Life-Changing Effects Of A Heart Attack, Study

A new survey reveals a majority of heart attack survivors characterize their attack as a life-altering "wake-up call," giving them renewed priorities and a second chance at life. However, many of those surveyed also say their heart attack left them with feelings of depression, hopelessness or fear. In fact, the survey showed that heart attack survivors are more likely to fear having another attack than death. Surprisingly, the survey also showed that while an overwhelming majority acknowledge their increased risk for another attack, 40 percent admit they are not doing everything they can to avoid one.

"I was particularly surprised that those surveyed indicated they fear another heart attack more than death and that a substantial number of people admitted they are not doing everything they can to avoid that fear from being realized," said Gus Littlefield, national board member of Mended Hearts, a nationwide heart patient support group affiliated with the American Heart Association. "The likelihood is far too high that heart attack survivors will suffer another attack within a few years. My hope is that through the ongoing efforts of Mended Hearts and some new tools, we can educate people on how to prevent a heart attack and motivate them to take action."

In the survey, 80 percent of heart attack survivors said they needed more information to manage their heart health. In order to provide patients with this critical information, Mended Hearts today announced the launch of "Heartfelt Wake-Up Call," a multi-phased initiative to provide education, tools and support to heart attack survivors and their families. "We hope that this new initiative will empower patients and their loved ones to take an active role in preventing a future heart attack and illustrate that heart attacks, while devastating at the time, can lead to positive life changes," said Littlefield.

Mended Hearts commissioned the survey of heart attack survivors, conducted by Harris Interactive� and funded by GlaxoSmithKline, to explore the impact of a heart attack on survivors and assess education and support needs. Based on the findings, Mended Hearts has developed practical tips for "Heartfelt Living" and "Heartfelt Support." To better support heart attack survivors and their caregivers in coping with life after a heart attack, additional information including tips sheets, survivor stories and heart-healthy holiday recipes is available on http://www.mendedhearts.org.

Heart Attack Survivors Speak Out The survey of 518 survivors also tapped into other emotional impacts of a heart attack. An overwhelming majority of those surveyed indicated their heart attack forced them to face their own mortality (90 percent). A majority of heart attack survivors say they reevaluated their priorities in life (55 percent) and ultimately believe they have been given a second chance at life (85 percent).


"My heart attack was certainly a wake-up call and one that changed the course of my life," said Frank Rella, a heart attack survivor, paramedic and author of Manhattan Medics. "I went from feeling fear for my future to finding a new sense of purpose. I changed my career path and became a paramedic so that I could help to save the lives of others, who hopefully will ultimately recognize their own wake-up call as a second chance to live a full and healthy life."

The survey also showed that in addition to acknowledging that they are at a higher risk for having another heart attack (88 percent), the majority of heart attack survivors also recognized an increased risk of developing a chronic condition such as heart failure (84 percent).

"I see these survey results come to life in my practice every day. While many of my patients who have suffered a heart attack are very aware and afraid of their increased risk of having another one, they are not doing everything they can to live a heart-healthy life," said Dr. William Abraham, director of the Division of Cardiovascular Medicine at The Ohio State University Medical Center. "I counsel and inform appropriate patients that with the right treatments, which for many include a beta-blocker, statin, ACE inhibitor and aspirin, healthy lifestyle choices and a good support system, they can help prevent a future cardiovascular event and live a full and active life."

Survey Reveals Gender Disparities

Not only did the survey show that both men and women view their heart attack as a "wake-up call," it also revealed key differences between the two groups in how they seek treatment and the emotional impact of a heart attack. Surprisingly, women (78 percent) were less likely to see their health care professional on a regular basis than men (92 percent), and men (86 percent) were more likely than women (72 percent) to get help with their treatment from someone else aside from their healthcare professional. These differences in how the two groups seek treatment may explain why more men (31 percent) than women (18 percent) feel strongly about knowing what they need to do to prevent a future heart attack.

About Heart Attacks

Each year in the U.S., nearly one million people suffer from heart attacks, known medically as myocardial infarction. Within only six years, nearly 20 percent of men and 35 percent of women will have another one and that risk is heightened in the winter months. A heart attack occurs when the blood supply to part of the heart muscle is severely reduced or blocked. This narrowing of the coronary vessels is often linked with risk factors such as smoking, diabetes, high blood pressure, high blood cholesterol, physical inactivity and obesity. There also may be risk factors associated with family history.

About Mended Hearts

Mended Hearts is a community-based, nationwide heart patient support group founded more than 50 years ago and affiliated with the American Heart Association. More than 21,000 members operate through 280 local chapters across the United States with two in Canada. Recognized for its role in facilitating a positive patient-care experience, Mended Hearts partners with 450 hospitals and rehabilitation clinics to offer heart patient services through visiting programs, support group meetings and educational forums. Its mission is "dedicated to inspiring hope in heart disease patients and their families."

About the Survey

Harris Interactive� conducted this online survey on behalf of Mended Hearts between October 12 and October 20, 2005 among a nationwide cross-section of 518 U.S. adults aged 18 or older who have experienced a heart attack. Data were weighted to be representative of the total population of U.S. adults aged 18 or older who have been diagnosed with a heart attack. Weighting was based on age within gender, education, race/ethnicity, region, income and propensity to be online. In theory, with probability samples of this size, one can say with 95 percent certainty that the results have a sampling error of +/- 6.6 percentage points of what they would be if the entire population of U.S. adults aged 18 or older who have been diagnosed with a heart attack had been polled with complete accuracy. Sampling error for the men's (n=342) and women's (n=176) sub-samples is higher and varies. This online sample is not a probability sample.

About Harris Interactive�

Harris Interactive Inc. (www.harrisinteractive.com), based in Rochester, New York, is the 13th largest and the fastest-growing market research firm in the world, most widely known for The Harris Poll� and for its pioneering leadership in the online market research industry. Long recognized by its clients for delivering insights that enable confident business decisions, the Company blends the science of innovative research with the art of strategic consulting to deliver knowledge that leads to measurable and enduring value. Harris Interactive serves clients worldwide through its United States, Europe (harrisinteractive.com/europe) and Asia offices, its wholly-owned subsidiary Novatris in Paris, France (www.novatris.com), and through an independent global network of affiliate market research companies.

Mended Hearts wishes to thank GlaxoSmithKline for funding to support this initiative. GlaxoSmithKline, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.

Continue to Read more ...

Sperm Impacts: Environmental Factors, Lifestyle, and Medications Affect Male Fertility

Montreal, Quebec - Researchers at the conjoint meeting of the American Society for Reproductive Medicine and the Canadian Fertility and Andrology Society today presented their work on the way different lifestyle choices, environmental factors, and medications can affect male fertility.

Researchers from Yale University School of Medicine and the University of Connecticut reported results of their review of male infertility patients seen over a 10 year period who had a history of anabolic steroid abuse. They found that not all patients who have a history of anabolic steroid abuse are infertile and that, for many, fertility returns after steroid use ceases. This recovery may require hormonal treatment, but can also happen spontaneously. The researchers examined the records of 15 patients with a clear history of self-administered steroid use and an average age of 33. Eleven of the 15 had the low testosterone levels and low levels of FSH and lutenizing hormone expected for steroid abusers; four with normal hormone levels had other causes contributing to their infertility. Nine of the 11 were azoospermic; they did not have any sperm in their ejaculates, while two had low sperm counts. Seven of the nine azoospermic patients resumed sperm production after they ceased steroid use; five of these required hormonal treatment; the other two resumed spermatogenesis spontaneously. ***

Scientists in Sao Paulo, Brazil have found a correlation between urban levels of air pollution and a decrease in the male-female sex ratio at birth for mice and humans. Birth registries were consulted for the number of babies born between January 2001 and December 2003 in the areas monitored for pollution. In the least polluted areas 51.7% of the babies born were male; in the most polluted areas the percentage of males born decreased to 50.7%. In a corresponding experimental study using mice, male mice were housed for the first four months of their life in either a filtered air-chamber or were exposed to unfiltered ambient air. After four months both groups were mated with female mice that had not been exposed to pollution. Males from the filtered air environment produced offspring with a 1.34 male/female ratio, while males that had been exposed to polluted air produced offspring with a 0.86 male/female ratio. In addition, spermatogenesis in the mice exposed to air pollution was negatively affected.

At the University at Buffalo, in Buffalo, NY, researchers have demonstrated that chronic exposure to nicotine and tobacco smoke results in a significant loss in the fertilizing capacity of sperm. The researchers examined whether the sperm of chronic tobacco smokers was defective in binding ton the human zona pellucida (the outer membrane of the egg). The sperm from 18 men who had each smoked more than 4 cigarettes a day for two or more years (average 15.6 years) was compared to the sperm of screened research donors (controls) in the Hemizona Assay (HZA). In this test, non-viable donor oocytes were halved, then one half of each egg was incubated with a smoker's sperm, while the matching half was incubated with control sperm. After incubation, the egg halves were examined and the numbers of sperm tightly bound to the zona pellucida were counted and compared. Two thirds of the smokers failed the HZA; their fertilizing capacity was just 25% that of the donors. An index representing the relative amount of smoking that a subject had done in his life was calculated for each smoker by multiplying the number of cigarettes per day by number of years smoking. Of those with the lower index scores, 71% passed the HZA; only 18% of the heavier smokers passed. Michigan scientists investigated whether there was a connection between metal levels in the blood and semen parameters of men who ate fish caught in the Great Lakes. They analyzed data from 144 study participants who had submitted blood for testing levels of 12 metals, semen for analysis, and questionnaire detailing their fish consumption history. Men with a history of any fish consumption in the preceding 12 months showed high levels of mercury in their blood. But this was not restricted to consumers of Great Lakes fish; high mercury levels were even more strongly associated with consumption of ocean fish. However no association was found between sperm concentration or motility and any metal.

Researchers at the National Institute for Child Health and Human Development and Walter Reed Army Medical Center found that regular use of ibuprofen, a non-steroidal anti-inflammatory drug (NSAID) does not affect semen parameters and clinical pregnancy rates in assisted reproductive technology patients. In the past, experiments in mice and cattle have shown that NSAIDs decrease the production of prostoglandins, components of seminal fluid, without affecting sperm counts or motility. Patients having semen analyses at the clinic completed a survey including questions on use of medication- daily use was considered to be regular use. Sixty-eight (6.3%) of 1082 patients were regular users of ibuprofen. When their semen parameters, use of ICSI, and clinical pregnancy rates for ART were compared to intermittent and non-users of ibuprofen, no differences emerged.

In a prospective controlled study using sperm from normal donors and four brands of vaginal lubricants (Pre-Seed�, FemGlide�, Replens�, Astroglide�) often recommended to fertility patients, researchers found that one brand does not cause a significant decrease in sperm motility or damage to chromatin integrity, while the others do. In the first experiment for motility, donor sperm were incubated for 30 minutes in medium free of lubricant and in medium containing 10% vaginal lubricant. Sperm motility was measured after incubation and ranged from 66% in the lubricant-free control medium to 2% in medium containing Astroglide�. The best performing lubricant in this experiment was Pre-Seed� with 64% motile sperm after incubation. In the second experiment to gauge chromatin damage caused by the lubricants, donor sperm were incubated in lubricant-free medium as a positive control , in medium containing 10% KY� as a negative control and in medium containing one of two lubricants, Pre-Seed� and FemGlide� . After four hours incubation the sperm were evaluated for damage to their genetic material and graded in accordance with the DNA fragmentation index. Pre-Seed� demonstrated the smallest increase in chromatin damage with a 7% increase over the control.

Researchers from Reproductive Biology Associates in Atlanta report that a high body mass index (BMI) in men correlates with reduced testosterone levels. Patients' heights and weights were recorded on the day their blood was drawn to test for reproductive hormones. Patients' BMIs were calculated and they were grouped into the published ranges for normal, overweight, and obese. Average testosterone levels were calculated for each group and it was discovered that overweight men have levels 24% lower than men of normal weight and obese men have levels 26% lower. Men with high BMI typically are found to have an abnormal semen analysis as well.

Peter Schlegel, MD, President of the Society for Male Reproduction and Urology remarked, "These presentations reflect the wide range of factors that can affect a man's fertility and show that men, like women, face many risks to their fertility that they can control. While some risks are beyond the individual's ability to influence, we recommend that people do what they can to stay healthy and avoid choices, like smoking, that are known dangers to health and men's fertility."

P-203 Cohen and Honig, Anabolic Steroid Associated Infertility: A Potentially Treatable and Reversible Cause of Male Infertility ***Note: Dr. Honig will present these results Tuesday, October 18 at 11:30 am. The embargo is adjusted accordingly.

O-31 Lictenfels et al, Evidences of a Decreased Male/Female Ration in Humans and Mice with Increasing Levels of Air Pollution in the City of Sao Paulo

O-32 Burkman et al, The Sperm from Most Chronic Tobacco Smokers Exhibit a Significant Decline in the Ability to Bind to the Human Egg

O-33 Wirth et al, Metal Levels in Blood Samples from Male Great Lake Fish Consumers

O-34 Robinson et al, Regular Use of Ibuprofin Does Not Affect Semen Parameters, Need for ICSI, or ART Clinical Pregnancy Rate

O-177 Agarwal et al, Changes in Sperm Motility and Chromatin Integrity Following Contact with Vaginal Lubricants

O-179 Roudebush et al, Men with High Body Mass Index Values Present with Lower Serum Testosterone Levels

The American Society for Reproductive Medicine, founded in 1944, is an organization of close to 8,500 physicians, researchers, nurses, technicians, and other professionals dedicated to advancing knowledge and expertise in reproductive biology. Affiliated societies include the Society for Assisted Reproductive Technology, The Society for Male Reproduction and Urology, the Society for Reproductive Endocrinology and Infertility, and the Society of Reproductive Surgeons.

The CFAS includes more than 400 obstetricians and gynaecologists, urologists, reproductive endocrinologists, research scientists, and other health care professionals from every province as well as several members from other countries. The Mission of the society is to promote the study of, education about and research on fertility, sterility and andrology, respond to social needs in regard to the complexities of human reproduction, provide expertise in the accreditation of clinical and laboratory therapeutics in new reproductive technologies, and establish valid processes for the measurement of outcomes of therapy.

Highlights From The Conjoint Meeting Of The American Society For Reproductive Medicine And The Canadian Fertility And Andrology Society

asrm.org/Media/Press/2005spermimpact.html

Continue to Read more ...

Ice Cream with a Sweet Future with Health Benefits

Low Carb and Low fat fads will come and go; what doctors say we need to best control our weight, diabetes, or fat intake are healthy foods that satisfy us plus portion control and self control. And even ICE CREAM can fall into that category. Here's an exciting scoop:

Dr. Michael Singer, a Texas ophthalmologist, spends his days treating patients who suffer from diabetes-related complications. He also volunteers his time at Camp Independence, a special camp in Texas for children who have diabetes. When Dr. Singer asked them to describe the most difficult aspect of being diabetic, hands down, the answer was NO ice cream!

That got the wheels in Dr. Singer's head spinning...and began a 5 year quest to develop an ice cream that diabetics CAN eat without the fear of raising their blood sugar levels. In the process, he also developed a healthier, great tasting ice cream for all of us! Four net carbs, low fat, low calorie and NO Sugar alcohol syndrome!

Today, that ice cream--il Dolce Futuro�--is now on the market. Unlike other low fat, low sugar, low carb ice creams on the market--this one not only tastes as creamy and delicious as the more fattening stuff..it also uses NO sugar OR sugar alcohols. If you're familiar with sugar alcohols you know that they have an unpleasant aftertaste and can cause all sorts of unpleasant digestive side effects. I was with Dr. Singer during a recent sample event at Central Market and people couldn't believe there was NO added sugar in the ice cream. They loved it.

While the inspiration for il Dolce Futuro was diabetic patients, it is a terrific dessert option for anyone wanting to watch their fat, carb, calorie or sugar intake. I think that's just about everyone, no?

The ice cream line (5 flavors and soon to expand) is being rolled out across Texas and several other states this year and is also available for purchase in several other states and online at DolceFood.com.

And here's perhaps even better news: a percentage of the proceeds will go toward diabetes research and obesity management programs.

I think its a great story of a doctor with a vision to help people...and in turn...make them happy! Now there's no reason why everyone can't enjoy the sweet life!

Please click here dolcefood.com/pdfs/Dolce_FactSheet.pdf to find nutritional information.

Leslie Komet Ausburn
210.479.7255
210.326.8992

il Dolce Futuro� premium light ice cream was created for people who love dessert and celebration but crave a healthy lifestyle. It is an amazing blend of passion, taste and the commitment to give people life's best choices.

Unlike other low-carbohydrate ice creams, il Dolce Futuro is also low in fat and calories and does not contain sugar alcohols. For more than five years, the founder, Dr. Michael Singer, worked with leading dairy scientists to perfect this premium ice cream - by committing to a higher standard for taste and health he set himself a huge challenge - and succeeded in developing the ultimate dessert for today's lifestyles.

Continue to Read more ...

Bonviva Intravenous Injection for Postmenopausal Osteoporosis Confirmed Effective over 2 years

An intravenous (I.V.) injection of the new osteoporosis drug called Bonviva (ibandronate), administered every two or three months, has been shown to be highly effective and well- tolerated over two years1. These results, from the DIVA study, were presented at the annual meeting of the American College of Rheumatology in San Diego, USA and suggest that the I.V. formulation of ibandronate may offer an effective alternative for a select group of women with postmenopausal osteoporosis who are unable to take oral bisphosphonates.

Pierre Delmas, Professor of Medicine and Rheumatology and Director of the INSERM Research Unit in Lyon commented on the implication of these results: "These findings are very exciting, as they confirm Bonviva I.V. injection has the potential to bring the long term bone strengthening benefits of bisphosphonate therapy to those women who are unable to stay upright for the required length of time* or have another medical condition which means they are unable to take an oral bisphosphonate. In addition, the clinician can be certain that the patient receives a therapeutic dose as part of an ongoing treatment regimen."

DIVA (Dosing IntraVenous Administration) studied the efficacy, safety and tolerability of two novel I.V. regimens - 2mg every two months or 3mg every three months. When compared to the once- daily oral formulation of ibandronate (which in previous studies has been shown to reduce the risk of vertebral fracture in women with postmenopausal osteoporosis by 62% over three years) both I.V. ibandronate regimens:

- - Demonstrated significantly greater increases in bone mineral density (BMD) at the lumbar spine

- - Showed consistently greater increases in BMD at all hip sites measured

- - Were well-tolerated, with similar overall rates of adverse events The most common side effects for I.V. ibandronate were bone, muscle or joint pain, flu-like illness and headache.1 Ibandronate I.V. injection is administered as a 15-30 second injection.

Regulatory files have been submitted to both the US and the European Union Health Authorities.

This announcement comes soon after the EU Commission granted marketing authorization (September 15th) for the unique once-monthly oral formulation of Bonviva. Approval was based on the 2-year results of a phase III study called MOBILE (Monthly Oral iBandronate In LadiEs). These results are also being presented at the ACR meeting. The 2-year results from MOBILE show that the monthly dose of Bonviva provides a significantly superior increase in BMD at the lumbar spine compared to the daily dose. The monthly dose of Bonviva was also well- tolerated, which is an important consideration for women taking medication for the long-term.2


Both the monthly oral and I.V. formulations represent important advances in the treatment of osteoporosis, as many patients discontinue daily and weekly osteoporosis therapy for convenience reasons. This may help to explain why more than half the patients with postmenopausal osteoporosis stop taking their once-daily or once-weekly bisphosphonate treatment within a year3, foregoing the bone-building benefits these drugs can only provide over time.4

About Bonviva I.V. injection

The regulatory submissions for Bonviva I.V.injection include the first year results of the DIVA study, released in July 2004. The NDA for Boniva I.V. injection was submitted to the FDA in the US in December 2004. The MAA for Bonviva I.V. injection was submitted to the EMEA in Europe in April 2005. Bonviva I.V. injection is administered as a 15-30 second injection, making it simple and convenient for administration.

About DIVA

DIVA (Dosing IntraVenous Administration) is a multinational, randomised, double-blind, active control multicentre study in 1,395 women with postmenopausal osteoporosis aged between 55 and 80 years of age. DIVA aims to compare the safety, efficacy and tolerability of the approved oral daily ibandronate 2.5mg regimen with two novel I.V. regimens: 2mg every two months and 3mg every three months, with lumbar spine BMD at one year as the primary endpoint.

The two-year findings from the study were presented at the ACR meeting. BMD at the lumbar spine increased more in the 2mg and 3mg I.V. dosing groups than in the daily oral dosing group (6.4 % and 6.3 % vs. 4.8 %, respectively). As at 1 year, the I.V. regimens were shown to be at least as good as the daily regimen (margin at year 2: 1.3%) and both I.V. regimens were actually superior (p<0.001) to the oral regimen. Substantial increases in bone density at the hip were also observed, and were also greater in the I.V. groups than in the oral daily regimen (3.4 % and 3.1 % vs. 2.2%, respectively). Clinically relevant decreases in bone breakdown (as measured by the biochemical marker of bone resorption, serum CTX) were observed in all three treatment groups. Both I.V. regimens were well tolerated.

About MOBILE

MOBILE (Monthly Oral iBandronate In LadiEs) is a randomised, double-blind trial comparing the efficacy and safety of monthly oral doses of ibandronate (100mg on a single day; 100mg as separate 50mg doses on two consecutive days; or 150mg on a single day) versus the oral daily regimen (2.5mg), approved by the FDA and European Commission, in 1,609 women with postmenopausal osteoporosis. The primary endpoint was analysed at 1 year. One year results from MOBILE were recently published in the Journal of Bone and Mineral Research and full two year results were presented at the Annual European Congress of Rheumatology, Vienna, Austria 8-11 June 2005.

Roche/GSK Collaboration

In December 2001, F. Hoffmann-La Roche Ltd (Roche) and GlaxoSmithKline (GSK) announced their plans to co-develop and co-promote Bonviva for the treatment and prevention of postmenopausal osteoporosis in a number of major markets, excluding Japan. The Roche/GSK collaboration provides expertise and commitment to bringing new osteoporosis therapies to market as quickly as possible.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of diseases, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of drugs for cancer and transplantation and a market leader in virology. In 2004 sales by the Pharmaceuticals Division totalled 21.7 billion Swiss francs, while the Diagnostics Division posted sales of 7.8 billion Swiss francs. Roche employs roughly 65,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (http://www.roche.com).

About GSK

GSK, one of the world's leading research-based pharmaceutical and healthcare companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.

Continue to Read more ...

Almonds Boost Vitamin E Intake and Lower Cholesterol, New Research

Grabbing a Handful of Almonds Can Help Overcome America's Vitamin E Shortage -

For those concerned about America's vitamin E shortfall, highlighted in the government's recently released Dietary Guidelines for Americans, consider grabbing a handful of almonds. A new study published in this month's Journal of the American Dietetic Association confirms that eating almonds significantly increases vitamin E levels in the plasma and red blood cells and simultaneously lowers cholesterol levels. This is the first study to demonstrate that eating almonds will result in higher vitamin E levels.

Researchers at Loma Linda University compared the effects of healthy men and women consuming three different diets for four weeks each, including a control diet that didn't include almonds, a low-almond diet and a high-almond diet. The low- and high-almond diets were designed by replacing 10 percent and 20 percent of total calories, respectively, with almonds -- that's about one to two handfuls of almonds a day. Study participants did not take multivitamins, vitamin E supplements, or other dietary supplements before or during the study. Changes in alpha-tocopherol vitamin E and cholesterol levels were evaluated after each four-week diet.

The study found that when people ate 10 percent of their calories from almonds, they increased their vitamin E levels by 13.7 percent. When participants consumed 20 percent of their calories from almonds, the effect was greater, increasing their vitamin E levels by 18.7 percent.

Participants also reduced their total cholesterol by 5 percent and lowered their LDL or "bad" cholesterol by nearly 7 percent as a result of consuming a high-almond diet.

"This study is important because it shows that eating almonds can significantly boost levels of vitamin E in the diet and bloodstream," says Ella Haddad, DrPH, RD, an author of the study. "Vitamin E is a powerful antioxidant that defends your cells against damage on a daily basis and prevents artery-clogging oxidation of cholesterol. Eating a handful of almonds a day is a great way to get the vitamin E your body needs to stay healthy."

Most Americans do not get enough vitamin E in their diets. According to the National Academy of Sciences' (NAS) Dietary Reference Intake report for vitamin E, Americans are only consuming half of the Recommended Daily Allowance (RDA) of 15 milligrams of alpha-tocopherol vitamin E a day, bringing attention to a vitamin E gap. The government's latest Dietary Guidelines for Americans further emphasized America's vitamin E shortfall. The Guidelines noted current vitamin E intake is "of concern," stressing the need for adults to get more vitamin E from foods in their diets.

Almonds are a leading food source of alpha-tocopherol vitamin E -- the only form recommended by NAS. A one-ounce handful provides 7.4 mg of vitamin E, or about 50 percent of the RDA, as well as healthy monounsaturated fats, dietary fiber, protein and important minerals. Adding a handful of almonds to the food choices you make throughout the day could close the gap between the recommendation and current consumption.

For more information about vitamin E and almonds, visit GetYourE.org and AlmondsAreIn.com.

Summary of Published Study:
Published: Journal of the American Dietetic Association, Vol. 105, No. 3, 449-454, March 2005

Research Organization: Loma Linda University

Study Title: Almonds in the diet simultaneously improve plasma alpha- tocopherol concentrations and reduce plasma lipids

Authors: Pera R. Jambazian, DrPH; Ella Haddad, DrPH, RD; Sujatha Rajaram, PhD; Jay Tanzman; Joan Sabate, MD, DrPH

Objective: Researcher assessed the dose-response effect of almond intake on plasma and red blood cell tocopherol concentrations in healthy adults enrolled in a randomized, crossover feeding trial

Subjects: Sixteen healthy men and women (8 men, 8 women) were selected from those participating in a randomized feeding trial investigating lipid responses to graded almond intakes.* Those selected did not take multivitamins, vitamin E supplements, or other dietary supplements before or during the study. Pertinent characteristics were age (between the ages of 28 and 54), body weight (150.58 to 162.48 lbs), and body mass index (calculated as kg/m(2)) 21.6 to 28.8.

Study Description: After a 2-week run-in period, participants were fed three diets for four weeks each: a control diet, a low-almond diet, and a high-almond diet, in which almonds contributed 0 percent, 10 percent and 20 percent of total energy, respectively. Changes in blood tocopherol levels were assayed by high pressure liquid chromatography.

Results: Incorporating almonds into the diet helped meet the revised Recommended Dietary Allowance of 15 mg/day of alpha-tocopherol and increased lipid-adjusted plasma and red blood cell alpha-tocopherol concentrations. A significant dose-response effect was observed between percent energy in the diet from almonds and plasma ratio of alpha-tocopherol to total cholesterol.

*Sabate J, Haddad E, Tanzman JS, Jambazian P, Rajaram S. Serum lipid response to a graded enrichment of a Step 1 diet with almonds: A randomized feeding trial. American Journal of Clinical Nutrition 2003; 77: 1379-1384.

The Almond Board of California administers a grower-enacted Federal Marketing Order under the supervision of the United States Department of Agriculture. Established in 1950, the Board's charge is to promote the best quality almonds, California's largest tree nut crop. For more information on the Almond Board of California or almonds, visit http://www.AlmondsAreIn.com.

Continue to Read more ...

Holistic Acne Solution Helps Thousands Worldwide in Quest for Clear Skin

After suffering from severe acne for more than 13 years, trying almost every conventional acne drug and treatment, Mike Walden, a 33 year old writer from California, began an extensive 4-year research to find an alternative cure for acne and perhaps reveal the truth behind what he calls "the inflammatory disease of lies and misconceptions".

"Acne sufferers are getting tired of being exploited", Says Walden "There are too many marketers and charlatans out to make a fast buck on the expense of the vulnerable. Acne sufferers cannot afford to spend their hard earned money on useless pricey acne cures and quick fixes only to be disappointed time and time again."

Through his research, Walden realized that there is an abundance of acne cures that focus merely on the symptoms of acne, but very few if any that focus on permanently fixing the root cause.

"The sad truth," adds Walden, "is that even the so called natural approaches to the treatment of acne that are aimed to cure acne from within, are either unrealistic, impractical and often pricey or they are just the same one- dimensional gimmick cures disguised as holistic solutions."

According to Walden, in order to permanently cure acne one must approach the disease from a holistic multi-dimensional perspective as oppose to tackling only a single factor that leads to acne formation. Furthermore, the program must be practical and logical to use.

"There is simply no other way, but the holistic way", says Walden, "The Acne No More™ program was born out of these necessities."

The Acne No More™ is a unique step-by-step holistic acne solution, consisting of several sub-plans each designed to tackle a different factor responsible for acne. The main idea is using both the powers of the body and the mind to help the skin heal itself from the inside out.

In a down-to-earth often very personal and moving style Walden will guide you through the entire practical process of getting rid of your acne holistically, and achieving glowing acne-free skin, without the costs and side effects of conventional acne medications.

Targeting acne sufferers who have tried or wish to avoid conventional drugs and harsh topical acne treatments, the Acne No More™ program has been proven effective with all types of acne, in all levels of severity.

Since its release, in early 2005, the Acne No More™ program, the result of 4 years of research and experiment, has literally helped thousands of people worldwide to achieve clear skin.

In a message to Walden, Vicky Evans a 26 years old from the U.K, who's 'before and after' photos are posted on the http://www.AcneNoMore.com website, writes: "I had terrible acne for more than 9 years. There were many times when I seriously thought about giving up until I found your program. Today, my skin is practically perfect. I look and I feel like a new woman. You really made a difference here and I have no words to express my gratitude."

"No, I'm not a dermatologist," laughs Walden, "but I sure am proud to have created a program that truly helps other acne sufferers to end their physical and emotional scarring for good and gain their lives back".

The Acne No More™ program includes personal one-on-one counseling and support through the process provided by the author.

Continue to Read more ...

When You Were Born Influences When You Reach The Menopause

Research by Italian experts on the menopause has found that that the month and the season in which a woman is born influence the age at which she reaches menopause.

A study of nearly 3,000 post-menopausal women showed that the earliest age of menopause was found in women born in March and the latest among those born in October. On average there was around 15 months' difference, with women born in October reaching menopause at over 50 years compared with under 49 years for women born in March.

Writing in Europe's leading reproductive medicine journal Human Reproduction[1], lead author Dr Angelo Cagnacci said that the findings reinforced the concept that prenatal environmental factors affected a baby's adult life.

"Mothers should be aware of this, considering that during pregnancy they are going to influence, not only the health of the newborn, but also the health and reproductive life of their child during adulthood," he said.

The study, at four university hospitals (Bologna, Ferrara, Modena and Parma), was carried out on 2,822 women who were at least a year past the menopause. It found that the mean age of menopause was 49.42 - 49.04 for spring-born women and 49.97 for autumn-born women.

Dr Cagnacci, associate professor of Obstetrics and Gynaecology at the University of Modena, said that they had controlled for factors likely to interfere significantly with the findings, such as age of menarche, weight, smoking etc., and independently of all these factors the age at menopause was conditioned by the season of birth.

He conceded that there were some limitations to the study - a possibility of recall bias, and it involved women referred to menopause centres rather than the general population. Also, the effect of seasons may differ in different geographic areas.

"Nevertheless, the data seem to suggest notable effects of the month/season of birth on the length of a woman's fertile life, further supporting a role for environmental factors in regulating adult reproductive life and the timing of its termination."

It was not known which seasonal environmental factors were capable of influencing timing of menopause via an action exerted before birth, or even before conception. The study speculated that modifications of environmental temperature and sunlight may influence foetal growth and therefore future reproductive capabilities; seasonally linked diet modifications or exposure to infections were other possibilities. Before conception, seasonal environmental factors influencing ooctye maturation may contribute to the development of defective embryos and weak adults.

"Our present data seem to indicate that women born in autumn develop better during their prenatal life and are born with a higher number of oocytes than women born in spring," said Dr Cagnacci. "An alternative explanation may be that early mortality is highest among children born in autumn, thus selecting the fittest for survival, although other studies do not support this hypothesis."

He said the researchers' view was that a prolonged reproductive period with a later menopause was an index of higher embryo quality and ultimately, their quality was passed on to their offspring.

The next phase of the research was seeing whether the season of birth of the women in the study influenced their psychological profile - affecting their susceptibility to conditions such as anxiety and depression, for example. "Results so far seem promising," he said.

[1] Season of birth influences the timing of menopause. Human Reproduction. doi:10.1093/humrep/dei040.

Notes:

1. PDF version of this press release and full embargoed text of the paper with complete results can be found from 09:00hrs London time Tuesday 10 May at: oup.co.uk/eshre/press-release/may05.pdf or is available from Margaret Willson.

2. Human Reproduction is a monthly journal of the European Society of Human Reproduction and Embryology (ESHRE). Dr Helen Beard, Managing Editor.
Tel: +44 (0) 1954 212404 Email: beardh@humanreproduction.co.uk
Please acknowledge Human Reproduction as a source

3. ESHRE's website is: http://www.eshre.com

4. Abstracts of other papers in ESHRE's three journals: Human Reproduction, Molecular Human Reproduction & Human Reproduction Update can be accessed post embargo from http://www3.oup.co.uk/eshre Full text of papers available on request from Margaret Willson.

European Society for Human Reproduction and Embryology
http://www.eshre.com

Continue to Read more ...

Bladder Pacemaker Treatment Relies on Electrical Pulses to Reduce Urge Incontinence

As Wendy Simmons goes about her job as a sales clerk in a women's clothing store, it's not uncommon for strangers to approach her and ask, "Are you the lady with the bladder pacemaker?"

While some women might shy away from this type of notoriety, Simmons is comfortable sharing the details of her struggle with urinary urge incontinence and how her life's changed for the better since having a relatively unknown treatment called InterStim therapy at Cedars-Sinai Medical Center. "I love helping people," she says, "and I want to be a part of making this treatment better known."

According to the American Urogynecologic Society, incontinence affects approximately 13 million people in the United States, - 11 million of whom are women. Urge incontinence is one of several types of incontinence, and is characterized by the sudden loss of urine at the wrong time and the wrong place. With urge incontinence, or "overactive bladder," the bladder contracts in an uncontrolled way even when it's not full. People of all ages can experience urge incontinence, depending on what the underlying problem is.

Gary Leach, M.D., a highly renowned urologist and co-director of the Women's Center for Continence and Pelvic Health at Cedars-Sinai, is one of only a few physicians in the United States actively using the bladder pacemaker (InterStim device) for patients with severe urge incontinence. While the U.S. Food and Drug Administration approved the therapy in 1999, Leach believes most doctors and patients are not aware of it.

As he explains, when treating women with severe bladder problems, there are three different indicators for using the bladder pacemaker device. The most common is refractory overactive bladder - a bladder that is unresponsive to treatment. Women with this condition have severe frequency and urgency incontinence and none of the usual medications have worked for them. The second indication is urinary retention (inability to urinate) and the third is pelvic pain. Some patients with interstitial cystitis who experience pelvic pain as their bladder fills have found the pacemaker therapy very helpful, he says.

"The good thing about this procedure is that it's done in two stages," says Leach. "In the first phase, we do a test to see if the device will work for this particular patient. This is an outpatient procedure and the patient is under local anesthesia for 20 to 30 minutes, and then goes home from the hospital the same day. Usually within seven to 10 days we have a very good idea as to whether they will respond to treatment (an estimated 70 to 80 percent respond positively), and if they do, we go ahead with the second phase."


During the first phase, Leach inserts a thin wire electrode next to one of the sacral nerves in the back that controls the bladder. This wire (which sends a signal to the nerve to tell the bladder to relax) is attached to a battery pack (about the size of a pager) that the patient wears on her belt for a week to 10 days. The battery pack generates electrical pulses which decrease the number of bladder contractions, thereby reducing the symptoms of urgency and frequency. For the next week or so the patient keeps a record of how often she urinates and how many sanitary pads she wears each day.

If the patient returns and reports that she is significantly improved, says Leach, then he proceeds to the second phase during which he implants a small pulse generator that looks like a cardiac pacemaker in the patient's upper buttocks area and attaches it to the wire that is already in place. This second phase is also an outpatient procedure under local anesthesia and is completed within 15 minutes.

"The beauty of this procedure is that we can test it to see if it works. If the patient comes back after the first phase and says she's only about 10 percent better, then we don't do the second phase. Instead, other options are pursued. For example, if the pacemaker procedure does not work for a patient, another procedure called augmentation cystoplasty, can be performed in which the bladder can be enlarged to three or four times its normal size by using a segment of the small intestine. While it is often successful in curing incontinence, many patients find that they are unable to empty their bladder well after this procedure and need to self-catheterize three to four times each day.

Leach reports that approximately 70 to 90 percent of his patients have a good response to the first phase of the Interstim trial and go on to have the pacemaker implanted. Once implanted, the device can be reprogrammed with a computer through the skin so it's not unusual, he says, for a patient to return to his office to have the device adjusted until the right setting is found.

Simmons says that her co-workers are "shocked by the difference the surgery has made in me. It's amazing. I used to be in and out of the bathroom all the time. Before this surgery I basically lived my life worrying about going to the bathroom. Now, for the first time in many years, I don't have any infections, I don't leak urine and I don't have to self-catheterize. I can sleep through the night without getting up to go to the bathroom. I just go about my business, going to the movies and out to dinner � incontinence isn't an issue for me anymore."

For more information about Cedars-Sinai's Women's Center for Continence and Pelvic Health, call (310) 423-9558.

One of only five hospitals in California whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 17 consecutive years, it has been named Los Angeles' most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and was recently fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP). Additional information is available at http://cedars-sinai.edu.

Continue to Read more ...

Premature Ejaculation - Experts debate Best Treatment

Leading psychiatrists and medical authorities in the field of sexual medicine are set to debate the topic: Premature Ejaculation - Psychological Therapy is preferable to Medical Therapy.

Irwin Goldstein, MD, Editor-in-Chief of The Journal of Sexual Medicine and Director of the Institute for Sexual Medicine at Boston University School of Medicine, will moderate this controversial debate at the Royal Sonesta Hotel in New Orleans, LA during a champagne breakfast on January 15, 2005. The debate is being held as part of an annual conference given by the Sexual Medicine Society of North America (SMSNA).

According to the World Health Organization, half of men aged 40-70 have sexual dysfunction. Premature ejaculation (PE) is one of the most common forms of dysfunction experienced and it can be caused by either psychological factors or underlying medical conditions.

Arguing in favor of psychological treatment for PE are Michael Perelman, PhD and David Rowland, PhD. Dr. Perelman is Clinical Associate Professor of Psychiatry, Reproductive Medicine, and Urology at Weill Medical College of Cornell University and Dr. Rowland currently serves as editor of the Annual Review of Sex Research.

James Barada, MD, Director of the Albany Center for Sexual Health and Culley Carson, MD, Professor of Surgery and Chief of the Division of Urology at the University of North Carolina at Chapel Hill, will argue in favor of medical therapy.

PE has for a long time been considered a psychological disorder, due to factors such as societal pressures, emotions, and psychological or physical control. However, many question this and cite various physical conditions that may contribute to or be linked to PE. Much success has been reached with treatment by medical therapies, such as PDE-5 inhibitors and anti-depressants. New therapies, including those that raise serotonin, are currently being developed to treat "rapid" ejaculation."

This event is sponsored by Ortho-McNeil Women's Healthcare and Urology and Blackwell Publishing. For more information on how you can attend the debate, please contact the conference coordinator for the Sexual Medicine Society of North America at Jennifer@wjweiser.com. For background information and previous articles on this topic from The Journal of Sexual Medicine, please contact Sharon Agsalda at sagsalda@bos.blackwellpublishing.com.

About The Journal of Sexual Medicine

The Journal of Sexual Medicine is the official journal of the International Society for Sexual Medicine and its five regional affiliate societies. It is the first journal owned and operated by the societies. The aim of the journal is to publish multidisciplinary basic science and clinical research to define and understand the scientific basis of male and female sexual function and dysfunction. The journal provides healthcare professionals in sexual medicine with essential educational content and promotes the exchange of scientific information generated from experimental and clinical research. The Journal of Sexual Medicine includes basic science and clinical research studies in the psychologic and biologic aspects of male and female sexual function and dysfunction, and highlights new observations and research, results with innovative treatments and all other topics relevant to clinical sexual medicine. For more information on The Journal of Sexual Medicine, please visit http://jsm.issir.org.

About Blackwell Publishing

Blackwell Publishing is the world's leading society publisher, partnering with more than 550 academic and professional societies. Blackwell publishes over 750 journals and 600 text and reference books annually, across a wide range of academic, medical, and professional subjects. The company remains independent with over 900 staff members in offices in the US, UK, Australia, China, Denmark, Germany, and Japan. Blackwell's mission as an expert publisher is to create long-term partnerships with our clients that enhance learning, disseminate research, and improve the quality of professional practice. For more information on Blackwell Publishing, please visit http://www.blackwellpublishing.com or www.blackwell-synergy.com.

Continue to Read more ...

Changing the Course of Depression by Changing the Environment

How many women in your practice are leaving your office with prescriptions for antidepressants? Yet do you know what questions to ask that can help you determine if their depression is the result of an emotionally abusive environment that has them feeling anxious, stressed, overwhelmed, lost, alone, and as though they're going crazy? Depressed? You bet. And most of you would be too if you lived in this constant state of emotional war zone still almost unrecognizable by our culture even today.

It has taken us decades to jump in with both feet to really dissect the intricacies of physical and sexual abuse, but emotional abuse is still barely perceptible on the horizon. And being understood � unless you've lived in it, you cannot begin to understand the "crazy making" that goes on behind closed doors �many in homes that look like the perfect Camelot from the outside.

What Is An Emotionally Abusive Environment?

It is any scenario where one person in a relationship (parent, boss, romantic partner, or even just best friends), feels more entitled, deserving, and/or more powerful than the other person � and then spends vast amounts of time proving that theory to their "lesser" partner.

For example, in one husband/wife relationship I consulted on, the husband demands from his wife every day, "Tell me what you're worth, honey � and don't get it wrong or there will be hell to pay." And his wife must respond each day, "I'm worth 29 cents, honey� The price of a bullet."

This emotional brainwashing day after day is a constant message to this woman that she is absolutely worthless. That her thoughts, actions, needs, and wants matter not. That her job in life is to essentially do whatever he "allows" her to do.

One woman I know has a husband who checks her odometer every day to determine if she indeed went exactly where she told him she went.

Yet another must answer her husband's calls by the third ring or she will be punished when she comes home.

Still another controlling man goes through his wife's purse, closet, and any personal areas she has, to show her that she had better not hide anything from him.

Many like to play mind games such as controlling who their spouse may see or even speak to on the phone. Often even relatives are not "allowed" to call the house as the husband may see this as an invasion of his privacy and a loss of control of his spouse to "outsiders." Some of these "subservient" women are not even allowed access or information regarding the family finances.

Why Do They Take It?

All these narcissistic individuals are so great at hypnotizing their "loved ones" into believing that they must indeed accept this treatment that the victims truly become confused, exhausted, and lost as to who they are any more. Many almost lose their own identity in these environments that do not promote each individual's needs or wants but focus all attention on the needs and wants of the narcissist.


By the time the "victim" comes to you, she may indeed seem like the crazy one. Many exhibit signs of Post Traumatic Stress Syndrome as well, when to all outward appearances there has been no trauma. Of course, physical symptoms related to stress may also be prevalent.

Not Just Spouses or Intimate Partners

While most easily identifiable in intimate relationships, the same damage can be inflicted in any relationship. A mother of grown children can make their lives miserable with her controlling, manipulative behavior and condemning and accusing commentary. A boss who takes credit for his or her employee's work and then is the tyrannical leader at the helm, can lead employees to becoming empty-eyed, "deer in the headlights." A teenaged girl with a critical teacher can have trouble sleeping and can fall prey to the same depressive feelings that the wife of the physical abuser succumbs to. All are relationships where pathologically narcissistic people, with their "stealth" behavior, can cause vast damage without ever even attracting attention.

While narcissistic people can be of either gender, odds are you will see mostly women victims who are willing to discuss these issues, once you identify them. However, keep in mind that men may be equally affected by this type of subtle and emotional brainwashing. Yet men may not be as willing to talk about their feelings, so you may have to dig a little deeper.

What Can You Do?

Become more aware of what emotional abuse looks like and then consider options for emotional support for your clients, in addition to supporting them through their depressive episodes until such time as they can find an emotionally healthy, safe environment.

First of all, go rent the old movie Gaslight. Made in 1944, nearly 40 years before Narcissistic Personality Disorder was an official diagnosis, one can clearly see the "crazy-making" behavior that is so cunningly applied by the narcissist to his victim. While the motive of the villain is criminal in this film, the behaviors are classic narcissist none-the-less. I have actually had clients of mine watch this film for 20 minutes and call me to tell me that they had to throw up as the recognition of the destructive brainwashing was so clear to them, that seeing it in the 3rd person suddenly turned on a light of recognition in their own lives.

Secondly, I give you a list of but a few questions that you can ask your client to help reveal if they are living in a toxic, emotionally abusive environment, (which may have already led to physical and/or sexual abuse as well.) If you client answers yes to a majority of these questions, then they are probably dealing with a destructive, narcissistic relationship.

The Detective Work

Here are a sampling of the questions which may open the conversation:

1. Do you struggle with feelings of guilt or blame that any problems in your relationship are your fault?
2. Are you frequently fearful of what your partner's mood might be like when he (or she) comes home at the end of the day?
3. Do you feel constantly exhausted?
4. Are you having trouble sleeping?
5. Do you ever wonder if your partner is telling you the complete truth?
6. Do you feel as though your partner is more important than you are?
7. Do you ever feel as though you are "walking on eggshells" around your partner?
8. Does your partner ever seem as though his (or her) personality can change in no time? For example, he came in the door after work seemingly happy, and in minutes is sullen, angry, quiet, or depressed?
9. Do you ever feel as though you are given the "silent treatment" by your partner? (They will know what you mean if they are.)
10. Do you have to ask your partner's permission to do anything?
11. Do you have limited or no access to your financial accounts?
12. Do you ever have suicidal thoughts?
13. Do you feel as though you are rarely getting your needs met in this relationship, or that your needs always come last?
14. Do you feel as though your partner treats you as though he or she is your parent, not your equal?

Red Flag Narcissistic Behaviors

In addition, you might ask them if any of these situations fit their partner's behavior. If so, they are indeed "red flags" to unhealthy behaviors.

1 Does your partner have a big ego and feel that others are less important than he?
2 Does your partner like to control others and the environment?
3 Does your partner feel that rules don't apply to him?
4 Does he or she take advantage of others to achieve his needs?
5 Does he or she show little respect for others, and may in fact refer to others as "idiots"?
6 Does he or she often criticize others?
7 Is he or she quick to take offense at comments others offer towards them, if those comments are not complimentary?
8 Does he have a quick temper?
9 Can his personality change at a moment's notice?
10 Does he ever exaggerate the truth or outright lie?
11 Does he deny he has any issues to work on but believes that if everyone will do as he tells them to do, then all will be fine?
12 Does he seem totally oblivious to understanding empathy and compassion for others but demands everyone jump if he is slighted or has his feelings hurt?
13 Does he blame others for all his problems?
14 Did he start out the relationship being very charismatic, charming, romantic, and almost "perfect" but those behaviors changed quickly as he became hardened, abusive, critical, and perhaps violent?
15 Did he suggest love and marriage while only in the relationship for a short time?

Recognition

These are just a few of the questions that can help determine if your client is living in this dangerous, emotional roller coaster situation. While an antidepressant may help to minimize her outward symptoms of depression, as long as the emotional war zone she lives in continues to hold fast, the cause of her depression will not likely go away.

While most therapists recognize Narcissistic Personality Disorder, narcissism itself is on a scale. Healthy narcissism is what most of us have. We set goals, strive to reach them, believe that we are capable of attaining them, and occasionally, when we stumble and do not reach the goal, we still pick ourselves up and go on. We have enough confidence in ourselves as being valuable people that we do not let occasional mistakes ruin our lives. At the same time, we have empathy and compassion for others.

According to the DSM - IV, Narcissistic Personality Disorder consists of 9 behaviors, which, if a client demonstrates 5 or more of these traits, is considered to have the disorder. These 9 characteristics are:

1.) Grandiose sense of self-importance,
2.) Obsessed with fantasies of unlimited power, success or brilliance,
3.) Is unique, can only be understood by other "worthy" people,
4.) Requires excessive admiration and attention
5.) Extreme sense of entitlement,
6.) Interpersonally exploitive,
7.) Lacks empathy and compassion,
8.) Envious of others,
9.) Arrogant, haughty behavior.

Are Only Those With NPD Dangerous?

My contention is this � just as there is a wide range between healthy narcissism and pathological Narcissistic Personality Disorder, those perpetrators who only display narcissistic traits can prove to be just as detrimental to their partners as those with NPD. Depending upon the codependent's emotional and psychological "baggage," a partner who only exhibits narcissistic "traits" can still inflict emotional abuse that can, over time, become the emotional brainwashing that leads to depression and other pathology.

If we look back to the "cult" environments of the 70's and 80's, we can see just what a powerful force emotional abuse can be � even to the point of self-destruction, as in the case with Reverend Jim Jones and the vast suicide of his followers.

Then of course, as the murder of Laci Peterson by her husband Scott became front page news, we are left to wonder just what life was like behind closed doors at the Peterson household. With Amber Frey's testimony about her "Perfect Partner" Scott Peterson turning into the perfect monster before her eyes, one can only assume that the sly, manipulative, lying, and controlling predator Peterson, played many more subtle games before he went on to reach the level of murder of his wife and unborn child.

While not all environments are fatal as with Jim Jones or Scott Peterson, let's hope that we can become aware of a variety of levels of emotionally toxic environments that our clients might be living in and stem the tied before we lose even one to the destructive side of depression caused by an environment that can be changeable, if intervention can be introduced by a sensitive caregiver.

So, before you simply write the next prescription for an antidepressant for the next woman in your practice who requests one, ask her some of these important questions. And if she answers yes to more than a few, perhaps it's time to find her an emotional support system in the way of social services or psychological intervention, at least at the same time that you write the script for the Wellbuterine or Prozac.

Continue to Read more ...

Chemicals in Tattoo inks Need Closer Scrutiny

As tattoos have grown in popularity, so have complaints of adverse side effects associated with both their application and removal. A new study, done by chemistry students at Northern Arizona University, looked at the chemical composition of a variety of tattoo inks to better understand their potential health risks.

The findings, presented today at the 229th national meeting of the American Chemical Society, the world's largest scientific society, suggest that closer regulation of the tattoo industry may be warranted, according to the researchers.

Although inks used in tattoos are subject to regulation by the U.S. Food and Drug Administration as cosmetics and color additives, the agency has not traditionally regulated them, letting the task fall to local jurisdictions, according to a fact sheet issued by the FDA Office of Cosmetics and Colors cfsan.fda.gov/~dms/cos-204.html. This effectively gives a tattoo artist license to inject whatever he or she deems appropriate under the skin, according to the researchers.

"Tattoos are no longer limited to the rough and rowdy," says Haley Finley-Jones, an undergraduate chemistry student and lead author of the study. "With the growing popularity of tattoos among young people, it is vital that we develop a better understanding of this form of self expression."

The new research - a joint effort between Finley-Jones and Leslie Wagner as part of an undergraduate research project directed by Jani Ingram, a professor of chemistry at NAU - has two main goals: to characterize the diversity of tattoo inks, and to determine if any inks pose health threats in the form of heavy metals or other potentially dangerous chemicals.

Overall, the study covers 17 inks from five different manufacturers. "We chose to study five different brands of black ink as it is the most common color used in tattoos," Finley-Jones says. The researchers also are testing three different brands of red, blue, yellow and white ink. Tattoo artists frequently mix inks to achieve the desired color, so the researchers selected their samples based on the most likely base colors.

Because there have been no previous studies, they are using analytical techniques that can test for a wide variety of chemical components, rather than looking for a specific group of compounds.

"At this point in the study, we have determined that the inks do in fact vary in composition from manufacturer to manufacturer and from color to color," Wagner says. The researchers also have found some indication of the presence of metals, and are in the process of running more tests to verify the identity of the metals.

A number of potential health problems might be stemming from the lack of oversight, according to the researchers. There have been a variety of claims that tattoo inks cause adverse effects in people, including allergic reactions to ink components, a burning sensation during the course of MRIs, and the migration of inks to different tissues in the body, such as the lungs.


It is unclear, however, what the specific causes of these reactions might be, and the only way to gain better understanding is to know what chemicals make up the inks, the researchers say. Finley-Jones and Wagner expect that the variation found in their testing and the potential presence of toxic metals will encourage regulators to begin monitoring the tattoo ink industry more closely.

There are other problems with unknown compositions of tattoo inks. For example, surgery to remove tattoos is becoming more widespread, and not knowing the composition makes the procedure more difficult. "Once the components of a tattoo ink have been identified, doctors removing the inks can use their knowledge of the chemical characteristics of the components to select a treatment that will be most effective and, hopefully, the least painful for the patient," Wagner says.

The American Chemical Society is a nonprofit organization, chartered by the U.S. Congress, with a multidisciplinary membership of more than 159,000 chemists and chemical engineers. It publishes numerous scientific journals and databases, convenes major research conferences and provides educational, science policy and career programs in chemistry. Its main offices are in Washington, D.C., and Columbus, Ohio.

- Jason Gorss

Haley Finley-Jones and Leslie D. Wagner are undergraduate chemistry students at Northern Arizona University in Flagstaff, Ariz.

Jani C. Ingram, Ph.D., is a professor of chemistry in the Department of Chemistry and Biochemistry at Northern Arizona University in Flagstaff, Ariz.

ANYL 248 In the flesh: Chemical characterization of tattoo inks

Haley Finley-Jones1, Leslie D. Wagner2, and Jani C. Ingram2. (1) Department of Chemistry and Biochemistry, Northern Arizona University, P. O. Box 5698, Flagstaff, AZ 86011, Fax: 928-523-8111, hjf2@dana.ucc.nau.edu, (2) Chemistry and Biochemistry, Northern Arizona University

The intentions of this study are to determine the composition of tattoo inks as currently they are not regulated. While the components of topically applied make-up must be approved by the FDA, a tattoo artist has the license to use whatever he deems appropriate for injection into the skin. The hypothesis this study seeks to prove is that there is a great variety in chemical compositions for tattoo inks on the market. It is expected that the variation of results will be useful in support of regulating the tattoo ink industry. To determine the actual variation of inks on the market, we will test several inks in a variety of colors. In this study we will employ a stepwise analytical approach to determine the chemical components of the ink samples. The results from metals analysis by ICP-MS and functional group screening by SIMS will be discussed.

Briefly explain in lay language what you have done, why it is significant and what are its implications (particularly to the general public)

Tattoos are no longer limited to the rough and rowdy. With the danger of dirty needles deteriorating, new potential risks are coming to the surface. The intent of this study is to determine the chemical composition of tattoo inks. It is widely unknown that tattoo ink manufacturing is not regulated by the FDA. Because of this, there are a number of potential health problems that might arise. There are other problems with unknown composition as well. For example, tattoo removal is becoming more prevalent and not knowing the composition makes it all the more difficult. In our research we have obtained a selection of inks varying in color and manufacturer. We are analyzing these inks using a variety of different techniques and methods. For health purposes, we are analyzing for heavy metals and other potentially dangerous chemicals. We are also trying to determine just how varied the components are. With the growing popularity of tattoos among young people, it is vital that we develop a better understanding of this form of self expression.

How new is this work and how does it differ from that of others who may be doing similar research?

This is the first scientific study done on the composition of tattoo inks. In literature searches, we were unable to find any similar research that had been published in a peer-edited journal.
Haley Finley-Jones
Department of Chemistry and Biochemistry
Northern Arizona University
P. O. Box 5698
Flagstaff, AZ 86011
Phone Number: 928-523-7877
Fax Number: 928-523-8111
Publishable Email: hjf2@dana.ucc.nau.edu

Contact: Michael Bernstein
619-525-6402, in San Diego
March 12-16, 2005
202-872-4445 (Washington, D.C.)
American Chemical Society
http://www.acs.org

Continue to Read more ...

Cialis(reg) (tadalafil) Overtakes Viagra as Top Selling Erectile Dysfunction Treatment in France

Lilly ICOS LLC reported today that Cialis(reg) (tadalafil)(1), the only erectile dysfunction (ED) treatment clinically proven to work up to 36 hours for most men, has surpassed Viagra(reg) (sildenafil citrate) in France for the second consecutive month.

In January 2005, Cialis accounted for 45 percent of the total PDE5 inhibitor tablets sold from wholesalers to pharmacies in France; Viagra's total for that same period was 44 percent. For the month of February 2005, Cialis continued its growth in France by attaining 49 percent of tablets sold from wholesalers to pharmacies, while Viagra had the second largest share with 40 percent, according to the latest IMS market share information.(2)

The market share of Cialis in France has grown consistently since the product was introduced in Europe in February 2003. Since December 2004, Cialis has secured an additional 6.4 percentage points of the total share of tablets from wholesalers to pharmacies to gain the largest share of sales in the French market.

"The success of Cialis in France is an exciting milestone for the brand and for Lilly ICOS, especially because we joined the market after the leader was so well established," said Leonard Blum, ICOS Vice President, Sales and Marketing. "The key benefit of Cialis -- the up-to-36 hours that Cialis gives a man and his partner to choose the moment for intimacy that's right for them -- is the reason we have always said Cialis would succeed in the ED marketplace. This benefit means couples who don't want to schedule romance can have time to relax and, for instance, have dinner or simply enjoy time together, allowing intimacy to happen when the moment is right."

Since its approval in the United States in November 2003, Cialis has increased its share of total prescriptions every month in the U.S. For the week ended April 1, 2005, Cialis held a 24 percent share of new and 22 percent of total U.S. oral ED treatment prescriptions.(3)

"We are not surprised by the success of Cialis in France, a country many people associate with romance and love," said Matt Beebe, Cialis U.S. Brand Team Leader, Lilly. "Here in the U.S., where Cialis was the third product to enter a very competitive market, we have our own success story -- just four months after launch, Cialis secured the second largest share of the ED market. We're pleased to see the market share of Cialis continue to grow each month as more and more men discover the benefits Cialis has to offer."

About ED

ED is defined as the consistent inability to attain and maintain an erection sufficient for sexual intercourse. ED affects an estimated 189 million men worldwide.(4) 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.(5,6) In many cases, however, both psychological and physical factors contribute to the condition.(7)


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 approximately 100 countries, including Australia, Brazil, Mexico, Canada, the United States and countries throughout Europe. More than 4.5 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, should not take Cialis. Such a combination could cause a sudden, unsafe drop in blood pressure.

Men should discuss their medical conditions and medications, including alpha blockers for prostate problems or high blood pressure, 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 or muscle ache. Although rare, men who experience an erection for more than four hours (priapism) should seek immediate medical attention. Men should not drink alcohol in excess with Cialis. Cialis does not protect a man or his partner from sexually transmitted diseases, including HIV.

Individual results may vary. Cialis studies were not designed to assess multiple intercourse attempts after a single dose. For full patient information, visit www.cialis.com.

About Lilly ICOS LLC

Lilly ICOS LLC, a joint venture between ICOS Corporation (Nasdaq: ICOS) and Eli Lilly and Company (NYSE: LLY), developed tadalafil for the treatment of erectile dysfunction.

ICOS Corporation, a biotechnology company headquartered in Bothell, Washington, is dedicated to bringing innovative therapeutics to patients. ICOS is marketing its product, Cialis (tadalafil), through Lilly ICOS LLC, for the treatment of erectile dysfunction. ICOS is working to develop treatments for serious unmet medical conditions such as benign prostatic hyperplasia, cancer and inflammatory diseases.

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 http://www.lilly.com.

P-LLY

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.

Continue to Read more ...

Colon Cancer, Xeloda plus oxaliplatin (XELOX) dramatically reduces hospital visits by over 60%

New data confirm that XELOX, a combination of Xeloda� (capecitabine) and oxaliplatin, is as safe as the current standard treatment of intravenous 5-fluorouracil/leucovorin (i.v. 5-FU/LV) in adjuvant colon cancer patients (post-surgery). Moreover, XELOX reduces the number of hospital visits by more than 60 percent compared to the current standard therapy, providing patients the freedom to live as normal a life as possible.1

"Being diagnosed with colon cancer shook me to the core. Having discussed treatment options with my doctor, I was thankful to be offered a combination treatment, including oral Xeloda, as it would mean much less time spent in hospital, so that I could get on with my life and return to work sooner," said Andy Griffin, a patient with colon cancer from the UK. "At such a difficult time in my life, it was important for me to be able to spend as much quality time with my family as possible."

In 2004, colorectal cancer was one of the leading cancers and accounted for 13 percent of all cancers.2 It is estimated that over 394,000 people die worldwide from colorectal cancer each year.3 Xeloda was approved in the EU for post-surgery treatment of colorectal cancer in April 2005. Approval was based on data (X-ACT study) that showed Xeloda to be at least equal to 5-FU/LV in terms of effectiveness with a strong trend towards improvement with fewer severe side-effects.4

"It's great to know that physicians have a new treatment option that will truly benefit their patients. This option is giving patients the freedom to live their lives while providing similar safety benefits to the current standard i.v. combination treatment in the post-surgery setting," said Professor Chris Twelves, University of Leeds and Bradford NHS Foundation Trust. "This study confirms that Xeloda, either on its own or in combination, is fast becoming the backbone of bowel cancer treatment."

Previous XELOX studies, conducted in patients where the disease has spread have shown that it is well tolerated with similar efficacy to the FOLFOX (oxaliplatin + 5-FU/LV) combination.5,6,7 XELOX is also being investigated in the largest ever Phase III clinical trial programme for the treatment of colorectal cancer, with over 4,000 patients from more than 30 countries involved.

XELODA IN COLORECTAL CANCER

Abstract Number 617 - Initial safety findings from XELOXA: a randomized phase III trial of capecitabine plus oxaliplatin vs. bolus 5-FU/LV as adjuvant therapy for patients (pts) with stage III colon cancer1: In early Phase III safety findings, from the largest population of patients treated with XELOX to date, compared with the current standard therapy, i.v. 5-FU/LV, XELOX demonstrates benefits for the patient in terms of side-effects:

# XELOX led to less myelosuppression (reduced production of red and white blood cells and platelets) and stomatitis (mouth inflammation / ulcers)

Presented at ECCO on Wednesday, 2 November, 11.30 CET (poster discussion)

About XELOX:

An abbreviation for a type of combination chemotherapy used to treat colorectal cancer; it contains Xeloda (capecitabine) and oxaliplatin.

About Xeloda:

Xeloda is licensed in more than 90 countries worldwide including the EU, USA, Japan, Australia and Canada.

Roche received marketing authorisation for Xeloda as a first-line monotherapy (by itself) in the treatment of metastatic colorectal cancer (colorectal cancer that has spread to other parts of the body) in most countries (including the EU and USA) in 2001. Xeloda has also been approved by the European Medicines Agency (EMEA) and U.S. Food and Drug Administration (FDA) for adjuvant (post-surgery) treatment of colon cancer in March and June 2005, respectively.

Xeloda is licensed in combination with Taxotere� (docetaxel) in women with metastatic breast cancer (breast cancer that has spread to other parts of the body) and whose disease has progressed following intravenous (i.v.) chemotherapy with anthracyclines. Xeloda monotherapy is also indicated for treatment of patients with metastatic breast cancer that is resistant to other chemotherapy drugs such as paclitaxel and anthracyclines. Xeloda is licensed for the first-line treatment of stomach cancer that has spread, in South Korea.

About Roche

Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2004 sales by the Pharmaceuticals Division totalled 21.7 billion Swiss francs, while the Diagnostics Division posted sales of 7.8 billion Swiss francs. Roche employs roughly 65,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai.
All trademarks used or mentioned in this release are legally protected.

References:
1. Schmoll HJ et al. Initial safety findings from XELOXA: a randomised phase III trial of capecitabine plus oxaliplatin vs. bolus 5-FU/LV as adjuvant therapy for patients (pts) with stage III colon cancer. Abstract 617 presented at the 13th European Cancer Conference, Paris, 2005.
2. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Annals of Oncology 2005;16:481-488
3. Boyle P, Langman JS. ABC of colorectal cancer. Epidemiology. BMJ 2000;321:805-808
4. Twelves C et al. Capecitabine as adjuvant treatment for stage III colon cancer. New Eng Journ Med 2005; vol 352: no.26: 2696-2704.
5. Arkenau HT et al. Infusional 5-fluorouracil/folinic acid plus oxaliplatin (FUFOX) versus capecitabine plus oxaliplatin (CAPOX) as first line treatment of metastatic colorectal cancer (MCRC): Results of the safety and efficacy analysis. Proc ASCO 2005 (Abst 3507).
6. Sastre J et al. Preliminary results of a randomized phase III trial of the TTD Group comparing Capecitabine and Oxaliplatin (CapeOx) vs. Oxaliplatin and 5-Fluorouracil in continuous infusion (5-FU CI) as first line treatment in advanced or metastatic colorectal cancer (CRC). Proc ASCO 2005 (Abst 3524).
7. Hochster HS et al. Safety and efficacy of bevacizumab (Bev) when added to oxaliplatin/fluoropyrimidine (O/F) regimens as first-line treatment of metastatic colorectal cancer (mCRC): TREE 1 & 2 Studies. Proc ASCO 2005 (Abst 3515).

Continue to Read more ...

High Doses Of Ibuprofen Cause Significant GI Bleeding, Despite Safety Profile

People who take high doses of ibuprofen on a regular basis are three times more likely to experience gastrointestinal (GI) bleeding than those who do not take painkillers. Results of a small, retrospective analysis published today in the American Gastroenterological Association (AGA) journal Clinical Gastroenterology and Hepatology show that significant GI bleeding can be observed as early as three days after starting an ibuprofen regimen in otherwise healthy people--giving credence to the belief that high doses of non-steroidal anti-inflammatory drugs (NSAIDs), no matter the safety profile, are likely to cause gastrointestinal bleeding that can be harmful to the digestive system.

"Unfortunately, people dealing with chronic pain, such as arthritis, often increase the recommended dose of their painkillers and they should be aware that the effects on the GI tract can be serious," said Richard H. Hunt, MD, senior study author from the McMaster University Health Science Centre. "Of all the NSAIDs available over-the-counter, ibuprofen was thought to have the least harmful effects on the GI tract. However, our study shows that healthy, young people and older people are at great risk of internal bleeding and should speak with their doctor to determine the risks of taking large amounts of ibuprofen."

Researchers from the McMaster University Health Science Centre in Ontario, Canada conducted a post-hoc analysis of two separate randomized studies that included 68 healthy volunteers who were given either four weeks of an ibuprofen regimen (800 mg, three times daily for 28 days) or a placebo--a dosage amount twice that of the recommended 1200 mg per day. Prior to starting the regimen, patients were evaluated for a one-week control period to demonstrate that they were not bleeding. Blood loss was determined in these subjects by conducting a radioactive analysis of Chromium-51 labeled red blood cells in stool during their baseline week and throughout the study.

Of the healthy subjects included in the study, those taking ibuprofen for 28 days experienced blood loss that was 3.64-fold greater than the placebo group. On average, those taking ibuprofen experienced blood loss as low as 40mL (approx. 1/5 cup) and as high as 299mL (approx. 1 cup). Bleeding was found to begin as early as three days after the start of the treatment and generally lasted the entire duration of the study in most subjects. According to study authors and previous studies, although the ibuprofen dose was higher than the recommended over-the-counter amount, blood loss, anemia and other adverse events can be observed at any dose of ibuprofen.

"While bleeding with a standard dose of ibuprofen is customary, the dose given in this study was twice that normally recommended over-the-counter by physicians," said Denis M. McCarthy, MD, PhD, author of an accompanying editorial and professor at the University of New Mexico School of Medicine. "Excessive bleeding in these people could signal underlying gastrointestinal problems and those suffering from diseases of the small or large intestines should consult their doctors about ibuprofen use." The authors of this study are hopeful that these findings will bring attention to the reality of the amount of painkillers potentially being used by patients at home and the fact that ibuprofen is often combined with other painkillers--potentially causing a greater amount of bleeding from the GI tract.

"The potential for serious GI complications should always be considered when ibuprofen is recommended for at-home use," said Hunt. "Elderly people and those with debilitating conditions such as arthritis should be especially cautious about the medications they are taking together and the adverse effects of those interactions. Serious bleeding can always occur even with over-the-counter drugs that are considered safe."

Ibuprofen is considered to have one of the most favorable safety profiles of all of the traditional non-selective NSAIDs, touted as the painkiller with the fewest side effects and lowest incidence of ulcers or GI bleeding. Everyday more than 30 million people take over-the-counter (OTC) and prescription NSAIDs for pain relief, headaches and arthritis. Although long-term use of NSAIDs in high doses can provide great benefit in terms of anti-inflammatory effects, pain relief and cardioprotective effects, there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers, hemorrhage and severe and potentially deadly gastrointestinal problems. Each year, the side effects of long-term NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths by some estimates.

In 2003, the AGA launched the R.E.D.U.C.E. (Risk Education to Decrease Ulcer Complications and Their Effects from NSAIDs) Campaign to help explain the potentially harmful effects of NSAIDs and how Americans can lower their risk for serious gastrointestinal problems.

About the AGA

The American Gastroenterological Association (AGA) is dedicated to the mission of advancing the science and practice of gastroenterology. Founded in 1897, the AGA is the oldest medical-specialty society in the United States. Comprised of two non-profit organizations--the AGA and the AGA Institute--our more than 14,500 members include physicians and scientists who research, diagnose and treat disorders of the gastrointestinal tract and liver. The AGA, a 501(c6) organization, administers all membership and public policy activities, while the AGA Institute, a 501(c3) organization, runs the organization's practice, research and educational programs. On a monthly basis, the AGA Institute publishes two highly respected journals, Gastroenterology and Clinical Gastroenterology and Hepatology. The organization's annual meeting is Digestive Disease Week, which is held each May and is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit http://www.cghjournal.org.

Continue to Read more ...

High Estrogen Levels During Pregnancy Associated With Improvement In Psoriasis

Increased levels of estrogen that occur during pregnancy may be associated with improvement in psoriasis, according to a study in the May issue of the Archives of Dermatology, one of the JAMA/Archives journals.

Anecdotal reports have suggested that psoriasis tends to improve during pregnancy, according to background information in the article. The current study investigated prospectively how psoriasis fluctuates in pregnancy and correlated progesterone and estrogen levels in pregnancy with psoriatic change.

Jenny E. Murase, M.D., of the University of California, Irvine, and colleagues compared changes over the course of one year in psoriatic body surface area in women with psoriasis in a group of 47 pregnant women and a control group of 27 non-pregnant pre-menopausal women. The women reported on their stress level, perceived psoriatic severity and the extent of their body surface affected by psoriasis five times over the course of the year: pregnant women at 10, 20 and 30 weeks gestation, and six and 24 weeks after birth and the control group at baseline, 10, 20, 36 and 54 weeks following enrollment. Hormone levels at each assessment were determined for 19 of the pregnant women.

During pregnancy, 55 percent of the patients reported improvement in psoriasis, 21 reported no change and 23 percent reported worsening. Only nine percent of patients reported improvement post partum, 26 reported no change and 65 percent reported worsening. Psoriatic body surface area decreased significantly from 10 to 20 weeks' gestation compared to controls and increased significantly six weeks post partum. Although 65 percent of the pregnant patients reported worsening, their psoriatic body surface area only returned to pre-pregnancy levels, the authors report. In pregnant women with 10 percent or greater psoriatic body surface area, lesions decreased by 83.8 percent during pregnancy. Psoriatic body surface area levels in the controls remained the same throughout the year.

"High level of estrogen correlated with improvement in psoriasis, whereas progesterone levels did not correlate with psoriatic change," the authors write. "We believe that further examination of how estrogen may improve psoriasis is warranted. ...Whether estriol [a form of estrogen] can improve psoriasis or can prevent worsening of psoriasis in menopause should be explored." (Arch Dermatol. 2005;141:601-606. Available post-embargo at archdermatol.com)

Continue to Read more ...