The Lowdown on High Blood Pressure

Just a few years ago, if your blood pressure was below 140/90, your doctor would have congratulated you. Now if it's between 120/80 and 139/89, you're labeled prehypertensive and soberly informed that you're more than 3 times as likely to have a heart attack. Indeed, when the National Institutes of Health established this new diagnostic category, about 50 million Americans awoke with a disease they didn't have the night before.

Like prediabetes and borderline-high cholesterol, prehypertension is one of several "predisease" conditions doctors are identifying. Some people think this trend is another example of insurance and drug companies trying to create more "sick" customers. After all, they argue, aren't we "pre" everything? Although I can't dispute that point, I can help you sort out what this BP category means to you.

First of all, prehypertension alone doesn't necessarily raise a red flag for me. If you're my patient, I'm going to consider your blood pressure within the context of your overall risk profile. If you have a family history of heart disease, stroke, and/or diabetes, then I'll take prehypertension very seriously. But if everybody in your family lived into their 90s and your lifestyle is sound, I'll worry much less. I never evaluate the condition just by itself.

That said, prehypertension, even in the absence of other risk factors, can be an effective wake-up call. People who develop prehypertension, especially before age 35, often go on to develop its dangerous big brother, so taking simple steps now could prevent bigger problems down the road.

12 Ways to lower blood pressure naturally.

If you haven't had your pressure checked recently, make an appointment with your doctor. If it's in the prehypertensive range, ask him to evaluate it in light of your other risk factors. Besides exercising more, not smoking, and moderating alcohol consumption, here are five key ways to control it:

1. Limit salt to 1,000 mg daily.

According to Harvard Medical School authorities, 75% of the sodium in our diet comes from prepared foods such as soups, cereals, cheese, and deli meats. Be wary of these.

2. Get 4.7 g of potassium daily.

Only 10% of men and 1% of women get adequate amounts of this mineral, which helps kidneys excrete sodium. Eat more tomatoes, oranges, baked potatoes (with skin), and bananas.

3. Get 1,200 mg of calcium daily.

This mineral also keeps blood pressure low. Low- or nonfat yogurt and milk, salmon, and broccoli are good sources.

4. Eat more whole grains.

In two studies (more than 60,000 participants tracked for 10 to 18 years), people who ate whole grain foods instead of refined carbohydrates significantly lowered their hypertension risk.

Try our heart-healthy food finder tool.


5. Consume no more than 6 teaspoons (100 calories) of sugar daily.

New research is finding that added sugars can raise blood pressure and triglycerides, in addition to obesity risk. Most people get triple that amount, and the major culprit is soft drinks (8 teaspoons in a 12-ounce soda).

Feel more in control? Great — you've lowered your blood pressure already.

GOOD NEWS FOR YOUR HEART

Read Agatston's blog for the latest advice and ask him questions at prevention.com/dragatston.

Arthur Agatston, MD, an associate professor of medicine at the University of Miami Miller School of Medicine, is the author of The South Beach Diet Supercharged: Faster Weight Loss and Better Health for Life. He maintains a cardiology practice and research foundation in Miami Beach, FL.

NOTE: Make sure to track blood pressure over time. Certain medications, including common OTC cold remedies, can temporarily elevate your readings.

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10 Heart Attack Symptoms You’re Most Likely to Ignore

Don't let that happen to you. Here, 10 heart symptoms you're likely to ignore -- and shouldn't.

1. Indigestion or nausea

One of the most oft-overlooked signs of a heart attack is nausea and stomach pain. Symptoms can range from mild indigestion to severe nausea, cramping, and vomiting. Others experience a cramping-style ache in the upper belly. Women and adults over age 60 are more likely to experience this symptom and not recognize it as tied to cardiac health.

Most cases of stomach ache and nausea aren't caused by a heart attack, of course. But watch out for this sign by becoming familiar with your own digestive habits; pay attention when anything seems out of the ordinary, particularly if it comes on suddenly and you haven't been exposed to stomach flu and haven't eaten anything out of the ordinary.

2. Jaw, ear, neck, or shoulder pain

A sharp pain and numbness in the chest, shoulder, and arm is an indicator of heart attack, but many people don't experience heart attack pain this way at all. Instead, they may feel pain in the neck or shoulder area, or it may feel like it’s running along the jaw and up by the ear. Some women specifically report feeling the pain between their shoulder blades.

A telltale sign: The pain comes and goes, rather than persisting unrelieved, as a pulled muscle would. This can make the pain both easy to overlook and difficult to pinpoint. You may notice pain in your neck one day, none the next day, then after that it might have moved to your ear and jaw. If you notice pain that seems to move or radiate upwards and out, this is important to bring to your doctor’s attention.

3. Sexual dysfunction

Having trouble achieving or keeping erections is common in men with coronary artery disease, but they may not make the connection. Just as arteries around the heart can narrow and harden, so can those that supply the penis -- and because those arteries are smaller, they may show damage sooner. One survey of European men being treated for cardiovascular disease found that two out of three had suffered from erectile dysfunction before they were ever diagnosed with heart trouble.

4. Exhaustion or fatigue

A sense of crushing fatigue that lasts for several days is another sign of heart trouble that's all too often overlooked or explained away. Women, in particular, often look back after a heart attack and mention this symptom. More than 70 percent of women in last year's NIH study, for example, reported extreme fatigue in the weeks or months prior to their heart attack.

The key here is that the fatigue is unusually strong -- not the kind of tiredness you can power through but the kind that lays you flat out in bed. If you're normally a fairly energetic person and suddenly feel sidelined by fatigue, a call to your doctor is in order.


5. Breathlessness and dizziness

When your heart isn't getting enough blood, it also isn't getting enough oxygen. And when there's not enough oxygen circulating in your blood, the result is feeling unable to draw a deep, satisfying breath -- the same feeling you get when you're at high elevation. Additional symptoms can be light-headedness and dizziness. But sadly, people don't attribute this symptom to heart disease, because they associate breathing with the lungs, not the heart.

In last year's NIH study, more than 40 percent of women heart attack victims remembered experiencing this symptom. A common description of the feeling: "I couldn't catch my breath while walking up the driveway."

6. Leg swelling or pain

When the heart muscle isn't functioning properly, waste products aren't carried away from tissues by the blood, and the result can be edema, or swelling caused by fluid retention. Edema usually starts in the feet, ankles, and legs because they're furthest from the heart, where circulation is poorer. In addition, when tissues don't get enough blood, it can lead to a painful condition called ischemia. Bring swelling and pain to the attention of your doctor.

7. Sleeplessness, insomnia, and anxiety

This is an odd one doctors can't yet explain. Those who've had heart attacks often remember experiencing a sudden, unexplained inability to fall asleep or stay asleep during the month or weeks before their heart attack. (Note: If you already experience insomnia regularly, this symptom can be hard to distinguish.)

Patients often report the feeling as one of being "keyed up" and wound tight; they remember lying in bed with racing thoughts and sometimes a racing heart. In the NIH report, many of the women surveyed reported feeling a sense of "impending doom," as if a disaster were about to occur. If you don't normally have trouble sleeping and begin to experience acute insomnia and anxiety for unexplained reasons, speak with your doctor.

8. Flu-like symptoms

Clammy, sweaty skin, along with feeling light-headed, fatigued, and weak, leads some people to believe they're coming down with the flu when, in fact, they're having a heart attack. Even the feeling of heaviness or pressure in the chest -- typical of some people's experience in a heart attack -- may be confused with having a chest cold or the flu.

If you experience severe flu-like symptoms that don't quite add up to the flu (no high temperature, for example), call your doctor or advice nurse to talk it over. Watch out also for persistent wheezing or chronic coughing that doesn't resolve itself; that can be a sign of heart disease, experts say. Patients sometimes attribute these symptoms to a cold or flu, asthma, or lung disease when what's happening is that poor circulation is causing fluid to accumulate in the lungs.

9. Rapid-fire pulse or heart rate

One little-known symptom that sometimes predates a heart attack is known as ventricular tachycardia, more commonly described as rapid and irregular pulse and heart rate. During these episodes, which come on suddenly, you feel as if your heart is beating very fast and hard, like you just ran up a hill -- except you didn't. "I'd look down and I could actually see my heart pounding," one person recalled. It can last just a few seconds or longer; if longer, you may also notice dizziness and weakness.

Some patients confuse these episodes with panic attacks. Rapid pulse and heartbeat that aren't brought on by exertion always signal an issue to bring to your doctor's attention.

10. You just don't feel like yourself

Heart attacks in older adults (especially those in their 80s and beyond, or in those who have dementia or multiple health conditions), can mimic many other conditions. But an overall theme heard from those whose loved ones suffered heart attacks is that in the days leading up to and after a cardiac event, they "just didn't seem like themselves."

A good rule of thumb, experts say, is to watch for clusters of symptoms that come on all at once and aren't typical of your normal experience. For example, a normally alert, energetic person suddenly begins to have muddled thinking, memory loss, deep fatigue, and a sense of being "out of it." The underlying cause could be something as simple as a urinary tract infection, but it could also be a heart attack. If your body is doing unusual things and you just don't feel "right," don't wait. See a doctor and ask for a thorough work-up.

And if you have any risk factors for cardiac disease, such as high blood pressure, high cholesterol, smoking, or family history of heart disease, make sure the doctor knows about those issues, too.
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Pathophysiology of Hydatidiform Mole ( H-Mole)

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Government to recruit hundreds of medical staff

JEDDAH: The Health Ministry on Tuesday announced its plan to recruit a large number of medical staff, especially highly qualified consultants, to work in hospitals across the Kingdom. Some of these medical personnel would be hired to work for a few months as per requirements, it said.

“The recruitment is planned as part of the ministry’s strategy to improve the health services provided to citizens in different parts of the country and reduce the difficulties faced by patients while visiting central hospitals,” the announcement said.

The ministry did not say how many consultants and other medical experts it was looking for. But an advertisement on its website showed that it would require hundreds of specialists and other medical staff to run various departments in some hospitals.

Dr. Yassir Bahadur, consultant oncologist at King Faisal Specialist Hospital and Research Center in Jeddah, said the ministry’s new recruitment drive would help newly opened hospitals in various parts of the Kingdom get experienced and qualified medical staff.

“There is a huge shortage of highly qualified consultants in the Kingdom’s hospitals, especially after the opening of new hospitals and medical colleges in different parts of the country,” Bahadur told Arab News.

He said the new recruitment plan would allow consultants on leave in the Kingdom to work for other hospitals. “This is a quick solution to the shortage of highly qualified consultants, which has become an international phenomenon,” Bahadur said.

The hospitals that required medical staff include Dammam Medical Center, Qatif Central Hospital, King Khaled Hospital in Hafr Al-Baten, King Fahd Hospital in Hufouf, King Khaled Hospital in Najran, King Fahd Hospital in Baha, King Abdul Aziz Specialist Hospital in Taif, King Khaled Hospital in Tabuk, Arar Central Hospital, King Fahd Central Hospital in Jazan, King Khaled Hospital in Hail, King Fahd Specialist Hospital in Buraidah, King Fahd Hospital in Madinah, Asir Central Hospital, King Abdullah Hospital in Bisha, King Abdul Aziz Hospital and Tumor Center in Jeddah.

The medical vacancies announced by the ministry include intensive care staff, cardiologists, surgeons, neurologists, oncologists, ophthalmologists, experts in plastic surgery, rheumatologists, dentists, pediatricians, psychologists, internists, ENT specialists, experts in blood diseases, gynecologists, experts in renal diseases, radiologists and laboratory technicians.

The ministry said applicants should be consultants in their field of specialization, adding that the contract period is one to three months. Selected candidates have to work 48 hours a week. Interested candidates may send their CVs to de-curative@moh.gov.sa.

By P.K. ABDUL GHAFOUR | ARAB NEWS 

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Room Assignments for Nurses Licensure Examination on July 3 & 4, 2010

PRC already released the Room Assignments for Nurses

Licensure Examination on July 3 & 4, 2010.

SEE YOUR ROOM ASSIGNMENT here (click the link)

GOODLUCK FUTURE NURSES!

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DOH wants graphic warnings on cigarette packs

The Department of Health (DOH) will issue this coming week an administrative order requiring cigarette manufacturers to place graphic warnings in their products, and expects to get the support of probably the country’s most powerful smoker — soon-to-be president Sen. Benigno “Noynoy" Aquino III.

“Palagay ko maski naninigarilyo ang pangulo di siya kokontra rito dahil ito public health. Ito ay sang-ayon sa Framework Convention on Tobacco Control, ito obligasyon natin bilang bansa na pumirma sa treaty na yan na dapat sundin," said Health Undersecretary Alexander Padilla in an interview on government-run dzRB radio.

(I do not expect the incoming president to object to this because this involves public health. This is in line with the Framework Convention on Tobacco Control and is part of our obligation as a country that ratified the treaty.)

Unofficial tallies by the Commission on Elections (Comelec) and various election watchdogs show Aquino ahead of his eight other contenders in the presidential race. He is also expected to lead when Congress starts next week the canvassing of votes for president and vice president cast last May 10.

Padilla said cigarette packs should have had the graphic warnings as early as 2008, three years after the country ratified the Framework Convention on Tobacco Control.

“Ito mga litrato sa pakete, yan ang known internationally, marami ang bansa na lumalabas nito (These graphic warnings are known internationally and many countries are coming out with this)," he said.

He said textual warnings such as “Cigarette smoking is dangerous to your health" and “Smoking kills" are not enough especially for young and illiterate smokers. “Ang karanasan ng ibang bansa binabalewala ang text warning. Pag nakita ang graphic warning sa kabataan at di marunong magbasa mas malaki ang epekto nito."

(In other countries, a textual warning is usually ignored. But a graphic warning has a big effect on the youth and on those who cannot read.)

Padilla said the graphic warnings will be colored and should offset the strategy of tobacco companies to target the youth as “replacements" for older generations of smokers. He also said the government will push for an absolute ban on cigarette advertising, including those in billboards.

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Health Care Reform: Tax Hikes on the Way

Here are 13 changes in the massive overhaul that could impact your tax bill, for better or worse.

The new health care reform law is chock-full of new taxes and tax increases that will affect many individuals and businesses, but it will be years before most of these hikes take a bite out of your -- or your company’s -- wallet. The law also has tax breaks to help both individuals and small businesses pay for insurance.

1. A new 10% excise tax on indoor tanning services on services provided after June 30, 2010.

2. The new law gives small firms tax credits as incentives to provide coverage, starting this tax year. Employers with 10 or fewer workers and average annual wages of less than $25,000 can receive a credit of up to 35% of their health premium costs each year through 2013. The credit is phased out for firms larger than that and disappears completely if a company has more than 25 employees or average annual wages of $50,000 or more. Beginning in 2014, small firms that sign up with one of the health exchanges to be created can receive a credit of up to 50% of their costs.

3. A requirement that businesses include the value of the health care benefits they provide to employees on W-2s, beginning with W-2s for 2011.

4. Elimination of a deduction employers now take for providing Medicare Part D prescription drug coverage to their retirees to the extent that the federal government subsidizes the coverage. This will not take effect until 2013.

5. Doubling the penalty for nonqualified distributions from health savings accounts, to 20%, beginning in 2011.

6. A limit on the amount that employees can contribute to health care flexible spending accounts to $2,500 a year, but the cap won't take effect until 2013.

7. A ban on using funds from flexible spending accounts, health reimbursement arrangements or health savings accounts for the cost of over-the-counter medications, starting in 2011.

8. Imposing a 0.9% Medicare surtax on wages of single taxpayers earning more than $200,000 a year and couples earning over $250,000, starting in 2013, as well as a 3.8% Medicare tax on their unearned income. The new law defines unearned income as interest, dividends, capital gains, annuities, royalties, and rents. Tax-exampt interest won’t be included, nor will income from retirement accounts.

9. A hike in the 7.5% floor on itemized deductions for medical expenses to 10%, beginning in 2013. But taxpayers age 65 and over are exempt from the cutback through 2016.

10. A new 40% excise tax, beginning in 2018, on high-cost health plans, levied on the portion that exceeds $10,200 for individuals and $27,500 for families.

11. A new tax on individuals who don't obtain adequate health coverage by 2014. The tax is be phased in over three years, starting at the greater of $95, or 1% of income, in 2014, and rising to the greater of $695, or 2.5% of income, in 2016.

12. Providing a refundable tax credit, once the individual mandate takes effect in 2014, to help low-income folks purchase coverage. To be eligible, a person's household income must be between 100% and 400% of the federal poverty level, generally around $11,000 to $44,000 for singles and $22,000 to $88,000 for families.

13. A nondeductible fee charged to businesses with 50 or more employees if the firms fail to offer adequate coverage. The fee will equal $2,000 times the number of employees, though it won’t count the first 30 workers in that calculation.

Copyrighted, Kiplinger Washington Editors, Inc.



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Swine Flu in Pregnancy Leads Some to ICU

Pregnant women with the H1N1 (swine) flu were 13 times more likely to become critically ill than non-pregnant women infected with H1N1, according to a report from researchers in Australia and New Zealand.

In the study, published online March 19 in BMJ, the investigators found that 11 percent of mothers and 12 percent of the babies died, but the authors noted that it is difficult to draw conclusions because there were few pregnant women infected with H1N1 to study.

The researchers, led by Dr. Ian Seppelt from the Australian and New Zealand Intensive Care Influenza Investigators, looked at the medical records of pregnant women and women who had given birth within the previous four weeks who had contracted H1N1 and were hospitalized in the intensive care unit (ICU) between June and August 2009.

Of 64 women included in the study, those who were more than 20 weeks pregnant faced a 13-fold higher risk of ending up in an ICU compared to women with H1N1 flu who weren't pregnant.

None of the women had been immunized against seasonal flu despite recommendations that moms-to-be get vaccinated, the study authors pointed out.

More information

The U.S. Centers for Disease Control and Prevention has more on H1N1 (swine) flu and pregnancy.

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British boy receives pioneering stem cell surgery

A researcher is seen preparing stem cells for culture at a medical study center. British and Italian doctors have carried out groundbreaking surgery to rebuild the windpipe of a 10-year-old British boy using stem cells developed within his own body.(AFP/Getty Images/File/Darren Hauck)

British and Italian doctors have carried out groundbreaking surgery to rebuild the windpipe of a 10-year-old British boy using stem cells developed within his own body, they said.

In an operation Monday lasting nearly nine hours, doctors at London's Great Ormond Street children's hospital implanted the boy with a donor trachea, or windpipe, that had been stripped of its cells and injected with his own.

Over the next month, doctors expect the boy's bone marrow stem cells to begin transforming themselves within his body into tracheal cells -- a process that, if successful, could lead to a revolution in regenerative medicine.

The new organ should not be rejected by the boy's immune system, a risk in traditional transplants, because the cells are derived from his own tissue.

"This procedure is different in a number of ways, and we believe it's a real milestone," said Professor Martin Birchall, head of translational regenerative medicine at University College London.

"It is the first time a child has received stem cell organ treatment, and it's the longest airway that has ever been replaced."

More clinical trials were needed to demonstrate that the process worked, he said, but if it did, it could lead to other organs such as the larynx or oesophagus being transplanted in hospitals around the world.

The boy, who has not been named, was born with a life-threatening condition called long segment tracheal stenosis, which meant he had a tiny windpipe that would not grow -- described by the team as like breathing through a straw.

Although he received various treatments, his condition deteriorated in November and his doctors called in Professor Paolo Macchiarini, a stem cell pioneer at the Careggi University Hospital in Florence.

Macchiarini led the surgery in Spain two years ago on 30-year-old Claudia Castillo, the first person to receive a transplant organ created from stem cells.

In her case, the new tissue was developed outside her body, but it is far less complicated to grow it within the body. The boy is only the second patient and the first child to have such a procedure.

Cardiothoracic surgeon Professor Martin Elliott, director of tracheal services at Great Ormond Street, said the boy was recovering well.

"The child is extremely well. He's breathing completely for himself and speaking, and he says it's easier for him to breathe than it has been for many years," Elliott said.



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Hand Bacteria Left On Surfaces Could be Forensic Tool

CSIs may one day be able to use more than DNA and fingerprints to catch criminals, as a new study finds that the bacteria that live on our hands are just as unique to each of us as our DNA. And traces of this "personal" DNA left behind on the surfaces we touch can be matched to the person who left it.

The human body - inside and out - plays host to billions of bacteria and other microbes; there are more bacteria in the human body than there are human body cells.

Previous research by Noah Fierer of the University of Colorado at Boulder and his colleagues had found that a typical human hand carries about 150 bacterial species and that only about 13 percent of the bacterial species found on any one hand are shared between two people.

"The obvious question then was whether we could identify objects that have been touched by particular individuals," Fierer said.

Fierer and his team set out to test this idea by trying to match the bacteria found on people's palms and fingers with those left behind on their respective computer keyboards and mouses.

In their first test, the team swabbed bacterial DNA from individual keys on three personal computer keyboards and matched them up to bacteria on the fingertips of the computer owners. They also compared the computer swabs to the bacteria DNA swabbed from people who had never touched the keyboards. The results: Bacteria from the computer owners matched much more closely to the bacteria on the keyboards than that from the strangers.

For the second test, the team swabbed nine computer mouses that hadn't been touched in more than 12 hours and compared the swabs with those taken from the palms of the computer owners. They compared the similarity of these two samples with 270 random samples from palms that had never touched the mouses. Again, the computer owner swabs matched much more closely to what was found on each computer mouse than did the random samples.

In a third test, the team also found that bacterial colonies swabbed from a person's skin and left at room temperature persisted for two weeks, pointing to the potential usefulness of "personal" bacteria as a forensic tool.

"Each one of us leaves a unique trail of bugs behind as we travel through our daily lives," Fierer said. "While this project is still in its preliminary stages, it could provide a way for forensics experts to independently confirm the accuracy of DNA and fingerprint analyses."

The new technique, described in the March 15 issue of the journal Proceedings of the National Academy of Sciences, could particularly prove useful as it is often difficult to obtain sufficient human DNA for forensic identification without the presence of blood, semen or saliva on an object. Bacterial DNA could also be useful in cases where clear fingerprints can't be lifted, though more research is needed to figure out how well skin bacteria sticks to different types of surfaces.

The technique could even be useful for distinguishing between identical twins, who share the same DNA, but still have different bacterial communities on their hands.

And criminals beware: Washing your hands won't get you off the hook. Fierer's previous work has shown that bacterial communities on the hand rebound within hours after hand washing.

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The 5 foods you should eat every day

Eating right on a budget can be a challenge, but it's certainly not impossible. Consider this your cheat sheet to the 5 inexpensive foods you should eat everyday for optimum health.


#1 Leafy greens
Medical experts call them one of nature's miracle foods. Leafy greens like Swiss chard and kale are high in nutrients like folate and vitamins A and C that can lower your risk of cancer. Just one cup of dark, leafy greens a day could also prevent diabetes and high blood pressure.

#2 Nuts
Many nutritionists recommend nuts like almonds, cashews and walnuts because they're high in natural fiber. Fiber slows your digestive process, keeping hunger and unhealthy mid-afternoon snacks at bay. Goodbye vending machine runs!

#3 Onions
Studies show that consuming onions on a regular basis may reduce symptoms of asthma and the risk of developing stomach cancer. Add them to soups and stir-fry, and just remember -- the stronger the onion, the greater the health benefit.

#4 Whole grains
Refined grains, like white rice and pasta, have lost 90% of their nutritional value through the refining process. As if that weren't reason enough to choose whole grains like brown rice, quinoa and whole oats, a recent study showed that a diet rich in whole grains actually flattens your belly by reducing fat storage in your lower abdominal region.

#5 Yogurt
Making yogurt part of your daily eating routine can improve your digestion -- if you're buying the right stuff. Check that the label lists "active cultures" to make sure you're getting healthy probiotics, and pick a yogurt rich in vitamin D to prevent osteoporosis.

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NCP: Acute Intermittent Pain related to muscle tearing due to spasm as manifested by facial grimace

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Protect Your Heart at Every Age

You're never too young—or too old—to start lowering your heart disease risk. Of course, exercising, eating healthy and reducing stress are key throughout life, but due to physiological changes that happen as we age, certain risk factors do become more of a threat.

In Your 20s

Stub Out a Social Smoking Habit
Smoking is enemy number one when it comes to heart disease, and even just a few cigarettes can do damage: New research from McGill University in Montreal found that smoking just one cigarette a day stiffens your arteries by a whopping 25 percent. Plus, smoking erases the hormonal advantage you have from estrogen, which can leave you vulnerable to a heart attack before menopause, explains Dr. Bonow.

Don't Ignore the Birth Control Factor
Remember that hormonal contraceptives slightly increase the risk of blood clots, so if you've ever had one, make sure to discuss it with your doctor before going on birth control. And if you're currently a smoker, don't take oral contraceptives, because the combo can be especially dangerous, says Sharonne N. Hayes, MD, director of the Women's Heart Clinic at Mayo Clinic in Rochester, Minnesota.

Watch Your Alcohol Intake
Moderate amounts of alcohol can have a beneficial effect on your heart. (By "moderate," we mean one drink a day or about 5 ounces—but many restaurants serve far more than that.) Overdoing it can raise triglycerides, increase blood pressure and lead to weight gain, thanks to all those empty calories.

In Your 30s


Get a Grip on Stress
When you're juggling career and family, it's crucial to find stress management techniques that work. "Untamed stress has a direct negative impact on heart health," says Dr. Stevens. "The constant bombardment of adrenaline raises blood pressure and destabilizes plaque in your arteries, making it likely to cause a clot or heart attack."

Lose the Baby Weight
No, you don't have to fit into your skinny jeans by the time the baby's 6 months old, but do aim to get back to your pre-pregnancy weight within one to two years. "Carrying around extra pounds can lead to high cholesterol, high blood pressure and other heart disease risk factors," Dr. Bonow says. Also remember that it's easier to lose weight in your 30s than in your 40s, when your metabolism slows down.

Stay Social
It's important to stay connected to friends and family for the sake of your mood and heart. Research at the University of Pittsburgh School of Medicine found that high levels of loneliness increase a woman's risk of heart disease by 76 percent. On the flip side, having strong social support can help lower your blood pressure and improve other cardiovascular functions. Set aside time once or twice a week to call friends, or make a monthly dinner date.

In Your 40s

Make Sleep a Priority
Thanks to peri-menopause, fluctuating hormone levels can interfere with a good night's sleep. But not getting at least seven hours of shut-eye regularly can lead to increased blood pressure, low-grade inflammation and higher levels of the stress hormone cortisol, all of which are harmful for your blood vessels and heart, explains Jennifer H. Mieres, MD, a cardiologist at New York University School of Medicine and coauthor of Heart Smart for Black Women and Latinas. Lack of sleep has also been linked to weight gain. So establish good habits: Turn in (and wake up) at the same time every day—even on weekends—and do your best to relax before going to bed, whether it's watching a favorite funny TV show or reading.

Reassess Your Risk Factors
You may discover that your cholesterol, blood pressure and blood sugar levels have changed in this decade, even if you aren't doing anything differently, says Dr. Hayes. In fact, 22 percent of 40-something women have high blood pressure and 50 percent have high cholesterol (a jump from 38 percent of women in their 30s), according to the National Heart, Lung, and Blood Institute. Also, be sure to get your thyroid checked around 45; hypothyroidism (an underactive thyroid gland), which becomes more common as women get older, can negatively affect your cholesterol levels as well as your heart.

Step Up Strength Training
You start to lose muscle mass more rapidly in your 40s, which causes your metabolism to slow down since muscle burns more calories than fat. Unfortunately, this makes it harder to stave off those extra pounds. To help maintain muscle and keep your metabolism going, aim for two 15-minute sessions weekly of lifting weights, using a resistance band or doing other toning exercises.

Carve out Personal Time
"Between the demands of work and family, it becomes even more challenging to find time for yourself in your 40s," says Dr. Mieres. But it's crucial to do so—not only to help ease stress but also to guard against depression, which commonly crops up in this decade and can raise your risk of heart disease. "Find at least 10 minutes of ‘me' time every day to do something—even if it's just chatting on the phone with a friend—that helps you destress and regroup," says Dr. Mieres.

In Your 50s

Move More
Around menopause, you tend to gain extra weight around your belly, which can lead to insulin resistance, inflammation and heart strain. Cardiovascular fitness also starts to decline, particularly if you're not that physically active to begin with. "Unfortunately, at this point, women have to burn more calories to stay at the same weight," Dr. Stevens says. Start taking the stairs instead of the elevator whenever you can, walk faster around the mall, or jog to the mailbox to send letters instead of sticking your hand out the car window as you drive by. Small changes really do add up.

Have an ECG
Silent heart abnormalities become more common in your 50s, and an electrocardiogram (ECG) to check your heart's electrical activity can pick them up, says Dr. Goldberg. Also ask your doctor if you should have a stress test; this is especially important if you're just starting to exercise.

Add Fiber
Besides being good for your cholesterol and blood sugar, pumping up your fiber intake (think whole grains like oatmeal, brown rice and flaxseeds, as well as beans, fruits and veggies) can help prevent constipation, which becomes more of a problem as you get older and your digestive system starts to slow down.

In Your 60s

Get Even More Vigilant About Screenings
After you go through menopause and get older, your blood pressure and cholesterol tend to go up, and blood vessels get stiffer. "Have your blood sugar, blood pressure and cholesterol measured yearly," advises Dr. Goldberg.

Consider Medication
If you have hypertension or high cholesterol, the way you've been managing it before may not be enough. "As you get older, you may need more aggressive therapy," Dr. Bonow says. "High blood pressure that was controlled with one medication may now require three to control it." Talk to your doctor about whether you need to add to or adjust your medications to control your risk factors.

Be Alert to Symptoms
Now is when the first noticeable symptoms of heart disease may appear, so it's important to know what's normal for your body and be on the lookout for worrisome signs like chest discomfort, shortness of breath or changes in exercise tolerance—meaning you suddenly feel winded going up a flight of stairs or feel unusually tired for no apparent reason, says Dr. Mieres. If these appear, see your doctor pronto!

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Drug Study : Ketorolac

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Drug Study : Ampicillin

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Vaccine May Prevent TB in People With HIV

TUESDAY, Feb. 9 (HealthDay News) -- A new vaccine prevents tuberculosis in people with HIV, a new study shows.

Phase III trials of 2,000 HIV-infected people in Tanzania found that the mycobacterium vaccae (MV) vaccine reduced the rate of definite tuberculosis (TB) by 39 percent. The findings have been published online in the journal AIDS.

TB is the most common cause of death among people in developing countries who have HIV/AIDS, and the results of the clinical trials are a "significant milestone," according to principal investigator Dr. Ford von Reyn, director of the DarDar International Programs for the infectious disease and international health section at Dartmouth Medical School, in Hanover, N.H.

"Since development of a new vaccine against tuberculosis is a major international health priority, especially for patients with HIV infection, we and our Tanzanian collaborators are very encouraged by the results," von Reyn said in a news release from the journal's publisher.

The next step, he said, involves improving manufacturing methods so that sufficient quantities of the MV vaccine can be produced for further studies and possible use in patients.

Because people newly infected with HIV risk contracting TB almost immediately, the researchers said, it's important that they get the MV vaccine before they begin taking antiretroviral drugs to fight the HIV infection.

More information

The American Lung Association has more about TB.

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Scientists find first genes linked to stuttering

NEW YORK – Why people stutter has long been a medical mystery, with the condition blamed over the years on emotional problems, overbearing parents and browbeating teachers. Now, for the first time, scientists have found genes that could explain some cases of stuttering.

"In terms of mythbusters, this is really an important step forward," said Jane Fraser, president of the Stuttering Foundation.

Researchers taking part in a government-funded study discovered mutations in three genes that appear to cause the speech problem in some people. Stuttering tends to run in families, and previous research suggested a genetic connection. But until now, researchers had not been able to pinpoint any culprit genes.

Dennis Drayna, a geneticist and senior author of the study, said he hopes the results help convince doubters that stuttering "is almost certainly a biological problem."

The research — released Wednesday by the New England Journal of Medicine — also points to a possible enzyme treatment for stuttering someday.

Without a known cause, stuttering has been attributed to such things as nervousness, lack of intelligence, stress or bad parenting. Stutterers were told it was all in their heads. Fraser said parents contact her group worried they have done something to cause their children's stuttering. Were they too strict? Too attentive? Didn't pay enough attention?

The gene discovery should lift that guilt, she said.

Drayna and other experts said that while stress and anxiety can make stuttering worse, they do not cause it. "It really is not an emotional disorder. It doesn't come from your interactions with other people," he said.

Stuttering usually starts in children as they are learning to talk. Most youngsters lose their stutter as their brain develops. For some, the stuttering persists. An estimated 3 million Americans stutter. Treatments include speech therapy and electronic devices.

"This is a very difficult disorder to study," said Drayna, who is with the National Institute on Deafness and Other Communication Disorders. "You can't study it in cells in a dish. You can't study it in a test tube. You can only study it in awake humans."

To find the genes, Drayna and others first looked at a large, inbred Pakistani family with many members who stuttered, and discovered a mutation on chromosome 12. Then they found the same mutation and two other mutated genes in a group of nearly 400 other people from Pakistan, the U.S. and England who stutter.

They didn't find the mutations in a similar group of people who don't stutter, except in one Pakistani volunteer.

The researchers estimate that the three gene variants account for 9 percent of all stuttering cases. But they are looking for other stuttering genes. In fact, between 50 percent and 70 percent of stuttering cases are thought to have a genetic component, Drayna said.

"The task of connecting the dots between genes and stuttering is just beginning," Simon E. Fisher of England's Oxford University wrote in an accompanying editorial.

The three implicated genes normally help run the "recycling bin" where cells of the body send their garbage. The mutations apparently interfere with that, affecting brain cells that control speech.

"People had suggested all sorts of causes for stuttering over the years. An inherited disorder of cell metabolism was never on anyone's list," Drayna said.

Two of the stuttering genes have previously been tied to rare diseases that can occur when the cell's recycling bin malfunctions.

Other related disorders are now being treated by replacing a missing enzyme, and that could eventually be a treatment method for some kinds of stuttering, the researchers said.

Kristin Chmela, a speech therapist from suburban Chicago who specializes in treating stuttering, said she was teased and bullied for her own stuttering while growing up, and "there were lots of days where I was afraid to go to school."

She said she is looking forward to sharing the gene discovery with those she treats: "It's going to be very interesting to see the reaction on some of their faces."

___

On the Net:

New England Journal: http://www.nejm.org

Stuttering Foundation: http://www.stutteringhelp.org


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Mumps outbreak in NY, NJ tops 1,500 cases

ATLANTA – A mumps outbreak among Orthodox Jews in New York and New Jersey has now surpassed 1,500 cases and shows no sign of ending soon, health officials said Thursday.

The 7-month-old outbreak began last summer at a boys camp in the Catskills. The campers were from Orthodox Jewish families, and cases multiplied when they returned to their close-knit communities in and around New York City.

Most had a mumps vaccination, but the shots don't prevent all cases, according to the Centers for Disease Control and Prevention. The mumps vaccine is 79 to 95 percent effective if two doses are given, so illnesses will still occur in vaccinated people when the virus spreads, health officials said.

With 1,521 cases, the mumps outbreak is the largest in the U.S. since 2006, when nearly 6,600 cases were reported, mostly in six Midwestern states. Usually fewer than 300 cases are reported annually.

Mumps is spread by coughing and sneezing. Common symptoms are fever, headache and swollen glands. Most cases are in children and teens. It is a mild disease but sometimes can lead to complications such as hearing loss, meningitis and swollen testicles that — in rare cases — can lead to sterility.

In the new outbreak, the first identified case was an 11-year-old boy who got sick in late June. He had just returned from the United Kingdom — where vaccination rates are lower and mumps is more common — before going to the camp in Sullivan County in upstate New York. About 25 campers got sick.

Since then, hundreds of cases have been diagnosed in Orthodox Jewish enclaves in the New York City borough of Brooklyn, in nearby Orange and Rockland counties and in four counties in New Jersey.

Orthodox Jews account for more than 97 percent of the cases, which most likely has to do with the insular nature of their community, said Dr. Guthrie Birkhead of the New York State Department of Health.

Many Orthodox Jewish families are large, and the virus spreads well in packed households, said Kathleen Gallagher, a CDC epidemiologist. She said seating arrangements in religious schools may also be contributing, with students facing each other across tables instead of in rows of desks facing forward.

Since 1989, health officials have recommended that children get two doses of a combination vaccine against measles, mumps and rubella. Birkhead said vaccination rates for Orthodox Jewish kids are about the same as those for other New York schoolchildren.

Among 1,100 from the new outbreak, the CDC said 88 percent had gotten at least one vaccine dose, 75 percent had two doses. Health officials last month began offering a third dose in some schools where the outbreak has persisted. So far, cases are continuing.

"We're not out of the woods yet," said Birkhead.

___

On the Net:

CDC report: http://www.cdc.gov/mmwr

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Proposed autism diagnosis changes anger "Aspies"

CHICAGO – In the autism world, "Aspies" are sometimes seen as the elites, the ones who are socially awkward, yet academically gifted and who embrace their quirkiness.

Now, many Aspies, a nickname for people with Asperger's syndrome, are upset over a proposal they see as an attack on their identity. Under proposed changes to the most widely used diagnostic manual of mental illness, Asperger's syndrome would no longer be a separate diagnosis.

Instead, Asperger's and other forms of autism would be lumped together in a single "autism spectrum disorders" category. Some parents say they'd welcome the change, thinking it would eliminate confusion over autism's variations and perhaps lead to better educational services for affected kids.

But opponents — mostly older teens and adults with Asperger's — disagree.

Liane Holliday Willey, a Michigan author and self-described Aspie whose daughter also has Asperger's, fears Asperger's kids will be stigmatized by the autism label — or will go undiagnosed and get no services at all.

Grouping Aspies with people "who have language delays, need more self-care and have lower IQs, how in the world are we going to rise to what we can do?" Willey said.

Rebecca Rubinstein, 23, a graduate student from Massapequa, N.Y., says she "vehemently" opposes the proposal and will think of herself as someone with Asperger's no matter what.

Autism and Asperger's "mean such different things," she said.

Yes and no.

Both are classified as neurodevelopmental disorders. Autism has long been considered a disorder that can range from mild to severe. Asperger's symptoms can vary, but the condition is generally thought of as a mild form and since 1994 has had a separate category in psychiatrists' diagnostic manual. Both autism and Asperger's involve poor social skills, repetitive behavior or interests, and problems communicating. But unlike classic autism, Asperger's does not typically involve delays in mental development or speech.

The American Psychiatric Association's proposed revisions, announced Wednesday, involve autism and several other conditions. The suggested autism changes are based on research advances since 1994 showing little difference between mild autism and Asperger's. Evidence also suggests that doctors use the term loosely and disagree on what it means, according to psychiatrists urging the revisions.

A new autism spectrum category recognizes that "the symptoms of these disorders represent a continuum from mild to severe, rather than being distinct disorders," said Dr. Edwin Cook, a University of Illinois at Chicago autism researcher and member of the APA work group proposing the changes.

The proposed revisions are posted online at http://www.DSM5.org for public comment, which will influence whether they are adopted. Publication of the updated manual is planned for May 2013.

Dr. Mina Dulcan, child and adolescent psychiatry chief at Chicago's Children's Memorial Hospital, said Aspies' opposition "is not really a medical question, it's an identity question."

"It would be just like if you were a student at MIT. You might not want to be lumped with somebody in the community college," said Dulcan who supports the diagnostic change.

"One of the characteristics of people with Asperger's is that they're very resistant to change," Dulcan added. The change "makes scientific sense. I'm sorry if it hurts people's feelings," she said.

Harold Doherty, a New Brunswick lawyer whose 13-year-old son has severe autism, opposes the proposed change for a different reason. He says the public perception of autism is skewed by success stories — the high-functioning "brainiac" kids who thrive despite their disability.

Doherty says people don't want to think about children like his son, Conor, who will never be able to function on his own. The revision would only skew the perception further, leading doctors and researchers to focus more on mild forms, he said.

It's not clear whether the change would affect autistic kids' access to special services.

But Kelli Gibson of Battle Creek, Mich., whose four sons have different forms of autism, thinks it would. She says the revision could make services now designated just for kids with an "autism" diagnosis available to less severely affected kids — including those with Asperger's and a variation called pervasive developmental disorder-not otherwise specified.

Also, Gibson said, she'd no longer have to use four different terms to describe her boys.

"Hallelujah! Let's just put them all in the same category and be done with it," Gibson said.

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Top Performing Schools NLE November 2009

Performance of Schools in the NLE November 2009 -

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Nursing Board Exam Results - November 2009

95,282 nursing graduates took the November 2009 Nurse Licensure Examinations (NLE) or the Nursing Board Exam last November 29 and 30, 2009.

This year has the highest number of Nursing Examinees in the history of the Nursing Board Exam.

The results will be posted here and here as soon as the Professional Regulation Commission release the Nurse Licensure Examinations (NLE) Board Results for the November 29 and 30, 2009 Nursing Board Exam.


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