Health Topic

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Everyone knows smoking and being obese is not healthy for you, but now a new study shows the odds of dying early are highest among obese smokers.


"We know that obesity and smoking by themselves are important health risk factors," said lead researcher Annemarie Koster, an epidemiologist at the U.S. National Institute on Aging. "We found that smoking and obesity are independent predictors of mortality, but smoking and being obese especially increases the mortality risk."

Smoking and obesity both carry a significant mortality risk, but particularly smoking, Koster said. "It seems that smoking cessation was associated with significantly lower mortality risk in every weight group," she said. "Quitting smoking will definitely improve your mortality risk, no matter in what weight group you are."


Losing weight will also lower mortality risk, Koster said. "Both losing weight and quitting smoking will increase your health and lower your mortality risk," she said.

The report was published in the November issue of The American Journal of Clinical Nutrition.


For the study, Koster's group collected data on 3.5 million members of the AARP, aged 50 to 71. In 1995-1996, and again in 1996-1997, AARP sent out questionnaires asking people about diet, family history of cancer, physical activity, hormone replacement therapy, weight, waist size, and smoking.

Using the U.S. Social Security Administration Death Master File, the researchers linked the AARP data with death records of the survey participants from 1996 to 2006. During that period, almost 20,000 men and 7,500 women died.


The researchers found that as weight increased, so did the rate of death. Across all weights, people who smoked had the highest death rates.

In fact, obese smokers had a six to eight times greater risk of dying compared with normal weight people who never smoked. In addition, among smokers with a large waist, the risk of dying was five times greater than among people with the smallest waists who never smoked, Koster's team found.


Dr. Norman H. Edelman, a professor of preventive medicine, internal medicine, physiology & biophysics at Stony Brook University in New York and chief medical officer at the American Lung Association, thinks that if you have to choose between losing weight or stopping smoking, you should stop smoking.

"Especially important is the finding that smoking cessation has a great effect on lowering risk of dying, one which far outweighs the slight increased risk from the associated increase in weight," Edelman said. "Also to note, if one is obese and smokes and has to choose between weight loss and smoking cessation to improve health, the latter will have a greater protective effect," he added.


Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, agreed that people can do simple things to improve their health and life span.

"We have long known that a surprisingly short list of potentially modifiable behaviors holds sway over an enormous range of mortality risk," Katz said. "Together, tobacco use, physical activity and dietary pattern are major determinants of the probable quality, and quantity, or our lives."


This report reaffirms the strong interactive effects of smoking and excess body fat on the risk of death, Katz said.

"If you are overweight and smoke, fixing either one can markedly improve your chances for a normal life span," Katz said. "Fix both, and the probability of benefit is huge. The message is clear: We all have the power to choose a better medical destiny."

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Vitamins C and E — pills taken by millions of Americans — do nothing to prevent heart disease in men, one of the largest and longest studies of these supplements has found.

Vitamin E even appeared to raise the risk of bleeding strokes, a danger seen in at least one earlier study.

Besides questioning whether vitamins help, "we have to worry about potential harm," said Barbara Howard, a nutrition scientist at MedStar Research Institute of Hyattsville, Md.

She has no role in the research but reviewed and discussed it Sunday at an American Heart Association conference. Results also were published online by the Journal of the American Medical Association.

About 12 percent of Americans take supplements of C and E despite growing evidence that these antioxidants do not prevent heart disease and may even be harmful.

Male smokers taking vitamin E had a higher rate of bleeding strokes in a previous study, and several others found no benefit for heart health.

As for vitamin C, some research suggests it may aid cancer, not fight it. A previous study in women at high risk of heart problems found it did not prevent heart attacks.

Few long-term studies have been done. The new one is the Physicians Health Study, led by Drs. Howard Sesso and J. Michael Gaziano of Harvard-affiliated Brigham and Women's Hospital in Boston.

It involved 14,641 male doctors, 50 or older, including 5 percent who had heart disease at the time the study started in 1997. They were put into four groups and given either vitamin E, vitamin C, both, or dummy pills. The dose of E was 400 international units every other day; C was 500 milligrams daily.

After an average of eight years, no difference was seen in the rates of heart attack, stroke or heart-related deaths among the groups.

However, 39 men taking E suffered bleeding strokes versus only 23 of the others, which works out to a 74 percent greater risk for vitamin-takers.

The study was funded by the National Institutes of Health and several vitamin makers. Results were so clear that they would be unlikely to change if the study were done in women, minorities, or with different formulations of the vitamins, Howard said.

"In these hard economic times, maybe we can save some money by not buying these supplements," she said.

A second study found that vitamins B-12 and B-9 (folic acid) did not prevent heart disease either, supporting the results of previous trials. That study involved more than 12,000 heart attack survivors and was led by Dr. Jane Armitage of the University of Oxford in England.

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When choosing soap, it is important to choose the right soap for your skin type, whether it is an herbal soap, a handmade soap or a commercial soap. Much commercial soap contains lots of chemicals which can be harmful to skin. A natural herbal soap can be a good alternative. This article contains:

* Which type of soap is best suited for oily skin?
* Tips on using soaps so they don't harm the skin
* What are the disadvantages of industrial soaps?

When choosing soap, it is important to choose the right soap for your skin type, whether it is an herbal soap, a handmade soap or a commercial soap. The following list will help you choose the right soap - herbal, natural or commercial - for your needs.

* Dry skin is skin that does not have enough sebum (the skin's natural oil). The best soap for dry skin is a gentle moisturizing soap. People with dry skin should avoid harsh soaps. Good commercial soaps include Olay or Dove, but skin cleansers are a better choice. Natural soaps that contain Aloe Vera, cocoa butter, avocado or vegetable oils are best for dry skin.

* Oily skin has too much sebum. It looks shiny and is prone to acne. It needs to be cleaned regularly. Soap is not as damaging for oily skin as it is for dry skin. An antibacterial soap or special cleansing soap is good for oily skin. Look for soaps (or make them yourself) with the following natural ingredients: lavender, chamomile and thyme or tea tree oil. Commercial anti-acne soaps may be beneficial if you suffer from spots or pimples.

* Combination skin contains a combination of oily skin and dry skin. Do not use soaps that are specially formulated to treat either dry skin or oily skin. It is hard to limit soap to the area that needs attention. Soaps for dry skin will make the oily areas even oilier and soaps for oily skin will make the dry areas drier. Using special cleansers are fine as they can more easily be used on the affected area. Choose commercial soaps and natural soaps for normal skin. Glycerin soap can be a good soap for combination skin. Be careful when using soap on the dry areas of your face.

* Normal skin is not too oily or too dry. Soap should generally be fine for use on normal skin. Do not choose soaps that are specially formulated for dry or oily skin, as they may cause problems. Many commercial soaps and herbal soaps are made for use on normal to oily or dry skin. These products are fine to use.

Soaps to Avoid

It is best to avoid soap altogether if you have a severe skin condition, like psoriasis, dermatitis or eczema. People with dry skin also need to be careful as some soap can be very drying. The following types of soaps may be damaging to the skin on the face and should be avoided.

* Soaps those are granular.
* Soaps with a high pH or acid-content.
* Soaps with lots of chemicals.
* Cheap commercial soaps.
* Soaps that are designed for a different type of skin than the one you have

Herbal Soaps: Are They Effective?

Much commercial soap contains lots of chemicals which can be harmful to skin. A natural herbal soap can be a good alternative. Soaps containing natural products are healthier for your skin and less likely to have any damaging effect. They are also less likely to provide a trigger for common skin complaints. Commercial soaps also remove the glycerin from soap. Glycerin helps the skin keep in moisture, and so soap that has had the glycerin removed is more drying. Natural soaps usually keep the glycerin in.

Natural soaps also make use of aromatherapy and herbal treatments to provide the best treatment for your skin. Herbs can help treatment skin problems and nourish the skin. Aromatherapy can have a positive effect on physical and emotional health.

When choosing a natural soap, check the ingredients. Some soaps may claim to be natural or herbal, but may in fact contain chemicals and harmful ingredients. They might also claim to contain ingredients such as lavender, when they really contain lavender scented oil. Scented oil is not the same thing as the essential oil and will not produce the same effect.

You can also make your own herbal soaps by using a soap base and adding different herbs and oils. The good thing about homemade soaps is you know exactly what ingredients are contained in the soap.l

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Cardiovascular disease has traditionally been seen as something that afflicts middle-aged or elderly men. Turning 40 and trudging off to the doctor for a checkup so you could rest assured that you won't drop dead during a weekly game of pickup hockey has been almost a rite of middle-aged passage for men.

Back in 1973, heart disease and stroke killed 45,404 men, according to figures from Statistics Canada. Thirty years later, the number of male deaths had fallen by 19 per cent to 37,004.Signs you're having a heart attack
Sudden pain in chest, neck, jaw, shoulders, arms or back. The pain can feel like squeezing, heaviness, pressure, burning or tightness.
Problems breathing.
Indigestion.
Vomiting, nausea.
Clammy skin.


On the other hand, in 1973, 34,924 women died from heart disease or stroke. By 2003, the number of women who died from heart disease or stroke almost matched the number of male deaths: 36,823.

Men still outnumber women when it comes to dying from heart attacks, but the gap has narrowed dramatically since 1973, when twice as many men died from heart attacks as women. In the next 30 years, male deaths dropped by 49 per cent to 10,643 while female deaths fell by 24 per cent to 8,019.

"It's a real concern that women's heart health has not kept pace with men's," said Dr. Beth Abramson, cardiologist and spokesperson for the Heart and Stroke Foundation.

"It's truly an equal opportunity killer."

"Women are living like men and dying like men. We have seen that rates for dying from heart disease and stroke are higher at every age and stage for a woman than a man."Signs you're having a stroke
Weakness, numbness or tingling in face, arms or legs, especially on one side of the body.
Trouble speaking or understanding speech.
Sudden blurring, double vision or loss of vision.
Sudden severe headache.
Dizziness, loss of balance.


The numbers all around have been getting far better for men — but women have not been seeing the same improvements.

Abramson says there are several reasons, including:
Women are less likely than men to be treated by a specialist.
Women are less likely to receive treatments such as angioplasty or cardiac bypass surgery.
Fewer women than men are referred to cardiologists.

"For years, it was assumed that this occurred because women were older and tended to be sicker when they were hospitalized," Abramson said.

"But even when you control for age and other health conditions, a woman's risk of dying within the first 30 days is 16 per cent higher than a man's for heart attack and 11 per cent higher for stroke."

Researchers don't know why the risk of death in the first 30 days is higher for women. As a cardiologist in Toronto, Abramson says she often sees female patients in her practice who ignore signs and symptoms of heart disease and stroke – leading to potentially deadly delays in getting treatment.

Abramson adds that a lot of women just aren't aware of the risks they face — and men are even less aware of the risks their spouses may face. A national survey by the Heart and Stroke Foundation found that 53 per cent of men believed that the number of heart and stroke deaths was somewhat or a lot less in women than in men.

"Even younger women need to go in for an exam and talk about issues beyond gynecological care. If we address risk at an annual exam, maybe we can prevent some of this."

The foundation has made several recommendations to try to bridge the gap, including:
More research into how heart disease and stroke affect women differently than men.
Tailoring health-care services to women's needs.
People need to be more proactive about their own health, including eating a balanced diet that is lower in saturated and trans fats.
People need to become more aware of their risk for heart disease and stroke.
'Floppy' versus 'stiff' hearts

Heart failure also looks radically different in women and as a result, it is often under-diagnosed, Dr. Peter Liu told the Canadian Cardiovascular Congress in October 2008.

Heart failure in most men is usually due to systolic dysfunction. The heart is weakened, dilated and cannot adequately pump the blood through the body. It is often described as a “floppy” heart. In-hospital heart attack mortality rate per 100 heart attacks 1997/98-1999/2000


On the other hand, female patients with heart failure are usually older but have diastolic dysfunction: a small and "stiff" heart, rather than a dilated or "floppy” heart. The heart's ability to relax between beats is impaired.

The symptoms are often not well recognized and, in the presence of a small heart, physicians often will miss the diagnosis, said Liu, heart and stroke/polo chair of medicine and physiology at the University of Toronto.

"We can expect a seismic change over the next decade as women with heart failure begin to swell the patient population," Liu warned.

To diagnose diastolic heart failure early on, a doctor orders an electrocardiogram and a blood test to check levels of a certain markers.

But the different ways in which cardiovascular disease affect men and women may not just be differences in approaches to care. A study out of Boston has found that the fine grit in polluted air boosts the risks of cardiovascular disease in older women much more powerfully than scientists previously thought.

It has long been known that fine grit — also called particulates — in polluted air contributes to lung and heart disease, with women possibly more susceptible than men because of smaller blood vessels and other biological differences. But this study found that problems were several times higher than a previous study by the American Cancer Society.

The tiny bits of grit are too small to see, but collectively they form that haze that settles over large industrial areas.

Meanwhile, a Quebec study has found that while cholesterol-lowering statin drugs reduce the risk of death after a heart attack, the effects seem to be greater for men than women. The researchers suggested the reason may be that statins are processed differently in men and women.

Statins are among the best-selling drugs on the planet.

Source:

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Most people in the general population have heard of CT (computed tomography) and MRI (Magnetic Resonance Imaging) even if they have never had either test used to diagnose or confirm illnesses. According to a ten-year study, the use of these tests has doubled (CT scans) and tripled (MRI’s), raising the cost of patient care and not necessarily providing any information that would not have been available with X-rays. Indeed, in many instances, the patients are receiving X-rays as well as one of the newer imaging tests.

The study covered patients enrolled in the Group Health Cooperative, a health maintenance organization in Washington State between 1997 and 2006. Researchers analyzed data from 377,000 patients who had over 5 million diagnostics tests. There were increases in all types of imaging with the average cost per patient increasing from $229 to $443. A study in July by the Government Accountability Office found Medicare spending on medical imaging doubled to $14 billion per year between 2000 and 2006, driven mostly by high-tech imaging.

The imaging does not seem to be directed at any particular disease or diseases, but generally was consistent among every group and every disease according to Dr. Rebecca Smith-Bindman of the University of California, San Francisco, whose research appears in the journal Health Affairs. That suggests that it is not patient symptoms driving the increase in testing, but other factors. She said that the benefits of imaging need to be weighed against their risks, including false positive results and the increased radiation exposure associate with CT scans.

This study did not address whether the imaging was appropriate and whether the increase testing resulting in improved patient care. The new technologies are fantastic, acknowledges Smith-Bindman, but they should be used judiciously.

The cost of health care in the United States is discussed continuously in the media and on other fronts, and the medical technology boom may be the biggest factor in the increase of costs. Within the health care setting "fee for services" practices receive financial benefits for extra testing including pay backs for investments in office-based scanning equipment.

One of the real reasons for increases in the tests may be patient expectations. There are some who want only what is necessary to diagnose or treat their condition. Other patients want every test imaginable for their illness regardless of whether it will provide better care. After all, saying "I had a CT scan this weekend" during Monday morning coffee break sounds much more dramatic than "I had an X-ray."l

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You can do so many things on the internet in today’s virtual environment, such as order your medications or a birthday gift, shop for the perfect outfit, and chat with friends. Now, visiting with your doctor is an option as well. Recently, the United States FDA gave Intel their approval to market their home monitoring system, Health Guide, which allows doctors and their medical staff to monitor patient’s medical status virtually, at their finger tips. This new system allows the elderly and seriously ill to avoid sometimes stressful, unwanted trips out, in order to receive prompt proper medical care.

There are probably very few people that actually look forward to doctor visits, but medical treatment is very important and in many cases, a matter or life or death. Many doctor’s visits are met with long waits, costly visits and germs. For those with critical conditions that need to be monitored more closely, being able to be treated from home allows for comfort as well as more immediate attentive care. With this new system, patients would have an avenue to talk to their doctor or provide vitals at any time. Health Guide PHS6000's along with an online interface, the Intel Health Care Management Suite, allows medical staffs and doctors to monitor patients in their homes and manage care remotely. Intel’s system has a touch-screen laptop and interface that is simple for even the more technically challenged patients and medically unaware person to use. The touch-screen has large icons along with voice prompts, and text that is read aloud as it appears on the screen.

Patients are provided step-by-step instructions on using the computer. The laptop has the capability to sound a reminder chime daily at a set time, as a reminder to the patients. When the patient responds, they will be run through several questions and prompts that can involve taking vital signs such as, blood pressure, heart rate, or sugar levels. Blood pressure cuffs and glucose measuring tools are conveniently connected to the computer. It is left up to the patient to input their needed medical information and to follow any medical instructions that are given.

The Health Guide system is being marketed to chronically ill patients first, allowing for more flexible evaluation times and even preventing some unneeded doctors visits. Once the information is collected it is stored and can be viewed by health care professionals through an FTP secure site and viewed at their convenience. Mariah Scott, head of sales and marketing for Intel's Digital Health Group, said "They can then manage their patients and only need to intervene if something is not normal. That's one of the aspects of cost efficiency and labor productivity we hope to see with this system. Instead of needing to call every patient every day, they can see that data in a dashboard and only need to intervene if there's an issue or concern. That should help nurses or case managers, move to more of a management by exception approach."

Intel’s new Health Care system can also be used to help educate patients. The company has licensed material from medical organizations including the Mayo Clinic and the American Heart Association, to provide the application's medical assessments, evidence-based treatment guidelines, educational multimedia content, and they are working to gather other educational content, for other conditions, with several other medical organizations. Pilot programs have begun through Aetna, Scan Health Plan, Erickson Retirement Communities, and the Providence Medical Group in Oregon, in order to evaluate the effectiveness of the new system on Intel’s patients.

"Health care is an area where getting and gathering the right information, and getting decisions made in a timely matter can make an enormous difference in patient care. We hope this technology helps with that," Scott said in an interview. Patients with chronic illnesses add up to at least 1 billion patients who could potentially benefit from the Intel system. The company plans to market the product to insurance companies, governments, and health care providers initially.l

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Honestly, I have really only heard of ginseng because I have seen it on bottles of tea in the refrigerated section of my local grocery store. Sure I have had ginseng before but it always seems to conjure up images of barefoot Berkeley residents of the natural food movement trying to cure what ails them. However it seems we might be able to learn something from them soon if the upcoming new experiments prove to be true. Highlighted in a recent press release is a five-year-long plan to find the anti-cancer properties of the American ginseng plant.

The National Center for Complementary and Alternative Medicine (NCCAM) announced last week that they are giving a grant of 6 million dollars to help breakdown the restorative elements of the American ginseng plant. American ginseng plant is part of the ivy family and has been found growing in Pennsylvania and New York State as well as the Appalachians and among the Ozark mountain ranges. The American ginseng has been used for medicinal purposes for centuries and is a favorite among Native Americans. Having been grown commercially in fields in Wisconsin and Minnesota, American ginseng has been in high demand for its use as a stimulant or an aphrodisiac and as treatment for type 2 diabetes and sexual dysfunction in men.

Part of NCCAM’s funding for this project is going to the opening of one of four new research centers across the United States. The first is the Wisconsin Center for the Neuroscience and Psychophysiology of Meditation which will focus on meditation’s effects on the brain as well as the body using emotion and emotional reactivity in order to help relieve stress and depression. The second clinic is at the University of California at San Francisco focusing on the meditation and the effects of metabolism and immunology through studying obesity and hormonal response therapy. Montana State University in Bozeman gets the third research center using CAM through botanical extracts against inflammatory disease and infection. The researchers at the University of Chicago Medical Center have been given the final opportunity to explore the hidden healing properties of the American ginseng in the hopes that it holds the key to defeating deadly cancer. Their research center, called the Center for Herbal Research on Colorectal Cancer, will delve into ginseng’s anti-tumor effects through lab and animal trials.

This isn’t the first time ginseng has been linked to helping cancer patients, but it was specifically aimed at aiding fatigue symptoms.

Josephine Briggs, the director of NCCAM comments on these four new clinics and what their research means, “[they are] all based on strong preliminary work, apply natural-product and mind-body CAM approaches across a range of health conditions that affect the American public….Their multidisciplinary, collaborative structure increases opportunities for improving health and discovering insights into important aspects of human biology."

The University of Chicago will be applying scientific research tools and techniques to natural medicine. Using different preparations of American ginseng—known scientifically as Panax quinquefolius—to hopefully reduce the number of patients with colon cancer or prevent it altogether.

Chun-Su Yuan, M.D., Ph.D., University of Chicago’s Cyrus Tang Professor of anesthesia and critical care says that while one third of adults in America use a supplement like ginseng everyday in lieu of traditional pharmacy cures that there is still a lot of research to be done because herbal medicine investigation is, "still in its infancy," and he continues, "…we know very little about how, when or even if these products are beneficial."

Even though herbal remedies have been used by many cultures over centuries, no one has tried to use a western approach to conventional drug testing against these techniques before so it will be hard to undertake but hopefully beneficial in the long run. Colorectal cancer is the second leading cause of cancer deaths in the United States and the third most common cancer.


American ginseng will be studied in three different projects. The first will study ginseng’s cancer cell killing abilities. Project number two will isolate the ginseng extracts that change gene expression within the cells of cancer tumors. The third research experiment will show ginseng’s internal communication skills that activate cell re-growth or cell death. Even without the official approval to cure cancer, I bet ginseng will start to become more of a household name in more than just supermarket teas. l

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Sensitive skin care is more than just choosing the right sensitive skin care product. Sensitive skin has a low tolerance level to certain products or environmental conditions. People with sensitive skin may react quickly to chemicals, heat or wind by developing red, blotchy and irritated skin. This following form part of this article:

* What are the methodologies for dealing with oily skin?
* Will fresh fruits and vegetables helps in having a healthy skin?
* What is the role of artificial cream and supplements helps in skin care?

Sensitive skin care is more than just choosing the right sensitive skin care product. To provide the best sensitive skin care, you need an overall approach to providing the best possible care.

Sensitive skin has a low tolerance level to certain products or environmental conditions. People with sensitive skin may react quickly to chemicals, heat or wind by developing red, blotchy and irritated skin. Different people have different levels of skin sensitivity. Some people may react to a product, while for others it produces no effect. Similarly, some people may have a very severe reaction, while others only have a mild reaction.
Problems Faced by People with Sensitive Skin
People with sensitive skin face many problems. The redness, irritation and blotchiness associated with sensitive skin can be uncomfortable and embarrassing. It can be annoying having to avoid everything that may cause sensitive skin to flare up. Providing the right sensitive skin care can be particularly difficult, as many skin products will have a negative effect.
Dealing with Sensitive Skin
NATURAL METHODS

Natural skin care can be an effective way of treating sensitive skin. Natural products are less likely to trigger the reaction that other products may have on sensitive skin. Here are some of the best natural ways to treat sensitive skin.

Food Intake and Hydration

Diet can play a big part in sensitive skin break outs. A healthy diet (containing plenty of fresh fruit and vegetables) will help skin look healthy. People with sensitive skin should pay attention to their diet and take note if any foods seem to trigger a sensitive skin reaction. Even some healthy foods may cause a reaction in some people, so do not discount these when you look at possible triggers. Hot and spicy foods are particularly likely to cause a negative effect.

People with healthy skin should also drink lots of water, which will help keep their skin hydrated. When skin is adequately hydrated, it is healthier and better able to fight off skin irritations.

Herbal Remedies

Herbal remedies are very good for sensitive skin, because they are free from the harsh chemicals that can cause skin problems. Generally, products that contain natural ingredients will be better for your skin and less likely to cause a sensitive skin reaction. Try the following remedies for some special sensitive skin care.

* Use almond or jojoba oil to cleanse your face.
* Comfrey steeped in water can make a good toner.
* Make a facial exfoliate by mixing grapefruit with oatmeal.
* Make a face mask out of fruit.
* Cucumber and yoghurt also makes a good face mask for sensitive skin.
* Licorice is a good product for sensitive skin. Look for skin care products that contain licorice.
* Green tea has anti-inflammatory properties, which may help prevent sensitive skin reactions.
* Aloe Vera can soothe skin that is red, irritated and blotchy. Apply directly to the skin.

Even when using natural products, people with sensitive skin need to be careful. As some sensitive skin reactions are caused by allergies, even organic products may cause an adverse reaction in someone. Check every product on a small area of your skin first, and stop using a product if it seems to be triggering the symptoms associated with sensitive skin.l

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According to the March of Dimes, heart defects are among the most common birth defects and are the leading cause of birth-related deaths. In the United States alone, about 35,000 infants (1 out of every 125) are born each year with heart defects. Among the most common congenital heart problems are heart valve defects, where the heart valve either does not close normally or is narrowed or blocked, so blood can’t flow smoothly. When these faulty valves cannot be surgically repaired, they must be replaced with new ones either from human or animal donors or from artificial material. Although these replacements are lifesaving, the valves neither grow nor develop as children do, requiring kids to undergo multiple surgeries to replace outgrown valves. However, German scientists are hopeful that within five to seven years, they will be able to fashion a new heart valve for children born with heart valve defects that would grow as the child develops using stem cells collected at birth from the child’s own umbilical cord blood.

In what is called a concept study, cardiologists at the University Hospital of Munich collected umbilical cord blood at birth and then froze it to preserve the cells. After 12 weeks, they harvested the stem cells, seeded them onto eight biodegradable heart valve scaffolds and grew them in the laboratory. Upon examination with electron microscopes, researchers could see the cells had grown into the pores of the scaffolding and formed a tissue layer. Biochemical examination indicated that the cells had produced important elements of the “extracellular matrix,” the portion of body tissue that functions outside of cells and is essential to tissue function and structure. Compared with human tissue from pulmonary heart valves, the tissue-engineered valves had 77.9 percent as much collagen (the main protein in connective tissue); 85 percent as much glycosaminoglycan (a carbohydrate important in connective tissue); and 67 percent as much elastin (a protein in connective tissue). The valves also contained desmin (a protein in muscle cells), laminin (a protein in all internal organs), alpha-actin (a protein that helps muscle cells contract) and CD31, VWF and VE-cadherin (components of blood vessel linings).

Over time, the scaffolds will dissolve, leaving behind a fully formed structure made from the cells, explained cardiac surgeon Ralf Sodian, who led the study. “The basic idea is to implant something living, functional from your own cells which will integrate into the surrounding tissue with the potential to grow,” Sodian said. “Tissue engineering provides the prospect of an ideal heart valve substitute that lasts throughout the patient’s lifetime and has the potential to grow with the recipient and to change shape as needed.”

Sodian cautioned that, while the technique shows promise, researchers need to work out several issues before they can attempt it in people. The next step is test the procedure by implanting these tissue-engineered heart valves into young lambs and watching to see how they grow and function over time. Sodian says he hopes to begin these experiments next year.

Although stem cells from human embryos are more versatile, since they are able to form any of the roughly 210 cell types found in the body, stem cells from umbilical cord blood have the potential to form many kinds of cells that can repair or replace damage to organs of the body. And, since the umbilical cord cells are not derived from human embryos, they don’t raise the ethical objections, such as those that led President George W. Bush to limit federal funding for embryonic stem cell research. However, reports are that President-elect Barack Obama plans to possibly undo the Bush restrictions on embryonic stem-cell research by executive order once he takes office on January 20.

The study findings were presented at the American Heart Association’s annual scientific sessions in New Orleans. l

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Heart disease and stroke remain the No. 1 and No. 3 causes of death in the United States. Combined, they were responsible for almost one-third of the total number of deaths reported in 2005. Several factors are well known to increase the risk of heart attack and stroke, including tobacco smoke, obesity, diabetes, high blood pressure and high cholesterol. This information has allowed people with these conditions to change their lifestyle or take medications to reduce their risk. However, about half of all heart attacks and strokes occur in people whose cholesterol is normal, raising questions about what other factors might also be involved. Evidence has been building that inflammation may play a critical role by causing plaque inside arteries to rupture, causing blood clots that block blood flow. But the usefulness of this information has remained far from clear—until now.

Findings of a highly anticipated study presented at a meeting of the American Heart Association in New Orleans produced powerful evidence that seemingly healthy people having what are considered safe cholesterol levels and no apparent risk for heart disease could lower their chances of having a heart attack or stroke or dying from any cause by taking a widely prescribed cholesterol medication—Crestor. “The potential public health benefits are huge,” said Dr. Paul M. Ridker of the Brigham and Women's Hospital in Boston, who presented the findings. “It really changes the way we have to think about prevention of heart attack and stroke.”

The study began in 2003 when Dr. Ridker and colleagues started prescribing either a daily 20 milligram dose of Crestor or a placebo to 17,802 middle-aged and elderly men and women in the U.S. and 25 other countries. One-fourth were black or Hispanic and 40 percent were women. Men had to be 50 or older, women, 60 or older. None had a history of heart problems or diabetes. All participants had safe cholesterol levels but had high CRP, a substance in the blood called C-reactive protein that signals inflammation. The study was slated to last for five years, but was stopped in March after an average follow-up of two years when an independent monitoring panel concluded that the benefit was too great to continue withholding the real drug from the participants receiving the placebo.

Compared with the placebo group, those taking Crestor were 54 percent less likely to have a heart attack, 48 percent less likely to have a stroke, 46 percent less likely to need angioplasty or bypass surgery to open a clogged artery, 44 percent less likely to suffer any of those events and 20 percent less likely to die from any cause. For example, there were 136 heart-related problems per year for every 10,000 people taking placebos versus 77 for those taking Crestor. While some of the participants had risk factors for heart disease, such as being overweight or having high blood pressure, the findings held true even for those who had no known risks other than their high CRP levels. “If you’re skinny it worked, if you’re heavy it worked. If you lived here or there, if you smoked, it worked,” Dr. Ridker said. “We were both shocked and elated.”

“These are very, very dramatic findings,” said Elizabeth G. Nabel, director of the National Heart, Lung and Blood Institute. “This really validates inflammation as being an important factor in the development and progression of heart disease, and that treating inflammation, even in the setting of a normal cholesterol level, may be very important for certain individuals.” Nabel noted that two other studies presented at the meeting also support the value of CRP testing.

Leading authorities predict these findings will prompt many doctors to use CRP testing to screen patients for inflammation and begin prescribing either Crestor or a less expensive generic statin to those who get worrisome results. Dr. Ridker said one of his colleagues predicted that over five years, an estimated 250,000 heart attacks, strokes, angioplasties or deaths from heart attacks could be prevented in the United States alone. “We could prevent a lot of heart attacks, stroke, bypass surgeries, angioplasties and save a lot of lives,” Ridker said. “To me that’s a good thing.”

Still, other experts are skeptical, arguing that the actual risk reduction for an individual would be very small. Dr. Mark A. Hlatky, a Stanford University cardiologist who wrote an editorial accompanying the study, said about 120 people would have to take Crestor for two years to prevent a single heart attack, stroke or death. “This would be a huge expansion of the boundaries of drug therapy,” he said. “Everybody likes the idea of prevention. We need to slow down and ask how many people are we going to be treating with drugs for the rest of their lives to prevent heart disease, versus a lot of other things we’re not doing (to improve health).”

Using federal health statistics, Drs. James Stein and Jon Keevil of the University of Wisconsin-Madison project that 7.4 million Americans, more than 4 percent of the adult population, are like the people in the study. They calculate that treating them all with Crestor would cost $9 billion a year and prevent approximately 30,000 heart attacks, strokes or deaths. “That’s pretty costly. This would be a very difficult sell” unless a person also had a family history or other risk factors for heart disease, said Dr. Thomas Pearson of the University of Rochester School of Medicine and Dentistry. Pearson was co-chairman of a joint government-heart association panel that wrote current guidelines for using CRP tests to guide treatment.

“We’re already struggling to provide health services for the 46 million Americans who don’t have health insurance in the United States,” said John Abramson, a clinical instructor at Harvard Medical School. “This is going to drain away a lot of money from the system for little or no benefit. We know that there are lifestyle interventions that are effective.”l