Monday, December 29, 2008

Latisse Approved for Longer Eyelashes Available 2009 by Prescription

Beginning 2009, Latisse, the newest addition to eyelash enhancement, will be available to women for longer, thicker and darker eyelashes. Allergan, the company that makes Latisse, has capitalized on their glaucoma eye drops, Lumigan, after discovering that the active ingredient promoted longer eyelashes. As seen by the video below, some physicians have used Lumigan "off label" to help women experience the benefits of the newly approved Latisse, which contains the active ingredient in Lumigan.

According to Allergan, "Latisse users can expect to experience longer, fuller, and darker eyelashes in as little as eight weeks, with full results in 16 weeks." However, longer eyelashes from Latisse might also cause some problems, such as darkening of the eyelids, which may or may not go away. Should you accidentally apply Latisse to an area other than the upper eyelid, at the lash line, you might find yourself with hair growth in undesirable areas. In addition, it is possible to experience irregular eyelash growth. Once you stop using it, your eyelashes will return to their normal state. Side effects of Latisse included itchy eyes, and eye redness.

Latisse may be a boon to those who experience hair loss from chemotherapy during cancer treatment, but so far Latisse is not recommended for children or cancer patients until further studies are conducted.

Lumigan, the drug that spawned the development of Latisse, has been found to darken the iris, leading to brown eyes. The color change may take months to occur, but once it occurs, it is not reversible. Latisse does not go directly in the eye, and trials did not report any changes in eye color when using Latisse cosmetically for eyelash growth, but a warning that eye color changes may occur accompanies use of Latisse.

You will not be able to purchase Latisse over the counter. Instead, it will require a prescription from your doctor or cosmetic surgeon.

Latisse was unanimously approved by the FDA. According to Scott Whitcup, M.D., Allergan's Executive Vice President of Research and Development, "LATISSE(TM) fulfills a significant and previously unmet need in the medical aesthetic marketplace with a product approved by the FDA that increases the growth of eyelashes, making them longer, thicker and darker."

Scientists are not exactly sure how Latisse works to promote eyelash beauty, but the active ingredient, Bimatoprost, is a lipid compound that binds with prostaglandins, found in the outer layer, or sheath, of the hair root.

Sales of Latisse are expected to top $500 million annually, as women flock to the pharmacy for the experience of longer, thick eyelashes.

Source: Allergan Announces U.S. Food and Drug Administration (FDA) Approval of LATISSE(TM) -- First and Only Treatment Approved by the FDA for Hypotrichosis of Eyelashes


Wednesday, December 24, 2008

Mixing Prescription Drugs and Supplements Poses Risks to Elders

Mixing prescription drugs with vitamins and other supplements poses risks, especially to elders on multiple medications. Mixing prescriptions with supplements can be harmful, especially for patients who take the blood thinner warfarin, or drugs for high blood pressure that can be dangerous when mixed with potassium supplements.

According to a recent survey, published in the Journal of the American Medical Association, over fifty percent of adults mix some sort of prescription drug with over-the-counter supplements. Four out of five American adults take at least one prescription drug that could potentially cause harm when mixed with prescription medication. Use of prescriptions is highest among elders age 75 to 85. Fifty percent of older adults take five or more prescriptions.

Dima M. Qato, Pharm.D. M.P.H., of the University of Chicago, and colleagues write, "Several factors have likely contributed to this increase in the rate of [the use of five or more medications] among older adults over the last decade. These include intensification of therapy for common chronic medical conditions (e.g., diabetes, cardiovascular disease), increased access to medications because of policy changes (e.g., Medicare Part D and assistance programs), and growth of the generic drug market." The increase in prescription medicine use over the last decade is cause for concern because many supplements have not been studied for their interaction with prescribed drugs.

Though most supplements do not cause harm when mixed with prescriptions, the study authors believe the issue deserves attention. "Our findings suggest that concurrent use of prescription and nonprescription medications in older adults remains a public health problem and could be an important focal point for further improvements in drug safety for seniors."

By identifying popular supplements, the researchers hope to establish a pattern of use that can be used to ensure safety when physicians prescribe medications.

They conclude, "Medications are a critical modality for prolongation of life and improved quality of life for many older adults. By establishing patterns of prescription and nonprescription medication use among older adults, these data may help support efforts to increase the safety and quality of pharmacotherapy for older adults."

If you take supplements, it is important to let your doctor know. Many physicians simply forget to ask what, if any, supplements are being used by their patients. It is never a good idea to mix prescription drugs with vitamins and other supplements without first discussing the pros and cons with your doctor. The new study shows there is a growing concern about the effects of taking multiple prescriptions mixed with supplements that may have unknown risks to elders. ◦

Sunday, December 21, 2008

New Concept Allows a Healthy Christmas Shopping Experience

The snow is delightful this time of year, and Suzy Snowflake looks beautiful. Snow can make Christmas shopping a daunting task. Surfing the net is a chore also, but we have an answer for your Christmas shopping needs. Reizit is a new concept that allows a better Christmas shopping experience for everyone.

Reizit is a community-marketing site where you can search, post products, and vote on consumer goods. The site (and concept) is new, and it ensures you will not have to spend hours out in the cold shopping for Christmas gifts, nor do you have to risk injury bustling about crowded malls.

I am especially enamored of the list of health products, including BPA free (stainless steel) drinking bottles from the Breast Cancer site, the Homemedic palm size percussion massager, and the Lomi Kona Escape Massage Lounger Chair.

If you are an online merchant, you may want to share your Christmas specials at Reizit. You will have an opportunity to describe your product, helping others with their Christmas shopping needs, raising awareness about your own products. Make sure you register so you can vote on the products that are listed. If you have purchased any of the merchandise submitted, leave a comment so everyone in the Reizit community benefits.

Christmas shopping should be fun, easy, and healthy when you eliminate stress by browsing and evaluating what others have to say about consumer products.

If you are looking for a healthy, stress free, Christmas shopping concept, you will definitely find a great list of products and gadgets for the holidays, reviewed by other consumers at Reizit. The site includes health products from a variety of merchants. Merry Christmas, and best wishes for a healthy and happy holiday. ◦

Thursday, December 18, 2008

Study Reveals Neuropsychological Basis of Selflessness

According to new research, selflessness can be learned through activities such as meditation and prayer. Researchers at MU School of Health Professions studied people with brain injuries, discovering that people with injuries to the right parietal region of the brain experience higher levels of spiritual transcendence. When we pray or meditate, activity in the right parietal region of the brain decreases, opening us to experiences that can promote psychological health and well-being.

According to Brick Johnstone, professor of health psychology in the MU School of Health Professions, “The brain functions in a certain way during spiritual experiences. We studied people with brain injury and found that people with injuries to the right parietal lobe of the brain reported higher levels of spiritual experiences, such as transcendence.”Johnstone feels the link is important, because it means that if we make a conscious effort we can connect with things beyond ourselves. The implication is that people in health care, or anyone engaged in peace studies, or religion can use meditation or prayer to decrease activity in the parietal lobe of the brain. In turn, a state of selflessness is created, benefiting individual mental health, while providing a genuine focus on the needs of others.

Johnstone further explains, “This research also addresses questions regarding the impact of neurologic versus cultural factors on spiritual experience. The ability to connect with things beyond the self, such as transcendent experiences, seems to occur for people who minimize right parietal functioning. This can be attained through cultural practices, such as intense meditation or prayer or because of a brain injury that impairs the functioning of the right parietal lobe. Either way, our study suggests that ‘selflessness’ is a neuropsychological foundation of spiritual experiences.”

The MU research was the first to use people with traumatic brain injuries to study the neuropsychological basis of spirituality. It also shows that we can all learn how to transcend, or go beyond our senses to improve our own state of well-being, as well as helping others.

Modern definitions of transcendence refer to truth, unity and goodness. According to Johnstone, “It is important to note that individuals experience their God or higher power in many different ways, but that all people from all religions and beliefs appear to experience these connections in a similar way. Our research focused on the personal experience of spiritual transcendence and does not in any way minimize the importance of religion or personal beliefs…”


Selflessness - The Core of All Major World Religions - Has Neuropsychological Connection, MU Study Finds

Saturday, December 13, 2008

Prescriptions for Exercise Effectively Increase Activity in Older Women

Prescriptions for exercise seem to have a positive impact on middle-age women, up to age 79. According to a study published online Dec. 12 in BMJ the, 'green prescription' programme’ has been shown to produce significant improvements in levels of physical activity and quality of life among 'relatively inactive' adults aged 40-79 in primary care over a 12 month period.” The program is currently used in New Zealand by primary care physicians, and has proven successful for improving quality of life.

When inactive women ( those who do not engage in thirty minutes of exercise at least five days per week), were given a written prescription outlining recommended exercises, the study authors saw a “10% incremental increase in adherence to physical activity among those receiving the intervention compared with the control group”.

Beverley A. Lawton, from the University of Otago in Wellington, New Zealand, and colleagues point out the cost effectiveness of the program, and note that women show better adherence when they are given written exercise instructions. The program, led by a nurse, includes interventions regarding specific exercise activities, followed by a six-month visit, and phone support for nine months.

The study showed revealed improved quality of life, and better physical function scores. One drawback was that the women who exercised experienced more falls than the control group, an area that needs improvement. The authors say, “Because encouraging brisk walking and other general physical activity can increase the risk of falls (particularly in people with a history of falls), we need a pragmatic approach. The next round of research and development needs to look at managing this risk."

Physical exercise is necessary to combat obesity and reduce risk our risk of a wide array of diseases. Steve Iliffe, from University College London, United Kingdom, and colleagues note, "the health benefits of exercise are so great that it is probably the most important self help treatment available”, in an editorial that accompanied the results of the exercise prescription program.

To get the women involved, a visit to the office helps the nurse identify exercise goals. The visit averaged seven to thirteen minutes. A hand-written prescription is then given to the patient. Telephone support is provided over a nine-month period. A visit to the physician is then provided at six months. At 12 months, then 24 months - 93% of the women given an exercise prescription remained in the study, versus 89% of those who were not given an exercise prescription. Average age of the women was 58.9 ± 7 years, and included 1089 women, followed over a two-year period.

The authors concluded, "Reducing physical inactivity by 10% across a primary care population of less active adults could have considerable health impact,” especially when combined with media support, dietary and physical activity programs.

The study shows that older women may need extra motivation and support to remain physically active. Implementing a prescription based exercise program appears to have genuine value for improving strength and quality of life in women over age 58.

BMJ. Published online December 12, 2008.

WALKING & ACTIVE LIFE- Trim, Fit & Healthy

Saturday, December 6, 2008

Massage for Sinus Problems in Children

No mother likes to see their child in pain. Winter weather brings colds, flu and sinus congestion to children and adults alike. Unfortunately, medications may not always work to relieve your child's sinus pain. Some medications have the opposite reaction when given to children, such as Benadryl, which can cause excitability versus the usual effect of drowsiness. Even worse, you might just not have sinus medication on hand to give your child. You may want to try a nurturing and pain relieving sinus massage. Learn to massage your child's face and scalp to help reduce sinus congestion and inflammation.

Before you decide whether to massage your child to relieve sinus congestion, consider some safety tips. If your child is feeling ill, he or she may not be receptive to a sinus massage. Do not massage the sinuses if your child has a fever.

Warm your hands before you massage the scalp of your child to relieve sinus congestion. You can use a warm massager, moving it gently around the face. Look at your child, focusing on his face to make sure your child is comfortable. You do not want to perform the sinus massage too fast, or with too much pressure. Most parents know when their child is uncomfortable, but make sure you ask your child to share with you how he or she is feeling.

First, gently massage the scalp. Put your fingers on the head and make circles to massage the scalp. Massaging your child's scalp will calm, preparing for the next part of the sinus massage.

Cover all areas of the scalp. Massage the top and the temples. Use soft glides toward the end of the massage.

The video below shows how to massage the cheeks. The goal is to get your child's sinuses to drain, as you provide warmth to the face during the massage. The circular motion, and gentle pressure beside the nose helps mobilize secretions that cause stuffy nose and sinus headache. Once that occurs, the sinuses are able to drain, relieving sinus pressure.

After you have massaged the scalp, move to the face. Apply pressure to each side of the nose for a few seconds. Move your hands outward and up to your child's forehead, then repeat. Watch the next video to see the technique used for sinus massage in children. Massaging the nose can relieve allergy symptoms for your child.

You can also apply a warm washcloth to the face after you massage the sinuses. The heat will facilitate drainage and open up your child's sinuses. Try our sponge massager. You can warm it, and use it on the face, forehead, scalp and back of the neck if you feel massage impaired.

With a bit of practice, and good communication, it may be possible to help your child get relief from sinus congestion and allergies by performing a simple sinus massage. ◦

Sunday, November 30, 2008

Decrease Holiday Stress with a Massage

Preventing disease has become a focus of Western health care. Eastern medicine has promoted disease prevention for centuries. Massage has many benefits that you can tap into to stay healthy and relaxed through the upcoming holidays. Preventing illness, especially during the holidays, can be a challenge.

Massage benefits the recipient as well as the person delivering the massage. Both people benefit from the energy. It does not take long how to learn to give each other a massage. A twenty-minute session can do wonders to decrease holiday stress and promote overall wellness.

Provide some holiday warmth by learning how to deliver a healthful massage. Some of the known benefits include stimulation of the lymphatic system, important for removing toxins from the body. Other massage benefits include stimulation of endorphins, naturally occurring substances that act much like opiates to provide pain relief and relaxation. Providing massage to a family member with health issues can alleviate the need for using pain medication that can disrupt social interaction, especially during the holidays when family time is cherished.

Learning ways to manage stress is essential for disease prevention. Stress contributes to heart disease, enhances depression, and influences every aspect of our lives. Stress management, through massage, translates into well-being for the holidays as well as year long. A short massage can alleviate fatigue, and provide more energy to accomplish needed tasks such as holiday shopping, decorating, house cleaning and baking goodies for your loved ones.

Anyone who suffers from arthritis will appreciate the benefits of massage. PMS always worsens when we are stressed – massage can help with fluid retention and lessen cramping. Massage can enhance recovery from surgery, and calm aggression in elders with Alzheimer’s disease.

You need to make sure you have massage oil or lotion. Warming oils are a favorite. Try some aromatherapy, such as lavender, to help promote a calming effect. Aromatherapy diffusers can be used anytime in the home, and are a welcome addition during a beneficial massage.

You do not have to be a massage therapist to learn how to provide a stress-relieving massage. Make certain you do not attempt to massage anyone who is under medical treatment, or recovering from a serious illness, without professional instruction.

Consider the benefits of massage, especially during the holiday season – it can be a real tension reliever. ◦

Tuesday, November 18, 2008

Sleep, Exercise Protects from Breast Cancer

Women who exercise regularly, and get at least seven hours of sleep each night, can significantly reduce their risk of breast cancer. The combination is important. Women, who exercise without needed slumber, put themselves at higher risk. The findings come from the American Association for Cancer Research, presented at the Seventh Annual International Conference on Frontiers in Cancer Prevention Research.

According to James McClain, Ph.D., cancer prevention fellow at the National Cancer Institute and lead author of the study says, "Short duration sleep appears to have opposing effects of physical activity on several key hormonal and metabolic parameters...” Dr. McClain explains that exercise probably influences hormones and immune function, though the exact reason exercise protects from cancer is not completely understood. Lack of sleep seems to thwart the benefits of exercise when it comes to breast and other types of cancer prevention. Sleeping less than seven hours a day was found to increase overall risk of cancer.

The researchers studied 5,968 women, specifically looking at the link between a good night’s sleep and cancer risk. The participants initially responded through a survey in 1998. The women were then tracked through the Washington County Cancer Registry and Maryland State Cancer Registry. The results found a significant link between sleep, physical activity and cancer incidence. The scientists concluded, “Current findings suggest that sleep duration modifies the relationship between physical activity and all-site cancer risk among young and middle-aged women."

Unfortunately, getting a good night’s sleep isn’t always easy. Insomnia is common problem. We put off sleep to “get things done”. Estimates show that approximately 32million people in the US suffer from insomnia. (1)

Prescription medications have side effects. Some interfere with mental acuity. Finding ways to guarantee quality sleep is attainable. The health benefits should not be underestimated.

Consider the following if you suffer from insomnia, difficulty falling asleep or interrupted sleep patterns. The National Cancer Institute estimates that 182, 460 women will be diagnosed, and die from breast cancer this year.

Exercise regularly.

Avoid eating late at night

Find ways to reduce stress – take a Yoga class, practice deep breathing, or simply
listen to restful music before going to bed..

Avoid caffeine, chocolate and alcohol late at night.

Keep a regular schedule of sleep – go to bed at the same time each night.

Limit fluid intake after dinner.

Try some Chamomile tea.

Block out noise – turn off the TV.

Read a good book.

Learn to meditate.

Ask your doctor if natural sleep aids are safe for you. Melatonin, valerian, and kava are known to help.

Have a warm glass of milk, yogurt, or light protein snack before bed. It’s important to avoid fatty foods.

Stop trying to do everything. Get rid of unnecessary chores, and simply learn to slow down.

If depression contributes to insomnia, please see your doctor for help.

Try some aromatherapy –lavender oil, diffused in the bedroom, sprayed, as a bath salt, or body lotion can promote rest and relaxation.

Focus on getting adequate amounts of calcium and magnesium from food or supplements.

Ask your partner for a back massage, a wonderful way to drift off to sleep.

(1) Insomnia Statistics

Exercise and Rest Reduce Cancer Risk

Melatrol Sleep Aid
Freedom From Insomnia
Lavender Oil

Tuesday, October 28, 2008

Whole Grains Reduce Heart Failure Risk

Food sources are increasingly becoming recognized for disease prevention. It’s difficult to give enough emphasis to the benefits, given our current rates of diabetes, heart disease and obesity. According to a new study, eating whole grains can modestly reduce your risk of heart failure, a condition that affects 5 million Americans. Past studies suggest that heart failure risk can be reduced by eating whole grains. Results of a large analysis, published in the November 2008 issue of the Journal of the American Dietetic Association, examining 14,000 White and African American adults shows that though the results were modest, whole grain consumption can certainly help.

Jennifer A. Nettleton, Ph.D writes, "Although risk estimates were modest, the totality of literature in this area suggests it would be prudent to recommend that those at high risk of HF increase their intake of whole grains and reduce intake of high-fat dairy and eggs…” In addition to eating more grains, it would also be prudent to reduce dietary fat and egg intake – the study found that heart failure risk increased by 23% per one serving of eggs.

Risks for heart failure include coronary artery disease, hypertension, obesity and insulin resistance. Good dietary habits are extremely important for protection from heart disease. According to the study, anyone at high risk for heart failure should reduce their intake of high fat and dairy products, focusing more on the benefits of whole grains. Follow the American Heart Association’s dietary guidelines for a healthy heart. It’s never too late to start.

Eating whole grains lowers heart failure risk, according to new study

Sunday, October 19, 2008

Asthma Drugs Found to Increase Muscle Strength

According to research from the University of Melbourne, it may be possible to improve muscle strength, preventing weakness and disabilities associated with aging. Preliminary research shows that commonly used asthma drugs, beta-agonists, reverse muscle wasting and weakness in rat studies. Dr James Ryall of the University’s Department of Physiology has published his findings in the scientific journal, Physiological Review.

We have much to learn about the changes that occur when we age. The current research may lead to a better understanding of the complex mechanisms associated with muscle loss. According to Dr. Ryall,”While the exact cellular and molecular mechanisms underlying sarcopenia have yet to be identified, they are likely to be highly complex and involve multiple different signalling pathways, presenting numerous targets for novel drug discovery.” Sarcopenia is the term to define muscle wasting and weakness.

None of us expect to find a magic pill that will prevent aging, but targeted research such as this just may surprise us all. Dr. Gordon Lynch who supervised the study, believes the findings are a significant contribution to to tapping into successful aging, pointing out that “Muscle wasting can deprive a person of functional independence and increase their risk of falls and fractures. It is one of ageing’s most serious consequences.”

The research is in no way a message to use beta-agonists for other than their intended purpose, as they can be dangerous to cardovascular health - the message is that researchers are one-step closer to understanding ways to help our aging population enjoy quality of life and maintain independence.

Dr. Ryall, as the result of his research, has been awarded the University of Melbourne’s 2007 Chancellor’s Prize for research. He will continue his doctoral studies at the National Institutes of Health in Bethesda, Maryland.

Until we find that magic pill, it’s important to remember that resistance training, whole foods to include five servings of fruits and vegetables daily, regular exercise, and fighting obesity are currently the best ways known to maintain quality of life, prevent injuries, and keep a sharp mind.

Muscle strength is important as we age, so don’t forget to focus on building muscle earlier rather than later. Studies show developing muscle in our 50’s will greatly add quality of life to our senior years.


Muscle Breakthrough


Simple Walking Improves Memory
Baby Boomers Should Focus on Building Muscle Now
Study - Men with Muscles Live Longer

Sunday, October 5, 2008

Massage Your Way Through Childbirth

We all know that childbirth causes muscle stretching, lacerations, and pain. Studies show that women (and their partners) who massage the muscular area below the vagina (the perineum), experience less tears and need for episiotomy during childbirth. In addition, ice massage can help relieve labor pain, and can be easily learned by your partner.

Physicians often make cuts (episiotomy) when it appears that too much stretching during childbirth will result in injury. Minor tears happen but rarely cause long-term problems.

According to Michael M. Beckmann, MD, and Andrea J. Garrett of the QE2 Jubilee Hospital in Queensland, Australia, "Perineal massage during the last month of pregnancy undertaken by the woman or her partner for as little as once or twice a week reduced the likelihood of perineal trauma (mainly episiotomies) and ongoing perineal pain." The study was published online January 2006 in The Cochrane Database of Systematic Reviews.

In January, 2007 the Cochrane database again searched for information about the benefits of perineal massage before childbirth, concluding, “Antenatal perineal massage reduces the likelihood of perineal trauma (mainly episiotomies) and the reporting of ongoing perineal pain and is generally well accepted by women. As such, women should be made aware of the likely benefit of perineal massage and provided with information on how to massage.” It was found that women who practiced perineal massage experienced 15% fewer episiotomies. Both partners can be involved to make childbirth less traumatic, facilitating quicker recovery and maternal activity.

How is Perineal Massage Performed?

Begin the practice at 34 weeks gestation. Either the woman or her partner can provide the massage. The instructions provided by one of the studies are as follows:
"Woman or partner performed daily 5- to 10-minute perineal massage from 34 weeks [of pregnancy]. One or two fingers are introduced 5 centimeters [about 2 inches] into the vagina, applying alternating downward and sideward pressure using sweet almond oil."

Massage devices have not been studied, so their usefulness is unknown. To date, manual massage is recommended. According to speculation, perineal massage should work not only for first-time delivery, but for subsequent pregnancies as well. The women studied were experiencing their first pregnancy.

Ice Massage for Labor Pain

Ice massage of the web between the thumb and forefinger, referred to as Ll4, or Hoku, and has been found to help the pain of labor and delivery. Researchers studied twenty women who were being admitted to the labor and delivery unit at Humana Hospital, Dade City, FL, in 1992. Ice massage to the Hoku meridian was performed for thirty minutes during each contraction.

Pain reduction was found to be significant. The ice massage was carried out on either hand, depending on what activities were being performed by the recipient at the onset of contractions.

Of note, though the exact meridian, or massage point is on the inside of the thumb, the skin may be fragile and sensitive to cold. To facilitate pain reduction, and reduce the potential for skin damage, massage was performed by snugly placing a bag on the web between the thumb and forefinger, filled with crushed ice. The web space is thicker, and less prone to trauma. (1)

The technique can easily be taught to family members – a consideration for anyone who is expecting. The end result, as perceived by the massage recipients? – pain became one of discomfort versus distress.

Adding the benefits of each of these massage suggestions during childbirth can contribute to a healthier, happier experience. It involves both partners, and possibly avoids the administration of potentially harmful medications, and the need for episiotomy.


Ice Massage for the Reduction of Labor Pain
Massage Cuts Need for Episiotomies

(1)10/20/09 Addendum:
According to Bette Waters, when massaging the hand,

"If you approach the area from the top of the hand you will be massaging tissue that can be fragile to friction and cold. You approach the site from the inside of the palm where the ice and friction is applied to the tissue made of different skin cells, the massage can be done intermittently for several hours with no harm to the skin. In the research paper a graphic demonstrating this technique appears".

Bette Waters is a Certified Nurse-Midwife, and author of Massage During Pregnancy., and author of the above referenced article from Medscape - Ice Massage for the Reduction of Labor Pain. ◦

Tuesday, September 30, 2008

Grants Available for Nature-Connected Education, Counseling

Reduce Greed and Increase Personal, Social and
Environmental Well Being

Dr. Michael Cohen

Dr. Michael Cohen has been called a "maverick genius". His approach to health and longevity rivals none - it's sensible. His professional and personal endeavours toward finding and helping others discover balance and better health (physical and emotional) cannot be argued as viable. We've tried medications to treat depression and stress, consumerism to make us happier (and it doesn't), and multiple forms of counselling - all with some success, but we've yet to hit the target.

Through nature, Dr. Cohen has helped others de-stress, support the environment, and yes, even stop smoking - all leading to better health - environmentally and personally.

September 28, 2008, Friday Harbor, WA - Michael J. Cohen, Ph.D.,
director of Project NatureConnect, today announced a special social
and environmental education grant program for individuals who have
had good experiences in nature. The program teaches them how to
green their personal and professional relationships in order to
remedy, and help others remedy, our personal, social and
environmental shortcomings. Participants learn how to think like
nature works to produce the unpolluted perfection of its balance and

Cohen notes that the program is essential because the bias in the way
we presently think makes us excessively conquer and exploit nature.
This detrimentally separates our psyche from the self-correcting
grace, spirit and restorative powers of nature in and around us. The
loss leaves us wanting, and when we want there is never enough. It
results in our destructive greed, stress and lack of self-worth along
with our excessiveness and disorders.

Cohen says, "There is hope. Even a walk in the park demonstrates that
our troubles subside when we truly reconnect with nature." In his new
book, Educating Counseling and Healing with Nature, he documents how Project NatureConnect's science enables us to make sensory contact with nature, backyard or back country and increase well being at
every level. The process helps our thinking interlace with the genius
of nature's peace, spirit and renewing ways. It empowers us to
recycle any garbage that has contaminated our sensibilities. It,
long-term, restores our senses so we may relate more sensitively and

Dr. Cohen can be reached at 360-378-6313,
Project NatureConnect's grants, methods and materials are available

I urge you to explore Project Nature Connect. We all need hope - especially now.

Stress Linked to Later Heart Disease According to 911 Survey

Stress and You - Learn to S-L-O-W Down

Sunday, September 28, 2008

Alternative Treatment for Sleep Apnea Awaits FDA Approval

Positional sleep apnea sufferers may soon find an alternative to CPAP machines, currently considered the most effective treatment for patients who stop breathing during sleep. Though CPAP (a machine that blows pressurized air through a mask to open the airway) is effective, approximately 50% of those suffering from positional sleep apnea use the machines incorrectly. Many patients find them burdensome and uncomfortable, causing non-compliance. Six percent of our population probably has positional sleep apnea, manifested by snoring at night, and excessive daytime fatigue.

A new device, “Zzoma”, is under study, created by former Temple Fellow Joseph G. Crocetti. Research is being conducted by Samuel Krachman, D.O., professor of medicine and director of the Sleep Disorders Center at Temple University School of Medicine and Hospital. The device is worn around the chest like a belt. A firm, foam material supports the back, preventing patients from moving onto their back – the body position that causes snoring and cessation of breathing.

Sleep apnea is a serious problem, leading to heart disease and high blood pressure. It can interfere with job performance, and lead to a host of other health problems if left untreated. Sleep apnea is an often missed diagnosis.

Dr. Krachman is hopeful the FDA will approve the sleep apnea aid, which he has been using on patients with mild to moderate sleep apnea, for study purposes, over the past year.

Photo by Ryan S. Brandenberg/Temple University
Samuel Krachman, D.O., holds Zzoma, a belt-like device worn during sleep to alleviate positional sleep apnea.


Research underway to give sleep apnea sufferers relief and rest


American Sleep Apnea Association

Thursday, September 25, 2008

Massage Decreases Pain and Boosts Mood in Cancer Patients

According to a trial published in the September 16 issue of the Annals of Internal Medicine, cancer patients may experience immediate benefits from massage, including decreased pain and improved mood.

Jean S. Kutner, MD, MSPH, from the University of Colorado Denver School of Medicine, and colleagues write, " Massage may interrupt the cycle of distress through the therapist's intention (presence, communication, and desire to produce a therapeutic response), induction of a relaxation response, increased blood and lymphatic circulation, potentiation of analgesic effects, decreased inflammation and edema, manual release of muscle spasms, increased endogenous endorphin release, and competing sensory stimuli that override pain signals."

The goal of the study was to determine if quality of life could be improved for cancer patients with massage. The Palliative Care Research Network was used for the analysis, and included 380 adult patients diagnosed with advanced cancer. Assessment end-points included the immediate change in pain, using a scale of 1-10 from the Memorial Pain Assessment Card, measured just prior to and immediately following massage intervention. Other predictors of effectiveness included change in mood, from the same assessment tool. Heart and respiratory rates were taken, and the McGill Quality of Life Questionnaire was used, which also uses a scale of 1-10. A 0-4 point scale was used to measure distress, taken from the Memorial Symptom Assessment Scale. The study group also analyzed the patient’s use of Morphine.

Two groups were studied – the massage group received six 30-minute massage sessions, and the control group received simple-touch sessions for 2 weeks. The patients were followed for three weeks. Both groups experienced improvement in pain and mood, but the massage group experience more significant benefit. The authors concluded, "Given the lack of sustained effects and the observed improvements in both study groups, the potential benefits of attention and simple touch should also be considered in this patient population."

Ann Intern Med. 2008; 149:369-379.


Controlling Surgical Pain with Foot and Hand Massage – Study Review
Get a Good Night’s Sleep with a Back Massage

Saturday, September 13, 2008

New Study Shows Spinal Manipulation of no Benefit for Low Back Pain

According to the September 5 Online First issue of the Annals of the Rheumatic Diseases, acute low back pain doesn't respond to spinal manipulative therapy (SMT), when used as an addition to routine medical care. Acute low back pain affects many people, and the current study suggests that you might want to think twice before having your back manipulated to treat low back pain.

Though the study was small, and different modalities may certainly be effective for individual pain control, the results are worth noting. The current research involved 104 patients, split into two groups – one assigned to conventional care that included medications and general advice, and the other SMT combined with traditional medical care. Neither group was permitted to use extra treatment, such as non-pharmacologic care or analgesics other than paracetamol, diclofenac, or dihydrocodeine as needed. The end-points were measured using an 11 point pain scale, during days 1 to 14, and an extended follow-up evaluation at 6 months.

The researchers found that pain reduction was similar in both groups, acutely, and with extended follow-up. The authors concluded, "SMT is unlikely to result in relevant early pain reduction in patients with acute low back pain.”

Spinal manipulation for the treatment of low back pain remains somewhat of a mystery. A 2004 Cochrane review showed that it is more effective than sham therapy, but also revealed that it is not any better than traditional measures used to treat low back pain. However, the patient sampling was small, and did not include the use of pain medications.

The take home message is that your doctor may not recommend chiropractic or osteopathic spinal manipulation if you experience sudden low back pain. Evidence seems to be lacking that it helps. It’s more likely that larger studies should be performed.

Nevertheless, it may be important to consider the current findings when making healthcare choices that can cost extra time and money, without proven benefit. No serious events occurred in the study group, which is also worth noting. Interestingly, guidelines issued to physicians for treatment of low back pain in October, 2007 did include spinal manipulation as a self-care option for acute low back pain.

Low back pain is estimated to affect 6% of adults on a daily basis; the prevalence over a lifetime is 60 to 70 percent. According to current guidelines, lumbar supports are of little benefit and the value of exercise for prevention of back injuries is mixed. The COST B13 Working Group on European Guidelines for Prevention in Low Back Pain recommends exercise to prevent work absence, while the US Preventive Services Task Force finds insufficient evidence to recommend for or against the routine use of exercise interventions to prevent back pain. (1)

Most acute episodes of low back pain resolve with conservative measures, according to past studies. Recommendations include continuing normal activities, massage, analgesics, Yoga, and acupuncture, all therapies that your doctor may support to alleviate acute episodes of low back pain.

(1) Am Fam Physician. 2007; 75:1181-1188.

Spinal Manipulation May Not Be Helpful for Low Back Pain


Low Back Pain
Strategies for Evaluation and Treatment of Acute Low Back Pain
No Clear Evidence to Support Use of Antidepressants for Chronic Low Back Pain
Verum or Sham Acupuncture Nearly Twice as Effective as Usual Therapy for Back Pain
Guidelines Issued for Management of Low Back Pain

Sunday, August 31, 2008

Study Review Shows Soy Protein Promotes Healthy Cholesterol Levels

According to a review, published online in the journal Atherosclerosis, soy protein has a beneficial effect for improving lipid profiles in people with mildly elevated cholesterol levels.

Authors of the study randomly searched Medline databases to find trials that matched pre-determined criteria for their research, choosing studies that evaluated the effect of 25 grams of soya protein on blood lipid levels, with the range between 15 and 40 grams. Thirty studies met the criteria, and the average soya intake was 26.9 g.

They found that the “inclusion of modest amounts soya protein (ca. 25 g) into the diet of adults with normal or mild hypercholesterolaemia resulted in small, highly significant reductions in total and LDL cholesterol, equivalent to ca. 6% LDL reduction. The authors concluded, “This practically achievable intake, particularly when combined with other dietary measures, can make a useful contribution to blood cholesterol management.”

Diabetes Care. 2008; 31:648-654.

Soy Studies

Past studies have shown that soy protein benefits patients with type 2 diabetes as well. The April 2008 issue of Diabetes Care published a study led by Leila Azadbakht, PhD, from the Isfahan University of Medical Sciences in Isfahan, Iran, and colleagues, showing that soy protein consumption…”significantly affected cardiovascular risk factors and kidney-related biomarkers among type 2 diabetic patients with nephropathy (kidney disease." (1)

Soy has also been found to reduce blood pressure in post-menopausal women, suggesting that “a handful of dry-roasted, unsalted soy nuts is an especially convenient and satiating option for patients”. The study, from Medscape “Best Evidence Review”, enlisted 60 women, 12 of whom had high blood pressure. The results found that half cup of unsalted, dry-roasted soy nuts containing 25 g of soy protein and 101 mg of aglycone isoflavones (genistein, daidzein, and glycitein) daily significantly lowered blood pressure and reduced LDL and apolipoprotein B levels by 11 and 8 percent respectively.(2)

Try substituting soy protein for meat whenever possible. There are many satisfying products available, even for hard core meat lovers. Check out 25 Ways to Enjoy Soy Foods, from the Soy Foods Association of North America. You’re sure to find something appealing and above all, healthy. It’s important to remember that better health can come from simple dietary changes.

(2) Hypertension and Soy: A Best Evidence Review

Source:Atherosclerosis: September 2008 (Vol. 200, Issue 1, Pages 13-27) ◦

Wednesday, August 27, 2008

Combination Exercise Benefits Patients with Coronary Artery Disease

Patients with coronary artery disease are likely to experience many benefits when exercise programs combine aerobic training (AT) with resistance training (RT), according to the results of a new study, published in the September issue of Medicine & Science in Sports & Exercise.

Recent guidelines for patients with coronary artery disease recommend that patients perform one set of six to ten repetitions of RT. According to Susan Marzolini, from the University of Toronto in Ontario, Canada, and colleagues, "Although recommendations for the AT prescription are widely known, the RT prescription when combined with AT remains unclear.”

The authors enrolled 72 patients with known coronary artery disease for the study. The participants were randomly assigned aerobic training (5 days/week) or resistance and aerobic training combined. The group performing the combination exercises was given one to three resistance training exercises in addition to aerobics, two days per week. Fifty-three subjects completed the program which measured VO2(peak), ventilatory anaerobic threshold(VAT), body composition, strength, endurance and adherence to the program.

Compared to the AT group, the AT/RT group experienced reduced body fat, and greater increase in strength and endurance. Patients who were given three sets of resistance training exercise had lower adherence to the number of sets performed versus those who were given just one set. Increase in VO2(peak) was not significantly different between the two groups. VAT improvements were significant in the group who performed three sets of resistance exercises versus one, as were gains in lean muscle mass.

The authors conclude, "The combination of RT and AT yields greater improvements in cardiovascular endpoints of exercise performance, skeletal muscle function, and body composition compared to AT alone, in spite of a 28% reduction in the actual AT training stimulus. These data strongly support a combined training intervention in CAD patients, and supports the use of multiple-set RT for patients desiring an increased RT stimulus."

Med Sci Sports Exerc. 2008;40:1557-1564.

Combined exercise works better
Men with Muscles Live Longer - Study

Saturday, August 23, 2008

Zoledronic Acid Prevents Bone Loss During Treatment for Breast Cancer

According to a study report from the Austrian Breast and Colorectal Cancer Study Group trial-12 (ABCSG-12), published online August 20 in Lancet Oncology, premenopausal women undergoing breast cancer treatment were able to prevent bone loss when Zolendronic acid was given in conjunction with chemotherapy. The study also reports that bone mineral density improved five years after treatment was discontinued.

Previous studies have shown that Zoledronic acid also prevents early breast cancer relapses, when combined with endocrine therapy. In the current study, designed to measure the effects of the drug on bone mineral density, the researchers also found that even more significant improvements two years after ending treatment.

Michael Gnant, MD, professor of surgery at the Medical University of Vienna and president of the Austrian Breast and Colorectal Cancer Study Group says, "With endocrine therapy for premenopausal women, there is substantial bone loss... this can be corrected with an easy and harmless treatment. We do recommend adjuvant zoledronic acid for the exact patient group described in this trial."

Study participants who received endocrine therapy alone were found to lose 11.3% and 7.3% of baseline lumbar spine and trochanter bone density respectively. Two years after treatment, there was no improvement. However, the women who received zoledronic acid showed improvement in bone density in both areas after 60 months.

The Importance of Strong Bones

Loss of bone density results in osteoporosis. Osteopenia is the term used for decreased bone mass. Bone mineral density tests measure the health of your bones, and are important in measuring a persons’ risk for fracture and injury – a problem that can cause permanent disability.

Risk factors include the use of certain medications, conditions such as anorexia, smoking and alcohol, family history, advancing age, and being Caucasian or Asian.

Though bone mineral density may return in women receiving breast cancer treatment, the author of the current study writes, “Currently, nobody can realistically say what consequence a long-term period of reduced bone-mineral density will have on later bone integrity." Anyone with chronic medical problems may be at risk. Ask your doctor for a bone density test if you have any risk factors or warning signs of bone loss or osteoporosis.

Source: Lancet Oncol. 2008; 9:840-849. Published online August 20, 2008.

Helpful Link:

Bone Health for Life

Friday, August 22, 2008

HPV Vaccine Caution Still Urged

Charlotte Haug, MD, PhD, from the Journal of the Norwegian Medical Association, in Oslo, writing a commentary in the August 21 issue of the New England Journal of Medicine urges caution regarding large scale programs for HPV vaccination, primarily because there are “too many unanswered questions”.

Dr. Haug says, "The real impact of HPV vaccination on cervical cancer will not be observable for decades. Rational choices about the introduction of medical interventions that might do good in the future but for which evidence is insufficient, especially since we will not know for many years whether the intervention will work or — in the worst case — do harm?"

The editorial accompanies a study published in New England Journal of Medicine, which uses a mathematical model to show the cost effectiveness of disseminating the vaccine in the United States. The study expects that the vaccine will be effective lifelong if highly targeted to girls, age 12. According to the conclusion, “The cost-effectiveness of HPV vaccination will depend on the duration of vaccine immunity and will be optimized by achieving high coverage in preadolescent girls, targeting initial catch-up efforts to women up to 18 or 21 years of age, and revising screening policies.”

Dr. Haug feels the model is “quite optimistic, saying testing trials and follow-up are still needed. One of the major questions that exist is whether the vaccine will last throughout life. If not, screening again becomes more effective than catch up programs.. In addition, studies haven’t proven whether the vaccine has the same effect on older women as pre- adolescents, something that to date is presumed.

The next few years should reveal more, but in the meantime, Dr. Haug is urging more research. She concludes, “We should concentrate on finding more solid answers through research rather than base consequential and costly decisions on yet-unproven assumptions."


Related: HPV Vaccine Causes Public Concern despite FDA/CDC Support

Thursday, August 21, 2008

Highly Effective Flu Vaccine Developed by UTMB Researchers

Researchers from the University of Texas, through a grant from the Bill and Melinda Gates Foundation, have developed a promising universal flu vaccine, effective against several strains of flu. Flu vaccine is due for major revision, and speculation has existed that manufacturers may not be able to meet the demand in time for flu season.

Christine Turley of the University of Texas at Galveston and director of clinical trials and clinical research at the Sealy Center for Vaccine Development at UTMB is the principal investigator of the study. The vaccine, (VaxInnate M2e), according to Turley is “very promising, based upon the immune responses and tolerability we saw in the clinical trial participants… which has the potential to be a safe, highly effective and much-needed option to prevent seasonal and pandemic influenza A."

The results of the vaccine trial will be reported in October at the Interscience Conference on Agents and Chemotherapy and the Infectious Disease Society of America (ICAAC/IDSA).

Included in the trial was an evaluation of the methods used to develop and produce the flu vaccine - time being of the essence. Vaxxinate's technology is such that, should the vaccine prove successful, we can expect timely delivery of the flu vaccine to meet national and international demands.


UTMB researchers test new vaccine to fight multiple influenza strains

Flu Vaccine Due for Major Changes – First Time Recommendation from Government Advisory Board

Tuesday, August 19, 2008

Silver Coated Breathing Tubes may Save Lives

According to the August 20 publication of Journal of the Journal of the American Medical Association (JAMA), using breathing tubes (endotracheal tubes) lined with silver may help save lives by preventing pneumonia in patients who require mechanical ventilation for more than twenty-four hours. The associated term is ventilator acquired pneumonia (VAP), a condition that contributes to a significant number of deaths in patients who require assisted breathing in a hospital setting, such as the intensive care unit.

The silver lining in the tube acts by reducing "VAP incidence by preventing bacterial colonization and biofilm formation". Colloidal silver has long been touted by naturopaths as the “antibiotic of the future”, and researchers have continued to develop the application in lieu of antibiotics.

The researchers screened 9417 adult patients between 2002 and 2006, randomizing 2003 of those who were expected to require mechanical ventilation for 24 hours or longer. According to the study conclusions, “Patients receiving a silver-coated endotracheal tube had a statistically significant reduction in the incidence of VAP and delayed time to VAP occurrence compared with those receiving a similar, uncoated tube.” The incidence of infection in the coated and uncoated tubes was 4.8% and 7.5% respectively. The participants were 18 years of age or older, and both males and females were included.

The findings of the study are valuable and timely when considering the ever increasing emergence of multi-drug resistant infections.

Silver-Coated Endotracheal Tubes and Incidence of Ventilator-Associated Pneumonia

Saturday, August 16, 2008

Too much Alcohol may Increase Tuberculosis Risk

Past studies have shown that drinking alcohol can improve longevity. Again, all things are best in moderation. According to a new study, excessive alcohol intake may increase the risk of active tuberculosis. The results follow a systematic review reported in the August 12 issue of BMC Public Health.

The cutoff level for defining an alcohol disorder was set at 40g per day. The investigators of the report found 3 cohort and 18 case-controlled studies, which they sub-categorized according to definition of exposure, and type of tuberculosis studied, also taking into account a variety of confounding information. The results yielded a 3.50 relative risk for tuberculosis in association with excessive alcohol consumption.

The authors write, "The risk of active tuberculosis is substantially elevated in people who drink more than 40 g alcohol per day, and/or have an alcohol use disorder. This may be due to both increased risk of infection related to specific social mixing patterns associated with alcohol use, as well as influence on the immune system of alcohol itself and of alcohol related conditions....These findings have implications for TB control strategies globally, particularly in countries where a high proportion of TB can be attributed to alcohol use."

The study is not without limitations, and may include bias regarding study results, underestimation of alcohol intake, misclassification of exposure, as well as bias in choosing control and study participants.

The authors suggest there may be benefit in further understanding “causal pathways with regards to risk of infection and risk of break down from infection to disease."

Certainly, the take home message for all of us is to moderate our activities and do our best to keep immunity intact through diet, exercise and – of course – by practicing good hand washing. It is also noteworthy that tuberculosis has been in the news a lot - the most recent news involving cases in California. Oh yes - and remain alert to alcohol related social mixing. Though that sounds tongue-in-cheek, it does have validity, especially for travelers.

BMC Public Health. Published online August 12, 2008. 2008;8:289. ◦

Thursday, August 14, 2008

Should You Eat Fish During Pregnancy?

According to a recent review from the Journal of Midwifery & Women's Health, there is no question that eating fish is good for everyone, even pregnant women. Unfortunately, there are also risks, as fish may contain high levels of methylmercury and polychlorinated biphenol’s (PCB’s), having a negative impact on embryonic development and maternal health. When combined, these contaminants may act synergistically causing an even greater health risk. (1)

Omega 3 fatty acids are beneficial during pregnancy, helping with fetal brain development, promoting higher IQ’s in children, and decreasing the risk of premature labor and delivery and hypertension.

The author of the current review, Tiffany Dovydaitis, RN, APN writes, “...all women of childbearing age should be informed of both the benefits and risks of fish consumption.” Several conflicting studies have been conducted, but the conflicting results make it difficult to know whether the benefits outweigh the risks”. According to the author’s review, …”current fish consumption recommendations from the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) are based in part on the assumption that there is a threshold where potential risk outweighs benefit. One major problem with such an approach is that the scientific community does not agree on what this threshold level might be. Secondly, there are no regulatory mechanisms to ensure that the amount of contaminants contained in species of commercially caught or farmed fish is homogeneous throughout the country. A 2006 study found that methylmercury levels in fish available in Illinois supermarkets far exceeded the FDA reference levels.”

Given the confusion regarding safe levels of contaminants from consuming fish during pregnancy, combined with the risk of inadvertently consuming fish that exceeds safe levels of contaminants, the only conclusions that can be drawn are that Omega 3’s are important, and should not be completely avoided during pregnancy. Suggestions include keeping women informed about the risks of fish consumption, and which fish to avoid. Safe fish oil capsules can be obtained , but should be guided by physician recommendation because they are not FDA regulated. Pre-natal vitamins can be taken containing vegetarian sources of Omega 3 fatty acids, though the benefits of Omega 3’s from plant sources, versus marine Omega 3’s are not as well documented.



Fish Consumption During Pregnancy: An Overview of the Risks and Benefits

Wednesday, August 13, 2008

Get a Good Night’s Sleep with a Back Massage

Most of us could use an extra hour of sleep. Medications for insomnia can be harmful, especially for elders. A simple back massage can help relieve insomnia, and in one study back massage was shown to improve sleep quality in critically ill patients following a six-minute back rub, in combination with muscle relaxation, mental imagery, and relaxing background music.(1)

Patients who were studied slept an hour longer than the control group, and descriptive statistics showed that quality of sleep was superior in the back massage group.

Sleep is essential for good health, recovery from illness and for promoting normal metabolism. It’s easy to forget that holistic interventions can do much to promote good health and aid recovery. Studies regarding the benefits of massage are well documented. The next time you or your partner have trouble sleeping, consider a short back massage.

Remember to use oil or lotion during the massage - less lotion provides better friction and allows more pressure. You may wish to use lavender scented oil for it's proven calming benefit. Start from the lower back, and apply gentle pressure with your thumbs just beside the spine, followed by longer srokes, using your palms, again on each side of the spine. If you feel comfortable, you can try a "kneading" motion around the shoulders and lower back. Remember to ask your recipient how the massage feels. You should be able to enjoy a good night's sleep with a simple and safe back massage.

If you take blood thinners or have any health problems that might be a contraindication to massage, please speak with your doctor.

Visit our store for massage oils and accessories.

(1) Am J Crit Care 1998 Jul; 7(4):288-99 Richards KC. University of Arkansas College of Nursing, Little Rock, USA. ◦

Sunday, August 10, 2008

Go Nuts for Heart Health

We’ve learned much about the role of inflammation and diet as it relates to heart disease. Consuming nuts with a meal can lower your risk of heart disease by reducing inflammation in the lining of the blood vessels. Sudden spikes in blood sugar follow the typical Western diet of mashed potatoes and white bread. Eating almonds, pistachios, or peanuts with a high carbohydrate meal moderates inflammation, slows digestion, and decreases the amount of oxidative stress that follows a high carbohydrate meal. Nuts are also rich in antioxidants.

Studies show that people who were given a Mediterranean, versus a low fat diet, significantly lowered systolic blood pressure, fasting blood sugar and inflammatory biomarkers for heart disease after three months. The study group supplemented their diet with either walnuts (30 g/day) or virgin olive oil (1 l/week).

Other studies show you can reduce your risk of diabetes and heart disease by 20 to 50 percent by eating nuts five times a week.(2) Suggestions include replacing nuts for sugary and starchy snacks such as pretzels and chips – items that are common in the American diet. Additonal benefits include lower triglyceride and increased HDL (good) cholesterol levels.

Nuts are a rich source of antioxidants, fiber, phytosterols, magnesium, and folic acid, and rich in monosaturated fats, making them an excellent heart healthy addition to your diet.

(1) Fito´ M, Guxens M, Corella D, et al. Effect of a traditional Mediterranean diet on lipoprotein oxidation. Arch Internal Med 2007;167: 1195–203.
(2) Jenkins D, Kendall C, Josse A, et al. Almonds decrease post-prandial glycemia, insulinemia, and oxidative damage in healthy individuals. J Nutr 2006;136:2987–92. ◦

Saturday, August 9, 2008

Experimental Antibody Shows Promise for Alzheimer’s Treatment

Scientists, using an experimental antibody, have successfully dissolved amyloid beta (Aβ) plaque in the brains of Alzheimer’s patients. The presence of Aβ plaque in the brain has long been thought to precede the onset of Alzheimer’s disease. The results of a Phase 2 study show such promise that Phase 3 trials are expected in 2009.

The agent (LY2062430, Eli Lilly), was given to patients intravenously, without safety issues according to the results, presented at the 2008 Alzheimer's Association International Conference on Alzheimer's Disease. The antibody successfully adhered to Aβ protein in patients with mild to moderate Alzheimer’s disease, facilitating removal of the detrimental deposits.

Eric Siemers, MD, medical director of the Alzheimer's disease research team at Eli Lilly says, “There was a dose response, so that patients who received more of the agent had less "free" Aβ in the blood. The effect of the antibody on the brain appears to be indirect. The team explained that as the antibody began to work, levels of Aβ in the cerebrospinal fluid began to increase. "We had to stop and think about this, and we realized that the most likely explanation for these elevated [Aβ] levels [in the CSF] was because the antibody was starting to dissolve brain plaques. The bottom line here is the results look quite good, and we didn't see any problem with this antibody," he said.

The 52 patients studied did not show any improvement in cognition, but the team says they are not surprised, given the short duration of the trial. Phase 3 trials will reveal whether the antibody will provide effective treatment for dementia. The researchers, in moving forward, say, "Based on the central safety profile and what we feel are compelling biomarker data, we've made a decision to go on to phase 3 with this antibody and will be starting a phase 3 study in 2009."

What you can do to Manage Your Risks of Alzheimer’s Disease

Remain physically active. According to William Thies, PhD, vice president of Medical and Scientific Relations for the Alzheimer’s Association, “Growing evidence shows that physical exercise does not have to be strenuous or require a major time commitment. It is most effective when done regularly, and in combination with a brain-healthy diet, mental activity and social interaction."(1)

Engage in regular social interaction. Married people, and those in a couple’s relationship in mid-life, have a decreased risk of developing Alzheimer's disease.

Manage stress, control your risk of heart disease through diet, medication, regular exercise, and stress relief techniques (meditation, Yoga, massage, pain control and group interaction). Recently discovered risk factors for dementia include excessive worry, or ruminating about problems, and the presence of metabolic syndrome (cardiovascular related symptoms – obesity, high blood pressure, glucose intolerance, and dyslipidemia).(2)

Immediate lifestyle changes have repeatedly been shown to reduce our risk of major illness, even decades from now.

Source: ICAD 2008: Alzheimer's Association International Conference on Alzheimer's Disease: Abstract 08-A-2053-ALZ. Presented July 30, 2008.

(1) New Research Shows That People With Better Physical Fitness Have Less Brain Atrophy in Alzheimer's
(2) Lifestyle Factors Contribute to Lowering and Raising Risk of Alzheimer's Disease

Saturday, July 26, 2008

New Guidelines Recommended for Treatment of Prediabetes

For the first time, a panel of experts in diabetes and metabolic disorders has issued a comprehensive regimen of guidelines for diabetes prevention. Prediabetes (elevated fasting glucose levels or impaired glucose tolerance) remains undiagnosed in the majority of our population, and is thought to exceed the number of people who are aware of the condition. The burden on health includes a significant risk of developing Type 2 diabetes and heart disease. The known prevalence of diabetes in the US is currently 56 million.

The American Association of Clinical Endocrinologists (AACE) is expected to issue their final document later this year in Endocrine Practice. In a news release, Yehuda Handlesman MD, FACP, FACE, treasurer of AACE and medical director of the Metabolic Institute of America says, “We understand the difficulties in implementing solutions, but as an association of endocrinologists we are committed to supporting community and national efforts in every way we can."

The new guidelines will include specific lifestyle changes, and medication recommendations when appropriate for those at risk. The goal is to recognize and treat type 2 diabetes early and aggressively.

The panel plans to use a two-fold approach. High risk groups may require medications to lower cholesterol and treat hypertension when lifestyle modification fails. Alan J. Garber, MD, PhD, FACE, professor of medicine, Baylor College of Medicine in Houston, Texas, and chairman of the Consensus Conference says, "Although lifestyle can clearly modify the progression of patients towards overt diabetes, it may not be sufficient. Close monitoring by family physicians is recommended for high risk groups.

Normal blood sugar levels are defined when fasting, at less than 100 mg/dl and glucose tolerance challenges less than 140 mg/dl. When blood glucose levels reach 126 in a fasting state and 200mg/dl after a glucose challenge, a diagnosis of diabetes is made. Those in the middle are poorly defined.

Lifestyle management is desirable because it is safe and can be an effective tool for reducing heart disease risk and the development of diabetes. Exercise, 5 days a week at moderate intensity has been recommended, though a recent study shows that high intensity interval exercise may be even more beneficial. Further recommendations include aspirin for prediabetic patients who are not at risk of bleeding. Guidelines for prediabetic cholesterol and blood pressure management are the same as those with diabetes.

Standards for diabetes prevention include the following dietary recommendations:

Primary prevention of diabetes

•Among individuals at high risk for developing type 2 diabetes, structured programs that emphasize lifestyle changes that include moderate weight loss (7% body weight) and regular physical activity (150 min/week), with dietary strategies including reduced calories and reduced intake of dietary fat, can reduce the risk for developing diabetes and are therefore recommended.
•Individuals at high risk for type 2 diabetes should be encouraged to achieve the U.S. Department of Agriculture (USDA) recommendation for dietary fiber (14 g fiber/1,000 kcal) and foods containing whole grains (one-half of grain intake).

Dietary fat intake in diabetes management

•Saturated fat intake should be <7% of total calories.
•Intake of trans fat should be minimized.

Carbohydrate intake in diabetes management

•Monitoring carbohydrate intake, whether by carbohydrate counting, exchanges, or experience-based estimation, remains a key strategy in achieving glycemic control.
•For individuals with diabetes, the use of the glycemic index and glycemic load may provide a modest additional benefit for glycemic control over that observed when total carbohydrate is considered alone.

Other nutrition recommendations

•Sugar alcohols and nonnutritive sweeteners are safe when consumed within the acceptable daily intake levels established by the Food and Drug Administration (FDA).
•If adults with diabetes choose to use alcohol, daily intake should be limited to a moderate amount (one drink per day or less for adult women and two drinks per day or less for adult men).
•Routine supplementation with antioxidants, such as vitamins E and C and carotene, is not advised because of lack of evidence of efficacy and concern related to long-term safety.
•Benefit from chromium supplementation in people with diabetes or obesity has not been conclusively demonstrated and, therefore, cannot be recommended.

The above recommendations can be found at:

The recommendations from the AACE for intensive screening, lifestyle changes,including nutrition and weight loss in addition to testing and monitoring of prediabetes are expected to decrease hospitalizations, provide healthcare savings, and decrease years of disease burden for those who are already at risk.

Source: AACE Consensus Statement of the AACE Task Force on Pre-diabetes. Released July 23, 2008. ◦

Saturday, July 19, 2008

Controlling Surgical Pain with Foot and Hand Massage – Study Review

A study published by Hsiao-Lan Wang, R.N., and Juanita F. Keck, R.N. in Pain Management Nursing, June 2004, (Vol. 5, No. 2, pp. 59-65), showed that twenty minutes of foot and hand massage “significantly reduced both pain intensity and distress resulting from incisional pain on the first postoperative day.” Each of the study participants were recovering from gastrointestinal, gynecological, urological, head, neck or plastic surgery. They all received pain medication one to four hours prior to the massage intervention, and each had asked for something to relieve incisional pain. Before, and immediately after the 20-minute massage, heart rate, respiratory rate and blood pressure were measured, and pain intensity and distress scores were evaluated.

The participants of the referenced study experienced significant reductions in both pain intensity and distress after the 20-minute foot and hand massage. Heart rate and respiratory rates decreased after the same therapist provided petrissage, kneading and friction for five minutes on each hand and each foot, for a total of 20 minutes.

The authors concluded: “Foot and hand massage appears to be an effective, inexpensive, low-risk, flexible, easily applied strategy for postoperative pain management.”

Though the study is not new, it seems alternative therapies are still overlooked, and studies perhaps forgotten, by even the most thoughtful and diligent practitioners of medicine. Healthcare administrators, when considering staff development in hospital and outpatient surgery settings, might take time to explore non-traditional options for patient care. Massage therapists and Nurses can provide much toward patient comfort and healing by providing and/or teaching massage techniques to family members. Improved patient outcomes include post-operative pain control, without excessive use of risky narcotics, shorter patient recovery times and fewer complications following surgery from patient mobilization.

As patient advocates, perhaps physicians, nurses and healthcare administrators should “step out of the box” and take a fresh look at proven alternative treatment options for patients in all types of healthcare settings. In this instance, a simple hand and foot massage sounds like a delightful alternative method for helping patients manage pain.

Resource: Foot and hand massage as an intervention for postoperative pain

Related: Massage Provides Pain Relief Following Surgery

Saturday, July 12, 2008

Computer Program Significantly Improves Memory in Healthy Elders-Study

Declining memory is thought to be a normal part of the aging process. It is also seen in the presence of inflammatory diseases, schizophrenia, neurodegenerative diseases and dementia. According to a new study, a computer based training program, dubbed “BrainStim”, significantly improved working memory in older healthy adults. The study results were presented at the 18th Meeting of the European Neurological Society, in Nice, France.

First author Iris K. Penner, PhD, from the University of Basel, in Switzerland, says the working program is based on a 1974 model published by Baddeley and Hitch that recognizes working memory as a temporary storage unit that we all use on a daily basis. Dr. Penner says, "So if, for example, you go to the supermarket, and you would like to remember what to buy, that is stored for a short period in working memory. If there is a problem with working memory, in the future you may have problems in other cognitive domains. That's why we focus the training on that central function."

The program was developed in three parts, with simplicity in mind. If performance drops, the tasks becomes less difficult; conversely it provides more challenge to the user, based on successful responses. The three parts involve the participants in finding their way on a city map after receiving visual or verbal instructions, finding matching pairs of cards based on a child’s card games, and recalling numbers provided at baseline, while performing an arithmetic task. The programs respectively target spatial orientation, visual object memory and the updating function of the central executive component of working memory, and working memory for recall.

"BrainStim" can be installed on any computer, and is based on Java runtime programming. The authors conclude, "In this concern, BrainStim seems to positively influence brain functionality in healthy elderly subjects and might therefore be a useful tool in prevention."

BrainStim is not yet available commercially, but the authors hope to develop further models, stating that a major German bookseller is interested in the training program.

Source: - 18th Meeting of the European Neurological Society: Abstract P485. Presented Monday, June 9, 2008.

Related: Cognitive Training May Have Long-Term Benefits on Activities of Daily Living in the Elderly

Saturday, July 5, 2008

Drug Free Treatment for Migraines Tested

Safe, drug free, effective treatment for migraine sufferers may be just around the corner. Study investigator Richard B. Lipton, MD, from the Albert Einstein College of Medicine, in the Bronx, New York presented evidence that TMS, or transcranial magnetic stimulation, may help patients that use the device as soon as warning signs of migraine appear (migraine with aura). The device is hand held, weighs less than 3 pounds, is rechargeable and portable.

The current study, presented at the 50th Annual Meeting of the American Headache Society is the second study of its kind. In 2006, the American Headache Society was presented with news that treatment using a large, tabletop TMS device reduced headache pain in the clinic. Because early intervention is necessary, the portable device has been designed for home use.

How it Works

Migraine headaches are thought to be a result of disturbances in the cortex of the brain, known as the cortical spreading depression (CSD) of Leão, or in other terms, a brain signal that is discordant. The hand-held TMS device is thought to disrupt cortical spreading depression. Animal experiments have replicated changes in blood flow that possibly occur with migraine headaches with aura, supporting the hypothesis, but the cause of migraine headaches has been elusive, making treatment difficult. (1) Many people cannot find relief with medications.

The challenge is to compare medication use to the TMS device, which fell short in relieving nausea, light sensitivity (photophobia), and increased sensitivity to sound (phonophobia). However, of the 164 outpatients studied, pain relief was superior when compared to the application of a sham device.

According to estimates, “Eleven million to 25 million Americans suffer from migraine, and headache is one of the top 10 reasons cited for an outpatient medical visit”. New drugs are being researched on a regular basis. Triptans are the most commonly prescribed medications used to treat migraine headaches, but the risk of side effects can be concerning to many patients. Treatment of migraine headaches without side effects that can be dangerous would be welcome news to millions of Americans.

Non-drug approaches to migraine headache treatment may include acupuncture, shiatsu massage, (a form of accupressure), regular exercise, and avoidance of dietary triggers. Some herbs, such as feverfew, and pine bark extract in combination with Vitamin C and Vitamin E have been shown to possibly help.

Source: American Headache Society 50th Annual Scientific Meeting: Abstract LB-OR28. Presented June 27, 2008.

Pathophysiology of the migraine aura
Experimental Portable Device Shows Promise in Treating Migraine with Aura
Transcranial Magnetic Stimulation Effective for Depression in Large Trial

Migraine Information by Ray Sahelian, M.D. Natural treatment for migraine, alternative migraine treatment

Monday, June 30, 2008

Analysis Shows Heart Attacks Under-Treated Following Hospitalization

According to an analysis published Junes 23 in the Archives of Internal Medicine, one in five patients experience angina (chest pain) within the first year after a heart attack, at least once a week. The association was strongest in younger patients, those who have had coronary bypass surgery (CABG), smoke, experience depression and had symptoms at rest during hospitalization. The study was led by Dr. Thomas M. Maddox, from the Denver Veterans Affairs Medical Center, Colorado. Data was obtained from the Prospective Registry Evaluating Outcomes After Myocardial Infarction: Events and Recover (PREMIER) registry.

Co-author, Dr. John S Rumsfeld (Denver Veterans Affairs Medical Center) believes smoking and depression should be a major focus that physicians should target to help patients improve outcomes after experiencing a heart attack. He urges doctors to remain vigilant during the first year in order to provide continuous care to this sector of patients. “Right now our healthcare system is set up to provide care in small episodes: either you’re in the hospital or not, or in the clinic or not - and that’s not a patient- centered healthcare model", says Dr. Rumsfeld.

What happens at home, after a patient is discharged from the hospital and returned to the care of their primary physician, is a concern. Dr. Rumsfeld believes that care following a heart attack requires some quality improvements to “make a real difference to patients’ quality of life and how long they live.”

It’s normal to experience depression after a heart attack. Many patients have difficulty with smoking cessation. Past studies have shown that depression alone accelerates the risk of poor outcomes, including re-hospitalization, recurrent chest pain and greater physical limitations(1). Studies also show that younger women are more prone to depression after a heart attack.(2)

Patients and family members can take an active role by reporting symptoms of depression and ongoing chest pain. It’s important to understand that self-help includes compliance with medication and open communication with your family physician. The American Heart Association has valuable resources for patients and caregivers. You can visit their site for more help and information about a “heart healthy life”. Don’t leave it all up to your doctor – take an active role in your care and discuss treatment options for smoking cessation, treatment of depression and cardiac rehabilitation programs.