Fighting Seasonal Affective Disorder Symptoms During Winter


For one in 300 Australians, June 1st marks not just the official start of gloomy weather.

The arrival of winter can also highlight the presence of a mild form of Seasonal Affective Disorder (SAD), when a person's mood takes a downturn along with the temperature and daylight hours.

Along with a gloomy outlook, the disorder could make a person feel lethargic and crave carbohydrate-rich fatty foods, Associate Professor Greg Murray from Swinburne University said.

"While winter SAD is most common in the northern hemisphere and appears to be rare in our temperate climate, research has shown that around one in 300 of the Australian adult population experiences SAD-like symptoms," said Dr Murray, who is convenor of clinical psychology programs at the Melbourne-based university.

"There is a trend for Australians to report lowered mood and energy levels in winter compared to the warmer months, but there are many ways to ease the symptoms."

Dr Murray said at its most extreme form, SAD was recognised as a type of recurrent depression.

People suffering a winter-time bout of depression should not put off seeking professional help, he said.

Otherwise, he offered some tips on battling SAD in its milder forms.

Dr Murray said sunlight was a natural mood enhancer, and people should aim for at least one hour of outdoor light each day, preferably in the morning.

Social activities tended to fall away during winter, affecting mood and energy levels, so a Winter Solstice or Christmas in July dinner party might provide some light relief.

Consider a gym membership during the colder months, Dr Murray said, and otherwise try to keep as active as possible.

The presence of colds and flu also made it harder to remain as productive as during the warmer months.

"For some people, acceptance of this natural rhythm is an important part of winter wellbeing," Dr Murray said.

"Although for most of us the mood and energy changes in winter can be addressed with these simple strategies, we should keep in mind that depression at any time of year can be difficult to shift and may require professional attention."

More on Seasonal Affective Disorder (SAD)

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At least 44 cases of Hepatitis C linked to an Australian Abortion Clinic

Patients of a late-term abortion clinic in Victoria may have been deliberately infected with hepatitis C after a further 32 women tested positive to the virus, bringing to 44 the total number of infections.

Health authorities and police are investigating allegations a cluster of patients of Melbourne's Croydon Day Surgery became infected with hepatitis C when James Latham Peters worked as an anaesthetist at the clinic over an 18 month period in 2008 and 2009.

The state's chief medical officer, John Carnie, said more than 1100 women who attended the clinic had been contacted for blood tests, with 44 so far testing positive to hepatitis C.

That contact was made after health authorities confirmed in April that 12 women who attended the Croydon Day Surgery became infected with hepatitis C, all of whom were linked directly to the clinic, and nine to the anaesthetist himself.

Since then, Dr Carnie said, 32 additional patients had tested positive to the virus and further genetic testing had linked 13 of those cases to the clinic.

"The more cases you find in this instance, it becomes more and more difficult to explain this by an accidental means," Dr Carnie said yesterday.

A spokesman for law firm Slater & Gordon said 30 patients of the Croydon Day Surgery had so far contacted the firm about compensation. It is understood letters of demand have been served on the clinic and Dr Peters. Slater & Gordon is yet to determine whether action will be taken against the Medical Practitioners Board of Victoria.

Health Minister Daniel Andrews yesterday described the hepatitis C outbreak as "a very serious matter", but he defended the effectiveness of the safety checks within the state's health system.

"I believe this is not about system failure; this is about, it would seem, the appalling, totally inappropriate behaviour of one particular person," Mr Andrews said.

"It is difficult to know what went on in that clinic."

Dr Peters has not worked at the Croydon Day Surgery since last December, and was suspended by the Medical Practitioners Board on February 15. The alleged infections occurred between 2006 and last year.

Victoria Police established a taskforce to investigate allegations that the hepatitis C infections were linked to  the surgery, after it received a request from the Department of Health in April.

No charges have been laid but police yesterday said in a statement: "Detectives are working to discover whether any criminal activity led to the spread of hepatitis C to patients at the facility."

Victoria Police said it was working closely with government and private agencies, but the investigation was likely to be a "long and involved" one.

Dr James Latham Peters was given a six-month suspended jail term in August 1996 after pleading guilty to 20 charges over providing his wife with a two-year non-stop supply of pethidine the Herald Sun reported.

Dr Peters voluntarily surrendered his medical registration but succeeded in having it restored within the past five years.

The Medical Practitioners Board is refusing to release details of Dr Peters' history, saying it must protect doctors' privacy.

It had placed him on a program for substance-abusing doctors, made him submit to drug tests for a year, and restricted his practice when he re-applied for registration. But the conditions were later removed.

More on Hepatitis C

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Swine Influenza aka H1N1

Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza viruses. In the recent outbreak cases of human infection with swine influenza A (H1N1), viruses were first reported in Mexico. Ninety one (9!) cases of swine flu infection have now been reported in the United States and additional cases have been reported internationally.
The CDC has determined that the swine influenza virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people. In addition, it is unclear why the disease is mild in all locations except Mexico. To date, there have been no fatalities and few people requiring hospitalization outside of Mexico. The one current fatality is a Mexican citizen who was being treated in the U.S.
There is increasing concern that this virus will become easily transmissible from person to person, and that a pandemic will occur. The severity of such a pandemic depends upon the virulence of the virus, which is uncertain at this time. A pandemic is a global disease outbreak that affects an exceptionally high proportion of the population. The H1N1 virus is a likely candidate to cause the next pandemic, although no one can predict with certainty that a pandemic will occur.
Human vaccines for the virus that causes swine flu have not been developed. There is no evidence that the individuals who received the seasonal flu vaccine have immunity to swine flu. Two anti-viral medications, Tamiflu (oseltamivir) and Relenza (zanamivir), have been shown to be effective in treating swine flu.

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Rheumatoid Arthritis Definition

Rheumatoid arthritis (RA) is a chronic, autoimmune disorder that causes the immune system to attack the joints, resulting in substantial loss of mobility and joint destruction. The disease is also systemic, meaning it often affects many extra-articular tissues throughout the body, such as the skin, blood vessels, heart, lungs and muscles.

Signs and Symptoms of Rheumatoid Arthritis

One of the most common symptoms of RA is daily joint pain. Most patients also experience some degree of depression and anxiety, which can impact functional status and quality of life.

Other symptoms include:

* Morning stiffness in and around the joints
* 3 or more joint areas with simultaneous soft tissue swelling or fluid
* Swollen joint areas in the wrist, knuckle or middle joint of the finger
* Fatigue, which can be severe during a flare-up
* General sense of not feeling well (malaise)

Although RA is traditionally a chronic disease, it tends to vary in severity, alternating between flare-ups and remission.

Causes and Risk Factors of Rheumatoid Arthritis
Doctors do not know why people develop RA, but it is believed to be the body's immune system attacking the tissue that lines a person's joints. More than 2 million people in the U.S. have RA. It is two to three times more common in women than men and typically develops between the ages of 20 and 50.

While RA itself is not inherited, what can be inherited are the genes that may make someone more likely to develop the disease. Although scientists believe it is unlikely that genes alone bring about RA, research continues to study the role genes play in the development of the disease. In addition to genetics, recent research suggests that RA may also be caused by environmental and hormonal factors.

Other factors that increase the risk of RA include:

* Getting older, incidences of RA increase with age
* Being female
* Heredity, a predisposition to RA runs in some families
* Smoking cigarettes over a long period of time

Doctors also believe that certain infections or factors in the environment may cause the immune system to attack the body's own tissues, resulting in inflammation in various organs of the body such as the lungs or eyes.

Diagnosis and Treatment of Rheumatoid Arthritis
While your family doctor may be able to diagnose your symptoms, only a qualified physician can diagnose you with RA. If you think you have RA, have your doctor refer you to a rheumatologist, a doctor specializing in managing conditions involving joints, muscles and bones. It is important to diagnose RA early, and patients should start aggressive treatment as soon as possible. However, proper treatment can greatly improve the quality of a person's life.

The cure for RA still remains unknown, but the main goal of treatment is to relieve symptoms, especially pain, as well as slow progression of the disease and prevent disability. Doctors may suggest a variety of treatment options to improve symptoms, such as medicines, therapies, procedures and lifestyle changes.

If you have been experiencing daily joint pain or any other symptoms of RA, it is best to schedule an appointment with your doctor for a proper diagnosis.

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Inhibiting TAK-1 Reverses Pancreatic cCncer Resistance to Chemotherapy

Inhibiting the action of an enzyme called TAK-1 reverses pancreatic cancer resistance to chemotherapy
, a finding that could lead to the development of a new way to treat the disease, researchers say.

Pancreatic cancer is resistant to every currently available anti-cancer treatment.

"During the past few years we have been studying the role played by a cytokine or regulatory protein called transforming growth factor-beta [TGFbeta] in the development of pancreatic cancer. Recently we focused our attention on a unique enzyme activated by TGFbeta, TAK-1, as a mediator for this extreme drug resistance" in pancreatic cancer, study author Dr. Davide Melisi said in a news release from the European Cancer Organization.

He and his colleagues developed a TAK-1 inhibitor and tested it on its own and in combination with the anti-cancer drugs gemcitabine, oxaliplatin and SN-38 (a metabolite of the anti-cancer drug irinotecan) in pancreatic cancer cell lines. They also tested the TAK-1 inhibitor combined with gemcitabine against pancreatic cancer
in mice.

"The use of this TAK-1 inhibitor increased the sensitivity of pancreatic cells to all three chemotherapeutic drugs," Melisi said.

"By combining it with classic anti-cancer drugs, we were able to use doses of drugs up to 70 times lower in comparison with the control to kill the same number of cancer cells. In mice, we were able to reduce significantly the tumor volume, to prolong the mice survival, and to reduce the toxicity by combining the TAK-1 inhibitor with very low doses of a classic chemotherapeutic drug, gemcitabine, that would have been ineffective otherwise," Melisi added.

The study was scheduled for presentation Sept. 24 at the joint meeting of the European Cancer Organization and the European Society for Medical Oncology in Berlin.

"This is the first time that TAK-1 has been indicated as a relevant target for the treatment of a solid tumor and that it is a valid approach to reverting the intrinsic drug resistance of pancreatic cancer," Melisi stated. "The TAK-1 inhibitor used in this study is an exciting drug that warrants further development for the treatment of pancreatic cancer."

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Face Masks and Hand-Washing May Stop Flu

Amy Norton

Face masks and clean hands may be key to preventing the influenza virus from spreading among family members, a study published Monday suggests.

The study, of 259 Hong Kong households, found that when family members wore face masks and minded their hand hygiene, the odds of catching the flu from an ill relative dropped by two-thirds.

The key was to start taking the two measures within 36 hours of the stricken family member's first symptoms. Flu symptoms typically include fever, sore throat, body aches and headache that arise suddenly.

The findings point to simple, inexpensive ways to curb flu transmission during both regular influenza season and during pandemics like the current swine flu (H1N1) outbreak, the researchers report in the online edition of the Annals of Internal Medicine.

"Some people may have the misconception that flu is so infectious that very little can be done to prevent household transmission," lead researcher Dr. Benjamin J. Cowling, an assistant professor at the University of Hong Kong School of Public Health, told Reuters Health in an email. "Our study demonstrates that this is not the case."

For the study, Cowling and his colleagues followed 259 households in which one family member had a confirmed case of influenza. The researchers randomly assigned each household into one of three groups: one that received education on a healthy diet and lifestyle; one that was instructed on good hand hygiene; and one that was instructed on both hand hygiene and face mask use.

In both hand-hygiene groups, family members were given liquid soap and told to wash their hands whenever they used the bathroom, sneezed or coughed. They were also given alcohol-based hand rub, to be used whenever they first arrived home and immediately after touching any potentially virus-contaminated surface.

Families in the face mask group were given disposable surgical masks to wear whenever they were not eating or sleeping.

Over the next week, family members in 19 percent of the study households developed a confirmed case of the flu. That risk was two- thirds lower in households where the hand-washing/face mask intervention was begun within 36 hours of a family member's first flu symptoms.

The risk was also somewhat lower in the hand-hygiene group.

The fact that hand-washing appeared effective, Cowling said, shows that the flu can spread via direct contact and, more indirectly, by touching virus-contaminated household objects like door handles, light switches and TV remotes.

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Brain Exercise Delays The Onset of Dementia

Anne Harding

A new study in Bronx seniors provides yet more evidence that keeping your brain active for fun can keep dementia at bay.

Dr. Charles B. Hall of the Albert Einstein College of Medicine in Bronx, New York, and his colleagues found that every day per week that a person engaged in one of six mentally stimulating leisure activities delayed the onset of dementia by about two months.

Hall and his colleagues had previously shown that people with more years of education who developed dementia did so later than less educated individuals. In the current study, he said, "it was the cognitive activity that mattered, not the education."

In the current study, published in Neurology, Hall and his team looked at 101 people who developed dementia. All were participating in the Bronx Aging Study, which has been following 488 people since the early 1980s.

All of the study participants, who ranged in age from 75 to 85, had reported their years of formal education at the study's outset, as well as how often each week they read, wrote, did crossword puzzles, played board or card games, participated in group discussions, or played music. A person scored 1 for each day that they did each activity. The study participants, all of whom were dementia free at the beginning of the study, underwent cognitive testing every 12 to 18 months.

The higher a person's score on the activity scale, the later the onset of accelerated mental decline, Hall and his colleagues found. For example, a person in the top 25 percent based on their activity scale, who engaged in 11 "activity days" a week, started their accelerated decline 1.29 years later, on average, than a person in the bottom 25 percent, with four activity days a week.

But once that decline began, it happened faster in people with higher activity scores.

The findings back up the idea of "cognitive reserve," Hall noted, which is the theory that education and brain exercise build extra capacity into the brain so it can better handle the damage to neurons caused by Alzheimer's disease. But once that damage reaches a certain point, a person will develop dementia.

Being more mentally active "might keep you out of a nursing home for a year or two," Hall said. "But it's not going to prevent Alzheimer's disease unfortunately, at least that's the theory, and this is evidence toward that theory." Eventually, he said, the disease "would overwhelm whatever reserve you had."

Hall and his colleagues are now investigating which of the six activities in the current study might give the most brain-preserving "bang for the buck." Studies will need to tease out whether education and later-life mental activities have effects that are independent of one another.

With what we know now, he added, engaging in these activities could help-and it certainly won't hurt. "You might get depressed from not being able to do a crossword puzzle, but there's really very little of a downside here."

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Michael Jackson's Health Problem History

Pop icon Michael Jackson, 50, who died Thursday afternoon after being rushed to a Los Angeles hospital in cardiac arrest, had a long history of confirmed health problems, in addition to rumored conditions.

In 1984, Jackson was burned while singing for a Pepsi-Cola commercial in Los Angeles, when the special effects smoke bomb misfired. He had to have major surgery on his scalp, and said that because of the intense pain he developed an addiction to painkillers.

He also was reported to have a form of lupus in the 1980s, but it was later said to have gone into remission.

He has had numerous plastic surgeries, including rhinoplasty and a chin implant.

In 1993, Jackson's dermatologist, Dr. Arnold Klein, released a statement saying that Jackson had a rare skin disease called vitiligo. Vitiligo causes a person to lose melanin, the pigment that determines the color of skin, hair and eyes, in patches or all over the body. The condition affects 1 percent to 2 percent of the population, and no one knows what causes it.

He was also hospitalized with chest pains in 1990 and postponed a concert because of dehydration in August 1993. A concert tour was cut short in November 1993 because of an addiction to prescription painkillers amid allegations of child molestation.

During a rehearsal at the Beacon Theater in New York in December 1995, the entertainer collapsed onstage from apparent dehydration and low blood pressure and was hospitalized.

While jurors deliberated in a case in which he was accused of child molestation in June 2005, Jackson went to a hospital for treatment of what his spokeswoman said was recurring back pain. He had complained of back problems before.

Rumors circulated in December that Jackson was ill and in need of a lung transplant because of Alpha-1 antitrypsin deficiency, a rare genetic condition.

More rumors emerged in May that Jackson had skin cancer. But Randy Phillips, president and CEO of AEG Live, told CNN at the time, "He's as healthy as he can be -- no health problems whatsoever."

Jackson apparently collapsed in his home in Los Angeles on Thursday and was taken by ambulance to UCLA Medical Center.

Brian Oxman, Jackson family attorney, told CNN Thursday that Jackson's use of medications had gotten in the way of doing rehearsals.

"His injuries, which he had sustained performing, where he had broken a vertebra and he had broken his leg from a fall on the stage, were getting in the way. I do not know the extent of the medications that he was taking," he said.

The results of toxicology tests on the body of Michael Jackson may not be available for six to eight weeks, the Los Angeles coroner's office said Friday.

Ed Winter, assistant chief coroner, said the autopsy exam will be conducted Friday, but few results are expected Friday because of the extensive tests being performed.

"The likelihood is very slim that we will have any results to release today because of the extensive [tests] that we're going to be performing," he said.

The office will likely not determine a cause of death "until we get results of all the tests," he said.

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Are you at risk for diabetes?

Definition of Diabetes

Diabetes is a disorder of metabolism, the process by which the body uses digested food for energy and growth. Most of the foods we eat are broken down into glucose, a form of sugar in the bloodstream that is used as the body's main fuel source. Insulin, the hormone produced by the pancreas, works together with glucose to help it enter the body's cells to be burned for energy. When people have diabetes, the pancreas either produces too little insulin, or the insulin produced cannot be used by the body. This prevents glucose from entering the cells, which ultimately denies the body of its main source of fuel.
Two Main Types of Diabetes

Type 1 diabetes occurs because the pancreas produces little or no insulin, which prevents glucose from entering the cells and causes high blood sugar levels. Type 1 diabetes can develop at any age, but is most common among people younger than 20 years old and must be managed by taking daily injections of insulin.

Type 2 diabetes is caused by insulin resistance, a condition in which the body cannot use the insulin produced by the pancreas. Type 2 diabetes is most common in people over age 45 and is usually associated with obesity (approximately 80% of people with type 2 diabetes are overweight), a family history of diabetes, previous history of gestational diabetes, physical inactivity and ethnicity.

Signs and Symptoms

When the body isn't processing enough glucose, the buildup is secreted into the urine, which passes out of the body. As a result, a person with diabetes will experience the following symptoms:

* Excessive thirst and appetite
* Increased urination
* Dry mouth
* Unusual weight loss or gain
* Weak, tired feeling
* Frequent yeast infections
* Blurred vision
* Numbness or tingling of the hands or feet
* Irritability
* Nausea, perhaps vomiting
* Itchiness, especially around the groin
* Slow-healing sores or cuts

People with type 1 diabetes usually develop symptoms within days or weeks, while people with type 2 diabetes often don't experience symptoms for years. Signs of diabetes may seem harmless and are often overlooked, but studies show early detection and treatment can greatly reduce the chance of complications.
Risk Factors of Diabetes

Doctors do not know why people develop RA, but it is believed to be the body's immune system attacking the tissue that lines a person's joints. More than 2 million people in the U.S. have RA. It is two to three times more common in women than men and typically develops between the ages of 20 and 50.

The following factors increase a person's chance of developing diabetes:

* Family history of diabetes
* Smoking
* Age (older than 45)
* Race or ethnic background
* Poor diet
* Diabetes during a previous pregnancy
* Being overweight, especially around the waist
* Years of heavy alcohol abuse
* History of hypertension (high blood pressure)
* Low activity level
* Abnormal blood cholesterol or triglyceride levels
* Certain drugs (these might increase blood sugar)
* History of gestational diabetes
* Delivery of a baby weighing more than 9 pounds

Managing Diabetes

While the cure for diabetes is still unknown, the goal of treatment is to keep blood sugars at a relatively even level. The main treatment for people with type 1 diabetes is exercise, a diabetic diet and daily injections of insulin. Insulin injections need to be balanced with meals and exercise, and blood sugar levels must be frequently tested.

When treating type 2 diabetes, doctors will first suggest lifestyle changes such as losing weight, following a diabetic diet and getting regular exercise. Once these measures become less effective in controlling glucose levels, oral medications are often prescribed. If oral medications are still unsuccessful, doctors may recommend insulin treatments.

Glucose levels that are excessively high or low can be extremely dangerous, even life-threatening. When blood sugar levels drop too low, a condition called hypoglycemia can occur, which causes a person to become nervous, shaky and confused. In severe cases the person may eventually lose consciousness. However, this condition can be reversed by eating or drinking something sugary, like a candy bar or glass of orange juice.

If you or someone you know has diabetes, making healthy lifestyle choices about diet, exercise and other health-related habits can improve glycemic (blood sugar) control and help prevent or minimize complications of diabetes.

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Induced Labor by means of Relaxation, Breathing, Orgasm ...

The Lamaze Technique is a natural childbirth technique developed in the 1940s by French obstetrician Dr. Ferdinand Lamaze as an alternative to the use of general anesthesia during labor. Dr. Lamaze was influenced by Soviet childbirth practices, which involved breathing and relaxation techniques under the supervision of a "monitrice" or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book Thank You, Dr. Lamaze.

Modern Lamaze childbirth classes teach expectant mothers breathing techniques and often other ways to work with the labor process to reduce the pain often associated with childbirth, such as hot and cold packs, changing positions, the use of a "birthing ball" to remain in a supposedly more natural upright position, and even orgasm to induce or hasten labor. When you see laboring women on TV or in movies huffing and puffing through clenched teeth, they're practicing the Lamaze technique of childbirth.

Myths about Lamaze

Myth #1: Lamaze is all about breathing.

Reality: The goal of Lamaze classes is to increase women's confidence in their ability to give birth. Lamaze classes help women discover the inner wisdom they already have for giving birth. Women learn simple coping strategies for labor, including focused breathing. But breathing techniques are just one of many things that help women in labor. Movement and positioning, labor support, massage, relaxation, hydrotherapy, and the use of heat and cold are some others.

Myth #2: Lamaze promises painless childbirth.

Reality: Many women are afraid of the pain that is a normal part of childbirth. The pain of labor and birth, like other pain, protects us. Responding to the pain of contractions - by changing positions and moving, by massaging, by moaning - actually strengthens the contractions, helps the baby settle into the pelvis and move through the birth canal, and reduces pain perception. Some women find that experiencing and coping with the pain of labor and birth is similar to the hard work demanded by dancers and athletes. Lamaze classes help women understand the value of pain and learn how to respond to pain in ways that both facilitate labor and increase comfort.

Myth #3: Lamaze childbirth means you can't have an epidural.

Reality: Lamaze classes provide information about natural pain relief options as well as epidural anesthesia. Eliminating pain completely makes it difficult to respond to contractions in ways that facilitate labor and birth. Women who have epidural anesthesia are required to have IV fluids and continuous electronic fetal monitoring. They may be encouraged to stay in bed and may need medications to increase the strength of her contractions. The ability to use many of the comfort techniques learned in Lamaze classes, such as changing positions, walking, and hydrotherapy may be limited. Lamaze education will assist women in making personal decisions that are right for them.

Myth #4: Lamaze doesn't work.

Reality: Lamaze that "works" has nothing to do with feeling pain, taking or avoiding medication, or developing complications that necessitate medical interventions. Lamaze teaches women that nature has designed birth simply and close to perfectly and that women already know how to give birth. Lamaze is working if women trust the natural process of birth, have confidence in their ability to give birth, have the freedom to work with their bodies as labor progresses, and are supported by health care providers, family and friends who wait patiently for nature to do its incredible work. Lamaze "works" if birth is allowed to work.

Myth #5: Lamaze is not for everyone.

Reality: Women have always prepared for the birth of their babies. Until recent times, women learned about birth from their own mothers and sisters. Birth took place at home with family rituals and traditions to help them feel confident in their ability to give birth. Women were surrounded by family and wise women who provided comfort and encouragement through labor and in the days and weeks after birth. Today, Lamaze childbirth classes provide the knowledge, skills, and support that help women give birth with confidence and joy as they have done for centuries. Lamaze preparation is for everyone!

Lamaze Philosophy of Birth

1) Birth is normal, natural, and healthy.

2) The experience of birth profoundly affects women and their families.

3) Women's inner wisdom guides them through birth.

4) Women's confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.

5) Women have the right to give birth free from routine medical interventions.

6) Birth can safely take place in birth centers and homes.

7) Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

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What To Ask Your Doctor During Your Visit

Your relationship with your doctor greatly influences your ability to make wise health decisions. It can also affect the outcome of your care. Partner with your doctor in making decisions about your health care. Common goals, shared effort, and good communication are the basis of successful doctor-patient partnerships.

Questions to ask your doctor
Even if you don't have a plan for treating your condition, your doctor does! These important questions will help you and your doctor create a treatment plan that is right for you.
How should I treat my condition?

What problems could occur from my condition?

What will happen if I don't treat my condition?

What lifestyle changes can help me deal with my condition?

How will this condition affect my life in the long-term?

When should I set my next appointment?

Questions if you receive a prescription
Some conditions can be managed with diet, exercise or other lifestyle changes; but it may be necessary to take a prescription medication as well. If you receive a prescription from your health professional, here are some specific questions you should be asking:
What is the benefit of this medication over another?

How does my medication work?

How do I take my medication?

Is my medication available in generic?

What are the possible side effects of my medication and what should I do if I
experience any?

What should I do if I miss a dose?

What are the risks of not taking my medication as prescribed?

How long will I have to take my medication?

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What Is Erectile Dysfunction?

Erectile Dysfunction is a male sexual dysfunction that makes men incapable of triggering off erections or sustaining the erections long enough to have a satisfactory sexual intercourse. Male sexual health is often placed at risk on account of a whole range of sexual disorders and among all the sexual problems suffered by men; erectile dysfunction is a prominent one. The other sexual disorders that constantly afflict men are ejaculatory problems like premature or early ejaculation, delayed or retarded ejaculation, dry orgasm, peyronie`s disease, priapism, male infertility et al.

Erectile Dysfunction: Another Name For Male Impotence

In 1993, the NIH Consensus Development Panel on Impotence called impotence "an important public health problem." The panel proposed that the term "impotence" be replaced by the less pejorative and more precise "erectile dysfunction" (ED) to signify "the inability to attain and/or maintain penile erection sufficient for satisfactory sexual performance."

How Erectile Dysfunction Sterilizes The Sex Life Of Men?

All the sexual dysfunctions affect men one way or the other but when it comes to male impotence or erectile dysfunction, the impact is very strong for the reason that once a person falls in the grip of erectile dysfunction, adequate amount of blood fail to reach his penile section. When proper blood flow to the penis is restricted, the person fails to trigger off erections necessary for satisfactory sexual intercourse. Erectile dysfunction not only sterilizes a man's sex life but also becomes a cause for other diseases such as depression.

Other Consequences Of Erectile Dysfunction

After erectile dysfunction or male impotence makes a man incapable of achieving sexual fulfillment with his partner, a whole array of unwanted circumstances evolve as the ultimate end result:

* Erectile Dysfunction means more than just the sexual incapability of a man. The emotions and uncertainties that coincide with this condition often have a significant effect on a man's self-esteem, as well as, his relationship with his partner.
* In case of erectile dysfunction afflicted married men, relationship breakdown is an inevitable outcome.
* There are significant consequences of erectile dysfunction like looking down upon by friends and peers and most particularly the rejection from girls can be very painful for a man.
* Guys are increasingly at the risk of losing their girlfriends as soon as their erectile dysfunction secret is out.
* Erectile dysfunction, the premier male sexual disorder is generally accompanied by tension, stress and other mental setbacks. These mental disorders further accelerate disaster in a man's personal as well as social life.

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The Side-Effects of Viagra

Every drug is accompanied with some of its side effects too apart from its benefits and Viagra is also no exception to it. But the side effects of Viagra are very mild and do not last for a long time. Some of the side effects of Viagra occur only if you take large dosages so if you are taking Viagra for the first time then it is best to start with the lowest pill dosages.

The most common are

* Headache
* Flushing of the face
* Upset stomach.
* Stuffiness of the nose

Less common medicine effects that may occur are

* Temporary changes in color vision (such as trouble telling the difference between blue and green objects or having a blue color tinge to them)
* Eyes becoming more sensitive to light or blurred vision
* Cloudy or bloody urine
* Increased frequency of urination
* Pain on urination
* Diarrhea

Some of the rarest side effects which have been noticed are as follows, though you must remember that these are some of the rarest side effects and does not necessarily mean to be experienced by everyone taking Viagra.

* Painful genital erection that lasts many hours.
* Convulsions or seizures
* Bleeding of the eye
* Decreased or double vision
* Prolonged and inappropriate erection of the penis.
* Anxiety

You should call a medical doctor immediately if you ever have an erection that lasts more than four hours.

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The causes of Erectile Dysfunction

The causes of erectile dysfunction can be broadly classified into two principal categories, physiological and psychological causes. From these two, physiological factors are found to be the primary cause of erectile dysfunction. However physicians state that approximately eighty-five percent of erectile dysfunction is attributed to physiological/organic conditions while only fifteen percent is due to psychological or mixed origin (both psychological and organic). Moreover, there are some lifestyle factors which are also found to cause erectile dysfunction to a substantial degree.

Physiological Causes Of Erectile Dysfunction

Some of the prominent physiological causes responsible for erectile dysfunction in men are detailed below:

* Vascular diseases like arteriosclerosis, hypertension, hypercholestremia,
* Diabetes
* PrescriptionMedications

(i)Antihypertensives such as beta-blockers, diuretic medications and calcium channel blockers.


(iii)Antiandrogen medications used in the treatment of prostate cancer

(iv) Chemotherapy/radiation therapy used in the treatment of cancer
* Substance abuse like the chronic intake of marijuana, cocaine, alcohol e.t.c.
* Radical Pelvic Surgery
* Neurological Diseases
* Deficiencies in the Endocrine System
* Psychological Erectile Dysfunction
* Anatomical deviation of the penis

Psychological Causes Of Erectile Dysfunction

Even though physiological reasons account for most of the cases of erectile dysfunction, the role played by psychological causes in triggering off erectile dysfunction in men cannot be ruled out altogether. The effective functioning of a man's sexual life depends a lot on his mental well being and only when a man is mentally steady and fine, he is able to extract the maximum sexual satisfaction by physically uniting with his partner. There are a lot of factors that cause mental disturbance in a man and make him a victim of erectile dysfunction thereby ruining his sex life. The psychological causes that lead to erectile dysfunction are namely,

* anxiety with regard to one's sexual performance
* Indifference towards the existing sexual relationship between partners
* Stress caused by hectic lifestyle and other factors
* Serious depression on account of relationship failure, business loss and similar other setbacks
* low self esteem resulting from earlier episodes of unfulfilled sex

Lifestyle Causes of Erectile Dysfunction

A healthy lifestyle prevents the occurrence of erectile dysfunction or male impotence to a considerable extent but if men continue to indulge in harmful vices like smoking, drinking, drug usage et al, then sooner or later they are likely to become erectile dysfunction patients. Important facts concerning lifestyle causes and erectile dysfunction are placed below:

* Excessive alcohol intake may increase high blood pressure levels and induce erectile dysfunction.
* High levels of nicotine released in the blood on account of cigarette smoking and the smoking of other tobacco containing substances reduce blood flow to the penis and lead to erectile dysfunction.
* Apart from alcohol and tobacco containing products, the intake of marijuana, cocaine, ecstasy is also a primary cause of male impotence.
* Overweight men as well as people leading sedentary lifestyle are highly at risk of erectile dysfunction.

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Viagra and Depression Induced Erectile Dysfunction

The term 'Impotence' has been replaced with 'Erectile Dysfunction' by the National Institute Health, USA . The erectile dysfunction is one of the most common sexual problems regarding male sexual health.

Erectile dysfunction has a range of physiological and psychological causes behind its occurrence. The psychological causes take the maximum share amongst the percentage of the reasons responsible for erectile dysfunction. According to a survey for both men and women approximately 78% cases of erectile dysfunction or inhibited sexual desire are of mental or emotional origin. This shows that erectile dysfunction is often the consequence of either sexual guilt or disturbed and cold relationships between the spouses or the partners. It is very important for us to clearly understand the causes which are responsible for erectile dysfunction like fear of intimacy, sexual guilt or may be some recreational drugs.

Coming to an altogether different area of discussion, let us throw some light on depression too which is often found closely related to many cases of erectile dysfunction. Impotence and Depression are highly coexisting condition. Depression is one of the most common and the most serious mental health problems that men are facing today. According to a study published in American Journal of Psychiatry successful treatment of erectile dysfunction or impotence in depressed men can lead to marked improvement in depression. 60% of all men over the age of 40 showed some degree of impotency and 30% of Americans have a depressive disorder every year. Study found a correlation between change in Impotence and change in depressive symptoms - but it was not cleared whether the depression caused impotence erectile dysfunction (ED), or impotence erectile dysfunction (ED) caused the depression.

For millions who suffer from depression the sexual side effects of the medication can be a big turn off for them to continue their treatment with the anti depressants like the selective serotonin inhibitor drugs used for treating depression. In a study it has been proved that Viagra, the oral pill to treat erectile dysfunction, can ease a man in his condition of depression by having a positive impact. When a person knows that he can lead a normal sexual life with Viagra, in spite of the sexual side effects caused by the anti depressants, he will surely not hesitate to shy away from his treatment for depression. This way, a man suffering from anxiety no more has to worry about his sexual problem of erectile dysfunction which is an undesired side effect of taking anti depressants. Viagra increases the body's ability to achieve and maintain an erection during sexual stimulation. A Survey indicates that Viagra showed great improvement in Men in their Impotency as well as in their depression.

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What is Benign Prostatic Hyperplasia a.k.a Enlarged Prostate?

Benign prostatic hyperplasia (BPH), known as an enlarged prostate, is a non-cancerous growth of the prostate that commonly occurs in men over 50. The prostate, which is located below the bladder and surrounds the first inch of the urethra (the duct through which urine and sperm are discharged), is a walnut-sized gland that secretes fluid for semen. As a man ages and the prostate gland grows, it compresses the urethra and bladder, resulting in restricted urine flow.
Symptoms of an Enlarged Prostate

While most symptoms of BPH start gradually, the most common ones involve changes or problems with urination.

* Difficulty starting to urinate
* Hesitant, weak urination stream
* Blood in the urine
* Interruption of urination stream

However, the size of the prostate does not determine the severity of a man's symptoms. While some men with extremely swollen glands have little obstruction and few symptoms, others with less enlarged glands experience more blockage and greater problems.

As the urethra narrows and the bladder wall becomes thicker, the bladder itself becomes smaller causing the following symptoms:

* Bladder irritability
* Urge to urinate frequently, especially at night
* Incontinence (the inability to control urination)

Over time BPH can lead to other urinary problems, such as urinary tract infections, bladder or kidney damage and bladder stones. In some cases these symptoms could be a warning of a more serious disease and should be treated by a doctor.
Risk Factors and Preventative Measures

While age is the most common risk factor, ethnicity and genetics also play a role in the development of BPH.

* Age: BPH is rare before the age of 40, but more than half of men in their 60s and as many as 90% in their 70s and 80s have some symptoms of BPH.
* Ethnicity: While BPH is common in Europeans and Americans of European descent, it is rare in Asian men.
* Heredity: Having a family history of BPH greatly increases a man's chances of developing the condition.

Lifestyle changes can also help reduce the occurrence of BPH symptoms:

* Reduce the intake of coffee, tea and soda
* Eat an early dinner to eliminate drinking fluids later in the evening
* Cut down on fluids after 7pm
* Drink 8 glasses of water per day to help prevent accumulation of bacteria
* Avoid over-the-counter (OTC) cold remedies that contain pseudoephedrine and antihistamines
* Avoid spicy and salty foods
* Stay regular (constipation may aggravate the urinary tract)
* Ejaculate regularly
* Take hot baths
* Avoid prolonged sitting
* Drink cranberry juice to increase the acidity of the urinary tract

Treatment Methods

Treatment options vary from case to case depending on the severity of the symptoms. If a patient's symptoms are mild, the usual procedure is "watchful waiting" and no pharmaceutical or surgical treatment is recommended. For moderate symptoms doctors may prescribe alpha-receptor blockers to relax the prostatic-urethral muscle or 5-alpha-reductase inhibitors to help shrink the size of the prostate. In extreme cases surgery is considered the most effective treatment option after other methods have been exhausted. There are different types of surgical treatments used to improve urine flow, including transurethral resection of the prostate (TURP) and transurethral incision of the prostate (TUIP), as well as several newer minimally invasive procedures.

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Could Your Child Be Suffering From Attention Deficit Hyperactivity Disorder (ADHD)

Attention-deficit/hyperactivity disorder (ADHD), previously known as attention deficit disorder (ADD), is a common mental condition characterized by poor concentration, distractibility, hyperactivity and impulsiveness that are inappropriate for the child's age. It affects between 3 and 5% of American children and is usually diagnosed in childhood, although roughly 60% of the cases continue into the adult years.Justify Full
Symptoms Of ADHD
The symptoms of ADHD can be broken down into 3 different subtypes: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype and a combined subtype.
Symptoms of the inattentive subtype of ADHD include the following:
* difficulty keeping the mind on any one thing
* skipping over details
* getting bored with a task before it’s completed
* making careless mistakes
* being easily distracted from a task, lesson, or conversation
* difficulty listening when directly addressed
* disorganization and forgetfulness
* difficulty following instructions or finishing tasks

Children experiencing the hyperactive/impulsive
form of ADHD may:

* have difficulty with quiet, sedentary activities
* fidget or have trouble staying in their seat
* talk excessively
* blurt out answers before questions are completed
* speak tactlessly or inappropriately
* exhibit difficulty waiting
* move around constantly, often running or climbing inappropriately
* interrupt or intrude on others

The combined subtype applies when a child shows symptoms of both the inattentive and hyperactivity/impulsivity type of ADHD. Children diagnosed with ADHD will exhibit persistent symptom in a variety of settings, including at home, in school and during extracurricular activities.

Causes of ADHD
While the cause of ADHD remains unknown, studies show that the brains of children with ADHD may function differently than those of other children, suggesting an imbalance of chemicals that help regulate behavior. Research also indicates that genetics play a significant role in the development of ADHD, contributing to about three quarters of the total ADHD population. However, roughly 1/5 of all ADHD cases are thought to be acquired after conception due to brain injury caused by substance abuse or physical trauma prenatally or postnatally.
Will my child outgrow ADHD?

While ADHD is considered a chronic disorder, symptoms often get better as children grow older and learn to adjust. Hyperactivity usually stops in the late teenage years, but about half the children diagnosed with ADHD will continue to be easily distracted, have mood swings, hot tempers and are unable to complete tasks. However, parenting plays an important role in helping a child with ADHD. Children with loving, supportive parents who work together with school staff, mental health workers and their doctor have the best chance of becoming well-adjusted adults.

Treatment of ADHD
Although there is no cure for ADHD, a child’s symptoms can be controlled with a combination of behavioral management, counseling and medication.

Behavioral management can help you and your child identify unwanted behaviors and replace them with more positive ones.

Counseling may include psychotherapy, social skills training or parental training, and it can often help a child deal with low self-esteem, anxiety, depression and stubborn behaviors.

Medication is most effective when it is combined with behavioral management or counseling. While there are many different types of ADHD medication, stimulants are the most common. By affecting the brain’s chemistry, it can help reduce overactivity and increase a child’s attention span.

If you think your child may have ADHA, talk to your doctor to learn what you can do to help.

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Breastfeeding Does NOT sag New Mother's Breast

Breastfeeding won’t make a new mom’s breasts sag, but having more babies might, a new study indicates.
“A lot of times, if a woman comes in for a breast lift or a breast augmentation, she’ll say ‘I want to fix what breastfeeding did to my breasts’,” University of Kentucky plastic surgeon Brian Rinker told Livescience. So he decided to study any possible connection. Rinker and his colleagues interviewed 132 women who came in for breast lifts or augmentation between 1998 and 2006. On average, the women were 39 years old, and 93% had experienced at least one pregnancy. Among the mothers, 58% had breastfed at least one of their children. The average duration of breastfeeding was nine months.
The researchers evaluated the study particpants’ medical history, body mass index, pre-pregnancy bra cup size and smoking status.
The results of the study, presented this week at a conference of the American Society of Plastic Surgeons, showed no difference in the degree of breast ptosis (or sagging) between women who breastfed and those who didn’t. The main factors that did affect sagging were age, smoking status and the number of pregnancies.
Rinker noted that the smoking connection made sense because “smoking breaks down a protein in the skin called elastin, which gives youthful skin its elastic appearance and supports the breast”.
Pregnancy also “has a very strong contribution to breast ptosis (sagging)”, Rinker said. “In fact, our study showed that those negative effects increase with each pregnancy.”
Rinker says this finding should alleviate the fears of new mothers over what nursing their child might do to their breasts in the long run and will encourage them to breastfeed because of the health benefits to their infant. “Women may be reluctant to breastfeed because of this unfounded myth that doing so means the end of youthful breasts,” Rinker said. “Now, expectant mothers can relax knowing breastfeeding does not sacrifice the appearance of their breasts.”

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Safe Handling Tips for Preventing Foodborne Illness From Pet Food and Pet Treats

Consumers can take steps to help prevent foodborne illness, including Salmonella -related illness, when handling pet foods and treats. These products, like many other types of foods, can be susceptible to harmful bacterial contamination.

Salmonella in pet foods and treats can cause serious infections in dogs and cats, and in people too, especially children, older people, and those with compromised immune systems. Salmonella in pet foods and treats potentially can be transferred to people ingesting or handling the contaminated products.

FDA has stepped up its efforts to minimize the incidence of foodborne illness associated with pet foods and treats. Pet owners and consumers can also help reduce the likelihood of infection from contaminated pet foods and treats by following safe handling instructions:

* Purchase products in good condition, without signs of damage to the packaging such as dents or tears.


* Wash your hands for 20 seconds with hot water and soap before and after handling pet foods and treats.
* Wash pet food bowls, dishes, and scooping utensils with soap and hot water after each use.
* Do not use the pet's feeding bowl as a scooping utensil—use a clean, dedicated scoop or spoon.
* Dispose of old or spoiled pet food products in a safe manner, such as in a securely tied plastic bag in a covered trash receptacle.


* Refrigerate promptly or discard any unused, leftover wet pet food. Refrigerators should be set at 40º F.
* Dry products should be stored in a cool, dry place—under 80º F.
* If possible, store dry pet food in its original bag inside a clean, dedicated plastic container with a lid, keeping the top of the bag folded closed.
* Keep pets away from food storage and preparation areas.
* Keep pets away from garbage and household trash.

Raw Food Diets

FDA does not advocate a raw meat, poultry, or seafood diet for pets, but is stepping up its efforts to minimize the risk such foods pose to animal and human health. The agency understands that some people prefer to feed these types of diets to their pets. For the protection of both you and your pet, the FDA recommends you follow these instructions when handling or using raw meat, poultry or seafood, for use in a pet’s diet:

* Keep raw meat and poultry products frozen until ready to use.
* Thaw in refrigerator or microwave.
* Keep raw food diets separate from other foods. Wash working surfaces, utensils (including cutting boards, preparation and feeding bowls), hands, and any other items that touch or contact raw meat, poultry or seafood with hot soapy water.
* Cover and refrigerate leftovers immediately or discard safely.

In addition:

* For added protection, kitchen sanitizers should be used on cutting boards and counter tops periodically. A sanitizing solution can be made by mixing one teaspoon of chlorine bleach to one quart of water.
* If you use plastic or other non-porous cutting boards, run them through the dishwasher after each use.

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Why You must take the Flu Shot this Flu Season?

Each winter, millions of people suffer from the flu. Flu—the short name for influenza—is caused by viruses. Viruses are very small germs. Some viruses can spread easily from one person to another. They cause illnesses or infections like the flu.

For some people, flu is a mild illness. For older people, especially those who have health problems like diabetes or heart disease, the flu can be very serious.

How Serious Is Flu?

Most people who get the flu feel much better in a week or two. But, some people can get very sick. For example, because your body is busy fighting off the flu, you might pick up a second infection. Older people are at great risk of these secondary infections, such as pneumonia.

How Does Flu Spread?

It was mid-November, and Ellen had not gotten a flu shot. One day she was out having lunch with a friend and noticed people sneezing and coughing at the next table. Two days later, Ellen woke up feeling achy and had a fever. She had the flu. Her husband Jack took care of her and was careful to wash his hands after touching Ellen’s dishes. But, a few days later he too was sick. Maybe he used the phone just after Ellen finished talking with their son. Or, maybe he touched a doorknob Ellen used after sneezing. Flu spreads easily from one person to another.

The flu is contagious—that means it spreads from person to person, often through the air. You can pass on the infection before you feel sick. You are contagious for several days after you get sick. You can catch the flu when someone near you coughs or sneezes. Or, if you touch something the virus is on, like Ellen and Jack’s phone or doorknob, and then touch your nose or mouth, you could catch the flu. The flu virus can live on a surface like a book or doorknob for a number of hours. Remember to wash your hands often when you are around someone who is sick. Make a point of washing them before eating and touching your eyes, nose, or mouth. If you can, stay away from sick people. That will help stop the flu from spreading.

Is It the Flu or a Cold?

It’s easy to confuse a common cold with the flu. A cold is milder than the flu, but since the flu can make older people very sick, you should know the difference. That way you will know when to call the doctor who might want to give you a prescription for medicines that can help you get over the flu.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call “stomach flu” is not influenza.

Why Do You Need A Flu Shot Every Year?

Flu viruses change often. Each year’s virus is just a little different than the year before. So every year the vaccine in the flu shot is changed. That’s one reason why you need a flu shot every fall.

Are There Side Effects?

Most people have no problem with a flu shot. In fact, for most people, the flu is more dangerous than the flu shot. When you get the flu shot, your arm might be sore, red, or swell a bit. These side effects may start shortly after getting the shot and can last up to 2 days. They should not get in the way of your daily activities. A few people do have a headache or a low-grade fever for about a day after they get the shot. The flu shot cannot cause you to get the flu. If you are allergic to eggs, you should not get the flu shot. Because eggs are used to make the flu vaccine, people who are allergic to eggs could have a serious reaction to the shot.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

Can Flu Be Prevented?

Getting a flu shot every year can help you stay healthy. A flu shot contains the flu vaccine, which could keep you from getting the flu. Medicare will pay for the shot, and so will many private health insurance plans. You can get a flu shot at your doctor’s office or from your local health department. Sometimes grocery or drug stores offer flu shots.

A flu shot won’t keep everyone healthy. But, getting the flu shot every year can mean that if you do get the flu, you might have only a mild case.

Who Should Get a Flu Shot?

The Centers for Disease Control and Prevention, part of the Federal Government, says that people age 50 and older should get a flu shot every year. Anyone who lives with or takes care of people age 50 or older should also have a flu shot every year.

When Should I Get My Flu Shot?

Most people get the flu between November and April. That’s why that time is called the flu season. It takes at least 2 weeks for your shot to start working, so try to get your flu shot in October or early November. Don’t worry if you can’t get your flu shot before the flu season starts. The shot can help keep you healthy no matter when you get it.

What Can I Do if I’m Sick?

If you get the flu, there are things you can do to feel better. First, call your doctor to see if there are medicines that can help. Remind him or her if you are taking drugs to fight cancer or other medicines that make it hard for your body to fight illness. There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after the flu begins, these drugs can make you feel better more quickly. Antibiotics do not help you get over the flu. They are sometimes prescribed to help you get over a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

Antivirals can also be used to prevent flu. If you hear that there is a flu outbreak in your area, check with your doctor. He or she could prescribe an antiviral that might protect you. Prevention is key. The first choice for preventing the flu is a flu shot.

If you are sick, try to rest in bed and drink plenty of fluids, like juice and water but not alcohol. Medicine such as aspirin or acetaminophen can bring down your fever, which might help with the aches and pains. It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs, as well as your nasal passages. These same areas are also bothered by smoking. Take it easy as much as you can until you are well.

It is important to check with your doctor when you first get the flu. Also, call your doctor if:

* your fever goes away and then comes back; you may have a more dangerous infection.
* you start having breathing or heart problems or other serious health problems.
* you feel sick and don’t seem to be getting better.
* you have a cough that begins to make thick mucus.

What About the “Bird” Flu?

Sometimes a new, different kind of flu virus appears. You may have heard about the avian or bird flu. This flu is an example of how changes in a flu virus might lead to serious illness. However, there is some good news about bird flu. It is rare in people. In most cases, the bird flu has not passed from one person to another, and so, it might not become widespread in humans. But this could change over time. Scientists are working on new vaccines that can help protect people from bird flu. Right now, the flu does not protect you against bird flu.

Things to Remember About the Flu

* The flu can be dangerous for older people.
* The flu can be prevented.
* Older people need a flu shot every year.
* Medicare pays for the flu shot.
* The flu shot is safe.

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"Sunshine" Vitamin D Reduces Breast Cancer Risk

Nidhi Sharma
Women who get an adequate amount of vitamin D through daily exposure to the Sun are less likely to develop breast cancer as compared to women who do not, new studies suggests.

The "sunshine vitamin," when taken in high doses may cut the risk of breast cancer by 70%. Vitamin D is synthesized naturally in human body after the skin is exposed to the ultraviolet (UV) rays and lack of UV exposure is linked to higher risk of breast cancer.

A new study led by Garland FC and colleagues from the University of California San Diego showed there is an association between low ultraviolet irradiance and higher breast cancer risk. The study, which is published in the March 17, 2008 issue of Breast Journal also found high levels of vitamin D translated to a 50% lower risk of breast cancer.

The researchers concluded that "there was a protective effect of UVB irradiance on risk of breast cancer that was independent of fertility rate, proportion of the population overweight, alcohol intake, animal energy intake, and other covariates."

A second study by Canadian researchers, found that women who spent time outdoors or got a lot of vitamin D from their diets or supplements. This holds true especially for teens who were 25% to 45% less likely to develop breast cancer than women with less vitamin D.

Approximately 1,150,000 cases and 410,000 deaths from breast cancer occur annually worldwide, including 215,000 new cases and 41,000 deaths in the United States.

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The Safety and Risks of Acupuncture Treatment

Most modern acupuncturists use disposable stainless steel needles of fine diameter (0.007" to 0.020", 0.18 mm to 0.51 mm), sterilized with ethylene oxide or by autoclave. These needles are far smaller in diameter (and therefore less painful) than the needles used to give shots, since they do not have to be hollow for purposes of injection. The upper third of these needles is wound with a thicker wire (typically bronze), or covered in plastic, to stiffen the needle and provide a handle for the acupuncturist to grasp while inserting. The size and type of needle used, and the depth of insertion, depend on the acupuncture style being practised.

Warming an acupuncture point, typically by moxibustion (the burning of a combination of herbs, primarily mugwort), is a different treatment than acupuncture itself and is often, but not exclusively, used as a supplemental treatment. The Chinese term zhen jiu (??), commonly used to refer to acupuncture, comes from zhen meaning "needle", and jiu meaning "moxibustion". Moxibustion is still used in the 21st century to varying degrees among the schools of oriental medicine. For example, one well known technique is to insert the needle at the desired acupuncture point, attach dried moxa to the external end of an acupuncture needle, and then ignite it. The moxa will then smolder for several minutes (depending on the amount adhered to the needle) and conduct heat through the needle to the tissue surrounding the needle in the patient's body. Another common technique is to hold a large glowing stick of moxa over the needles. Moxa is also sometimes burned at the skin surface, usually by applying an ointment to the skin to protect from burns, though burning of the skin is general practice in China.

An example of acupuncture treatment

In western medicine, vascular headaches (the kind that are accompanied by throbbing veins in the temples) are typically treated with analgesics such as aspirin and/or by the use of agents such as niacin that dilate the affected blood vessels in the scalp, but in acupuncture a common treatment for such headaches is to stimulate the sensitive points that are located roughly in the center of the webs between the thumbs and the palms of the patient, the hé gu points. These points are described by acupuncture theory as "targeting the face and head" and are considered to be the most important point when treating disorders affecting the face and head. The patient reclines, and the points on each hand are first sterilized with alcohol, and then thin, disposable needles are inserted to a depth of approximately 3-5 mm until a characteristic "twinge" is felt by the patient, often accompanied by a slight twitching of the area between the thumb and hand. Most patients report a pleasurable "tingling" sensation and feeling of relaxation while the needles are in place. The needles are retained for 15-20 minutes while the patient rests, and then are removed.

In the clinical practice of acupuncturists, patients frequently report one or more of certain kinds of sensation that are associated with this treatment, sensations that are stronger than those that would be felt by a patient not suffering from a vascular headache:

* Extreme sensitivity to pain at the points in the webs of the thumbs.
* In bad headaches, a feeling of nausea that persists for roughly the same period as the stimulation being administered to the webs of the thumbs.
* Simultaneous relief of the headache.

Indications according to acupuncturists in the West

According to the American Academy of Medical Acupuncture (2004), acupuncture may be considered as a complementary therapy for the conditions in the list below. The conditions labeled with are also included in the World Health Organization list of acupuncture indications. These cases, however, are based on clinical experience, and not necessarily on controlled clinical research: furthermore, the inclusion of specific diseases are not meant to indicate the extent of acupuncture's efficacy in treating them.

* Abdominal distention/flatulence
* Acute and chronic pain control
* Allergic sinusitis
* Anesthesia for high-risk patients or patients with previous adverse responses to anesthetics
* Anorexia
* Anxiety, fright, panic
* Arthritis/arthrosis
* Atypical chest pain (negative workup)
* Bursitis, tendinitis, carpal tunnel syndrome
* Certain functional gastrointestinal disorders (nausea and vomiting, esophageal spasm, hyperacidity, irritable bowel)
* Cervical and lumbar spine syndromes
* Constipation, diarrhea
* Cough with contraindications for narcotics
* Drug detoxification
* Dysmenorrhea, pelvic pain
* Frozen shoulder
* Headache (migraine and tension-type), vertigo (Meniere disease), tinnitus
* Idiopathic palpitations, sinus tachycardia
* In fractures, assisting in pain control, edema, and enhancing healing process
* Muscle spasms, tremors, tics, contractures
* Neuralgias (trigeminal, herpes zoster, postherpetic pain, other)
* Paresthesias
* Persistent hiccups
* Phantom pain
* Plantar fasciitis
* Post-traumatic and post-operative ileus
* Premenstrual syndrome
* Selected dermatoses (urticaria, pruritus, eczema, psoriasis)
* Sequelae of stroke syndrome (aphasia, hemiplegia)
* Seventh nerve palsy
* Severe hyperthermia
* Sprains and contusions
* Temporo-mandibular joint derangement, bruxism
* Urinary incontinence, retention (neurogenic, spastic, adverse drug effect)

Safety and risks

Because acupuncture needles penetrate the skin, many forms of acupuncture are invasive procedures, and therefore not without risk. Injuries are rare among patients treated by trained practitioners.

Certain forms of acupuncture such as the Japanese Toyohari and Shonishin often use non-invasive techniques, in which specially-designed needles are rubbed or pressed against the skin. These methods are common in Japanese pediatric use.

Common, minor adverse events

A survey by Ernst et al. of over 400 patients receiving over 3500 acupuncture treatments found that the most common adverse effects from acupuncture were:

* Minor bleeding after removal of the needles, seen in roughly 3% of patients. (Holding a cotton ball for about one minute over the site of puncture is usually sufficient to stop the bleeding.)
* Hematoma, seen in about 2% of patients, which manifests as bruises. These usually go away after a few days.
* Dizziness, seen in about 1% of patients. Some patients have a conscious or unconscious fear of needles which can produce dizziness and other symptoms of anxiety. Patients are usually treated lying down in order to reduce likelihood of fainting.

The survey concluded: "Acupuncture has adverse effects, like any therapeutic approach. If it is used according to established safety rules and carefully at appropriate anatomic regions, it is a safe treatment method."

Other injury

* Other risks of injury from the insertion of acupuncture needles include:
* Nerve injury, resulting from the accidental puncture of any nerve.
* Brain damage or stroke, which is possible with very deep needling at the base of the skull.
* Pneumothorax from deep needling into the lung.
* Kidney damage from deep needling in the low back.
* Haemopericardium, or puncture of the protective membrane surrounding the heart, which may occur with needling over a sternal foramen (an undetectable hole in the breastbone which can occur in up to 10% of people [citation needed]).
* Risk of terminating pregnancy with the use of certain acupuncture points that have been shown to stimulate the production of adrenocorticotropic hormone (ACTH) and oxytocin.

These risks are slight and can all be avoided through proper training of acupuncturists. For correct perspective, their risk should be compared to the level of side effects of common drugs and biomedical treatment - see below. Graduates of medical schools and (in the US) accreditated acupuncture schools receive thorough instruction in proper technique so as to avoid these events.

Risks from omitting orthodox medical care

Some doctors believe that receiving any form of alternative medical care without also receiving orthodox western medical care is inherently risky, since undiagnosed disease may go untreated and could worsen. For this reason many acupuncturists and doctors prefer to consider acupuncture a complementary therapy rather than an alternative therapy.

Critics also express concern that unethical or naive practitioners may induce patients to exhaust financial resources by pursuing ineffective treatment. However, many recent public health departments in modern countries have acknowledged the benefits of acupuncture by instituting regulations, ultimately raising the level of medicine practiced in these jurisdictions.

Safety compared to other treatments

Commenting on the relative safety of acupuncture compared to other treatments, the NIH consensus panel stated that "(a)dverse side effects of acupuncture are extremely low and often lower than conventional treatments." They also stated:

"the incidence of adverse effects is substantially lower than that of many drugs or other accepted medical procedures used for the same condition. For example, musculoskeletal conditions, such as fibromyalgia, myofascial pain, and tennis elbow... are conditions for which acupuncture may be beneficial. These painful conditions are often treated with, among other things, anti-inflammatory medications (aspirin, ibuprofen, etc.) or with steroid injections. Both medical interventions have a potential for deleterious side effects but are still widely used and are considered acceptable treatments."

In a Japanese survey of 55,291 acupuncture treatments given over five years by 73 acupuncturists, 99.8% of them were performed with no significant minor adverse effects and zero major adverse incidents (Hitoshi Yamashita, Bac, Hiroshi Tsukayama, BA, Yasuo Tanno, MD, PhD. Kazushi Nishijo, PhD, JAMA). Two combined studies in the UK of 66,229 acupuncture treatments yielded only 134 minor adverse events. (British Medical Journal 2001 Sep 1). The total of 121,520 treatments with acupuncture therapy were given with no major adverse incidents (for comparison, a single such event would have indicated a 0.0008% incidence).

This is in comparison to 2,216,000 serious adverse drug reactions that occurred in hospitals 1994. (Lazarou J, Pomeranz BH, Corey PN., JAMA. 1998 Apr 15;279(15):1200-5.) So to compare indirectly, Acupuncture has a 0.2% chance of causing a minor adverse effect compared to prescription medications having a 6.7% chance of causing a serious adverse event in a hospital setting.

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Gastroenteritis outbreak claims 120 lives in Northern Nigeria

The Nigerian Ministry of Health is trying to determine what caused a gastroenteritis outbreak that has claimed 120 lives in northern Nigeria’s Sokoto state and dozens more in the northwest, according to national health statistics.

“Unfortunately, it is the environment,” said the Ministry of Health’s deputy director, Abdul Nasidi. “The environment is so dirty. We are trying to work with the Ministry of Environment to inculcate in Nigerians how to live in a better environment. We want to get to the bottom of these outbreaks.”

Not cholera

“It is a serious outbreak,” Sokoto state health commissioner, Jabbi Kilgori, said at the height of the outbreak on 10 October. “We have 23 local government areas and at least 10 are affected. We have between 2,000 and 3,000 people affected and 120 deaths.”

He said authorities had initially thought the illness was cholera.

“We have received reports from four, five states in the northwest in particular,” said the Ministry of Health’s Nasidi on 11 October. “From some of the samples taken, we tested for cholera and they were all negative.”

Similar to cholera, gastroenteritis causes diarrhoea, but beyond that, stomach and intestinal inflammation can also cause pain, nausea and vomiting. Parasite-laden faecal-contaminated drinking or cooking water cause both illnesses. If left untreated, both can quickly kill.


Kilgori told IRIN officials are acting as quickly as possible, contrary to what some locals said was a sluggish start to control the spread: “We [local health officials] are taking measures, including the use of oral dehydration [and] antibiotics, disinfecting the affected areas and ensuring that sanitation is improved – especially where people defecate,” he said, adding that the source of drinking water must be protected.

Kilgori said Sokoto state is distributing gastroenteritis treatments worth US$200,000 in the north.

Rivers, ponds and open wells in northern Nigeria, which serve as the main sources of drinking water in the typically arid communities, have been contaminated by unusually heavy rains in recent months, the doctor told IRIN.

“We have to provide proper latrines to these communities,” said Kilgori. “We are also working to protect the source of drinking water and encourage people to avoid drinking water from open water sources.”


Northern residents said the death toll may be higher as most of the deaths were never reported and the victims were buried the same day, in line with Islamic custom.

“I can confirm 90 deaths in Dange Shunni [in the northern region] alone,” declared Sokoto-based primary health worker, Aminu Abdullahi, who visited the area in early October. “Most of [the people] died at home and were buried without the health authorities being informed.”

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Irish Law Reform Commisssion To Consider Advance Medical Directive

There is a need for legislation to cater for people who want to make advance care directives – in other words, who want to make their wishes known about what should happen to them in the event of an incapacitating accident or illness, the Law Reform Commission (LRC) has said.

An advance care directive sets out a person’s wishes about what should happen to them in the event of an incapacitating accident, such as a serious car crash, or illness, such as a stroke or Alzheimer’s disease, that makes it impossible for them to communicate their wishes directly.

Such a directive can be written or verbal and quite often, the person will also nominate another person to carry out their wishes. This other person is sometimes called a health care proxy.

At its annual conference today, the LRC is launching its Consultation Paper on Bioethics: Advance Care Directives, which forms part of its Third Programme of Law Reform 2008-2014.

The paper provisionally recommends that there is a need for legislation in this area and it makes 25 specific recommendations on the topic. Some of the main recommendations it makes are:

-The proposed legislation would not involve euthanasia or assisted suicide and it would not allow a person to refuse basic care.
-It would only deal with advance care directives involving refusal of treatment, e.g. ‘I do not wish to be resuscitated’. It would not deal with requests for treatment, e.g. ‘I want a liver transplant’.
-An advance care directive could be written or verbal, however one that refuses life sustaining treatment would have to be in writing.
-The proposed legislation could, in general, allow a person to refuse treatment on religious grounds.
-A person should be encouraged to seek medical advice when making an advance care directive, but this should only be mandatory in the case of directives involving the refusal of life sustaining treatment.
-A healthcare professional would not have any legal liability where they follow an advance care directive that they believe to be valid and applicable to the condition being treated.

The Law Reform Commission is an independent statutory body whose main role is to keep the law under review and to make proposals for reform. Today’s conference is taking place at Dublin Castle.

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the effectiveness of computer-aided detection (CAD) for screening mammography

When it comes to reading mammogram results, two heads aren’t always better than one.

A new study found that so-called computer-aided detection (CAD) for screening mammography has rates of cancer detection similar to mammograms read by two different radiologists.

“Reading mammograms by a single reader (radiologist) using CAD has been shown to be as clinically effective as having films read by two expert readers,” said the study’s lead author, Dr. Fiona Gilbert, a professor of radiology at the University of Aberdeen in the United Kingdom.

“Women should be reassured that the final decision on recall is made by the human reader using their knowledge and experience to decide if any areas of the mammogram marked by CAD merit further investigations,” she said.

In the United Kingdom and many European countries, the recommendation is that every mammogram be read by two independent radiologists. This practice isn’t common in the United States, according to Dr. Thomas Hall, director of breast imaging for Providence Hospital in Southfield, Mich. “Most mammograms are single-read in America, though most places now, when they get digital mammography, also get CAD,” he said.

Gilbert said, “We know that two readers will detect approximately 10 percent more cancers than a single reader.” But two readers aren’t always available. Sometimes, there might be seasonal shortages, as might occur during the holidays. Or, it may be that there aren’t enough resources to have multiple radiologists available to read mammography results, she said.

So, Gilbert and her colleagues wanted to know if the computer plus one reader would be similarly effective to two readers.

To assess this question, the researchers randomly assigned more than 31,000 women undergoing routine screening mammography to have their films read by two radiologists, by CAD and one radiologist, or using both measures.

Double reading found 87.7 percent of the cancers, while CAD plus a single reading was able to detect 87.2 percent. Recall rates, that is the number of women called back for further testing due to suspicious findings, were 3.4 percent for double reading and 3.9 percent for single reading with CAD.

The study findings were expected to be published in the Oct. 16 issue of the New England Journal of Medicine, but were posted online Oct. 1.

“CAD could increase the cancer detection rate of a single reader in breast screening centers currently using single reading alone,” said Gilbert, who added that, “in countries where double reading is standard practice, CAD could be used if there is a shortage of readers without compromising cancer detection rates.”

Hall said it’s likely that, if this study had been done with a digital mammography system, the results would have been even better. He said for this study, the researchers took mammography films and scanned them into the computer before the computer reading. That means the computer was essentially checking a copy, and when you copy something, information may be lost, he said.

“There are definite advantages to digital mammography with CAD. Digital helps you visualize the anatomy better, and the CAD helps keep you on your toes,” Hall said.

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What You Need to Know About Seasonal Flu Vaccine

The single best way to protect against the flu is to get vaccinated each year.

There are two types of vaccines:

* The "flu shot"— an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

* The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year.

About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.
When to Get Vaccinated

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

Who Should Get Vaccinated

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious flu complications or people who live with or care for those at high risk for serious complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

1. Children aged 6 months up to their 19th birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain chronic medical conditions
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:
a. Health care workers
b. Household contacts of persons at high risk for complications from the flu
c. Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy* people 2-49 years of age who are not pregnant.
Who Should Not Be Vaccinated

There are some people who should not be vaccinated without first consulting a physician. These include

* People who have a severe allergy to chicken eggs.
* People who have had a severe reaction to an influenza vaccination.
* People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
* Children less than 6 months of age (influenza vaccine is not approved for this age group), and
* People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Effectiveness

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.
Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are

* Soreness, redness, or swelling where the shot was given
* Fever (low grade)
* Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

LAIV (FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include

* runny nose
* wheezing
* headache
* vomiting
* muscle aches
* fever

In adults, side effects from LAIV (FluMist®) can include

* runny nose
* headache
* sore throat
* cough

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