Metabolic Syndrome Triggered by Overeating, Not Obesity

(HealthDay News) -- Overeating, not the obesity it causes, is the actual cause of metabolic syndrome, suggests a study with mice by researchers at the University of Texas Southwestern Medical Center at Dallas.

Metabolic syndrome is a collection of health factors that increase the risk of developing insulin resistance, fatty liver, heart disease and type 2 diabetes.

This study was among the first to propose that weight gain is an early symptom, not a direct cause, of metabolic syndrome, the researchers said.

"Most people today think that obesity itself causes metabolic syndrome," senior author Dr. Roger Unger, professor of internal medicine, said in a prepared statement. "We're ingrained to think obesity is the cause of all health problems, when, in fact, it is the spillover of fat into organs other than fat cells that damages these organs, such as the heart and the liver. Depositing fatty molecules in fat cells where they belong actually delays that harmful spillover."

In this study, Under and his colleagues compared normal mice to mice that were genetically altered to prevent their fat cells from expanding. Both groups of mice were overfed.

The normal mice got fat but didn't develop signs of metabolic syndrome until after about seven weeks of overeating. The genetically altered mice stayed slim but became seriously ill within a few weeks and displayed evidence of severe heart problems and major increases in blood sugar levels eight weeks before minimal heart problems developed in the normal mice, the researchers said.

The genetically altered mice showed significant damage to heart cells and to the insulin-secreting cells in the pancreas. They also got sick quicker, because the extra calories they consumed weren't stored in fat cells, but rather in other tissues, the researchers said.

The study was published online in the journal Proceedings of the National Academy of Sciences.

The exact cause of metabolic syndrome, which affects about 50 million Americans, is unknown, but lack of exercise and obesity have been tagged as the primary underlying contributors to the development of the condition, according to background information in the study.

More information
The U.S. National Heart, Lung, and Blood Institute has more about metabolic syndrome.

Relevence of Ayurveda in today’s life

The diseases pertaining to life science are neither contagious nor influenced by genetics. These diseases breed in exhausted bodies that are out-of-shape due to unhealthy and frenzied lifestyles. These diseases involve both mind and body and hence holistic approach of Ayurveda is essential in bringing about well being and good health and plays a major role in treating diseases prevalent in today’s world.

The advantages of holistic treatments for combating heart diseases, diabetes and cancer, as in Ayurvedic literature has already been proven and accepted in countries like Japan, Singapore and Finland.

Ayurveda emphasizes that an individual should adopt healthy habits like regular routine schedule for sleep, proper cleansing practices, body massage, meditation, regular physical exercises, yoga, good clothing habits, a balanced diet depending on the weather, adequate intake of fluids, avoiding anger and stress and maintaining healthy relationships, sex life that is socially permissible and self education.

The holistic approach of Ayurveda involves usage of drug, behavioral changes and diet in tackling problems of mind and body to ensure vitality and good health. In Ayurveda, an illness is treated by four main procedures; cleansing (Samshodhana), Palliation (Samshamana), rejuvenation (Rasayana) and spiritual and psychological healing (Satvavajaya). When there is an imbalance of doshas, the lifestyles and dietary managements that are based on these doshas get disturbed.

Ayurveda And Geriatric Care

The twenty-first century is witnessing a gradual decline in fertility, and with increase in life expectancy, the society will need to grapple with issues of longevity. The cause of morbidity and mortality world over is shifting from communicable diseases a few decades ago to non-communicable diseases. The leading causes of mortality among aged people comprise respiratory problems, heart diseases, cancer and stroke. Significant causes of morbidity among this group is chronic inflammatory and degenerative conditions such as Arthritis, Diabetes Osteoporosis, Alzheimer’s disease, depression, psychiatric disorders, Parkinson’s disease and age related urinary problems.

The biggest challenge with geriatric problem is that in most of the cases the condition cannot be attributed to a single cause or in certain conditions of neuro-psychiatric disorders like, Senile dementia, Alzheimer’s depression, the structural cause is unknown. In such cases the conventional medical therapy fails to come out with effective management plan and hence is severely compromised. Another challenge with conventional medical therapy is that it does not have health-promoting agents. Ayurveda on the other hand has interventions like chayavanaprasha, triphala that enhance physiological processes that influence metabolic and immunological status. Such interventions are significant in the context of geriatric care.

The twenty-first century is witnessing a gradual decline in fertility, and with increase in life expectancy, the society will need to grapple with issues of longevity. The cause of morbidity and mortality world over is shifting from communicable diseases a few decades ago to non-communicable diseases. The leading causes of mortality among aged people comprise respiratory problems, heart diseases, cancer and stroke. Significant causes of morbidity among this group is chronic inflammatory and degenerative conditions such as Arthritis, Diabetes Osteoporosis, Alzheimer’s disease, depression, psychiatric disorders, Parkinson’s disease and age related urinary problems.

The biggest challenge with geriatric problem is that in most of the cases the condition cannot be attributed to a single cause or in certain conditions of neuro-psychiatric disorders like, Senile dementia, Alzheimer’s depression, the structural cause is unknown. In such cases the conventional medical therapy fails to come out with effective management plan and hence is severely compromised. Another challenge with conventional medical therapy is that it does not have health-promoting agents. Ayurveda on the other hand has interventions like chayavanaprasha, triphala that enhance physiological processes that influence metabolic and immunological status. Such interventions are significant in the context of geriatric care.

Rasayana therapy of Ayurveda is a dedicated stream of medication for immune promotive, antidegenerative and rejuvenative health care and is known for preventing the effects of ageing and improving the quality of life of healthy as well as diseased individuals. Scientific studies have proven the efficacious role of Rasayana remedies in the management of chronic life style related diseases and degenerative changes.

Rasayana is normally advised during the degenerative phase, which starts from around 45 yrs in both male and female. A holistic system like Ayurveda approaches this condition through two-fold methods. One is a radical approach in which it recharges the whole metabolic process of the body by eliminating the toxins from the system by a three to four months rigorous and organized process known as Kutipraveeshika Rasayana. However, this process is seldom practiced due to the extreme intricacy of the physiological process involved and the need for utmost care to be taken by the physician and subject including the environment where the treatment is done. Hence this Kutipraveeshika remains as a textual marvel of Ayurveda than a practical process of contemporary relevance.

The second approach of Ayurveda, which is quite popular today, is called Vataatapika Rasayana – which can go along with the normal day to day life. This type of Rasayana is particularly important in the current scenario, as it is has a relatively easy mode of administration without any restrictive pre-conditions.

Describing the effects of Rasayana, the classical texts of Ayurveda say that from Rasayana one attains longevity, improved harmony and intelligence, freedom from disorder, youthful vigor, excellence of luster, complexion and voice, optimum strength of physique and senses, command over language, respectability and brilliance. Ayurveda considers the physical structure to be composed of 7 dhatus starting from Rasa {Rasadi Dhatus} and Rasayana is the tool to create premium dhatus (body tissues). The main utility of Rasayana therapy is in functional and degenerative disorders that have a chronic or long standing nature. In such cases, in fact, Rasayana is the only solution from the point of view of effective management in any system of medicine. Rasayana becomes more fruitful and effective if it is preceded with suitable panchakarma (purificatory therapy). The reason we see mixed results in many cases where Rasayana is employed is because of the fact that either this purification is not done or improperly done. Panchakarma is a bio-cleansing regimen comprising of five main procedures that facilitates better bioavailability of the pharmacological therapies, helps to bring about homeostatis of body-humors, eliminates disease-causing complexes from the body and checks the recurrence and progression of disease. The five fold measures comprehended in this therapy are-Vamana (Therapeutic Emesis), Virechana (therapeutic Purgation), Asthapana Vasti (Therapeutic Decoction Enema), Anuvasana Vasti (Therapeutic oil Enema), Nasya Karma (Nasal administration of medicaments).

Panchakarma procedures are preceded by Snehana (therapeutic Oleation) and Swedana (Sudation) applications to make the body system conducive for elimination of bio-toxins and cleansing of channels. This is effective in managing autoimmune, neurological, psychiatric and musculo-skeletal diseases of chronic and metabolic origin.

Ayurvedic treatment as such is very individualistic and one medicine found to be useful in a condition in a particular person might not work at all in another. Hence it is a challenge to come out with generalized management solutions for a condition that would suit all. It is difficult to bring out management plans for a particular disease condition and implement the same on a large scale. It is important that we respect both holism of traditional medicine as well as reductionism of modern biomedicine because both are ways of looking at nature and depending on the purpose both the views can be extremely useful. Furthermore the whole and the part are certainly related but it is not a one-to-one relationship.

The understanding that it is not one-to-one relationship and learning how to relate the whole perspective (the systemic theories of Ayurveda & Yoga) with part (structural theories of western biomedicine) is the outlook that should underline the implementation of trans-disciplinary research projects. Today, nobody in the academic field has all the answers of how to combine and correlate part and whole perspectives in the context of clinical research design, clinical practice, content of courses on Ayurveda and Yoga, in the context of laboratory research in pharmacognosy and product development, and in assessment of community based local health practices. It is important to understand that drug trials for evaluating efficacy of Ayurvedic interventions is a reductionist approach and is an inappropriate design. Instead clinical trials should evaluate the efficacy of a whole management package which may consist of drugs, diet, Yoga, Panchakarma including differential diagnosis to identify the specific nature of tridoshic imbalance.

The World population of the elderly is increasing and by the year 2050, adults older than 65 years will comprise 1/5th of the global population. In India 3.8% of the population are older than 65 years of age. According to an estimate the likely number of elderly people in India by 2016 will be around 113 million.

The biggest challenge in the contemporary application of Ayurvedic geriatrics would be to come up with protocols to document, diagnose in an integrative framework and manage geriatric problems. This would require critical investment in establishing advanced research, treatment and teaching centers that have a state of the art facility to deal with geriatrics. It is essential that a multi-dimensional intervention be conceived that will involve a) trans-disciplinary research b) advanced treatment centers and c) specialized postgraduate education. There is a very urgent need to establish centers in the country that would engage in the kind of trans-disciplinary research that we are envisaging in order to take Ayurveda globally and also to bring the clinical services of Ayurveda into the mainstream. This would require a generous funding for undertaking such research and also establishing centers that would provide effective clinical services. There is also a need to support specialized trans-disciplinary PG researches in centres where PG in geriatrics is offered.

Source: PIB

AyurGold-Maintain Optimal Blood Chemistry for Good Health

Blood chemistry is regulated by negative feedback in order to keep the body in homeostasis (optimal equilibrium). The levels of glucose in the blood are monitored by the cells in the pancreas.

If the blood glucose level falls to dangerous levels (caused by very heavy exercise or lack of food for extended periods), some pancreas cells release glucagon, a hormone that acts on liver cells to increase blood glucose levels.

Stored glycogen is converted into glucose by a process called glycogenolysis. The glucose is then released into the bloodstream, increasing blood sugar levels.

Blood sugar levels are also increased by "stress" hormones such as adrenalin, steroids, infections, trauma, and the ingestion of food. When levels of blood sugar rise, whether as a result of glycogen conversion, or from the digestion of a meal, a different hormone is released from beta cells found in the Islets of Langerhans in the pancreas.

This hormone, insulin, causes the liver to convert more glucose into glycogen. This process is called glycogenesis and it forces about two-thirds of body cells (primarily muscle and fat tissue cells) to take up glucose from the blood, thereby decreasing blood sugar levels. A breakdown in body homeostasis can lead to dangerously high or low blood sugar levels.

This can become a chronic condition leading to the onset of diabetes. According to the World Health Organization, in 1985, an estimated 30 million people worldwide had diabetes. By 1995, this number shot up to 135 million. The latest WHO estimate for the number of people with diabetes worldwide is 177 million. This will increase to at least 300 million by 2025.

The number of deaths attributed to diabetes is likely to be around 4 million. These projections take into account the fact that there will be more people in the world due to population growth and that there will be more elderly people due to population aging.

They also account for urbanization - the fact that people are moving from rural areas to cities, particularly in developing countries. This migration affects the number of people who are likely to have diabetes, because people living in cities of developing countries tend to be less physically active and have higher levels of obesity than people in rural areas.

In fact, current trends in obesity suggest that these projections are conservative and that the increase in the prevalence of diabetes may be even greater. In developing countries, people in the middle and most productive years of their lives are particularly affected by diabetes.

In these countries, three-quarters of all people with diabetes are under 65 years old and 25% of all adults with diabetes are younger than 44. In developed countries, more than half of all people with diabetes are older than 65, and only 8% of adults with diabetes are younger than 44. Because of its chronic nature, the severity of its complications, and the means required to control it, diabetes is a costly disease, not only for the affected individuals and the families involved, but also for the health authorities.

Studies in India estimate that, for a low-income Indian family, as much as 25% of family income may be devoted to diabetes care. For families in the USA, the corresponding figure is 10%. The total healthcare cost of a person with diabetes in the USA is between two and three times those for people without the condition.

A recent analysis of healthcare expenditure in the Western Pacific region has shown that 16% of hospital expenditure was spent on people afflicted with diabetes. In the Republic of the Marshall Islands, this figure was 25%. The cost of diabetes affects everyone, everywhere, but they are not only a financial problem. Intangible costs (pain, anxiety, inconvenience, and generally lower quality of life) also have great impact on the lives of patients and their families and are the most difficult to quantify.

Direct costs to individuals and their families include medical care, drugs, insulin, and other supplies. Patients may also have to bear other personal costs, such as increased payments for health and life insurance. Recent treatment cost estimates for Argentina, Brazil, and Mexico were US $3.9 billion, US $0.8 billion and US $2.0 billion, respectively.

Each of these is an annual figure and is rising as prevalence of diabetes increases. For most countries, the largest portion of diabetes expenditure is cost of hospital admissions for the treatment of long-term complications, such as heart disease, stroke, kidney failure, and foot problems.

Western medicine relies on aggressive prescription drugs and surgery to deal with many problems related to irregular blood chemistry in the body. Unfortunately, these methods often result in unwanted and even dangerous side effects. And natural pills provide only fleeting, inconsistent results.

Ayurveda, the science of life, prevention and longevity, is the oldest and most holistic and comprehensive medical system available. Its fundamentals can be found in Hindu scriptures called the Vedas - the ancient Indian books of wisdom written over 5,000 years ago. Ayurveda applies the inherent principles of nature to help maintain optimum health in a person by keeping the individual's body, mind, and spirit in perfect equilibrium with nature.

India Herbs has a seasoned group of Ayurvedic doctors specialized in Vajikarana, one of the eight major specialties of Ayurveda. Vajikarana prescribes the therapeutic use of various herbal and tonic preparations to address the root cause of irregular blood chemistry, while strengthening your body and overall well-being.

India Herbs' Vajikarana scientists combine a proprietary herbal formula based on centuries' old wisdom with advice on diet, exercise, mental training, and relaxation to help men and women overcome their health concerns through safe and natural means.

Results: The precise combination of ingredients in AyurGold along with a mind-body focus precisely addresses your blood chemistry concerns!
more information:
http://www.india-herbs.com/aff/dreddyclinic/ayurgold

Ginger - the spice of life...

Moreover, according to Ayurveda, a patient of any acute disease should never be given plain water to drink. The drinking water should e boiled with dry ginger and then cooled and administered in sips. The 'cold' of the water is thus neutralized and the body's digestive 'fire' is protected.

As a remedy, ginger is unsurpassed in diseased due to Kapha and Pitta. There is nothing like it for the common cold. It has even been found useful in cases of influenza.

Some mix dry ginger with honey and lick it from a spoon. Some mix it with gud (solidified molasses), which has the property of making the urine and feces flow freely.

Since an important cause of upper respiratory congestion is incomplete evacuation of wastes, ginger and gud are often remarkably effective in relieving such congestion.

This combination is good for hiccough also, whether swallowed or inhaled as a snuff. Inhaling it causes a quicker, more direct effect.

• Cold
• Colitis
• Diarrhea
• influenza
• vomiting

Any sort of cough can be treated with ginger. Dry cough, which is due to Vata, responds well to the juice of raw ginger; productive cough, due to Kapha, is better treated with dry ginger and honey. Even shortness of breath, vomiting and giddiness, all due to vitiated Vata, can be conquered with ginger.

Ginger is good in every disease characterized by the accumulation of undigested or partially digested food, known in Ayurveda as Ama.

Any diarrhea or dysentery can be treated with ginger. There is a school of thought which suggests that an individual suffering from dysentery or colitis follow a diet restricted to lassi , as prepared above with the substitution of / for raw ginger.

• Colitis
• diarrhea
• Flatulence

Hyperacidity is known in Ayurveda as Amla pitta. As its name suggests, the Pitta of the body becomes 'sour' and leads to trouble. Ginger can cure hyperacidity without the help of any other medication. It returns the Pitta to normal by regulating instead of depressing the production of stomach acid.

Abdominal distention deflates when confronted by ginger, especially when it is mixed with asafetida and rock salt. Trapped gases are evacuated with ease.

Ginger is even useful in cases of piles. Unfortunately, Indians are so fond of spicy foods they often overuse ginger and as a result, produce piles. It seems paradoxical that a single substance can both cure and cause the same illness, but is merely a question of the amount consume. "Ati sarvatra varjayet" (always avoid excess) is the watchword of Ayurveda.

Dry ginger made into a thick paste with water is used as a plaster on the forehead in case of headache; on the chest in case of cold, cor yza, congestion or bronchitis; over rheumatic joints; over any swollen part of the body. In rheumatic fever and syndromes which resemble it, characterized by fever, severe joint inflammation and general systemic complications (suggesting that Vata is being afflicted by Ama), treatment begins with the active purification of the body by purgation.

Decoction of dry ginger is mixed with castor oil in a ratio of 2:1 and is given internally. The castor oil flushes out the digestive tract; the ginger digests any remaining Ama and frees the digestive organs to transform nutrients efficiently again.

• Bronchitis
• Cold
• fever
• Flatulence
• Headache
• Vata
• Rheumatic fever

Ginger finds a place in many compound medicines. There is Visvabhesaja Vati, which is dry ginger mixed with an equal quantity of the juice o raw ginger; the combination is then rubbed in a special type of mortar and pestle until it becomes dry. This process is repeated up to twenty-one times to fully potentiate the resulting medication. It can be used in any condition which calls for ginger.

The most important compound of ginger, however, is Trikatu, "Three Pungents", which is composed of equal parts of dry ginger, black pepper and long pepper (Piper longum). It is especially useful in dyspepsia, loss of appetite and flatulence.

In addition, ginger is used to potentate, in the manner described above, such drugs as Anandabhairava Vati (fever and teething troubles in children), Gandhaka Rasayana (skin diseases, joint troubles, any condition which involves formation of pus), Catus Bhuja Kalpa (heart disease, asthma), and numerous others.

• Asthma

Perhaps I should mention that ginger is not a cure-all, and that any persistent or serious illness should be treated with the help of a physician. But as you stroll through your food store and see the plump rhizomes of Zingiber officianalis, please do it respect as benefits its position as a proven remedy.

We offer also per email a diet consultation, feel free to contact us for more details. Thank you.

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New Kind of Stem Cells Reverse Sickle Cell Anemia

(HealthDay News) --Scientists have succeeded in using cells virtually identical to embryonic stem cells to "correct" sickle cell anemia in mice.

The breakthrough was made possible by another advance announced barely two weeks ago that scientists had created "induced pluripotent stem" (iPS) cells from human skin cells. These iPS cells are very similar, although not exactly identical, to embryonic stem cells. The process bypasses the need to use embryos, and thus circumvents many of the ethical complications surrounding this type of research.

The first research announcement had left open the question of whether iPS cells could actually be used for therapeutic purposes.

That question has now been at least partially answered by this latest report.

"This study is important as a proof of principle that these iPS cells can be used to correct mutations," said Dr. Jacob Hanna, lead author of the study, which is published in the Dec. 6 online issue of Science Express.

Hanna is a postdoctoral fellow in Rudolf Jaenisch's laboratory at The Whitehead Institute in Boston.

"It's very fascinating that they're using these reprogrammed cells to make hematopoietic cells [which can produce different blood and immune cells] to then treat the genetic defect in these mice," said Paul Sanberg, director of the University of South Florida Center for Aging and Brain Repair in Tampa.

Embryonic stem cells are pluripotent, meaning they have the capacity to develop into virtually any cell type in the body. The hope is that such cells may one day yield treatments or cures for diseases such as diabetes, liver failure, spinal injury, stroke, Alzheimer's disease and heart disease.

However, harvesting embryonic stem cells involves destroying a viable embryo, stirring much political debate. In the United States, embryonic stem cell research has been severely limited since August 2001, when President George W. Bush placed limits on federal funding of the field and restricted the number of embryonic stem cell lines that could be used.

Since that time, researchers have been racing to find other sources of viable stem cells -- iPS cells are one outcome of that race.

For this study, Hanna and his colleagues used a process similar to the one revealed two weeks ago, taking skin cells from the tails of mice with sickle cell anemia and using them to produce iPS cells. The researchers then replaced the mutated gene with a healthy gene in the new cells.
Once the iPS cells had differentiated into hematopoietic stem cells, they were reintroduced into the mice, where they began to produce healthy blood cells.

Some 10 percent of the human population, mostly blacks, carry the mutation for sickle cell anemia. The exact mutation is well known, as is the protocol for differentiating embryonic stem cells into precursors of bone marrow adult stem cells, making the condition well-suited to study.

In sickle cell anemia, red blood cells become sickle-shaped and can't move easily through the blood vessels.

Although exciting, the process is still fraught with potential danger.

The procedure to turn skin cells into iPS cells could lead to cancer (although none of the mice in this study showed any evidence of tumors). Also, the healthy genes were introduced into the mice via retroviruses, which can introduce other problems.

"Now the major question in the field is can you make iPSs with a safer method, that don't use retroviruses, because viruses can integrate into the DNA and activate dangerous genes or silence necessary genes," Hanna explained.

"I like the fact that they're saying this is a first step, because they're using retroviruses, and they have to show that this is a safe approach," added Sanberg.

More information
Learn more about stem cells at the International Society for Stem Cell Research.

Mini Strokes: Major Health Threats

(HealthDay News) -- Doctors call them transient ischemic attacks, but they're more commonly known as "mini-strokes."

But make no mistake -- they can be deadly.

What's worse, many people who suffer such an attack rarely seek medical help. Just one in 10 people who experienced symptoms of a transient ischemic attack (TIA) sought the proper emergency care, a recent study published in the journal Stroke found.

Urgent care is critical, because some people who suffer TIAs will have a major stroke as soon as a day or two after the mini-stroke.

"People need urgent medical attention not for the symptoms that have passed but for what might be coming. Many people don't have a TIA before they have a stroke, so, in a sense, it's fortunate to have one. Now you have a chance to intervene," said Dr. Keith Siller, medical director of the Comprehensive Stroke Care Center at New York University Medical Center
.
A transient ischemic attack occurs when blood flow to a part of the brain is temporarily blocked. When this occurs, symptoms come on suddenly and last anywhere from a few minutes to many hours. Symptoms may include:

• Sudden loss of speech or the ability to understand others.
• Rapid onset of weakness or numbness of the face, arm or leg, especially if it occurs on only one side of the body.
• Sudden loss of, or change in, vision that may occur in one or both eyes.
• Sudden difficulty walking or maintaining balance.

One thing you may not feel with a stroke is pain.

"Pain is not the right thing to look for in stroke," said Dr. Christian Schumacher, a neurologist at the Stern Stroke Center at Montefiore Medical Center in New York City. "People expect that like a heart attack, which is often painful, that stroke will cause pain. But stroke symptoms are, in most cases, without pain."

One exception, Siller added, is what's known as a hemorrhagic stroke. In this instance, you would likely experience a sudden, severe, unexplained headache. If you have such a headache or any of the above symptoms, Siller said, you should get to the hospital immediately.

Unfortunately, not many people realize the need for urgent care. In the Stroke study, British researchers surveyed 241 people who had experienced a transient ischemic attack. Just 44.4 percent sought medical care within a few hours of experiencing TIA symptoms, and only 10 percent sought any emergency medical care for their symptoms.

Another 44 percent waited longer than a day after their symptoms to seek care. People who had symptoms that lasted more than one hour -- and those with motor symptoms, such as difficulty walking -- were more likely to seek care. If the TIA symptoms occurred on a weekend, people were more likely to delay seeking treatment.

People "want to wait until they feel better, and most TIAs get better within an hour. If it gets better, people just think, 'Oh, that was weird,' and then they may call their doctor later," Schumacher said.

Or, they may just forget the symptoms altogether, Siller said. "When symptoms are gone, and they feel better, people forget. But, it's a misconception that if it went away, it doesn't mean anything," he said.

"Although TIA is called a mini-stroke; it's like having a real stroke. It's a warning sign for a major disabling stroke," Schumacher said.

Getting to the hospital as soon as possible after TIA or stroke symptoms begin is critical. The reason: Clot-busting drugs that can spare you many of stroke's worst effects -- including paralysis -- have to be administered within several hours after the onset of symptoms to be effective, Siller explained.

"If you wait, we can't do as much to help you," he said.

Siller also recommends discussing your risk factors with your physician. The most common risk factor for stroke is a past history of a stroke or a TIA. People with high blood pressure, high cholesterol, diabetes and those with heart disease also have an increased risk of stroke, making it even more important for them to act quickly if they have any TIA symptoms.

More information
The American Heart Association has more on transient ischemic attacks.

Obesity Can Hurt Kids' Hearts

(HealthDay News) -- Obese children and those at risk for obesity show early signs of heart disease -- similar to that seen in obese adults, U.S. researchers say.

The study, by a team at Washington University School of Medicine, St. Louis, included 168 children ages 10 to 18. All of the children had undergone cardiac ultrasound to check on symptoms such as heart murmur, chest pain, acid reflux or high blood cholesterol. Of the children, 33 were obese, 20 were at risk for obesity, and 115 were normal weight.

The researchers used a new tissue Doppler imaging technique called "vector velocity imaging" that can track the movement of the heart's muscular wall.

"In the patients who are obese, the rate of motion of heart muscle changed," Dr. Angela Sharkey, an associate professor of pediatrics at Washington University School of Medicine and a pediatric cardiologist at St. Louis Children's Hospital, said in a prepared statement. "As a child's BMIA (body mass index for age) increases, we see alterations in both the relaxation and contraction phase of the heartbeat. Many of these changes that have been seen in adults were assumed to be from long-standing obesity, but it may be that these changes start much earlier in life than we thought."

"Based on this study, these subtle markers can help us predict who could be at risk for heart disease and heart attacks," Sharkey said.

The findings were published in the winter issue of the Journal of Cardiometabolic Syndrome.
Vector velocity imaging could help doctors follow obese children to see if these changes in the heart progress and to determine if interventions -- such as dietary changes, increased exercise, and the use of cholesterol-lowering statin drugs -- have any effect, Sharkey said.

About 19 percent of American children ages 6 to 11 and 17 percent of those ages 12 to 19 are overweight, according to the U.S. Centers for Disease Control and Prevention.

More information
The Nemours Foundation has more about overweight and obese children.

Reflux Can Precipitate Chest Pain, Cough

(HealthDay News) -- Severe chest pain and chronic cough are little known, but potentially serious, symptoms of gastroesophageal reflux disease (GERD), researchers say.

Many people with these symptoms don't realize they have GERD, the researchers noted in two studies presented this week at the annual scientific meeting of the American College of Gastroenterology, in Philadelphia.

In one study, a team at Brigham and Women's Hospital in Boston measured pH levels in the esophagus of 31 emergency department patients who complained of serious chest pain.

Abnormal reflux of acid into the esophagus that would fit the diagnosis of GERD was found in 57 percent of the patients.

More women than men had chest pain that wasn't related to the heart. Men more often had upright reflux (which occurs when a patient is awake), while women experienced both supine reflux (occurs during sleep) and upright reflux.

"Often the role of acid reflux has been overlooked as a potential factor in the diagnosis and treatment of patients with serious chest pain. But, it is important for patients never to assume their chest pain is caused by GERD, until they have been thoroughly evaluated by a physician to rule out heart disease. If they experience persistent chest pain, they should seek emergency medical care," study lead investigator Dr. Julia J. Liu said in a prepared statement.

The second study, by researchers at the Medical University of South Carolina in Charleston, included patients with persistent cough who took stomach acid-suppressing proton pump inhibitor drugs over a period of three years. The study was conducted to assess the cost-effectiveness of a device (MII-pH) that can detect non-acid reflux. Conventional pH testing only measures acidity.

"The use of MII-pH testing in patients who experience reflux of non-acid stomach contents is cost-effective by helping clinicians determine which patients would benefit from anti-reflux surgery and excluding those for whom surgery may have no benefit. This warrants further evaluation of widespread application of MII-pH testing in the diagnosis of patients with persistent chronic cough on adequate medical therapy," researcher Dr. Deepika Koya said in a prepared statement.

More information
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about GERD.

Lyme Disease Relapse Often a New Infection

(HealthDay News) -- Many people who believe they're suffering a relapse of Lyme disease may actually have been bitten by another tick and have a second, completely new infection, a new study suggests.

"It is striking how often re-infection appears to occur," lead author Dr. Robert B. Nadelman, professor of medicine at New York Medical College, said in a prepared statement. "Our findings support clinical evidence that a surprising number of patients experience more than one episode of Lyme disease and that recurrent infections are unrelated to the original infection."

Lyme disease, which affects about 20,000 Americans a year, is caused by Borrelia burgdorferi, a bacterium that's transmitted to humans by deer ticks. About 95 percent of patients recover completely and quickly with two to three weeks of antibiotic treatment. Left untreated, the infection usually goes away within a month. However, untreated patients can relapse and/or develop late complications that affect the joints, heart, or nervous system, according to background information in a new release about the study.

Many patients who are diagnosed and successfully treated for Lyme disease develop the infection again, likely because they live in areas where deer ticks are common, the researchers said.

They analyzed B. burgdorferi genotypes from skin biopsies of 272 people diagnosed with Lyme diseases between 1991 and 2005. The team found that some of the patients had suffered separate Lyme disease-causing tick bites.

The findings "underscore the importance of preventing exposure to ticks, by covering exposed skin, using tick repellants, and performing self-examination for ticks on a regular basis during the tick season," Nadelman said.

The findings were to be reported Thursday at the annual meeting of the Infectious Diseases Society of America, in San Diego.

More information
The American Medical Association has more about Lyme disease.

High HDL Levels Protect Heart Health

(HealthDay News) -- High levels of "good" HDL cholesterol protect against heart disease and stroke no matter what the blood levels of "bad" LDL cholesterol are, a new study shows.

The incidence of heart attack, stroke and other cardiovascular problems was 40 percent lower in the one-fifth of participants in a major trial who had the highest HDL cholesterol levels, regardless of their LDL cholesterol levels, according to a report in the Sept. 27 issue of the New England Journal of Medicine. The protective effect of high HDL readings was evident even in patients with an LDL reading below 70, well under the recommended level for heart health.

"The fundamental important message of the paper is that if you take HDL high enough, LDL doesn't matter," said study author Dr. Philip Barter, director of the Heart Research Institute in Sydney, Australia.

LDL cholesterol is involved in the formation of fatty plaques that eventually can block an artery; HDL cholesterol prevents the formation of those plaque.

"What we desperately need is a new drug to raise HDL levels," Barter said.

No such drug is in sight, however. Pfizer halted a 15,000-participant trial of an HDL-raising drug, torcetrapib, last year, because the death rate was higher in those taking the drug than in those taking a placebo. Pfizer had planned to market torcetrapib in combination with its LDL-lowering statin, Lipitor.

The only available HDL-raising drug therapy now available is large doses of niacin, which can increase HDL levels by about 20 percent, Barter said. But that treatment has annoying side effects, such as serious skin flushing and itching, he said. New formulations have lessened but not eliminated the side effects, he added.

Barter is now doing studies to determine whether the damage caused by torcetrapib is closely related to the drug's HDL-raising effect. "If the effect is unrelated to HDL, that class of drugs still has a future, because other members of the class might not have the problem," he said.

"That still has to be put to the test. New members of the class of drugs could be introduced into clinical trials, probably as early as next year."

The new study has settled one issue, Barter said. "We saw a residual cardiovascular risk in some people with low LDL levels," he said. "It now appears that the major cause of that risk was low HDL levels. The implication is that we should be treating HDL as well as LDL."

"There is a residual risk, and we think that a substantial proportion of this is mediated by low HDL levels," said Dr. Vera Bittner, a professor of medicine at the University of Alabama at Birmingham and one of the trial leaders. "We all agree that we need drugs that can raise HDL levels, so that we can test the hypothesis that raising HDL will reduce risk."

But Bittner said she was "not quite willing to make the leap of faith that an HDL intervention will work, and the premature discontinuation of the [Pfizer] trial proves my point."

More information
Learn about HDL and LDL cholesterol from the American Heart Association.

Flaxseed May Relieve Hot Flashes

(HealthDay News) -- Flaxseed may be one way to reduce the bothersome hot flashes of menopause, Mayo Clinic researchers report.

A small pilot study found that postmenopausal women not on estrogen who used dietary flaxseed daily reported a 50 percent reduction in hot flashes over the course of six weeks.

"Flaxseed worked very well," said Dr. Sandhya Pruthi, director of the Mayo Breast Clinic at the Mayo Clinic in Rochester, Minn. "The women who used it said it really helped them."

But another expert, Dr. Wulf H. Utian, executive director of the North American Menopause Society, cautioned that the study was too preliminary to prove that flaxseed is effective.

While hormone replacement therapy, particularly estrogen, is effective against hot flashes, its long-term use has fallen out of favor since the large study known as the Women's Health Initiative found an increased risk of heart disease, breast cancer and other problems with long-term HRT use. So, Pruthi and her team were looking at options for women who suffered from hot flashes but didn't want to take estrogen.

They enrolled 29 postmenopausal women, median age 55, in the study. To join, the women had to have at least 14 hot flashes a week for at least one month.

"Flaxseed has some natural phytoestrogens," Pruthi said, explaining how it, like the hormone estrogen, could possibly have an effect on hot flashes.

Over the course of the study, the women sprinkled 40 grams of crushed flaxseed daily into yogurt or cereal or mixed it with orange juice or water.

In the end, 21 women completed the study; others had dropped out because of side effects. Of those who finished, the researchers said, the frequency of hot flashes declined 50 percent, and the hot flash score -- a combined measure of a flash's severity and frequency -- was found to have decreased about 57 percent.

"By the second or third week, most women noticed improvement," Pruthi said, adding that she is now planning a larger study to compare flaxseed to a placebo.

Until those results are in, Utian is not convinced the flaxseed is a proven treatment for hot flashes.

"This reduction [in the pilot study] could fall into the placebo effect," he said.

The study was also relatively brief, he added. And many women experiencing menopause suffer many more hot flashes than 14 a week. (Fifteen of the Mayo study women reported 10 or more a week, but 13 reported 2 to 9 a week.)

Utian added, however, that he was not aware of any harm in eating flaxseed.

And Pruthi said that because the fiber content gave some women in the study abdominal discomfort, those that find it hard on the stomach should consider starting at a lower dose and working up.

Her research was just published in the summer 2007 issue of the Journal of the Society for Integrative Oncology.

More information
To learn more about hot flashes, visit Breast cancer.org.

Obesity-Linked Woes Boost Kids' Lifetime Heart Risk

(HealthDay News) -- Obese children diagnosed with health problems collectively known as the "metabolic syndrome" are at higher risk for developing heart disease as adults, new research reveals.

Compared to healthier youngsters, school-age children with the condition face a 14.5 times greater risk of cardiovascular disease when they reached their 30s and 40s, the study found.
Components of the syndrome include high blood pressure, high body mass, high blood pressure and high triglycerides (blood fats).

"I wasn't exactly shocked, but this is the first time we have shown that children who have this constellation of factors known as metabolic syndrome are at an increased risk for cardiovascular disease in their adult years," said study lead author John A. Morrison, a research professor of pediatrics who also works in the division of cardiology at Cincinnati Children's Hospital Medical Center in Ohio.

The findings are published in the August issue of Pediatrics.

According to the American Heart Association, more than 50 million Americans have the metabolic syndrome. The condition is typically diagnosed on the basis of having at least three of the following characteristics: abdominal obesity; high blood pressure; insulin resistance (in which the body can't process insulin or blood sugar properly); a high risk for arterial plaque build-up due to high levels of triglycerides, low HDL ("good") cholesterol and high LDL ("bad") cholesterol; and a high risk for clotting and inflammation as indicated by the elevated presence of certain blood proteins.

Researchers long ago established that, for adults, having the metabolic syndrome increases their risk for both heart disease and diabetes. Physicians now recommend that patients combating the condition embark on a weight-loss program geared toward developing healthier eating habits and increased physical activity.

To explore a possible link between pediatric metabolic syndrome and adult heart disease, Morrison and his team cross-referenced data for contributing syndrome characteristics collected from a pool of 771 children between 1973 and 1978, and then again between 2000 and 2004.

The participants were drawn from the Cincinnati region and were between the ages of 6 and 19 in the first study and 30 and 48 in the follow-up study. A little less than three-quarters of the pool were white and a little more than a quarter were black.

Patient blood samples were taken the time of study enrollment and then 25 years later. The researchers gauged blood pressure; body mass index (BMI); and cholesterol. Blood triglyceride and glucose levels were also assessed.

The participants also reported any history of heart attack or stroke, or procedures such as coronary bypass or angioplasty.

Four percent of the participants -- 31 boys and girls -- had metabolic syndrome as children, while more than 25 percent had the condition 25 years later, the researchers reported.

Among those with pediatric metabolic syndrome, almost 70 percent still had the condition as adults, and almost 20 percent had gone on to develop cardiac disease in the intervening years.
In contrast, only 1.5 percent of the children who did not have the syndrome as kids went on to experience heart trouble as adults.

Furthermore, any rise or fall in BMI over the 25 years was linked to a concurrent rise or fall in risk for developing the metabolic syndrome. In that time frame, every BMI bump or drop of 10 points translated into a 24 percent risk increase or decrease for the syndrome, the team reported.

Morrison and his colleagues said their findings should help doctors and parents identify young patients who are at an increased risk for serious adult illness. They could also point the way toward ways to reduce that risk.

"So, there's some good news here," said Morrison. "Pediatric weight is not destiny. If you're obese as a child, you can do something to lose the pounds. And you must do something to lose the pounds, if you want to reduce risk."

Dr. Brenda Kohn, an associate professor of pediatrics at the New York University School of Medicine, added that proactive parental and physician intervention is critical to help children avoid behaviors that keep the syndrome going.

"The treatment has to be started in childhood, in adolescence," she advised. "Eating patterns, activity patterns, all start in infancy. Good habits have to start early."

"So, it's very, very important that a child is raised in an environment where physical exercise is encouraged on a routine basis and eating patterns are geared to healthy eating decisions," added Kohn, who is also a medical advisory board member with the Juvenile Diabetes Foundation.

"Children should be monitored at least once yearly by a physician in order to ensure that all these goals are being met," she said.

More information
For additional information on metabolic syndrome, visit the American Heart Association.

Fish Helps Statins Protect the Heart

(HealthDay News) -- People taking cholesterol-lowering drugs called statins who also consume omega-3 fatty acids -- typically found in fish and fish oil -- have a better chance of avoiding heart problems than patients who take statins alone.

That's the conclusion of a new study by Japanese researchers that is published in the March 31 issue of The Lancet.

"Our study shows that long-term use of EPA (an omega-3 fatty acid) at therapeutic doses is effective for prevention of major coronary events in hypercholesterolemia (high cholesterol) patients given statins in Japan who consume a large amount of fish," said lead researcher Dr. Mitsuhiro Yokoyama. He is a professor of medicine at the Kobe University Graduate School of Medicine.

In the study, called the Japan EPA Lipid Intervention Study, Yokoyama and his colleagues assigned 18,645 people to receive either 1,800 milligrams of one of the omega-3 fatty acids, eicosapentaenoic acid (EPA), every day plus a statin, or a statin alone.

During an average follow-up of 4.6 years, the researchers found a 19 percent reduction in major coronary events among patients taking EPA. Patients taking EPA also had 19 percent fewer non-fatal events -- including non-fatal heart attack, unstable angina, and coronary revascularization -- than people taking statins alone. However, the incidence of sudden cardiac death and death from heart disease did not differ between the groups.

The preventive effects of EPA are of both clinical interest and therapeutic importance, Yokoyama said. "EPA is thought to exert its plaque-stabilization effect via mechanisms that are independent of a reduction in cholesterol," he added.

Sickness and death from coronary artery disease is very low in Japan in comparison with the United States and northern Europe, Yokoyama said. "This difference might be explained partly due to differences in dietary habits, including fish consumption. We want to know whether our results can be generalized to other populations who consume a small intake of fish and have very high mortality from coronary artery disease," he said.

One expert thinks the study results aren't surprising, but they are interesting, because the research was done in a country where people eat more fish than they do in the United States.
"This study is further evidence of the benefit of omega-3 fatty acids for protecting against heart attacks and other cardiac events," said Dr. Dariush Mozaffarian, an assistant professor of epidemiology at Harvard Medical School and Harvard School of Public Health, and author of an accompanying editorial in the journal.

Mozaffarian said that the trial was done, in part, to see if combining EPA with a statin could be effective in reducing cardiac events.

While there did appear to be a benefit in taking EPA, coupling it with a statin in one pill isn't necessary, Mozaffarian said. "The pharmaceutical manufacturers are facing the end of patents on their statins," he said. "The idea of putting a statin and EPA in a single pill is really just marketing," he added.

Mozaffarian noted that a healthful diet should provide enough EPA to reduce the risk of heart trouble. "People should be able to get a cardioprotective dose of omega-3 fatty acids by eating fish twice a week," he said.

More information
The latest recommendations on omega-3 fatty acids are available from the American Heart Association.

Groundhogs, Other Hibernators, Could Aid Human Health

(HealthDay News) -- When Punxsutawney Phil popped up to look for his shadow Friday morning, he was not just forecasting how long winter will last.

Biologists now think that Phil and his fellow groundhogs, along with other animals in hibernation, could foreshadow advances in human health.

In fact, hibernators' amazing ability to manipulate their own metabolisms could lead to breakthroughs in improving organ transplant and in fighting such illnesses as obesity, diabetes, heart disease and even Alzheimer's, research shows.

"Remember, our physiology, and even our genetic makeup, isn't that different, in terms of basic bodily functions, [from] these hibernating mammals," said Hannah Carey, a professor in the School of Veterinary Medicine at the University of Wisconsin-Madison.

"The blueprint, the genes to do these things are there -- we're just not activating the same physiological pathways," said Carey, who is also president-elect of the American Physiological Society.

A wide range of mammals hibernate, from tiny squirrels to the grizzly bear. And hibernation isn't restricted to cold-weather climates: Scientists recently discovered that a Madagascar primate, the fat-tailed lemur, also goes into the hibernating state known as "torpor" during that tropical island's dry season.

"Torpor is a word we use for this state of physiological down-regulation," Carey explained. "Hearts slow down to a few beats per minute, and the animals are breathing only a few breaths per minute. Blood flow is very slowed, and their metabolism is suppressed."

Body temperature during torpor can fall to near-freezing in many hibernating squirrels, Carey added. In fact, the Arctic ground squirrel's hibernating temperature actually drops below freezing.

Close investigation of hibernating states is giving scientists new insight into animal physiology and, as a bonus, human health and disease as well. Some examples:

• Organ transplant. Harvested human organs kept at cold temperatures can only remain viable for a few days at most. So, how do squirrels' livers and intestines stay perfectly healthy at less than 40 degrees Fahrenheit for weeks on end? In one study, "we found that [hibernating] squirrels maintain, in a much healthier state, the microcirculation of the liver," Carey said. Insights into just how this happens could increase the viability and number of human organs available for transplant, she said.
• Heart attack. Rousing from weeks of torpor, hibernating mammals flood their near-dormant organs with fresh blood, a process called reperfusion. But doctors know that the speedy reperfusion of hearts after heart attack is, in itself, a major cause of damage to cardiac tissues. "But hibernators, faced with the very same kind of experimental insult, are very well-protected," Carey said. "They seem to have bumped up their defenses." Understanding those natural defenses might lead to better heart attack care, she said.
• Obesity. Gregory Florant, a biology professor at Colorado State University, has been studying the role in hibernation of a fat cell-secreted hormone called leptin. He explained that leptin, along with other biochemical signals, may help typically ravenous animals shut down their appetites as winter approaches. "Likewise, if we can determine what the hierarchy here is for shutting down the appetite, that may allow us to make gains on how to curb people's appetites so they don't eat as much," he said.
• Diabetes. Gearing up for hibernation means packing on weight -- a lot of weight. And hibernation means mammals turn into "the ultimate couch potatoes," Florant said. So, why don't these fattened-up bears, groundhogs and squirrels slip into type 2 diabetes, as humans so easily do? "That's a really interesting health perspective," Florant said. "They never go into frank diabetes, even though they become almost morbidly obese." Unraveling that mystery could lead to new ways to fight diabetes, he added.
• Alzheimer's. Carey pointed to another intriguing phenomenon: As the time mammals spend in torpor increases, vital cell connections begin to weaken within their brains. However, most hibernating mammals actually rouse themselves in their burrows every so often, and this appears to help these neural connections reestablish themselves. "So, people are saying, 'these guys are great models for things like Alzheimer's disease and [brain] lesions such as neurodegeneration,' " Carey said. In essence, hibernating mammals experience real brain damage, "but then they reverse themselves," according to Carey.

Finding out how that happens could further human brain research, she said.
With all of these physiological advantages, Punxsutawney Phil and his mammalian brethren appear to be on to something, the experts said.

"Different animals come up with different ways to cope with environmental stresses," Carey said. "Of course, we use our brains, so we have coats, electric heaters, that kind of thing. But it's really cold here in Wisconsin right now: Sometimes I look out there and think that maybe hibernation is a pretty smart idea."

More information
Find out more about groundhogs and Groundhog Day at Cornell University.

Gene Variant May Predict Heart Disease, Stroke

(HealthDay News) -- Researchers have identified a gene variant associated with the early signs of heart disease and stroke in women.
None of the more than 11,000 participants in the 25-year study has yet had heart disease or a stroke, but the signs point toward increased risk, said study author Dr. Edward Lammer, a pediatrician and geneticist at the Children's Hospital Oakland Research Institute in California. The report is published in the February issue of Atherosclerosis, Thrombosis and Vascular Biology.

"We found changes in two blood vessel areas," Lammer said. "In the coronary arteries, we found calcification. We also found thickening of the carotid arteries in the neck."

A buildup of calcium makes the coronary arteries less flexible and more vulnerable to damage. Thickening of the carotid arteries, the main blood vessels to the brain, can be a prelude to a stroke.

Those changes have been seen only in women. "We have no idea why," Lammer said, although it's possible that the signs of risk will develop later in men than in women.

Now, the researchers must wait to see whether women in whom the changes have been seen run into cardiovascular trouble.

They haven't so far, probably because they are too young, Lammer said. The study began in 1971 and has followed 11,377 residents of Muscatine, Iowa, since their early teens. The Oakland researchers are working with physicians at the University of Iowa on the study.

Lammer and his colleagues measured about 100 gene variants in the study participants. One of them, designated LTC4S, has been found to be associated with a fourfold increased risk of the early signs of heart disease and stroke, after adjustment for standard risk factors such as smoking, cholesterol and blood pressure levels, Lammer said.

"What's intriguing is that the gene variant we found is involved in regulating the inflammatory response," he said. "A research group from Iceland has reported that two genes in the same pathway are risk factors for stroke. This gene generates leukotrienes, chemicals that mediate the inflammatory response."

The LTC4S gene variant has previously been associated with asthma, "which in essence is an inflammatory reaction," Lammer said. "The hope is that our early results keep the finger pointed at the role of inflammation regulation as very important for atherosclerosis, heart disease and stroke."

The fact that the link between the gene variant and the danger signs seen so far is not associated with standard risk factors could make gene testing an important part of early risk assessment for many Americans, Lammer said. "About half the people in the study appear to have this variant," he said.

Lammer and his associates are continuing to follow the people in the study to check on the incidence of heart disease and stroke associated with the gene variant.

"If it is a risk factor that is genetic, we could identify the risk factor very early in life and develop interventions, behavioral changes or medications that ameliorate the risk," he said.

More information
Background information about the genetics of heart disease is provided by the American Heart Association.

Binge Drinking May Be Biggest Alcohol Threat: Survey

(HealthDay News) -- A statewide New Mexico survey suggests that most Americans who drink too much may not, in fact, be full-blown alcoholics but rather binge drinkers.

While the poll revealed that 16.5 percent of that state's residents are excessive drinkers, only 1.8 percent of the men and women interviewed met the official definition for alcohol dependence.

In turn, most of these excessive drinkers were found to be engaged in "binge drinking" -- defined as imbibing five or more drinks at one sitting.

"Short-term episodic drinking -- not alcoholism -- is the predominant alcohol-related problem," said study co-author Jim Roeber, an alcohol epidemiologist with the New Mexico Department of Health in Santa Fe.

Reporting in the February issue of Alcoholism: Clinical & Experimental Research, the authors referenced 2001 figures from the U.S. Centers for Disease Control and Prevention (CDC) outlining the tragic impact of serious alcohol abuse.

In that year, an estimated 75,000 Americans lost their lives due to excessive alcohol use, the researchers said.

According to the CDC, men who consume an average of more than two drinks per day are considered "heavy drinkers." For women, that line is drawn at more than one drink per day.

Both the study authors and the CDC pointed out that excessive alcohol use is associated with the development of many serious health problems, including liver cirrhosis, pancreatitis, various cancers, high blood pressure, as well as elevating risk for depression and suicide.

Alcohol abuse also promotes a variety of dangerous behaviors, such as driving or operating machinery while impaired.

To gauge the nature of the problem in New Mexico, Roeber and his colleagues analyzed a 2002 telephone survey conducted by the New Mexico Department of Health with CDC assistance.
Focusing on drinking behavior in the month prior to the interview, the researchers asked almost 4,800 state residents over the age of 18 to recall how often they had engaged in binge drinking, heavy drinking, and/or alcohol-impaired driving. Alcohol dependence was also assessed.

People identified as "dependent" were defined as having experienced three or more problems associated with alcoholism over the past year: a build-up of tolerance to alcohol; withdrawal symptoms when deprived; a persistent desire to drink; drinking more than initially intended; devoting undue time to drinking; eschewing other social and job-related activities for drinking; developing alcohol-related psychological problems; or being unable to stop drinking.

Drunk-driving was defined as driving at least once when having "perhaps too much to drink" over the prior 30 days.

Roeber and his team found that while 55 percent of those interviewed were current drinkers, fewer than 2 percent were actually alcoholics. Alcoholism was more prevalent among young males, the college educated, and non-whites.

This was in stark contrast to the nearly 17 percent of those interviewed who engaged in excessive drinking, among whom binge drinking was far and away the most common problem -- evident among nearly 88 percent of this group.

The researchers found that while just two percent of all those interviewed had driven drunk, nearly 12 percent of excessive drinkers and just over 17 percent of alcoholics had done so in the past month.

Nevertheless, the researchers concluded that despite having one of the highest alcoholism rates in the United States, the bulk of New Mexico's alcohol problem was a function of excessive drinking and not, in fact, alcoholism.

Roeber hopes the New Mexico finding will lead to a national shift in public health policy. That policy now directs approximately $4 billion toward alcoholism treatment, while only $1 billion goes toward alcohol abuse prevention.

"There's a whole range of different ways to intervene to try and prevent episodic drinking, which is very different from taking a person who's alcohol dependent and getting them through treatment," he said.

Increasing the price of alcohol, improving enforcement of minimum age drinking laws, and bolstering excessive drinking monitoring in bar environments are some of the specific ways to curtail excessive drinking, Roeber said.

Deborah Dawson, an epidemiologist at the National Institute on Alcohol Abuse and Alcoholism in Washington, D.C., agreed with that stance.

"Our own studies show a very similar picture on a national level, so I would say the New Mexico findings are a representative pattern of the U.S. as a whole," Dawson noted. "So, we need to allocate money ideally for both prevention and treatment and not put it all in one pot or the other."

Dr. Timothy Naimi, a New Mexican public health physician who works as part of the CDC's Alcohol Team, also agreed.

"Do we prevent heart attacks by standing in the ER and waiting for people to roll in with chest pain?" he asked. "No. We treat high blood pressure and cholesterol with the idea of preventing it. It's folly not to do the same with alcohol use. Otherwise, we're a day late and a dollar short."
Naimi said the study was an important wake-up call for drinkers and medical professionals alike.

"A typical defense for someone who might drink in a risky way -- when a loved one or a physician asks them about their drinking -- is to say 'I'm not an alcoholic,' " Naimi noted. "And the point is that while that may be true, that doesn't mean that those people who are drinking too much are not at risk for alcohol-related problems."

"So, we need to recognize that the risks from excessive drinking begin way before people reach the stage of alcoholism," Naimi added. "Because while not all excessive drinkers will become alcoholics, it is one, among many, bad possible outcomes that stem from excessive drinking. And, of course, alcoholics don't just roll out of bed that way. All were once, in fact, excessive drinkers in a milder form."

More information
For more on excessive drinking and alcoholism, visit the U.S. National Institute on Alcohol Abuse and Alcoholism.

New Test May Predict Stroke Risk After 'Mini Stroke'

(HealthDay News) -- Neurologists say they've developed a quick test to assess the risk that someone who suffers a transient ischemic attack (TIA), or "mini stroke," will have a major stroke in the following 48 hours.

The test combines elements of two earlier predictive assessments. Those tests were designed to determine the risk of a stroke within seven and 90 days, respectively.

"We took each of the elements in those tests, combined them into a whole series of new scores, chose the best one, and validated them in new cohorts," said Dr. S. Claiborne Johnston, associate professor of neurology at the University of California, San Francisco, and lead author of a report in the journal The Lancet.

About 240,000 TIAs -- minor blockages in brain arteries -- are diagnosed in the United States each year, and up to 20 percent of them will be followed by a major stroke. It's important to assess the immediate danger, because half of those strokes will occur within the first two days after a TIA, Johnston said.

The new test can be administered in a few minutes, he added. It measures blood pressure, speech impairment, weakness on one side of the body, diabetes and age.

Using the tests on a large number of people who had TIAs showed that 21 percent were at high risk, meaning they had a 1-in-12 chance of having a stroke in the following 48 hours. Another 45 percent were classified as being at moderate risk, with a 4.1 percent chance of a stroke.

"This is the first large-scale study to validate these scores," Johnston said. "We are at a new level where we feel confident that the scores are useful in clinical practice in the Western world."
The test can help determine which patients should be hospitalized and which can safely be sent home, he said.

"We are hoping that neurologists, emergency physicians and primary care doctors will hear about this score and start using it widely," Johnston said. "Currently, it doesn't seem that physicians are making decisions based on risk. They are hospitalizing people whether they are at high risk or not."

Dr. Brett L. Cucchiara, assistant professor of neurology at the University of Pennsylvania, said he currently hospitalizes every patient who suffers a TIA. The reason, he said, is real doubt about the value of all risk-assessment tests.

His view of the new report is that it is "very interesting and suggests that this strategy may be useful." But, Cucchiara added, "we really need to see these kinds of findings replicated by an independent group before they are ready for prime time."

He pointed to a new Portuguese study, about to be published, that seems to have discredited an earlier stroke risk-assessment method.

"In their study, which was much larger, there was no predictive value at all," Cucchiara said. "I'm not sure these tests are proven enough to send patients home from the emergency room."
Another report in the same issue of the journal found that MRI is better than the commonly used CT scan for the detection of acute stroke.

The study of 356 patients, done at the U.S. National Institute of Neurological Diseases and Stroke, found that MRI detected stroke and brain hemorrhages more frequently than CT, and that MRI should be the preferred test, despite its extra cost.

More information
Find out more on the symptoms and dangers of TIAs at the American Heart Association.

Health Tip: Treating a Sports Injury

(HealthDay News) -- If you've been injured while exercising or playing a sport, the first thing you should do is to quit the activity and evaluate the injury.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases says you should see a doctor if the injury is extremely painful, is causing significant swelling, or if you can't put any weight on the injured area. You should also see a doctor if you've aggravated an old injury that's become painful or swollen.

If you're treating the injury at home, begin the RICE method as quickly as possible and follow it for at least the next 48 hours. RICE stands for: Rest, Ice, Compression, and Elevation. In short, don't exercise or strain the area, and keep it iced for 20 minutes at a time, four to eight times per day. And, if possible, keep the area wrapped and elevated to a level above the heart.

Campaign to Heighten Awareness of Lung Disease

(HealthDay News) -- Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and a new campaign launched Thursday is aimed at spreading awareness about this killer respiratory condition.

The campaign -- sponsored by the U.S. National Heart, Lung, and Blood Institute (NHLBI) and a number of professional, health and advocacy groups -- will include print and radio public service announcements, fact sheets for patients and people at risk for COPD, a Web site, an educational video, and materials to help community-based groups inform the public about the signs and symptoms of COPD.

COPD develops slowly and affects breathing. Symptoms included shortness of breath, constant coughing, wheezing, and excess sputum production.

People over age 45 with a history of smoking are at highest risk for COPD. Other risk factors include exposure to secondhand smoke or pollutants. Some people have a genetic risk for the disease, according to the NHLBI.

About 12 million Americans are currently diagnosed with COPD, and it's estimated that another 12 million have COPD but have not been diagnosed, even though they have symptoms.

"Many people with early signs of COPD simply avoid activities they used to enjoy because they become short of breath more easily. We want people to know that these symptoms have a name -- COPD -- that diagnosis is easy, requiring only a simple breathing test (spirometry) in your doctor's office, and that treatment can help," Dr. Elizabeth G. Nabel, NHLBI director, said in a prepared statement.

Treatments such as inhaled bronchodilators, inhaled corticosteroids, and pulmonary rehabilitation help control symptoms and improve exercise capacity. Another treatment, oxygen therapy, may help prolong the life of patients with severe COPD.

More information
The American Academy of Family Physicians has more about COPD.