Mourning Death of Loved One Raises Your Risk of Dying

The grieving that follows a loved one's death can increase your risk of death, from suicide as well as other causes, a new review shows.

The most vulnerable period was the first 30 days following the loss.

More research needs to be done on targeting high-risk individuals and on what interventions might be helpful, according to the article in the Dec. 8 issue of The Lancet.

"There is a strong need for more evaluation of the efficacy of psychotherapeutic intervention programs for bereaved people, to better establish: (1) what type of help is [most] effective; (2) who precisely benefits from it; and (3) under what circumstances positive results are most likely to occur," said study author Margaret Stroebe, special chair of the Research Institute for Psychology and Health at Utrecht University in the Netherlands, in association with the Dutch Association for Grief Counseling. "Bereavement intervention is not indicated for all bereaved persons, just on the grounds that they have suffered the loss of a loved person... We need to increase understanding and channel resources to those who do need and are likely to benefit from professional help."

Even in the 21st century, grief carries with it a stigma that is hard to erase.

"So often in our society, grief is still viewed as something abnormal. You have to go back to work within two days, if you're lucky, five days," said Rebekah Lancto, bereavement coordinator at Metropolitan Jewish Hospice and Metropolitan Jewish Palliative Care, in New York City. "It doesn't go away six months later. In fact, that may be when grief really hits you, but life goes on, and people ask you why aren't you happy."

According to this article, death of a spouse is highly stressful and ranks as the life event needing the most "readjustment."

Others point to the difficulty of losing a spouse, especially during the first year.

"You may frequently see spouses engaging in leisure activities that they previously engaged in such as horseback riding or car racing or skiing that they might do now in a more dangerous way," said Rhoda Goldstein, a bereavement care coordinator for the Lippincott Family Hospice at Fox Chase Cancer Center in Philadelphia. "I frequently hear spouses say immediately after a death, 'My life has no meaning any more.' Many people have passive suicidal ideation, not that they intend to do anything deliberate to act on it, but they wish they wouldn't wake up in the morning."

According to Goldstein, some spouses may drink more heavily or use more prescription medications. And some spouses may have neglected their own health while taking care of an ailing husband or wife, leading to their own death.

The authors of the Lancet paper went through the available literature on grief and bereavement, focusing on papers published after 1997. Here are their main points:

* Most of the studies report gender differences in death rates after bereavement, with widowers (men) having a higher risk of dying after a loss than widows (women).
* The risk of dying appears to be higher for younger people who have lost a spouse than for their older counterparts.
* The risk of dying for widowed people is highest in the early months after the loss.
* The risk of death from suicide is also greater, with one study finding a 66-fold increased risk in the first week of bereavement for widowers and 9.6-fold for widows.
* Widows and widowers are more likely to have physical health problems, especially soon after the loss. Complaints include headaches, dizziness, indigestion and chest pain, and they result in higher rates of disability, drug use and hospitalizations.
* Research is starting to reveal biological links between bereavement and these physical ailments. For instance, bereavement can affect the immune system.
* Bereavement is also associated with different psychological symptoms and illnesses, including depression, anxiety, insomnia and social dysfunction.
* In extreme cases, losing a loved one can result in clinical depression or even post-traumatic stress disorder.
* Bereavement can also involve memory problems, loss of appetite and difficulty with concentration.
* Responses to a loss can range from mild and relatively short-term to more extreme and long-lasting, persisting for months or years.

In general, however, the authors stated, grief is a normal, natural process and "professional psychological intervention is generally neither justified nor effective for uncomplicated forms of grief."

"We try to educate people before they go through a death that this is healthy, normal response and being able to talk about it is a healthy, normal thing to do," Lancto said.

Health Tip: Best Toys for Baby

Choosing toys for young babies may seem easy, but it's important to choose toys that are appropriate for their age, and that don't pose any health risks.

The Virginia Cooperative Extension offers these guidelines on choosing toys for babies up to 1 year old:

* Look for toys that teach baby about sights, sounds, and touch.
* Choose sturdy, unbreakable rattles that appeal to several of baby's senses.
* Choose brightly colored, sturdy toys -- especially those that make noise.
* Choose toys that are safe for baby to put in her mouth and chew on.
* Avoid toys with small parts that can be swallowed -- such as buttons or eyes -- or toys with cords.

Weight Gain After Breast Cancer Deadly

Weight gain after a diagnosis of invasive breast cancer can be deadly. For every 11 pounds gained, the risk of dying from breast cancer increases by 14%, according to a new study.

"If women gained more than 22 pounds, they were 83% more likely to die of breast cancer than those who gained or lost less than 5 pounds," says Hazel B. Nichols, a doctoral student in epidemiology at Johns Hopkins Bloomberg School of Public Health in Baltimore.

She led the study, presented at the American Association for Cancer Research's Sixth Annual International Conference on Frontiers in Cancer Prevention Research in Philadelphia.

At the same meeting, other researchers reported that women with breast cancer who had high insulin levels, which tend to occur in heavier women, are also at an increased risk of death.

Weight Gain-Death Risk Study

In the first study, Nichols and her colleagues evaluated nearly 4,000 women who had been diagnosed with invasive breast cancer in the years 1988 to 2001.

They asked the women to report their weight, weight gain, physical activity, diet, medication history, and quality of life, following them up for more than six years.

During the follow-up, 121 women died of breast cancer and 421 died from all causes, including breast cancer.

When the researchers looked at weight status and death, the risk of breast cancer death was more than twice as high among those women who were obese after the diagnosis (who may or may not have been obese before) compared with those who were normal weight during the follow-up, Nichols found.

Obesity is defined as having a body mass index or BMI of 30 or above. A 5-foot-4 woman who weighs 175 has a BMI of 30.

"We do see a trend, in general, that there is increased risk of breast cancer mortality with increasing body mass index," Nichols tells WebMD.

Being overweight but not obese was not as risky, Nichols says. Overweight women with a BMI of 25 to 29.9, she found, were 1.3 times more likely to die from their breast cancer, an increased risk that could have been due to chance in the study.

The study did have an important limitation, Nichols tells WebMD. "We did not have extensive information on other medical conditions in later age," she says. "The extremes in risk may be related to other medical conditions that affect your risk of dying."

Insulin-Breast Cancer Death Link

In a second study, women with invasive breast cancer and high blood levels of C-peptide, a marker of insulin secretion, were more likely to die than women with lower C-peptide levels, according to Melinda Irwin, PhD, MPH, an assistant professor at the Yale University School of Public Health in New Haven, Conn.

"Women who are heavier tend to have higher C-peptide or higher insulin levels," she tells WebMD.

Her team followed 689 women enrolled in a National Cancer Institute initiative study known as the HEAL (Health, Eating, Activity and Lifestyle) study. All had breast cancer, but not type 2 diabetes. They were all postmenopausal, either naturally or due to chemotherapy.

Irwin's team monitored health status periodically, from six months after the diagnosis until 2004 or until the patient's death, taking blood samples to measure their C-peptide levels.

The younger the women were, the more dramatic the risk of death linked with high C-peptide, she says. Women with high C-peptide levels who were ages 40 to 55 when they provided the blood samples had a nearly five times increased risk of breast cancer death compared with the same ages of women who had lower C-peptide levels.

Perspective on Weight Gain and Breast Cancer

The new findings echo previous research that has found a link not only between excess weight and death in breast cancer patients but also excess weight and breast cancer recurrence.

Excess weight can also increase risk of getting breast cancer, other research has found, at least for postmenopausal women. "In the postmenopausal period, adipose tissue is the primary source of estrogen," Nichols says. "So the greater BMI in postmenopausal women may increase exposure to circulating estrogen [thus "feeding" the cancer]."

The message is clear, Irwin says. Paying attention to diet and exercise and trying to maintain a healthy weight is crucial.

Cancer-Suppressing Gene Tied to Female Fertility

A gene long linked to suppressing the growth of cancer may also play a vital role in human reproduction, researchers report.

In experiments with mice, researchers found that females lacking the p53 gene had fewer embryos implanted in the uterus, less chance of becoming pregnant, and when they did conceive, they had fewer offspring. A lack of p53 did not affect the fertility of male mice, however.

"This is an amazing new function for a gene that everybody thought they knew what it did," said lead researcher Arnold J. Levine, a professor at the Institute for Advanced Study, in Princeton, N.J. "This is a gene that is not only watching over us so that we cannot get cancer, but it watches over our genome so that we can develop normally," he added.

The report appears in the Nov. 29 issue of Nature.

The p53 gene responds to a variety of stresses, such as radiation damage, in ways that allow it to protect cells against cancer, Levine explained. However, he added, "We found, quite by surprise, the normal function of p53 in the uterus of mice."

In order for embryos to implant in the uterus, a cytokine called LIF (leukemia inhibitory factor) is essential, and "p53 turns on the gene that makes LIF," Levine explained. "It's estrogen plus p53 making LIF that allows implantation."

In mice without the p53 gene, males are fine, but females only infrequently implant eggs and "the litter sizes go way down," Levine said. However, when these mice were given an injection of LIF, they reproduced normally.

Whether this finding has implications for humans isn't clear, Levine said. "We do know that humans require LIF in the uterus, but whether p53 has the same function in humans is something we are working on," he said.

Levine believes that p53 could play a part in human reproduction and infertility, but "there must be other factors as well," he said.

Defects in p53 are extremely rare in humans. "There are about 250 families in the United States that have defects in the p53 gene, a condition called Li-Fraumeni syndrome. This syndrome predisposes patients to cancer at an early age," Levine said.

One expert believes the finding could have clinical implications.

"Some humans show genetic variation in the amount of p53 they can produce and how well some of these variants of p53 function," said Colin Stewart, a principal investigator at the Institute of Medical Biology in Singapore and author of an accompanying editorial in the journal.

One study suggested that some women who have difficulty in getting pregnant tend to have the less efficient form of p53, Stewart noted.

"This may be why they have problems becoming pregnant, because the less efficient form of p53 does not make sufficient amounts of LIF that are necessary to get the embryo to attach to the wall of the uterus," Stewart said.

Drugs are currently being developed that would either improve the way p53 works or block the action of defective forms of p53, Stewart said.

"Some of these drugs may turn out to be useful in helping women conceive by improving the function of p53 in the uterus. Others may turn out to be possible contraceptives by blocking p53's function in the uterus," he added.

By: Steven Reinberg
SOURCES: Arnold J. Levine, Ph.D., professor, Institute for Advanced Study, Princeton, N.J.; Colin Stewart, Ph.D., principal investigator, Institute of Medical Biology, Singapore; Nov. 29, 2007, Nature.

Urban Women May Have Greater Breast Cancer Risk

Women who live in urban areas appear to have more dense breast tissue than their suburban or rural counterparts, new research suggests.

The finding is potentially important because women with more dense breasts have a higher risk of breast cancer.

The study, which compared women living and working in London to those living outside the city, found that city-dwelling women were more likely than their rural peers to have dense breasts.

"Our study suggests that the closer to urban and high population densities that a woman resides, and in particular works, the greater likelihood there is that she will have denser breasts," said study author Dr. Nicholas Perry, director of the London Breast Institute at the Princess Grace Hospital.

"For every 1 percent increase in breast density, there is said to be a 2 percent increase in the relative risk of developing breast cancer," he added.

Perry was to present the findings Monday at the Radiological Society of North America's annual meeting, in Chicago.

Each year, nearly 180,000 American women are diagnosed with invasive breast cancer, and about 40,500 die from the disease, according to the American Cancer Society (ACS). Over a lifetime, about one in eight women will develop breast cancer.

Known risk factors include a family history of the disease, getting your first period before the age of 12, beginning menopause after age 55, not having children or having your first child after 30, being overweight, drinking more than one alcoholic drink a day, and living a sedentary lifestyle, according to the ACS.

The new study included digital mammograms from 972 women, between 29 and 87 years old, living or working in rural, suburban and urban areas. Two hundred and twenty-five women were from rural areas, 135 lived in the suburbs, and 257 women either lived or worked in an urban area.

Breast density isn't an indicator of breast size, noted Dr. Julia Smith, director of the New York University Cancer Institute's Breast Cancer Screening and Prevention Program. Instead, breast density indicates more glandular breast tissue and ducts rather than fatty tissue. That means more area for breast cancer to develop and hide, she explained.

Overall, 26 percent of the women in the study had breasts that were classified as fatty, while the remaining women had density findings ranging from scattered to extremely dense. Thirty-one percent of the rural residents had breasts classified as fatty, while 26 percent of suburban women and just 22 percent of urban women did.

Perry and his colleagues found that women who lived and worked in a city were more likely to have dense breasts than either their rural or suburban counterparts. Urban women had a 54 percent greater chance of having dense breasts than women living in rural areas, and suburban women had a 14 percent higher risk of dense breasts than rural women.

"This is an interesting finding," Smith said. "But, we need to tease out the confounding factors. Are these population issues or does being in an urban environment increase risk?"

For example, she said, urban women may have better diets and may exercise more, both of which can contribute to denser breast tissue, Smith said.

Perry also said there are many lifestyle factors that need to be considered, and he hopes that now that he and his colleagues have drawn attention to the issue, more studies will be done to uncover the cause of this disparity.

One concern that Perry has is that past studies have found that urban women may be less likely to undergo screening for breast cancer, and this study suggests that it may be even more important for these women to get mammograms as recommended.

"All women should be given the opportunity to participate in breast screening programs, if eligible, but perhaps women in the city need to be extra vigilant in this regard and not miss out," Perry said.

By: Serena Gordon
SOURCES: Nicholas Perry, M.B.B.S., consultant radiologist, and director, The London Breast Institute, The Princess Grace Hospital, London; Julia Smith, M.D., Ph.D., director, New York University Cancer Institute's Breast Cancer Screening and Prevention Program, and director, the Lynne Cohen Breast Cancer Preventive Care Program, New York University Cancer Institute and Bellevue Hospital, New York City; Nov. 26, 2007, presentation, Radiological Society of North America annual meeting, Chicago.

Hurricanes Katrina, Rita Left Skin Rashes in Their Wake

Workers helping to rebuild New Orleans after hurricanes Katrina and Rita suffered from several different skin disorders, and new research suggests that many of the rashes were caused by some kind of insect bite.

"Dermatologic conditions have always been really common, but a systematic investigation had not really been done in the past," said study author Rebecca Noe, a staff epidemiologist with the National Center for Preparedness, Detection and Control of Infectious Disease at the U.S. Centers for Disease Control and Prevention in Atlanta. "When I did a literature search, I typically saw people saying 'rashes.' It was really general."

The study was published in the November issue of the Archives of Dermatology.

After the devastation of Katrina and Rita in August and September 2005, scientists had a chance to delve deeper.

Twenty-two percent of diseases treated in the aftermath of the twin disasters were skin-related.

At the end of September 2005, members of the CDC were asked by New Orleans hospital officials to assist investigating an outbreak of skin diseases among construction workers.

A group of men repairing roofs on a military base had rashes so severe they couldn't continue working.

The CDC investigators looked at biopsies and examined the living situations of 136 workers who were staying in 11 screened-in wooden huts on the military base. The workers had limited sanitation facilities (the main shower trailer was out of order).

Fifty-eight of the workers, or 42.6 percent, reported rashes. Of these, 70.7 percent were examined, and 27 (65.9 percent) were found to have papular urticaria, basically a reaction to insect bites.

Eight (19.5 percent) had bacterial folliculitis, an infection causing inflammation around the hair follicles. Six (14.6 percent) were found to have fiberglass dermatitis, irritation and inflammation resulting from contact with fiberglass. Two (4.9 percent) had brachioradial photodermatitis, a reaction to sunlight.

Men who were sleeping in previously flooded huts were 20 times more likely to have developed papular urticaria and four times more likely to have a self-reported rash.

Native American workers were more likely to develop papular urticaria and fiberglass dermatitis.

The investigators never found the creature(s) responsible for the outbreaks, but they suspect that a mite infestation of the huts was responsible.

"Some sort of bug was in the hut," Noe said.

Whenever flooding or another disturbance to the ecosystem occurs, rodents and birds are displaced and mites are left looking for other hosts -- humans included.

The findings were consistent with what on-the-scene specialists saw. Dr. Richard A. Keller, a Mohs' surgeon at Ochsner Health System, returned to work the Saturday after Hurricane Katrina and was the only, or one of the only, dermatologists in the city for two or three weeks.

He saw several cases of skin infections that rumors circulating at the time attributed to some strange, Louisiana-specific disease. Instead, the problems were similar to what the CDC found: papular eruptions, poison ivy and photoallergic eruptions.

"We reassured everyone that this wasn't some odd disease," Keller said. "The big thing we did was dispel the rumors."

The CDC recommended that the men living on the military base be relocated to other sleeping quarters, get improved laundry and shower services, and use insect repellant.

"Lay people need to make sure, if they're going into their home that has been flooded, to wear repellant and, if you can, long-sleeved clothing," Noe added.

Health Tip: Buying Athletic Shoes

Properly fitted athletic shoes are an essential part of every workout. But finding the right shoe could be a challenge.

Here are some guidelines, courtesy of the American Academy of Orthopaedic Surgeons:

* Because feet swell with activity, always try on athletic shoes later in the day or after a workout.
* Try on shoes with the same type of socks that you use to work out.
* Make sure you can easily wiggle your toes when the shoes are laced up, and that your heel doesn't slip as you walk.
* Try walking or running a few steps in the store to be sure the shoes are comfortable. You should not have to "break in" athletic shoes.
* Always fully lace shoes when trying them on, as you would to work out.
* If you work out frequently, buy a shoe specific to the sport or exercise that you perform.

Simple Tips Keep the Flu at Bay

Between 5 percent and 20 percent of Americans will get hit by the flu bug this year, but some simple precautions can keep you from becoming one of that number, an expert said.

The flu shot is the most effective method of preventing the flu, said Dr. Robert C. Goldszer, associate chief medical officer at Brigham and Women's Hospital in Boston. It's important to get your shot early in the flu season -- October and November -- and to get a shot every year, Goldszer said. Everyone is eligible for a flu shot, and many places offer it for little or no cost.

If you do start to feel symptoms of the flu (tired, nauseous, congested, achy), get extra rest and drink plenty of fluids -- at least a quart of water every day. Proper hydration and nutrition can help lessen flu symptoms.

If you have the flu, try not to spread it to people around you. Flu viruses are spread by coughing and sneezing. Most people can spread the flu beginning one day before symptoms develop to up to five days after they become ill.

If you do have symptoms, stay home from work or school and avoid public places. Cover your mouth and nose when coughing or sneezing.

Take steps to protect yourself from getting the flu. If you use public transit or work in a crowded place, disinfect your hands regularly and avoid close contact with people who appear to have flu symptoms.

-- Robert Preidt

Killer Cold Virus

Despite New Ad14 Bug's Fatal Potential, Most Get Mild Illness

It's been deadly for 10 Americans -- but most people who catch the new strain of Ad14 "killer cold virus" get only a mild illness, the CDC says.

Here's the main thing the federal health agency wants you to know: The new strain of Ad14 certainly can cause very serious disease. But it's not nearly as deadly as other bugs that circulate every winter.

Nobody knows how many more people will die from Ad14 this year -- if any. But the number is sure to be vastly smaller than the average year's toll of 36,000 deaths from flu and 11,000 deaths from respiratory syncytial virus (RSV).

What do we need to know about the new virus this winter? WebMD spoke with the CDC's Larry J. Anderson, MD, chief of the division of viral and rickettsial diseases, National Center for Infectious Diseases.

What are the symptoms of infection with the new Ad14 virus?

Anderson: "First, people should know that this is one of the adenoviruses, which can cause a wide range of things. Probably the most common is respiratory illness. This means there is a kind of layering of symptoms. First there are the symptoms of a common cold, but possibly with a fever: runny nose, sore throat, and cough. Then there may be the more severe symptoms of lower respiratory involvement: productive cough, shortness of breath.

"Almost all the 51 types of adenovirus can cause the full range of symptoms -- and so can rhinovirus, a different cold virus. What is unusual about Ad14 is the severity of symptoms. It is not that the other adenoviruses can't do this, they just don't do it this often."

Does everyone who catches Ad14 get a serious illness?

Anderson: "In the outbreak at Lackland Air Force Base, the vast majority of individuals infected with Ad14 had the more mild end of the spectrum of illness. They tended to have fever with cold, but only the minority of individuals were hospitalized. In our preliminary analysis of data from an investigation looking at recruits over the course of the six and a half weeks of military training, a little over 150 or 160 people -- about half -- got infected with Ad14. Maybe 5% had no symptoms, but nobody was hospitalized in that group.

"That is reassuring. And if you think about the epidemic in Oregon, we saw that the cases were not linked to one another. That means the virus had to have spread out in a variety of places. A lot of other people must have been infected for it to spread that broadly. This means that many people were infected that weren't all that ill."

With Ad14 possibly circulating this winter, is there anything people should do when they come down with a cold or flu-like illness?

Anderson: "Do what you usually do. Ad14 really should not change the way you look at respiratory illness this season at all. If you think about relative risk, flu regularly causes more than 30,000 deaths. RSV is a much greater risk in the young child. And rhinoviruses are likely to cause a lot more disease than Ad14. That's because this is an uncommon infection, and the more common infections will be much more of a problem.

"Now here's what you can do. Get your flu vaccination. Get your pneumococcal vaccination. And observe good hygiene -- this means frequent hand washing, and covering your mouth whenever you cough or sneeze."

Let's say my spouse or my child gets cold or flu symptoms. When is it time to call a doctor?

Anderson: "The things to watch out for are persistent fever, a fever that keeps getting higher, or any trouble breathing. It is a matter of symptoms getting more severe -- and when you reach the point of needing medical attention depends on the age and underlying physical condition of the person who is ill."

The earliest victim of this new virus was a baby. What's the message to parents in terms of watching a child with a runny nose or a cold?

Anderson: "Small children always have a runny nose. And there is a whole host of things that can become more severe in the infant; Ad14 is just one of those. Particularly in a young infant, the criteria that you use to decide whether to check with a doctor are different in different situations. For example, in this New York child that died, lethargy and poor feeding were an indication of a more severe illness.

"Really, it is hard to tell. But a mother knows when her child is sick. If you think your child is sick, consult a doctor. It does no harm for a new mother who is not experienced just to call a doctor when she's not sure, just to check in."

How can you know if you have an Ad14 infection?

Anderson: "If you have a serious case of pneumonia, it could be Ad14. Then your doctor should check with the local health department. Ad14 needs to be included in the list of possible causes of severe pneumonia -- but it is not the situation where you have a test and are scared because it's Ad14. Because if you had Ad14 and a cold, you would not do anything different unless you got sicker. So you treat and monitor a flu-like illness based on the severity of clinical symptoms. Suspecting that is it Ad14 doesn't tell you your illness is bad. But if it is bad, your doctor may suspect Ad14 as one of several possible causes."
Is there any particular treatment for Ad14 illness?

Anderson: "There is no antiviral drug licensed or known to be effective for adenovirus infections. Treatment is specific to the symptoms. If a person is having trouble breathing, that patient may be intubated in really severe cases."

Who is most at risk of Ad14 infection and severe illness?

Anderson: "Adenoviruses have been a problem for military recruits for a long time. Ad3, Ad4, Ad7, sometimes Ad21, now Ad14. That appears to be a problem because of crowding together in open-floor dorms, and it is possibly related to stress and physical exertion. But this has been going on for a long time.

"Otherwise we don't know a lot about Ad14. We have not been watching it that long. What we do know, if we look at the individuals that had more severe disease, it is the young infant and the older patient. Infants are at risk of a number of infections because they are small, they have immature immune systems, and they are not as good as adults are at fighting off infections. But non-military cases were in older patients. So this gets down to the same groups that would be at risk for flu or other respiratory pathogens.

"The real message is that clinician and public-health folks, when they thinking about patients with pneumonia for which they don't know the cause, to keep Ad14 on the suspect list of pathogens that may be causing the illness. This is important not so much for the individual person as for public health measures."

Does the CDC expect Ad14 to become a bigger public health problem?

Anderson: "We don't know if it is going to be a bigger problem. We had this cluster in Oregon, which for the broader public health community is the one that stands out. But we have not had reports of other clusters of cases like this. This probably means there have not been any other major clusters of cases. One reason we put out the MMWR report is to alert public health officials so we can see whether this is a wider problem. That we have not heard anything more suggests it is not a major public health problem like flu or RSV.

"So is Ad14 something I should be alarmed about? The answer is no. Doctors should keep it in mind when making a diagnosis, but there is nothing different for people to do."

Women More Attracted to Risky Men When Most Likely to Conceive

Women are most attracted to sex with masculine, high-risk men during ovulation, when they are most likely to get pregnant, a Kinsey Institute study suggests.

Heather Rupp, PhD, a research fellow at the Kinsey Institute, studied 12 single heterosexual women aged 23 to 28. While hooked up to an fMRI machine that detects activity in different parts of the brain, the women looked at 256 photos of male faces.

Using a computer morphing program, researchers altered the photos to make the male faces look more or less masculine. The women were also given sexual risk information on the men that included their number of sexual partners and their typical condom-use patterns.

After viewing the faces and the information, the women were asked to rate how likely they were to have sex with the man in each photo.

But in this study, Rupp and colleagues weren't as much interested in who the women said they'd have sex with as in what happened inside their heads.

Around the time of ovulation, when the women were most likely to conceive after unprotected sex, the women's brains showed more activity in areas linked to reward and risk taking. Stimuli that arouse this area of the brain include drugs, alcohol, and gambling.

During ovulation, the women also had weaker brain responses in brain areas linked to inhibition and risk evaluation. And while women showed more activity in brain areas linked to decision-making and reward when looking at photos of high-risk men than when looking at photos of low-risk men, this activity was weaker during ovulation than it was later in the menstrual cycle.

At this week's annual meeting of the Society for Neuroscience, Rupp suggested that during ovulation, women may be more likely to engage in risky sex and be more vulnerable to drug and alcohol abuse than at other times.

"At ovulation, when is likely, women may prioritize fertilization and find masculine men more rewarding and less risky," Rupp suggested in her meeting presentation. "Towards the end of the menstrual cycle, when hormones are preparing for potential pregnancy, the priority may shift from mating to finding a low-risk, stable partner who can provide more parental investment and resources."

By Daniel J. DeNoon

SOURCES: Society for Neuroscience annual meeting, San Diego, Nov. 3-7, 2007. News release, Indiana University.

Shock-Absorbing Shoes: Bad for Knees?

Study Shows Foot-Stabilizing Walking Shoes and Clogs May Put Strain on Arthritic Knees

Those shock-absorbing athletic shoes and clogs designed to protect and cushion the feet may be bad for arthritic knees.

When researchers examined the effects of different types of footwear on people with knee osteoarthritis, they found that going barefoot put less stress on knee joints than wearing foot-stabilizing walking shoes or clogs.

Flip-flops and a flexible walking shoe were also better choices for minimizing impact to the knees during normal walking.

The researchers determined this by assessing a standard measure of knee joint impact, known as knee load.

"Knee loads play an important role in the progression of knee osteoarthritis," researcher Najia Shakoor, MD, of Rush Medical College, says in a news release. "Shoes have traditionally been engineered to provide foot comfort and little previous attention has been directed to the effects that shoes may have on loading of osteoarthritic knees."

She notes that flat, flexible shoes were best for minimizing the impact on knee joints.

The findings were presented at the annual meeting of the American College of Rheumatology in Boston.

Impact of Shoes on Osteoarthritis

According to the Arthritis Foundation, 21 million Americans have osteoarthritis, a chronic disease in which the cartilage that serves as a shock absorber in the joints is broken down over time.

Also known as degenerative joint disease, osteoarthritis is a leading cause of disability among adults. Obesity, age, and joint overuse or injury are risk factors for the condition.

In a 2006 study with a similar design, Shakoor and colleagues reported that going barefoot put less stress on knee joints than wearing everyday walking shoes.

In their latest study, the researchers examined knee loads among 13 women and three men (average age 56 years) with knee osteoarthritis while they were barefoot, and then while they wore a popular brand of clogs, a foot-stabilizing walking shoe, a flat, flexible walking shoe, and flip-flops.

Compared to walking barefoot, the clogs and foot-stabilizing walking shoes were associated with significantly higher knee loading.

"These results highlight the importance of re-evaluating the design of modern day shoes in terms of their effects on knee loads and knee osteoarthritis," the researchers write.

More Study Needed

Rheumatologist Dennis Boulware, MD, says he was surprised by the finding that shoes that are good for ailing feet may not be good for ailing knees.

"This does make me a bit concerned about advising patients about certain types of footwear," he says. "I will certainly pay more attention to knee complaints when I put someone in [foot-stabilizing] shoes for foot problems."

Boulware, who is chief of rheumatology for Kaiser Permanente, Honolulu, adds that larger studies are needed to confirm the findings.

"I am somewhat skeptical because of the small size of the study," he says. "But this is clearly something we need to know more about."

By: Salynn Boyles
WebMD Medical News

Reviewed By: Louise Chang, MD

Dissatisfied, ladies? Tips to reach the Big O

If you’re having a hard time reaching the Big O, you’re hardly alone! Studies show that about 10 percent of women have never experienced an orgasm, and 50 percent of women have had trouble getting aroused at some point.

So why are so many women having trouble climaxing? And what can men do to help women reach orgasm? Dr. Gail Saltz and Dr. Drew Pinsky tackle these tough questions and dispense their expert advice:

Q: Why are some women able to achieve an orgasm easier than other women?

Dr. Gail: There is a real range when it comes to women having orgasms. There is likely a biologic difference between women (though exactly what that is is not known), but some women have a lower threshold for orgasm and some higher, which reflects differences in sensitivity.

There is a big psychological difference between women in that some women are more uninhibited than others and can let themselves go without guilt or shame and this makes it easier for them to have an orgasm. Anxiety interferes both psychologically and biologically (in the brain by blocking certain neural pathways) with reaching a climax.

Lastly, there are differences in education levels about the body and sex; some women simply know a lot more about how to have an orgasm than others.

Q: Are men and women wired differently in terms of how they achieve an orgasm?

Dr. Gail: Women take on average 20 minutes of stimulation and arousal to have an orgasm. Men take quite a bit less. Women also have more variation in what they find to be stimulating as well as having more difficulty defining exactly where and how stimulation works best. Only 20 percent of women are able to orgasm with intercourse alone, most women need some sort of direct clitoral stimulation.

Dr. Drew: Yes, men and women are wired differently, moreover women are wired differently from each other. Many times women will feel as though they are flawed because they are not living up to a certain standard of climaxing. Men make it worse because they generalize what’s needed to make a woman climax. Often men believe women are the same, and once they figure what works for one woman they apply that same method to all the other women they are intimate with, and that’s one of the major problems.

* 50-60% of women will never have an orgasm via intercourse and will require clitoral stimulation to climax.
* 30% of women will have a reliable orgasm with intercourse.
* 10% of women will orgasm with intercourse and could possibly have sequential orgasms.
* 5% of women have true multiple orgasms only through intercourse and these women typically find oral sex uncomfortable.

Q: What are factors that could contribute to a woman having a hard time or not achieving an orgasm at all?

Dr. Gail: Many things can interfere with a woman’s ability to have an orgasm — some medications (antidepressants and antihistamines are big offenders), anxiety, depression, alcohol (more than a little), old myths and inhibitions about it being wrong or scary to enjoy sex, hormonal changes.

Of course, sex really means pleasuring yourself and your partner and this does not necessarily include having an orgasm. Sex can be fun and wonderful without. However, many woman find the release of orgasm to be an important component and many men are really excited and gratified by their partner reaching orgasm.

Dr. Drew: Genetics could play a role. There is a tremendous amount of genetic information in the XX chromosomes. As a result, a woman’s genes could make it more difficult to orgasm during sex. Medications can lower a woman’s sex drive and interfere with a woman’s ability to climax. These medications include antidepressants, birth control pills and hormone medications. I only know of three antidepressants that do not interfere with a woman’s sexual function.

Menopause, perimenopause, childbirth and breast-feeding can all cause a woman’s sex drive to shut down. A woman’s emotional state is another factor. If a woman is tired or stressed out or preoccupied, all of these emotions could make it harder for her to climax.

Q: Are there some women who have no idea how their bodies work and as a result they don’t know how to get aroused?

Dr. Gail: One of the biggest impediments for women is that they have never really understood, looked at or examined their own genitals. They have not really figured out what kind of stimulation and where feels best for them, so they are not able to guide a partner in this.

Many men don’t know either, unless they have had a partner who has really shown them, and even then because each person is different they cannot know what works for you. Many women are afraid to ask questions because they feel if it's not obvious, it must be because their genitals don’t work properly and they can’t have an orgasm. This is really untrue, but such a powerful belief can certainly keep you from becoming aroused enough.

Q: What can a man do to help the woman he’s with climax if she’s having trouble?

Dr. Drew: Men need to understand the biology of the female he is dealing with. Men have to recognize that women are not all the same when it comes to what can get them aroused. Men think that foreplay is kissing and touching a woman’s genitals. But for some women, foreplay is having a nice intimate dinner or connecting emotionally through various situations. Also, both people do not need to be so concerned with getting to the finish line and climaxing. Couples should be more concerned about creating a more intimate relationship with each other. Finally, men need to pay more attention to their partner's needs and try figuring out what works best for the person they are with, and men should not assume their partner wants what they want.

Q: Can you give a list of general tips a woman can use that will help a woman get sexually aroused and ultimately climax?

Dr. Gail: If you are trying to climax and haven’t been able to, or if it's very difficult for you and you wish it were easier, here are some suggestions:

* Self-stimulation. Its hard to say enough good things about how important it is to know yourself. Even if you have a partner, you only stand to make things better by practicing alone, when the pressure is off, to find out what works best for you and discover how to show him, too.
* Try a vibrator. A battery-operated vibrator can help “break through” an obstacle to climaxing. Once you have had the experience several times, it will give you confidence that you “work just fine” and allow you to replicate that stimulation on your own or with your partner.
* More direct stimulation. You can’t count on intercourse alone to provide enough stimulation. Manually, orally or with a vibrator, you may need to have you or your partner stimulate the clitoris more directly.
* Use fantasy! You need a good fantasy to boost arousal enough to climax ... thinking about what you should make for dinner tomorrow during sex is not going to do it.
* Try new things. Like with anything else in life, the same old, same old can get boring and boring does not go well together with orgasm. so mix it up and try new things to increase your arousal.

Dr. Drew: First, every person is highly individualized so if a person is seriously concerned, then they first need to get a medical evaluation and make sure there’s nothing biologically going on to prevent them from climaxing.

* Focus on emotional intimacy with your partner.
* Experiment and try new ways to please yourself.
* Don’t be afraid to communicate with your partner because men aim to please and they want to please you!
* Understand that your partner cannot read your mind, so talk to your partner about how you’re feeling and what you need.

Acute Low Back Pain Does Not Benefit From Spinal Manipulative Therapy Or Diclofenac

If you suffer from acute low back pain, are receiving recommended first line-care, you do not recover any faster if you are receiving spinal manipulative therapy and/or diclofenac, according to an article in The Lancet, this week's issue.

(Diclofenac is marketed as Voltaren, Voltarol, Diclon, Dicloflex Difen, Difene, Cataflam, Pennsaid, Rhumalgan, Modifenac, Abitren, Arthrotec and Zolterol.)

General Practitioners (GPs) in the UK are told to give acute low back pain patients advice and paracetamol (acetaminophen) as the first line of care. The advice tells the patient to remain active, avoid bed rest, and reassures the patient that his/her prognosis is favorable. NSAIDs (non-steroidal anti-inflammatory drugs), such as Diclofenac, and spinal manipulative therapy are recommended for second-line management options for fast recovery, explain the authors.

Mark Hancock, Back Pain Research Group, University of Sydney, Australia, and team looked at 240 patients, all of whom suffered from acute low back pain. They had all been to their GPs and had received paracetamol and advice. They were randomly placed into four treatment groups׃

- Group 1
Received diclofenac 50 mg twice daily plus placebo manipulative therapy

- Group 2
Received spinal manipulative therapy and placebo drug

- Group 3
Received diclofenac 50 mg twice daily plus spinal manipulative therapy

- Group 4
Received double placebo

The researchers did not find any significant difference in the recovery times of those receiving diclofenac or spinal manipulative therapy compared to those receiving the placebo drug or placebo manipulative therapy.

237 of the 240 patients either recovered or were censored* 12 weeks after randomization. Even though 22 patients experienced possible undesirable side-effects, such as gastrointestinal disturbance, dizziness and heart palpitations, they were evenly spread across the placebo and non-placebo groups.

"Neither diclofenac nor spinal manipulative therapy gave clinically useful effects on the primary outcome of time to recovery. Findings from the secondary analyses support the primary analyses, showing no significant effects on pain, disability, or global perceived effect at one, two, four, or 12 weeks, when diclofenac or spinal manipulative therapy, or both, were added to baseline care," the researchers wrote.

"These results are important because both diclofenac and spinal manipulative therapy have potential risks and additional costs for patients. If patients have high rates of recovery with baseline care and no clinically worthwhile benefit from the addition of diclofenac or spinal manipulative therapy, then GPs can manage patients confidently without exposing them to increased risks and costs associated with NSAIDs or spinal manipulative therapy," they concluded.

Accompanying Comment

"The limited or absent beneficial effect of diclofenac for acute low back pain after adequate first-line treatment may have wide implications. NSAIDs are widely prescribed for a range of acute musculoskeletal disorders," Dr Bart Koes, Department of General Practice, Erasmus University Medical Centre, Rotterdam, Netherlands, wrote.

Dr. Koes concluded "The important message is that the management of acute low back pain in primary care (advice and prescription of paracetamol) is sufficient for most patients."

*Censored is a term specific to the type of analysis used (survival analysis or Cox regression). Patients are censored if the study ends before they have experienced the event - in this case recovery .In this type of analysis such patients still add to the data (denominator) during the period until they are censored. Therefore patients censored at 12 weeks have provided full data and are not drop outs.

source׃ Christian Nordqvist
Copyright: Medical News Today

Some Women Risk Cervical Cancer 25 YearsOn

Women treated for precancerous lesions are at increased risk of developing cervical or vaginal cancer for at least another 25 years, according to a study suggesting that follow-up tests fall dangerously short.

Using data from Sweden's national cancer registry, the researchers say that women who have had severe lesions in the cervix are more than twice as likely to develop one of the two cancers than women in the general population.

The findings underscore the need for follow-up tests to continue for at least 25 years after treatment, far longer than the current five or 10 years standard in most European countries, says Dr Björn Strander, a gynaecologist at Sahlgren University Hospital in Sweden.

Strander led the study, which is published online today by the British Medical Journal.

"This is a warning to the healthcare system to keep track of these women," he says.

"It has not been known these women remain at risk for such a very long time."

Most cervical cancer are caused by the sexually transmitted human papilloma virus (HPV) and it is the second most common type of cancer in women. Vaginal cancer is far rarer.

Women in many countries have a Pap smear to check for early signs of these lesions, which are easily removed if caught before they develop into cancer.

Nonetheless cervical cancer kills 300,000 each year, mostly in developing countries.

Recently introduced vaccines protect women against certain strains of HPV, but not all.

More than 132,000 women

In their study, the researchers mined the National Swedish Cancer Register for information recorded from 1958 to 2002 on more than 132,000 women diagnosed with precancerous lesions called severe dysplasia or carcinoma in situ (CIS).

These conditions occur in the mucous lining of the cervix and vagina and are considered a potential forerunner of cancer.

They found that 881 women developed cervical cancer and 111 women had vaginal cancer more than one year following their diagnosis, even after they had their lesions removed.

The risk remained high for a long time, they say.

"We haven't investigated why but there are indications it could be because a lack of surveillance," Strander says. "The risk is quite steady. It does not decrease."

Older women

A woman's risk also rose if she was older at diagnosis, also possibly due to the healthcare system letting down its guard during follow-up care, Strander says.

The Swedish study did not look at whether a Pap smear or DNA test represented the best way to screen these women but said it merits further study, Strander adds.

Two Italian researchers writing in a related editorial agree the findings should spark further study and say they clearly show current testing guidelines are not sufficient.

"One clear indication is that women treated for [severe pre-cancerous lesions] should continue surveillance beyond the age limit of regular screening," they write.

Heart Plays A Losing Game of Catch-Up as People Age

Researchers at Johns Hopkins have evidence to explain why the supposedly natural act of aging is by itself a very potent risk factor for life-threatening heart failure.

In a study to be presented Nov. 4 at the American Heart Association's (AHA) annual Scientific Sessions in Orlando, Fla., the Hopkins team analyzed more than a half-dozen measurements of heart structure and pumping function to assess minute changes in the hearts of 5,004 men and women, age 45 to 84, of different ethnic backgrounds and with no existing symptoms of heart disease.

Researchers found that each year as people age, the time it takes for their heart muscles to squeeze and relax grows longer, by 2 percent to 5 percent.

Test results were obtained from study participants who had undergone high-tech magnetic resonance imaging of the heart - tagged MRI - which measures individual muscle segment changes with each heartbeat.

The findings, researchers say, offer insight into the root causes of heart failure. They are especially valuable now as millions of baby boomers in America move into their 60s, a time when most signs and symptoms of heart problems first appear.

Estimates show that more than 5 million Americans have some from of congestive heart failure, marked by symptoms such as shortness of breath and fatigue.

"Our results demonstrate just how the heart plays a losing game of catch-up as people age," says Susan Cheng, M.D., a former medicine resident at Hopkins who led the study. "It's an amazing piece of the puzzle of heart failure that finally singles out the effects of age over better-known risk factors such as high blood pressure in otherwise healthy people and regardless of race."

"We already knew that the heart is constantly trying to adapt to risk factors, but now we know that this task gets more difficult as the heart ages and loses a little bit of its pumping capacity every year," says Cheng, now a cardiology fellow in Boston.

She says the findings could lead to diagnostic tests to identify those whose hearts are aging faster than others, enabling preventive drug therapy, pacemakers, or lifestyle changes to slow or even reverse the deleterious effects.

Hopkins cardiologist Jo?Lima, M.D., the senior study investigator, says effects of aging have been hard to determine because of inherent flaws in using standard criteria to assess heart function. The current gold standard, he says, is the heart's ejection fraction, a ratio of the amount of blood pumped out with each heartbeat to the total volume of blood available for pumping. An ejection fraction of 50 percent to 65 percent is considered normal.

Study results showed that ejection fraction actually rose by 0.01 percent with every year. But Lima calls this figure misleading because the total amount of blood available for pumping, the bottom number in the ratio, decreases as the size of the heart cavity shrinks and heart walls thicken, falsely boosting test results when heart function is actually failing.

When researchers separated the numbers, the actual amount of blood pumped out by the heart fell by 8 milliliters per year, says Lima, an associate professor at The Johns Hopkins University School of Medicine and its Heart Institute.

The flaw in using ratios, he notes, also helped to mask the gradual shrinkage of heart muscle mass. Researchers found that heart muscle mass declined by on average 0.3 grams per year. This occurred even though heart wall thickness had expanded and despite an increase in another standard measure of heart function, the ratio of left ventricular mass to blood volume, which went up by 5 milligrams per milliliter each year.

Lima says it's important not to be misled by existing tests for heart function, especially ejection fraction ratios, when diagnosing patients. He points out that almost half of the 550,000 Americans newly diagnosed each year with heart failure - mostly women over age 50 - have a non-systolic form, in which the ejection fraction appears the same, even though heart function is declining. "Age could be the deciding factor in determining who gets this kind of heart failure," he says.

"This study highlights how the aging heart's anatomy and function change hand in hand over time, similar to arteries stiffening, bones weakening from loss of calcium, and kidney function declining," says Lima. "Physicians and patients need to recognize it as a process that can be accelerated by risk factors or possibly slowed down by healthy lifestyle choices and sound medical care."

The next step, researchers say, is to look for so-called biological markers, usually blood proteins, which can track the effects of the aging process on heart shape and function and to measure these markers, so that a test specific to aging of the cardiovascular system can be developed.

Study participants from six centers across North America were drawn from a larger pool of 7,000 ethnically diverse adults, including African Americans, Chinese Americans, Caucasians and Hispanics - all monitored to see who develops heart failure. Started in 2000, the Multiethnic Study of Atherosclerosis (MESA) is set to run for another six years. It is the first large-scale analysis of racial or ethnic differences in heart function. So far, 79 study participants have developed congestive heart failure.

Vitamin D May Not Cut Cancer Deaths

Study Shows No Link Between Vitamin D Level and Cancer Deaths -- Except for Colorectal Cancer

Oct. 30, 2007 -- Cancer researchers today reported that blood levels of vitamin D -- whether high or low -- may not help prevent adults from dying of cancer over a dozen years.

But colorectal cancer may be the exception, according to the scientists, who included D. Michal Freedman, PhD, MPH, of the National Cancer Institute.

Vitamin D has attracted attention from researchers for its possible anticancer effects.

Freedman's team studied data on more than 16,800 people aged 17 and older who participated in U.S. health studies between 1988 and 1994.

In those studies, participants got a blood test to measure their blood level of vitamin D.

Freedman and colleagues followed the participants through 2000. During those 12 years, 536 participants died of cancer.

Participants' vitamin D levels at the study's start didn't appear to affect cancer mortality in general, regardless of age, sex, race, or other factors.

However, people with high levels of vitamin D at the study's start were 72% less likely than those with low levels of vitamin D to die of colorectal cancer.

Death rates for the other cancers that were studied, including lung cancer, breast cancer, prostate cancer, other digestive cancers, non-Hodgkin's lymphoma, and leukemia, weren't linked to vitamin D blood levels.

The study's limits include the fact that participants only had their vitamin D level checked once. So it's not clear if their vitamin D level rose or fell over the years.

Freedman's team had lots of data including which participants smoked and exercised. But they can't rule out the possible influence of other factors.

The study appears in next week's edition of the Journal of the National Cancer Institute.

An editorial published with the study states that "the relationship between nutritional factors and colorectal as well as other cancers is complicated" and that the findings "must be put into the context of total diet and lifestyle."

The editorial was written by experts including Johanna Dyer, DSc, RD, of the Office of Dietary Supplements at the National Institutes of Health (NIH).

Progression Of HIV, Early Death Affected By Lifetime Trauma

Even though effective drug cocktails have improved the outlook for many patients with HIV, disease progression, including the time from AIDS onset to death, varies widely from patient to patient. Now, a study led by the University of North Carolina at Chapel Hill School of Medicine provides new evidence that psychological factors play a role in disease progression.

The study is the first-known in the era of highly active antiretroviral therapy (HAART) for HIV to show that traumatic life events, such as physical or sexual abuse, are associated with faster mortality, both from AIDS-related and all causes.

"Trauma and depression are common among people with HIV, and trauma and depression seem to have an effect on disease progression and mortality in HIV. Given that, it is critical that clinicians treating people infected with HIV recognize depression and trauma as risk factors for poor health outcomes, and thus screen and refer patients for psychological and psychiatric treatment when these problems are present," said Jane Leserman, Ph.D., professor of psychiatry and medicine and lead author of the study.

"Some combination of cognitive behavioral therapy and medication might be very beneficial for patients experiencing severe or multiple types of trauma," Leserman said.

The study is published in the Nov. 1, 2007 edition of the American Journal of Psychiatry.

The researchers interviewed a group of 490 HIV infected patients in the rural southeast. Those who reported a greater number of categories of traumatic life events had faster death from all causes and from AIDS. More than half of the patients in the study experienced three or more lifetime traumas, and half had experienced physical or sexual abuse.

Unlike depression, the effects of which have been more widely studied in the era of HAART, with trauma, it's possible to establish a time ordering of events.

"In our study, these traumatic events occurred in most cases many years before the progression of the patients' HIV. So it's a more compelling argument for a causal effect of trauma," Leserman said. "Trauma, most of it occurring two or more years before the study, seemed to continue to have a major impact on these patients."

Leserman hopes to study whether treating HIV patients for trauma results in better health outcomes. "We need further study of trauma treatment in this population to find out if that attenuates some of the negative effects," she said.

Immense new facility to house BioMed 21 research at Washington University Medical Center

Through $30-million gift, building is named BJC Institute of Health at Washington University

Oct. 30, 2007 -- The largest building ever constructed on the campus of Washington University School of Medicine in St. Louis will be the home base for BioMed 21 — the University's innovative research initiative designed to speed scientific discovery and apply breakthroughs to patient care rapidly. The building is supported by a $30 million gift to Washington University's medical school from BJC HealthCare and will be named the BJC Institute of Health at Washington University.

Construction began in the summer of 2007 on the new building, which will house not only BioMed 21 laboratories and support facilities but also two academic departments of the School of Medicine as well as some support operations of Barnes-Jewish Hospital. The University will be adding 240,000 square feet of research space, and the estimated total cost of the building will be $235 million. As a hub for BioMed 21, the building will provide space for five newly created Interdisciplinary Research Centers (IRCs).

In other major developments exemplifying the progress of the BioMed 21 program, an $11 million, 16,000 square-foot, free-standing computing facility is being constructed to house the computing equipment needed to support the rapidly expanding research of the world-leading Genome Sequencing Center. (See related announcement.) In addition, 15,000 square feet of space are being added to the previously established Center for Genome Sciences to support 11 new investigators who will design and interpret genome-anchored clinical studies linking disease traits to human genetic makeup.

Launched in 2003, BioMed 21 creates a multidisciplinary- and translational-research imperative for basic scientists and clinician-researchers from many different medical disciplines. "We launched BioMed 21 because we recognized that effective collaboration among researchers in different fields is essential to the future of medicine," says Larry J. Shapiro, M.D., executive vice chancellor for medical affairs and dean of the School of Medicine. "The initiative creates mechanisms to more quickly bring basic scientific knowledge to application for medical treatments. These expansions announced today are monumental and demonstrate the strength of our commitment to research that will revolutionize medical care."

The BioMed 21 IRCs will occupy two floors and other School of Medicine facilities will occupy another three floors of the planned 11 floors in the nearly 700,000 square-foot BJC Institute of Health at Washington University. The new Institute is at the southwest corner of Euclid Avenue and Children's Place, directly across the street from the McDonnell Pediatric Research Building, a joint project of the School of Medicine and St. Louis Children's Hospital.

Located in the heart of the Washington University Medical Center Campus, the building will be in immediate proximity to the facilities in which Washington University Physicians provide patient care: Barnes-Jewish Hospital, St. Louis Children's Hospital, the Center for Advanced Medicine and the Alvin J. Siteman Cancer Center.

The academic departments of the School of Medicine that will have laboratory space in the building are the Department of Pathology and Immunology, headed by Herbert W. "Skip" Virgin, M.D., Ph.D., the Edward Mallinckrodt Professor of Pathology, and the Department of Obstetrics and Gynecology, headed by George A. Macones, M.D., the Mitchell and Elaine Yanow Professor of Obstetrics and Gynecology.

The five IRCs selected to occupy the new building were chosen through a novel competitive application process that assessed the proposals' scientific merit and alignment with the core principles of the BioMed 21 initiative. Each addresses a disease-specific area — cancer, cardiovascular disease, neurodegenerative diseases, infectious diseases or membrane excitability diseases — and each includes researchers from several scientific disciplines and academic departments, who proposed to work together in designated laboratory space within the new building. The IRCs will include established faculty members and will recruit additional new faculty members who possess specific expertise needed to fulfill their missions.

"It's a tremendous opportunity — new ideas and inspiration can arise when researchers with different training and experience are able to interact closely on a daily basis," Shapiro says. "The centers will allow them to better share information, resources and skills to achieve an advanced level of discovery pertinent to human disease."

The IRCs are

* the Center for Cancer Genomics, led by Simon Powell, M.D., Ph.D., professor and head of radiation oncology;

* the Center for the Investigation of Membrane Excitability Disorders (CIMED), led by Jeanne Nerbonne, Ph.D., the Alumni Endowed Professor of Molecular Biology and Pharmacology, and Colin Nichols, Ph.D., the Carl F. Cori Professor;

* the center for Women's Infectious Disease Research (cWIDR), led by Scott Hultgren, Ph.D., the Helen Lehbrink Stoever Professor of Molecular Microbiology, and Michael Caparon, Jr., Ph.D., professor of molecular microbiology;

* the Hope Center Program on Protein Folding and Neurodegeneration, led by Alison M. Goate, D. Phil., the Samuel and Mae S. Ludwig Chair in Psychiatry at Barnes-Jewish Hospital, and David Holtzman, M.D., the Andrew B. and Gretchen P. Jones Professor and head of Neurology; and

* the Center for Interdisciplinary Studies of Diabetic Cardiovascular Disease, led by Jean E. Schaffer, M.D., professor of medicine and of molecular biology and pharmacology, and Daniel S. Ory, M.D., associate professor of medicine and of cell biology and physiology.

The Center for Cancer Genomics will capitalize on the strength of genome sequencing at the School of Medicine and the research orientation of the Siteman Cancer Center. This IRC aims to find genetic variants that modify a person's cancer risk and a person's response to cancer therapies. It will also identify biological mechanisms and markers that will lead to improved cancer diagnoses and treatments.

The Center for Membrane Excitability Disorders will investigate the molecular, cellular and systemic mechanisms that underlie both inherited and acquired membrane excitability diseases, which include epilepsy, migraine, congenital cardiac dysfunction, neonatal diabetes and cystic fibrosis.

The center for Women's Infectious Disease Research will focus on infectious conditions prevalent in women. Researchers will investigate the role of infectious agents — bacteria and viruses — in such medical issues as premature birth, bladder dysfunction, recurrent urinary tract infections, cancer, diabetes and heart disease.

The Hope Center Program on Protein Folding and Neurodegeneration will study problems that tend to affect the aging brain: Alzheimer's disease, Parkinson's disease, Huntington's disease, front-temporal dementia and amyotrophic lateral sclerosis (ALS), among others. Such disorders appear to stem from aggregation of proteins that become misfolded, and researchers will seek a better understanding of this process.

The Center for Interdisciplinary Studies of Diabetic Cardiovascular Disease will address how the metabolic changes found in diabetes — alterations in the way sugars and fats are processed in the body — lead to heart disease, a significant complication of diabetes. Researchers will investigate methods for early diagnosis and effective treatment of heart disease in diabetes.

Building planners estimate that BioMed 21 researchers will occupy labs in the new building by December 2009. Cannon Design, an international architectural, engineering and planning firm, is the project architect and S. M. Wilson is the general contractor.

Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and mid-Missouri regions. With net revenues of $2.9 billion, BJC serves urban, suburban and rural communities and includes 13 hospitals and other health service organizations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

Siteman Cancer Center is the only federally-designated Comprehensive Cancer Center within a 240-mile radius of St. Louis. Siteman Cancer Center is composed of the combined cancer research and treatment programs of Barnes-Jewish Hospital and Washington University School of Medicine. Siteman has satellite locations in West County and St. Peters, in addition to its full-service facility at Washington University Medical Center on South Kingshighway.

Bladder Control for Women

ATLANTA (Ivanhoe Newswire) -- It's a problem 13 million women in America have, but few will admit it or do anything about it. Now, there's a new medical breakthrough that could be the solution.

Sharon Tomlinson is going for the green today. But it wasn't long ago she was too embarrassed to play golf … or even go out at all, always in fear that an accident might happen.

"If you cough, lots of times you would find yourself wet, and it became awkward," Tomlinson says.

She suffered from urinary incontinence.

"I always had to take a change of clothing with me wherever I went," Tomlinson says.

A balloon could help millions of women like her!

"This will provide a permanent solution," says Naill Galloway, M.D., a urologist at Emory University in Atlanta, Ga.

The Adjustable Continence Therapy (ACT) is implanted through two small, barely noticeable incisions in a woman's labial fold. An adjustable balloon is placed on each side of the urethra. They're inflated with fluid to support the muscles and stop incontinence.

"The patient who's offered this kind of treatment has to have a bladder control problem that's truly due to weakness," Dr. Galloway says.

Dr. Galloway believes this could help millions of women if they just admit they have a problem, like Tomlinson finally did.

"A lot of women are embarrassed to say anything about it," she says.

Fed up, Tomlinson took care of her problem and is now back in the game.

ACT is still in clinical trials. Researchers at a recent medical conference presented data showing those who use the device report significant improvement. ACT is reversible if it doesn't work for some reason and more fluid can be added to the balloon if needed.

A similar device called "Pro-ACT" is being tested in men with stress urinary incontinence after prostate surgery.

Four More Hospitals Screening for Super-Staph

In Europe, the intervention is known as 'search and destroy.' Search for every source of drug-resistant bacteria coming into a hospital and destroy opportunities for the superbugs to spread.

It's how countries from the Netherlands to England have battled the growing threat posed by methicillin-resistant Staphylococcus aureus (MRSA) and brought soaring infection rates under control.

Now, Loyola University Health System and three local Veterans Affairs facilities are embracing the tactic. Come November, Loyola will start testing all hospital patients for MRSA and taking aggressive steps to prevent its transmission. Hines VA Hospital near Maywood and the North Chicago and Jesse Brown VA Medical Centers implemented what's known as 'universal screening' for MRSA at the end of September.

'It's a safety decision: We want to do what's in the best interest of our patients,' said Dr. Paul Whelton, Loyola's chief executive, who announced the new policy Monday.

The four health facilities are implementing similar strategies. Every patient admitted to Loyola or the VA facilities will get a nasal swab from a nurse. The swabs will be sent to a laboratory for a DNA test to determine if MRSA is present.

The goal is to find patients who carry the bug without knowing it and who are at high risk of becoming infected when they undergo surgery or other invasive procedures. These 'MRSA-colonized' patients can easily transmit the bacteria to others.

Patients testing positive for MRSA will be placed in a private room, and medical staff will be required to wear disposable gowns and gloves and follow strict hand-washing regimens.

Only one other institution in the Chicago area has a similar policy: Evanston Northwestern Healthcare has been checking all patients at its three hospitals for MRSA and taking vigorous steps to combat the bacteria since 2005.

Dr. John Jernigan, a MRSA expert at the Centers for Disease Control and Prevention, said that universal screening was 'uncommon' in the U.S. and that evidence supporting it was limited.

But concern over MRSA is mounting, fueled by new data from the CDC showing that invasive infections caused by the bacteria strike nearly 94,000 people every year and kill about 19,000.

How best to combat the bacteria remains a much-debated question. The CDC advises hospitals to institute strict hygiene standards and focus on disinfecting potentially contaminated areas. If that doesn't work, the agency recommends that hospitals test patients and take measures to reduce transmission.

'No randomized peer-reviewed studies have been published which show the benefit of screening all patients for MRSA,' said Dr. Gordon Trenholme, director of infectious disease at Rush University Medical Center, in an e-mail.

But numerous reports from the field suggest screening does lower MRSA infection rates.

source: chicago tribune

Organic Food Is More Nutritious Say EU Researchers

Early results of a 12 million pound, 4-year EU study on the benefits of organic food suggest that some of them, such as fruit, vegetables and milk, are more nutritious than non-organically produced food and may contain higher concentrations of cancer fighting and heart beneficial antioxidants.

The results were released to the press but there is no mention of a of a journal publication as yet. The research team said its findings will be published in full within the next 12 months.

The findings were announced by Professor Carlo Leifert of the Tesco Centre for Organic Agriculture based at Newcastle University, UK, who with his team are working on the EU funded project called the Quality Low Input Food (QLIF) project, the biggest ever to research the pros and cons of organic farming and food.

Prof Leifert told the press that the research results suggested that eating organic food was equivalent to eating an extra portion of fruit and vegetables a day.

The early results of the study show that organic fruit and vegetables have up to 40 per cent more antioxidants than non-organically grown produce. Even greater contrasts were found for milk, with organic milk containing up to 60 per cent more antioxidants and healthy fatty acids, said Leifert.

The Newcastle University researchers raise cattle and grow fruit and vegetables on 725 acres of organic and non-organic farms situated next to each other at the university's agriculture centre in Stocksfield, Northumberland. Similar set ups exist at other research centres across Europe.

Leifert's findings contradict advice by the UK government's Food Standards Agency which states that organic produce is no healthier than non-organically produced food.

QualityLowInputFood (QLIF) is a European Union (EU) sponsored project that aims to "improve quality, ensure safety and reduce cost along the organic and 'low input' food supply chains through research, dissemination and training activities".

According to information on its website, QLIF focuses on "increasing value to both consumers and producers using a fork to farm approach".

The project was set up in March 2004 and has a grant of 18 million Euros (12.6 million pounds, or 25.8 million dollars) from the EU.

The QLIF research programme involves 31 research centres, companies and universities in Europe and beyond.

Leifert said he and his team now want to explore the underlying mechanisms by which organic as opposed to non-organic farming methods lead to such higher concentrations of healthy nutrients.

A spokeswoman for the Soil Association told the press that they were pleased with the results and this could be the start of a significant change in what consumers buy.

Jabs to Beat Cervical Cancer

Plans to vaccinate young girls to help protect against cervical cancer are set to be announced by the Government.

Professor David Salisbury, director of immunisation, will set out how and when girls will receive the jab against the sexually transmitted infection human papillomavirus (HPV).

HPV causes most cases of cervical cancer, which kills more than 1,000 women in the UK each year.

The jab would revolutionise the approach to beating the disease.

The Government has already agreed that girls around the age of 12 or 13 will receive the vaccine in three doses over a six-month period at a cost of around 300 per full course.

The Joint Committee on Vaccination and Immunisation (JCVI), which recommended the jabs to the Department, has been holding meetings on how the vaccination programme will be rolled out.

The Department of Health also ordered an independent review in June of the costs to the NHS.

The jabs are not compulsory but would be offered to girls in all parts of the UK.

At present, there are two jabs designed to be used in a vaccination programme: Gardasil, made by Merck and Sanofi Pasteur; and Cervarix, made by GlaxoSmithKline.

Smear testing will need to continue after the vaccine is introduced, which is expected to be from next year.

A Third Of Americans Extremely Stressed, New Survey

A new national survey by the American Psychological Association (APA) suggests that one third of Americans are living with extreme stress while nearly half believe stress is damaging their health, their relationships, and work productivity, and that it has got worse in the last 5 years.

Three quarters of Americans (compared with 60 per cent last year) said money and work caused them the most stress, with half mentioning housing costs such as rent and mortgage as a big factor, a result that the APA suggests is linked to the US housing crisis.

Stress had a negative effect on personal and working life, was the view of nearly 50 per cent of Americans, and about one third said it was difficult to manage the responsibilities of work and family.

One quarter of Americans said that stress alienated them from a friend or family member and 8 per cent linked it to divorce or separation.

Executive director for professional practice at the APA, psychologist Dr Russ Newman said that:

"Stress in America continues to escalate and is affecting every aspect of people's lives - from work to personal relationships to sleep patterns and eating habits, as well as their health."

"We know that stress is a fact of life and some stress can have a positive impact, however, the high stress levels that many Americans report experiencing can have long-term health consequences, ranging from fatigue to obesity and heart disease," he added.

The Stress in America online survey is part of the APA's Mind/Body Health Public Education Campaign. The survey involved 1,848 adults and was carried out in September 2007 on behalf of the APA by Harris Interactive. The results were adjusted for age, sex, race and ethnicity, education, region, and household income to make them representative of the overall American adult population.

Participants were asked questions that distinguished between appropriate and excessive levels of stress, assessed attitude and perceptions, the leading sources of stress, what people did to manage it and what resources they used, and the impact it had on their personal and working lives.

The key results showed that:

* 28 per cent of Americans said they were managing stress extremely well.

* However, over 70 per cent reported recently having physical and psychological symptoms of stress.

* Physical symptoms included: fatigue (51 per cent), headache (44 per cent), upset stomach (34 per cent), muscle tension (30 per cent) and others.

* Psychological symptoms included: feeling angry or irritable (50 per cent), feeling nervous (45 per cent), lacking energy (45 per cent), feeling tearful (35 per cent).

* Nearly half of Americans said stress caused them to lay awake at night.

* 43 per cent of Americans said they were overeating or eating unhealthily as a way to manage stress.

* 36 per cent said they had skipped a meal in the last month because of stress.

* Drinkers (39 per cent) and smokers (19 per cent) said they drank or smoked more when highly stressed.

* 43 per cent said they watched TV more than 2 hours a day and 39 per cent said they played video games or surfed the Net.

* A good proportion also mentioned healthy ways to manage stress, including: listening to music (54 per cent), reading (52 per cent), exercising or walking (50 per cent), being with family and friends (40 per cent), and praying (34 per cent).

The survey also asked participants about their motivation to change lifestyle or behaviour to reduce stress or manage it more effectively. 35 per cent said they would make changes if diagnosed with a chronic condition. The main motivator for change, mentioned by 60 per cent of the respondents, would be to feel better. 38 per cent said they would be motivated to make changes if they received encouragement from a spouse or partner.

New Malaria Cases in Kingston, Jamaica

The Centers for Disease Control and Prevention (CDC) has received a report of an additional case of Plasmodium falciparum malaria in a resident of Kingston, Jamaica. This brings the total number of recent cases to two, suggesting that the outbreak that started in September 2006 resulting in 370 cases by June 2007 is still continuing. As a result, CDC is reinstating the recommendation that US travelers to Kingston, Jamaica, take malaria preventive medication (prophylaxis).

This recommendation is expected to be temporary and does not apply to other areas of Jamaica. Jamaica is a country where malaria is not considered endemic and malaria transmission does not normally occur. The Ministry of Health in Jamaica has responded to these latest cases with heightened surveillance for malaria cases, measures to control mosquitoes (larviciding and spraying), and educating the local population.

Antimalarial Medication

CDC recommends antimalarial medication for travelers who stay overnight in Kingston, Jamaica, only. Travelers to other areas of Jamaica do not need to take an antimalarial drug. This recommendation is expected to be temporary. Travelers should periodically check the CDC Travelers’ Health website for updates.

Chloroquine, the recommended prophylaxis, has a long history of use and safety and is well tolerated by most people, including children. People with an allergy to chloroquine should discuss an alternative antimalarial drug with their health-care provider. To learn more about chloroquine, including dosing information, see Information for the Public: Prescription Drugs for Malaria.

Other Prevention Measures

Because no antimalarial drug is 100% protective, travelers to Jamaica should take precautions to protect against mosquito bites:

* Use insect repellent on exposed skin surfaces when outdoors, particularly from dusk to dawn. Repellents containing 30%-50% DEET (N, N-diethyl-m-toluamide) are recommended for adults. Lower concentrations of DEET offer shorter-term protection, requiring more frequent reapplication.
o For additional information regarding the use of repellent on infants and children, please see the “Insect and Other Arthropod Protection” section in Traveling Safely with Infants and Children and the “Children” section of CDC’s Frequently Asked Questions about Repellent Use.
* To learn more about preventing mosquito bites and the appropriate use of insect repellents, visit Protection Against Mosquitoes and Other Arthropods in CDC Health Information for International Travel 2008 and What You Need to Know about Mosquito Repellents.

Malaria caused by P. falciparum may rapidly result in a severe, life-threatening illness if not promptly treated. If you have traveled to Jamaica and you become ill with fever and other flu-like symptoms, you should immediately seek professional medical care; inform your health-care provider about your recent travel.

More Information

For additional information about health recommendations for travel to Jamaica, visit CDC’s Travelers’ Health webpage, Health Information for Travel to Jamaica.

Additional information about malaria can be found at the CDC Malaria homepage.

Health-care providers needing assistance with diagnosis or management of suspected cases of malaria should call the CDC Malaria Hotline: 770-488-7788 (M-F, 8 am-4:30 pm, Eastern Time). For consultation after hours, call 770-488-7100 and ask to speak with a CDC Malaria Branch clinician.

"Vibrating Mice" Develop Less Fat, Study Shows

A new study in mice could shake up the fight against fat.

Laboratory mice that spent 15 minutes a day on a vibrating platform developed 28 percent less fat than control mice during a recent experiment.

But forget the ads for waistband-jiggling vibration belts guaranteed to "burn away fat." These mice experienced very subtle, almost undetectable, tremors.

Scientists theorize that as the mice developed, the vibrations mimicked muscle activity and induced their stem cells to develop into bone or muscle cells rather than fat cells.

"We're not burning fat or taking fat mice and making them skinny," said lead author Clinton Rubin, a biomedical engineer at the State University of New York, Stony Brook.

"We're taking mice who are growing and ... influencing the decision of stem cells [so that they don't] become fat cells."

(Related news: "Modified Mice Stay Super-Fit -- Without Exercise" [August 25, 2004].)

The finding came in part from research in human spaceflight. Rubin and colleagues are trying to induce stem cells to become bone cells in order to offset the bone loss that results in zero-gravity space environments.

Rubin has also co-founded a for-profit company, Juvent Medical, that is using a similar concept to treat osteoporosis.

The study will appear this week in the journal Proceedings of the National Academy of Science.

Fighting Fat Before it Appears

The human body needs fat cells, which store food energy for future use.

Most doctors believe that obesity is the result of consuming more calories than a body burns. Recent research suggests that genetics and other factors may also play a role.

Rubin cautions that the study is preliminary and raises as many questions as it answers.

But the possibilities for human weight control are intriguing, and they may include developmental as well as metabolic factors.

"Just imagine a way to keep people from getting fat that is not [only] about how many Oreos they eat or how much they exercise—but about keeping them from forming fat cells in the first place," he said.

No Guilt-Free Solutions

But if the prospect of consequence-free overeating and sloth sounds too good to be true, it probably is, experts say.

"The reason we have those cells is to take [in] excess fat," said Roger Unger, an obesity researcher at the University of Texas Southwestern Medical Center.

"If you inhibit [fat cells] and overeat, you haven't done that person a favor," said Unger, who was not involved in the new research.

"The surplus lipids would end up in organs where you don't want to have surplus lipids—like the heart and the liver."

"People that don't have [as many] fat cells, if they overeat, get very sick—[they get] sicker at a much earlier age than people who first get fat and then develop complications."

Rexford Ahima is a University of Pennsylvania endocrinologist.

"The idea that 'non-strenuous work' can reduce body fat is intriguing; however, the findings have to be interpreted with caution," he said.

Ahima noted that key information regarding the mice's energy expenditure, hormones, and metabolism remains unknown and may have impacted the results.

Air Quality Danger From Laser Printers

Recent reports by the American Chemical Society and other organizations have indicated that certain laser printers used in offices, as well as homes, release tiny particles from the toner material used in them. Since these reports were issued, ClearFlite Air Purifier (www.airpurifiers.com) has received many requests for clarification about air purification products that can help to keep office air cleaner and safer.

Elyria, OH (PRWEB) September 25, 2007 -- Recent reports by the American Chemical Society and other organizations have indicated that certain laser printers used in offices, as well as homes, release tiny particles from the toner material used in them. Since these reports were issued, ClearFlite Air Purifier has received many requests for clarification about air purification products that can help to keep office air cleaner and safer.


ClearFlite Air Purifier requested statements from the manufacturers of the products it sells clarifying whether or not their products were capable of capturing these ultra fine particles. Their statements are given below in alphabetical order by company name:

"At AllerAir, we have consistently maintained that airborne chemicals and particles pose a serious health threat both at home and in the workplace; in fact it's the basis our entire company philosophy. Our most popular air purifiers are designed with 18 to 28 pounds of activated carbon for chemical, gas and odor protection coupled with medical-grade HEPA filters for ultra-fine particles. We also offer special carbon blends to better adsorb common office pollutants like toner, ink, VOC's, and ozone. The recent study on desktop laser printers and poor air quality only confirms that the dangers of airborne chemicals and particles are real and potentially far-reaching. Until more research is done in this area, we believe it's the responsibility of all employers and employees to take adequate steps to protect the clean air that is vital to us all." This statement was provided by Sam Teitelbaum, President and Founder of AllerAir.

David Fuller, Sales Manager of Austin Air Systems provided this statement: "Current research finds that many household and office printers, faxes and copiers are emitting harmful ultafine particles and chemical emissions, including ozone. Breathing in these ultrafine particles and chemicals may pose a health hazard, experts caution. Austin Air's HealthMate air cleaner aids in the removal of these harmful emissions before office patrons breathe them in. In addition, the HealthMate reduces the chemicals and ozone pollutions present in the office air from other contributing machines (faxes, copiers, etc) and environment factors which is industry-unmatched use of 60 feet of top grade medical HEPA filtration and 15 pounds of activated carbon and zeolite."

Blueair President and Founder, Bengt Rittri, provided this statement regarding Blueair air purification products: "Blueair air purifiers are a perfect solution to trap airborne toner particles from laser printers. A Laser printer can emit millions of small pollutants. Blueair will trap millions of particles in minutes."

Exercise Can Reduce Breast Cancer Risk: Fitness Expert David Berger Suggests First Steps in Fitness Program

A woman's risk for breast cancer can be reduced through regular exercise, which lowers hormone levels. Fitness guru David Berger recommends beginning an exercise regimen during October, which is Breast Cancer Awareness month. Berger has developed a free, downloadable Exercast of three exercises that are an excellent beginning for any new fitness routine.

Wilmington, DE (PRWEB) October 20, 2007 -- Breast Cancer Awareness Month, recognized each October, is an ideal time for women to take a step toward breast cancer prevention by starting an exercise program, says Fitness Expert David Berger, developer of the Number One Me™ personal coaching system. Studies have proven that exercise reduces breast cancer risk because it can decrease hormone levels, especially in young women.

"With the increased national attention on breast cancer, it is a great time to get the message out that women can take a personal stand against breast cancer by exercising and lowering their risks," Berger says.

In fact, physical activity is likely to reduce personal risk for all cancers. Research shows that about one-third of all cancer deaths are related to dietary factors and lack of physical activity in adulthood. The American Cancer Society suggests 45 to 60 minutes of exercise five or more days a week.

Berger has developed a series of exercises and a free downloadable Exercast to make it easy for women who want to start an exercise routine during Breast Cancer Awareness Month--or at any time. The Exercast is available at http://www.numberoneme.com/images/pinkribbon.wmv

When you've mastered these routines, visit www.numberoneme.com to learn more about building an exercise program for LIFE.

About David Berger: At the age of 18, weighing over 250 pounds with a 40-inch waist and smoking a pack of cigarettes a day, David Berger struggled to climb a single flight of stairs. David's journey to better health began when he quit smoking. He also decided that he would immediately begin eating healthier and exercising, climbing a single flight of stairs a day and adding another flight each week. He also started performing calisthenic exercises. Through his commitment to his consistent and progressive approach, he lost over 88 pounds and 6 inches from his waist within one year. David went on to earn a degree in Kinesiology from West Chester University and launch Progressive Fitness Coaching and now the NUMBER ONE ME! personal coaching DVD.

About Number One Me™ at www.numberoneme.com: Increase your core strength, balance, endurance and flexibility…Be Fit For Life. David Berger's NUMBER ONE ME--Personal Coaching for Personal Best! Learn to effectively use the single greatest piece of exercise equipment ever created…your body. Over 45 calisthenic exercises instructed for you in three levels of progression: beginner, intermediate, and advanced. Exercise at your convenience and in the comfort of your home with peak-performance coach David Berger. No more excuses.