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Posts Tagged ‘Health’

WebMD – Expert Q&A: Fighting Midlife Weight Gain

Posted by 4love2love on July 26, 2011

An interview with Pamela Peeke, MD
By Kathleen Doheny
WebMD Feature
Reviewed by Louise Chang, MD

First, you notice shopping for clothes isn’t as fun or simple as it used to be. Next comes the “muffin top” spilling over the jeans. Then the scale delivers dire news: You’re 10, 15, maybe 20 pounds beyond your “normal” weight.

Midlife weight gain is common. Many Americans gain a pound or so every year as they make their way through young adulthood, ending up fat and flabby at age 40 and beyond.

But it is not inevitable, says Pamela Peeke, MD, MPH, the author of the best-seller Fight FatAfter Forty. Peeke also serves as the chief medical correspondent for Discovery Health TV and often appears as a medical commentator on television news and talk shows.

Why do so many people gain weight in midlife?

Blame it on hormones in convergence with poor lifestyle choices, overeating, not exercising enough, and stress.

But hormones only account for about 2 to 5 pounds. The rest is the result of overeating, poor lifestyle choices — such as not exercising enough — and stress.

How can I not be one of those people who gains?

The keys are three: mind, mouth, muscle.

Use your mind to control stress. If you walk around and everything is stressful, you have a problem. You may respond to stress by making poorer lifestyle choices, such as not eating healthfully and not exercising enough.

Look at your nutrition — in terms of quality, quantity, and frequency of eating. You should eat often.

Quality is all about eating whole foods, fruits, and vegetables, whole grains, lean protein.

Processed foods are bad. Anything that comes in a family-size bag, turn in the opposite direction and run.

Quantity is where a lot of people fall. The majority are baffled by what a serving size should look like. When eating out, and in doubt, eat half of it or less.

Be accountable for calories. You need a general idea of how many calories you need. An average woman, not an athlete, in her 40s or 50s, needs about 1,500 to 1,600 calories a day, on average, if she is exercising. A middle-aged man, average height and not an athlete but exercising, needs about 1,800 to 2,000.

Muscle, of course, refers to the need to exercise and, of course, to weight train.

Should my goal weight increase when I hit midlife?

A better goal than focusing on scale weight is to keep track of body fat. The goals should be to decrease body fat and optimize bone strength.

For a man, a body fat percentage of 18% to 25% is not bad for 40-plus. For women 40-plus, 22% to 27% is not bad.

To get that body fat percentage, you need to have excellent fitness to maintain a good muscle base.

Also, a man should have a waist circumference below 40 inches and a woman below 35 inches.

I’m 40-plus, eating right, and exercising but not losing weight. Why do I have midlife weight gain?

If you have tailored your portion sizes to ones that are appropriate, look at the frequency of your eating. Eat every three or four hours. But not too late at night. The later you eat, the lighter you eat is a good rule.

Eat a balance of lean protein, fats, and carbs. Make the fat good fat, not palm oil or hydrogenated oil, but high-quality good fats [such as those in nuts]. The protein should be lean — a turkey burger or a veggie burger.

Most people have been doing the same exercise routine for years, and your body acclimates. Fat cells at 40 are reticent to give it up. Mix up the exercise routine. Exercise at least five times a week, and I mean cardio.

Add intensity. Add some level of weight training, and challenge yourself with the weights. [Getting professional instruction is advised if you’re a novice.] Weight train two or three times a week.

Building muscle gives you that metabolic edge, since muscle mass burns more calories than fat.

Does HRT cause midlife weight gain, is that the culprit?

You can’t blame the low doses of HRT in use today for midlife weight gain, at least not for any more than a few pounds. You do get a little more bloated on it, but it does not cause body fat accumulation. Overeating, not exercising, and stress do.

What’s up with this belly? I never ever had one before.

I call it the menopot. On a man, it’s the manopot.

Excess body fat occurring in the lower abdomen is associated with aging, after 40. This excess body fat in the normal range is usually only 2 to 5 pounds. And you do get a little pooch.

How can I lose this belly?

You minimize it by following the mind-mouth-muscle concepts.

But it’s probably unrealistic to expect a stomach as flat as your 20-something stomach.

Can I boost my metabolism?

Absolutely. You can optimize your metabolism throughout life relative to your age by maintaining the highest level of training you can, within the limits and constraints of your life.

If you lose muscle mass [by not exercising], obviously your metabolism is going to drop.

Of course strength or weight training is crucial.

What workout or workouts are best for midlife people?

Creative cardio. Burn 400 to 500 calories a day in cardio. On the elliptical, for instance, you can burn about 400 calories in about 35 minutes. Cross train as much as you can. Burn the 400 to 500 calories all at once or accrue it.

And don’t forget the weight training.

What’s your weakness? What’s the hardest part, for you, of staying on track and fighting flab after 40?

Because of long days and all my commitments, getting enough sleep. I remind myself: the poorer your sleep, the wider your girth.

Eating dinner not too late. Sometimes I am on a plane or a train, I don’t have the control I want over how late I eat. In general, do not eat dinner past 8:30. I like to eat right about 7.

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WebMD – You Asked! Expert A’s to Your Beauty Q’s: Pretty Feet

Posted by 4love2love on July 24, 2011

Step into spring with our expert picks for softer, more radiant feet.
By Ayren Jackson-Cannady
WebMD the Magazine – Feature
Reviewed by Karyn Grossman, MD

In each issue of WebMD the Magazine, our experts answer your questions aboutskin care, beauty, makeup, hair care, and more. In our March-April 2011 issue, Daphne LaSalle, 30, who lives on the U.S. Air Force Base in Altus, Okla., asked about beautifying her feet for summer. We ran her question by two doctors: Eric Reynolds, DPM, a podiatrist in Jersey City, N.J., and Elizabeth Tanzi, MD, who is co-director of the Washington Institute of Dermatologic Laser Surgery in Washington, D.C., as well as an assistant professor of dermatology at Johns Hopkins University. Here’s what they had to say:

Q: What can I do now to get my feet soft and ready to show off by sandal season?

Tanzi’s top picks:

A: Thick, dry patches pop up on heels during winter months because feet are often crammed into heavy socks and boots that don’t allow for effective exfoliation of dead skin. To loosen up that scaly epidermis, use a nightly cream likeDr. Scholl’s Ultra Overnight Foot Cream($6.99), containing aloe and palm oil to soothe tough skin.

To buff the dead skin away once it’s been softened, try the PedEgg Pro Pedicure Foot File with Handle ($12.99). It’s better than a pumice stone for gently sanding down thick skin on the heel and ball of the foot because its stainless-steel micro files stay sharp. Once the bottoms of your feet are smooth, keep them hydrated with an emollient-rich lotion likeL’Occitane Shea Butter Foot Cream ($26), which is packed with moisture-locking shea butter.

If you painted your toes in rich, dark hues throughout the winter, you may be noticing some nail yellowing. Take a break from polish for a week or two, and the discoloration will slowly fade. Once you’re back to coating your toenails in polish, be sure to start with a clear base coat without formaldehyde, a chemical that can react with the keratin protein in nails and make them change colors. The formaldehyde-free OPI Start-to-Finish Base & Top Coat ($12.50) is a good one to try.

Reynolds’s top picks:

A: During winter months when humidity is low, skin dries out more rapidly. In some cases, feet get so dry they peel or crack. While there are plenty of prescriptionmedications that work wonders, I like to start with home remedies, which are inexpensive and can be just as effective.

To soften super-dry areas, soak your feet in original Listerine AntisepticMouthwash ($4) (yes, Listerine!) once or twice a week. Mix one part Listerine with two parts warm water in a basin and soak your feet for 15 to 20 minutes, then apply a moisturizer like Eucerin Plus Intensive Repair Foot Creme ($5.59), which contains hydrating urea. In addition to skin-sloughing benzoic acid, Listerine contains ethanol, which kills bacteria, fungi, and germs that can lead to athlete’s foot.

Coating feet in a cream like Burt’s Bees Thoroughly Therapeutic Honey & Bilberry Foot Creme ($10), which is loaded with moisture-replenishing honey and jojoba oil, and wearing socks to bed is an excellent way to lock in moisture for softer feet. If you can’t stand to sleep in socks, place a humidifier at the foot of your bed to keep feet hydrated. Treat thick, dry patches on your feet by massaging them with Vicks VapoRub topical ointment ($3) in the p.m. to battle bacteria while you sleep.

Symptoms of Common Foot Problems

A normal nail bed is pink and smooth. Anything other than that may be a sign of a serious medical condition, Reynolds says. Here’s what to be wary of.

Are your nails brown or black?

See a doctor ASAP. A black or brown spot on your nail could be an indication ofmelanoma, the most dangerous form of skin cancer.

Are they green?

This might be a bacterial or fungal infection caused by trauma to the nail. The tint could be from trapped fluid or pus underneath the nail.

Are there horizontal ridges?

Bumpy lines that run across the nail may be an indication of chronic eczema on the skin under or around the toenail.

Are there vertical ridges?

Some people with rheumatoid arthritis or problems with circulation have lines running along the length of their toenails.

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

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FDA Alert – Drug Safety Communication: Multaq (dronedarone) – Increased Risk of Death or Serious Cardiovascular Events

Posted by 4love2love on July 24, 2011

July 21, 2011

ISSUE
: FDA notified healthcareprofessionals that it is reviewing data from a clinical trial that evaluated the effects of the antiarrhythmic drug Multaq (dronedarone) in patients with permanent atrial fibrillation. The study was stopped early after the data monitoring committee found a two-fold increase in death, as well as two-fold increases in stroke and hospitalization for heart failure in patients receiving Multaq compared to patients taking a placebo. FDA is evaluating whether and how the preliminary results of the PALLAS study apply to patients taking Multaq for paroxysmal or persistent atrial fibrillation or atrial flutter. The PALLAS study results are considered preliminary at this time because the data have not undergone quality assurance procedures and have not been completely adjudicated. FDA will update the public when more information is available.

BACKGROUND: Multaq is approved for use to reduce the risk of cardiovascular hospitalization in patients with paroxysmal or persistent atrial fibrillation (AF) or atrial flutter (AFL), with a recent episode of AF/AFL and associated cardiovascular risk factors, who are in sinus rhythm or who will be cardioverted.

RECOMMENDATION: At this time, patients taking Multaq should talk to their healthcareprofessional about whether they should continue to take Multaq for non-permanent atrial fibrillation. Patients should not stop taking Multaq without talking to a healthcare professional. Healthcare professionals should not prescribe Multaq to patients with permanent atrial fibrillation. See the Data Summary in the Drug Safety Communication for additional details.

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FDA Alert – Drug Safety Communication: CardioGen-82 PET Scan – Increased Radiation Exposure

Posted by 4love2love on July 24, 2011

July 15, 2011

ISSUE:
 FDA notified the public and the medical imaging community about the potential for inadvertent, increased radiation exposure in patients who underwent or will be undergoing cardiac positron emission tomography (PET) scans with rubidium (Rb)-82 chloride injection from CardioGen-82 manufactured by Bracco Diagnostics, Inc.

BACKGROUND: A CardioGen-82 PET scan is one of a variety of nuclear medicine scans and uses the radioactive drug Rb-82 chloride injection to evaluate the heart. FDA has received reports of two patients who received more radiation than expected from CardioGen-82. The excess radiation was due to strontium isotopes which may have been inadvertently injected into the patients due to a “strontium breakthrough” problem with CardioGen-82.

RECOMMENDATION: At this time, FDA believes that the risk of harm from this exposure is minimal, although any unnecessary exposure to radiation is undesirable. The estimated amount of excess radiation the two patients received is similar to that other patients may receive with cumulative exposure to certain other types of heart scans. It would take much more radiation to cause any severe adverse health effects in patients.

Healthcare professionals should closely follow the required testing and quality control procedures essential to help detect strontium breakthrough from CardioGen-82. Other types of heart scans provide information very similar to CardioGen-82 and professionals are encouraged to consider these alternatives while FDA completes its investigation of the reported cases of excess radiation exposure.

Patients who have recently had heart scans should talk to their healthcare professional if they have any questions. Patients who are planning to undergo a heart scan should talk to the healthcare professional if they are unsure of the type of planned heart scan and the radiation risks associated with the scan.

FDA is actively investigating the root cause of this failure with CardioGen-82 and will promptly notify the public with updates.

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FDA Alert – Public Notification: Slim Forte Slimming Capsule and Slim Forte Double Power Slimming Capsules – Undeclared Drug Ingredient

Posted by 4love2love on July 24, 2011

July 8, 2011

ISSUE
: FDA is advising consumers not to purchase or use Slim Forte Slimming Capsule and Slim Forte Double Power Slimming Capsules. FDA laboratory analysis confirmed that these products contain sibutramine. Sibutramine is a controlled substance that was removed from the U.S. market in October 2010 for safety reasons. These products pose a threat to consumers because sibutramine is known to substantially increase blood pressure and/or pulse rate in some patients and may present a significant risk for patients with a history of coronary artery disease, congestive heart failure, arrhythmias, or stroke. These products may also interact in life threatening ways with other medications a consumer may be taking.

BACKGROUND: Slim Forte Slimming Capsule and Slim Forte Double Power Slimming Capsules are products marketed for weight loss, sold on various websites and distributed by LA Beauty Store, Inc. This notification is to inform the public of a growing trend of products marketed as dietary supplements or conventional foods with hidden drugs and chemicals.

RECOMMENDATION: Consumers should stop using these products immediately and throw them away. Consumers who have experienced any negative side effects should consult a health care professional as soon as possible.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

[07/08/2011 – Public Notification – FDA]

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FDA Approves Lazanda – First Fentanyl Nasal Spray – for the Management of Breakthrough Pain in Cancer Patients

Posted by 4love2love on July 24, 2011

FDA Approves Lazanda – First Fentanyl Nasal Spray – for the Management of Breakthrough Pain in Cancer Patients

“Lazanda is an important new option for patients with cancer who experience excruciating breakthrough pain,” says Jeffrey H. Buchalter, chief executive officer of Archimedes Pharma. “Lazanda, which uses our patented PecSys® drug delivery system, is designed to deliver medicine in a rapid, but controlled manner, and provides patients with an effective alternative to manage their breakthrough pain.”

Breakthrough pain in cancer (BTPc) is an intense, sudden pain that is often unpredictable and debilitating and occurs despite otherwise appropriate opioid therapy for background pain. BTPc has a different profile from background pain. BTPc often has high intensity, a rapid onset, usually reaching maximum intensity within five minutes, and a short duration, lasting between 30 and 60 minutes per episode. On average, BTPc affects more than half of patients with cancer and often interferes with patients’ health and ability to engage in daily living activities.

“As the first fentanyl nasal spray in the U.S., Lazanda provides a new approach to managing the often debilitating and inadequately-treated episodes of breakthrough pain that many patients with cancer experience,” said Donald Taylor, M.D., director at Taylor Research LLC., and clinical investigator for Lazanda. “Current treatment options typically utilize short-acting oral opioid medications that cannot provide pain relief with an onset of action or duration of effect that matches the time course of a BTPc episode. Lazanda’s rapid and controlled availability is a much better match for the nature of an episode of breakthrough pain, giving physicians a new and powerful tool for treating cancer breakthrough pain.”

Lazanda will be available in the second half of this year through a Risk Evaluation and Mitigation Strategy (REMS) program, which is intended to minimize the risk of misuse, abuse, addiction, overdose, and serious complications due to medication errors. Under the Lazanda REMS program, pharmacies, distributors, and health care professionals who prescribe to outpatients are required to enroll in the program to dispense, distribute, and prescribe Lazanda.

“We fully support the FDA mandate to implement a REMS program for Lazanda as an important way to provide patients, healthcare providers, and pharmacists with the information they need about the appropriate and safe use of Lazanda,” said Buchalter. “Archimedes Pharma looks forward to working closely with health care professionals to ensure safe and consistent access to Lazanda for the patients who are seeking relief from unbearable episodes of breakthrough pain in cancer.”

About Lazanda (fentanyl) nasal spray

Lazanda contains fentanyl, which is a Schedule II controlled substance, and uses Archimedes Pharma’s patented drug delivery system, PecSys®.

Lazanda, incorporating PecSys technology, delivers fentanyl in a rapid, but controlled manner and is designed to deliver a fine mist spray to a mucus membrane, in this case the nasal membrane. Each spray of Lazanda forms a gel when it contacts the nasal mucosa; the active ingredient is then rapidly absorbed across the mucus membrane and directly into the blood stream.

The efficacy of Lazanda for the management of breakthrough pain in adult cancer patients was established in a double-blind, placebo-controlled clinical study in which Lazanda showed a statistically significant improvement compared with placebo on the primary endpoint, the sum of the pain intensity difference at 30 minutes (SPID30). More than 500 patients evaluated in the clinical trial program (which included three phase III clinical trials) contributed to the understanding of the tolerability and safety profile of Lazanda. The most common adverse events associated with Lazanda were consistent with opioid treatment and included vomiting, nausea, pyrexia (fever), and constipation.

Important Safety Information

Warnings: Potential for Abuse and Importance of Proper Patient Selection

Lazanda contains fentanyl, an opioid agonist and a Schedule II controlled substance, with an abuse liability similar to other opioid analgesics. Lazanda can be abused in a manner similar to other opioid agonists, legal or illicit. Consider the potential for abuse when prescribing or dispensing Lazanda in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion. Schedule II opioid substances, which include morphine, oxycodone, hydromorphone, oxymorphone, and methadone, have the highest potential for abuse and risk of fatal overdose due to respiratory depression. Serious adverse events, including deaths, in patients treated with other oral transmucosal fentanyl products have been reported. Deaths occurred as a result of improper patient selection (e.g., use in opioid non-tolerant patients) and/or improper dosing. The substitution of Lazanda for any other fentanyl product may result in fatal overdose.

Lazanda is indicated only for the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. Patients considered opioid tolerant are those who are taking at least 60 mg of oral morphine/day, 25 mcg of transdermal fentanyl/hour, 30 mg of oxycodone/day, 8 mg oral hydromorphone/day, 25 mg oral oxymorphone/day, or an equianalgesic dose of another opioid for one week or longer.

Lazanda is contraindicated in opioid non-tolerant patients and is contraindicated in the management of acute or postoperative pain, including headache/migraine, dental pain, or use in the emergency room. Life-threatening respiratory depression could occur at any dose in opioid non-tolerant patients. Deaths have occurred in opioid non-tolerant patients treated with other fentanyl products. When prescribing, do not convert patients on a mcg per mcg basis from another fentanyl product to Lazanda. Patients beginning treatment with Lazanda must begin with titration from the 100 mcg dose. (see Dosage and Administration)

When dispensing, do not substitute a Lazanda prescription for any other fentanyl product. Substantial differences exist in the pharmacokinetics of Lazanda compared to other fentanyl products that could result in clinically important differences in the rate and extent of absorption of fentanyl and could result in fatal overdose.

Special care must be used when dosing with Lazanda. If the breakthrough pain episode is not relieved, patients must wait at least 2 hours before taking another dose of Lazanda. (see Dosage and Administration)

Lazanda is intended to be used only in the care of opioid tolerant patients with cancer and only by healthcare professionals who are knowledgeable of, and skilled in, the use of Schedule II opioids to treat cancer pain.

Patients and their caregivers must be instructed that Lazanda contains a medicine in an amount that can be fatal in children, in individuals for whom it is not prescribed, and in those who are not opioid tolerant. Lazanda must be kept out of the reach of children at all times. (see Patient/Caregiver Instructions)

The concomitant use of Lazanda with cytochrome P450 3A4 inhibitors may result in an increase in fentanyl plasma concentrations and may cause potentially fatal respiratory depression.

Because of the risk for misuse, abuse, addiction, and overdose, Lazanda is available only through a restricted program, required by the Food and Drug Administration, called the Lazanda REMS (Risk Evaluation and Mitigation Strategy) program. Under the Lazanda REMS program,healthcare professionals who prescribe to outpatients, pharmacies, and distributors must enroll in the program to prescribe, receive, dispense, and distribute Lazanda, respectively. [see Warnings and Precautions]. Further information is available at http://www.LazandaREMS.com or by calling 1-855-841-4234.

Contraindications

  • Lazanda is contraindicated in the management of pain in opioid non-tolerant patients, because life-threatening hypoventilation could occur at any dose in patients not already taking around-the-clock opioid therapy.
  • Lazanda is contraindicated in the management of acute or postoperative pain, including headache/migraine, dental pain, or use in the emergency room.
  • Lazanda is contraindicated in patients with known intolerance or hypersensitivity to any of its components or the drug fentanyl. Anaphylaxis and hypersensitivity have been reported in association with the use of other oral transmucosal fentanyl products.

Warnings And Precautions

  • Patients must not be converted to Lazanda from other fentanyl products because it is not equivalent to other fentanyl products on a mcg per mcg basis, and such substitution could result in a fatal overdose; do not substitute Lazanda for another fentanyl product when being dispensed.
  • Serious or fatal respiratory depression can occur even at recommended doses in patients using Lazanda. Respiratory depression is more likely to occur in patients with underlying respiratory disorders and elderly or debilitated patients, in opioid non-tolerant patients, or when opioids are given in conjunction with other drugs that depress respiration.
  • Lazanda could be fatal to individuals for whom it is not prescribed and for those who are not opioid tolerant.
  • Patients and their caregivers must be instructed that Lazanda contains medicine in an amount that could be fatal to a child and thus must keep both used and unused bottles in their child-resistant container and out of the reach of children at all times and all residual fentanyl must be emptied before disposal.
  • Patients on concomitant CNS depressants must be monitored for a change in opioid effects and adjust the dose of Lazanda.
  • Concomitant use with potent cytochrome P450 3A4 inhibitors may increase depressant effects including hypoventilation, hypotension, and profound sedation. Monitor and consider dosage adjustment if warranted.
  • Cautiously adjust the dose of Lazanda in patients with chronic obstructive pulmonary disease or preexisting medical conditions predisposing them to respiratory depression.
  • Administer Lazanda with extreme caution in patients particularly susceptible to intracranial effects of CO2 retention, such as those with evidence of increased intracranial pressure or impaired consciousness.
  • Patients taking Lazanda must be warned that opioid analgesics impair the mental and/or physical ability required for the performance of potentially dangerous tasks (e.g., driving a car or operating machinery).
  • Use Lazanda with caution in patients with bradyarrhythmias.
  • Lazanda is not recommended for use in patients who have received MAO inhibitors within 14 days, because severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics.

Drug Interactions

  • Potential interactions may occur when Lazanda is given concurrently with agents that affect CYP3A4 activity. Monitor patients for signs of opioid toxicity who begin therapy with, or increase the dose of, inhibitors of CYP3A4 or stop therapy with, or decrease the dose of, inducers of CYP3A4.Monitor patients who are taking vasoconstrictive nasal agents to treat allergic rhinitis for potentially impaired pain management.

Use In Specific Populations

  • Safety and efficacy below 18 years of age have not been established.
  • There are no adequate and well-controlled studies of Lazanda in pregnant women. Do not use Lazanda during labor and delivery or in women who are nursing.
  • Lazanda should be administered with caution in patients with impaired renal or hepatic function and titrated to clinical effect in patients with severe renal or hepatic disease.

Adverse Reactions

  • Most common adverse events during titration (frequency greater than or equal to 5%): nausea, vomiting, and dizziness.
  • Most common adverse events during maintenance (frequency greater than or equal to 5%): vomiting, nausea, pyrexia, and constipation.

Please see the accompanying full Prescribing Information including boxed warning. For more information please see http://www.lazanda.com.

About Archimedes Pharma

Archimedes Pharma is an international specialty pharmaceutical company providing novel and advanced treatments to address unmet needs for people living with serious or life-threatening chronic and debilitating illnesses. Archimedes Pharma markets a diverse portfolio of speciality products and has operations in the U.S. and throughout Europe. Archimedes Pharma U.S. Inc. is a subsidiary of Archimedes Pharma Ltd. For more information, please visit: http://www.ArchimedesPharma.com.

Lazanda®, PecFent®, and PecSys® are registered trademarks of Archimedes Development Ltd.

SOURCE Archimedes Pharma Ltd.

Posted: June 2011

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FDA Alert – Recall: Endocet (oxycodone / acetaminophen) Tablets, ( 10mg, 325mg ) – Some Bottles Contain Different Strength Tablets

Posted by 4love2love on July 24, 2011

June 27, 2011
ISSUE: Endo Pharmaceuticals  and FDA notified pharmacists and patients of a nationwide consumer level recall of Endocet (oxycodone/acetaminophen, USP) Tablets, 10 mg/325 mg  because some bottles may contain different strength tablets, resulting in  patients taking more than the intended acetaminophen dose. Unintentional administration of tablets with increased acetaminophen content may result in liver toxicity, especially in patients on other acetaminophen containing medications, patients with liver dysfunction, or people who consume more than 3 alcoholic beverages a day.

BACKGROUND: The affected lots were distributed between April 19, 2011 and May 10, 2011 directly to wholesalers who are located in the following states: AL, AZ, CA, CO, NY, OH, ND, PR, IL, KY, NH, NJ, LA, NC, MO, PA, FL and TN. These wholesalers may further distribute to other retailers and wholesalers nationwide. Lot numbers can be found on the side of the manufacturer’s bottle. Tablet descriptions and photographs are provided in the firm’s press release.

RECOMMENDATION: Consumers who have the affected product should stop using the product and contact Endo’s agent Stericycle at 1-866-723-2681 for return of the product.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

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FDA MedWatch Alert – Erythropoiesis-Stimulating Agents (ESAs) In Chronic Kidney Disease: Drug Safety Communication – Modified Dosing Recommendations

Posted by 4love2love on July 24, 2011

June 24, 2011
Epoetin alfa (marketed as Epogen and Procrit) and darbepoetin alfa (marketed as Aranesp)

ISSUE: FDA notified healthcare professionalsthat new, modified recommendations for more conservative dosing of Erythropoiesis-Stimulating Agents (ESAs) in patients with chronic kidney disease (CKD) have been approved to improve the safe use of these drugs. FDA has made these recommendations because of data showing increased risks of cardiovascular events with ESAs in this patient population. The new dosing recommendations are based on clinical trials showing that using ESAs to target a hemoglobin level of greater than 11 g/dL in patients with CKD provides no additional benefit than lower target levels, and increases the risk of experiencing serious adverse cardiovascular events, such as heart attack or stroke.

BACKGROUND: ESAs treat certain types of anemia by stimulating the bone marrow to produce red blood cells and by decreasing the need for blood transfusions. The manufacturer has revised the Boxed Warning, Warnings and Precautions, and Dosage and Administration sections of the labels for the ESAs to include this new information.

RECOMMENDATIONHealthcare professionals should weigh the possible benefits of using ESAs to decrease the need for red blood cell transfusions in CKD patients against the increased risks for serious cardiovascular events, and should inform their patients of the current understanding of potential risks and benefits. Therapy should be individualized to the patient and the lowest possible ESA dose given to reduce the need for transfusions. See the Drug Safety Communication for additional information including a table of key trials and other supporting references. Treatment with ESAs in CKD was discussed at the Cardiovascular and Renal Drugs Advisory Committee, held October 18, 2010. For summary minutes of that Advisory Committee, see link below.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

  • Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
  • Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

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WebMD – Extreme Fitness: Calorie-Torching Workouts

Posted by 4love2love on July 18, 2011

Please remember to consult your physician before beginning any new exercise activities. Depending on your health, some of these exercises may be too strenuous for your personal situation. Swimming exercises are really good for low-impact, calorie burning exercises for people with more limited abilities, aged, or with certain limitations or physical disabilities. Whether or not you will be able to perform some of these exercises will depend on your individual situation. Please take care when getting into any new exercise regime.

 

Don’t plan on reading a magazine while you do these workouts. You’re entering a no-slacking zone.
By Annabelle Robertson
WebMD Feature
Reviewed by Laura J. Martin, MD

Looking to blast calories? Get ready — it’s going to be intense.

“It’s got to be high intensity, whatever the workout is, if you’re going to torch calories — not just burn them,” says Bret Emery, a behavioral psychologist and weight loss specialist based in Weston, Fla. “Heart rate is key. That’s the speedometer of the body. If we speed the body up, it will burn more calories, just as a car will burn more fuel if it speeds up.”

Also, you need to mix up your workouts so they stay challenging. This will help keep your heart rate up, and force your body to burn more calories, Weston says.

The following workouts will zap calories, but they’ll also push your body way past your comfort zone. So check with your doctor before taking on the challenge. Don’t just tell your doctor you want to work out — let him or her know exactly what you’re planning to do. That way, your doctor can make sure you’re ready.

If you’re not active now, remember that it is better to ease into exercise in order to help prevent injury. Even though you may want to go all-out immediately, it’s wiser not to.

Interval Workout

Interval training is all about challenge and recovery — over and over — for a cardio blast.

You can do intervals many different ways — running, on any sort of cardio equipment, or in a pool.

This particular workout — which comes from Michael Banks, certified personal trainer and owner of Body by Banks Corporation in Salt Lake City — uses a treadmill. If you’re already fit, you can add dumbbells for an extra challenge.

1. Warm Up: On the treadmill, with the incline set at a challenging angle, power walk at a speed of 3-3.5 for 7 minutes. Keep your elbows up above your heart. Stop, get off the treadmill, and stretch.

2. Sprint: Drop the incline to 0, increase the treadmill speed, and sprint hard for 30 seconds. Aim for 90% of your maximum heart rate. To recover, bring your speed down to 3.0 and walk for one minute.

3. Squats: Get off the treadmill and squat, with your bottom out to the rear and your legs slightly apart. Then jump from the squatting position into the air, landing in the same squat position as before. Do this for one set of 15 or 20, working your quadriceps. If you’re already in good shape, hold dumbbells by your sides.

4. Overhead Presses: Do 15 or 20 overhead presses with the weights, pushing them straight up and directly over your shoulders.

5. Sprint: Get back on the treadmill and sprint for 30 seconds (no incline). The goal is to be at 80% of your maximum heart rate. To recover, decrease your speed to 3.0 and walk for one minute.

6. Tricep Extensions: Using dumbbells, do one set of 15 or 20 overhead tricep extensions. Your elbows should point toward the ceiling, with the weights behind your head. Lift the weights directly above your head and back down again.

7. Pushups. Do one set of 15 push-ups, with your elbows at a 90-degree angle from the body. Modification: Do the push-ups with your knees on the ground, but do 25 instead of 15.

8. Sprint: Back to the treadmill. Sprint for 1 minute, aiming for 70% of your maximum heart rate. To recover, jog for 90 seconds.

9. Jumping Jacks. Do one set of 15 or 20 jumping jacks. If you’re strong enough, add two 10- or 15-pound dumbbells — lift up the weights when you jump out, in an overhead press position, pulling them back down to shoulderheight as your legs go back together.

10. Finale: Incline your treadmill to an angle that really challenges you — but don’t hang onto the treadmill’s rails. Walk at a 2.0-3.5 speed for 30 seconds, aiming for 60% of your maximum heart rate. To recover, bring the treadmill down to a 1.0 incline and drop your speed to 1.9 or 2.0 for a 1-minute walk. Finish by stretching.

Quick CrossFit Series

CrossFit workouts are about getting maximum effort in minimum time.

The following exercises come from Doug Katona, co-founder and owner of CrossFit Endurance in Newport Beach, Calif. They can be done on their own, all together, or in any combination.

30-90s

  1. Warm up for 10-12 minutes, finishing the warm-up at 75% of your maximum heart rate or at 7.5 on the perceived exertion scale, in which 0 is no effort and 10 is your max.
  2. Choose any type of cardio. Do it at your maximum effort for 30 seconds.
  3. Stop and recover for 2 minutes, or for 90 seconds if you’re already in good condition. Do not shortchange the rest period.
  4. Do this up to three times.

Body Weight Blast

As fast as you can, do 10 squats, 10 push-ups, and 10 full sit-ups. Then do nine reps of each. Then eight, seven, six, and so forth, until you reach one rep of each exercise. Rest as little as possible between sets. Record your time and try to improve each week.

100 Burpees

If you only have a little time, try to do 100 burpees. Or, if that’s too much, start with 25, then move to 50, then to 75, until you can do 100.

Begin in a squat position with your hands on the floor, in front.

  • Kick back your feet to a push-up position.
  • Return your feet to the squat position.
  • Jump from the squat position into the air, straight above you.
  • Repeat, moving as fast as possible

Rowing or Indoor Cycling

Don’t overlook the rowing machine and stationary bikes in your gym. You may be sitting down, but you’ll be sweating when you try this workout from Scott Nohejl, coach and program director of The Chatham Area Rowing Association in Savannah, Ga.

  1. Row or bike for a minute.
  2. Sprawl with push-up. Run in place, with your feet just coming off the ground, for a count of five. Lower yourself onto your hands, jump your legs backward to a push-up position. Do one push-up, then bring the legs back, tucking them in. Stand and repeat for 1 minute.
  3. Squats. With hands on top of your head, squat so your knees are at 90 degrees — make sure they do not go past your toes — and then stand up. Repeat for 1 minute.
  4. Side jumps. With feet together, toes pointed forward, jump from side to side for 1 minute.
  5. Rest for 5 minutes.
  6. Row or bike for 1 minute.
  7. Scissor jumps. With one leg in front and the other in back, jump and “scissor” your legs before landing. Do this for 1 minute.
  8. Sumo jumps. Squat down, then jump, bringing your feet slightly off the ground. Do this for 1 minute.
  9. Jumping jacks. Do these for 1 minute.

Repeat the full set four times, nonstop, for a 16-minute workout. Cool down, and then stretch.

Swimming

The pool isn’t just for cooling off. It’s also a great way to heat up your metabolism — and burn a maximum number of calories.

Craig Keller, chair of the U.S. MastersSwimming Coaches Committee and head coach of the Asphalt Green Masters Swim Team in New York City, offers several workouts for swimmers, including two that will work well for people with injuries.

If you like distance, begin with two 500-yard (or meter) freestyle swims on intervals of 6.5 minutes. The quicker you finish, the more time you’ll have to rest. Then swim at an easy pace for two minutes.

Follow that with two 400-yard freestyle swims on a 5.5-minute interval, and another easy, two-minute swim. Finish with two 300-yard swims on 4.5-minute intervals.

Sprinters may prefer this workout:

  1. Do 20 freestyle lengths (25 yards) with five seconds of rest in between lengths. Recover with a 100-yard swim of your choice, at an easy pace.
  2. Do 16 25-yard swims of your choice with 10 seconds of rest, followed by another slow-paced 100-yard swim of your choice.
  3. Next, do 12 25-yard freestyle lengths with 15 seconds of rest between each. Recover with a 100-yard swim.
  4. End with 8 25-yard Freestyle lengths, resting for 20 seconds between lengths.

Got a leg or hip injury? Just grab a buoy and do a “pull swim” instead.

This workout consists of three rounds of four 200-yard freestyle swims. For the first, put the buoy between your ankles and pull the four 200-yard swims on 3-minute intervals. For the second round, remove the buoy and swim, dragging your legs. Do these 200-yard swims on 2.75-minute intervals. For the final round, place the buoy between your legs and pull on 2.5-minute intervals.

If your arms or shoulders are hurting – or you simply want to work your legs – use a kickboard and do two sets of four 100-yard swims, with 20 seconds of rest between each.

For the first 100 yards, kick hard for the first 25 yards, then go easy for the remaining 75 yards. For the second 100 yards, kick hard for 50 and easy for 50. Kick hard for 75 yards, then easy for 25 on the third one. And for the last one, go all out. Repeat the set.

More Calorie Burners

There are lots of other great options for burning calories through exercise. Here are some:

  • Playing basketball
  • Running
  • Jumping rope
  • Cross-country skiing
  • Taking an aerobics class
  • Spinning (stationary bike class)
  • Dancing (the faster you dance, the more calories you’ll burn)

Exactly how many calories you burn depends on your weight – and how intensely you do the exercise.

© 2010 WebMD, LLC. All rights reserved.

 

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WebMD – You Can Start Feeling Better: 8 Important Things to Do About Depression

Posted by 4love2love on July 18, 2011

Fears and Facts About Antidepressants

WebMD Medical Reference

By Mary Anne Dunkin

Reviewed By Brunilda Nazario, MD

Along with counseling, antidepressants are a common part of treatment for depression. And they are usually effective. Six out of 10 people treated with antidepressants feel better with the first one they try. If the first antidepressant medication doesn’t help, the second or third often will. Most people eventually find one that works for them. Yet many people who could benefit from an antidepressant never try one, often because of fears and misconceptions about them, experts say.

Here are eight common fears about antidepressants, as well as facts that can help you decide if an antidepressant might be right for you.

Fear: Antidepressants make you forget your problems rather than deal with them.

Fact: Antidepressants can’t make you forget your problems, but they may make it easier for you to deal with them. Being depressed can distort your perception of your problems and sap you of the energy to address difficult issues. Many therapists report that when their patients take antidepressants, it helps them make more progress in counseling.

Fear: Antidepressants change your personality or turn you into a zombie.

Fact: When administered correctly, antidepressants will not change your personality. They will help you feel like yourself again and return to your previous level of functioning. (If a person who isn’t depressed takes antidepressants, they do not improve that person’s mood or functioning.) Rarely, people experience apathy or loss of emotions while on certain antidepressants. When this happens, switching to a different antidepressant may help.

Fear: Taking an antidepressant will make me gain weight.

Fact: Like all drugs, antidepressants have side effects, and weight gain can be a common one of many of them. Some antidepressants may be more likely than others to cause weight gain; others may actually cause you to lose some weight. If this is a concern, talk with your doctor.

Fear: If I start taking antidepressants, I’ll have to take them for the rest of my life.

Fact: Most people who take antidepressants need to take them continuously for six to nine months – not necessarily a lifetime. Once an antidepressant gets depression under control, you should work with your doctor to decide when to stop your medication and then decrease your dose gradually. Discontinuing them suddenly may cause problems such as headaches, dizziness, and nausea.

Fear: Antidepressants will destroy my sex life.

Fact: Antidepressants can have an effect on sexual functioning. The problem is usually an inability to achieve orgasm rather than a lack of desire. But because depression itself decreases libido, a medication that eases depression may improve your sex life. As with other side effects, certain antidepressants may be more likely than others to cause sexual problems.

Fear: Antidepressants are expensive and aren’t covered by insurance.

Fact: Antidepressants are usually covered by insurance plans with prescription drug coverage. The cost of antidepressant therapy varies widely, depending on the dosage, the drug you are taking, and whether it is available as a generic. Even without insurance coverage, it is possible to purchase a generic antidepressant for as little as $15 per month.

Fear: Taking an antidepressant is a sign of weakness.

Fact: Like medical conditions such as diabetes or high cholesterol, major depression is a condition that often responds to medication.When depression interferes with your ability to function normally, seeking treatment is not a sign of weakness. It’s a sign of good self-care.

Fear: Antidepressants increase the risk of suicide.

Fact: Studies in recent years have raised concerns that antidepressants may raise the risk of suicide among children, adolescents, and young adults. For example, a 2009 review in the British Medical Journal (BMJ) analyzed 372 studies involving nearly 100,000 people who were taking antidepressants. It found that compared to placebo, use of antidepressant drugs was associated with a small increased risk for suicidal thoughts in some children and young adults, have no effect on suicide risk among those 25 to 64, and reduce risk in those 65 and older.

In 2004, the FDA required manufacturers of antidepressants to revise their labels to include a black box warning statement about these risks.

Other studies paint a different picture. A 2006 study published in PLoS Medicine suggests that the use of antidepressants has saved thousands of lives. Data show that the U.S. suicide rate held fairly steady for 15 years prior to the introduction of the widely used antidepressant fluoxetine (Prozac) and then dropped steadily over 14 years while sales of Prozac rose. The research team found the strongest effect among women.

The bottom line: Regardless of your age or sex, it’s important to see a doctor immediately if you have suicidal tendencies or witness them in others.

 

© 2010 WebMD, LLC.

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WebMD – Cosmetic Surgery Self-Assessment

Posted by 4love2love on July 18, 2011

Most people seek cosmetic surgery to feel better about themselves. Does it work? Studies suggest that patients are generally pleased with the outcome of their cosmetic surgery and report improvement in self-esteem, social confidence, and quality of life.

However, cosmetic surgery may not be appropriate for every person or every problem. If you are considering cosmetic surgery, take some time to contemplate these questions:

1. Why am I considering cosmetic surgery?

The healthiest reason to have cosmetic surgery is to improve your self-image — the way that you feel about yourself. People who have a strong self-image are usually more confident, effective in work and social situations, and comfortable with their relationships. Cosmetic surgery is often thought of as psychological surgery. Its purpose is to enhance your feeling of well-being and to foster emotional health.

2. Am I having cosmetic surgery to please others or myself?

Make sure that you are considering cosmetic surgery for internal reasons having to do with yourself, and not external reasons. Cosmetic surgery cannot stop your boyfriend from leaving you. It cannot bring you new friends. It cannot get you a better job. You’ll likely be disappointed in the results if you are having cosmetic surgery to please someone else.

3. Are my expectations realistic?

Having realistic expectations may be the single most important factor in achieving a successful result. Cosmetic surgery can dramatically improve your appearance, but it has its limitations. It is unwise to expect that cosmetic surgery can create the face of a celebrity (with the hope of acquiring a celebrity lifestyle) or restore the lost youth of decades past.

4. Am I emotionally prepared for cosmetic surgery?

There are certain circumstances under which cosmetic surgery may be inappropriate. These include a crisis or an emotional upheaval such as divorce, death of a spouse, or loss of a job. Also, surgeons are reluctant to consider cosmetic surgery on patients who are depressed, have significant mental illness, are impossible to please, or are obsessed with perfection.

5. Is now the best time for cosmetic surgery?

Even if you are emotionally prepared for cosmetic surgery, you may want to delay it if you are under external pressure or preoccupied with other matters. Plan your surgery when you are relaxed and can afford the time to convalesce and heal afterwards. Otherwise, you may face longer and more difficult recovery periods.

6. How will I adjust to the change in my body image?

It may take some time for you to adjust to your new body image. This is especially true for procedures that create a major change to your face, such as nose surgery (rhinoplasty). Procedures such as Botox injections, which merely create a younger looking you, are easier to accept.

7. Am I prepared to handle unexpected results?

Cosmetic surgeons, like all surgeons, cannot offer you guaranteed results. Unexpected results occur rarely, but when they do occur they create emotional distress for both the patient and the surgeon. You must be prepared for the worst case scenario and realize that it will require time, patience, and a mutual trust between you and your surgeon to work toward improvement.

8. Do I have a support network?

It’s important to have someone to support you physically and emotionally during your recovery. Realize that you may have days when you feel depressed as you go through the healing period. Beware of negative comments from friends or family members who may have issues with your decision to change your appearance. Graciously decline offers of help from those who may be critical of your decision.

9. Have I considered and accepted the risks?

There is risk involved with any surgery. In addition to the general risks related to anesthesia, blood loss, and infection, specific risks for cosmetic surgery include skin loss, asymmetry, slow healing, numbness and minor dimples and puckers. You must consider and accept all of the risks for each procedure before making your decision to have cosmetic surgery.

10. Can I afford cosmetic surgery?

Cosmetic surgery is usually not covered by health insurance. You are choosing to accept the costs in exchange for surgery that will help you feel better about yourself. If you can’t afford the cost, in addition to a second procedure should one be needed, the added financial stress could actually make you feel worse about yourself.

 

© 2009 WebMD, LLC. All rights reserved.

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WebMD – Everyday Fitness

Posted by 4love2love on July 18, 2011

with Pamela Peeke, MD, MPH, FACP

Living life to the fullest is all about striving for a mind-body balance every day. Achieve a mental, nutritional, and physical transformation for life with tips from wellness expert Pamela Peeke, MD.

Monday, May 23, 2011

Glorious Glutes for a Sunsational Summer

Your Best Beach Body, Part Three

Welcome to Week Three of our “Back to the Beach” six week campaign. If you’ve missed the first two weeks, or need a refresher, click here. We’ve begun our Beach Mind Beach Body journey, but this time with a mental and physical twist.

Instead of obsessing about body parts, I’m asking you to engage your mind to see how your lifestyle behaviors are reflected in how you look and feel. If you do, you’ll experience a royal win win — by being more mindful of your body all day, your body will benefit by all of that attention. You’ll look great and feel so much better. This week we’ll use your beautiful behind as a case in point.

Hey, call it what you want — behind, booty, derriere — those soft pillows of feminine flesh serve you well all day. They power you out of chairs, up the stairs and straighten you up after tying your sneakers. I’ll bet you didn’t know that the gluteus maximus is the largest muscle in the body. Keep in mind, that, like all other muscles, if you don’t use it, you lose it. Simple routines that anyone can do will keep your rear end from sagging into those less than attractive rolls of bountiful butt straining your pant seams.

Many of you have a love-hate relationship with your butt. Well, that ends now. It’s time for you to express your own Glute Gratitude. Yep, let’s take what you’ve got and appreciate and optimize it.

Staying consistent with my MIND MOUTH MUSCLE template, you’re going to enter this third week with Power MIND. As I’ve noted in the previous blogs, you’ll fight any urge to default back to self-denigrating comments about your body. We’ll have none of that! Instead, this week you’ll say, “I’m smart, beautiful and fun and this week I’m going to practice body gratitude.” Every day, wake up and appreciate all of the body parts that work. Stop concentrating on what you can’t do, and pay attention to what you can do. This is especially true for as you age. Joints are creaking and there’s that recurring pain. Adapt and adjust and be happy you’re here today to rock and roll through another 24 hour life adventure.

Moving to the MOUTH, how about a few simple tricks to help you with the cravings that can destroy your best beach body intentions? Get over the urge to splurge by:

1) Medicating with Movement: Stop using food to anesthetize your stresses. Instead, get up and move. Research has shown that when that creepy craving starts to hit, you should hit the road. All it takes is 15 minutes of walking to increase levels of both the pleasure chemical dopamine as well as the mood modulator serotonin. In combination, they help you win the food fight.

2) Pound down the Protein: Got a craving? Grab lean protein all day long — for meals and snacks. Protein helps to curb the “I’m starving and I need to eat everything that’s not tacked down” hunger hormone, ghrelin. Avoid only eating protein at main meals. If you include protein in your snacks (low fat dairy, peanut butter on apple slices), you’ll keep this hunger hormone in check all through the day.

3) Substitute: Hey, it’s OK to have a treat every now and again. When you do, how about creating a tasty, healthy “cheat” by doing simple substitutions. Instead of grabbing something with boatloads of addictive refined sugar, make a fruit parfait with fresh berries and yogurt. Forget the potato chips and instead have hummus and carrots.

Now it’s time to honor that gluteal MUSCLE. I love these exercises because most are simple and easy to do throughout the day. Remember to always check with your medical team before you engage in any physical activities, especially if you have a medical and/or physical condition.

1) Stop Sitting So Much: Get up more often throughout the day. Walk while you talk on the phone. I always recommend standing and moving every 30 minutes. You’ll increase your fat burning metabolism as well as engage your muscles to keep them firm and fit.

2)  Stay Mindful of Your Rearful: As many times as you can, become mentally aware of your behind and as you do, contract your glutes. You can be standing in line, walking up stairs or running to the bus. Pay attention to how they feel as you move. As I noted in a previous blog, engaging your core throughout the day keeps your posture upright and makes you appear taller and slimmer. The same is true for the glutes. Become glute aware!

3) Burn Your Butt Fat: As you proceed to do some of the glute exercises, just remember that in addition to strength training and good nutrition, you absolutely need to be doing regular cardio (goal is to burn 400 calories each session) with intensity intervals. That means when you hit the hills by increasing your treadmill’s incline, you’ll cook a ton of calories compared to simply walking on the flat. Crank up your treadmill’s incline to 5%, walking at a pace of around 3.5-4MPH and you’ll burn at least 350 calories per hour, which is a 64% increase over walking on a flat surface. Or ramp up the speed with which you walk. Intensity intervals simply mean adding hills and/or speed every now and again to your workout. Check out the WebMD resources on how to do interval training.

4) Butt Blasters:

  • Backward Leg Toe Touch and Lift: Stand behind a chair, toes facing forward, with both hands placed on top of the chair for stability. Keeping both knees straight, extend your left leg back pointing your toes with your big toe is touching the ground behind you. Gently lift your left leg about 30 degrees off the ground without bending your knee. Tighten your glutes and hold for a count of 10. Bring down and touch the ground with your pointed big toe and lift right back up for another count of 10. Repeat this 5 times and switch sides.
  • Donkey Kick Crossover: Grab a mat and get on all fours with your hands under your shoulders. Keep your left knee and ankle flexed as you lift your knee to hip level behind you. Hold for a count of 5 and bring down, touching the mat briefly and lift again. Repeat 5 times and switch sides.
  • Butt Bridge: Lie face up on a mat with knees bent and feet flat, arms by your side. Left hips slowly off the floor, forming a straight line from knees to shoulders. Tighten your glutes and maintain this bridge position for a count of 10. Bring your butt down for 10 seconds and lift back up again into bridge position for a count of 10. See if you can do it for a count of 20. Repeat 5 times.
  • Sizzling Squat: Stand with your feet shoulder-width apart. Engage your core abdominal muscles. Place your hands behind your head, elbows out to the side. Squat down, never going beyond a 90 degree angle to your lower legs. For novices or anyone with knee issues, just squat down enough to feel your glutes engage well and hold for a count of 3. As you stand up, for an added twist, rotate your trunk to the left and lift your bent left knee in front of you. Return to squat again. Switch sides and repeat. Do this whole set 5 times.
  • Invisible Chair Wall Squat: You can do this anytime and anywhere there’s a wall. Standing straight, place your back on a wall. Squat down as previously described, and imagine you’re sitting on an invisible chair. Squeeze your glutes. Hold for a count of 5-10 (or 20 for the advanced), and stand up. Rest for 10 seconds and repeat 5 times.

Everything I’ve described is simple and doable. So, do it already! Summer’s around the corner. That’s your “bottom” line! Next week, we’ll move upstairs anatomically to help you with your right to bare strong and fit arms for a sensational season. Keep it going everyone!

Read the Series:

© 2011 WebMD, LLC.

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WebMD – Raising Healthy Kids – Ways to Keep Kids at a Healthy Weight

Posted by 4love2love on July 18, 2011

WebMD Medical Reference

Reviewed By David Ludwig, MD, PhD

If your child is at a healthy weight now, you may wonder what you can do to help him maintain it.

If your child is currently overweight, you may wonder how you can help her stick to a serious diet and exercise plan.

Well, according to experts, rigorous diets and exercise plans are not the healthy habits to be striving for. Singling out an overweight kid will just make him feel persecuted and unhappy. It also won’t work.

Instead, you can help your overweight kid move toward a healthy weight in much the same way you can help a healthy weight kid maintain that healthy weight. How? By making it easy for everyone in your family to make healthy choices and encouraging them to make those choices so consistently that they become your family’s healthy habits.

Making healthy choices can help an overweight kid who is still growing hold his weight steady so he can grow into his weight as he gets taller. Small healthy choices also give healthy weight kids the habits and foundation to maintain their weight.

Healthy Habit 1: Choose to eat dinner as a family.

You can encourage family health by having the whole family sit down to dinner together as often as possible.

It might seem like an indirect way to help with your child’s weight, but experts say it can help. Studies have found that family meals are associated with a healthier diet and lower rates of obesity.

Why? Experts say that social eating is good for us. Family dinners are a healthy habit that help us stay emotionally connected.

Plus, when kids eat on their own — especially plopped down in front of the TV — they might not pay attention to their hunger and absentmindedly overeat.

Finally, when you cook at home, you control the menu, so it’s easier for everyone to eat healthy.

Healthy Habit 2: Don’t let your child set the menu.

It’s potentially a disservice to your family’s health to let a child’s limited tastes dictate the family’s diet. If you do, you might wind up eating hot dogs and mac and cheese every night.

When you’re cooking healthy meals — filled with vegetables, fruits, whole grains, lean meats, and dairy — your child might not like the vegetables that show up on her plate. But keep offering them anyway. Studies show that the more kids are exposed to a food, the more likely they are to try it.

When you’re making a healthy entrée that your child might not like, experts recommend that you include a healthy food that she does like — fruit, for instance — as a side dish. That way, there’s something familiar for her.

If she protests, experts suggest that you be firm: Make it clear that her choices are limited to what you’ve served. Resist the temptation to cave in and make her a separate meal. In time, she’ll come to accept the limits that you’re setting — and will start trying some healthier foods.

Healthy Habit 3: Choose to reduce TV time.

Because many studies have found a clear association between television-watching and obesity, experts say that reducing your kids’ TV time makes sense. The American Academy of Pediatrics recommends no more than 1 to 2 hours of TV watching a day for kids aged 2 and older. It’s best if children younger than 2 not watch TV at all.

Of course, the most effective way to curb your child’s TV watching is for you to also limit your time in front of it. The easiest way to successfully have a healthy family is for you to lead by example.

Afraid such healthy goals will challenge your poise and patience? If you’re swooping in every 15 minutes, scowling, and clicking off the TV, you might face a revolt — or your kids will just scurry off to a different screen — a computer, video game, or TV in another room.

To keep your cool and remember your goal to have a healthy family, don’t focus on what your kids can’t do, but what they can do. For instance, don’t even mention after-school TV. Instead, create a list of activities — rain or shine — that can be done after school instead of TV watching, like dancing to favorite songs or biking in the neighborhood. Then, help your child pick 1 to try.

Healthy Habit 4: Buy a pedometer for everyone in the family.

It’s not enough for you to demand that your child exercise. Instead, inspire your whole family to move more.

Outfitting each family member with a pedometer encourages healthy habits. Once a kid starts to track how many steps he’s taking, it’s pretty natural to want to take more. At the end of the day, everyone can compare the number of steps they took and chart their progress. It can become a fun competition that leads to better family health. Studies have found that pedometers can be effective in kids as young as 6.

How many steps should your child be taking? While many adults aim for 10,000 steps per day, researchers say that a child’s target should actually be higher. One study found that for kids aged 6 to 12, a healthy goal for girls was 12,000 steps a day and 15,000 steps a day for boys.

That might seem like a lot, but kids are naturally more active than adults. Of course, a child’s stride is much shorter, so they won’t walk as far as you will.

Start slowly. Begin by aiming for an additional 2,000 steps to what each person takes on an average day now. Even that modest increase will help with family health.

Healthy Habit 5: Choose not to micromanage your child’s eating.

As a parent, you don’t want to be watching every bite of food that goes into your kid’s mouth. You don’t want to be swatting her hand away from the cookie jar all the time. That sort of micromanaging will just make everyone miserable.

Instead, the easiest path to raising a healthy family is to remove the source of conflict. Replace the cookie jar with a fruit bowl. After all, kids do most of their eating at home — that’s true even for many teens. Because parents are the ones who shop, you have control over the food that’s in the house.

When you’re at the grocery store, swap the chips and cookies you normally put in your cart with healthier options. Don’t buy sugary drinks like soda and juice-like drinks, and limit the amount of 100% fruit juice you buy.

Buy only foods that you want your child to eat. It will boost your family’s health, and you won’t worry so much about which food she’s choosing for a snack.

Healthy Habit 6: Choose healthy ways to manage stress.

Some studies have shown that kids with stressed-out moms are more likely to be overweight. The cause of the stress can be anything from health problems in the family, money issues, or problems with their mate.

So, here’s another reason to enlist help to find solutions to your stressors — to help your kid’s weight stay in a healthy range. Try these healthy stress relievers:

  • Talk it out with a friend, counselor, or religious advisor.
  • Use exercise as a way to burn off stress.
  • Tell your kids about your stress, using words they can understand.
  • Look for support to help you with the things causing you distress from family, government programs, hospital classes, and so forth.

By handling stress in healthy ways you set a great example for your kids, too.

Healthy Habit 7: Choose to make sleep more important.

Studies have found that a lack of sleep is associated with weight gain. When kids are overtired, changes to hormones and metabolism seem to increase the risk of obesity.

To raise healthy kids, enforce a routine bedtime. You can make the transition easier by trying to make the time before bed relaxing. A helpful way to do this is to remove distractions from your child’s bedroom — including TVs, cell phones, and computers.

Sticking with the same routine even on the weekends can help eliminate fluctuations in mood from fatigue and avoid that Monday-morning angst from trying to get back on schedule.

Bedtime may get harder with teens. As kids hit adolescence, their body clocks reset, and they become biologically wired to stay up late. Because high school starts so early, many teens are chronically overtired and at higher risk of obesity as a result.

As a parent, the best you can do is to work with your teen to encourage healthy sleep habits before bed. Help them see just how much better they feel when they do get enough sleep and how much easier it is to concentrate in school.

A healthy amount of sleep helps reduce the risk of obesity in adults too. So prioritize sleep accordingly to set a healthy example for your family.

Healthy Habit 8: Choose to be consistent about family health.

Consult with an expert — like a dietitian or childhood weight loss expert — to adopt basic, sensible changes to your family’s diet and exercise routine and stick with them.

If after a few months you don’t think these healthy habits are helping — if, for instance, your child has been gaining weight — check in again with an expert and tweak your family’s plan.

The most important thing to help your family adopt healthy habits is to stick to your plan. Stay consistent: about the foods you have in the house, about family exercise routines, and about bedtime.

If you do, your kids are more likely to accept your rules in the long run. If they sense any hesitation on your part, they’re more likely to argue and push back. With persistence, you will be able to help your kids adopt healthy habits, and they will benefit for the rest of their lives.

 

© 2011 WebMD, LLC.

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Huffington Post – What Is ‘Smelly Hair Syndrome?’

Posted by 4love2love on July 6, 2011

Perry Romanowski

Cosmetic chemist, co-creator of BeautyBrains.com

Posted: 07/5/11 08:12 AM ET

Everyone has an occasional “bad hair day,” but for those unfortunate people stricken with a condition known as “Smelly Hair Syndrome,” a bad hair day can mean relationship problems, taunts from coworkers and even expulsion from school. Consider these examples:

“I wash my hair and by the middle of the day it has a sweaty, muggy smell … I’m a sophomore in college, never had a boyfriend, never even kissed a guy, all because of this smelly demon that I have had to cope with since eighth grade.” — Corrin, The Beauty Brains Forum

“I go to work everyday because I have no choice, but my co-workers are very cruel to me because of the bad odor they smell coming from my head. They don’t know how hard I try to take care of this problem.” — Sierra, The Beauty Brains Forum

“An 8-year-old girl said she was removed from her classroom at a Seattle school because of the way her hair smelled. She has now missed a full week at Thurgood Marshall Elementary.” — KIRO TV report

What’s going on here? What is “Smelly Hair Syndrome” and can it really be so socially stigmatizing? After receiving hundreds of questions about this issue we were intrigued to find out more.

The symptoms of smelly hair
We discovered that Smelly Hair Syndrome manifests in one striking symptom: a horrific odor that emanates from the hair and scalp. According to the people who have commented on our blog, the olfactory character of the smell varies from person to person. Some describe it as “… stinks like a diaper.” Others have compared the smell to “sour milk, wet dog, moldy hay, potatoes, an old shoe or dirty socks, a jacket that’s never been to the dry cleaner, and an oily smell mixed with vomit.” The most unusual description we’ve heard was “… sort of a cross between Dorito’s Bold BBQ chips and cinnamon (and not a sweet smell, actually kinda foul) and maybe a hint of cheese.” And, finally, one unfortunate reader told us that “my hair is so smelly that sometimes flies buzz around my head.”

The odor is so strong that other people can easily notice it (“I know my co-workers could smell it and I was so embarrassed.”) Spouses and significant others have also told us that the odor is problematic because it can transfer to towels and pillow cases. For some people the smell is noticeable right after showering; for others it starts a few days after they’ve washed their hair. We received several comments from people who shower before sleep and wake up with a smelly scalp. Interestingly, one person pointed out that their hair starts out with one scent right after washing and changes to a different odor about 12 hours later. In addition to the malodor, some people experience increase in oily hair and scalp. One woman notices a “thick, oily, flour-like substance on my scalp.”

Causes and cures
These secondary symptoms made us wonder if a potential cause of Smelly Hair Syndrome could be seborrheic dermatitis (seb-o-REE-ik der-muh-TI-tis), because it causes an increase in oil production and flaky scalp residue. However, according to Mayo Clinic’s webpage, scalp odors like those described above are not typically associated with seborrheic dermatitis. Furthermore, our readers tell us that in many cases their doctors have not been able to identify a definitive cause. Many said that their doctors didn’t take the problem seriously: “I even went to the dermatologist. Twice! He never heard of such a thing and seemed to not even believe me which made me very angry! Why don’t these doctors have a clue?!” “I went to see a dermatologist. Which was of no help! I got prescriptions and so forth but nothing worked.”

Without a satisfactory medical explanation, people are left to figure out their own cures. Our readers have tried just about everything you can think of, including medicated shampoos like Nizoral, Selsun Blue, Neutrogena T/Gel, Head & Shoulders and Denorex. They’ve used tea tree-based products (like Giovanni Tea Tree Triple Treat conditioner) because of the alleged anti-fungal properties of tea tree oil (unfortunately, most tea tree oil shampoos contain very little of the actual oil). In desperation, some people have even tried medicated pet shampoos.

Others have forsaken commercial products for home remedies like lemon juice, baking soda, apple cider vinegar, coconut oil, aloe vera, neem oil, chlorophyll supplements and a mixture of honey and cinnamon. One person even uses hand sanitizer on her scalp two or three times a day. Then there’s the most elaborate of all the treatments we’ve heard of: “I go to this salon where they rub a liquid into your hair, wrap it in plastic wrap and steam it. This is followed with something they call ‘frequency treatment’ — it is a glass rod attached to a machine and they deliver something like an electrical impulse.”

What really works to treat Smelly Hair Syndrome? Of all the solutions proposed by our readers, two seemed to provide reasonably consistent results: Dial antibacterial liquid body wash and sulfur-containing soaps. These treatments make sense from a scientific point of view, if the cause is bacterial or fungal. An antibacterial agent (like the Triclosan used in the Dial bodywash) could prevent bacteria from growing, while sulfur could reduce scalp oiliness thereby eliminating the “food” that bacteria or fungi need to grow. For those who haven’t had success with other treatments, these two options maybe worth a try. Of course, you should consult with a dermatologist to ensure your symptoms aren’t caused by psoriasis or some other condition.

Conclusion
From the comments we’ve received, Smelly Hair Syndrome appears to be a real problem that is unresolved for many people. Based on our readers’ input, the medical community has not yet provided a satisfactory solution. According to our understanding of chemistry and hair and scalp biology, shampooing with sulfur and Triclosan-based soaps may offer some relief. We hope that more definitive treatment options are identified by the medical and cosmetic science communities.

 

© 2011 TheHuffingtonPost.com, Inc.

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Huffington Post – Bunions: When Do They Become Something To Worry About?

Posted by 4love2love on July 6, 2011

Neal M. Blitz, D.P.M., F.A.C.F.A.S.

Chief of Foot Surgery and Associate Chairman of Orthopaedics, Bronx-Lebanon Hospital in New York

Posted: 07/5/11 08:36 AM ET
Look down at your feet — would you know if you have a bunion?

Many people know the term ‘bunion’ and that it occurs on a foot, but don’t know exactly what a bunion is.

Most people think a bunion is an abnormal growth of bone at the base of the big toe. This is incorrect (at least in most cases). A bunion is actually a structural problem where the big toe joint becomes subluxed and drifts towards the smaller toes. A displaced bone, called a metatarsal, becomes prominent on the inside of the foot. The bunion simply refers to the enlarged prominent ‘knobby’ area.

2011-07-03-DrNealBlitzHuffPoBunionBlogPic1Final.jpg

Bunions may progress in size and severity. A bunion may start of as minor issue and, over time, may develop into a severe disfiguring foot deformity. See below:

2011-07-03-DrNealBlitzBunionProgressionHuffPoFINAL.jpg
So if you have bunion, here are 10 important things you should know, as you consider treatment:

  1. Not all bunions are painful.
  2. The medical term is hallux abducto valgus.
  3. They come in different sizes: small, medium, large or severe.
  4. Genetics. You may have inherited your grandmothers feet.
  5. They occur more often in women than men.
  6. Pointy-toed shoes and high heels may result in bunions.
  7. Bunions may get bigger over time, or not.
  8. The bunion may cause problems with the lesser toes.
  9. Non-operative treatments are mostly aimed at treating the symptoms.
  10. Surgical treatment goals are to realign the natural position of the toe.

When to seek treatment?

There is not a specific point when bunion sufferers ‘must’ start treatment despite the bunion severity. Some people begin treatment with the smallest bunion while others neglect the condition until severe. Reasons to seek medical treatment are:

 

  • Presence of Pain? Pain and discomfort is the most common reason to seek treatment. Pain directly on the bunion is a symptom of direct shoe pressure. Joint pain suggests arthritic degeneration. Pain on the ball of the foot is concerning for altered foot biomechanics and a sign of a bigger problem. Pain should not be ignored.

 

 

  • Interference with Activity? Some people wait until a bunion interferes with activities before seeking medical treatment and I think this is a mistake. Impact activities (such as running, tennis) may be more challenging to perform. If left ignored, simple everyday walking may become problematic. You should take measures that keep you active and healthy.

 

 

  • Inability to Wear Certain Shoes? In this subset of patients, it’s the sheer size of the bunion preventing fashionable shoes that motivates treatment — not pain. These patients have learned to live with discomfort but chose fashion over foot health. Clearly, inability to wear shoes is a valid reason for intervention.

 

 

  • An Unsightly Bunion? Foot care experts are less concerned with cosmetic appearance as they are about pain, activity restrictions and overall foot function. Often insurance companies only cover medical bunion treatments if pain is present, regardless of size.

 

 

  • Overlapping toes? When the second toe has overlapped the big toe, it’s an obvious indicator of a global foot problem, and is often associated with collapse of the foot. Interestingly, these problems are not always painful as the condition develops overtime and the pain may be muted, or patients have accepted a certain amount of foot discomfort. The driving force for treatment becomes secondary problems such as metatarsal stress fractures or inability to fit shoes.

 

How to limit progression of a bunion?

It is important to understand that not all bunions become worse (or bigger). Some bunions never change in size. Others may progress onto a major foot deformity. Genetics play a big role and you may be ‘destined’ to develop a ‘bad’ bunion. Below are non-surgical measures to mitigate pain as well as limit the progression.

 

  • Smart Shoe Selection: Avoiding shoes that are bad for your foot health may be the best preventive measure you can take. Pointy toes shoes directly pushes on the big toe inappropriately, and in my opinion are ‘bunion formers.’ If the bunion becomes irritated, then spot stretching the shoe limits symptoms. High heels may also contribute to bunions due to altered foot mechanics — so limit time in them. Flip flops are considered a “poor footwear” choice by most health care professionals. Minimalist shoes seem to be a better lightweight alternative.

 

 

  • Counteract Muscle Spasms: Muscle spasms within the foot are often due to a muscular imbalance, and an important warning sign that muscles are trying to stabilize bone structure. Strained muscles are less effective at stabilizing the foot and a bunion may progress. Deep massage and mineral foot soaks ease tension in the foot.

 

 

  • Foot Strengthening: It’s important to keep your foot muscles strong to counteract the muscular imbalance. Perform simple toe exercises daily — such as picking up marbles (or a handkerchief) with your toes. Commercially available toe exercising devices may have therapeutic benefits but studies do not exist demonstrating efficacy.

 

 

  • Arch Supports: Bunions and foot deformities tend to occur in people with flat feet and/or ligamentous laxity. Arch supports provide extrinsic structure and promote a more ‘proper’ alignment and may limit bunions from getting bigger. Over the counter inserts are a good first start. Doctor-prescribed molded orthotics have the benefit of being custom to your foot and therapeutically tweaked.

 

 

  • Pain Medication (Oral & Topical): Non-steroidal anti-inflammatory medication is commonly recommended to decrease pain and inflammation. Topical treatments also help manage inflammation and pain symptoms. Capsaicin cream/ointment (derived from spicy chili peppers) is a potent pain reliever that works via a neurochemical pathway. Be sure that the skin overlying the bunion is intact, otherwise capsaicin will cause an intense burning sensation. Topical products containing methyl salicylate distract the pain perception by causing cooling/warming skin sensations. Topical corticosteroid cream may temporarily reduce inflammation and should be used intermittently because it may cause thinning of the skin as well as hypopigmentation.

 

 

  • Bunion Padding: A pad limits direct pressure and may prevent the pain cascade altogether. Chronic bunion inflammation can result in deeper bone problems, so prevention is beneficial. More importantly, a properly placed pad may provide a physical blockade that prevents the bunion from pushing out. Pads may be composed of felt, moleskin or gel.

 

 

  • Toe Spacers & Bunion Splints: The purpose of this intervention is to physically place the big toe in a more normal position. A toe spacer (often made of silicone) is worn while walking. A bunion splint is a useful device (worn while sleeping) to physically realign the big toe.

 

If you have a bunion, do what it takes to take care of your feet and prevent progression. If the above measures don’t help, then surgery may be inevitable.

~ Dr. Neal M. Blitz

To learn more about Dr. Blitz, please visit www.nealblitz.com

Follow Neal M. Blitz, D.P.M., F.A.C.F.A.S. on Twitter: www.twitter.com/DrNealBlitz

 

© 2011 TheHuffingtonPost.com, Inc.

 

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