIDs regularly. This study included nearly 2,500 men living in the neighborhood of the Mayo Clinic in Minnesota. Data on NSAID use and prostate enlargement arose from questionnaires the men completed every two years from 1990 to 2002.
There are several theories as to how NSAIDs might keep prostates from enlarging. According to St. Sauver, the drugs may reduce prostate cell growth or increase the natural death of these cells. Another theory credits the drugs' anti-inflammatory activity.
The findings should not be seen as a green light for men to rush out and start taking these painkillers without consulting a doctor first, the experts stressed. Men should always be cautious about taking NSAIDs, St. Sauver said, because the drugs raise risks for gastrointestinal bleeding.
"We would like to see the results of our study replicated," she said. "If it can be, it would be important to figure out what kind of dose and what kind of timing would be proper."
The warning against indiscriminate use of NSAIDs was repeated in stronger terms by Eric Jacobs, senior epidemiologist at the American Cancer Society.
Jacobs headed a study last year that found that men who had taken NSAIDs regularly for a long period of time were at slightly decreased risk of developing prostate cancer.
"The important thing about NSAIDs in general is that they can have very serious side effects, gastrointestinal bleeding that can be fatal," Jacobs said. "We do not recommend using NSAIDs for cancer prevention."
Many of the men in the Mayo Clinic study were taking low-dose aspirin to protect against heart disease, he said. "Currently, the decision about whether or not to take aspirin is based on balancing cardiovascular benefits with the risk of gastrointestinal bleeding," Jacobs said. "If someone is at high risk, the doctor can decide that the benefits outweigh the risk. Currently, cancer is not part of the risk-benefit ratio."
More information
There's more on prostate enlargement at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
The common condition, called benign prostatic hyperplasia, typically affects one of every four men ages 40 to 50 and almost half of those over 70, experts say. Enlarged prostate can lead to frequent urination and other bothersome effects.
However, men who regularly took a non-steroidal anti-inflammatory drug (NSAID) "had a reduction of 50 percent in enlargement and a 35 percent reduction in moderate to severe urinary problems," said Jenny St. Sauver, a Mayo Clinic epidemiologist who led the study, which was reported in the American Journal of Epidemiology.
It didn't matter which NSAID a man was taking: aspirin, ibuprofen, naproxen (Aleve) or a more expensive cox-2 inhibitor such as Celebrex, St. Sauver said. "Eighty percent were taking daily aspirin," she said. "We did look at the other drugs, but the differences were not statistically significant."
The study was prompted by several earlier studies that suggested a decreased risk of prostate cancer for men who took NSAIDs regularly. This study included nearly 2,500 men living in the neighborhood of the Mayo Clinic in Minnesota. Data on NSAID use and prostate enlargement arose from questionnaires the men completed every two years from 1990 to 2002.
There are several theories as to how NSAIDs might keep prostates from enlarging. According to St. Sauver, the drugs may reduce prostate cell growth or increase the natural death of these cells. Another theory credits the drugs' anti-inflammatory activity.
The findings should not be seen as a green light for men to rush out and start taking these painkillers without consulting a doctor first, the experts stressed. Men should always be cautious about taking NSAIDs, St. Sauver said, because the drugs raise risks for gastrointestinal bleeding.
"We would like to see the results of our study replicated," she said. "If it can be, it would be important to figure out what kind of dose and what kind of timing would be proper."
The warning against indiscriminate use of NSAIDs was repeated in stronger terms by Eric Jacobs, senior epidemiologist at the American Cancer Society.
Jacobs headed a study last year that found that men who had taken NSAIDs regularly for a long period of time were at slightly decreased risk of developing prostate cancer.
"The important thing about NSAIDs in general is that they can have very serious side effects, gastrointestinal bleeding that can be fatal," Jacobs said. "We do not recommend using NSAIDs for cancer prevention."
Many of the men in the Mayo Clinic study were taking low-dose aspirin to protect against heart disease, he said. "Currently, the decision about whether or not to take aspirin is based on balancing cardiovascular benefits with the risk of gastrointestinal bleeding," Jacobs said. "If someone is at high risk, the doctor can decide that the benefits outweigh the risk. Currently, cancer is not part of the risk-benefit ratio."
More information
There's more on prostate enlargement at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
60: The New 45
(HealthDay News) -- Thirty years ago, Olga Bloom, a professional violinist living in New York City, was celebrating her 57th birthday and thinking hard about how she'd spend whatever years lay ahead.
"I didn't retire," said Bloom, now 87, in a recent interview. "I had stopped working in New York as a musician, but I knew I wasn't just going to sit in a garden and 'wait.' "
Instead, she bought herself a barge.
With it, Bloom founded Barge Music, and today she still runs her decades-old chamber music "floating concert hall" that is anchored in New York City's East River.
As she "pushes toward 90," Bloom said she's grateful for the time and opportunity she's had to help others while doing something she loves. Her advice to the estimated 78 million Baby Boomers who are now reaching age 60: "Look around you, and find that place to be generous."
Many of the millions of Americans born between 1946 and 1964 are taking Bloom's advice to heart. Experts say the post-World War II generation is changing the very definition of "old" age. For many, 60 is the not only the new 50 -- it's the new 45.
"There was this magical age of 65 proposed for retirement in the 19th century, but I think that's very out of fashion now," said Bloom's physician, Dr. Barbara Paris, vice chairwoman of medicine and director of the department of geriatrics at Maimonides Medical Center, in New York City.
"Baby Boomers just aren't thinking that way anymore," she said. "Especially if they have financial independence, they're going to retire from whatever boring job they have and do what they want to do for the next 20, 30 years."
Statistically speaking, the average 60-year-old American can look forward to at least another 20 years of life, Paris said, and probably more. In fact, the insurance industry recently revamped its actuarial tables to reflect life spans that now top-off at a grizzled 120.
The world's oldest man, a Puerto Rican named Emiliano Mercado del Toro, turned 115 last week. And the oldest woman, Maria Esther de Capovilla of Ecuador, died Monday at 116, the Associated Press reported.
Paris said very few people can expect to live that long, but "it's reasonable that more of us will live to be over 100."
There's also a continuing trend toward what experts call the "compression of morbidity."
"Essentially, the bad things that happen when you are sick is being compressed now into a shorter period at the very end of your life," Paris explained. That means that today's over-60s can expect less debilitating, chronic illness than their parents faced, giving them more active, productive lives.
"In fact, whereas death rates are declining now by about 1 percent per year, morbidity is declining twice as quickly, at 2 percent per year," Paris said.
Better health is even changing the nature of geriatrics, said Paris, who's been practicing in the field for more than 30 years. "When I started out, anybody over 65 was my patient," she said. "Now, I rarely see a patient under 75."
She credits the increasing pep of America's older citizens on improvements in preventive medicine, advances in drug development and innovative medical technologies -- especially in areas such as joint replacement and the management of cardiovascular disease.
Drugs such as Viagra, Cialis and Levitra have even given a boost to aging Americans' sex lives. One recent U.S.-European study found men in their 50s were now happier with their sex lives than men in their 30s. In another survey, conducted in 1998, 43 percent of both men and women over 60 said sex was as good for them now as it was in their youth.
The notion of retirement is changing, too. According to the American Association of Retired Persons (AARP), recent polls of Americans age 40 and over found two-thirds saying they would work well past 65. For some, financial pressures and a lack of retirement funding make this more of a necessity than a choice. "But even that reflects the perception that they will be healthy enough to work," a spokesman for the AARP said.
Many older people are choosing to embark, as Bloom did, on second careers in a field they love. Others are following a more gradual change in lifestyle.
"They're working part-time, maybe changing their position within their institution or work environment," Paris said. The era of the "golden handshake" as a final good-bye to the workplace is fading, she said.
There's a downside to everything, of course, even when it comes to extended health and longevity.
"I have patients in their 90s who are still very functional, but many say they don't really want to live much longer, because all of their friends are gone," Paris said. "And in some very sad cases -- not unheard of -- a 90-year-old parent may become the caregiver for a 70-year-old child with cancer or some other illness."
Older workers can also find it tough to compete in the job market, especially when young people fresh out of school will work for relatively little money. "As a society, we're not set up for them in a positive way," Paris said. "Despite everything, this is still a country that's youth-oriented, where young is beautiful and old is ugly. It's terrible."
Still, for a growing number of people, a 60th birthday marks a new beginning -- not the beginning of the end.
For Bloom -- who still spends most of her waking hours on the East River managing Barge Music -- it's all about giving back.
"Generosity is necessary," she said. "You have to give yourself to others, in whatever capacity you can."
More information
Find out more about healthy aging at the U.S. Centers for Disease Control and Prevention.
"I didn't retire," said Bloom, now 87, in a recent interview. "I had stopped working in New York as a musician, but I knew I wasn't just going to sit in a garden and 'wait.' "
Instead, she bought herself a barge.
With it, Bloom founded Barge Music, and today she still runs her decades-old chamber music "floating concert hall" that is anchored in New York City's East River.
As she "pushes toward 90," Bloom said she's grateful for the time and opportunity she's had to help others while doing something she loves. Her advice to the estimated 78 million Baby Boomers who are now reaching age 60: "Look around you, and find that place to be generous."
Many of the millions of Americans born between 1946 and 1964 are taking Bloom's advice to heart. Experts say the post-World War II generation is changing the very definition of "old" age. For many, 60 is the not only the new 50 -- it's the new 45.
"There was this magical age of 65 proposed for retirement in the 19th century, but I think that's very out of fashion now," said Bloom's physician, Dr. Barbara Paris, vice chairwoman of medicine and director of the department of geriatrics at Maimonides Medical Center, in New York City.
"Baby Boomers just aren't thinking that way anymore," she said. "Especially if they have financial independence, they're going to retire from whatever boring job they have and do what they want to do for the next 20, 30 years."
Statistically speaking, the average 60-year-old American can look forward to at least another 20 years of life, Paris said, and probably more. In fact, the insurance industry recently revamped its actuarial tables to reflect life spans that now top-off at a grizzled 120.
The world's oldest man, a Puerto Rican named Emiliano Mercado del Toro, turned 115 last week. And the oldest woman, Maria Esther de Capovilla of Ecuador, died Monday at 116, the Associated Press reported.
Paris said very few people can expect to live that long, but "it's reasonable that more of us will live to be over 100."
There's also a continuing trend toward what experts call the "compression of morbidity."
"Essentially, the bad things that happen when you are sick is being compressed now into a shorter period at the very end of your life," Paris explained. That means that today's over-60s can expect less debilitating, chronic illness than their parents faced, giving them more active, productive lives.
"In fact, whereas death rates are declining now by about 1 percent per year, morbidity is declining twice as quickly, at 2 percent per year," Paris said.
Better health is even changing the nature of geriatrics, said Paris, who's been practicing in the field for more than 30 years. "When I started out, anybody over 65 was my patient," she said. "Now, I rarely see a patient under 75."
She credits the increasing pep of America's older citizens on improvements in preventive medicine, advances in drug development and innovative medical technologies -- especially in areas such as joint replacement and the management of cardiovascular disease.
Drugs such as Viagra, Cialis and Levitra have even given a boost to aging Americans' sex lives. One recent U.S.-European study found men in their 50s were now happier with their sex lives than men in their 30s. In another survey, conducted in 1998, 43 percent of both men and women over 60 said sex was as good for them now as it was in their youth.
The notion of retirement is changing, too. According to the American Association of Retired Persons (AARP), recent polls of Americans age 40 and over found two-thirds saying they would work well past 65. For some, financial pressures and a lack of retirement funding make this more of a necessity than a choice. "But even that reflects the perception that they will be healthy enough to work," a spokesman for the AARP said.
Many older people are choosing to embark, as Bloom did, on second careers in a field they love. Others are following a more gradual change in lifestyle.
"They're working part-time, maybe changing their position within their institution or work environment," Paris said. The era of the "golden handshake" as a final good-bye to the workplace is fading, she said.
There's a downside to everything, of course, even when it comes to extended health and longevity.
"I have patients in their 90s who are still very functional, but many say they don't really want to live much longer, because all of their friends are gone," Paris said. "And in some very sad cases -- not unheard of -- a 90-year-old parent may become the caregiver for a 70-year-old child with cancer or some other illness."
Older workers can also find it tough to compete in the job market, especially when young people fresh out of school will work for relatively little money. "As a society, we're not set up for them in a positive way," Paris said. "Despite everything, this is still a country that's youth-oriented, where young is beautiful and old is ugly. It's terrible."
Still, for a growing number of people, a 60th birthday marks a new beginning -- not the beginning of the end.
For Bloom -- who still spends most of her waking hours on the East River managing Barge Music -- it's all about giving back.
"Generosity is necessary," she said. "You have to give yourself to others, in whatever capacity you can."
More information
Find out more about healthy aging at the U.S. Centers for Disease Control and Prevention.
Race Plays Role in Stroke's Aftermath
(HealthDay News) -- One of the first nationwide studies of stroke's long-term effects finds it seriously lowers survivors' quality of life, and that black survivors tend to fare worse than whites."The disparity between the black and white populations is actually wider among the stroke population than the non-stroke population," said study author Dr. Jipan Xie, a public health analyst at the U.S. Centers for Disease Control and Prevention in Atlanta.
The report is published in the Sept. 1 online issue of Stroke.
Xie's team looked at federal data from the Household Component of the Medical Expenditure Panel Survey, conducted in 2000 and 2002. They focused on 39,680 adults, including 1,040 who had survived a stroke.
Patients were evaluated by a number of measurements for physical and mental health, physical functioning, pain, energy/fatigue, general health, social functioning and limitations due to physical health, emotional problems or mental health.
The researchers also assessed the patient's ability for self-care, usual activities, pain/discomfort and anxiety/depression. They had patients score their health status on a scale of 0 to 100, with the best possible health rated as 100.
Compared to people without any history of stroke, stroke survivors scored 4.1 percent lower on mental health scores, 7.9 percent lower on physical health scores, 6.9 percent lower on daily ability scores and 7.2 percent lower in rating their overall health.
These quality-of-life disparities were even greater between white stroke survivors and black or Hispanic stroke survivors, the researchers added.
Xie thinks that these data will help health-care professionals understand the longer term impact of stroke, especially since she expects to see many more people surviving strokes.
"We need to know what the national level of the impact of stroke is," Xie said. "As mortality has been declining, we expect more people to become stroke survivors. And quality of life is important health information -- we now have information on the quality of life among stroke survivors."
Xie believes that improvements in initial stroke care and rehabilitation can boost quality of life for stroke survivors.
"Stroke causes severe reduction in quality of life. So, it is important to improve the quality of care of stroke," Xie said.
The findings come as "no real surprise," added Dr. Norman M. Kaplan, a clinical professor in the division of hypertension at the University of Texas Southwestern Medical Center. "Strokes are becoming even more prominent as people get older. When people have a heart attack, they usually get over it, but a stroke leaves part of the brain impaired. So, there is always some loss of quality of life after a stroke."
The main cause of stroke is high blood pressure, Kaplan said. "Blacks have more strokes than whites," he noted. "The main reason is that they don't get control of their blood pressure because they don't get as much medical attention," usually because lower incomes restrict their access to care.
Improvements in prevention, initial treatment and access to post-stroke rehabilitation can help stroke survivors lead better, more productive lives, another expert said.
"More programs are needed that promote high-quality medical care, which could have an impact on patient outcomes," said Dr. Eric Smith, associate director of acute stroke services at Massachusetts General Hospital in Boston. "We also need steps to insure that high-quality medical care is available for everyone, regardless of race or ethnicity."
Smith believes too few patients are receiving the powerful clot-busting drug tPA when stroke first strikes.
"There [also] needs to be better preventive strategies for stroke," he said. "Also, persons who have less access to medical insurance may not be able to arrange the same level of rehabilitation as others."
More information
Find out more at the American Stroke Association.
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