How I Overcame My 50-Year Struggle With Gynecomastia

Before we get started, here's a little story from one of my clients, Sammie Fields.
Hey there I’m Sammie.

I’m in my 70s now and I’m finally enjoying my life as a masculine-looking guy. I struggled with gynecomastia ever since puberty. Back in the day it was totally unheard of for a man to have breasts.

Man boobs were quite a rare thing. If you think having man boobs is bad now, try having them in the 60s. I spent my entire life in fear that someone would notice my breasts. I stayed away from women - I was horrified of the bedroom. I also stayed away from the beach and only got out wearing the thickest of clothing to try and conceal myself.

Back then there was no internet, and no information out there to help me. I tried everything I could to try and get rid of my man boobs. I lost weight and tried different diets but all to no avail.

One day however, just a few years ago I came across a newspaper article.

This article complained of how male fish in our waters were becoming feminized. Scientists had studied these male fish and found how they had developed feminine characteristics, even to the point of producing eggs! Apparently this was due to the prevalence of the female hormone estrogen in our water supply.

Apparently, due to most government water filtration systems (including the US), estrogen passes unfiltered right into our taps, and straight into your belly when you drink that glass of water.

The estrogen is being absorbed by us and is resulting in modern man having low sperm counts, fertility problems and gynecomastia. Heck it might even be responsible for the boom in the male cosmetics industry (joke).

So I went out there, did some research and found some other shocking sources of estrogen that exist especially in the modern environment, but were also there in the past albeit in much lower quantities and not as widespread back in the day.

Why am I telling you all this?

Well I lost my man boobs in my mid-sixties. The only way I managed to succeed was after I armed myself with the facts, and all the information I needed to know about the very root cause of my gynecomastia.

If I could get rid of my gynecomastia in my sixties, then I know for a fact that anyone else can do it too. So if you're about to give up or you have given up and are ready to face the world as a pseudo-man, then I'm here to tell you to wake up! Get out of that trance, shake yourself up and inform yourself of real working tactics that have been proven time and time again to help many thousands of guys lose their man boobs permanently using all-natural methods.

And I can't think of a better person to help you than my good friend Robert Hull. I leave you to his very capable hands and I'm sure that you will learn much on his new blog.

Thursday, March 31, 2011

Another Silent Epidemic

Take a short journey with me and learn about a serious sexually transmitted disease called Chlamydia. Find out what signs and symptoms are almost always present when women have been infected by chlamydia. Discover the treatments for chlamydia and prevention tips for this STD which, if not treated promptly and properly, can have a devastating affect on your future fertility.

Source: http://womenshealth.about.com/b/2011/02/26/another-silent-epidemic.htm

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Dye extends life (if you're a worm)

?Scientists have discovered a dye that could slow down the ageing process in humans,? the Daily Express has reported. According to the newspaper, the yellow dye is a compound currently used in neuroscience laboratories to detect damaged proteins seen in the brains of patients with Alzheimer?s disease.

The laboratory study behind this report found that worms lived up to 70% longer when they were exposed to Thioflavin T (ThT), a dye commonly used in the laboratory to stain protein in cells. The dye also reversed paralysis caused by their muscle cells accumulating amyloid proteins, which are implicated in Alzheimer?s disease.

While the findings will be of interest to scientists, these are preliminary results and the effects of this dye on human health are unclear. Potential new treatments for humans face a long timeline of testing and review to determine whether they are safe and effective. It is unlikely the systems in the worms are comparable with what might happen in the human body, and it remains to be seen whether ThT can be used to extend life.

Where did the story come from?

The study was carried out by researchers from the Buck Institute for Research on Aging, the Dominican University in California and the Karolinska Institute in Sweden. The work was supported by the Larry L Hillblom Foundation and the US National Institutes of Health. Individual researchers also received support from various organisations. The study was published in the peer-reviewed scientific journal Nature.

Newspaper headlines have generally featured claims that the key to longevity has been discovered, which detracts from the reality that this was a study in worms. Also, this was early research and it is likely that a lot of further research will be needed before we can tell if this technology is applicable to humans.

What kind of research was this?

The researchers say that studies have shown that the maintenance of a careful balance of protein in cells is linked to cell longevity. They hypothesise that providing animals with treatments that promote this balance may improve lifespan. They tested this theory in a laboratory experiment using adult worms known as Caenorhabditis elegans. These small worms usually live in the soil but are commonly studied in laboratory settings. The particular substance studied is Thioflavin T (ThT). This is dye often used in a laboratory setting to stain cells that are examined under a microscope. It specifically marks the presence of fibrous protein complexes, such as the amyloid proteins implicated in Alzheimer?s disease.

What did the research involve?

The researchers tested a number of substances for their effects on the balance of proteins in worms. The substances were:

  • Thioflavin T (ThT)
  • Curcumin (turmeric)
  • 2-(2-hydroxyphenyl)-benzoxazole (HBX)
  • 2-(2-hydroxyphenyl) benzothiazole(HBT)
  • 2-(2-aminophenyl)-1H-benzimidazole (BM)
  • Rifampicin (an antibiotic)

The worms were exposed to the different substances and to different doses of them by saturating the medium in the dishes the worms were growing in. Every second day the researchers assessed whether the worms on the plate were alive, dead or lost, rating worms that did not respond to touch as dead.

In other experiments they used worms that had been genetically modified to have diseases in which proteins accumulated in muscle tissue. These proteins were amyloid beta and polyglutamine (polyQ) protein. Amyloid beta is also associated with lesions in Alzheimer?s disease.

Worms unable to regulate this protein develop lesions in their muscles and become paralysed. The researchers exposed these diseased worms to the ThT and to the other compounds to determine whether they were able to restore protein regulation in the worms. They also undertook a series of other experiments designed to help them understand what processes ThT was acting upon in order to affect lifespan.

What were the basic results?

Exposure to ThT throughout life increased the average lifespan of the worms by about 60% and by 43-78% beyond their untreated maximum lifespan. However, at high doses, ThT was toxic and reduced lifespan. At all ages, treatment with ThT resulted in reductions in rates of age-specific mortality and in age-related decline in spontaneous movement. This indicated improved health.

Treatment with ThT was able to restore movement in those worms that were paralysed by lesions of amyloid beta (the protein found in a brain with Alzheimer?s disease).

The effects of ThT on lifespan depended on the presence of other molecules (skn-1 transcription factor and a regulator molecular called HSF-1). The researchers say that ThT mimics the stress response that ultimately leads to better regulation of protein, stopping them from aggregating (i.e. collecting together to form clumps).

How did the researchers interpret the results?

The researchers conclude that their study has shown molecules that can mimic the stress response and target the complex processes that regulate the balance of proteins in cells may ?provide opportunities for intervention in ageing and age-related disease?.

Conclusion

This well-described laboratory study has found that a dye commonly used in the laboratory to help identify the presence of protein complexes in cells actually interacts with these proteins in a beneficial way that could prevent them building up in cells. This effect appears to increase the lifespan of nematode worms and also to reduce (or reverse) the age-related paralysis that occurs when amyloid lesions build up in their muscle cells.

Amyloid beta lesions are responsible for Alzheimer?s disease in humans and many newspapers have made the leap from these discoveries to a potential ability to extend human longevity using the Thioflavin T (ThT) dye studied. It is too soon to know whether ThT could be safely given to humans and whether it will have any effect on the lifespan of individuals.

News headlines that have suggested that ThT is the key to long life are overly optimistic given the early stage of this research. For example, the Daily Mail reported that ThT ?slowed the symptoms of dementia in worms bred to mimic aspects of Alzheimer?s?. It is not clear where this claim has come from or indeed, what the symptoms of dementia might be in a worm.

Links To The Headlines

Yellow dye used to test Alzheimer's could hold key to living longer. Daily Mail, March 31 2011

Found - dye that may help us to live longer. Daily Express, March 31 2011

Links To Science

Alavez S, Vantipalli MC, Zucker DJS et al. Amyloid-binding compounds maintain protein homeostasis during ageing and extend lifespan. Nature, Published online 30 March 2011

Source: http://www.nhs.uk/news/2011/03March/Pages/worms-yellow-dye-long-life-secret.aspx

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The rise of the female midlife crisis

Jeffries initially volunteered for six months but found she didn?t want to go home when her time was up. 'I felt so much more confident and assertive. There was a sense of relaxation, of certainty this was the right thing to do.?

Jeffries did return briefly to Britain but felt a completely different person. 'I found it really stressful. Things that used to matter to me were no longer important. I?d been very materialistic, but now I didn?t need to have a car, I didn?t need new clothes.

'When I went through the list of my friends I thought, ?Do I want to see you?? and with a lot of them the answer was no. I realised who my real friends were, as opposed to the friends I went out drinking with. I?d been bumbling along from boyfriend to boyfriend, job to job, but the time out I had had made me really learn about myself and what I wanted.?

Her relationship with her on-off boyfriend had also changed and shortly after she returned to Tanzania she ended it. 'It had always been on his terms but it finished on my terms. Different things were more important to me than having a boyfriend. He was possessive and insecure and worried too much.

'I thought, ?People in Tanzania have nothing and they are happy; they don?t moan all the time.? I realised I had always needed to be with somebody but now I was happy in myself.?

Despite ? or more probably because of ? her new-found independence, Jeffries soon fell in love with a local tour guide, Frank. They have just had a baby boy, Joshua. 'Kids had never been on my priority list before, but when I saw how Frank was around children I suddenly wanted one.?

Although Jeffries may sound on the young side, what she had undergone was a midlife crisis. Traditionally these are viewed as the preserve of fiftysomething men who overnight gain an earring, a Harley-Davidson and a teenage girlfriend.

But increasing numbers of women are wrangling with what Carl Jung called 'the afternoon of life??, an unspecified time of angst and self-doubt that can kick in at any time from 35 to 55, even if the signs are usually less conspicuous.

According to the mental-health charity Mind, typical symptoms of a crisis are boredom, a feeling of worthlessness, lack of meaning and, most of all, a terrifying sense that time is running out.

Once this state of mind was associated with the menopausal and 'empty nesters?? , women like Shirley Valentine, the housewife of Willy Russell?s play of the same name who walked out on her husband and went to Greece for a fling with a Greek bar owner.

Twenty years on, however, our definition of midlife is more confused. Women in their fifties may be suffering from hot flushes and caring for elderly parents while also raising young children, dressing in miniskirts and going out clubbing.

At the same time, pressures on women to succeed as young as possible can make them reach breaking-point far earlier than in the past. 'By the time you are just 30 these days you?re pushing the glass ceiling,? says Professor Cary Cooper, the president of the relationships charity Relate.

'The average age of a chief executive has gone down from the late fifties to the forties in just a decade, so you?ve either made it or you haven?t. It means either you invest more in work, possibly at the expense of family life, or you think, ?I?m not going anywhere in this job so what?s the point????

A recent Relate report found that people aged between 35 and 44 were most likely to be in crisis. This is the time when many mothers feel their identities have been swallowed up by their children. Childless women, on the other hand, may be realising they may never enjoy family life. Relentlessly bombarded by images of 21-year-olds in bikinis, they can feel past their prime, their potential unfulfilled.

For these educated, sophisticated women the poster girl is Elizabeth Gilbert, the glamorous thirtysomething whose bestselling memoir Eat, Pray, Love recorded how she left an unsatisfying marriage, quit her job and spent a year travelling round the world.

One yoga instructor, who teaches in Mysore, India, says he knows Gilbert?s followers well. 'I call them the FFFs ? female, fat and 40,? he says. 'They?ve either left it too late to have babies or their children have grown up. Either way, they don?t know what to do with their lives and are searching for some truths.?

Roger Salwey, the director of Oyster Worldwide, the company that organised Tracey Jeffries? gap year, is more tactful in his description. 'We have noticed a big market in divorced women, far more so than in men,? he says.

What crisis sufferers of any age tend to share is a new awareness of life?s fragility. Myra Hunter, a psychologist, says: 'There can be transition every decade ? some women feel better in their forties. What brings them to a crisis is that they?ve undergone a significant event that?s triggered thoughts about where they have been and who they are.?

For Helen Jones, 45, the turning-point was her long-term partner?s death from lung cancer at the age of 40. 'I was left a single parent to our son and with a strong sense that life was too short and that I had not been living life as I should be living it.?

That feeling was compounded when Jones had to give up her job as a car valet following a whiplash injury. 'I couldn?t do my job anymore so I ended up working in a call centre. But when you get to a certain age you don?t want to stay in a dead-end job.?

By this time she was in a new relationship with Heather Bradley, 39, whom she married in a civil ceremony four years ago. During a night out they decided to give up their jobs and open Gabrielle?s, a hotel for women in Blackpool.

'Everyone said, ?You?re mad.? Heather had never been to Blackpool and I had only been once as a child. We were living in Rotherham, we?d just bought a beautiful detached house together and we were only two years into our relationship.

'The banks wouldn?t lend us money because we knew nothing about the hospitality industry. My son was nine and we had to take him out of his school and uproot him from family and friends. So it was very scary. But life?s about more than material things. We knew we didn?t want to be answerable to anyone workwise.?

Despite the non-stop demands of running a hotel, Jones still maintains her life?s-too-short attitude. 'It?s hard to take holidays because we have to turn down business, but we always ensure we make time to get away. I know now that you have to prioritise lifestyle over money, that we?ll never be rich or have a brand-new car again but we?ll always be happy.?

As with Jones, it took the death of a loved one for Frieda De Ley, 44, to ? in her words ? 'wake up??. Having enjoyed a lucrative career as an executive in an industrial insurance company, De Ley was jolted into action after her mother was diagnosed with cancer and told she had two months to live.

'We had a very, very strong bond and the shock made me see that the life I was leading was not what I wanted anymore. I was earning a lot of money, but I was living out of a suitcase and not enjoying it. I?d gone into engineering because I was good at science and my parents thought it was a good career, but this trigger made me realise that all these years I?d actually been following the wrong path.?

Her colleagues were 'flabbergasted? when, aged 35, she resigned to retrain as a psychologist. She worked first in the public sector before setting up her own business, FDL ? For Developing Leaders, to advise, train and coach people in the workplace.

For De Ley, from Chiswick, west London, the choice wasn?t just about finding more enjoyable work, but about prioritising home life, too. 'Until then my husband and I had been living off microwaved meals but I wanted to change all that. We had a house, we had a garden, but I was working too hard to enjoy it and make it nice.

'A lot of my friends were spurred to slow down because they wanted to spend time with their children, but even without children I think a time comes when you want just to enjoy your home more.?

For women who have concentrated too much on their families, however, the opposite may be true. Yvonna Demczynska, 53, had happily abandoned a career in marketing that her family had 'pushed her into? to bring up two sons.

But as the children grew up she began to feel unfulfilled. With no experience or training, 10 years ago she opened the Flow Gallery in Notting Hill, west London, showcasing applied art from all over the world.

'I just wasn?t getting enough stimulation with the children at home,? she says. 'I loved them very much but I needed something for myself. I was definitely losing confidence and when I hit 40 I thought, ?If I don?t do something soon that I really love when will I do it?? It was quite a risk ? I had no experience and I found it very difficult to speak to people about what I was doing.?

The gallery took off but then Demczynska?s husband of 27 years left her. 'It was a really big shock. It takes a long time to heal the pain of abandonment. Without the gallery I don?t know what I would have done. Luckily, the confidence it has given me has overflowed into my personal life. I have finally found my potential.?

Not all midlife crises have such happy endings: 25 per cent of middle-aged women suffer from depression and anxiety, compared with 14 per cent of men. But tackled head on and with courage, a crisis can still be transformative.

As Tracey Jeffries says: 'I was so nervous going to Tanzania because I was surrounded by 18- and 19-year-olds on their gap years but I got so much more of the experience than they did.

'Their lives haven?t begun yet and I was beginning to think mine was over. Sometimes you need to step back from your life and think: ?Is this really me?? It?s a lot more difficult to do it when you?re older, but it?s certainly worth it.?

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/13b9ad75/l/0L0Stelegraph0O0Cfamily0C840A45720CThe0Erise0Eof0Ethe0Efemale0Emidlife0Ecrisis0Bhtml/story01.htm

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Avian flu suspected at Missouri facility

STORY HIGHLIGHTS

  • Probable case of bird flu found during routine testing at southwest Missouri facility
  • Poultry facility is under quarantine during investigation
  • State says it is extremely rare for humans to be affected by this type of bird flu
  • Cargill Corp. says it will euthanize up to 15,000 turkeys

(CNN) -- A poultry facility in southwest Missouri was quarantined after the discovery of a suspected case of bird flu, officials said.

"As a precaution, the poultry facility has been quarantined following preliminary results obtained during routine testing," the Missouri Department of Agriculture said in a news release.

Additional tests will authenticate the viral disease at the Polk County facility, the state said Wednesday, adding that it is extremely rare for humans to be affected by this type of bird flu.

Cargill Corp. will euthanize up to 15,000 younger birds exposed to older turkeys that tested positive for bird flu antibodies, said Mike Martin, director of communications for the company.

Martin said Thursday the older birds are being harvested at another Missouri location. Their meat poses no health risk, he said.

Flocks within six miles of the facility are being tested. Test results may be back as early as Friday, Cargill said.

"At the time the tests were conducted, the birds had no symptoms of the avian influenza. However, the antibodies mean at some time, the animal immune systems responded to the avian influenza," Martin said. "The flu could have been present in the water, ground, air or transmitted by other migrating birds."

Cargill owns the birds but uses the farm under a contract, he said.

"This flu is not transferable to humans," Martin said. "The real concern is for animals and the flu not being spread to other animal herds."

The U.S Agriculture Department is monitoring the situation.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/Fc07VFihRoc/index.html

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Airport scanners: Some doctors opt out

The Transportation Safety Administraiton says full-body scans, which emit a small amount of radiation, are safe.

STORY HIGHLIGHTS

  • Seeing doctor decline airport full-body scan sparked correspondent's curiosity
  • She asked other doctors randomly about whether they submit to "backscatter" scans
  • TSA says multiple studies have shown that scanners' radiation levels are safe.

(CNN) -- I was in the security line at an airport a few months ago when I watched a fellow passenger do something I'd never seen done before: He dissed the scan.

"I'd like to opt out," he said, as a security agent went scurrying for a male agent to give this man a full-body pat-down, the requirement for anyone who refuses to go through the full-body scanner.

Wow, I thought, this man really must want to avoid the scanner if he's willing to get groped by a total stranger.

The Transportation Security Administration says the so-called backscatter scans, which emit a small amount of radiation, are safe. "Multiple independent studies have confirmed that the technology used to protect passengers when they fly is safe for their health," says TSA spokesman Nicholas Kimball. "TSA takes many precautions to regularly verify that all machines are operating properly."

Another type of airport scanner uses "millimeter wave" technology, which uses electromagnetic waves and has not raised the same level of public concerns as the backscatter scans.

So why all the worry? In my obnoxious journalist way, I pounced on the guy to ask him why he'd done it.

"I'm a doctor at M.D. Anderson, and I don't want radiation if I can avoid it," he said.

I was next in line. I'd just watched a doctor at M.D. Anderson, a top cancer hospital, opt out because he wanted to avoid radiation. Does that mean I should, too? I had a second to make a decision. I decided to opt out, too.

The pat-down, I learned, is not such an easy option. First, you have to make a bit of a spectacle of yourself by publicly asking for something different. Secondly, it takes time (not a lot, but enough to be a problem if you're running late) and thirdly, I ended up being touched in places previously reserved for my husband and my gynecologist.

I began to wonder if the doctor was being a little paranoid. Was the radiation so dangerous that it was worth the hassle and embarrassment? To get a little perspective, when I returned home I randomly asked doctors I respect what they do in the security line. It was a completely unscientific sampling, but it yielded this interesting result: All these doctors are smart people with access to the same scientific data, and yet made very different choices.

Doctors who say "yes" to the scanners

I started, of course, with my colleague Dr. Sanjay Gupta, a neurosurgeon, who told me he hasn't opted out thus far.

Many other doctors feel the same way.

"I go through them," said Dr. Greg Zorman, chief of neurosurgery at Memorial Healthcare System in Florida. "The amount of radiation you get isn't worth worrying about."

Dr. Drew Pinsky, an internist and host of a new show on HLN that makes its debut on April 4, called the amount of radiation "inconsequential."

The radiation you get from a backscatter imaging machine used at many airports is the same amount of radiation you get from sitting on an airplane for two minutes, according to research released this week by the University of California San Francisco.

The researchers calculated for every 100 million passengers who fly seven one-way flights a year, six of them could get cancer as a result of the radiation exposure from the full-body scans.

The California researchers made these calculations based on information from the manufacturers. Some researchers question whether the manufacturers' measurements are valid. David Brenner, director of the Center for Radiological Research at Columbia University, says he thinks the exposure to radiation is actually 10 times more than what the manufacturers claim.

Even so, Brenner (who's a physicist, not a medical doctor) still goes through the scanners at airports because even by his calculations the amount of radiation is still small.

Doctors who say "no" to the scanners

Dr. Otis Brawley, chief medical officer of the American Cancer Society, takes a pat-down instead of going through a scanner when he travels. He says he's concerned about whether the machines are calibrated and inspected properly.

"USA Today did a piece on how badly TSA maintained their X-ray equipment for carryon bags, and this gave me little confidence," he wrote to me in an e-mail.

Brawley's deputy concurs.

"I do whatever I can to avoid the scanner," Dr. Len Lichtenfeld wrote to me in an e-mail.

He says as a frequent flier, he's concerned about the cumulative effect of the radiation.

"This is a total body scan -- not a dental or chest X-ray," he wrote to me. "Total body radiation is not something I find very comforting based on my medical knowledge."

Lichtenfeld says it doesn't necessarily give him great comfort that the TSA says the scans are safe.

"I can still remember getting my feet radiated as a child when I went to the shoe store and they had a machine which could see how my foot fit in the new shoes," he says. "We were told then that they were safe, and they were not."

(At first I thought Lichtenfeld was making this up, but you can actually see one of these foot scanners at the Museum of Questionable Medical Devices at the Science Museum of Minnesota.)

Another doctor who opts for the pat-down is Dr. Dong Kim, Rep. Gabrielle Giffords' neurosurgeon.

"There is really no absolutely safe dose of radiation," says Kim, chair of the department of neurosurgery at the University of Texas Medical School. "Each exposure is additive, and there is no need to incur any extra radiation when there is an alternative."

This was echoed by several other physicians, including Dr. Andrew Weil.

"All radiation exposure adds to the cumulative total you've received over your lifetime," Weil wrote to me in an e-mail. "Cancer risks correlate with that number, so no dose of radiation is too small to matter."

Doctors exposed to radiation at work are particularly sensitive to this issue, as I learned when I got through security that day in the airport and chased after the doctor who'd opted out.

I learned his name is Dr. Karl Bilimoria, and he's a surgical oncology fellow at M.D. Anderson. He says this is a frequent topic of discussion among his colleagues.

"If we can avoid a little radiation in exchange for the two extra minutes needed for a pat-down, then we will," he says.

Source: http://rss.cnn.com/~r/rss/cnn_health/~3/VAGtx7gTJCI/index.html

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Herpes Simplex Infections (Cold Sores, Non-Genital)

Cold Sores
(Herpes Simplex Infections, Non-Genital)

Medical Authors: Mohamad El Mortada, MD, MaryAnn Tran, MD, Corrine Young, PharmD, and Mary D. Nettleman, MD, MS, MACP
Medical Editor:
Melissa Conrad St�ppler, MD

Causes, Symptoms, and Treatment of Cold Sores

Cold sores. These small, painful sores are caused by herpes simplex virus type 1. Once you are exposed to the virus, it can hide in your body for years. Things that trigger the virus and lead to cold sores include:

  • Getting too much sun
  • Having a cold or infection
  • Having your period
  • Feeling stressed

Cold sores can spread from person to person. They most often form on the lips and sometimes under the nose or chin. The sores heal in about 7 to 10 days without scarring. You can buy over-the-counter drugs to put on cold sores to help relieve pain. If you get cold sores a lot, talk with your doctor or dentist about a prescription for an antiviral drug. These drugs can help reduce healing time and the number of new sores.

SOURCE: Womenshealth.gov


What are herpes simplex infections?

Herpes simplex virus (HSV) can cause infections that affect the mouth, the face, the genitals, the skin, the buttocks, and the anal area. This article will concentrate on non-genital herpes. Many people acquire the virus and have no symptoms. For others, painful blisters appear near the area where the virus entered the body. Typically, the blisters heal completely but reappear at some point in the future when least expected (or desired). In between attacks, the virus resides deep in the roots of the nerves that supply the involved area. When herpes simplex lesions appear in their most common location, around the mouth and lips, people often refer to them as "cold sores" and "fever blisters."

What causes cold sores?

There are two types of HSV, type I and type II. In general, type I, also known as herpes labialis, causes infections above the waist, most commonly as oral "cold sores." Type II infections occur mainly below the waist, leading to genital herpes. However, both types of HSVs are capable of infecting the skin at any location on the body.

Herpes infections, no matter where they occur first, have a tendency to recur in more or less the same place. Such recurrences may happen often (for example, several times per year) or only occasionally (for example, once or twice a year).

What makes herpes (cold sores) recur?

After infection, the virus enters the nerve cells and travels up the nerve until it comes to a place called a ganglion. There, it lays quietly in a stage that is referred to as "dormant" or "latent." At times, the virus can become active and start replicating again and travel down the nerve to the skin, causing sores and blisters. The exact mechanism behind this is not clear, but it is known that some conditions seem to be associated with recurrences, including

  • a fever, a cold, or the flu;
  • ultraviolet radiation (exposure to the sun);
  • stress;
  • changes in the immune system;
  • trauma to the involved area;
  • sometimes there is no apparent cause of the recurrence.

How do cold sores spread?

Infections caused by HSV are contagious. The virus is spread from person to person by kissing, by close contact with herpetic lesions, or even from contact with apparently normal skin that is shedding the virus. Infected saliva is a common means of virus transmission. People are most contagious when they have active blister-like sores. Once the blisters have dried and crusted over (within a few days), the risk of contagion is significantly lessened. However, a person infected with HSV can pass it on to another person regardless of the presence or absence of symptoms and visible sores or blisters. This is because the virus is sometimes shed in saliva even when sores are not present. Despite popular myth, it is almost impossible to catch herpes (cold sores) from surfaces, towels, or washcloths.



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Suggested Reading on Herpes Simplex Infections (Cold Sores, Non-Genital) by Our Doctors

    • Stress
      • Stress occurs when forces from the outside world impinge on the individual. Stress is a normal part of life. However, over-stress, can be harmful. There is now speculation, as well as some evidence, that points to the abnormal stress responses as being involved in causing various diseases or conditions.
    • Genital Herpes In Women
      • Genital herpes, a viral infection by the herpes simplex virus (HSV), is transmitted during sexual contact with the mucous-covered linings of the mouth, vagina, or the genital skin. A typical outbreak begins with an itching or tingling sensation followed by redness of the skin and blister formation. The blisters and ulcers that form when the blisters break are painful to the touch and last from 7 days to 2 weeks. Though there is no cure for herpes, there are ways to treat outbreaks.
    • Fever
      • Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
    • Miscarriage
      • A miscarriage is any pregnancy that ends spontaneously before the fetus can survive. Miscarriage usually occurs before the 13th week of pregnancy. The cause of a miscarriage cannot always be determined. The most common causes of a miscarriage in the first trimester are collagen vascular disease (lupus), hormonal problems, diabetes, chromosomal abnormalities, and congenital abnormalities of the uterus.
    • Flu (Influenza)
      • Influenza (flu) is a respiratory illness caused by a virus. Flu symptoms include fever, cough, sore throat, runny nose, headache, fatigue, and muscle aches. The flu may be prevented with an annual influenza vaccination.
    • Erythema Nodosum
      • Erythema nodosum is a skin inflammation that results in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. Erythema nodosum can resolve on its own in 3 to 6 weeks, leaving a bruised area. Treatments include anti-inflammatory medications and cortisone by mouth or injection.
    • Canker Sores
      • Canker sore is a small ulcer crater in the lining of the mouth. Canker sores are one of the most common problems that occur in the mouth. Canker sores typically last for 10-14 days and they heal without leaving a scar.
    • Cold, Flu, Allergy Treatments
      • Before treating a cold, the flu, or allergies with over-the-counter (OTC) medications, it's important to know what's causing the symptoms, which symptoms one wishes to relieve, and the active ingredients in the OTC product. Taking products that only contain the medications needed for relieving your symptoms prevents ingestion of unnecessary medications and reduces the chances of side effects.
    • Meningitis
      • Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
    • Genital Warts in Men (HPV Virus)
      • The HPV virus (genital warts) in men can cause health problems. Genital warts are confined primarily to the moist skin of the genitals or around the anus. Genital warts are caused by the human papillomaviruses (HPVs), which are transmitted through sexual contact.
    • Ganglion
      • A ganglion is a fluid-filled cyst that forms from the joint or tendon lining. Ganglia are most frequently found in the ankles and wrists and are usually painless. A ganglion often resolves on its own. Aspiration of the ganglion fluid or surgery may be necessary.
    • Herpes of the Eye
      • Herpes of the Eye is developed by the herpes simplex 1 virus that usually lives around the nerve fibers in humans. Symptoms of herpes of the eye include pain in and around only one eye, redness rash or sores on the eyelids, redness of the eye, and swelling and cloudiness of the cornea.
    • Scars
      • Scar formation is a natural part of the healing process after injury. The depth and size of the wound incision and the location of the injury impact the scar's characteristics, but your age, heredity and even sex or ethnicity will affect how your skin reacts.




From WebMD

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Herpes Simplex Infections (Cold Sores, Non-Genital)

HPV Virus (Genital Warts ) in Men Introduction

Much of the information about HPV virus (human papillomavirus) centers on women, since having the virus increases their risk of getting cervical cancer. But HPV virus in men can cause health problems, too. So it's important for men to understand how to reduce the risks of HPV infection.

It can increase a man's risk of getting genital cancers, although these cancers are not common. HPV can also cause genital warts in men, just as in women.

More than half of men who are sexually active in the United States will have HPV at some time in their life. Often, a man will clear the virus on his own, with no health problems.

Risks of HPV Virus in Men

Some of the 30 or so types of HPV associated with genital cancers can lead to cancer of the anus or penis in men. Both of these cancer types are rare. In those with a healthy immune system, they are even rarer. Abou...

Read the Genital Warts in Men (HPV Virus) article �


Source: http://www.medicinenet.com/guide.asp?s=rss&a=9632&k=Womens_Health_General

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How do professional women cope with the menopause?

While hormone replacement therapy (HRT) used to be seen by many as the panacea, its safety profile has plummeted since research in 2002 linked it with a higher risk of breast cancer, stroke and blood clots (even though for most women the risk of these is still small ? see box).

A million women quit HRT virtually overnight and by 2006, only 15 per cent of those aged 50-plus were taking it, compared to 40 per cent in 2000. Only this month, figures from Cancer Research UK pointed to HRT as the cause of the small rise in breast cancer over the past decade.

Since then, not much has emerged as an effective treatment for menopause symptoms. The latest research suggests that acupuncture may help ease hot flushes, with women who had needles inserted at various points on the body reporting fewer of these symptoms than those who had sham treatment. The theory is that this traditional Chinese treatment may help stabilise the body?s temperature controls. But, with only 53 women participating, the findings are far from proven.

For women in demanding jobs like Layward?s senior management role, this time of life can be particularly tough. At work she did her best to hide her symptoms, despite feeling lousy much of the time. ?There was no way on earth I would have gone to HR and told them about how I was feeling,? she says. ?It would have felt like professional suicide.?

And with hot flushes visibly obvious, she didn?t wish to become a figure of fun to some of her more ribald colleagues. ?In the past, I?d seen women at work teased when they were having hot flushes? she says.

High-profile celebrities such as Oprah and Kim Cattrall (whose character, Samantha, experiences hot flushes in Sex and the City) may be ?coming out? about the menopause; but new research reveals that, as in Layward?s case, ?the change? is still something working women prefer to keep to themselves, out of embarrassment and fear of being seen as less competent.

The study, just published by the University of Nottingham, has shown that nearly half of women going through the menopause have difficulty coping with symptoms at work; yet two thirds say they would not dream of disclosing their menopausal status to their bosses, male or female. This was particularly true of those in demanding jobs ? which might involve giving presentations at lengthy meetings, for example. Half of these said they would also avoid mentioning hot flushes and other symptoms to colleagues, especially if these were men or younger women,

It is understandable that people want to keep intimate health details to themselves, says lead researcher Amanda Griffiths, Professor of Occupational Health Psychology at Nottingham. But with 3.5 million women over the age of 50 working full-time, the challenge of the menopause is fast becoming an occupational health issue and should be treated as such, with more support from employers, she says.

?If women don?t feel they can speak openly, then they won?t get the support they need,? she argues. Prof Griffiths?s study is the basis of new guidance published by the TUC on how support for menopausal women can be increased, through more awareness, more flexible working hours and, crucially, improvements in workplace temperature control and ventilation.

?If you need to take a break and have a lie down, you are entitled to ask for it. It should be understood that you may need a fan, to sit by an open window or have time out,? she adds.

Jenny Hislop, senior researcher in primary care at Oxford University, who has recently conducted extensive interviews with nearly 50 menopausal women for the charity website, Healthtalkonline, agrees that women are reluctant to talk about some of the difficulties.

?We found that menopausal symptoms are at odds with the self-confident, professional image women want to convey at work,? she says.

Her interviews include one senior police officer who contemplated early retirement when she felt her hard-won authority was being undermined by menopausal symptoms. ?I was suffering frequent panic attacks and very frightening problems with concentration and memory loss. It felt as though somebody had taken the chip out of my brain,? she says. Another woman, working on a Tesco checkout, felt it was better to join in male colleagues? laughter at her hot flushes than show her feelings. ?Deep down, you?re upset, but it?s happening in a public place so what can you do? You get your blonde jokes, you get your menopause jokes,? she says.

It doesn?t help that the menopause is largely neglected in medical education and GP training, says Oxford GP Sally Hope, a specialist in women?s reproductive health. ?The consensus among GPs today is that menopausal symptoms are trivial ? and most doctors don?t have time to offer the support needed or talk through the complex issues surrounding HRT.?

Layward, who is now working as an independent scientific consultant, eventually decided to take HRT after carefully weighing up its risks and benefits, and says she has never regretted it. ?My symptoms disappeared as quickly as they had arrived and six years later, I still feel great. Anyone who tries to take it off me will have a fight on their hands.?

Just in case any younger women are now dreading the menopause, there is a liberating upside to this time of life, she adds reassuringly. It is not just that her children are grown up and flown the nest. ?Not having to worry about getting pregnant or the menstrual cycle is lovely, and I feel I have a lot more confidence and experience.?

www.healthtalkonline.org

Menopause: what works?

Eight out of 10 women suffer from menopausal symptoms, linked to fluctuations in hormone levels as fertility comes to an end. These include hot flushes, memory loss, mood swings and vaginal dryness.

HRT is effective but has risks for every 1,000 women using HRT in their 50s, there will be six extra cases of breast cancer, blood clots or stroke. Regulatory bodies advise taking the ?lowest possible dose for the shortest possible time?.

Tibolone, a synthetic hormone, can help but, like HRT, it increases the risk of stroke and breast cancer. Clonidine is sometimes used to treat hot flushes but has side effects. Testosterone, combined with oestrogen, may occasionally be given as implants for low sex drive.

Some women take plant oestrogens, available as supplements, but one study from 2007 found no good evidence for these. Some experts worry that these could increase the risk of hormone-related cancers. Researchers are not sure if herbal remedies, such as agnus castus and black cohosh, are effective.

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/1357b6c7/l/0L0Stelegraph0O0Chealth0C83767680CHow0Edo0Eprofessional0Ewomen0Ecope0Ewith0Ethe0Emenopause0Bhtml/story01.htm

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What We're Reading This Week

health:blogDotted Line
NEWS MARCH 25

Kristen Dold


Food Face
Your food choices can make your skin look young and beautiful or old and gross. Diet coach Judy Weitzman shares the foods that top both lists.
Via genConnect

Fennel is Fantastic
Yes, true, but how to cook it? Try braising! From the blogger: "This is such a lovely late-winter-oh-but-it's-spring-but-it-doesn't-feel-like-it-yet dish." And we couldn't agree more.
Via Gluten-Free Girl

Red Cabbage vs. Radicchio
Although they may look similar, these two leafy veggies differ significantly in flavor, not to mention price! Here's a handy post on how to tell them apart complete with a simple recipe for Radicchio and Orange Salad with Citrus-Champagne Vinaigrette. Via Food Blogga

'Dread to Risk' Ratio
If you've been following the nuclear crisis in Japan, you've probably got lots of questions about radiation. Check out what one doctor has to say about your risk (or lack thereof!) from things like airplanes and x-rays.
Via NY Daily News

Coulda Woulda Shoulda
Having regrets about the cake you ate for breakfast? What about that last boyfriend? According to a new study, most of the regrets Americans have are about love. Following heartbreak: family, career, education, and money woes.
Via Healthland

Hungry Monster
Everyone knows that replacing cookies with carrots can leave you cranky, but new research suggests that it has more to do with practicing self-control than it does with disappointed taste buds.
Via Healthland

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Source: http://www.womenshealthmag.com/health/news-march-25

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Sleep 'affects weight loss'

?Good sleep is dream recipe to lose weight,? reported the Daily Express. People who get around eight hours sleep a night and reduce their stress levels have double the chance of slimming down, it continued.

This study looked for associations between sleep, stress and success at sticking to a weight loss programme. People who had less than six hours sleep or more than eight hours per day were less likely to achieve weight loss than those who had between six and eight hours. High stress levels also affected weight loss. When combined with poor sleep, stressed people were about half as likely to be successful at weight loss than their less stressed counterparts who got between six and eight hours of sleep.

The results support previous research linking sleep problems to obesity. The findings also make intuitive sense: people who aren?t getting enough sleep and are under stress may have more difficulty sticking to the demands of a weight loss programme. However, this association does not mean that poor sleep causes obesity, or that healthy sleep patterns are a means of achieving weight loss. It is possible that underlying health problems are associated with both poor sleep and obesity.

Where did the story come from?

The study was carried out by researchers from Kaiser Permanente Center for Health Research in Portland, US. Kaiser Permanente is a private health care company. The research was funded by a grant from the National Center for Complementary and Alternative Medicine, National Institutes of Health. The study was published in the�peer-reviewed International Journal of Obesity.

The details of the study were generally reported accurately. The Express was incorrect in stating that people getting over eight hours sleep were more likely to lose weight.

What kind of research was this?

This research is a two-phase clinical trial aimed at comparing two different approaches to maintaining weight loss that has been achieved through a weight loss programme. This research paper concentrates on the first initial weight loss phase, constituting a non-randomised, intensive, six-month behavioural weight loss programme.

The researchers measured various factors to see how much they contributed to the success of the programme, including sleep time, screen time (e.g. TV watching), depression and stress levels. Phase 2, the randomised weight loss maintenance part of the study which will be comparing the two different approaches, will be reported at some point in the future.

They point out that disordered sleep patterns have been identified as a likely risk factor for obesity and that a growing number of experimental studies have observed that lower sleep duration is associated with weight gain. This may be due to sleep affecting hormone levels, which in turn are associated with feelings of fullness or hunger. Similarly, they say, an association has been found between screen time and obesity, and between depression and stress and obesity.

What did the research involve?

In this phase of the trial, researchers recruited 472 obese adults to a six-month intensive weight loss intervention programme. The adults had to be 30 years or over with a BMI of 30-50, and weighing less than 400lbs (28.5 stones or 180kg).

The programme was aimed at changing the participants? behaviour. It involved:

  • reducing their dietary intake by 500 calories a day, with the aim of losing 0.5 to 2lbs weekly
  • eating a healthy low-fat diet
  • exercising moderately most days (at least 180 minutes weekly)
  • recording daily consumption of food, drink and exercise
  • setting short-term goals and action plans to achieve them
  • to attend all group sessions. There were 22 group sessions, led by nutrition and behavioural counsellors over six months

At the start of the trial, trained staff measured the participants? weight and repeated this at each weight loss session that they attended, as well as at the final visit at the end of the six-month period. Participants who lost at least 4.5kg during this phase were eligible for phase 2 of the trial.

The researchers also recorded other measures at the beginning of the trial, including sleep time, stress levels, depression and screen time. The first three of these were recorded using standardised questionnaires.

They used the Perceived Stress Scale (PSS) to measure stress. This is a self-completed 10 item questionnaire with scores ranging from 0 to 40. Higher scores indicate greater stress in the previous month.

Statistical methods were then used to evaluate whether these factors had any association with success in the weight loss programme, as measured by eligibility for the second phase. They also looked for any association between weight loss and adherence to certain other measures, such as attending sessions, time spent on exercise and keeping food diaries.

What were the basic results?

Over the six-month period:

  • Average weight loss was 6.3 kg, with 60% of participants losing at least 4.5kg (10lbs) (and therefore were eligible for Phase 2 of the study).
  • Participants attended an average of 73.1% of sessions, completed 5.1 daily food records weekly and reported 195.1 minutes of exercise per week.
  • Measurements of both sleep time and lower stress (P=0.024) taken at the start of the trial predicted success in the weight loss programme.
  • In particular, people who reported sleeping between six and seven or between seven and eight hours daily at the start of the study were more likely to lose at least 4.5kg than those who slept six hours or less or eight hours or more.

People reporting both less than six hours sleep and the highest stress scores were only about half as likely to succeed in the programme and progress to the second stage, as those sleeping between six and eight hours, with lower stress scores

Changes in stress and depression levels during the study were also associated with changes in weight loss, although changes in sleep and screen time did not show any association with weight loss. Measures of attendance, exercise minutes and food diaries were all positively associated with weight loss.

Screen time did not have any association with success in the weight loss programme.

How did the researchers interpret the results?

The researchers say that early evaluation of sleep and stress levels in weight loss studies could identify which participants might need additional counselling.

They say that ?chronic stress may trigger hormonal reactions that result in an intake of energy-dense foods, so that eating becomes a ?coping behaviour? and palatable food becomes ?addictive?. Lack of sleep may also affect hormones associated with feelings of fullness or hunger.

Conclusion

This study found that people who slept between six and eight hours a night had a greater chance of achieving their weight-loss goal than those who slept less or more. It also found that lower stress levels were associated with greater success at weight loss, particularly when combined with between six and eight hours of sleep. These findings support previous research linking obesity with poor sleep. It seems intuitive that if someone is not sleeping well and is under stress, then sticking to a weight loss programme will be more difficult.

It should be noted that the study relied on people self-reporting the hours they slept and their stress levels. This introduces the possibility of error. Although people with certain health conditions were excluded, it is possible that those who slept less (or more) had other health problems that also made it difficult for them to lose weight. Also, it is possible that people who slept longer were less likely to lose weight because they were less active generally, rather than because they were sleeping longer.

It is important to point out that the study does not imply that weight loss can be achieved by getting a healthy amount of sleep alone. Asking people about their sleep habits and stress may be a way of identifying those who could need more help with losing weight.

Sensible diet and exercise regimes are proven methods of achieving weight loss. It seems sensible that they would be more difficult to adhere to if people are not getting adequate sleep and/or are under stress.

Links To The Headlines

If you dream of weight loss, try having a good sleep.The Daily Telegraph, March 20 2011

Want to win the battle of the bulge? A good night's sleep will help you stick to your diet.Daily Mail, March 20 2011

Sleep patterns affect weight loss.�BBC News, March 20 2011

Good sleep is dream recipe to lose weight.Daily Express, March 20 2011

Links To Science

Elder CR, Gullion CM, Funk KL, et al.�Impact of sleep, screen time, depression and stress on weight change in the intensive weight loss phase of the LIFE study. International Journal of Obesity 2011, March 29

Source: http://www.nhs.uk/news/2011/03March/Pages/sleep-and-weight-loss.aspx

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Paracetamol in pregnancy linked to asthma

?Pregnant women who take paracetamol could be increasing the risk of their child developing asthma,? the Daily Express has reported.

The news is based on a review that systematically combined the findings from six previous studies examining whether paracetamol use in pregnancy is associated with asthma in early childhood. It should be noted that the review looked at cases of wheeze, which may not necessarily indicate asthma. Of the six studies examined, three found a significant association with paracetamol use and three did not. When pooled, the results suggested a 21% higher risk of wheeze for children whose mothers had used the painkiller.

There are important limitations to the review, particularly the fact that it looked at wheeze rather than asthma. The contradictory results of the individual studies and the lack of adjustment for factors such as parental smoking also undermine the reliability of the results. However, the findings of this initial review are important, and the topic is worthy of further research to try to clarify any possible association.

Expectant mothers should not be overly concerned. There are many causes of childhood asthma, and exposing the developing foetus or child to smoke is likely to be a more important one. Paracetamol remains safe for use at standard adult dose if required during pregnancy or breastfeeding.

Where did the story come from?

The study was carried out by researchers from the Medical Research Institute of New Zealand, the University of Otago Wellington, New Zealand, and the University of Southampton. No sources of funding were reported. The study was published in the�peer-reviewed medical journal, Clinical and Experimental Epidemiology.

The Daily Express has accurately reflected the reporting of this review, though the review itself has several important limitations which mean that further, carefully conducted and reported research is needed to clarify these associations.

What kind of research was this?

This was a�systematic review, which aimed to investigate whether paracetamol use in pregnancy may be associated with asthma in infancy and childhood. A previous systematic review had noted an association between paracetamol use in a child or an adult and the risk of them developing wheeze or asthma.

A systematic review of cohort studies is the best way of gathering together the global evidence regarding a particular exposure (paracetamol) and subsequent development of a disease outcome (asthma). All reviews involve a degree of limitation due to the variation in study methods, the populations included, follow-up periods and methods of outcome assessment used in the individual studies.

What did the research involve?

The authors searched medical databases and reference lists for relevant�randomised controlled trials or�observational studies published up to 2010. Eligible studies were either RCTs of women randomised to paracetamol or a placebo drug during pregnancy, or cohort studies that had compared a group of women who had used paracetamol during pregnancy against a control group who had not used paracetamol. All studies had investigated how this affected the likelihood of wheeze or asthma in the child.

The gathered studies were assessed in detail for their quality and the methods used. The main outcome of interest to the reviewers�was ?current wheeze?, which was defined as wheeze in the 12 months prior to the assessment. The reviewers pooled the odds of asthma or wheeze in those who took paracetamol and those who did not, and used them to calculate a ratio of risk. During this process they applied statistical processes that took into account the differences in methods and results of the various studies.

What were the basic results?

Six studies met the inclusion criteria: five cohort studies and one cross-sectional survey. No RCTs were identified. Studies assessed children between the ages of 2.5 and 7 years, and all looked at how paracetamol use during pregnancy related to the outcome of current wheeze. Only one of the five cohorts reported the specific period of pregnancy during which paracetamol was used (20-32 weeks). The review classified women as either users or non-users of paracetamol, but did not look at dosage or length of paracetamol use.

The six studies gave very variable results. Three of them found a significant association between paracetamol use and current wheeze. Three of them found no association. All of these risk associations were reported to be unadjusted for any confounders. When the authors of the current review pooled these six results, they found that there was a 21% increased chance of current wheeze in the child if the mother had used paracetamol during pregnancy (odds ratio�[OR] 1.21, 95%�confidence interval [CI] 1.02 to 1.44).

How did the researchers interpret the results?

The researchers conclude that ?the use of paracetamol during pregnancy is associated with an increased risk of childhood asthma?. They say that further research is now required ?to determine the impact of paracetamol during pregnancy on the risk of wheezing in offspring so that appropriate public health recommendations can be made?.

Conclusion

The findings of this study should be interpreted carefully, particularly as the six observational studies included in the review had variable results: three had found a significant association between pregnant paracetamol use and wheeze, and three did not. While the odds ratio when pooling these six results found a statistically significant association, this finding should also be considered in light of some important limitations:

  • The review categorised paracetamol use in each study as either ?yes? or ?no?. Only one of the pooled studies specifically looked at paracetamol use during the latter half of pregnancy (20-32 weeks). This, along with wide differences in the categorisation of paracetamol doses in the individual studies, means that when pooling the results, only the broad considerations of whether women had used paracetamol or not could be used. Therefore this cannot inform us about, for example,�dosage or duration of use.
  • The review reported a considerable variation across the included studies in the adjustments they made for confounders. The review did not explicitly report these. It presented its summary odds ratio of 1.21 as an unadjusted summary calculated without considering any confounders. This means that there are other factors, both measured or unmeasured, that could vary between paracetamol users and non-users, which could also account for the difference seen. The authors mention maternal smoking, respiratory disease, length of pregnancy, pet ownership and social class as possible confounders.
  • The main outcome of the review was ?current wheeze?, defined as wheeze in the 12 months prior to the assessment. Asthma is notoriously difficult to diagnose during infancy and childhood; sometimes a nocturnal cough can be the only symptom. Likewise, a wheeze can commonly occur with respiratory tract infections in a child who does not have asthma. Therefore it is not possible to know for certain whether the children categorised as having ?current wheeze? actually had asthma.

The findings of this review, as the authors conclude, are clearly worthy of further study to see whether an association could exist between paracetamol use in pregnancy and asthma or wheeze in the child. However, given the uncertainty surrounding these initial findings, pregnant women should not be overly concerned by this possible association until this further research is complete.

Asthma is a relatively common condition in children and can be increased by several risk factors or triggers. A family history of asthma and other allergic conditions, combined with environmental irritants, are the most established triggers. Key among these is exposure to smoke in infancy and childhood. Other research has linked smoking while pregnant to risk of asthma in the child.

Paracetamol use in pregnancy, or while breastfeeding, is not known to be associated with any harms to the developing foetus or infant. Current advice is that it remains safe for use during pregnancy at the recommended adult dose (up to 1g every 4-6 hours, with a maximum of 4g in any 24-hour period).

Links To The Headlines

Asthma link to pills. Daily Express, March 30 2011

Links To Science

Eyers S, Weatherall M, Jefferies S and Beasley R. Paracetamol in pregnancy and the risk of wheezing in offspring: a systematic review and meta-analysis. Clinical & Experimental Allergy, 41, 482?489

Source: http://www.nhs.uk/news/2011/03March/Pages/paracetamol-pregnancy-asthma-link.aspx

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Breast cancer drugs for healthy women

Among the most widely prescribed cancer drugs is tamoxifen. It works to reduce levels of oestrogen, which causes many breast cancers to grow.

The drug is not currently approved for use in Britain as a preventive treatment to stop healthy women developing cancer, although it is used in this way in America.

The report's lead author, Prof Jack Cuzick, from Queen Mary, University of London, said doctors should be authorised to prescribe tamoxifen as a preventive therapy in Britain, even though the drug can have serious side effects.

He said: "There are trials ongoing looking at new drugs that may be more effective and less toxic ? that is the future. For the present, there are clearly the five to 10 per cent of women who are at high enough risk that they really should consider this.?

International trials have shown that tamoxifen reduces the risk of the most common kind of breast cancer by about one third among women who are at increased risk of the disease.

The report, which followed an international conference of 150 breast cancer specialists in London last year, also recommended widening the methods used to identify women who are at risk of developing the disease.

Currently only women who have a family history of breast cancer, such as a mother or sister with the disease, are routinely considered for preventive treatments.

But studies have found that women who show increased breast density in mammogram scans are also at greater risk of developing the disease.

If long-term research confirms the pattern, breast density should be included when identifying patients who could benefit from drugs to prevent cancer, the academics said.

Cancer Research UK welcomed the findings. Dr Lesley Walker, the charity?s director of cancer information, said: ?Being able to accurately predict breast cancer risk and who will respond to preventative drugs like these is a crucial step in ensuring women get the most suitable treatment.?

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/13acae11/l/0L0Stelegraph0O0Chealth0Cwomen0Ishealth0C8410A2620CBreast0Ecancer0Edrugs0Efor0Ehealthy0Ewomen0Bhtml/story01.htm

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The rise of the female midlife crisis

Jeffries initially volunteered for six months but found she didn?t want to go home when her time was up. 'I felt so much more confident and assertive. There was a sense of relaxation, of certainty this was the right thing to do.?

Jeffries did return briefly to Britain but felt a completely different person. 'I found it really stressful. Things that used to matter to me were no longer important. I?d been very materialistic, but now I didn?t need to have a car, I didn?t need new clothes.

'When I went through the list of my friends I thought, ?Do I want to see you?? and with a lot of them the answer was no. I realised who my real friends were, as opposed to the friends I went out drinking with. I?d been bumbling along from boyfriend to boyfriend, job to job, but the time out I had had made me really learn about myself and what I wanted.?

Her relationship with her on-off boyfriend had also changed and shortly after she returned to Tanzania she ended it. 'It had always been on his terms but it finished on my terms. Different things were more important to me than having a boyfriend. He was possessive and insecure and worried too much.

'I thought, ?People in Tanzania have nothing and they are happy; they don?t moan all the time.? I realised I had always needed to be with somebody but now I was happy in myself.?

Despite ? or more probably because of ? her new-found independence, Jeffries soon fell in love with a local tour guide, Frank. They have just had a baby boy, Joshua. 'Kids had never been on my priority list before, but when I saw how Frank was around children I suddenly wanted one.?

Although Jeffries may sound on the young side, what she had undergone was a midlife crisis. Traditionally these are viewed as the preserve of fiftysomething men who overnight gain an earring, a Harley-Davidson and a teenage girlfriend.

But increasing numbers of women are wrangling with what Carl Jung called 'the afternoon of life??, an unspecified time of angst and self-doubt that can kick in at any time from 35 to 55, even if the signs are usually less conspicuous.

According to the mental-health charity Mind, typical symptoms of a crisis are boredom, a feeling of worthlessness, lack of meaning and, most of all, a terrifying sense that time is running out.

Once this state of mind was associated with the menopausal and 'empty nesters?? , women like Shirley Valentine, the housewife of Willy Russell?s play of the same name who walked out on her husband and went to Greece for a fling with a Greek bar owner.

Twenty years on, however, our definition of midlife is more confused. Women in their fifties may be suffering from hot flushes and caring for elderly parents while also raising young children, dressing in miniskirts and going out clubbing.

At the same time, pressures on women to succeed as young as possible can make them reach breaking-point far earlier than in the past. 'By the time you are just 30 these days you?re pushing the glass ceiling,? says Professor Cary Cooper, the president of the relationships charity Relate.

'The average age of a chief executive has gone down from the late fifties to the forties in just a decade, so you?ve either made it or you haven?t. It means either you invest more in work, possibly at the expense of family life, or you think, ?I?m not going anywhere in this job so what?s the point????

A recent Relate report found that people aged between 35 and 44 were most likely to be in crisis. This is the time when many mothers feel their identities have been swallowed up by their children. Childless women, on the other hand, may be realising they may never enjoy family life. Relentlessly bombarded by images of 21-year-olds in bikinis, they can feel past their prime, their potential unfulfilled.

For these educated, sophisticated women the poster girl is Elizabeth Gilbert, the glamorous thirtysomething whose bestselling memoir Eat, Pray, Love recorded how she left an unsatisfying marriage, quit her job and spent a year travelling round the world.

One yoga instructor, who teaches in Mysore, India, says he knows Gilbert?s followers well. 'I call them the FFFs ? female, fat and 40,? he says. 'They?ve either left it too late to have babies or their children have grown up. Either way, they don?t know what to do with their lives and are searching for some truths.?

Roger Salwey, the director of Oyster Worldwide, the company that organised Tracey Jeffries? gap year, is more tactful in his description. 'We have noticed a big market in divorced women, far more so than in men,? he says.

What crisis sufferers of any age tend to share is a new awareness of life?s fragility. Myra Hunter, a psychologist, says: 'There can be transition every decade ? some women feel better in their forties. What brings them to a crisis is that they?ve undergone a significant event that?s triggered thoughts about where they have been and who they are.?

For Helen Jones, 45, the turning-point was her long-term partner?s death from lung cancer at the age of 40. 'I was left a single parent to our son and with a strong sense that life was too short and that I had not been living life as I should be living it.?

That feeling was compounded when Jones had to give up her job as a car valet following a whiplash injury. 'I couldn?t do my job anymore so I ended up working in a call centre. But when you get to a certain age you don?t want to stay in a dead-end job.?

By this time she was in a new relationship with Heather Bradley, 39, whom she married in a civil ceremony four years ago. During a night out they decided to give up their jobs and open Gabrielle?s, a hotel for women in Blackpool.

'Everyone said, ?You?re mad.? Heather had never been to Blackpool and I had only been once as a child. We were living in Rotherham, we?d just bought a beautiful detached house together and we were only two years into our relationship.

'The banks wouldn?t lend us money because we knew nothing about the hospitality industry. My son was nine and we had to take him out of his school and uproot him from family and friends. So it was very scary. But life?s about more than material things. We knew we didn?t want to be answerable to anyone workwise.?

Despite the non-stop demands of running a hotel, Jones still maintains her life?s-too-short attitude. 'It?s hard to take holidays because we have to turn down business, but we always ensure we make time to get away. I know now that you have to prioritise lifestyle over money, that we?ll never be rich or have a brand-new car again but we?ll always be happy.?

As with Jones, it took the death of a loved one for Frieda De Ley, 44, to ? in her words ? 'wake up??. Having enjoyed a lucrative career as an executive in an industrial insurance company, De Ley was jolted into action after her mother was diagnosed with cancer and told she had two months to live.

'We had a very, very strong bond and the shock made me see that the life I was leading was not what I wanted anymore. I was earning a lot of money, but I was living out of a suitcase and not enjoying it. I?d gone into engineering because I was good at science and my parents thought it was a good career, but this trigger made me realise that all these years I?d actually been following the wrong path.?

Her colleagues were 'flabbergasted? when, aged 35, she resigned to retrain as a psychologist. She worked first in the public sector before setting up her own business, FDL ? For Developing Leaders, to advise, train and coach people in the workplace.

For De Ley, from Chiswick, west London, the choice wasn?t just about finding more enjoyable work, but about prioritising home life, too. 'Until then my husband and I had been living off microwaved meals but I wanted to change all that. We had a house, we had a garden, but I was working too hard to enjoy it and make it nice.

'A lot of my friends were spurred to slow down because they wanted to spend time with their children, but even without children I think a time comes when you want just to enjoy your home more.?

For women who have concentrated too much on their families, however, the opposite may be true. Yvonna Demczynska, 53, had happily abandoned a career in marketing that her family had 'pushed her into? to bring up two sons.

But as the children grew up she began to feel unfulfilled. With no experience or training, 10 years ago she opened the Flow Gallery in Notting Hill, west London, showcasing applied art from all over the world.

'I just wasn?t getting enough stimulation with the children at home,? she says. 'I loved them very much but I needed something for myself. I was definitely losing confidence and when I hit 40 I thought, ?If I don?t do something soon that I really love when will I do it?? It was quite a risk ? I had no experience and I found it very difficult to speak to people about what I was doing.?

The gallery took off but then Demczynska?s husband of 27 years left her. 'It was a really big shock. It takes a long time to heal the pain of abandonment. Without the gallery I don?t know what I would have done. Luckily, the confidence it has given me has overflowed into my personal life. I have finally found my potential.?

Not all midlife crises have such happy endings: 25 per cent of middle-aged women suffer from depression and anxiety, compared with 14 per cent of men. But tackled head on and with courage, a crisis can still be transformative.

As Tracey Jeffries says: 'I was so nervous going to Tanzania because I was surrounded by 18- and 19-year-olds on their gap years but I got so much more of the experience than they did.

'Their lives haven?t begun yet and I was beginning to think mine was over. Sometimes you need to step back from your life and think: ?Is this really me?? It?s a lot more difficult to do it when you?re older, but it?s certainly worth it.?

Source: http://telegraph.feedsportal.com/c/32726/f/568409/s/13b9ad75/l/0L0Stelegraph0O0Cfamily0C840A45720CThe0Erise0Eof0Ethe0Efemale0Emidlife0Ecrisis0Bhtml/story01.htm

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Wednesday, March 30, 2011

Patient nerves affect blood diagnosis

?Doctors cause a third of stubborn high blood pressure,? reported the BBC News. The news service reports that some cases of hard-to-treat high blood pressure may actually be caused by patient nervousness at being seen by a doctor.

The news is based on a Spanish study which compared blood pressure measurements taken in a doctor?s surgery and measurements gathered using a 24-hour monitoring device in people believed to have resistant hypertension. Resistant hypertension was defined in this study as high blood pressure that had not responded to concurrent use of three or more high blood pressure medications.

The study found that 37% of patients with resistant hypertension (based on the doctor?s surgery measurements) actually had blood pressure within the normal range when it was measured with 24-hour monitoring. This suggests that an anxious response to being in a doctor?s surgery may affect a proportion of patients? blood pressure readings.

At present, NICE recommends that raised blood pressure is confirmed on at least two further readings at a separate time. However, recent draft recommendations issued by NICE have called for the introduction of home-based or ambulatory blood pressure monitoring to confirm diagnoses of high blood pressure. These are expected to be approved later this year.

Where did the story come from?

The study was carried out by researchers from The University of Barcelona, and it was funded by Lacer Laboratories, Spain.

The study was published in the�peer-reviewed medical journal, Hypertension.

The Daily Mail reported that ?thousands are wrongly treated for high blood pressure?.� However, this should not be assumed on the basis of this research alone: the study only looked at a subgroup of people with high blood pressure - those who had been diagnosed with resistant hypertension, i.e. high blood pressure despite being treated with multiple anti-hypertension medications.

�Also, the study did not assess whether these people had originally been misdiagnosed with hypertension or whether their medication was actually just working to control what would have otherwise been high blood pressure. The study was also in Spain, where the medical practices for treating hypertension may vary from those used in the UK.

The Daily Mail and the BBC News did highlight draft NICE guidelines which propose that home or ambulatory blood pressure monitoring should be used to confirm any initial diagnosis of hypertension.

What kind of research was this?

The researchers say that a proportion of the high blood pressure measurements taken at the doctor?s office may be affected by the ?white coat effect?, where a person?s blood pressure may be affected by the anxiety they feel while visiting the doctor. In turn, these readings may go on to form the basis of a patient?s treatment strategy.

This was a cohort study, which followed patients with persistent resistant hypertension (high blood pressure). It compared their blood pressure readings, which were taken in a doctor?s office and obtained using a blood pressure monitoring device that could measure their blood pressure as they went about their daily lives. In this study, resistant hypertension was defined as blood pressure that remained above the target threshold (140/90mmHg) despite the concurrent use of three hypertensive agents at full doses, one of them being a diuretic.

The ambulatory blood pressure monitoring (ABPM) used in this study was performed using a device that was worn by the patient over a 24-hour period in order to measure their blood pressure in 20-minute intervals throughout the day. This method allows doctors to assess fluctuations in blood pressure and examine whether blood pressure remains high for extended periods of the day.

The Spanish researchers say that these devices are currently used in a small proportion of referred patients. They wanted to use this technology to record data from a large group of patients with hypertension according to measurements taken in their doctor?s office.

What did the research involve?

The study was carried out in Spain, and recruited patients who were registered with the Spanish Ambulatory Blood Pressure Monitoring (ABPM) registry. This registry was set up to promote the use of ABPM in clinical practice. The patients were recruited from this registry if:

  • they had enough information regarding office blood pressure measurements and had ABPM data of good quality.
  • they had resistant hypertension that was uncontrolled despite using more than three blood pressure medications (including one diuretic).
  • their doctor?s office BP measurements were over 140 and/or 90 mm Hg ? the commonly accepted threshold for defining high blood pressure.

In total, the researchers analysed data on 8,295 patients with resistant hypertension (this population with resistant hypertension was approximately 12% of patients with hypertension).

The patients wore the ABPM device for 24 hours, and their blood pressure was measured every 20 minutes. The majority of patients? measurements using this device had been on working days, during which the participants were asked to maintain their usual activities. Daytime and night time periods were defined according to the patient?s self-reported data of going to bed and getting up times.

The researchers classified patients based on how their blood pressure during the night related to their daytime BP (expressed as a percentage). People were classified as:

  • extreme dippers if their systolic or diastolic BP fell by more than 20% in the night
  • dippers if it fell between 10 and 20%
  • non-dippers if it fell between 0 and 10%
  • risers if BP increased during night time

The researchers also looked at data on the patients? age, sex, height, weight, smoking status and whether they had diabetes. All of these factors may have influenced their blood pressure.

What were the basic results?

Using the ABPM data, the researchers found that 5,182 of the 8,295 patients (62.5%) who had been diagnosed with resistant hypertension in a clinical setting had true resistant hypertension when assessed using ambulatory 24-hour blood pressure monitoring and cut-off values of more than 130 and/or 80mmHg. The other 3,113 patients (37.5%) showed BP values below this cut-off and were classified as having ?white coat? resistant hypertension.

The patients with true resistant hypertension tended to be younger, male, have a longer duration of hypertension, and have a worse cardiovascular risk profile. For example, being smokers, having diabetes and having heart or kidney damage.

The researchers found that the group with true resistant hypertension had a higher proportion of ?riser? pattern patients (i.e. BP increased during the night) than the group with white coat hypertension. (22% vs. 18%; p<0.001).

How did the researchers interpret the results?

The researchers estimated that ?resistant hypertension is present in 12% of the treated hypertensive population?, but say that ?among them more than one third have normal ambulatory blood pressure?. They emphasise a need to use ambulatory blood pressure monitoring in order to make a correct diagnosis of resistant hypertension and to manage this condition.

Although they found that a worse cardiovascular risk factor profile was associated with true resistant hypertension, they emphasised that this association is weak.

Conclusion

This research in a relatively large Spanish cohort has assessed the prevalence of true resistant hypertension in a population that had been diagnosed with this condition using blood pressure measurements taken in the doctor?s surgery. The observation that approximately a third of the assessed population?s blood pressure was within a normal range over the 24-hour period suggests that diagnoses should take into account ?white coat hypertension?, or blood pressure changes as a response to being in the doctor?s surgery.

Current UK guidelines recommended that an initial diagnosis of high blood pressure is confirmed on at least two further surgery visits. However, The National Institute for Health and Clinical Excellence (NICE) has recently issued revised draft guidance for hypertension. It recommends that 24-hour ambulatory blood pressure monitoring (ABPM) should be used to confirm the diagnosis of hypertension if the first and second blood pressure measurements taken during a consultation with a doctor are both higher than 140/90mmHg. While these proposed changes in diagnoses are still subject to revision, it is expected that they will be introduced later this year.

Links To The Headlines

Doctors cause a third of stubborn high blood pressure. BBC News, 29 March 2011

Fear of doctors may cause blood pressure misdiagnosis. Daily Mirror, 29 March 2011

37% 'wrongly treated for high blood pressure' because their heart rate jumps through fear of GPs. Daily Mail, 29 March 2011

Links To Science

de la Sierra A, Segura J, Banegas JR et al. Clinical Features of 8295 Patients With Resistant Hypertension Classified on the Basis of Ambulatory Blood Pressure Monitoring. Hypertension 2011, Published online before print March 28

Source: http://www.nhs.uk/news/2011/03March/Pages/white-coat-effect-high-blood-pressure.aspx

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