General Precautions with Actonel

Actonel is used to treat Paget’s disease of the bone. it is also used to prevent and treat:
*postmenopausal osteoporosis
*glucocorticoid-induced osteoporosis in men and women

you should tell your doctor if you are taking aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDS), because taken togetherwith Actonel, aspirin and NSAIDS can increase the probability of stomach irritation.

You should not take Actonel if you:
*have low calcium levels in the blood
*have bone or mineral problems that have not been treated by your health care provider
*have severe kidney problems
*are unable to stand or sit up for at least 30 minutes.

Eat This Way for Your Heart

If you've had a heart attack, adopting a Mediterranean-style diet can significantly lengthen your life, an important study has found.

Researchers with the GISSI-Prevenzione Study, a large-scale Italian clinical trial, followed more than 11,000 Italians who'd recently had heart attacks. After nearly 4 years, they found that those who ate more fresh fruits and vegetables and used olive oil were approximately one-third less likely to die than those with the most butter and vegetable oils in their diet. Experts speculate that this healthy eating style could help prevent a first heart attack, too.

This study, from 2000, adds to the mounting evidence of the health benefits of Mediterranean-style dining. But many Americans still don't know how to eat the way the Romans and Athenians do. "It's a vague notion for many people here, but it needn't be," notes Artemis P. Simopoulos, MD, author of The Omega Diet (HarperCollins, 1999) and president of the Center for Genetics, Nutrition, and Health in Washington, DC. Here's how to do it:

• Eat at least seven servings of fruits and vegetables daily (Prevention recommends nine).
• Have fatty fish such as salmon (rich in heart-healthy omega-3 fatty acids) at least twice a week, or take 1 g of omega-3-rich fish oil in capsule form daily.
• Substitute heart-healthy olive and canola oils for other oils and saturated or hydrogenated fats.
• Eat less saturated fat and cholesterol.

Common Pain Drugs to Get New Warnings

Over-the-counter pain relievers used by hundreds of millions of Americans will carry stricter safety warnings under regulations proposed by the FDA.

Labels would warn of the potential for severe liver damage with the use of acetaminophen, the pain reliever contained in Tylenol. Warnings would also go on painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen, aspirin, and naproxen, cautioning of a risk of gastrointestinal bleeding with overuse. Brand names include Advil, Motrin, and Aleve.

Many nonprescription drugs already carry similar warnings. But FDA officials said they are seeking to make the alerts more visible and specific after reports suggesting that injury related to common pain relievers -- while uncommon -- is more prevalent than previously thought.
"We think that warning has to be more prominently displayed," said Charles Ganley, MD, director of the FDA's office of nonprescription products. "The consumers have to be more cognizant of what they're taking for pain relief."

There are more than 20 different forms of NSAIDs, though not all are available without a prescription. Still, together with acetaminophen, they comprise hundreds of products.
New Labels Proposed

The agency said it intends to require acetaminophen manufacturers to display the words "liver warning" in prominent type on packaging. Labels must alert consumers that severe liver damage can result if they take more than the recommended maximum daily dose, combine the pills with other drugs and those that also contain acetaminophen, or drink moderate amounts of alcohol while taking the drug.

NSAIDs would have to carry similarly prominent warnings saying the drugs can lead to gastrointestinal bleeding in patients over 60, those with previous ulcers or bleeding, those who take a blood thinner, those taking more than one product containing an NSAID, and in patients already taking certain medications such as a corticosteroid like prednisone.

The drugs would also continue to carry existing alerts about exceeding the maximum daily dose, taking it for longer than directed, and mixing them with alcohol, the agency said.
Ganley said the agency believes acetaminophen to be "quite safe" but that risk of liver failure exists for the hundreds of millions of Americans who take the drugs.
"Those rare circumstances are adding up to large numbers," he told reporters.

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The Pill Comes Under the Spotlight

eptives.

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FDA advisors are planning to review existing birth control pills this week. This decision follows results from clinical studies that show the incidence of pregnancies to have increased by twice over the last 10 years, while the subjects were on the pill.

Improper use, inferior products and other reasons are considered, as causes for this observation and the panel will discuss whether more stringent guidelines will be needed for safety and efficiancy.

The Pill is the most popular method of the birth control in the U.S., accounting for more than 30 percent of all birth control use, according to the Mayo Clinic, while tubal sterilization, or the surgical blocking of a woman's fallopian tubes, is the second-most popular at 27 percent. Male condoms are next, at 18 percent.

Some 19 percent of all American women aged 15 to 44 use The Pill, according to the Centers for Disease Control. But many men and women don't use birth control at all, or they use it without success.

The outcome of these meetings could affect the 13 million-plus women and girls who take birth control pills in America, and the estimated $4 billion market for birth control drugs, dominated by Barr, Watson, Johnson and Johnson and Wyeth pharmaceuticals.

Pills approved in the 1960's allowed less than one pregnancy per 100 women taking the pill for a year. Newer pills allow over two pregnancies in a similar group of women.

Experts say this may be partly because new pills have fewer hormones that could lead to dangerous blood clots and heart disease.

The topics to be discussed by the FDA panel include: Clinical trial design issues, contraceptive efficacy and risk or benefit assessment cycle control (scheduled and unscheduled bleeding and spotting) and other measures of product acceptability to the user, translation of clinical trial findings of efficacy and safety into "real world" effectiveness and safety, extended dosing regimens, phase 4 commitments by applicants for further investigation, generally of uncommon but serious safety issues and role and impact of labeling for communication of clinical trial findings including product efficacy, risk, and other benefits.

FDA officials hope to use this information to create a guidance document for the clinical investigation of hormonal contraceptives.

DIABETES DRUGS

What are the types ?
Insulins may be short-acting (soluble), or modified to lengthen their action. There are 40 or more types available. Because insulin cannot be absorbed by the bowel, it must be given by injection. Much insulin is now made by genetic engineering methods; some is still extracted directly from pork or beef pancreas. There are several types of tablets. The sulphonylureas are tolbutamide, glibenclamide (Daonil, Euglucon), gliclazide (Diamicron), chlorpropamide, tolazamide (Tolanase), gliquidone (Glurenorm), glimepiride (Amaryl) and glipizide (Glibenese, Minodiab). The only biguanide is metformin (Glucophage). Acarbose (Glucobay) is also used. Guar gum (Guarem), repaglinide (Novonorm) and rosiglitazone (Avandia) are also used.

What are they for ?
They are only used to treat diabetes mellitus. Insulin is essential for so-called type 1 diabetes where the body cannot make insulin. In type 2 diabetes some insulin is still made, but not enough to satisfy the body's needs. If diet treatment alone is not fully effective, tablets are added. Sometimes insulin is also needed in type 2 diabetes.They are only used to treat diabetes mellitus. Insulin is essential for so-called type 1 diabetes where the body cannot make insulin. In type 2 diabetes some insulin is still made, but not enough to satisfy the body's needs. If diet treatment alone is not fully effective, tablets are added. Sometimes insulin is also needed in type 2 diabetes.

How do they work ?
Insulin helps glucose to get into your body's cells. Inside the cells, insulin helps glucose to be changed into energy, and into other substances like proteins and fat. Sulphonylureas help the pancreas to make more insulin. They also help insulin to act on body cells. Metformin works on the cells directly, especially in muscles and liver. Insulin already there is helped to work better. Acarbose stops starches being converted to sugar in the bowel. Less sugar therefore gets into the body. Guar gum reduces absorption of carbohydrates after a meal. Repaglinide increases the body's own insulin supply and is sometimes given with another tablet such as metformin. Rosiglitazone helps the body's own insulin to work better by making the cells more sensitive to its actions. It is used together with metformin or a sulphonylurea. It can also be used with insulin injections, to improve their action.

How should they be used ?
Insulin injections are usually given at least twice a day, 15 to 30 minutes before meals. The best control of blood sugar is often achieved with short-acting insulin three times a day before main meals, with a long-acting insulin at breakfast or bed-time. Insulin can be given by syringe or by pens. In pens, insulin is loaded as cartridges just like with a fountain pen. Insulin can also be given by a pump either outside the body or implanted in it. Tablets are taken once to three times a day in type 2 diabetes when dieting alone is not enough. Follow the instructions that you have been given as to when to take your tablets in relation to meals : some should be taken before and others after meals. You should always take them regularly: not just when glucose in the blood or urine rises. Sometimes, your doctor will prescribe a combination of these drugs. This helps to improve control of the blood sugar level. Under no circumstances should you stop any drugs for diabetes unless your doctor advises it.

During Treatment …You may need to increase doses of insulin or tablets if the blood or urine glucose levels rise. Such dose increases may be needed if you gain weight, eat more or are under stress. Bigger doses are often needed if you have an infection. You may need less insulin or tablets if you are exercising more. If you are not sure how to handle these problems, your doctor will advise how to change your own doses. You will need to adjust your doses of insulin or tablets to keep the blood glucose level as close as possible to the normal range. Insulin or sulphonylureas can lower your glucose level too far (below 2.2 mmol/l: 40 mg/dl). This causes hypoglycaemia (or "hypos"). Sweating, trembling, hunger, faintness and even coma may result. Regular meals and sometimes snacks are essential to reduce this risk. Let your doctor know if you get anything other than occasional or mild hypos. Always keep a supply of glucose such as Dextrosol or lump sugar in your pocket or bag. Any anti-diabetic tablets can cause stomach and bowel upset, usually diarrhoea. With both metformin and acarbose, these often lessen with continued use. If they persist, see your doctor. Acarbose and guar gum are particularly likely to give you a lot of wind. Occasionally the sulphonylureas can cause skin rashes or (yellow) jaundice: again, see your doctor if this happens. Metformin is not usually prescribed if you have kidney, liver or heart problems. It can then cause the serious condition of lactic acidosis. Chlorpropamide is also unsafe with kidney failure.

Drug Interference …Alcohol can also worsen or even cause "hypos", if you eat too little. Both ACE inhibitors and beta-blockers, drugs used for blood pressure treatment, can lower blood glucose, which can be helpful or harmful. Beta-blockers can also worsen "hypos" if they occur. Water tablets (diuretics) and particularly steroids (cortisone-like tablets) can raise blood glucose, sometimes to very high levels. Doses of your anti-diabetic drug are likely to need increasing. Your doctor will guide you. Some antibiotics, anti-inflammation and antifungal drugs increase the effect of anti-diabetic tablets.

Hiatus Hernia

Hiatus hernia is the Lon Chaney of internal distresses: it's the condition of 1000 faces - all of them scarier than the real one. On any given day, a stiff, frightening chest pain could send you to the hospital labelled as a possible heart attack victim. (And that's what you might be, so don't take any chances.) But if what you really have is a suddenly apparent, kicking and screaming hiatus hernia, your doctors, at first glance, might think you are having either a coronary, biliary colic, pancreatitis, a gastric or duodenal ulcer, a disorder of the oesophagus (gullet), a digestive malfunction, angina or anyone of many other good but wrong guesses..

It's really a sheep in wolfs clothing, though, and hardly a rare, exotic disease. Estimates as to the number of people who have hiatus hernias go as high as 18 per cent, and most don't even know they have them. It's a sneaky - and, usually, asymptomatic - little digestive-tract devil. And, more often than not, it is nothing much to worry about, despite the pain.

What is hiatus hernia?
A normal oesophagus, in its long, narrow descent from the mouth to the stomach, must pass through a taut sheet of muscle: the diaphragm, which may be thought of as both the floor of the chest and the ceiling of the abdominal cavity. To get to the 'stomach, the oesophagus pokes through a teardrop-shaped opening in the diaphragm called the hiatus. It's at this point that the oesophagus and stomach join, and where a valve system (the lower oesophageal sphincter) keeps deposited food (and the acid working to digest it) from backing up into the oesophagus.

In a hiatus hernia, the upper part. of the stomach has slid up past the diaphragmatic hiatus (weakened, perhaps, by age) and into the chest. From 75 to 95 per cent of hiatus hernias are of this 'sliding' type. These come and go, sliding back and forth, depending on body position and other factors. In another kind, the 'rolling', or para-oesophageal, hernia, the oesophagus - stomach junction stays in its normal location (as opposed to the action of- the 'sliding' type), but a portion of the large lower curved section of the stomach rides up through the hiatus and rolls forward in the chest cavity. These 'rolling' hernias can be big problems and may require surgery, but they're relatively rare.

A hiatus hernia, in and of itself, is not a painful condition. Whereas, for example a broken artn. results in pain, a hiatus hernia results for the most part in nothing except an anatomical deviation. The major difficulty associated with 'sliding' hiatal hernias is gastro-oesophageal reflux, which is a backwash of stomach juices and which, in the case of hiatus hernias, is probably caused by the stomach's unnaturally altered position. Reflux happens when the oesophageal sphincter is weak and allows acidic gastric fluids to travel in the wrong direction.

It's important to know that reflux can happen in somebody who doesn't have a hiatus hernia. Just because you have heartburn doesn't mean you have the condition and, conversely, just because you have a hiatus hernia doesn't mean you're bound to have heartburn, chest pains, acid backup into the throat or other reflux-associated discomforts. But, then again, you might. A visit to your doctor ought to let you know what your inner story is.

How do hiatus hernias get that way? Nobody's sure, and it probably varies from case to case. It could be the result of a congenital problem, or a side­effect of being pregnant or having given birth, or an offshoot of over-eating or obesity. Any undue increase in abdominal pressure can do the deed. Some researchers believe that straining during defecation can cause the stomach to be pushed up through a weakened hiatus.

Keeping the problem at bay

The usual treatments and advice have little to do, actually, with fixing the hernia itself but rather address the issue of keeping the reflux in check. Some of these bits of wisdom are :-

Lose weight.
Avoid bending or stooping.
Don't wear tight belts or girdles.
Avoid alcoholic beverages (and cola drinks, too).
Don't smoke (it helps produce stomach acid, which is just what you don't need more of).
As with peptic ulcers, eat several little meals every day, rather than a couple of large ones.
Wait at least 21/2 to 3 hours after a meal before lying down.
Sleep with your head elevated 8 to 10 inches.
Avoid drinking coffee and eating chocolate (they weaken the oesophageal sphincter), and avoid acidic foods, such as oranges, grapefruit and tomatoes.
Be wary of garlic, onion and peppermint, too.
Avoid taking oestrogen drugs - they aggravate heartburn (among other things).
Studies have shown a link between hiatus hernia and gallstones - where you find one, chances are pretty good that you'll find the other - and suggest that lack of fibre in the diet is to blame for both. Lowering animal-fat consumption and increasing fibre, especially in the form of bran, prevents gallstones. At the same time, a high-fibre diet increases the size of stools and eliminates the straining that can cause hiatus hernia. Wrote British researcher Denis P. Burkitt, 'The hypothesis that fibre-depleted die.ts are a major factor in the causation of hiatus hernia is consistent with all that is known of the disease' (American Journal of Clinical Nutrition, March 1981).

The most serious physical effects related to hiatus hernia have to do with damage to the oesophagus. The acidic stomach juices wash back into it and normally cause only inflammation and irritation (and, one researcher suggests. asthma attacks). Continued reflux, however, can cause ulceration, scarring and, ultimately, blockage of the oesophagus, requiring surgery. And matters get worse if you use aspirin. The aspirin 'may become trapped for extended periods in the oesophagi of patients with oesophageal hiatus hernia,' wrote Dr Vernon M. Smith; this trapping action allows the aspirin to 'injure alkaline mucosa by direct contact.

By cutting out acidic foods - especially citrus fruits and fruit juices - in order to avoid complications, some reflux hiatus hernia sufferers have come down with vitamin C deficiencies bordering on scurvy. For these people, vitamin C supplements are probably just what the nutritionist ordered.

Many doctors will cavalierly prescribe frequent antacid use to patients with hiatus hernia related heartburn problems. The antacids will cover up the hurt - but long term consumption of antacids containing aluminum compounds could leach your body of calcium, resulting in the thinning of your bones and bone pain.

Only the most severe cases warrant surgery. If there is a potential of the herniated stomach pinching off the oesphagus, bleeding, or danger of lung or heart damage, then an operation is necessary. But only about 5 per cent or less of hiatus hernia patients require anything other than good medical advice and a change in habits. Besides its general uselessness, unwarranted hiatus hernia surgery also can be risky, and may itself produce new symptoms far worse than any associated with the original discomfort. It's best to get a second opinion

Nicotine Levels in Cigarettes Rising

Nicotine levels in cigarettes rose 11% from 1998 to 2005, according to a Harvard School of Public Health analysis.

Nicotine is the main addictive ingredient in cigarettes.

The Harvard analysis confirms an earlier report by Massachusetts health officials.

Tobacco industry officials deny there has been a deliberate attempt to manipulate nicotine levels in cigarettes, saying the nicotine in tobacco products fluctuates randomly from year to year.

But the lead author of the Harvard study says the upward trend cannot be explained by random market fluctuations.

"We do agree that there are fluctuations from year to year," Gregory Connolly, DMD, MPH, tells. "But when we plotted those fluctuations out, there was a significant increase in nicotine levels on the order of 1.6% per year, or 11% over a seven-year period."

Expanded Analysis

The report was based on data provided by cigarette manufacturers to the Massachusetts Department of Public Health.

Based on an analysis of the data from 1998 to 2004, Massachusetts health officials reported an upward trend in nicotine levels in cigarettes last August.

That report was strongly criticized by tobacco industry leader Philip Morris USA.

In a news release, company officials argued that the failure to include data from 1997 and 2005 in the original report influenced the findings.

The new analysis, with includes those years, was conducted, in part, to address the criticism, Connolly says.

The Harvard findings confirm a statistically significant upward trend in nicotine levels, as measured in cigarette smoke, between 1997 and 2005.

The increase was seen in all major cigarette types -- including full flavor, light, medium, and ultralight -- and in both mentholated and non-mentholated brands.


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ANGER AND STRESS

CALM DOWN! -- Medical researchers have found that extreme anger can trigger a heart attack. They interviewed over 1600 patients after they suffered heart attacks and found that angry outbursts potentially doubled their risk of the attacks.

ANYONE FOR QUILTING? -- Sewing may help relieve your stress. One study found women lowered their blood pressure and heart rates when they sewed. Knitting and needlework may provide the same benefits.

RELIEVING STRESS -- Breathe slowly and deeply. Three or four deep breaths provide the most immediate feeling of calmness anywhere, anytime.

Supplement Aid: Tranquilon is an excellent product with Kava Kava and other herbs specifully formulated to relieve stress.

DEPRESSION - Change your physiology. One of the best ways to help with depression is to change your physical state. Do the following:


Sit or stand up straight.
Throw your shoulders back.
Hold your head up high and look up with your eyes.
Put a big smile on your face and breath deeply.
Think about something good in your life, if you can't think of something good, then think about what could be good.
Give yourself more energy. This article contains excellent information on how to give yourself more energy.

Oral Health Tips

Proper brushing is essential for cleaning teeth and gums effectively. Use a toothbrush with soft, nylon, round-ended bristles that will not scratch and irritate teeth or damage gums.

Place bristles along the gumline at a 45-degree angle. Bristles should contact both the tooth surface and the gumline.




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Gently brush the outer tooth surfaces of 2-3 teeth using a vibrating back & forth rolling motion. Move brush to the next group of 2-3 teeth and repeat.




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Maintain a 45-degree angle with bristles contacting the tooth surface and gumline. Gently brush using back, forth, and rolling motion along all of the inner tooth surfaces.




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Tilt brush vertically behind the front teeth. Make several up & down strokes using the front half of the brush.





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Place the brush against the biting surface of the teeth & use a gentle back & forth scrubbing motion. Brush the tongue from back to front to remove odor-producing bacteria.

Tai Chi,Aerobic Exercise and its Advantages

There are so many fitness programs available today, the general public is often confused as to which are the best. Consequently, they are the willing guinea pigs of every fitness fad that comes along.

Tai Chi involves three primary subjects:

* Health - An unhealthy or otherwise uncomfortable person will find it difficult to meditate to a state of calmness or to use Tai Chi as a martial art. Tai Chi's health training therefore concentrates on relieving the physical effects of stress on the body and mind.
* Meditation - The focus meditation and subsequent calmness cultivated by the meditative aspect of Tai Chi is seen as necessary to maintain optimum health (in the sense of effectively maintaining stress relief or homeostasis) and in order to use it as a soft style martial art.
* Martial art - The ability to competently use Tai Chi as a martial art is said to be proof that the health and meditation aspects are working according to the dictates of the theory of Tai Chi Chuan.

Advantages of Tai Chi

The majority of the studies included in the systematic review found that tai chi had a wide range of positive benefits on overall health and well-being, from increased muscle strength and flexibility, to lowered blood pressure, to enhanced immune function. A brief synopsis of each category is as follows:

Balance control and falls: Eleven studies, including two randomized, controlled trials, measured postural stability, strength, flexibility, and other aspects crucial to a person's ability to maintain balance.

Cardiovascular and respiratory systems: More than a dozen studies were analyzed, involving patients of various age and several styles of tai chi. Two studies found that elderly patients who practiced tai chi four times a week for one year exhibited enhanced cardiorespiratory function, strength and flexibility compared with a control group.


Endocrine and immune systems: Two studies evaluated the effects of tai chi on immunity and the endocrine system. One study of 98 elderly men found that tai chi could significantly affect endocrine function, particularly activity of the pituitary gland. The second study found that patients who practiced tai chi regularly for four years or more had "significantly higher" numbers of a class of immune cells called T-cells in the blood compared to untrained patients.

Hypertension: Four studies involving more than 400 patients were included in the analysis. The duration of tai chi training lasted from 8 weeks to 3 years; blood pressure, oxygen uptake and heart rate were among the variables measured in each study. One randomized, controlled trial found similar reductions in systolic blood pressure between patients practicing tai chi and those engaging in regular aerobic exercise.

Musculoskeletal conditions: A non-randomized study suggested that tai chi could improve muscle strength and endurance in the knees of elderly individuals, and a fourth study of patients with multiple sclerosis found that subjects who practiced tai chi experienced improvements in vitality, social functioning, mental health, and the ability to carry out certain physical activities.

Other: The three studies in this group examined tai chi's effects on a wide range of disorders. One study showed that older adults practicing classical Yang-style tai chi twice a week for six months were better able to achieve their desired results when performing certain functions. A case-control study of elderly men revealed that those who practiced tai chi for more than 11 years had higher skin blood flow levels and improved blood vessel conductance compared to sedentary men. The final study of 22 young people found that by practicing tai chi, one could significantly reduce the number of nightmares experienced during sleep.