Q&A With Idina Menzel

The actress and singer talks about her new movie, 'Frozen,' plus food, fitness, and family.

By Stephanie Stephens
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

With credits in stage, film, television, and music, Idina Menzel, 42, has won a Tony Award for her green-girl portrayal of Elphaba in the musical Wicked, and garnered a Tony nomination for her character Maureen in Rent. On television, she's played Rachel's biological mother, Shelby Corcoran, on Fox's hit series Glee. Also a songwriter, Menzel, who's known for her strong and emotional performances, has recorded four of her own albums. She's toured since 2012, singing classic pop and musical-theater favorites in venues such as New York's Carnegie Hall and the Walt Disney Concert Hall in Los Angeles. This month she voices her first Disney animated film, Frozen. Early next spring, she reunites with the stellar theatrical creative team she's worked with previously in a new musical, If/Then. Menzel has been married to actor Taye Diggs for 10 years and the couple has a little boy, Walker.

How do you nurture yourself?

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"Along with enough sleep and taking proper supplements, I steam -- in my steam shower. I find it's very healing, more than just your typical "tea and honey." I let the steam get into my throat and I can even warm up my voice and vocalize. And I steam my skin, which is great for getting all that stuff off of my face. When I was playing the Green Witch in Wicked, I had so much makeup to get off -- it was an ordeal. The steam really helped, and my skin looked good.

How do manage your health?

"I think it's about staying in front of any illness. If I feel anything, I run to the doctor."

What's your go-to tip for great skin care?

"In addition to steam, I like Kate Somerville's Purify Clarifying Cleanser."

When you're overworked and stressed out, how do you reset and unwind?

"Ever since I've become a mom, my priorities and perspective on things have changed. Sometimes when things are feeling a little chaotic, I try to focus on my son and what he needs. That really makes me understand the insignificance of things that I'm stressing about.

"For instance, if I get on stage and get nervous, I form this image of him in my mind, and I think, 'None of this matters -- if I screw up, or someone doesn't like me out there -- that's nothing in comparison to what I need to be a great mother.'"

What's your go-to healthy snack and why?

"Blueberries. Also, I'm trying to be gluten-free, so I enjoy the bars from Pure."

What's your healthy dinner?

"I love sushi. I eat lots of chicken, or a piece of grilled fish like tilapia, with spinach and Brussels sprouts."

What three ingredients are always in your refrigerator and/or pantry?

source : Q&A With Idina Menzel

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Q&A With Owen Wilson

The actor talks about his new movie ('Free Birds'), plus why he practices gratitude.

By Matt McMillen
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

In Free Birds, you travel back in time to save turkeys from becoming Thanksgiving’s main course. Is turkey on your Thanksgiving menu this year?

Yes, turkey is on the menu. In fact, I’m planning on having some turkey today.

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How did you prepare to play a turkey?

There wasn’t a lot of preparation needed. It just kind of came naturally to me, playing a turkey. I guess I just had a lifetime of preparation for it.

What is the biggest difference between acting in an animated film and playing a live action role?

It’s like when you’re a kid with make believe. It’s all sort of in your head. It’s also just easier. There isn’t a big crew, no hair and makeup and wardrobe. You just roll out of bed and go up to the sound studio. I like it. I would never have thought, based on my voice, that I would have done a lot of animated work, but for some reason it happened.

How do you celebrate Thanksgiving?

I celebrate it in Dallas with my family. We watch the Cowboys game, eat Thanksgiving dinner, and maybe try to get up a football game earlier in the day. My mom makes the Thanksgiving dinner, and she’s great at it. She makes apple pie, pecan pie, turkey, stuffing, cranberry sauce, mashed potatoes, yams. I’d say it’s my favorite meal of the year.

What does the holiday mean to you?

I read an article a few years ago about how the holiday is a nightmare for nutritionists, but for psychologists, there’s actually something quite healthy about it. The idea of giving thanks, of being grateful, has a lot of health benefits. The simple act of writing down three things a day you’re grateful for has a measurable impact on people’s happiness and contentment. I wasn’t writing them down, but over the course of the day, I’d see a sunset, or someone laughing, and I’d check that off and say that’s something to be grateful for. It shifts your perspective because you’re now looking for things to be happy about. Take the time, make the decision, to slow things down, and make a conscious effort to look for things over the course of a day to feel good about.

You’ve been a father for nearly 3 years now. How has life changed for you in that time?

There’s this new person that didn’t exist a few years ago, and it’s this person that I have incredible love for, and beyond that, it’s fun and it's gotten more fun. As Ford plays around, and laughs and talks more, it just keeps getting better and better. I love to be around him. That’s the biggest change, having this little person around who, if I have to pick someone to be around, is at the top of the list.

source : Q&A With Owen Wilson

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How Christina Applegate Stays Healthy and Happy

The actress dishes about 'Anchorman 2,' parenting, and self-esteem.

By Lauren Paige Kennedy
WebMD Magazine - Feature

Reviewed by Hansa D. Bhargava, MD

Raised in Los Angeles by a single mother, comedic actor Christina Applegate, 41, remembers feeling the same pressures we all face growing up: trying to fit in with other kids while also forging a healthy sense of self.

Applegate, who returns next month to the big screen in Anchorman 2: The Legend Continues with funnymen Steve Carell, Will Ferrell, and Paul Rudd, says she was never the type to chase after the popular crowd or adopt fashion fads. Quite the opposite: "I was the kid at 13 whose head was shaved," she says. "I wore thrift-shop clothes and Doc Martens, and worked that whole vagabond-hobo look."

That's not to say she didn't sometimes battle doubt. "I've never met a girl who hasn't struggled," she says of the female penchant for picking apart personal imperfections. "Seems to be a universal part of our development."

Even with California-blonde good looks, and with the success of her late-'80s hit sitcom, Married...With Children, under her belt -- plus the rabid male fan base that came with it -- Applegate had to work hard on her own self-esteem when she was younger. 

"I remember being around 20 years old, and I still didn't feel so comfortable in my skin," she says. "A girlfriend of mine, who was a few years older, said: 'Trust me. You're going to -- all of sudden! -- be in your skin. You just will, and all of that [anxiety] will go away.' And she was right. I did feel like: I am who I am. I don't care what anyone thinks. That was a great moment when I realized it."

These are refreshing words coming from a woman who's been performing since she was a baby -- the television and film star landed her first commercial at 5 months -- in a town famous for shaking the confidence of many a head-turning beauty. And while Hollywood is notoriously hard on child stars, this is one actor who's managed to segue seamlessly from youthful roles to top-tier status with her humor, sense of style, and self-esteem fully intact.

Applegate on Parenting

These days, the mother of 2-year-old Sadie - with musician husband Martyn LeNoble, of Porno for Pyros fame -- takes care to cultivate a strong streak of individualism in her daughter. It begins each morning with how her toddler dresses herself for the day.

"Self-esteem is something you as a parent want to instill in your kids, to be an individual," she says. "That's what it was for me [when I was younger], when I finally felt like I was following no one. And Sadie is such an individual! I don't make her wear anything. Sometimes her outfits are ridiculously awesome. Some are ridiculously ridiculous and beautiful. She'll insist on wearing two differently colored shoes to school. She insists on the blue one and the green one. And I'll say: 'Great! Do it!' I love watching her be independent."

source : How Christina Applegate Stays Healthy and Happy

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Q&A With Sugarland's Jennifer Nettles

Over the last year this country music star has given birth to a baby and a new solo album.

By Gina Shaw
WebMD Magazine - Feature

Reviewed by Hansa D. Bhargava, MD

Your son, Magnus, is now 11 months old. What's been the biggest revelation about being a new mom?

Children require you to be truly present in the moment. I tend to be one of those people who thinks about four to five steps ahead. That has served me well in my life and in my career, and in my success. But when your child has a need, it's all about him. It helps with your perspective. You don't have time for a lot of superfluous stuff, not even your own. It really is like a fire for the intellect: It cleans things out and lets you know what's really important.

What's been the hardest part of parenting?

The sleep! I've gone without sleep before but never really seen what this kind of sleep deprivation can do. They talk about mommy brain and searching for words? I've had moments where I literally laugh at myself. I am a woman who works with words for a living and I can't come up with the word "mirror"? "Look in the... look in the...check in the...whatever!" It's ridiculous!

How did you choose Magnus' name?

Back in 2010, we [Nettles and Sugarland partner Kristian Bush] appeared on CNN's Heroes show, hosted by Anderson Cooper, which highlights humanitarian organizations and philanthropists throughout the world. There was a gentleman from Scotland whose first name was Magnus. [Magnus MacFarlane-Barrow, whose nonprofit, Mary's Meals, provides free daily meals to 400,000 children worldwide.] He was standing there in his kilt, talking about this wonderful organization, and I thought, "Magnus -- that's a really good name!" I wasn't pregnant yet but even then, my husband and I had been talking about when we did have children, we'd want an "M" name, because his last name is Miller. I thought, "Justin will love that name, it sounds so strong!" And from that point forward it was our top contender for a boy.

You're a pretty devoted nursing mom. How has breastfeeding gone for you?

I'm in the lucky camp that it came easily for me. He and I had a deal before he was born: I told him that he could cook and stay in there as long as he wanted, as long as he came out with a sweet demeanor and latched like it was his job. Not only does he latch like it's his job, he does not take a bottle, he will not suck a pacifier, he will not suck a finger. He is a mommy-booby boy for sure.

Have you written any songs for Magnus yet?

On this album [That Girl, her first solo album], I have a couple of songs inspired by giving birth and having a child for the first time, and the deep, deep love and the extreme change it is. But I didn't want the whole album to be an album of lullabies; we're all many-faceted people, so I wanted to have a well-rounded album that spoke to a lot of subjects and topics. I also write fun songs throughout the day. There's one song, "You Are So Precious to Me," that I've sung for him since he was little, and he just lights up and smiles. Hey, I've written songs about constipation!

source : Q&A With Sugarland's Jennifer Nettles

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Early HIV Treatment a Win-Win, Researchers Report

A cost-effective way to help patients stay healthy and prevent virus transmission, study finds

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) -- Providing early antiretroviral drug treatment for recently infected HIV patients and their uninfected sexual partners is a cost-effective way to help patients stay healthy and prevent transmission of HIV, a new study finds.

The study, published Oct. 31 in the New England Journal of Medicine, looked at HIV patients in India and South Africa. Some of the patients received early antiretroviral therapy while the start of treatment was delayed for other patients. HIV is the virus that causes AIDS.

During the first five years of the study, 93 percent of those who received early antiretroviral therapy survived, compared with 83 percent of those whose treatment was delayed. Life expectancy was nearly 16 years for those in the early treatment group, compared with nearly 14 years for those in the delayed treatment group.

During the first five years, the potential costs of infections -- particularly tuberculosis -- prevented by early treatment of HIV patients in South Africa outweighed the costs of antiretroviral therapy drugs, suggesting that the early treatment strategy would reduce overall costs.

This was not the case in India, where the costs of treating HIV-related infections are less. Even so, early antiretroviral therapy in India was projected to be cost-effective according to established standards, the researchers said.

They also found that across patients' lifetimes, early antiretroviral therapy was very cost-effective in both countries. While most of the benefits of early treatment were seen in the HIV-infected patients -- fewer illnesses and deaths -- there were also added health care and economic cost savings from reducing HIV transmission, according to the study.

"By demonstrating that early HIV therapy not only has long-term clinical benefits to individuals but also provides excellent economic value in both low- and middle-income countries, this study provides a critical answer to an urgent policy question," study corresponding author Dr. Rochelle Walensky, of the Massachusetts General Hospital Division of Infectious Disease, said in a hospital news release.

"HIV-infected patients live healthier lives, their partners are protected from HIV, and the investment is superb," she added.

Walensky, a professor of Medicine at Harvard Medical School, said the findings point to a need to "redouble international efforts" to provide early antiretroviral therapy to any HIV-infected person who can benefit from it.

Her colleague, Dr. Kenneth Freedberg, director of the Medical Practice Evaluation Center at Massachusetts General, agreed.

"Some people have questioned whether providing early [antiretroviral therapy] to all who need it would be feasible in resource-limited countries," he said in the news release. "We've shown that in countries like South Africa, where it actually saves money in the short-term, the answer is 'yes.' We believe that continued international public and private partnerships can make this true in other countries as well."

Freedberg said such an investment could bring about dramatic decreases in infections and illness that could save millions of lives over the next decade.

source : Early HIV Treatment a Win-Win, Researchers Report

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New Drug May Someday Battle Obesity and Diabetes

Mouse studies found it did double duty; human trials too short to see effect, researchers report

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) -- A new diabetes drug may one day perform double duty for patients, controlling both their blood sugar levels and helping them lose weight, researchers report.

In mouse trials, doctors found the drug prompted weight loss, in addition to managing blood sugar levels.

"That [weight loss] is not what this drug was designed to do, but it's a very attractive additional benefit," said study co-author Richard DiMarchi, a research chemist at Indiana University in whose lab the drug was created.

The injectable medication is based on a single molecule that combines the properties of two hormones that send chemical signals to the pancreas, said DiMarchi.

"They signal to the pancreas that you are taking a meal," DiMarchi said. "The pancreas then responds by secreting insulin and to synthesize additional amounts of insulin for subsequent use."

People with type 2 diabetes have lower levels of these pancreas-signaling hormones, which are known as incretins, explained Dr. John Anderson, president of medicine and science at the American Diabetes Association.

"The incretin defect in type 2 diabetes is well known, and it's only within the last few years we have had agents to treat it," Anderson said.

Human and primate trials revealed that the new drug controls blood sugar with fewer side effects than other diabetes medications. Those side effects can include nausea, vomiting and stomach pain.

"In this study, the degree of gastrointestinal discomfort is much more modest than is experienced in conventional drugs," DiMarchi said. "We get beneficial glycemic control with this combination drug, and it seems to be with less adverse drug effect."

The medication combines the action of the hormones GLP-1 and GIP. Current diabetes medications of this sort target GLP-1 receptors in the body; studies involving GIP have produced mixed results.

GLP is known to suppress appetite, and DiMarchi said the weight loss observed in mice might be occurring because the second hormone, GIP, is somehow "turbo-charging" that appetite suppression.

In the mouse trials, a drug based on GLP-1 alone decreased body weight by an average 15 percent. But the new drug combining GLP-1 and GIP decreased body weight by nearly 21 percent, as well as controlling blood glucose and decreasing appetite.

A six-week human trial involving 53 patients with type 2 diabetes found that the medication effectively controlled their blood sugar levels. However, the researchers did not note any change in weight during the relatively short study period.

The higher potency of the combined molecule suggests it could be administered at lower doses than other incretin-based medications, reducing side effects and making the drug easier to take.

"Currently approved drugs are quite effective," DiMarchi said, "but they are insufficient in normalizing glucose, and they certainly don't cause much loss of body weight."

source : New Drug May Someday Battle Obesity and Diabetes

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Why Insurers Cancel Policies, And What You Can Do When It Happens

By Julie Appleby

Wed, Oct 30 2013

News that health insurers are ending the policies of what could be millions of Americans has rattled consumers and added to the debate over the health care law.

If you or a family member has been notified that your individual policy is being cancelled at year’s end, you may be stunned and upset.

House Republicans sparred with Health and Human Services Secretary Kathleen Sebelius Wednesday over the cancellations, with Sebelius saying the law generally didn’t require insurers to discontinue plans if they were in effect at the time of the law’s enactment in March 2010.

No one knows how many of the estimated 14 million people who buy their own insurance are getting such notices, but the numbers are substantial. Some insurers report discontinuing 20 percent of their individual business, while other insurers have notified up to 80 percent of policyholders that they will have to change plans.

Here is a guide to help you understand the bigger picture, including why your premiums and benefits are likely to change next year and what you should consider as you shop for a new policy.

Q. Why is this happening?

A. The so-called individual market was targeted by the health care law because it didn’t work well for many people who do not get coverage through an employer, particularly those who were older or had health problems. The latter were often rejected for coverage, charged more or had their conditions excluded from coverage.  Some policies were so skimpy they provided only the barest of coverage when someone did fall ill.

Starting Jan. 1, insurers can no longer reject people who are sick or charge them more than the healthy under the Affordable Care Act. They must also beef up policies to meet minimum standards and add benefits, such as prescription drug coverage, maternity care and mental health services.

Q. Why am I getting this notice?

A. Most likely your plan didn’t meet all the standards of the federal health law.  One type of policy being discontinued by Florida Blue, for example, did not cover hospitalizations or emergency room visits and paid a maximum of $50 toward doctor visits.  It’s possible your plan also had deductibles and other potential expenses - such as copayments for doctors and hospital care -- that exceeded the law’s annual out-of-pocket maximum of $6,350 for individuals or $12,700 for families. Insurers may have just decided to end certain types of policies, something they have always had the ability to do. Some policies that fail to meet the law’s standards can still be sold, but only if the insurer decides to continue them and they are “grandfathered,” meaning you purchased one before March 2010 and neither you nor the insurer has made any substantial change since then.  Adjusting an annual deductible, which many people do each year to keep down their premiums, is a change that could end grandfathered status.

source : Why Insurers Cancel Policies, And What You Can Do When It Happens

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Study of Twins Shows How Smoking Ages the Face

Siblings who smoked had more wrinkles, creases, droops and jowls

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) -- A study comparing the faces of identical twins confirms what many smokers fear -- the habit does prematurely age a person's skin, taking a serious toll on looks even after just five years.

Researchers from Case Western Reserve University in Ohio used the annual Twins Day Festival in Twinsburg, Ohio, to identify 79 pairs of twins in which one sibling smoked and the other didn't.

The twins who were smokers showed many more signs of skin aging, the researchers found. Their faces featured more wrinkles, creases, droops and jowls.

"Smoking harms virtually every organ in the body, including your skin," said Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids. "Whether you are doing it for vanity or your health, one of the most important health decisions of your life is not to start smoking, or to quit if you have."

The research team attended the Twins Day Festival every year between 2007 and 2010, eventually finding 79 pairs of twins to compare. The twins filled out questionnaires regarding their smoking and lifestyle, and professional photographers snapped individual pictures of them both.

A panel of three plastic surgeons then analyzed the twin's facial features, grading the amount of aging they saw in each person's face using a standardized assessment tool. The researchers used questionnaire results to control for other factors that might prematurely age skin, including sun damage, alcohol use and work stress.

Twins who smoke, when compared to their nonsmoking siblings, had worse scores for baggy eyes, baggy cheeks, smile lines and wrinkles along their upper and lower lips.

Researchers also compared the faces of twins who both smoke, but one of the pair had been smoking for at least five years longer than his or her sibling. They found more baggy eyes, baggy cheeks and lower-lip wrinkles in twins who had been smoking longer.

The judges identified the smoking twin as appearing older in photographs 57 percent of the time compared with the nonsmoking twin, and the twin who had smoked for a longer period of time was identified as older about 64 percent of the time.

The premature aging caused by smoking seemed to mainly affect the lower two-thirds of a person's face, the authors said. There were no apparent differences between smokers and nonsmokers when it came to forehead wrinkles or crow's feet, for example.

The study was published in the November issue of the journal Plastic and Reconstructive Surgery.

Smoking can affect a person's skin tone by robbing cells of needed oxygen, said Dr. Cheryl Healton, president and CEO of the anti-tobacco advocacy group Legacy.

"It's widely known that tobacco causes cardiac problems and disrupts oxygenation," Healton said. "Getting good oxygenation really affects a person's complexion."

Smoking also might cause wrinkles, folds and droops by damaging connective fibers like collagen and elastin that help maintain skin elasticity, the researchers added.

"A less taut skin envelope cannot counteract the effects of gravity," they said.

Healton said people should heed the findings as yet another reason to quit smoking immediately. As the study found, even five years can make a difference, she said.

"It's really bad to smoke, and it definitely affects your appearance," she said. "Not smoking is good for your looks."

source : Study of Twins Shows How Smoking Ages the Face

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Sebelius Says 'Hold Me Accountable' for Website 'Debacle'

By Karen Pallarito

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) -- U.S. Health and Human Services Secretary Kathleen Sebelius on Wednesday claimed responsibility for the failed rollout of HealthCare.gov and committed to fixing the website's many software and system problems.

"I am as frustrated and angry as anyone with the flawed launch of HealthCare.gov," Sebelius testified before the House of Representatives' Energy and Commerce Committee. "So let me say directly to these Americans: You deserve better, I apologize. I'm accountable to you for fixing these problems."

Sebelius, who testified under oath, appeared before members of Congress for the first time since the troubled Oct. 1 rollout of the federal health insurance marketplace that's intended to let millions of uninsured Americans purchase health-care coverage.

The secretary's much-anticipated remarks came amid a rising chorus of GOP calls in the House and Senate seeking her resignation. Sen. Lamar Alexander (R-Tenn.) on Tuesday joined at least two other Senators in calling for her to step down.

Sebelius is the second member of the Obama administration to testify this week. On Tuesday, Marilyn Tavenner, administrator of the Centers for Medicare and Medicaid, issued a public apology in testimony before the House Ways and Means Committee and discussed efforts to improve the website within a month.

On Wednesday, Sebelius admitted that "end-to-end" testing of the website had been inadequate. Now that problems are being identified and resolved, she said she expects HealthCare.gov to be functioning optimally by the end of November.

But in opening remarks, Energy and Commerce Committee Chairman Fred Upton (R-Mich) said the site was down early Wednesday morning when "we were hit with an error message."

Rep. Henry Waxman (D-Calif.), the committee's second-most senior member, compared the website glitches to early problems with the rollout of Medicare's prescription drug program, which took effect Jan. 1, 2006. He urged his fellow committee members "to stop hyperventilating."

As with the prescription drug program, "the early glitches with this program will soon be forgotten," he said.

The federal website is the entry point for millions of Americans in 36 states to enroll in health insurance plans that take effect in 2014 under the Affordable Care Act. People in 14 states and the District of Columbia may enroll through state-based health insurance exchanges, or marketplaces.

But since Day One, consumers attempting to access HealthCare.gov have experienced long wait times, timeouts and error messages, making it difficult to enroll for health-care coverage online.

In a heated exchange, Rep. Marsha Blackburn (R-Tennessee) pressed Sebelius for the names of people "responsible for this debacle."

"Hold me accountable for the debacle. I'm responsible," Sebelius said.

Along with the website foul-up, many committee members grilled the secretary on another issue: recent cancellations of individual health insurance policies.

Recalling President Barack Obama's oft-repeated promise to Americans that "if you like your health plan, you can keep it," Republican members told stories of constituents receiving cancellation notices from their insurers.

"We know that in the individual market, a number of the plans being sold are not 'grandfathered' and are not currently meeting the (health reform) law," Sebelius acknowledged.

Historically, people with individual insurance policies could be "locked out, priced out, dumped out" of their coverage. But new protections under the Affordable Care Act will prevent such abuses, she said.

source : Sebelius Says 'Hold Me Accountable' for Website 'Debacle'

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Balance Training Seems to Prevent Falls by Elderly

Researchers base findings on review of 17 studies

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

TUESDAY, Oct. 29 (HealthDay News) -- Exercise programs meant to prevent falls in seniors may also help prevent injuries caused by falls, according to a new review.

Fall-related injuries are common among seniors and a major cause of long-term pain and disability. They also increase the risk of having to go to a nursing home and have a high economic cost.

The new findings, published online Oct. 29 in the journal bmj.com, suggest that "reducing the risk of falling and improving protective responses during a fall may be an important and feasible means of preventing fractures and other serious injuries in the elderly," the study authors wrote in a journal news release.

Well-designed exercise programs can prevent falls in seniors living at home, but there is a lack of evidence on whether such programs can help prevent fall-related injuries, said French researchers Fabienne El-Khoury and colleagues.

In this review, they analyzed 17 studies that looked at whether fall-prevention exercises lowered seniors' risk of fractures and other injuries caused by falls. More than 4,000 participants were involved in all.

Tai Chi was the exercise in two of the studies, but most of them used gait, balance, strength and functional training, which involves workouts that help people do normal daily activities.

Most of the programs reduced fall-related injuries and appeared to significantly curb falls that lead to fractures, serious injuries and medical care.

Balance training was emphasized in all of the exercises that were effective in preventing falls, the researchers noted.

source : Balance Training Seems to Prevent Falls by Elderly

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Activity, Brace May Ease Arthritis Pain

By Kathleen Doheny
WebMD Health News

Reviewed by Arefa Cassoobhoy, MD, MPH

Oct. 30, 2013 (San Diego) -- Osteoarthritis can be painful, but exercise can improve the quality of life for people with OA or those at high risk for it, according to new research.

For people who have OA of the knee, a simple brace can ease pain greatly, another new study says.

Both studies were presented this week at the annual meeting of the American College of Rheumatology in San Diego.

OA, or the ''wear-and-tear'' arthritis linked with age, is the most common form of arthritis. Its symptoms include joint pain and stiffness. 

Move to Improve Quality of Life

Even a little exercise can help, says study researcher Kai Sun, MD. She is a researcher at Northwestern University in Chicago.

She compared the quality of life in three groups:

• Inactive people
• Those who did some exercise
• Those who did the recommended 150 minutes of moderate to vigorous exercise each week

"The overall quality of life is better with each increasing level of physical activity," she says.

At the study start and then 2 years later, patients answered questions about their quality of life. This included their energy levels,  social interactions, and general health.

People who exercised some said they had 10 more days of good health a year.

People who met the recommended guidelines reported 20 more days of good health a year.

Brace the Knee, Ease the Pain

For people with a form of knee osteoarthritis that affects the kneecap, wearing a knee brace may help pain, says David  Felson, MD, MPH. He is a professor of medicine and epidemiology at Boston University School of Medicine.

Knee OA is marked by progressive damage to the joint cartilage, the cushioning material at the end of long bones. The damage can lead to weakened muscles, pain, and swelling.

Patients who wore a knee brace said it reduced pain by about 40% over 6 weeks, Felson says. Based on the study, he recommends a soft Neoprene-like brace, with a hole for the knee cap.

A doctor can best diagnose knee OA, he says.

Felson reports working as a consultant for Knee Creations. Arthritis Research U.K. funded the study. 

Improving Life With OA

The findings of both studies make sense, says Milton Helfenstein Jr., MD, a professor of rheumatology at the Federal University of Sao Paulo in Brazil. 

He recommends both aerobic exercise and strength training for his patients. He tailors the recommendation to their weight and level of fitness. He suggests that someone who hasn't been exercising start with 15 minutes, three times a week, and work up.

Helfenstein also recommends knee braces for patients with the type of knee OA studied, patellofemoral OA. But he is not certain everyone would keep the brace on for the average of 7 hours that the patients in the study did.

He says the brace stabilizes the knee, reducing friction between joints. This lessens the pain.

These findings were presented at a medical conference. They should be considered preliminary, as they have not yet undergone the ''peer review'' process, in which outside experts scrutinize the data prior to publication in a medical journal.

source : Activity, Brace May Ease Arthritis Pain

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E-Cigarettes May Not Be Gateway to Smoking: Study

It found few teens go on to smoke cigarettes, use other kinds of tobacco after 'vaping'

WebMD News from HealthDay

By Brenda Goodman

HealthDay Reporter

TUESDAY, Oct. 29 (HealthDay News) -- E-cigarettes don't appear to entice teens to try smoking tobacco, a new study says.

The researchers noted that doesn't mean that e-cigarettes are risk-free, but it should reassure parents that teens who try the devices may simply be doing so for the novelty and aren't necessarily setting themselves up for a lifetime of nicotine addiction.

Last month, the U.S. Centers for Disease Control and Prevention warned that "vaping," or inhaling the nicotine vapors from e-cigarettes, might be a dangerous new fad that could set teens up for smoking.

In just one year, the number of kids in grades six through 12 who said they'd ever tried an e-cigarette more than doubled, rising from 3.3 percent to 6.8 percent. Among the 2.1 percent who said they were current e-cigarette users, more than three-quarters said they also smoked regular cigarettes.

Given that overlap, many health experts worried that e-cigarettes might be acting like a gateway drug, sucking kids more deeply into nicotine addiction, and law officials urged the U.S. Food and Drug Administration to regulate e-cigarettes as tobacco products.

The new study suggests that may not be the case.

Researchers surveyed 1,300 college students about their tobacco and nicotine use. The average age of study participants was 19.

"We asked what the first tobacco product they ever tried was and what their current tobacco use looked like," said researcher Theodore Wagener, an assistant professor of general and community pediatrics at the University of Oklahoma Health Sciences Center, in Oklahoma City.

Overall, 43 students said their first nicotine product was an e-cigarette. Of that group, only one person said they went on to smoke regular cigarettes. And the vast majority who started with e-cigarettes said they weren't currently using any nicotine or tobacco.

"It didn't seem as though it really proved to be a gateway to anything," said Wagener, who presented his findings at a meeting of the American Association for Cancer Research, in National Harbor, Md.

Study findings presented at medical conferences are considered preliminary since they haven't been carefully reviewed by outside experts for publication in a medical journal.

E-cigarettes, which use a heating element to vaporize a liquid nicotine solution, are relatively easy for teens to purchase.

While federal rules block the sale of regular cigarettes to anyone under age 18, there are currently no such rules for e-cigarettes. About half of states prohibit the sale of e-cigarettes to minors, but they can also be bought online.

The devices are advertised on TV and popular YouTube videos. They come in sweet flavors that appeal to teens like green apple, watermelon and bubble gum.

"The use of these products is increasing dramatically," while little is known about the risks, said Scott Leischow, who co-leads the cancer prevention and control program at the Mayo Clinic in Scottsdale, Ariz.

source : E-Cigarettes May Not Be Gateway to Smoking: Study

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Health Agency Chief Apologizes for Federal Website Woes

By Karen Pallarito

HealthDay Reporter

TUESDAY, Oct. 29 (HealthDay News) -- The head of the federal agency responsible for HealthCare.gov issued a public apology Tuesday for problems that have plagued the health insurance website since its Oct. 1 launch.

"I want to apologize to you that the website has not worked as well as it should," Marilyn Tavenner, administrator of the U.S. Centers for Medicare and Medicaid Services, told members of the House of Representatives' Ways and Means Committee at a hearing on the Affordable Care Act.

Tavenner told the committee that the website problems were being fixed.

"We are seeing improvements each week, and as we've said publicly, by the end of November, the experience on the site will be smooth for the vast majority of users," she said.

Last week, the Obama administration announced that a "punch list" of website fixes have been identified and were being implemented to eliminate the bugs in the system and improve the consumer shopping experience.

Tavenner's apology comes one day before the Obama administration's top health official, Health and Human Services Secretary Kathleen Sebelius, is scheduled to testify before the House Energy and Commerce Committee.

Sebelius is expected to face tough questioning from committee members about the troubled rollout of the federal marketplace, a key component of the historic and controversial Affordable Care Act that is intended to bring health coverage to millions of uninsured Americans.

The law requires most Americans to have health insurance or pay tax penalties. But in light of the HealthCare.gov website foul-up, many Republicans and some Democrats are seeking a one-year delay of the penalties.

Tavenner admitted that the website's "initial experience has not lived up to our expectations or the expectations of the American people, and it is not acceptable."

"We are committed to improving the performance and have already made progress," she said, citing efforts to debug the site, add capacity and improve the consumer shopping experience.

Rep. Dave Camp (R-Mich.), chairman of the committee, repeatedly asked Tavenner for the number of people who have actually enrolled in health plans through the federal and state marketplaces. HealthCare.gov handles insurance registration for 36 states; the remaining 14 states and the District of Columbia operate their own sites.

"We will not have those numbers until mid-November," Tavenner said, noting that the initial number is expected to be small.

Camp expressed concern about preventing a spike in premiums if not enough young adults enroll in coverage. Tavenner said health-plan rates for 2014 are "very competitive."

The successful enrollment of younger, healthier adults is considered vital to the success of the Affordable Care Act -- sometimes called Obamacare -- because their premiums are expected to help offset the cost of care required by older, sicker Americans.

source : Health Agency Chief Apologizes for Federal Website Woes

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Tips for Parenting College Students

WebMD Feature

Reviewed by Hansa D. Bhargava, MD

When children head off to college, they start to become more independent, but they still need your support. 

“It’s a big shift in your relationship with your child. Often, parents are not prepared for the distance and independence young adults need,” says Annette Reiter, a licensed marriage and family therapist in St. Petersburg, FL.

You may wonder if your child is staying healthy and keeping up with schoolwork. But you also want to give them enough room to grow and to learn independently.

These five tips can help make the transition smoother for you and your child.

Show Confidence in Them

Some parents want to call or text their kids every day to talk about their grades and homework, says Reiter. It’s better, though, to send the message that you trust your child by letting them take responsibility for their schoolwork.

“Unless they are really struggling, leave their grades up to them,” Reiter says. 

When your child tells you about a problem they’re having -- for example, a conflict with a roommate -- don’t rush to solve it for them. Instead, listen and coach them on how to solve it. 

“It’s time for them to solve most of the minor problems in their lives,” Reiter explains. “If you’re always running to their rescue and don’t let them experience stress, then they won’t have ways to manage stress as an adult.”

Make a Plan for Keeping in Touch

Talk with your child about how often you’ll communicate when they’re at college. Find ways to keep in touch that work for you both.  

“Be flexible about using the technology your kid prefers, such as video chatting, texting, or instant messaging, says Cora Collette Breuner, MD, MPH, professor of adolescent medicine at the University of Washington.

“If kids know you’re trying to meet them at their level, they will open up more,” she notes.

Kids also appreciate it when you send them fun messages some of the time, says Laura Kastner, PhD, a clinical psychologist at the University of Washington.

“Instead of just texting to ask how they did on their test, send them a funny picture of the family dog going through the garbage,” she says.

Pay Attention to Signs of Trouble

If your child suddenly has a big change in personality -- for instance, if a very social kid starts spending a lot of time alone -- that could be something to talk with them about. Are they doing OK? How are their grades? Are they partying a lot, sleeping too much, or showing any other signs that concern you?

If so, encourage your child to go to the student counseling office. If your child is living in a dorm with an RA (resident advisor), you could get in touch with their RA for their feedback. Also, consider visiting the campus to check on your child in person. 

source : Tips for Parenting College Students

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Single Dads: How to Balance Work and Kids

By Matt McMillen
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

Nearly 2 million fathers in the United States are raising their kids alone. Most have been married, but close to a third never tied the knot. A few are widowers. No matter how men find themselves in single-parent mode, experts say it's not a good idea to let pride get in the way of being the best parent possible.

"Men often have an 'I can do it all myself' attitude," says psychologist Barry Ginsberg, PhD. That thinking can make things tough, especially when you have to balance kids and career. Ginsberg's advice: Learn to ask for help.

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"It's very important to develop a resource system," he says. "If your child gets sick while you're at work, it is nice to know there's someone who can pick him or her up."

Ginsberg tells single dads he counsels to connect with neighbors, friends, and other parents -- people they can rely on when they need a hand. But he acknowledges this is not always easy for guys.

"It's a shame issue. They're embarrassed if they have to say, 'I could use some help.' They feel they're not good enough as men, or they'll lose respect if they can't handle it on their own."

Where Single Dads Can Find Support

One place to start is your child's school. "It's all about networking with other parents," says Ginsberg. "Get to know people."

Another is your job. Talk to your boss about a more flexible schedule. For example, ask if you can work from home on certain days and discuss ways to limit work-related travel. At the very least, your employer should be aware of your situation. That way, if a problem arises, you don't have to answer a lot of questions before you leave to attend to your child.

Q&A

Q: "How will I know the time's right to introduce my new girlfriend to my kids?"

Daniel Ostrov, 44 advertising executive, Portland, Ore.

A: "Two things should guide you: The welfare of your children and the stability of your new relationship. Children may take a while to adjust to a situation. Introducing another woman too soon could upset them. In the case of divorce, for example, the kids might blame the new girlfriend for the breakup of your marriage, even if she had no involvement. You should also ask yourself, 'Does this relationship have legs?' If you introduce her to the kids and then break up, it may echothe trauma."

Ronald Levant, EdD, professor of psychology, The University of Akron

Expert Tip

"If you've just divorced, keep things as simple and stable as possible. Joint custody should follow a regular routine, and try to keep your kids' rooms set up the way they like them." -- Ronald Levant, EdD

Find more articles, browse back issues, and read the current issue of "WebMD Magazine." 

source : Single Dads: How to Balance Work and Kids

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You Asked! Expert A's to Beauty Q's: Hair Removal

Struggling to get unwanted hair off your face, legs, and other spots? Our experts share their favorite products and favorite techniques.

Debra Jaliman, MD, dermatologist and author of Skin Rules: Trade Secrets From a Top New York Dermatologist:

Blade Runner

Schick Intuition Pure Nourishment Razor ($9.99) -- "I like razors with multiple blades and conditioning strips, like this one infused with coconut milk and almond oil. For the closest shave, shave against the growth. If you have sensitive skin, shave in the direction of the hair growth."

Smooth Move

Remington Smooth & Silky Epilator ($59.99) -- "For the best epilation [an epilator is a hand-held electrical device that grasps and pulls out unwanted hairs], it is essential to exfoliate. Then epilate against the grain, and if you’re sensitive to pain, take an over-the-counter pain reliever a half hour before."

Foam Run

Satin Care Dry Skin Shave Gel ($3.49) -- "Don’t shave on dry skin, as you will get cuts, nicks, and micro-abrasions that can lead to bumps. To prevent bumps, use a hydrating shaving gel like this -- not soap. Wait a few minutes in the shower after applying the gel and let it penetrate."

Stubble Trouble

Veet Fast Acting Gel Cream Hair Remover ($9) -- "Depilatories [chemical-based creams that break down keratin for easy hair removal] have come a long way. They have much nicer scents, and they leave your skin feeling smooth and soft. Do a patch test to make certain you are not allergic."

Jennifer MacGregor, MD,assistant clinical professor of dermatology, Columbia University Medical Center:

Wax Relief

Eucerin Redness Relief Daily Perfecting Lotion ($14.99) -- "Waxing pulls at the skin and removes the outer layer of skin, which can be especially irritating to sensitive skin. If you notice irritation or redness after waxing, apply a calming cream like this to avoid bumps or infections."

Fuzz Fighter

Olay Smooth Finish Facial Hair Removal Duo Kit ($23.99) -- "Even with great facial depilatories like this one, which comes with a barrier balm, I recommend trying two test areas. First, test on the arm and then on the face in an area, like the jawline, that is less noticeable than the upper lip."

Finer Point

Bliss ‘Fuzz’ Off ($24) -- "I love the convenient applicator on this facial hair removal cream because it allows for easy application and removal. Plus, it’s infused with vitamin E and soothing willowherb, so post-treatment itchiness is almost nonexistent."

Main Tweeze

Revlon Designer Collection Slanted Tweezers ($6) -- "Slanted tweezers are ideal for grabbing and removing individual hairs, but don’t overdo it. One of the biggest no-nos is using tweezers to pick at ingrown hairs. This can leave brown spots and even permanent scarring."

The opinions expressed in this section are of the experts and are not the opinions of WebMD. WebMD does not endorse any specific product, service, or treatment.

Find more articles, browse back issues, and read the current issue of "WebMD Magazine."

source : You Asked! Expert A's to Beauty Q's: Hair Removal

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Hiking Benefits Heart, Mind, and Body

By Kara Mayer Robinson
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

Hiking outdoors comes with a bounty of perks: nice views, fresh air, and the sounds and smells of nature. Hiking is a powerful cardio workout that boasts all the health benefits of walking, including less risk of heart disease, diabetes, breast cancer, and colon cancer, as well as better blood pressure and blood sugar levels. Because hiking is a weight-bearing exercise -- you’re moving against gravity while staying upright -- it boosts bone density and helps combat osteoporosis (thinning bones).

Hiking is also good for muscle strength. The activity targets your glutes, quadriceps, hamstrings, hip flexors, and lower leg muscles. It works your shoulders, strengthens your core, and improves balance. And hiking can help you control your weight.

It's also a powerful mood booster. "Research shows that hiking has a positive impact on combating the symptoms of stress and anxiety," says Gregory A. Miller, PhD, president of the American Hiking Society. "Being in nature is ingrained in our DNA, and we sometimes forget that."

Safe Hiking Tips

Start slow. A short, local hike is best for beginners. Gradually work up to trails with hills or uneven terrain.

Bring a buddy. It’s best not to hike alone at first, especially on unfamiliar or remote trails. A partner or group can help you navigate and assist if you get hurt. As your skill level improves, you’ll feel more comfortable going solo.

Know before you go. Familiarize yourself with the trail map. Check the weather and dress and pack accordingly. If storms are a possibility, rethink your plan.

Use common sense. Follow marked paths and trails. Avoid contact with questionable plants and animals.

Get into a groove. On the days you can’t make it to the trails, power-walk on a hilly terrain while carrying various degrees of weight in a backpack -- it will keep your hiking skills and fitness level on track.

Step Up Your Hiking Workout

You can get more out of your hiking with these fitness-boosting strategies.

Use poles. Digging into the ground and propelling yourself forward pushes your upper body muscles to work harder and gives you a stronger cardio workout.

Head for the hills. Even a small hill will intensify your heart rate and burn extra calories. The American Hiking Society’s Miller says a 5% to 10% incline equals a 30% to 40% increase in calorie burn.

Bump it up. Uneven terrain can work muscles while improving balance and stability.

Weigh yourself down. Stock your daypack with extra weight. (Water’s a good option.) According to Miller, a 10- to 15-pound daypack will boost your calorie burn by 10% to 15% while strengthening your lower back muscles.

Find more articles, browse back issues, and read the current issue of "WebMD Magazine." 

source : Hiking Benefits Heart, Mind, and Body

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How to Get a Celebrity Smile

A dentist to the stars reveals the secrets she shares with her clients.

By Stephanie Watson
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

Watch any red-carpet awards show, and there's a good chance some of the brilliantly white smiles beaming at the camera were custom-crafted by Los Angeles dentist Grace Sun, DDS.

For 30 years, the renowned cosmetic dentist has created camera-ready grins for celebs such as Ellen Page, Jean-Claude Van Damme, Sheryl Crow, Jennifer Love Hewitt, and Samuel L. Jackson.

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Sun's practice is about more than aesthetics, though. She also emphasizes the benefits of good oral hygiene. Even if you're not planning to attend a movie premiere anytime soon, you can benefit from the secrets she shares with her A-list clientele. Here's what she has to say:

Don't rely solely on your dentist.

"Some people give the responsibility [for their teeth] to their health professional -- they think all they need to do is go to the dentist for a cleaning twice a year. You should be responsible for your own oral health with daily home care."

Watch your diet.

"Diet is important. Certain foods are damaging to the teeth. The more acidic they are, the more chance there is of erosion, and that can be a problem. Refined foods adhere more easily to the surface of the teeth, which is why whole wheat bread is better for your teeth than white bread."

Think before you drink.

"Alcohol turns into sugar. People drink without thinking much of it, but alcohol will create erosion and damage the structure of the teeth."

Keep a fluoride stash.

"Have fluoride at home to re-mineralize the teeth, which will make them stronger and more resistant to breakdown. Ask what type of fluoride your health professional recommends. You can choose from a number of different fluoride gels or rinses. There are also alternatives, such as calcium phosphate."

Don't use your teeth as a tool.

"We see dental accidents. People use their front teeth as a tool -- for example, to open plastic bags. Your teeth should be working as a group. When they work as a group, the force distribution is better, and each one takes less stress. When you use one particular tooth to focus all the force, the chance of breaking it is higher. Teeth are not diamonds. You've got to be careful with them.

Ask your dentist about the basics.

"Some people I see brush only once a day. No one ever told them how many times they need to brush their teeth. We still need to review the proper home care program with our patients and not assume that they already know."

Grace Sun's Own Oral Health Habits

What's your dental care regimen?

"I treat this as a fun routine. I have a very soft microfilament toothbrush that I use for the gums, and I have a regular brush that's for my teeth, and I have a rotary electric toothbrush. I go through my brushing and then use my hydro floss oral irrigator. At the same time I do squats and relevés. I have music on. To me, it's time to take care of myself."

How do you care for your teeth while on the go?

"I'm always able to brush. I have my hygiene bag with me. On the airplane, I go to the bathroom to do it. If I travel in the car, I have water so I can rinse."

How do you come up with the advice you give your patients?

"Whatever I tell them to do I try out myself. I try different toothpastes, different bleaching products. I go to the market and look at what's out there, like over-the-counter night guards and other types of dental products."

Find more articles, browse back issues, and read the current issue of "WebMD Magazine." 

source : How to Get a Celebrity Smile

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Do You Really Need Eye Cream?

You've heard the promises: Eye creams reduce or even erase the signs of aging: fine lines, wrinkles, and dark circles. But aren't eye creams just more-expensive moisturizers in a smaller package?

Not necessarily, says dermatologist Patricia Farris, MD, a clinical associate professor at Tulane University School of Medicine. "Eye creams are formulated specifically for the delicate skin around the eye, so they tend to be thicker. They contain more oil than a regular facial lotion, and they have a lot of active ingredients aimed at the problems we see around the eyes," Farris explains.

The skin around the eyes is more fragile, more prone to dryness, and quicker to show age and fatigue. Squinting and constant movement of the eyes also hasten the appearance of lines and wrinkles, and fluids collect under the eyes and cause puffiness and dark circles. Eye creams can address some of these issues.

Fine lines and wrinkles come from both sun damage and your skin making less collagen as you age. Collagen helps maintain skin's elasticity. Vitamin C, peptides, and retinol have boosted collagen production, studies of skin creams show. Ceramide and hyaluronic acid also help; these are moisturizers that help prevent water loss in the skin and improve elasticity.

"Retinol is one of my personal favorites," Farris says. But it can be harsh on some skin. RoC Retinol Correxion Sensitive Eye Cream ($22.99) contains a gentle dose of retinol along with hyaluronic acid.

Dark circles under the eyes come from genes, sun damage, age, and blood build-up. Sodium ascorbate, or vitamin C, can thicken the skin and help conceal dark circles after about 6 months. Niacinamide, or vitamin B3, and kojic acid can lighten dark circles.

Farris likes Olay Regenerist Eye Regenerating Cream Plus Touch of Concealer ($21.99), which contains vitamin B3 to lighten dark circles and peptides to boost collagen.

Puffiness is a buildup of fluid and blood under the eyes. Some studies show that caffeine can help circulation, which could reduce puffiness. Other studies show that cold temperatures are just as effective to treat puffiness. That's why some people refrigerate their eye creams.

Find more articles, browse back issues, and read the current issue of "WebMD Magazine." 

source : Do You Really Need Eye Cream?

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The Trampoline Workout

Jump at this chance to blast calories and have a little fun!

By Jodi Helmer
WebMD Magazine - Feature

Reviewed by Michael W. Smith, MD

Jumping on a mini trampoline, also called rebounding, is a low-impact cardio workout that improves muscle tone and balance while torching 160 calories per 30 minutes of bouncing, fitness experts say. Basheerah Ahmad, founder of the fitness consulting firm 360 Transformation, encourages celebrity clients like Carrie Underwood, Jordin Sparks, and Vivica A. Fox to use a mini trampoline in their exercise routines. "You get an amazing workout and it’s so much fun," she says.

Purchase a mini trampoline from a fitness equipment retailer, and fit these moves into your fitness regimen at least three times per week. For best results, repeat the sequence of three moves at least three times.

Basic Trampoline Bounce

Ahmad says the basic bounce "seems simple but it burns a lot of calories." It also tones the quads, glutes, and calf muscles.

1. Stand on the mini trampoline with your feet about 6 inches apart. 

2. Bend your arms, keeping your elbows at your sides.

3. With a slight bend in your knees, lightly bounce up and down. Your feet should come about 6 inches off the trampoline.

4. Repeat 30 times.

Trampoline Prances

"This move will get your heart rate up and give you a great workout," Ahmad says.

1. Stand on the mini trampoline with your feet 6 inches apart.

2. With your hands on your hips and knees slightly bent, bounce on the balls of your feet and alternate raising your right and left knees to hip level (mimicking the "knees up" running-in-place exercise from gym class).

3. Repeat 60 times (30 lifts per leg).

Trampoline Squats

"You have to engage your core muscles to perform this move on an unstable surface," Ahmad explains.

1. Stand on the mini trampoline with your feet together and arms at your sides.

2. Jump up, spread your feet just wider than shoulder width, and land in a squat position with your knees bent and thighs parallel to the ground -- as if you were going to sit down in a chair. Your arms should be straight out in front of you.

3. Lightly bounce back to your starting position and repeat 20 times.

Find more articles, browse back issues, and read the current issue of "WebMD Magazine."

source : The Trampoline Workout

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Reports of U.S. Cases of Flesh-Eating Drug Questioned

DEA says none of the drug samples tested so far has been confirmed as home-cooked krokodil

WebMD News from HealthDay

By Brenda Goodman

HealthDay Reporter

TUESDAY, Oct. 29 (HealthDay News) -- Has the new "flesh-eating" drug of abuse known as krokodil reached the United States?

The drug is dubbed krokodil, the Russian word for crocodile, because it originated in that country and can cause horrific skin lesions resembling reptilian skin. Recent media reports have suggested that the home-cooked drug, which carries the scientific name desomorphine, has now reached addicts in the United States.

But drug enforcement agents say they aren't sure, and they continue to collect and test drug samples from areas where doctors have seen patients with suspicious skin lesions.

So far, a sample sent from Chicago, where doctors report that they've treated five patients who may have used the drug, including two sisters who have been widely photographed and interviewed about their experience, proved to be heroin.

"We're checking this out. We're very, very concerned about it. We would hate to see something like this catch on here," said Barbara Carreno, a press officer at the U.S. Drug Enforcement Administration.

Krokodil has been a scourge in Russia for the last decade, where it's cooked at home as an alternative to heroin.

Carreno said the drug flourished in rural areas in Russia, where addicts didn't have access to purer narcotics. However, heroin is relatively easily accessible and cheap in the United States, so there would seem to be less of an incentive to mix up the more caustic concoction here, she said.

Krokodil is made by combining codeine pills with common ingredients such as gasoline, red phosphorus from match tips, alcohol, and iodine. Experts say the result is a highly addictive drug that's also highly corrosive to the body.

A high from a drug like morphine lasts four to six hours. But the high from krokodil lasts only about 90 minutes, added Stephen Dewey, director of the Laboratory for Behavioral and Molecular Neuroimaging at the Feinstein Institute for Medical Research in Manhasset, N.Y. Dewey studies how addictive drugs affect the brain. Typically, he said, "the shorter the high, the more addictive the drug."

Users who inject krokodil quickly suffer the consequences.

"It kills the blood supply to the skin, so the skin starts to decompose and come off," Dewey explained.

Photos of victims have been horrific. They show users with open sores that sink deep into the flesh, skin on legs and arms blackened and rotting, or fingertips eaten away as if by acid. Krokodil gets its street name from its tendency to turn human skin green and scaly.

Users who can't break the habit face amputations and death. Doctors in Oklahoma say a local man died from using krokodil last year. They say autopsy detected traces of desomorphine and other drugs in his system.

Through September, six cases of suspected krokodil abuse had been reported to U.S. poison control centers in 2013, said Brett Schuster, a spokesman for the American Association of Poison Control Centers in Alexandria, Va. Recent media reports have suggested there may be even more.

So far, however, none of the cases has been confirmed.

"We don't want to question anything that doctors are finding. I can only say that we, so far, have not gotten a sample that has turned out to be krokodil," Carreno said.

source : Reports of U.S. Cases of Flesh-Eating Drug Questioned

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Mondays Might Be Your Best Day to Quit Smoking

Smokers most likely to seek online advice about quitting on the first day of the workweek, study finds

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- Smokers are most likely to think about kicking their habit on Mondays, according to a new study, and this finding may help boost the effectiveness of anti-smoking campaigns.

For the study, the investigators monitored online searches about quitting smoking that were conducted in English, French, Chinese, Portuguese, Russian and Spanish worldwide between 2008 and 2012.

The results showed that people searched about quitting smoking more often early in the week, with the number of searches highest on Mondays. The number of searches on Mondays was 25 percent higher than the combined average number of searches on Tuesday through Sunday.

This pattern was consistent across all six languages, according to the study, which was published Oct. 28 in the journal JAMA Internal Medicine.

On Mondays, searches in English for information about quitting smoking were 11 percent higher than on Wednesdays, 67 percent higher than on Fridays and 145 percent higher than on Saturdays, the results showed.

These findings may lead to changes in the way health officials and providers design anti-smoking programs, said study lead author John Ayers, of San Diego State University.

"Popular belief has been that the decision to quit smoking is unpredictable or even chaotic," Ayers said in a university news release. "By taking a bird's-eye view of Google searches, however, we find anything but chaos. Instead, Google search data reveals interest in quitting is part of a larger collective pattern of behavior dependent on the day of the week."

Study co-author Joanna Cohen, director of the Johns Hopkins Institute for Global Tobacco Control, suggested that "campaigns for people to quit may benefit from shifting to weekly cues. We know it takes smokers many quit attempts before they succeed, so prompting them to try again on Mondays may be an effective and easy-to-implement campaign."

Further research is needed to learn more about the reasons for these findings and how they could help boost quit rates, Ayers said, but the immediate message for smokers is straightforward: "If you're a smoker, just remember: Quit this Monday. Everyone else is doing it."

source : Mondays Might Be Your Best Day to Quit Smoking

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Lyrica May Ease Pain for Depressed Fibromyalgia Patients

Study finds drug safe, effective in combination with antidepressants

HealthDay – Not on Site

By Kathleen Doheny

HealthDay Reporter

MONDAY, Oct. 28 (HealthDay News) -- Fibromyalgia and depression often go hand in hand, and a new study finds that the drug Lyrica helps ease pain in patients being treated for both conditions.

Lyrica (pregabalin) is approved in the United States to treat fibromyalgia and nerve pain from diabetes and herpes, but little was known about its safety and effectiveness when also taken with antidepressants, the researchers explained.

"For those people with fibromyalgia who also have depression, which is very common, and who take an antidepressant but still have pain, taking [Lyrica] can reduce the severity of the pain while they continue on their antidepressant," said study author Dr. Lesley Arnold, professor of psychiatry and behavioral neuroscience at the University of Cincinnati College of Medicine.

"And it appears to be safe and tolerable for most people," Arnold added.

Arnold is scheduled to present the findings this week at the American College of Rheumatology annual meeting in San Diego. She is a consultant for Pfizer, the maker of Lyrica, and other pharmaceutical companies, including Takeda, Eli Lilly, AstraZeneca and others.

Fibromyalgia is a long-term syndrome that involves pain at different points throughout the body and tenderness in the joints, muscles, tendons and other soft tissues. The syndrome has been linked to fatigue, sleep problems, anxiety and depression, but its cause is unknown. Women aged 20 to 50 are most often affected.

The new study was done because the original research on Lyrica for fibromyalgia indications excluded people taking antidepressants, Arnold said. About 50 percent to 70 percent of those with fibromyalgia report a lifetime history of depression, and about one in four has taken antidepressants, Arnold said said.

For the new study, Arnold's team evaluated 197 patients, mostly women, with diagnosed fibromyalgia. Their average pain level was at least four on a scale of zero to 10, with 10 being the worst. All also had clinical depression and were taking antidepressants. Their average age was 50.

The researchers randomly assigned the patients to two six-week treatments, with a two-week break in between. Patients either got Lyrica or placebo the first six weeks, then received the other treatment for the next six-week period. They didn't know which treatment they were getting.

Lyrica was started at a dose of 150 milligrams (mg) a day and increased to 300 mg to 450 mg, based on response.

At the start, the average pain score was 6.7 of 10. After taking Lyrica, the pain score dropped to 4.84 and after taking the placebo it fell to 5.45. The drug worked better than placebo. "It was a noticeable improvement in pain," Arnold said.

Side effects with the drug included dizziness and drowsiness, Arnold said. Four serious adverse effects occurred but were unrelated to the drug, she said.

source : Lyrica May Ease Pain for Depressed Fibromyalgia Patients

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Child Shyness: Help Your Shy Kid

Work with your child’s natural shyness to improve coping skills.

By Shahreen Abedin
WebMD Feature

Reviewed by Hansa D. Bhargava, MD

Every child has bashful moments. Some kids, though, are shy.

Can you simply let your child be shy, or do you need to "bring them out?"

“You can do both,” says Christopher Kearney, PhD, a professor of psychology at the University of Nevada, Las Vegas.  

A shy child may not become a social butterfly, Kearney says. “But you can still help them learn how to function in social settings and build relationships.”

How shy is too shy?

In general, there’s nothing wrong with being shy. Shy kids are often better listeners and get in less trouble at school.

Being bashful becomes a problem when it gets in the way of doing what’s normally expected, or when it’s making your child unhappy. You may want to get professional advice if your child:

• Doesn’t want to go to school
• Has trouble making friends
• Frets about going to birthday parties or sports practice
• Has anxiety about being shy

What causes shyness?

Shyness is pretty common. It’s estimated that between 20% to 48% of people have shy personalities.

Most shy kids are simply born that way, although negative experiences can also play a role.  Did your child’s shyness come on suddenly? If so, an event might have triggered it, and they may need help getting past it.

Embracing the shy personality

Some traits are often seen in shy children.  

“Once you recognize these natural behaviors, you can work with them instead of against them,” says Bernardo Carducci, PhD, director of the Shyness Research Institute at Indiana University Southeast.

Shy kids are typically self-reliant, thoughtful, and empathetic, but often don’t like trying new things. They are often slow to warm up, taking longer to adjust to a new situation. They may want to be social, but avoid approaching others because they’re afraid or don’t know how.

It’s important that they approach situations at their pace, not your own, Carducci says.

Tips for helping a shy child

Here are some tactics to help your shy child in social situations:

Provide an entry strategy. Help your child approach a group of peers and listen, allowing everyone some time to get used to each other. Teach them to find a break in the chatting and join in. Offer them talking points beforehand, such as, “I like boats, too.”

Build confidence. Remind them of a time when they were in new situations and got through it. When going to a birthday party, for example, bring up another party you went to and how much fun they had with the other children.

“Help them through challenges that are self-reinforcing, so they want to do them again,” Kearney says.

Work on social skills. Give your child chances to practice their social skills whenever you can. In the store, encourage them to pay the cashier. At dinner, have them order their own meal. Invite a friend over to play so they can get more practice being with peers.

Offer feedback. Praise or reward your little one for small steps, like saying “hi” or waving. If they freeze up in front of someone, talk about it. Discuss things they can try next time.

Express empathy. Tell your child that you can see they're feeling shy, and that you feel that way too sometimes. Share stories about times when you overcame your own shyness.

Model outgoing behavior. When you show your child how to greet people, converse, and be friendly, they get more comfortable doing the same.

Above all, show love and acceptance. Let them know it’s OK to be shy. 

source : Child Shyness: Help Your Shy Kid

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