What is SARS? What Are The Symptoms of SARS?

SARS or Severe acute respiratory syndrome is a viral respiratory illness caused by a coronavirus, called SARS-associated coronavirus (SARS-CoV). SARS was first reported in Asia in February 2003.

Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe, and Asia before the SARS global outbreak of 2003 was contained.

This fact sheet gives basic information about the illness and what CDC has done to control SARS in the United States.

The SARS outbreak of 2003

According to the World Health Organization (WHO), a total of 8,098 people worldwide became sick with SARS during the 2003 outbreak. Of these, 774 died.

In the United States, only eight people had laboratory evidence of SARS-CoV infection. All of these people had traveled to other parts of the world with SARS. SARS did not spread more widely in the community in the United States.

What are the symptoms of SARS?

In general, SARS begins with a high fever (temperature greater than 100.4°F [>38.0°C]). Other symptoms may include headache, an overall feeling of discomfort, and body aches.

Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry cough. Most patients develop pneumonia.

How does SARS spread?

The main way that SARS seems to spread is by close person-to-person contact. The virus that causes SARS is thought to be transmitted most readily by respiratory droplets (droplet spread) produced when an infected person coughs or sneezes.

Droplet spread can happen when droplets from the cough or sneeze of an infected person are propelled a short distance (generally up to 3 feet) through the air and deposited on the mucous membranes of the mouth, nose, or eyes of persons who are nearby.

The virus also can spread when a person touches a surface or object contaminated with infectious droplets and then touches his or her mouth, nose, or eye(s). In addition, it is possible that the SARS virus might spread more broadly through the air (airborne spread) or by other ways that are not now known.

What does "close contact" mean?

In the context of SARS, close contact means having cared for or lived with someone with SARS or having direct contact with respiratory secretions or body fluids of a patient with SARS.

Examples of close contact include kissing or hugging, sharing eating or drinking utensils, talking to someone within 3 feet, and touching someone directly. Close contact does not include activities like walking by a person or briefly sitting across a waiting room or office.

CDC response to SARS during the 2003 outbreak

CDC worked closely with WHO and other partners in a global effort to address the SARS outbreak of 2003. For its part, CDC took the following actions:

• Activated its Emergency Operations Center to provide round-the-clock coordination and response.
• Committed more than 800 medical experts and support staff to work on the SARS response.
• Deployed medical officers, epidemiologists, and other specialists to assist with on-site investigations around the world.
• Provided assistance to state and local health departments in investigating possible cases of SARS in the United States.
• Conducted extensive laboratory testing of clinical specimens from SARS patients to identify the cause of the disease.
• Initiated a system for distributing health alert notices to travelers who may have been exposed to cases of SARS.

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Topiramate: a potential new medication for treating alcoholism

-- Few medications to treat alcoholism exist.

-- New research shows that a drug called topiramate can reduce self-reported drinking.

-- This finding is corroborated by corresponding decreases in serum gamma-glutamyl transferase levels, a biological marker of heavy drinking.

-- Topiramate also appears able to reduce self-reported craving.

At present, only two drugs are currently approved for use in the United States for the treatment of alcohol dependence: the opiate antagonist naltrexone and the alcohol-aversive agent disulfiram. A third medication called acamprosate (calcium acetyl homotaurinate), used in Europe and elsewhere to prevent relapse in alcoholics, is currently under review for use by the U.S. Food and Drug Administration. A "proof-of-concept clinical trial" published in the August issue of Alcoholism: Clinical & Experimental Research examines a potential fourth medication - topiramate - which can act contemporaneously on more than one neuromodulator of dopamine function. Results indicate that topiramate can reduce consumption and craving in alcohol-dependent patients who are not yet abstinent.

"Few medications to treat alcoholism exist," said Bankole A. Johnson, Wurzbach Distinguished Professor in the departments of psychiatry and pharmacology at The University of Texas - Health Science Center at San Antonio, and sole author of the manuscript. "This study is the first demonstration of topiramate's efficacy for treating alcohol dependence � treatment was efficacious at reducing not only drinking and craving for alcohol, but also improving abstinence and lifestyle."

"Alcohol-drinking behavior is complex, involving many neurotransmitter systems," added Raye Z. Litten, co-leader of the Medications Development Team at the National Institute on Alcohol Abuse and Alcoholism. "Dr. Johnson has postulated that targeting several key sites through the use of topiramate could result in a significant decrease in drinking. His results help to show that - unlike disulfiram, which causes an aversive effect - naltrexone, acamprosate, and topiramate can all act to reduce craving or urge to drink.

This work is an important step in exploring new types of agents that may have a more potent effect in preventing or reducing drinking."

Brain pathways containing the neurotransmitter dopamine, also referred to as the "feel-good" brain chemical, are believed to mediate alcohol's rewarding effects, including craving. Whereas alcohol consumption facilitates dopamine neurotransmission, topiramate - a sulfamate fructo-pyranose derivative - decreases dopamine release through antagonism of glutamate activity at alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA)/kainite receptors and facilitation of the inhibitory neurotransmitter, gamma amino butyric acid (GABA).

Johnson conducted a "proof-of-concept" clinical trial, an experiment designed to test the direct consequences of an idea. Trial participants comprised 150 individuals (107 males, 43 females), 21 to 65 years of age, all of whom were diagnosed with alcohol dependence according to criteria from the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition. For a 12-week period, 75 patients received topiramate (an escalating dose of 25 mg/day to 300 mg/day), 75 received a placebo, and all received a minimal intervention called Brief Behavioral Compliance Enhancement Treatment. Patients self-reported their alcohol consumption (drinks/day, drinks/drinking day, percent heavy drinking days, percent days abstinent) and craving (using the Obsessive Compulsive Drinking Scale). In addition, serum gamma-glutamyl transferase (GGT) levels - considered a sensitive and reliable biological marker of heavy drinking - were measured at baseline and at three, six, nine, and 12 weeks.

"We found a topiramate-induced improvement in self-reported drinking outcomes," said Johnson, "which was corroborated by corresponding decreases in plasma GGT levels. In addition, topiramate was significantly superior to placebo at reducing craving. Because the dose increased with time, the effects of topiramate were confounded to a certain degree by the dosage amount.

However, in my experience, patients need to exceed 200 mg a day of topiramate to have significant benefit in terms of drinking reductions. Of course, there will be exceptional folk who derive benefit at lower levels."

"Results of this study suggest that topiramate has a greater effect on drinking than naltrexone and acamprosate," added Litten. "On the other hand, topiramate appears to have more severe side-effects than naltrexone and acamprosate."

Johnson said the few side effects that were reported in topiramate recipients were mild to moderate in nature, including occasional dizziness, tingling in the skin, psychomotor slowing, word-naming difficulties, and weight loss.

Both Johnson and Litten remarked on topiramate's apparent ability to reduce consumption in alcohol-dependent patients who were still drinking. Thus, said Litten, "patients were not required to be abstinent before taking the medication."

"Most alcoholics seek help while they are still drinking and wish to quit," added Johnson, "not when they are abstinent. Therefore, topiramate can serve to deliver treatment when it is needed most - at the point of crisis when the patient is still drinking and looking for help to quit.

Additionally, topiramate appears to have the potential to reduce alcohol withdrawal symptoms. So it is possible that it can be used for inpatient detoxification and then continued in the outpatient setting to prevent relapse."

"Furthermore," said Litten, "the medication was effective with minimal behavioral intervention, suggesting a potential use in primary-care settings." However, he cautioned, "we must continue to develop and test new types of medications. We also need to test medications in special, understudied populations such as those suffering from psychiatric and/or substance abuse comorbidity, adolescents, and minorities.

Because alcoholism is a heterogeneous disease, we most likely need medications that act on multiple sites. A combination of medications and behavioral therapies will most likely product the best outcome. Finally, we know that all patients do not respond to treatment. It is essential to investigate patient characteristics and identify those who do respond to a medication. In particular, the field of pharmacogenetics is most promising, that is, predicting a therapeutic response as well a toxic effect based on one's genetic profile."

Alcoholism: Clinical & Experimental Research is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. This study, "Progress in the Development of Topiramate for Treating Alcohol Dependence: From a Hypothesis to a Proof-of-Concept Study," was funded by the National Institute on Alcohol Abuse and Alcoholism. 

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Oily fish. What are the benefits? How much should I eat? What about farmed fish?

What are the benefits of eating oily fish?

There is good evidence that eating oily fish reduces the risk of death from heart disease, as they're a good source of omega 3 polyunsaturated fatty acids. White fish also contain these fatty acids, but at much lower levels than in oily fish.

Omega 3 fatty acids are important for the development of the central nervous system in babies, before and after they are born. There is some evidence suggesting that if women eat oily fish when they are pregnant and when breastfeeding this helps their baby's development.

Everyone should eat at least two portions of fish a week, including one portion of oily fish. A portion is 140g.

What are oily fish?

Oily fish include salmon, trout, mackerel, sardines, pilchards, herring, kipper, eel and whitebait. These fish count as oily fish when they're canned, fresh or frozen.

Fresh tuna is an oily fish but canned tuna doesn't count as oily. This is because when it's canned these fats are reduced to levels similar to white fish. So, canned tuna is a healthy choice for most people, but it doesn't have the same benefits as eating oily fish.
v Can I eat as much oily fish as I like?

Even though eating oily fish has a number of benefits, there are limits to the amount we should eat.

Girls and women who might have a baby one day shouldn't eat more than two portions of oily fish a week. A portion is 140g. In general, this advice also applies to women who are pregnant or breastfeeding.

Women who aren't going to get pregnant in the future, boys and men can eat up to four portions a week.

Why should I limit the amount of oily fish I eat?

Because they can contain dioxins and PCBs.

Dioxins are a type of pollutant found in fish. They are by-products from a number of industrial processes and household fires. They are found throughout the environment and are found in fish.

PCBs (polychlorinated biphenyls) are another type of pollutant, which were used mainly in electrical equipment. But PCBs haven't been manufactured since the 1970s and they are no longer permitted in the UK.

Levels of both dioxins and PCBs are falling in the environment and the food we eat.

Dioxins and PCBs will not have an immediate effect on your health. Any risk comes from taking in high levels over a long period of time.

Is the advice on eating farmed salmon different to other types of oily fish?

No, the advice on farmed salmon is the same - that is that girls or women who might have a baby one day and women who are pregnant or breastfeeding shouldn't eat more than two portions a week. Women who aren't going to get pregnant in the future, boys and men can eat up to four portions a week. A portion is 140g. Remember that if you are eating this much salmon in a week, you shouldn't eat other types of oily fish as well.

Should I eat oily fish when I'm pregnant or breastfeeding?

You should eat oily fish when you're pregnant or breastfeeding because this could help your baby's development.

In general, the advice for pregnant and breastfeeding women is the same as for girls and women who might have a baby one day - that is that you shouldn't eat more than two portions of oily fish a week.

When you're pregnant, or planning to get pregnant, you should eat no more than four medium-size cans of tuna a week (with a drained weight of about 140g per can), or two fresh tuna steaks (weighing about 140g when cooked or 170g raw).

Remember that fresh tuna is oily fish, so if you eat two fresh tuna steaks in one week, you shouldn't eat any other oily fish that week. Tinned tuna doesn't count as oily fish, so you can eat this on top of the maximum of two portions of oily fish (as long as it's not fresh tuna or swordfish), but remember not to eat more than four medium-sized cans a week.

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Camel's milk to treat diabetes

The milk of the camel has traditionally been used to treat diabetes. Surprisingly, camel milk does seem to contain high levels of insulin or an insulin-like protein which appears to be able to pass through the stomach without being destroyed.

The stomach's acidity would normally destroy insulin - this is why developing 'oral insulin' is such a challenge.

A small month-long study in people with Type 1 diabetes (which does not appear to have been formally published) suggested that drinking almost a pint of camel milk daily improved blood glucose levels, reducing the need for insulin.

As there have not been enough studies in humans yet, Diabetes UK does not recommend camel milk as a treatment for diabetes - an animal's milk contains nutrients that are tailored for its young

We don't know what the longer-term effects of drinking camel's milk are for humans - like any sensible wise man we'll be keeping a close watch on future developments.

"So, don't get the hump this Christmas if your local supermarket doesn't stock camel's milk," jokes Diabetes UK Care Adviser Phil Casey.
http://www.diabetes.org.uk/news/dec04/camel.htm

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Why did Chiron Flu Crisis Affect USA more than England?

Why did the British never allow themselves to become dependent on just two flu major flu vaccine suppliers like the Americans did? According to health experts, they did this in case the current Chiron flu vaccine crisis happened - to make sure the nation's people were not left in a vulnerable position.

Last August UK officials, with the same information the US officials had, decided something had to be done in case the Chiron supplies, 14% of UK supplies, went belly up. The US officials decided to believe Chiron and gamble 48% of their supplies on an assurance that everything would turn out fine despite some worrying set backs.

When October 5th arrived, the British authorities pulled the plug on the Chiron, Liverpool, supplies. US authorities were caught out - nothing had been done in advance, the country had allowed itself to get into this situation.

Even without this crisis, the UK authorities have always had a situation where they can fall back on six or seven suppliers that have been pre-approved by UK authorities. The US, on the other hand, only has two - one of which has let them down. Had the US had more pre-approved suppliers, had the US started to do something about this problem last August when alarm bells were ringing, had the US��.? This is what many Americans are now starting to ask.

The American Health Dept saw no reason last August to do anything, says their spokesman Tony Jewell. Americans hear him and ask, so why did the British have a reason, you both worked on the same information, didn't you?

America's only other supplier, Aventis, may have upped supplies if they had been asked in advance - say last August - said an Aventis spokesman. But no one from the US approached them on this matter, not till after Oct 5.

In a nutshell, one country that was 14% dependent did something early on while another that was 48% dependent did nothing.

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What is a Coffee Enema? How Does a Coffee Enema Work?

The use of coffee in enemas for detoxification purposes is well known. It is a common herbalogical remedy that has been suggested by holistic and alternative medicine professionals for many years.

Warning: This article is for your information only. It is not medical advice.

Why it is said to work

The effects of a coffee enema are different than a saline enema. The most important difference between a saline enema and a coffee enema is the presence of caffeine in the coffee. Caffeine, theophylline and theobromine, combine to stimulate the relaxation of smooth muscles causing dilatation of blood vessels and bile ducts. The effects of having a coffee enema are not the same as drinking coffee. The veins of the anus are very close to the surface of the tissue. The caffeine is therefore absorbed more quickly (and in higher concentration) than it is in when coffee is drunk.

Liver benefits

Additionally, coffee has a chemical makeup that is stimulative. The enzymes in coffee, known as palmitates, help the liver carry away the toxins in bile acid. The coffee is absorbed into the hemorrhoidal vein, then taken up to the liver by the portal vein. With the bile ducts dilated, bile carries toxins away to the gastro-intestinal tract. Simultaneously, peristaltic activity is encouraged because of the flooding of the lower colon. Thus, when the colon is evacuated, the toxins and bile are carried out of the body.

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How risky is oral sex?

Oral sex is the sucking or licking of someone's external genitalia (penis or vulva) or anus. Most experts agree that having unprotected oral sex is not as risky as having unprotected anal or vaginal intercourse. But oral sex is not risk free.

Unprotected oral sex is less risky than unprotected intercourse because the skin inside the mouth is stronger and thicker than the skin inside the vagina or anus. The skin inside your mouth is less likely to tear during oral sex, allowing fewer opportunities for HIV to enter the bloodstream. Also, it is believed that there is a substance in saliva that actually inhibits HIV.

Remember, even though the risk is low for HIV transmission during oral sex with someone who is HIV positive or whose HIV status is not known, many other sexually transmitted infections (STIs), including gonorrhea, chlamidya and herpes can be spread through unprotected oral sex.

Who is at risk?

Body fluids that can transmit HIV include pre-ejaculate fluid, semen, vaginal fluids and blood (including menstrual blood). The receptive partner (the person performing the oral sex act) is at more risk than the insertive partner (the person being stimulated orally). This is due to the fact that the receptive partner comes into contact with more fluids that can transmit the infection.

What increases the risk of HIV getting into my bloodstream?

The risk of HIV entering your bloodstream increases if:

-- You have any cuts or sores in your mouth, even if they are unnoticeable. These tiny cuts could be caused by disease, dental work, flossing, brushing or even from eating "sharp" foods like chips.

-- The skin in your mouth or on your partner's genitals is torn (even unnoticeably) during rough, very penetrative or prolonged oral sex.

-- You have a throat infection or other STI.

How do I reduce the risk of getting or spreading HIV through oral sex?

-- Use an unlubricated latex condom (try flavoured condoms) for oral sex on a man.

-- Use a dental dam (or a condom, cut lengthwise) for oral sex on a woman.

-- Don't have oral sex right after brushing or flossing your teeth; wait at least 30 minutes.

-- Try to avoid getting body fluids in your mouth.

-- After oral sex, rinse with water or an anti-bacterial mouthwash.

There's no evidence that spitting is more or less risky than swallowing. It is clear, however, that the longer infected fluids remain in the mouth, the more possible it is for infection to occur.

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Super strong 5 year old boy is just a regular kid, says doctor, Germany

Dr Markus Schuelke says that a German 5-year-old boy who is twice as strong as most of his peers is just a normal child. A genetic mutation has blessed him with much more muscle and less fat than his peers. Although he looks just like any other child of his age, he can perform feats of great strength.

Dr. Schuelke said that you would not notice anything different about him if he were in a crowd of kids. But the boy can lift very heavy objects.

Schuelke has known this boy since he was a couple of days old. His parents brought him in because he had been twitching. The twitching was nothing to worry about, said Schuelke. But he did notice that the baby had a lot of muscle on him.

After monitoring the boy for five years, Schuelke says he has a genetic mutation that enhances muscle growth.

The boy has a muscular mother - she used to be sprinter. His mother's brothers are all muscular as well.

You can read about this in the New England Journal of Medicine.

After DNA tests on the boy, scientists found he had a mutation in the myostatin gene. This gene controls the growth of muscles in humans. His body cannot produce the myostatin protein.

This research could one day lead to myostatin hormone therapy to treat people with muscular dystrophy. Muscular dystrophy is a degenerative condition - there is no cure.

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Anthrax vaccine serious side-effects kept from soldiers who were vaccinated

Australian authorities vaccinated all its soldiers against anthrax before they went to Iraq. What it did not do, however, was to tell them that most of its soldiers who returned from Afghanistan previously, got ill from taking the same vaccine.

Thank God the soldiers sent to Iraq did not have the unusual side effects the previous soldiers had had.

Most of the Australian troops sent to Afghanistan in 2001 became ill, said the Australian government.

Officials are saying they did not tell the soldiers bond for Iraq because they did not want to make them anxious. They also said that they did not expect the soldiers this time round to suffer any side-effects.

75% of the soldiers sent to Afghanistan became ill as a result of taking the Anthrax vaccine. Confidential papers were released to an Australian newspaper under Freedom-of-Information Rules.

The soldiers experienced swelling, a high level of pain and flu-like symptoms as well. They never found out what caused the side-effects, suspended the vaccination programme for several weeks and then resumed it.

Australian military doctors have suggested that other factors could have contributed to the side-effects felt in Afghanistan. The soldiers were working at constantly changing altitudes, they had high physical workloads and the temperatures fluctuated a great deal.

In 2003, the authorities still went ahead and vaccinated all their troops sent to Iraq, even though they knew what had happened to their troops who had taken this vaccine before. The authorities did not even know what had caused the side-effects.

In order to demonstrate faith in the vaccine, Robert Hill, Australia's Defence Minister, vaccinated himself just before the troops were sent to Iraq.

About 40 service people were sent back from Iraq because they refused to be jabbed (vaccinated). They have not been disciplined.

So far, no unusual side-effects have been reported since the troops came back from Iraq.

'We were in a position where all we would have been able to tell them was that there had been a problem,' Air Commodore Tony Austin told reporters.

'We had not been able to identify a cause from that and we had absolutely no evidence to suggest that we were likely to see that again, based on overseas experience and our own experience when we reinstituted the programme in Iraq. So, I think to have advised people of that would have been quite counterproductive. I think that would have increased anxiety levels amongst our people.'

Opposition party defence spokesman, Chris Evans said 'The defence department hasn't been honest with the troops, hasn't been honest with the parliament, and the minister needs to provide answers as to what's gone on here."

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Sleep Apnea Associated with Stomach Acid Backflow into Throat

Medical researchers have long suspected a relationship between gastro-esophageal reflux disease (GERD) and obstructive sleep apnea (OSA), two medical conditions which can have a deleterious effect on a patient's quality of life. Now, a team of Canadian researchers has determined that there are significant relationships between laryngopharyngeal reflux (LPR), OSA, and upper airway sensory impairment.

Laryngopharyngeal reflux, or LPR, is the backflow of stomach contents up the esophagus and into the upper airway, whereas GERD includes backflow only into the esophagus. The refluxed stomach contents (refluxate) are primarily composed of acid and activated pepsin, a proteolytic enzyme needed to digest food in the stomach. The damage from this disorder can be extensive. Symptoms of laryngopharyngeal reflux include altered voice, throat clearing, vocal fatigue, and cough, and have been linked to more substantial illnesses including laryngospasm , tightening of the larynx, and glottic carcinoma. This disorder is common in the North American adult population, estimated to affect up to 35 percent of the population 40 years or older.

Obstructive sleep apnea (OSA) affects 4-9 percent of males and 1-4 percent of females in the general population. The authors of this study have identified airway inflammation, a mucosal sensory impairment in the oropharynx (pharynx posterior to the mouth), velopharynx (soft palate), and larynx (voice box) of OSA patients, using endoscopic sensory testing. Correlations between the level of laryngeal sensory impairment and apnea severity strongly suggest that this sensory impairment plays a role in the functioning of OSA.

While previous studies have shown that GERD is prevalent among patients with OSA, the authors of this study are unaware of previous evaluation of LPR in this patient population. Accordingly, otolaryngologists from several hospitals in Montreal hypothesized that LPR is prevalent among OSA patients, and that this contributes to impaired laryngeal sensation, which in turn may contribute to the pathophysiology of OSA.

A new study evaluates the prevalence of LPR in consecutive patients with OSA using the reflux finding score and assesses the relationships between the finding of LPR and the severity of both upper airway sensory impairment and OSA. The authors of "Laryngopharyngeal Reflux, Upper Airway Sensory Impairment, and Obstructive Sleep Apnea," all from Montreal, Canada, are Richard J. Payne MD, and Saul Frenkiel MD FRCS, from the Jewish General Hospital, McGill University, Montreal; Karen M. Kost MD FRCS, and Anthony G. Zeitouni MD FRCS, at the Royal Victoria Hospital, McGill University; George Sejean MD FRCS, with St. Mary's Hospital; Dr. Robert C. Sweet FRCS, affiliated with Montreal General Hospital, McGill University; and Naftaly Naor, Lourdes Hernandez MD, and R. John Kimoff MD FRCP, McGill University Health Centre. Their findings are being presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, being held September 19-22, 2004, at the Jacob K. Javits Convention Center, New York City, NY.

Methodology: This was a prospective, blinded study of 34 patients who underwent overnight diagnostic polysomnography (PSG), a sleep study, and upper airway endoscopy during the daytime for purposes of sensory testing (EST) and assessment of LPR using the reflex finding score (RFS).

A diagnosis of subject OSA was made on the basis of an AHI value ≥15 events per hour. Other measures of OSA severity included measures of sleep disruption (microarousal index), mean apnea and hypopnea duration, mean SaO2 during sleep, time spent <90 percent hypoxia and lowest point of hypoxia during sleep. The laryngopharyngeal reflux assessment entailed videotaping the EST. Two investigators independently determined the RFS for each subject. The mean RFS score for the subject was then calculated. A mean value for RFS > 7 confirmed a diagnosis of LPR.

Results: There were 26 males and eight females enrolled in the study. For the group overall, the mean age was 43.9 � 2.4 (SE) years and the mean body mass index was 26.5 � 0.8 kg/m2. The corresponding data for the 29 subjects with OSA were 45.4 � 2.3 years and 27.2 � 0.8 kg/m2. Key findings included:

� Sleep Study findings: A majority (29/34) were found to have an AHI ≥ 15 events per hour indicating that 85 percent of the subjects had OSA.

� Laryngopharyngeal reflux assessment findings: Of the 34 subjects, 30 were found to have a mean RFS > 7, yielding an 88 percent prevalence of LPR in this subject group. The prevalence of LPR in subjects with OSA was 93 percent (26/28).

� Relationships between LPR, apnea severity, and upper airway sensory function: For patients with OSA, there was a significant correlation between the severity of LPR and OSA. There was also a slightly weaker but still significant correlation between RFS scores and the nadir hypoxia for the night. These findings therefore point to a strong relationship between LPR as reflected in the RFS score and apnea severity.

Conclusions: In this study, a validated endoscopic scoring algorithm assessed LPR among patients with obstructive sleep apnea and found a dramatically higher prevalence (93 percent) for LPR than that reported for the general population. Furthermore, the severity of LPR, as reflected by RFS values correlated significantly with several key measures of apnea severity, pointed to an important interaction between these two disorders. The authors confirmed that LPR severity correlated with laryngeal sensory dysfunction, but not oropharyngeal or velopharyngeal (soft palate) sensory impairment (not previously evaluated). Previous observations that laryngeal, but not oropharyngeal or velopharyngeal sensory dysfunction correlates with apnea severity were also confirmed.

Note: The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) represents the nation's 11,000 otolaryngologist-head and neck surgeons. These specialists diagnose and treat disorders of the ear, nose, and throat and related structures of the head and neck. Learn more about the specialty and otolaryngic disorders at the AAO-HNS Internet web site, http://www.entnet.org.

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What To Eat (And Not To Eat) When Pregnant

While you're pregnant, you should eat a healthy balanced diet, to make sure that you get enough energy and nutrients for your baby to grow and develop, and for your body to cope with the changes taking place.

Try to eat plenty of foods containing iron, to make sure you are getting enough of this important mineral. Good sources of iron include red meat, pulses, bread, green vegetables and fortified breakfast cereals. Try to have some food or drink containing vitamin C, such as a glass of fruit juice, at the same time as an iron-rich meal, because this will help your body absorb the iron.

Although liver contains lots of iron, you should avoid eating it while you're pregnant because it contains high levels of vitamin A, which could harm your baby if you have too much.

You should also take a 400 microgram (mcg) folic acid supplement each day until at least the 12th week of your pregnancy. And try to include foods containing folic acid in your diet, such as green vegetables and brown rice, bread and fortified breakfast cereals. Folic acid has been shown to reduce the risk of neural tube defects in the unborn baby, such as spina bifida.

While you're pregnant, you should avoid eating the following things:

• soft mould-ripened cheeses, such as Camembert and Brie, and blue-veined cheeses
• any type of pate
• any food that isn't properly cooked, especially undercooked meat and raw or undercooked eggs (always make sure that food is piping hot all the way through before you eat it)
• shark, swordfish or marlin

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Slim-Fast Optima Diet Plan Includes More Food Choices Than Ever Before

With over 30 published clinical trials and a 25-year history of helping dieters lose weight and keep it off, Slim-Fast introduces the new Slim-Fast Optima Diet, a balanced and sustainable approach to weight loss that will help dieters achieve success over the long-term. The Optima Diet is formulated to include a precise nutritional balance of lean proteins, complex carbohydrates and a healthy fat profile, so that every calorie works harder to keep dieters satisfied.

The new Optima Diet mixes and matches more of your favorite foods with Slim-Fast meal and snack bars, smoothies and shakes. There are hundreds of food choices that are included as part of the plan. In addition, the new Slim-Fast Optima products contain up to 55 percent less sugar than the regular Slim-Fast product line. The Diet is about progress, not perfection. It is formulated to help dieters achieve their healthy weight, which is determined by their individual needs and goals, not dictated by societal standards.

"My patients tell me that the toughest things about sticking to a diet is feeling hungry, deprived and bored," says registered dietitian Molly Gee, M.Ed, R.D., chair of the Weight Management Dietetic Practice Group of the American Dietetic Association and obesity researcher at Baylor College of Medicine. "Using the principle of harder working calories, Slim-Fast has created a diet and product line that helps keep dieters satisfied so they are more likely to stick to their diets and successfully lose weight."

The Optima Diet includes four essential elements to ensure weight loss success: a personalized, balanced meal plan, a physical activity program, expert support and advice, and motivational tools for tracking progress. The Slim-Fast Optima Diet follows the recommendations of leading health organizations including the American Heart Association, American Dietetic Association, National Institutes of Health (NIH) and the World Health Organization (WHO).

"The Slim-Fast Optima Diet is a safe and sensible way to lose weight," says Terry Olson, General Manager and Vice President of Marketing, for the Slim-Fast brand, a business unit of Unilever. "Based on the latest nutritional research and recommendations, our own internal research and consumer input, we devised a plan that is personalized, flexible, easily fits into their lifestyle and most importantly, is satisfying and effective."

Slim-Fast's Optima Diet translates the latest results from top obesity research as the basis for its practical approach to weight management. The Diet, with its meals, snacks and macronutrient balance, is designed make weight loss effective and sustainable. "It can be difficult to achieve nutritional adequacy as well as a feeling of satisfaction on any diet," adds Gee. "The Slim-Fast products provide balanced nutrition to help ensure that essential nutrients are part of the diet. And as part of a structured plan, the products offer simplified calorie and portion control, and promote flexible food choices."

As a guide to this new approach to weight loss, Slim-Fast has introduced The Little Book of Weight Loss Success. Written by weight loss experts, the book features useful dieting tips and outlines how the Optima Diet can be personalized, along with sample meal plans and recipes. There are also suggestions for dining out, physical activity and support programs. The book also shares testimonial tips from successful Slim-Fast dieters.

The Little Book reinforces the importance of tracking one's success, and comes with a food and activity tracker. Throughout 2005, Slim-Fast plans to distribute 10 million free copies of the book at retail locations, online at http://www.slimfast.com or by calling the toll free number 1-800-SLIMFAST.

Slim-Fast, a business unit of Unilever, is headquartered in West Palm Beach, FL. Slim-Fast offers delicious and balanced nutritional products, meal planning and exercise advice to aid in weight loss and weight maintenance, which can result in improved health. The Slim-Fast product line includes an affordable range of shakes, smoothies, powders, meal bars, snack bars, breakfast bars and muffin bars that are available in retail outlets nationwide. Visit http://www.slimfast.com or call 1-800-SLIMFAST for more information.

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Chemical Sensitivities and Perfume

Fragrances are now used in almost every cleaning, laundry, and personal-care product on the market. Since people have been using perfumes for hundreds of years. It's reasonable to wonder why the problem of using scents has surfaced only recently.

Until the 20th century, perfumes were made from natural ingredients derived directly from plants and animals, and as fragrances became cheaper and more widespread, they also became more synthetic.

The National Academy of Sciences reports that 95% of the chemicals used in fragrances today are synthetic compounds derived from petroleum, including known toxins capable of causing cancer, birth defects, central nervous system disorders and allergic reactions.

We have been brainwashed by the industry to feel we must cover up our natural scents with toxic chemicals. Many of the same chemicals in perfumes are the same chemicals that are in cigarette smoke.

You would think the government would protect people by attempting to regulate the industries that are causing harm; however, the cosmetic industry is self regulated and isn't required to give formulations, test results, safety data or consumer complaints to the FDA.

When you use perfume or cologne, remember you are using powerful chemicals regulated solely by the industry that sells them. Just because they don't affect you now doesn't mean they won't affect someone in line next to you (giving them a migraine or sinus problems), or that you will always be immune to their effects. These chemicals go directly into the blood stream when applied to our skin, and are also absorbed into the skin from our clothing.

We also inhale these chemical fumes that go straight to our brains where they can do major harm, and many of these chemical fumes have a "narcotic" effect. ("Smelling Good But Feeling Bad, Synthetic Perfumes, Colognes and Scents Are Turning Up Noses," Green Living Your Health, and "The Health Risks of Perfume and Other Scented Products," emagazine.com - March 2002} Author's comment: These effects from scents can surface days after the exposure, and many people do not connect the strong perfume/cologne smell on the lady or gentleman next to them at the opera to their headache or upset stomach days later.

One of the big toxic offenders is perfume and other scented products. Did you know that many of the ingredients in your perfume are the exact same ingredients found in gasoline???!! The scary thing is that the perfume industry is not regulated at all, and they can put any number of chemicals in fragrance without revealing what those chemicals are, and how they affect humans. We humans are all participating in a giant "lab" experiment against our knowledge and against our will, and it is making some of us very sick.
{"Multiple Chemical Sensitivity - Environmental Illness," www.ourlittleplace.com place.com - April 2002}

Fragrance-free policies are beginning to take hold in work places across the United States and Canada. Here are just a few examples:

Evergreen State College in Olympia, Washington, asked its employees and students to refrain voluntarily from wearing scented products.

The entire Halifax Regional Municipality in Nova Scotia has a "scent-awareness" program that urges the use of unscented products only.

Alacrity Ventures, a Berkeley, California-based venture-capital firm, not only encourages its employees to go fragrance-free but also uses only unscented janitorial products.

Many businesses, at the request of their employees, are voluntarily creating fragrance-free policies, says Tracie Saab, a consultant with the "Job Accommodation Network," a Morgantown, West Virginia group that educates disabled workers and their employers. These policies are applauded by people with asthma, allergies, and the controversial disorder called multiple chemical sensitivity, in which even low levels of exposure to chemicals (from pesticides to perfumes) can trigger headaches, fatigue and other symptoms. "It is easier for businesses to enact these policies than to risk legal action somewhere down the line," says Saab.
{"Stink-Free Office Mates," Natural Health, Nov./Dec. 2000}

Many migraineurs are so sensitive to fragrance that people wearing perfumes and colognes around them trigger an immediate and severe migraine attack. You can make your house a fragrance-free zone, and if you have a visitor who is either not aware of this or forgets, most of the fragrance can be removed with alcohol wipes if it has been put on the skin and not the clothing.

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What Are The World's Healthiest Foods?

Among the thousands of different foods our world provides, the majority contain at least several of the nutrients our bodies need but to be included as one of the World's Healthiest Foods they had to meet the criteria listed below.

The criteria we used will also help you understand why some of your favorite (and also nutritious) foods may not be included on our list. For example, Readers have asked why mango, a very nutritious food, is not among the World's Healthiest Foods. While mangoes taste great and are rich in vitamins and minerals, they do not fit our criteria of familiarity and availability.

1. The World's Healthiest Foods are the Most Nutrient Dense

The World's Healthiest Foods have been selected because they are among the richest sources of many of the essential nutrients needed for optimal health. We used a concept called nutrient density to determine which foods have the highest nutritional value.

Nutrient density is a measure of the amount of nutrients a food contains in comparison to the number of calories. A food is more nutrient dense when the level of nutrients is high in relationship to the number of calories the food contains. By eating the World's Healthiest Foods, you'll get all the essential nutrients that you need for excellent health, including vitamins, minerals, phytonutrients, essential fatty acids, fiber and more for the least number of calories.

2. The World's Healthiest Foods are Whole Foods

The World's Healthiest Foods are also whole foods complete with all their rich natural endowment of nutrients. They have not been highly processed nor do they contain synthetic, artificial or irradiated ingredients. And whenever possible, The Healthier Way of Eating recommends purchasing "Organically Grown" foods, since they not only promote your health, but also the health of our planet.

3. The World's Healthiest Foods are Familiar Foods

The World's Healthiest Foods are common "everyday" foods. These include the fruits, vegetables, whole grains, nuts and seeds, lean meats, fish, olive oil, herbs and spices that are familiar to most people.

4. The World's Healthiest Foods are Readily Available

Although there are many foods that are exceptionally nutritious, many of them are not readily available in different areas of the country. The World's Healthiest Foods are foods that the majority people can easily find at their local market.

5. The World's Healthiest Foods are Affordable

We have selected foods that are not only familiar and available, but also affordable, especially if you purchase them locally and in season. This is also the time when they are the freshest and of the best quality.

6. The World's Healthiest Foods Taste Good

The World's Healthiest Foods are also some of the world's best tasting foods. We have created recipes using the World's Healthiest Foods that do not overpower, but enhance, the unique flavor of each food. Each recipe provides a flavor adventure so you can discover new ways to experience and enjoy the great natural tastes of these foods.

View the whole list on www.whfoods.com

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Listerine antiseptic as effective as dental floss

A survey of 1,004 consumers and 300 dentists confirms what many suspected all along - a majority of Americans don't floss their teeth as often as they should and their gums are suffering as a result. According to a 2004 oral hygiene survey by TIS, a division of NOP World, Americans are too busy and too tired to floss. In fact, approximately 90% of dentists state that most patients do not floss daily. Not the best scenario for optimal oral health--daily flossing has long been considered the standard for removing gum disease-causing plaque that can't be removed by brushing alone. Until recently. Published research has now proven that rinsing with Listerine™ Antiseptic is as effective as flossing at reducing plaque and gingivitis between teeth.

For the legions of consumers who may not adequately floss, the new studies behind Listerine Antiseptic will be considered big news. In only 30 seconds, twice a day, consumers can improve the odds of beating plaque and gingivitis, achieving significant health benefits once thought only possible with daily flossing. However, if you are already flossing, don't toss that floss! An optimal Listerine Antiseptic routine should include daily flossing. Dental professionals strongly recommend that consumers take this news as an opportunity to speak to their dentists and hygienists about how they can enhance their oral care routine.

"After 125-years, Listerine Antiseptic continues to amaze us," said Lori Kumar, Ph.D., Vice President, Oral Care R&D, Pfizer Consumer Healthcare. "These findings support the benefit of adding a Listerine Antiseptic mouthwash to a daily oral care routine, especially for people that may not adequately floss."

Scientific Studies Provide Solutions

A long-term study published in the Journal of the American Dental Association (JADA) demonstrates that rinsing twice daily with Listerine Antiseptic mouthrinse is as effective at reducing plaque and gingivitis in areas between the teeth as flossing once daily.

In the study published in JADA, Listerine Antiseptic reduced plaque between the teeth by 20 percent and gingivitis by 11 percent, while flossing led to 3.4 percent and 4.3 percent reductions respectively. This trial reinforces the findings of a prior study published in the American Journal of Dentistry (AJD). Both studies compared the effectiveness of 30-second, twice daily use of Listerine Antiseptic to once daily flossing in more than 600 people ages 18-65 with mild to moderate gingivitis. These six-month randomized and evaluator-blinded studies were conducted in two independent research-testing facilities.

"People who don't floss are contributing to plaque build-up that can lead to gingivitis, the earliest and mildest form of gum disease," says Christine Charles, RDH Associate Director, Oral Care Clinical Research at Pfizer Consumer Healthcare and a lead on the two studies comparing the effectiveness of Listerine Antiseptic and flossing. "A major benefit of flossing is that it can penetrate the areas where your toothbrush can't reach," added Ms. Charles. "As a liquid solution, Listerine Antiseptic easily flows into these hard to reach areas between teeth and with a microbial action kills the germs that cause plaque and gingivitis."

From the Mouths of Patients and Dentists

Although American consumers know they should floss daily to prevent plaque and gum disease, approximately 90% of dentists surveyed reported that most of their patients actually do not floss regularly. Less than one quarter of American consumers think their dentist would give them an "A" grade for oral hygiene, and 42 percent predict they'd get a "C" or lower, according to a newly released TIS survey of consumers and dentists. Still, 67 percent of consumers claim to feel little or no guilt for not following their dentists' recommendations to floss daily. Consumers surveyed justify their behavior to dentists: 68 percent of the surveyed dentists say their patients complain that they are too time-starved or too tired to floss at the end of the day.

The question remains, will dentists now simply advise their patients to rinse in lieu of flossing? Hopefully not. An optimal Listerine Antiseptic routine should include daily flossing. Eighty-three percent of the dentists surveyed say they would recommend rinsing with Listerine Antiseptic twice daily to patients who don't floss properly. The benefit of rinsing with Listerine Antiseptic extends from those who don't floss properly to those who do. In fact, 74 percent of dentists even said they would recommend adding Listerine Antiseptic to the regimen of patients who already floss properly. And the news of the Listerine Antiseptic flossing studies resonates with those not currently using the product. In the consumer survey, a sizeable 72 percent stated they would use Listerine Antiseptic, given it is as effective as floss against removing plaque and gingivitis between teeth.

About the Survey

The oral care hygiene survey, with a focus on flossing challenges, was conducted by TIS, a division of NOP World, in April 2004, interviewing a nationwide sample of 1,000+ U.S. adults ages 18 years and over. Data for the total sample were weighted to be representative of the total U.S. adult population on the basis of region, age within gender, education, household income, and race/ethnicity. A second survey was conducted with 300 dentists nationwide. The surveys were sponsored by Pfizer Consumer Healthcare, makers of Listerine Antiseptic.

About Plaque and Gingivitis

Plaque, a soft, sticky almost colorless film of bacteria, is directly responsible for the development of gingivitis, an early and reversible form of gum disease. Gingivitis can lead to more advanced gum disease (periodontitis), which when left untreated can lead to eventual tooth loss. Three out of four adults experience a form of gum disease at some point in their lives.

About Listerine

Listerine Antiseptic Mouthwash is the number one dentist-recommended brand of mouthwash and is the only leading over-the-counter brand that carries the American Dental Association's (ADA) Seal of Acceptance. Made by Pfizer Inc, Listerine contains clinically proven active ingredients that kill germs, help prevent and reduce plaque and gingivitis and control bad breath. For more information about Listerine, please call: 1-800-223-0182, 8:30 a.m. to 5:00 p.m. Eastern Standard Time.

About Pfizer

Pfizer Inc discovers, develops, manufactures and markets leading prescription medicines for humans and animals and many of the world's best-known consumer products.

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What Are The Different Types Of Eczema?

Eczema is a group of persistant skin conditions which can affect people of all ages. There are many different types of eczema.

Atopic eczema

Atopic eczema is the commonest form of eczema and is closely linked with asthma and hayfever. It can affect both children and adults, usually running in families. One of the most common symptoms of atopic eczema is its itchiness (or pruritis), which can be almost unbearable. Other symptoms include overall dryness of the skin, redness and inflammation. Constant scratching can also cause the skin to split, leaving it prone to infection. In infected eczema the skin may crack and weep ('wet' eczema). Treatments include emollients to maintain skin hydration and steroids to reduce inflammation.

Allergic contact dermatitis

Develops when the body's immune system reacts against a substance in contact with the skin. The allergic reaction often develops over a period of time through repeated contact with the substance. For example, an allergic reaction may occur to nickel, which is often found in earrings, belt buckles and jeans buttons. Reactions can also occur after contact with other substances such as perfumes and rubber. In order to prevent repeated reactions it is best to prevent contact with anything that you know causes a rash.

Irritant contact dermatitis

This is a type of eczema caused by frequent contact with everyday substances, such as detergents and chemicals, which are irritating to the skin. It most commonly occurs on the hands of adults and can be prevented by avoiding the irritants and keeping the skin moisturised.

Infantile seborrhoeic eczema

A common condition affecting babies under one year old, the exact cause of which is unknown. Also referred to as cradle cap, it usually starts on the scalp or the nappy area and quickly spreads. Although this type of eczema looks unpleasant, it is not sore or itchy and does not cause the baby to feel uncomfortable or unwell. Normally this type of eczema will clear in just a few months, though the use of moisturising creams and bath oils can help to speed this along.

Adult seborrhoeic eczema

Characteristically affects adults between the ages of 20 and 40. It is usually seen on the scalp as mild dandruff, but can spread to the face, ears and chest. The skin becomes red, inflamed and starts to flake. The condition is believed to be caused by a yeast growth. If the condition becomes infected, treatment with an anti-fungal cream may be necessary.

Varicose eczema

Varicose eczema affects the lower legs of those in their middle to late years, being caused by poor circulation. Commonly the skin around the ankles is affected, becoming speckled, itchy and inflamed. Treatment is with emollients and steroid creams. If left untreated, the skin can break down, resulting in an ulcer.

Discoid eczema

Is usually found in adults and appears suddenly as a few coin shaped areas of red skin, normally on the trunk or lower legs. They become itchy and can weep fluid. Usually discoid eczema is treated with emollients (and steroid creams if necessary).

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The substance in a food that can cause an allergic reaction in certain people is called an allergen. There is generally more than one kind of allergen in each food. Most allergic reactions to food are mild but a small proportion of people with a food allergy can have severe reactions. The symptoms of food allergy can affect almost any part of the body, including the skin, the heart, and the respiratory and gastrointestinal systems. Symptoms can appear within minutes, or up to several hours after the person has eaten the food they are allergic to. They can include: -- rashes (usually very itchy) -- tingling sensation in the mouth -- swelling of the lips, tongue, face and throat -- difficulty breathing -- diarrhoea -- vomiting -- abdominal cramps On rare occasions, food allergy can also cause a rapid drop in blood pressure and loss of consciousness. These symptoms are usually linked to a life-threatening form of allergy known as anaphylaxis (pronounced anna-fill-axis). Anaphylaxis, sometimes called anaphylactic shock, can be fatal if not treated immediately, usually with an injection of epinephrine (adrenaline). When someone has an anaphylactic reaction, they can have symptoms in different parts of the body at the same time, causing rashes, swelling of the lips and throat, difficulty breathing and a rapid fall in blood pressure. The first symptoms of anaphylaxis can develop within minutes and severe breathing difficulties can develop up to several hours after eating the food. Many anaphylactic reactions can be misleadingly mild at first, so it's better to be cautious and not underestimate the danger. People with asthma are more likely to have a severe reaction affecting the lungs. Anaphylaxis can also be caused by other things, such as bee and wasp stings, and drug allergy, but food allergy is one of the most common causes. Peanuts, milk, eggs and fish are the most common foods to cause anaphylaxis in the UK and Europe. Nuts, sesame seeds and shellfish can also cause it. Generally, the symptoms of food allergy are more severe than other types of food intolerance. When someone has a food allergy, a tiny amount of the problem food can cause a reaction, but usually the symptoms of other types of food intolerance are caused by larger amounts. Often the symptoms of food intolerance start some time after eating the food, which can make the condition difficult to diagnose. ORAL ALLERGY SYNDROME Certain foods, particularly fruit and vegetables, can cause reactions such as itching or rashes when they touch the lips and mouth. This is called oral allergy syndrome and is a symptom of food allergy. These reactions usually happen in people who are sensitive to pollen, for example pollens from birch, grass, or plants in the daisy family such as ragweed and mugwort. This is because the protein in these pollens, which certain people react to, is also found in some fruit and vegetables. For example, a person who is sensitive to ragweed pollen may develop rashes on the lips when they eat melon, and someone who is sensitive to birch tree pollen may react to apples. Cooking often destroys the allergens that cause this kind of reaction in fresh fruit and vegetables so, for example, people who react to raw apples might be able to eat cooked apples. EXERCISE-INDUCED FOOD ALLERGY This is when someone has an allergic reaction to a particular food when they eat it just before they exercise. People who are sensitive in this way may normally be able to eat the food with only a mild reaction, or no reaction at all, but they can have a severe reaction (including anaphylaxis) if they eat it just before they exercise. ALLERGIC CROSS-REACTION Sometimes, if someone has an allergy to one thing they will also react to other things. This can happen because different foods (or substances) contain either the same allergen or an allergen with a similar structure. This means different foods can cause similar allergic reactions, which is known as allergic cross-reaction. Allergic cross-reaction means that someone could suffer an allergic reaction even when they're avoiding the foods they know they're allergic to. For example, if someone is allergic to peanuts, they might also react to other legumes such as soya, peas, lentils and beans. Allergic cross-reactions can also happen between certain fruit or vegetables and latex (known as latex-food syndrome), or the pollens that cause hayfever. Only some people who have food allergies will experience allergic cross-reaction. Some food allergies can also be linked because of what is known as an 'associated reactivity'. This means that although the substances don't contain the same allergen, it's quite common for people who are allergic to one substance also to react to another substance. For example, people with peanut allergy are often allergic to nuts or eggs too. And people who are allergic to soya might also be sensitive to milk.

Researchers in Spain have discovered that a cannabis extract makes brain tumors shrink by halting the growth of blood vessels that supply the tumors with life. Cannabis has chemicals called cannabinoids, these are the chemicals that could effectively starve tumors to death, say the researchers.

The study was carried out at the Complutense University, Madrid, Spain.

The team used mice to demonstrate that the cannabinoids block vessel growth.

You can read about this latest research in the journal Cancer Research.

Apparently, the procedure is also effective in humans.

The Spanish team, led by Dr Manuel Guzm�n, wanted to see whether they could prevent glioblastoma multiforme cancer from growing by cutting off its blood supply. Glioblastoma multiforme is one of the most difficult cancers to treat - it seldom responds to any medical intervention, such as radiotherapy, chemotherapy and surgery.

The scientists knew that cannabinoids will block the growth of blood vessels (to tumors) in mice - they wanted to find out whether the same thing would happen with humans.

The mice were given a cancer similar to the human brain cancer (glioblastoma multiforme). The mice were then given cannabinoids and the genes examined.

The genes associated with blood vessel growth in tumors through the production of a chemical called vascular endothelial growth factor (VEGF) had their activity reduced.

Cannabinoids halt VEGF production by producing Ceramide. Ceramide controls cell death.

Dr Guzm�n said: "As far as we know, this is the first report showing that ceramide depresses VEGF pathway by interfering with VEGF production."

They then wanted to see if this would also happen with humans.

They selected two patients who had glioblastoma multiforme and had not responded to chemotherapy, radiotherapy or surgery. The scientists took samples from them before and after treating them with a cannabinoids solution - this was administered directly into the tumor.

Amazingly, both patients experienced reduced VEGF levels in the tumor as a result of treatment with cannabinoids.

The researchers said that the results were encouraging. In order to be sure about their findings they need to carry out a larger study, they said.

Dr Guzm�n said "The present findings provide a novel pharmacological target for cannabinoid-based therapies."

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Allergic reactions to food. What types of allergic reactions are there?

The substance in a food that can cause an allergic reaction in certain people is called an allergen. There is generally more than one kind of allergen in each food.

Most allergic reactions to food are mild but a small proportion of people with a food allergy can have severe reactions. The symptoms of food allergy can affect almost any part of the body, including the skin, the heart, and the respiratory and gastrointestinal systems.

Symptoms can appear within minutes, or up to several hours after the person has eaten the food they are allergic to. They can include:

-- rashes (usually very itchy)
-- tingling sensation in the mouth
-- swelling of the lips, tongue, face and throat
-- difficulty breathing
-- diarrhoea
-- vomiting
-- abdominal cramps

On rare occasions, food allergy can also cause a rapid drop in blood pressure and loss of consciousness. These symptoms are usually linked to a life-threatening form of allergy known as anaphylaxis (pronounced anna-fill-axis). Anaphylaxis, sometimes called anaphylactic shock, can be fatal if not treated immediately, usually with an injection of epinephrine (adrenaline).

When someone has an anaphylactic reaction, they can have symptoms in different parts of the body at the same time, causing rashes, swelling of the lips and throat, difficulty breathing and a rapid fall in blood pressure.

The first symptoms of anaphylaxis can develop within minutes and severe breathing difficulties can develop up to several hours after eating the food. Many anaphylactic reactions can be misleadingly mild at first, so it's better to be cautious and not underestimate the danger. People with asthma are more likely to have a severe reaction affecting the lungs.

Anaphylaxis can also be caused by other things, such as bee and wasp stings, and drug allergy, but food allergy is one of the most common causes. Peanuts, milk, eggs and fish are the most common foods to cause anaphylaxis in the UK and Europe. Nuts, sesame seeds and shellfish can also cause it.

Generally, the symptoms of food allergy are more severe than other types of food intolerance. When someone has a food allergy, a tiny amount of the problem food can cause a reaction, but usually the symptoms of other types of food intolerance are caused by larger amounts. Often the symptoms of food intolerance start some time after eating the food, which can make the condition difficult to diagnose.

ORAL ALLERGY SYNDROME

Certain foods, particularly fruit and vegetables, can cause reactions such as itching or rashes when they touch the lips and mouth. This is called oral allergy syndrome and is a symptom of food allergy. These reactions usually happen in people who are sensitive to pollen, for example pollens from birch, grass, or plants in the daisy family such as ragweed and mugwort. This is because the protein in these pollens, which certain people react to, is also found in some fruit and vegetables.

For example, a person who is sensitive to ragweed pollen may develop rashes on the lips when they eat melon, and someone who is sensitive to birch tree pollen may react to apples. Cooking often destroys the allergens that cause this kind of reaction in fresh fruit and vegetables so, for example, people who react to raw apples might be able to eat cooked apples.

EXERCISE-INDUCED FOOD ALLERGY

This is when someone has an allergic reaction to a particular food when they eat it just before they exercise. People who are sensitive in this way may normally be able to eat the food with only a mild reaction, or no reaction at all, but they can have a severe reaction (including anaphylaxis) if they eat it just before they exercise.

ALLERGIC CROSS-REACTION

Sometimes, if someone has an allergy to one thing they will also react to other things. This can happen because different foods (or substances) contain either the same allergen or an allergen with a similar structure. This means different foods can cause similar allergic reactions, which is known as allergic cross-reaction.

Allergic cross-reaction means that someone could suffer an allergic reaction even when they're avoiding the foods they know they're allergic to. For example, if someone is allergic to peanuts, they might also react to other legumes such as soya, peas, lentils and beans. Allergic cross-reactions can also happen between certain fruit or vegetables and latex (known as latex-food syndrome), or the pollens that cause hayfever. Only some people who have food allergies will experience allergic cross-reaction.

Some food allergies can also be linked because of what is known as an 'associated reactivity'. This means that although the substances don't contain the same allergen, it's quite common for people who are allergic to one substance also to react to another substance. For example, people with peanut allergy are often allergic to nuts or eggs too. And people who are allergic to soya might also be sensitive to milk.

Continue to Read more ...

How many types of cancers are there?

The other day someone asked me how many types of cancers there are. As you can see below, there are hundreds:

Acute Lymphoblastic Leukemia, Adult
Acute Lymphoblastic Leukemia, Childhood
Acute Myeloid Leukemia, Adult
Acute Myeloid Leukemia, Childhood
Adrenocortical Carcinoma
Adrenocortical Carcinoma, Childhood
AIDS-Related Cancers
AIDS-Related Lymphoma
Anal Cancer
Astrocytoma, Childhood Cerebellar
Astrocytoma, Childhood Cerebral
Bile Duct Cancer, Extrahepatic
Bladder Cancer
Bladder Cancer, Childhood
Bone Cancer, Osteosarcoma/Malignant Fibrous Histiocytoma
Brain Stem Glioma, Childhood
Brain Tumor, Adult
Brain Tumor, Brain Stem Glioma, Childhood
Brain Tumor, Cerebellar Astrocytoma, Childhood
Brain Tumor, Cerebral Astrocytoma/Malignant Glioma, Childhood
Brain Tumor, Ependymoma, Childhood
Brain Tumor, Medulloblastoma, Childhood
Brain Tumor, Supratentorial Primitive Neuroectodermal Tumors, Childhood
Brain Tumor, Visual Pathway and Hypothalamic Glioma, Childhood
Brain Tumor, Childhood (Other)
Breast Cancer
Breast Cancer and Pregnancy
Breast Cancer, Childhood
Breast Cancer, Male
Bronchial Adenomas/Carcinoids, Childhood
Carcinoid Tumor, Childhood
Carcinoid Tumor,Gastrointestinal
Carcinoma, Adrenocortical
Carcinoma, Islet Cell
Carcinoma of Unknown Primary
Central Nervous System Lymphoma, Primary
Cerebellar Astrocytoma, Childhood
Cerebral Astrocytoma/Malignant Glioma, Childhood
Cervical Cancer
Childhood Cancers
Chronic Lymphocytic Leukemia
Chronic Myelogenous Leukemia
Chronic Myeloproliferative Disorders
Clear Cell Sarcoma of Tendon Sheaths
Colon Cancer
Colorectal Cancer, Childhood
Cutaneous T-Cell Lymphoma
Endometrial Cancer
Ependymoma, Childhood
Epithelial Cancer, Ovarian
Esophageal Cancer
Esophageal Cancer, Childhood
Ewing's Family of Tumors
Extracranial Germ Cell Tumor, Childhood
Extragonadal Germ Cell Tumor
Extrahepatic Bile Duct Cancer
Eye Cancer, Intraocular Melanoma
Eye Cancer, Retinoblastoma
Gallbladder Cancer
Gastric (Stomach) Cancer
Gastric (Stomach) Cancer, Childhood
Gastrointestinal Carcinoid Tumor
Germ Cell Tumor, Extracranial, Childhood
Germ Cell Tumor, Extragonadal
Germ Cell Tumor, Ovarian
Gestational Trophoblastic Tumor
Glioma, Childhood Brain Stem
Glioma, Childhood Visual Pathway and Hypothalamic
Hairy Cell Leukemia
Head and Neck Cancer
Hepatocellular (Liver) Cancer, Adult (Primary)
Hepatocellular (Liver) Cancer, Childhood (Primary)
Hodgkin's Lymphoma, Adult
Hodgkin's Lymphoma, Childhood
Hodgkin's Lymphoma During Pregnancy
Hypopharyngeal Cancer
Hypothalamic and Visual Pathway Glioma, Childhood
Intraocular Melanoma
Islet Cell Carcinoma (Endocrine Pancreas)
Kaposi's Sarcoma
Kidney Cancer
Laryngeal Cancer
Laryngeal Cancer, Childhood
Leukemia , Acute Lymphoblastic, Adult
Leukemia, Acute Lymphoblastic, Childhood
Leukemia, Acute Myeloid, Adult
Leukemia, Acute Myeloid, Childhood
Leukemia, Chronic Lymphocytic
Leukemia, Chronic Myelogenous
Leukemia, Hairy Cell
Lip and Oral Cavity Cancer
Liver Cancer, Adult (Primary)
Liver Cancer, Childhood (Primary)
Lung Cancer, Non-Small Cell
Lung Cancer, Small Cell
Lymphoblastic Leukemia, Adult Acute
Lymphoblastic Leukemia, Childhood Acute
Lymphocytic Leukemia, Chronic
Lymphoma, AIDS-Related
Lymphoma, Central Nervous System (Primary)
Lymphoma, Cutaneous T-Cell
Lymphoma, Hodgkin's, Adult
Lymphoma, Hodgkin's, Childhood
Lymphoma, Hodgkin's During Pregnancy
Lymphoma, Non-Hodgkin's, Adult
Lymphoma, Non-Hodgkin's, Childhood
Non-Hodgkin's During Pregnancy
Lymphoma, Primary Central Nervous System
Macroglobulinemia, Waldenstr�m's
Male Breast Cancer
Malignant Mesothelioma, Adult
Malignant Mesothelioma, Childhood
Medulloblastoma, Childhood
Melanoma
Melanoma, Intraocular
Merkel Cell Carcinoma
Mesothelioma, Malignant
Metastatic Squamous Neck Cancer with Occult Primary
Multiple Endocrine Neoplasia Syndrome, Childhood
Multiple Myeloma/Plasma Cell Neoplasm
Mycosis Fungoides
Myelodysplastic Syndromes
Myelodysplastic/Myeloproliferative Diseases
Myelogenous Leukemia, Chronic
Myeloid Leukemia, Adult Acute
Myeloid Leukemia, Childhood Acute
Myeloma, Multiple
Myeloproliferative Disorders, Chronic
Nasal Cavity and Paranasal Sinus Cancer
Nasopharyngeal Cancer
Nasopharyngeal Cancer, Childhood
Neuroblastoma
Non-Hodgkin's Lymphoma, Adult
Non-Hodgkin's Lymphoma, Childhood
Non-Hodgkin's Lymphoma During Pregnancy
Non-Small Cell Lung Cancer
Oral Cancer, Childhood
Oral Cavity and Lip Cancer
Oropharyngeal Cancer
Osteosarcoma/Malignant Fibrous Histiocytoma of Bone
Ovarian Cancer, Childhood
Ovarian Epithelial Cancer
Ovarian Germ Cell Tumor
Ovarian Low Malignant Potential Tumor
Pancreatic Cancer
Pancreatic Cancer, Childhood
Pancreatic Cancer, Islet Cell
Paranasal Sinus and Nasal Cavity Cancer
Parathyroid Cancer
Penile Cancer
Pheochromocytoma
Pineal and Supratentorial Primitive Neuroectodermal Tumors, Childhood
Pituitary Tumor
Plasma Cell Neoplasm/Multiple Myeloma
Pleuropulmonary Blastoma
Pregnancy and Breast Cancer
Pregnancy and Hodgkin's Lymphoma
Pregnancy and Non-Hodgkin's Lymphoma
Primary Central Nervous System Lymphoma
Primary Liver Cancer, Adult
Primary Liver Cancer, Childhood
Prostate Cancer
Rectal Cancer
Renal Cell (Kidney) Cancer
Renal Cell Cancer, Childhood
Renal Pelvis and Ureter, Transitional Cell Cancer
Retinoblastoma
Rhabdomyosarcoma, Childhood
Salivary Gland Cancer
Salivary Gland Cancer, Childhood
Sarcoma, Ewing's Family of Tumors
Sarcoma, Kaposi's
Sarcoma (Osteosarcoma)/Malignant Fibrous Histiocytoma of Bone
Sarcoma, Rhabdomyosarcoma, Childhood
Sarcoma, Soft Tissue, Adult
Sarcoma, Soft Tissue, Childhood
Sezary Syndrome
Skin Cancer
Skin Cancer, Childhood
Skin Cancer (Melanoma)
Skin Carcinoma, Merkel Cell
Small Cell Lung Cancer
Small Intestine Cancer
Soft Tissue Sarcoma, Adult
Soft Tissue Sarcoma, Childhood
Squamous Neck Cancer with Occult Primary, Metastatic
Stomach (Gastric) Cancer
Stomach (Gastric) Cancer, Childhood
Supratentorial Primitive Neuroectodermal Tumors, Childhood
T-Cell Lymphoma, Cutaneous
Testicular Cancer
Thymoma, Childhood
Thymoma and Thymic Carcinoma Thyroid Cancer
Thyroid Cancer, Childhood
Transitional Cell Cancer of the Renal Pelvis and Ureter
Trophoblastic Tumor, Gestational
Unknown Primary Site, Carcinoma of, Adult
Unknown Primary Site, Cancer of, Childhood
Unusual Cancers of Childhood
Ureter and Renal Pelvis, Transitional Cell Cancer
Urethral Cancer
Uterine Cancer, Endometrial
Uterine Sarcoma
Vaginal Cancer
Visual Pathway and Hypothalamic Glioma, Childhood
Vulvar Cancer
Waldenstrom's Macroglobulinemia
Wilms' Tumor

Source: http://www.cancer.gov

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Yoga. How does yoga work? What kind of class should I choose?

If you want to try a trendy exercise these days, why not have a go at yoga. You will be in the company of host of celebrity converts who may be seen curling up in pretzel-like positions - Madonna, Sting, and Geri Halliwell leading the ranks. Yoga has experienced such a surge in popularity that certain classes are now so crammed with mats that it can be hard to do a basic sun salutation without head-butting a fellow practitioner.

Unlike many celebrity fads, yoga could hardly be described as being flash-in-the-pan fashion. It's been around for thousands of years - the discipline is mentioned in the 3000-year-old Vedic texts - the most ancient written record of Indian culture, and has been flourishing as a fully fledged discipline since around 500BC. It is still highly regarded as a science in the country of its origin, and there is even a 'yoga university,' Bihar Yoga Bharati, in Munger, India.

While a belief in the power of yoga is not so widespread in the West, there is no doubt that people turn to the discipline for a number of reasons; to reduce stress, avoid illness - and sometimes just to get a flatter stomach.

How does yoga work?

Yoga is taken from the Sanskrit word 'yuga' to join. It aims for the perfect union of body, mind, and spirit, through a system of postures, breath control, sounds, meditation, and other practices.

Yoga classes are often longer than other exercise classes, and typically last between one and three hours. During your session, your teacher will guide you through a series of moves. Many of the positions that you will learn in yoga have simple names, such as the Cat, the Plank, the Warrior. In comparison to other exercise classes that you may have tried, yoga is based on precision and exact alignment, and you may spend a great deal of time perfecting positions.

Some yoga teachers will use other terminology during lessons, and your first sessions may seem awash with terms such as pranayama, pratyahara and asana. Try not to be put off by this, because mastering 'yoga speak' is not central to good practice.

One of the really beneficial aspects of yoga is that many forms are suitable for almost everyone. The discipline is practised by people of all ages - there are even mother-and-baby classes available. It is very non-competitive, so it can be an excellent way to get back into exercise if you feel intimidated by the thought of high-energy aerobics classes.

What kind of class should I choose?

There are numerous types of yoga, but you'll find some keywords and styles are mentioned more frequently than others. There may well be variations between classes that are branded as having the same style - but some understanding of terms is helpful. No type of yoga is inherently 'harder' than the rest; just check how experienced your class is before you join in.

-- Hatha yoga - 'Hatha' is a blanket term for the 'physical' element of yoga within the discipline as a whole. It covers nearly all types of yoga, but if your class is actually called 'Hatha Yoga,' you can generally expect a balanced, moderate intensity session. During a class you'll do posture and breathing exercises.

-- Iyengar yoga - This branch of Hatha yoga style focuses on understanding the body and how it works. Students focus on symmetry and alignment, sometimes using props - such as straps, wooden blocks, and chairs - to achieve postures. Each pose is held for a longer amount of time than in most other yoga styles.

-- Astanga yoga - If you want a physically demanding workout, Astanga yoga offers a fast-paced series of sequential poses beginning with sun salutations. Students move from one posture to another in a continual flow and link movements from breath to breath. This physically demanding yoga was developed to build strength, flexibility, and stamina. It often helps to be reasonably fit before you start a class.

What are the health benefits of yoga?

The primary benefit of yoga is an increase in suppleness. Yoga aims to increase the flexibility of your muscles and tendons, which will decrease your chance of injury in other sports. However, apart from astanga yoga, where you leap from pose to pose in a flowing movement, yoga does not increase aerobic fitness, so you are best to combine your sessions with exercise that gets you out of breath, such as brisk walking or jogging.

Because yoga is a 'whole body exercise,' there are few people who pursue yoga purely to increase fitness. The emphasis on controlled breathing and meditation means that stress reduction is a principal reason why people take up this exercise. While it is debatable whether meditation per se is qualitatively different from other forms of deep relaxation, how many of us do actually take time out to relax properly? If you live on the hectic side of life, then taking regular time out to practice yoga may be very helpful.

Does yoga have medical benefits?

Yogis claim that yogic practices can be tailored to help treat specific mental and physical disorders. According to the UK charity Yoga For Health Foundation (YHF), many people use yoga to alleviate problems presented by many chronic illnesses.

Although there is little scientific evidence supporting the efficacy of yoga for specific medical conditions, it is likely - at the very least - improve your general wellbeing and is unlikely to do any harm.

Of course, yoga should never replace conventional medicine and you should talk to your doctor before taking up yoga if you have a serious medical condition.

Yoga will never be everybody's cup of herbal tea, but it is an excellent form of exercise that has been around for millennia for a number of good reasons. Don't expect it to be a panacea - but with regular practice it will improve your flexibility and general wellbeing.

Further information:

British Wheel of Yoga Central charity supporting yoga in the UK. Good source of events and classes

http://www.yoga.co.uk : list of yoga teachers and classes across the UK

http://www.bupa.co.uk

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What Is The World's Smelliest Cheese? Vieux Boulogne

Vieux Boulogne, a soft, yet firm French cheese made from cow's milk and matured by washing with beer, tops a list of the smelliest cheeses reveals scientists today. The artisan-made cheese was tested for its smell along with other known pungent cheeses by Cranfield University on behalf of Fine Cheeses from France.

"Love it or loathe it, the sign of a fine cheese is often its characteristic smell as well as its flavour and texture and we wanted to find out if France's reputation for producing smelly cheeses was true," said Sally Clarke from Fine Cheeses from France.

Dr Stephen White, senior research officer Cranfield University led the study by using an electronic nose as well as a human olfactory panel to sniff out those with the strongest scent.

Fifteen cheeses were selected with the help of cheese experts in France and the UK and put through the smelly stakes. Dr Stephen White said: "The results suggest that electronic nose technology could be a useful tool for cheese characterisation, quality control and authenticity testing in the future. The smelliest cheeses were washed rind cheeses. There was no obvious correlation between the age of the selected cheeses and smelliness, nor type of milk origin, although cows' milk cheeses did dominate the smell chart."

Cheeses whose rinds are washed (in a salt water solution, beer or brandy) were rated smelliest. Tops was Vieux Boulogne followed by Pont l'Eveque - both washed rind cheeses, produced from the milk of cows raised on the lush, coastal pastures of Normandy.

Camembert de Normandie, the most widely imitated cheese in the world, was rated third. It has a natural rind and is best known for its creamy texture and mushroomy aroma. Hard cheeses were found to be least smelly of all. Goat's cheese, English Farmhouse Cheddar, Ossau Iraty, Raclette and Parmesan took the bottom five places in the smell league.

Pungent smelling cheeses are becoming more popular in the UK - Epoisses de Bourgogne (probably the most pungent smelling cheese that is widely available here) is now sold in Sainsbury's, Tesco and Waitrose, but in this study it was found to be less pungent than other speciality rind washed cheeses such as Livarot.

The World's Smelliest Cheeses

In order - Most smelly first

-- Vieux Boulogne - Cow's milk cheese from Boulogne sur Mer, Pas de Calais, aged 7-9 weeks, rind is washed with beer

-- Pont l'Eveque AOC - Cow's milk cheese from Normandy, aged 6 weeks, rind is washed with brine

-- Camembert de Normandie AOC - Cow's milk cheese from Normandy, min age 21 days, soft, bloomy rind

-- Munster - Cow's milk cheese from Alsace Lorraine, N E France, aged 3 weeks, rind is washed with brine

-- Brie de Meaux AOC - Cow's milk cheese from Ile de France, outside Paris, aged 4-8 weeks, soft, bloomy rind

-- Roquefort AOC - Sheep's milk cheese from Roquefort, near Toulouse, aged 3 months, blue mould cheese

-- Reblochon AOC - Cow's milk cheese from Savoie region in France, aged 3-4 weeks

-- Livarot AOC - Cow's milk cheese from Normandy, aged 90 days, rind is washed with brine

-- Banon AOC - Goat's milk cheese from Provence region, aged 1-2 weeks and wrapped in chestnut leaves

-- Epoisses de Bourgogne AOC - Cow's milk cheese from Burgundy, aged 4-6 weeks, rind is washed with brandy (Marc de Bourgogne)

-- Parmesan - Cow's milk cheese from Italy, aged 2 years

-- Raclette - Cow's milk cheese from French Alps, aged 2 months

-- Ossau Iraty AOC - Sheep's milk cheese from Basque region in S France, aged 3 months

-- Cheddar - Cow's milk cheese made across the UK, aged 6-24 months

Least Smelly Cheese

-- Crottin de Chavignol AOC - Goat's milk cheese from Chavignol near to Sancerre in the Centre region of France, aged for minimum of 10 up to 6 months. The test sample was aged 4-6 weeks old.

Patricia Michelson, owner of La Fromagerie cheese shops in London said: "The group of washed rind cheeses, originating in northern France have a reputation for their strong smell which results from the milk enzymes reacting to the brine or alcoholic solution which is brushed onto their surface during the cheese making process.

"Vieux Boulogne is a young, modern cheese with a surprisingly mellow and gentle taste that's perfect served with some crusty bread and a beer. It's a great cheese to try, as it doesn't have the earthy, farmyardy flavours that some people find overpowering."

Sally Clarke said: "France has a huge selection of weird and wonderful whiffy cheeses and their smell often disguises a delicate, subtle flavour that has to be tried to be believed. So, we're encouraging British shoppers to be a little more daring with their Christmas cheeseboard by choosing one of the cheeses from our smell study."

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All about mumps. How long does it last? What are the symptoms and complications?

HOW LONG DOES MUMPS LASTS

If you catch mumps, you will probably be ill for 7 - 10 days.

THE SYMPTOMS

Mumps will make you feel generally unwell, and 60-70% of those infected will develop symptoms such as:

-- Painful and swollen glands in the cheeks, neck or under the jaw

-- Fever

-- Headache

-- Abdominal pain

-- Loss of appetite

SERIOUS COMPLICATIONS

Although most people will get over mumps without too many problems, a significant number will go on to develop serious complications.

The numbers in the brackets indicate how common each complication is, based on reports of past cases of the disease:

-- in older males, swollen, painful testicles (1 in 5)

-- central nervous system involvement is common - meningitis/encephalitis (1 in 200-5,000)

-- pancreatitis (1 in 30)

-- deafness - usually with partial or complete recovery (1 in 25)

-- mumps during pregnancy can lead to spontaneous abortion.

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What does tsunami mean? What is a tsunami? How do they differ from other waves?

A tsunami (pronounced tsoo-nah-mee) is a wave train, or series of waves, generated in a body of water by an impulsive disturbance that vertically displaces the water column. Earthquakes, landslides, volcanic eruptions, explosions, and even the impact of cosmic bodies, such as meteorites, can generate tsunamis. Tsunamis can savagely attack coastlines, causing devastating property damage and loss of life.

What does "tsunami" mean?

Tsunami is a Japanese word with the English translation, "harbor wave." Represented by two characters, the top character, "tsu," means harbor, while the bottom character, "nami," means "wave." In the past, tsunamis were sometimes referred to as "tidal waves" by the general public, and as "seismic sea waves" by the scientific community. The term "tidal wave" is a misnomer; although a tsunami's impact upon a coastline is dependent upon the tidal level at the time a tsunami strikes, tsunamis are unrelated to the tides. Tides result from the imbalanced, extraterrestrial, gravitational influences of the moon, sun, and planets. The term "seismic sea wave" is also misleading. "Seismic" implies an earthquake-related generation mechanism, but a tsunami can also be caused by a nonseismic event, such as a landslide or meteorite impact.

How do tsunamis differ from other water waves?

Tsunamis are unlike wind-generated waves, which many of us may have observed on a local lake or at a coastal beach, in that they are characterized as shallow-water waves, with long periods and wave lengths. The wind-generated swell one sees at a California beach, for example, spawned by a storm out in the Pacific and rhythmically rolling in, one wave after another, might have a period of about 10 seconds and a wave length of 150 m. A tsunami, on the other hand, can have a wavelength in excess of 100 km and period on the order of one hour.

As a result of their long wave lengths, tsunamis behave as shallow-water waves. A wave becomes a shallow-water wave when the ratio between the water depth and its wave length gets very small. Shallow-water waves move at a speed that is equal to the square root of the product of the acceleration of gravity (9.8 m/s/s) and the water depth - let's see what this implies: In the Pacific Ocean, where the typical water depth is about 4000 m, a tsunami travels at about 200 m/s, or over 700 km/hr. Because the rate at which a wave loses its energy is inversely related to its wave length, tsunamis not only propagate at high speeds, they can also travel great, transoceanic distances with limited energy losses.

This animation (2.3 MB), produced by Professor Nobuo Shuto of the Disaster Control Research Center, Tohoku University, Japan, shows the propagation of the earthquake-generated 1960 Chilean tsunami across the Pacific. Note the vastness of the area across which the tsunami travels - Japan, which is over 17,000 km away from the tsunami's source off the coast of Chile, lost 200 lives to this tsunami. Also note how the wave crests bend as the tsunami travels - this is called refraction. Wave refraction is caused by segments of the wave moving at different speeds as the water depth along the crest varies. Please note that the vertical scale has been exagaerated in this animation - tsunamis are only about a meter high at the most in the open ocean. (The QuickTime movie presented here was digitized from a video tape produced from the original computer-generated animation.)

How do earthquakes generate tsunamis?

Tsunamis can be generated when the sea floor abruptly deforms and vertically displaces the overlying water. Tectonic earthquakes are a particular kind of earthquake that are associated with the earth's crustal deformation; when these earthquakes occur beneath the sea, the water above the deformed area is displaced from its equilibrium position. Waves are formed as the displaced water mass, which acts under the influence of gravity, attempts to regain its equilibrium. When large areas of the sea floor elevate or subside, a tsunami can be created.

Large vertical movements of the earth's crust can occur at plate boundaries. Plates interact along these boundaries called faults. Around the margins of the Pacific Ocean, for example, denser oceanic plates slip under continental plates in a process known as subduction. Subduction earthquakes are particularly effective in generating tsunamis.

This simulation (2 MB) of the 1993 Hokkaido earthquake-generated tsunami, developed by Takeyuki Takahashi of the Disaster Control Research Center, Tohoku University, Japan, shows the initial water-surface profile over the source area and the subsequent wave propagation away from the source. Areas in blue represent a water surface that is lower than the mean water level, while areas in red represent an elevated water surface. The initial water-surface profile, as shown in this image, reflects a large, long uplifted area of the sea floor lying to the west (left) of Okushiri Island, with a much smaller subsided area immediately adjacent to the southwest corner of Okushiri.

What happens to a tsunami as it approaches land?

As a tsunami leaves the deep water of the open ocean and travels into the shallower water near the coast, it transforms. If you read the "How do tsunamis differ from other water waves?" section, you discovered that a tsunami travels at a speed that is related to the water depth - hence, as the water depth decreases, the tsunami slows. The tsunami's energy flux, which is dependent on both its wave speed and wave height, remains nearly constant. Consequently, as the tsunami's speed diminishes as it travels into shallower water, its height grows. Because of this shoaling effect, a tsunami, imperceptible at sea, may grow to be several meters or more in height near the coast. When it finally reaches the coast, a tsunami may appear as a rapidly rising or falling tide, a series of breaking waves, or even a bore.

What happens when a tsunami encounters land?

As a tsunami approaches shore, we've learned in the "What happens to a tsunami as it approaches land?" section that it begins to slow and grow in height. Just like other water waves, tsunamis begin to lose energy as they rush onshore - part of the wave energy is reflected offshore, while the shoreward-propagating wave energy is dissipated through bottom friction and turbulence. Despite these losses, tsunamis still reach the coast with tremendous amounts of energy. Tsunamis have great erosional potential, stripping beaches of sand that may have taken years to accumulate and undermining trees and other coastal vegetation. Capable of inundating, or flooding, hundreds of meters inland past the typical high-water level, the fast-moving water associated with the inundating tsunami can crush homes and other coastal structures. Tsunamis may reach a maximum vertical height onshore above sea level, often called a runup height, of 10, 20, and even 30 meters.

This numerical simulation (2.6 MB), produced by Professor Nobuo Shuto of the Disaster Control Research Center, Tohoku University, Japan, shows the 1923 Kanto tsunami attacking a Japanese village. A longer version (6.2 MB) of the this animation is also available. Note that the structures in this model are rigid - in a real-life tsunami, coastal structures often are destroyed. (The QuickTime movie presented here was digitized from a video tape produced from the original computer-generated animation.)
http://www.geophys.washington.edu/tsunami/intro.html  

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Erectile dysfunction drug Cialis (tadalafil) does well in US market

After only six months, Cialis� (tadalafil)1, the latest oral erectile dysfunction (ED) treatment on the market in the U.S., is challenging Viagra� (sildenafil citrate)2for share of the ED market as Cialis leads in new treatment initiations by urologists3 and switches from other products for April. Cialis is marketed by Lilly ICOS LLC, a joint venture between Eli Lilly and Company (NYSE: LLY) and ICOS Corporation (Nasdaq: ICOS). Cialis is the only ED treatment shown to improve erectile function up to 36 hours in most men. Cialis can be taken without regard to food.

Cialis Leads in New Treatment Initiations

According to market research firm ImpactRx� (which tracks the habits of a panel of high prescribing physicians and may reflect emerging trends in doctors' offices today)4, U.S. urologists initiated treatment with Cialis in April at a rate of more than two-to-one over each of the other oral ED treatments. In fact, Cialis represented 56 percent of new treatment initiations by urologists in April, compared to 21 percent for Levitra (vardenafil HCl)5 and 23 percent for Viagra.6

Based on data from IMS, another source of market information, in April, Cialis represented 30 percent of new ED treatment prescriptions written by urologists, compared to 16 percent for Levitra and 54 percent for Viagra.7

Cialis Leads in Switches

In April, nearly two thirds of all men who switched their oral ED treatment switched to Cialis. Following is information from ImpactRx� on share of new prescriptions written in April by doctors changing their patients' ED treatment from product to another.

CIALIS
Primary Care Physicians 60% Urologists 69%

LEVITRA
Primary Care Physicians 36% Urologists 26%

VIAGRA
Primary Care Physicians 4% Urologists 5%

In an independent clinical study, more men selected Cialis as their preferred treatment of choice after trying different oral ED medications, primarily because of how long the drug worked.8 This may explain why many men with ED who are on oral treatment are switching to Cialis.

Cialis Challenges Viagra

The percentages of new prescriptions written by all doctors for oral ED treatments in April broke out as follows: Cialis, 19 percent; Levitra, 14 percent; and Viagra, 67 percent.9 "The early success of Cialis in the U.S. is similar to the trend we saw when it first became available in other countries. Cialis has claimed market shares of 19 percent to 39 percent across Europe, and even higher in some other markets," said Leonard Blum, vice president of marketing, ICOS Corporation. In the first quarter of 2004, Cialis achieved $108 million in global sales. More than two million men around the world have been treated with Cialis since its first introduction globally last year.

"For us, the number of Cialis prescriptions written by urologists is one of the most important indicators of future trends. Urologists are the experts in treating ED. We expected that urologists would be the quickest adopters of Cialis, and the data suggest that these specialists, like their peers overseas, are making Cialis their preferred treatment," said Blum.

Benefits of Cialis

Cialis is changing the way doctors and patients think about treating ED by offering two important benefits: a 36-hour window of opportunity for intimacy and the ability to take the tablet on an empty stomach or with a meal, without concern that high-fat food will reduce the absorption of the medicine.

"What the marketplace tells us is that men and their partners are truly taking advantage of the benefits of Cialis," said Matt Beebe, U.S. brand team leader for Cialis, Lilly ICOS LLC. "Men can take Cialis Friday evening and choose the moment for romance as late as Sunday morning. Because Cialis works for up to 36 hours, it allows a man and his partner to relax, forget about planning intimacy and let it happen when the moment is right for them."

About Cialis

Cialis, approved by the FDA in November 2003 for the treatment of erectile dysfunction, is the only oral ED treatment shown to improve erectile function up to 36 hours in most men. Cialis can be taken without regard to food. The absorption of Cialis is not reduced by food, including high-fat foods. Cialis is currently available in more than 60 countries, including Australia, Brazil, Mexico, Canada, the United States and countries throughout Europe. More than two million patients worldwide have been treated with Cialis since its first introduction in February 2003.

Cialis is available by prescription only and is not for everyone. Men taking nitrates, often used for chest pain, or certain alpha-blockers for prostate problems or high blood pressure, should not take Cialis. Such combinations could cause a sudden, unsafe drop in blood pressure.

Men should discuss their health status with their doctors to ensure Cialis is right for them and that they are healthy enough for sexual activity.

The most common side effects with Cialis were headache, upset stomach, delayed backache and muscle ache. Although rare, men who experience an erection for more than four hours should seek immediate medical attention. Men should not drink alcohol in excess with Cialis. Cialis studies were not designed to assess multiple intercourse attempts after a single dose.

For full patient information, visit www.cialis.com.

About ED

ED is defined as the consistent inability to attain and maintain an erection sufficient for sexual intercourse. ED affects an estimated 152 million men and their partners worldwide.10 Experts believe that 80 - 90 percent of ED cases are related to a physical or medical condition, like diabetes, cardiovascular diseases, and prostate cancer treatment, while 10 - 20 percent are due to psychological causes.11,12 In many cases, however, both psychological and physiological factors contribute to the condition.13

About Lilly ICOS LLC

Lilly ICOS LLC, a joint venture between ICOS Corporation and Eli Lilly and Company, developed tadalafil for the treatment of erectile dysfunction.

Lilly, a leading innovation-driven corporation is developing a growing portfolio of first-in-class and best-in-class pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers - through medicines and information - for some of the world's most urgent medical needs. Additional information about Lilly is available at www.lilly.com.

ICOS Corporation, a biotechnology company, is dedicated to bringing innovative therapeutics to patients. Headquartered in Bothell, Wash., ICOS is marketing its first product, Cialis (tadalafil), for the treatment of erectile dysfunction. ICOS is working to develop treatments for serious unmet medical conditions such as chronic obstructive pulmonary disease, cancer and inflammatory diseases.

B-roll is available via satellite, C-band feed:
WEDNESDAY, JUNE 2, 10:30 - 11:00 AM EDT C-Band, IA 6, Tr. 21, DL 4120
WEDNESDAY, JUNE 2, 13:15 - 13:45 PM EDT C-Band, IA 5, Tr. 23, DL 4160
THURSDAY, JUNE 3, 13:00 - 13:30 PM EDT C-Band, IA 5, Tr. 14, DL 3980
Except for historical information contained herein, this press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements are based on current expectations, estimates and projections about the industry, management beliefs and certain assumptions made by the management of ICOS and Lilly. Investors are cautioned that matters subject to forward-looking statements involve risks and uncertainties, including economic, competitive, governmental, technological, legal and other factors discussed in the two companies' respective filings with the Securities and Exchange Commission, which may affect the business and prospects of the two companies and Lilly ICOS. Results and the timing and outcome of events may differ materially from those expressed or implied by the forward-looking statements in this press release. More specifically, there can be no assurance that Cialis will achieve commercial success or that competing products will not pre-empt market opportunities that might exist for the product.

References

1. Cialis� is a registered trademark of Lilly ICOS LLC. All other trademarks are the property of their respective owners.
2. Viagra� is a registered trademark of Pfizer, Inc.
3. The term "new treatment initiations" indicates when a physician writes out a new prescription for patients never before treated, and for patients switching from one product to another. This does not include prescriptions conveyed to pharmacies by phone or refills of existing prescriptions. In this release, new treatment initiations describes data from ImpactRx only.
4. ImpactRx� has a panel of high prescribing physicians that recorded information on patient visits (patient identity is non-identifiable), including diagnosis and treatment. ImpactRx data includes new prescriptions written and refills but not prescriptions conveyed by phone. ImpactRx records information from the physician perspective and not what happens at the pharmacy.
5. Levitra� is a registered trademark of Bayer/GSK.
6. ImpactRx, "PromoLink," April 2004.
7. Computed from IMS NPA Plus�, April 2004. IMS numbers vary from those of ImpactRx primarily because IMS data represent aggregated pharmacy sales, reflecting what is filled at the pharmacy including new prescriptions for continuing users and prescriptions called in by phone.
8. "The Three PDE 5 Inhibitors Sildenafil, Tadalafil And Vardenafil - Results Of A Comparative Preference Trial In 222 Patients With Erectile Dysfunction," Hartmut Porst, et. al., presented in poster session at American Urological Association Annual Meeting, May 2004.
9. Computed from IMS NPA PlusTM, April 2004.
10. Aytac Ia, McKinlay JB, Krane RJ. The Likely Worldwide Increase in Erectile Dysfunction Between 1995 and 2025 and Some Possible Policy Consequences. BJU Int 1999; 84: 50-56.
11. Shabsigh, R. (2002). Back To Great Sex: Overcome ED and Reclaim Lost Intimacy. New York: Kensington.
12. Diseases and Conditions: Impotence, http://www.impotence.org/FAQ/index.asp . Data accessed 11.20.03
13. Lue, Tom F. Erectile Dysfunction. N Engl J Med 2000; 342: 1802-1813

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