American Journal Of Medicine

August 10, 2007

Smokeless Tobacco: Unsafe Alternative

Filed under: Uncategorized — Luis @ 5:00 am

Aug. 10, 2007 -- Looking for a safe substitute for cigarettes? Smokeless tobacco isn't the way to go, according to a new report.       

The report shows that smokeless tobacco may be as bad -- or worse -- than cigarettes, in terms of exposing users to certain cancer-causing chemicals.

"Our results raise serious questions about the strategy of using smokeless tobacco as a substitute for cigarette smoking. Long-term nicotine replacement therapy may be a better option," write the researchers, who included the University of Minnesota's Steven Hecht, PhD.

"This study lends evidence to support the notion that oral use of tobacco actually provides a more efficient means for delivering certain carcinogens into the body through the bloodstream, although cigarette smoke includes a host of carcinogenic products that aren't a major factor in smokeless tobacco," Hecht says in a news release.

Smokeless Tobacco vs. Cigarettes

Data came from six studies that together included 420 smokers and 182 smokeless tobacco users, all of whom were trying to cut down on their tobacco use.

Hecht's team compared levels of certain cancer-causing chemicals detected in the participants' urine samples.

Levels of those chemicals from the smokeless tobacco users were equal to or higher than the levels from the cigarette smokers.

The researchers say that while "there is no doubt that the risk for lung cancer is greater in smokers than in smokeless tobacco users," smokeless tobacco isn't harmless and can cause oral cancer.

The report didn't include details about the participants' medical history. The findings appear in the August edition of the journal Cancer Epidemiology, Biomarkers & Prevention.

SOURCES: Hecht, S. Cancer Epidemiology, Biomarkers & Prevention, August 2007; vol 16: pp 1567-1572. News release, American Association for Cancer Research.

© 2007 WebMD, Inc. All rights reserved.

August 9, 2007

Heat Waves Increase Hospitalizations

Filed under: Uncategorized — Luis @ 5:00 am

Aug. 9, 2007 -- When heat waves hit, more senior citizens are hospitalized, a new Italian study shows.

The researchers included Giuseppe Mastrangelo, MD, of Italy's University of Padova.

They tracked hospitalizations among people age 75 and older during five heat waves that took place in Italy's Veneto region during 2002 and 2003.

Mastrangelo's team noted a rise in hospitalizations for heat-related conditions (dehydration, heat stroke, and acute kidney failure) among elders.

"At least four consecutive hot, humid days were required to observe a major increase in hospital admissions," write Mastrangelo and colleagues.

For instance, elders' hospitalizations for heat-related conditions more than doubled and their hospitalizations for respiratory diseases rose by about 50% when heat waves lasted for at least four days.

Heat waves that struck later in the summer didn't appear to lead to fewer hospitalizations than heat waves that hit earlier in the season.

That finding suggests that people don't get used to the heat as the summer progresses, the researchers note online in the journal BMC Public Health.

Heat Wave Health

More than 8,000 people in the U.S. died from excessive heat exposure between 1979 and 2003, according to the CDC.

Heat-related deaths and illnesses are often preventable. Here are the CDC's tips:

  • Stay indoors in an air-conditioned place.
  • Drink plenty of fluids -- and not just when you're thirsty -- unless your doctor advises otherwise or you're taking water pills (diuretics).
  • A sports drink can replace salt and minerals lost in sweat. Talk to your doctor first if you're on a low-salt diet.
  • Wear as little clothing as possible at home.
  • Choose lightweight, light-colored, loose-fitting clothes.
  • Limit your outdoor activity. If you must go out, aim for the morning or evening.
  • When outside, try to rest often in shady areas.
  • Wear a wide-brimmed hat, sunglasses, and sunscreen with an SPF of 15 or higher.
  • Pace yourself, and stop all activity if your heart pounds or you start gasping for breath in the heat.
  • Check on babies, kids, elders, people who are ill, and others who may be particularly vulnerable to heat-related illnesses.

SOURCES: Mastrangelo, G. BMC Public Health, Aug. 9, 2007; online edition. CDC: "Extreme Heat: A Prevention Guide to Promote Your Personal Health and Safety." News release, BioMed Central.

© 2007 WebMD, Inc. All rights reserved.

Nexium, Prilosec: No Heart Risks Seen

Filed under: Uncategorized — Luis @ 5:00 am

Aug. 9, 2007 -- The FDA today reported that so far, it has found no signs of heart risks associated with long-term use of the drugs Prilosec and Nexium.

Prilosec and Nexium belong to a class of drugs called proton pump inhibitors. They work by reducing the amount of acid produced by the stomach.

Both drugs are used to treat conditions including gastroesophageal reflux disease (GERD) and stomach and duodenal ulcers. Prilosec is also sold over the counter for frequent heartburn.

The FDA is conducting an ongoing review of new safety data on Prilosec and Nexium, which are made by the drug company AstraZeneca.

"The FDA has concluded preliminarily that these data do not suggest an increased risk of heart problems in patients treated with either of these products," the FDA's Paul Seligman, MD, MPH, told reporters today.

"At this time, we are recommending that health care providers and patients do not alter either their prescribing practices or taking of these drugs," says Seligman, who is the associate director of the Office of Safety Policy and Communication at the FDA's Center for Drug Evaluation and Research.

Seligman says the FDA has been in touch with regulators in the U.K, New Zealand, Australia, and Canada, who have reached similar conclusions about Prilosec and Nexium.

However, the FDA hasn't finished its review of the Prilosec and Nexium data. The FDA plans to complete its review within three months.

Prilosec, Nexium Data

On May 29, AstraZeneca informed the FDA of early results from a long-term study of Prilosec and an analysis of an ongoing study on Nexium. Both studies included patients with severe GERD.

In the Prilosec study, which lasted for 14 years, patients took Prilosec or got surgery to treat their severe GERD. In the ongoing Nexium study, patients took Nexium or got surgery to treat their GERD.

"In these studies, AstraZeneca was attempting to ascertain whether drug therapy with either of these drugs or surgery was most effective in relieving and preventing recurrence of symptoms of severe GERD," says Seligman.

The data raised concerns that long-term use of Prilosec or Nexium may have increased the risk of heart attacks, heart failure, and heart-related sudden death in those patients taking either one of those drugs, compared to patients who received surgery.

In the Prilosec study, more patients treated with Prilosec had heart attacks, heart failure, and heart-related sudden death than did the patients who had surgery. The difference between the two groups of patients was seen within the first year of the study, and continued over time.

In the ongoing Nexium study, initial data from this study suggested a difference between treatments in the rate of cardiovascular events. But an updated report submitted by AstraZeneca found that the number of patients who experienced heart problems was similar in both treatment groups. 

No Heart Risk Seen

While both studies collected safety data, they didn't specify how heart problems, such as heart attacks, were to be defined or documented. As a result, the FDA says evaluating the information that has been gathered about the safety of either drug in these studies is difficult.

Since May 29, AstraZeneca has provided the FDA with a large amount of additional data from the two trials, along with pooled analyses of other studies.

At this point, the FDA's initial review of that data doesn't suggest an increased risk of heart problems for patients treated with Prilosec or Nexium.

Seligman notes that while the review isn't complete, the FDA issued today's statement as part of its commitment to inform health care providers and patients about emerging safety issues that affect public health.

SOURCES: Paul Seligman, MD, MPH, associate director, Office of Safety Policy and Communication, Center for Drug Evaluation and Research, FDA. News release, FDA. FDA: "Early Communication About an Ongoing Safety Reivew -- Omeprazole (Prilosec) and Esomeprazole (Nexium)."

© 2007 WebMD, Inc. All rights reserved.

Top 9 Fitness Myths — Busted!

Filed under: Uncategorized — Luis @ 5:00 am

It's easy to fall into the trap: A workout buddy passes along an exercise tip, and then you pass it on to several folks you know. One day, you're at the gym, and sure enough, you hear the same tip repeated, so you figure it must be true. But experts say that in the world of fitness, myths and half-truths abound – and some of them may be keeping you from getting the workout you need.

"Some myths are just harmless half-truths, but many others can actually be harmful," says professional triathlete and personal coach Eric Harr, author of The Portable Personal Trainer. "They can cause frustration in working out and sometimes even lead to injury," he notes.

One reason myths get started, says Harr, is that we all react to exercise a little differently. So what's true for one person may not be true for another.

"In this sense you sometimes have to find your own 'exercise truths' – the things that are true for you," says Harr.

That said, experts say there are also some fitness myths that just need busting, and the sooner the better!

To help put you on the path to a healthier, safer, and more enjoyable workout, WebMD got the lowdown from several top experts on what's true and what's not when it comes to exercise tips.

Fitness Myth No. 1: Running on a treadmill puts less stress on your knees than running on asphalt or pavement.

"Running is a great workout, but it can impact the knees -- and since it's the force of your body weight on your joints that causes the stress, it's the same whether you're on a treadmill or on asphalt," says Todd Schlifstein, DO, a clinical instructor at New York University Medical Center's Rusk Institute.

The best way to reduce knee impact, says Schlifstein, is to vary your workout.

"If you mix running with other cardio activities, like an elliptical machine, or you ride a stationary bike, you will reduce impact on your knees so you'll be able to run for many more years," says Schlifstein.

Fitness Myth No. 2: Doing crunches or working on an "ab machine" will get rid of belly fat.

Don't believe everything you hear on those late-night infomercials! Harr says that while an ab-crunching device might "help strengthen the muscles around your midsection and improve your posture," being able to "see" your abdominal muscles has to do with your overall percentage of body fat.  If you don't lose the belly fat, he says, you won't see the ab muscles.

But can doing ab crunches help you to lose that belly fat? Experts say no.

"You can’t pick and choose areas where you’d like to burn fat," says Phil Tyne, director of the fitness center at the Baylor Tom Landry Health & Wellness Center in Dallas.  So crunches aren't going to target weight loss in that area.  

"In order to burn fat, you should create a workout that includes both cardiovascular and strength-training elements. This will decrease your overall body fat content," including the area around your midsection, he says. 

Fitness Myth No. 3: An aerobic workout will boost your metabolism for hours after you stop working out.

This statement is actually true -- but the calorie burn is probably not nearly as much as you think!  

Harr says that while your metabolism will continue to burn at a slightly higher rate after you finish an aerobic workout, the amount is not statistically significant. In fact, it allows you to burn only about 20 extra calories for the day. While there's a little bit more of a metabolic boost after strength training, he says, it's still marginal.

"It doesn't really count towards your caloric burn," he says.

Fitness Myth No. 4: Swimming is a great weight loss activity.

While swimming is great for increasing lung capacity, toning muscles, and even helping to burn off excess tension, Harr says the surprising truth is that unless you are swimming for hours a day, it may not help you lose much weight.

"Because the buoyancy of the water is supporting your body, you're not working as hard as it would if, say, you were moving on your own steam -- like you do when you run," says Harr. 

Further, he says, it's not uncommon to feel ravenous when you come out of the water.

"It may actually cause you to eat more than you normally would, so it can make it harder to stay with an eating plan," he says.

Fitness Myth No. 5: Yoga can help with all sorts of back pain.

The truth is that yoga can help with back pain, but it's not equally good for all types.

"If your back pain is muscle-related, then yes, the yoga stretches and some of the positions can help. It can also help build a stronger core, which for many people is the answer to lower back pain," says Schlifstein.

But if your back problems are related other problems (such as a ruptured disc) yoga is not likely to help, he says. What's more, it could actually irritate the injury and cause you more pain.

If you do have back pain, get your doctor's OK before starting any type of exercise program.

Fitness Myth No. 6: If you're not working up a sweat, you're not working hard enough.

"Sweating is not necessarily an indicator of exertion," says Tyne. "Sweating is your body’s way of cooling itself."

It's possible to burn a significant number of calories without breaking a sweat: Try taking a walk or doing some light weight training. 

Fitness Myth No. 7: As long as you feel OK when you're working out, you're probably not overdoing it.

One of the biggest mistakes people tend to make when starting or returning to an exercise program is doing too much too soon. The reason we do that, says Schlifstein, is because we feel OK while we are working out.

 "You don't really feel the overdoing it part until a day or two later," he says.

No matter how good you feel when you return to an activity after an absence, Schlifstein says you should never try to duplicate how much or how hard you worked in the past.  Even if you don't feel it at the moment, you'll feel it in time, he says -- and it could take you back out of the game again.

Fitness Myth No. 8: Machines are a safer way to exercise because you're doing it right every time.

Although it may seem as if an exercise machine automatically puts your body in the right position and helps you do all the movements correctly, that's only true if the machine is properly adjusted for your weight and height, experts say.

"Unless you have a coach or a trainer or someone figure out what is the right setting for you, you can make just as many mistakes in form and function, and have just as high a risk of injury, on a machine as if you work out with free weights or do any other type of nonmachine workout," says Schlifstein.

Fitness Myth No. 9: When it comes to working out, you've got to feel some pain if you're going to gain any benefits.

Of all the fitness rumors ever to have surfaced, experts agree that the "no pain-no gain" holds the most potential for harm.

While you should expect to have some degree of soreness a day or two after working out, Schlifstein says, that's very different from feeling pain while you are working out.

"A fitness activity should not hurt while you are doing it, and if it does, then either you are doing it wrong, or you already have an injury," he says.

As for "working through the pain," experts don't advise it.  They say that if it hurts, stop, rest, and see if the pain goes away. If it doesn't go away, or if it begins again or increases after you start to work out, Schlifstein says, see a doctor.

Stroke Risk Linked to Some Migraines

Filed under: Uncategorized — Luis @ 5:00 am

Aug. 9, 2007 -- Some migraines may increase young women's odds of having a stroke, according to a new study.

The study -- published online today in the journal Stroke -- comes from experts including Leah MacClellan, MSPH, and Steven Kittner, MD, of the University of Maryland School of Medicine in Baltimore.

MacClellan, Kittner, and colleagues studied 1,000 African-American and white women age 15-49 living in and around the Baltimore-Washington, D.C. area.

The women were in their mid- to late-30s, on average (age range: 15-49). Stroke, which is America's third leading cause of death and a major cause of disability, usually strikes decades later.

The researchers asked the women about their history of headaches, including migraines.

Compared to the women who hadn't had a stroke, the stroke survivors were 50% more likely to report having a history of migraines with visual aura in the year or years before their stroke.

Symptoms of migraine with visual aura included ever seeing spots, lines, or flashing lights during a migraine.

Migraines without visual aura weren't linked to increased stroke risk.

Reducing Stroke Risk

Among the women who reported a history of migraine with visual aura, those who smoked and took oral contraceptives were seven times more likely to have had a stroke.

"Young women with probable migraine with visual symptoms can reduce their risk of stroke by stopping smoking and finding alternatives to the use of estrogen-containing contraceptives," Kittner states in an American Heart Association news release.

He uses the term "probable migraine" because the women's migraines weren't necessarily diagnosed by a doctor.

The researchers took many stroke risk factors into consideration. But they didn't have data on factors including the women's cholesterol levels, alcohol use, physical activity, and medications.

SOURCES: MacClellan, L. Stroke, Aug. 9, 2007; online edition. News release, American Heart Association.

© 2007 WebMD, Inc. All rights reserved.
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