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| Home |
Cellphone and cancer 24-
July 2008 |
| Selected
papers |
Red Bull gives you wings - and heart trouble?
15- August 2008 |
| Medical
news |
HIV dates back to
around 1900 02-
October 2008 |
| Members |
Skin changes in postmenopausal women
unaffected by hormone therapy 02-
October 2008 |
| Membership |
Breast cancer and moisturizers!
19-
December
2008 |
| Webwatch |
UV rays more damaging on ski slopes 19-
December
2008 |
| Skin
Care |
Stress may
trigger bad habits which increase heart attack risk 19-
December
2008 |
| Dermcalender |
AAD guidelines
committee is going to ease mtx monitoring
12-
February
2009 |
| Cases |
Don't blow your nose when you have a cold!12-
February
2009 |
| Text |
Vitamin D deficiency linked to
multiple sclerosis
12-
February
2009 |
| Letters |
Be more careful in
holidays! |
| Journals |
Patients with Psoriasis are at Increased Risk
for Developing Other Medical Conditions
02- April 2008 |
| Organizations |
Shisha; more dangerous than cigarette 01- June 2008 |
| Foundations |
Robotic Hair transplant
01- June 2008 |
| General
Sites |
Under eye dark-circles
12-June 2008 |
| Quiz |
Intensive
therapy to target normal glycated hemoglobin levels do not reduce...17-July 2008 |
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Cellphone and cancer
Dr. Ronald B. Herberman, the
director of the University of Pittsburgh Cancer Institute, notes
that while the evidence about a cellphone-cancer link remains
unclear, people should take precautions, particularly for children.
“Really at the heart of my
concern is that we shouldn’t wait for a definitive study to come
out, but err on the side of being safe rather than sorry later,” Dr.
Herberman told The Associated Press.
Earlier this year, three
prominent brain surgeons raised similar concerns while speaking on
“The Larry King Show.” Their concerns were largely based on
observational studies that showed only an association between
cellphone use and cancer, not a causal relationship. The most
important of these studies is called Interphone, a vast research
effort in 13 countries, including Canada, Israel and several in
Europe.
Some of the research suggests a
link between cellphone use and three types of tumors: glioma; cancer
of the parotid, a salivary gland near the ear; and acoustic neuroma,
a tumor that essentially occurs where the ear meets the brain. All
these tumors are rare, so even if cellphone use does increase risk,
the risk is still very low.
On Wednesday, Dr. Herberman sent
a memo to about 3,000 faculty and staff saying that children should
use cellphones only for emergencies because their brains are still
developing. He advised adults to keep cellphones away from the head
and use the speakerphone or a wireless headset, he said.
“Although the evidence is still
controversial, I am convinced that there are sufficient data to
warrant issuing an advisory to share some precautionary advice on
cellphone use,” he wrote in his memo.
Source:


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Red Bull gives you wings - and
heart trouble?
Red Bull may claim to “give you
wings” but drinking too much of
the popular energy drink may
also lead to heart damage, a
study suggests.
A
study of 30 university students
aged between 20 and 24 years old
found that drinking just one
250ml sugar-free can of the
caffeinated energy drink
increased the “stickiness” of
the blood and raised the risk of
blood clots forming.
Using tests to measure blood
pressure and the state of blood
vessels around the body, the
Australian researchers said that
after drinking one can
participants had shown a
cardiovascular profile similar
to that of someone with heart
disease.
Scott Willoughby, of the Cardiovascular Research Centre at the Royal Adelaide Hospital and Adelaide University, said that he was alarmed at the results, and suggested that older adults who already have symptoms of heart disease should refrain from drinking too much of the energy drink. ...
Red Bull, which has the catchphrase “Red Bull gives you wings”, was created in Austria in the 1980s. The company last year sold 3.5 billion cans of the drink in 143 countries. Cans of Red Bull already carry health warnings advising customers not to drink more two cans a day.
Source: Times Online
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HIV
dates back to around 1900
Genetic analysis of tissue
specimen recently discovered in the Democratic Republic of the
Congo leads researchers to believe the virus that causes AIDS
has been present for more than a century.
The study, led by
evolutionary biologist Michael Worobey of the University of
Arizona in Tucson, puts the date of origin at around 1900,
which is 30 years earlier than previous analyses.
HIV-1, the most common form of
the virus, is known to have originated in chimpanzees because of
close genetic similarities to a simian virus. It now infects an
estimated 33 million people worldwide.
But figuring out when the virus jumped species and became
established in humans has been difficult. The first cases in the
U.S. were recognized in 1981, and the oldest evidence of the
virus is a 1959 blood sample taken from a man who lived in what
was then the Belgian Congo.
To find the point of origin, the scientists relied on a
well-recognized genetic technique to determine the mutation
rates of different sub-types of the virus. With a known rate of
mutation, researchers could then, in essence, run the clock
backward to find the point where the different sub-types were
the same. That common ancestor would represent the first
appearance of the virus in humans before it mutated.....
SOURCE: Nature
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Skin
changes in postmenopausal women unaffected by hormone therapy
05 September 2008
SOURCE: J Am Acad Dermatol 2008; 59:397-404
Age-related facial skin changes in
postmenopausal women are unaffected by long-term hormone therapy, according
to findings published in the Journal of the American Academy of
Dermatology.
Declining estrogen levels are associated
with a variety of skin changes in postmenopausal women, such as decreased
skin thickness, collagen content and elasticity, increased fine wrinkling
and dryness, and impaired wound healing. Many of these changes are
reportedly reversed or improved by estrogen supplementation.
Phillips and team evaluated the effects
of continuous combined norethindrone acetate (NA) and ethinyl estradiol (EE)
in the control of mild-to-moderate age-related skin changes in 485 women who
were, on average, 5 years postmenopausal. The women were randomly assigned
to receive double-blind treatment with placebo, 1 mg NA/5 µg EE, or 1 mg
NA/10 µg EE, for 48 weeks.
At week 48, there were no significant
differences between placebo and the hormone therapy groups with regard to
the primary endpoints: investigator global assessment of coarse and fine
facial wrinkling, and patient self-assessment of changes in wrinkling.
Instead, slight decreases for both endpoints were observed in all three
treatment groups.
There were also no significant
differences among the three treatment groups for the secondary endpoints.
Secondary endpoints included investigator global assessment and patient
self-assessment of skin laxity/sagging and texture/dryness, as well as
wrinkle depth and skin elasticity.
"It is possible that longer treatment
duration, or different formulations or doses of estrogen, might have more
positive effects," comment Phillips and team. "Differing progestogen
combinations and examination of nonphotodamaged skin might also demonstrate
different outcomes."
Phillips and colleagues note that a
marginally significant overall treatment effect was observed in the subgroup
of women who were less than 24 months postmenopausal (n=57).
Despite the result being unreliable due
to the small sample size, and the fact that the current study was not
designed to look at women who were in the early postmenopausal period, the
researchers say that "future studies in this group would be of interest,
particularly as hormone therapy given close to menopause appears to be
safest."

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Breast cancer and
skin moisturizers!
Source: Medpage
MedPage(12/17,
Bankhead) reported that "breast cancer patients may
unknowingly expose themselves to estrogen by using
certain skin moisturizers," according to a
researcher at the San Antonio Breast Cancer
Symposium. Adrienne C. Olson, Pharm.D., of
Breastlink in Rancho Palos Verdes, "collected
containers of 16 nonprescription skin moisturizers,
spanning a wide cost range." Dr. Olson "sent the
samples to a research laboratory, which tested the
products for the presence of estradiol, estrone, and
estriol." According to Dr. Olson, "laboratory
analyses identified a half-dozen different products
containing measurable levels of estriol and estrone,"
even though "none of the products listed the
estrogenic hormones among its ingredients."

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UV
rays more damaging on ski slopes
The combination of higher altitude and
ultraviolet (UV) rays reflected by the snow puts skiers
and snowboarders at an increased risk of sun damage and
ultimately, skin cancer.
While it "is easy to associate
winter with frostbite and windburn... most people are
unaware that UV rays can be even more damaging on the
slopes than on the beach." That's because "UV exposure
increases eight to10 percent with every 1,000 feet above
sea level." In addition, "snow reflects about 80 percent
of the UV light from the sun, meaning that you are often
hit by the same rays twice." Winter sports enthusiasts
should "use a broad-spectrum sunscreen with an SPF of 15
or higher," and "apply it 30 minutes before hitting the
slopes," even on cloudy days, and wear a "lip balm with
an SPF 15 or higher."
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Stress
may trigger bad habits which increase heart attack risk
HealthDay
(12/15, Edelson) reported, "Stress increases the risk of heart attack and
other cardiovascular problems by pushing people toward bad habits,"
according to a study published in the Dec. 16/23 issue of the Journal of
the American College of Cardiology. Mark Hamer, Ph.D., of University
College London, and colleagues, "followed 6,576 participants in the Scottish
Health Study, which started with them filling out a 12-item questionnaire
designed to measure their general happiness by listing such things as
symptoms of depression or anxiety and recent sleep disturbances. About 15
percent of the people in the study were classified as suffering from
psychosocial stress on the basis of their answers." The investigators "also
collected physical data, starting with basic information on weight, height,
physical activity, alcohol intake, smoking, and blood levels of cholesterol
and C-reactive protein (CRP)."
Participants "were followed for an average of seven
years, and during this time there were 223 incident cardiovascular disease
events, including 63 fatal events,"
Medscape (12/15, O'Riordan) added.
"In an age- and sex-adjusted model, individuals identified as
psychologically distressed on the GHQ-12 [General Health Questionnaire] had
a 54 percent increased risk of cardiovascular events during the follow-up
period, confirming existing data." Overall, the authors demonstrated that
"behavioral factors, including smoking, physical activity, and alcohol
consumption, accounted for 65 percent of the relationship between
psychological distress and cardiovascular disease risk." Notably, another
"19 percent of the association was explained by pathophysiological risk
factors, such as hypertension" and CRP.

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AAD guidelines committee is going to
ease mtx monitoring
February 12, 2009
The "American Academy of Dermatology (AAD) is poised
to loosen the decade-old guideline recommendation aimed at reducing
liver damage from giving methotrexate for psoriasis." During a
presentation at the Skin Disease Education Foundation Hawaii
Dermatology Seminar, John Y.M. Koo, M.D., of the University of
California-San Francisco, "said that he and other members of the AAD
guidelines committee have 'hashed out in a manuscript form' an
update that recommends periodic liver biopsies when patients reach a
threshold of 3.5 g of methotrexate." Dr. Koo cautioned, however,
that the recommendation "would cover only patients 'who have no risk
factors whatever -- no fatty liver disease, no obesity, no
diabetes,'" because "patients with such risk factors are not
recommended for methotrexate therapy." While "the guideline must be
approved by the AAD," Dr. Koo "said he expected that approval within
the next few months." Currently, "guidelines recommend periodic
liver biopsies," citing "a cumulative dose threshold of 1.5 g."
SOURCE: Dermatology Daily

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Don't blow your
nose when you have a cold!
Blowing your nose to alleviate
stuffiness may be second nature, but some people argue it does no
good, reversing the flow of mucus into the sinuses and slowing the
drainage.
Counterintuitive, perhaps, but
research shows it to be true.
To test the notion, Dr. J. Owen
Hendley and other pediatric infectious disease researchers at the
University of Virginia conducted CT scans and other measurements as
subjects coughed, sneezed and blew their noses. In some cases, the
subjects had an opaque dye dripped into their rear nasal cavities.
Coughing and sneezing generated
little if any pressure in the nasal cavities. But nose blowing
generated enormous pressure — “equivalent to a person’s diastolic
blood pressure reading,” Dr. Hendley said — and propelled mucus into
the sinuses every time. Dr. Hendley said it was unclear whether this
was harmful, but added that during sickness it could shoot viruses
or bacteria into the sinuses, and possibly cause further infection.
The proper method is to blow one
nostril at a time and to take decongestants, said Dr. Anil Kumar
Lalwani, chairman of the department of otolaryngology at the New
York University Langone Medical Center. This prevents a buildup of
excess pressure.
Source: New York Times
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Vitamin D deficiency linked to multiple
sclerosis
While no specific cause of multiple
sclerosis (MS) has yet to be determined, research has shown that vitamin
D, which the body produces as a result of exposure to sunlight, may help
control a gene that is known to increase the risk of MS. In the study,
scientists from the University of British Columbia and University of
Oxford conducted research on a section of the genome on chromosome six
that has been shown to have the greatest impact on increasing the risk
of MS. In fact, one in 300 people living in the UK who carries a single
copy of the gene variant DRB1*1501 - and one in 100 who carries two
copies - are likely to develop MS. In a normal population, just one in
1,000 will develop the condition.
The researchers discovered that when
proteins are activated by vitamin D, they bind to a particular DNA
sequence located next to DRB1*1501. This alters the gene's function.
One reason could be due to an effect
on the thymus, the part of the immune system that produces T cells to
protect the body against bacteria and viruses. In people who carry
DRB1*1501, vitamin D deficiency early on in life can impact the ability
of the thymus to detect "rogue" T cells. When those cells are allowed to
continue attacking the body, it can result in the loss of the protective
myelin sheath in the brain and spinal cord. This can cause neurological
damage.
Co-author, Professor George Ebers,
from the Wellcome Trust Centre for Human Genetics, at the University of
Oxford, notes that "we show that the main environmental risk candidate -
vitamin D - and the main gene region are directly linked and interact."
And he suggests that supplements of vitamin D taken during pregnancy and
during the child's early years could help reduce the risk of developing
MS later on in life.
And adds Simon Gillespie, chief
executive of the MS Society, "These remarkable results tie together
leading theories about the environment, genes and MS but they are only
part of the jigsaw. This discovery opens up new avenues of MS research
and future experiments will help put the pieces together."
Source:
http://news.bbc.co.uk/2/hi/health/7871598.stm

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Be
more careful in holidays!
Americans are more likely to die
on Christmas Day, the day after Christmas, and on New Year's Day than on
any other day of the year.
In a comprehensive study of 53 million U.S. death certificates spanning
the years 1973-2001, researchers discovered significant spikes in both
cardiac and non-cardiac deaths during the holidays. They also warned this
trend is on the rise.
"From the point of view of a public health problem, it's something
that's getting worse over time rather than better," said lead
researcher David Phillips, a professor of sociology at the University of
California at San Diego.
He believes the phenomenon may stem from patients' tendency to postpone
medical care during the holidays, as well as holiday-specific staffing
patterns at hospitals nationwide.
The findings appear in the Dec. 14 issue of Circulation.
Philip and his colleagues found that three days -- Dec. 25 and 26, and
Jan. 1 -- were the worst in terms of deaths from both cardiac and
non-cardiac causes.
"In the case of heart deaths, there's an 11.9 percent excess [of
deaths] on those days" beyond what would normally be expected during
that season, Phillips said.
"In the case of the non-heart deaths for those three days, what
you find is an extra 12.2 percent of deaths," he added.
The observed spikes in death rates were especially sharp among
individuals who died soon after onset of their symptoms -- patients who
were dead on arrival (DOA) by the time they reached emergency care. During
the holidays, DOA rates climbed by nearly 5 percent over normal, the
researchers found.
Why the sharp rise in deaths around the holidays? According to
Phillips, a close examination of data ruled out likely suspects such as
cold weather or changes in diet and exercise patterns. For example, he
said, the rise in holiday deaths was seen even among nursing home
patients, whose diets and activities tend to be strictly controlled.
Kloner suggested that the emotional stress associated with the holiday
season might be to blame -- things like "dealing with relatives
whether you like them or not, financial stresses, and travel during the
holidays."
But Phillips disagreed. He pointed out that the Christmas and New
Year's Day peaks in mortality were also seen among individuals affected by
advanced Alzheimer's disease. "Many of these people don't even
understand anymore that there is a holiday going on," he said. Based
on that finding, "we don't think the evidence points neatly toward
the idea of emotional stress playing a role," Phillips said.
Instead, two factors -- patient attitudes to symptoms and hospital
staffing changes -- appear most likely to blame, he said.
According to Phillips, too many patients adopt an "'I'll take care
of that later'" attitude when presented with unsettling symptoms
during the holidays.
"They underuse urgent-care facilities. That's been shown in
previous studies," he said. There's also the added complication of
holiday travel. According to Phillips, individuals far away from their
doctors may choose to put off needed care until their return.
Holiday staffing patterns at hospitals may play a key role, as well.
"It could be there's reduced levels of health-care staffing, or staff
members who are unfamiliar with individual patients," Kloner said.
According to Phillips, more study needs to be done to see if better
hospital staffing practices can reduce the holiday rise in mortality.
The findings are much more than a minor statistical bump, he said.
According to the study, the "holiday effect" may account for an
additional 42,039 U.S. deaths over the study period.
And it's a trend that's been growing in significance year by year, the
researchers add. According to the study, the first three years of data
(1973-1975) pegged excess holiday mortality at just 0.95 percent above
what would be expected during the winter months. By the study's end,
1999-2001, that bump had risen nearly fivefold, to 4.4 percent above
seasonal norms.
"This effect is getting bigger over time," Phillips said.
"It seems risky to ignore it."
SOURCE: healthday

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Patients With Psoriasis are At Increased Risk For Developing Other Serious
Medical Conditions
It has long been known that
psoriasis, a chronic skin condition characterized by thick, red, scaly
plaques that itch and bleed, can have a significant negative impact on a
patient's overall quality of life. Now, dermatologists are finding that
psoriasis, especially severe psoriasis, is linked with a number of serious
medical conditions -- including cardiovascular disease, depression and
cancer.
In the report entitled, "National
Psoriasis Foundation clinical consensus on psoriasis comorbidities and
recommendations for screening," published online in the Journal of the
American Academy of Dermatology, dermatologist Alexa B. Kimball, MD, MPH,
FAAD, associate professor of dermatology at Harvard Medical School in
Boston, Mass., led a task force of the National Psoriasis Foundation Medical
Board that explored psoriasis co-morbidities. The group presented a summary
of recently published research on the association between psoriasis and
other medical conditions and recommendations on how dermatologists can help
at-risk patients find appropriate preventative care or treatment.
"Our review found that people with
more severe cases of psoriasis appear to have an increased incidence of
psoriatic arthritis, cardiovascular disease, hypertension, diabetes, cancer,
depression, obesity and even other immune-related conditions such as Crohn's
disease," said Dr. Kimball. "I advise patients at minimum to follow the
nationally recognized recommendations that are appropriate for their age and
gender. These include getting regular, comprehensive exams from their
doctors and working to make lifestyle changes such as losing weight,
exercising more, quitting smoking, reducing high blood pressure, controlling
cholesterol, maintaining emotional health, and managing diabetes as
needed."
Cardiovascular Risk
Dr. Kimball noted that psoriasis has
been associated with increased cardiovascular disease for decades.
Initially, this was attributed to the increased prevalence of behavioral
risk factors -- such as obesity and smoking, which are thought to be linked
to the psychosocial burden of psoriasis. However, two recent studies have
enhanced dermatologists' understanding of cardiovascular risk in
psoriasis patients. "One large population-based study demonstrated an
increased risk of myocardial infarction in patients with psoriasis
--particularly those with severe cases of the disease -- even when
accounting for major cardiovascular risk factors, such as obesity, smoking,
diabetes and hypertension," explained Dr. Kimball.
"Similarly, a small study of a
well-defined population of patients with very severe psoriasis demonstrated
that these patients had ahigher frequency of coronary artery disease
compared to a control group of patients, even when controlling for known
risk factors for atherosclerosis. Taken together, these studies suggest that
psoriasis itself may be a risk factor for developing atherosclerosis and
myocardial infarction."
Other factors that may increase the
risk of cardiovascular disease include behavioral-driven risk factors such
as obesity, smoking and depression. These risk factors can be modified by
changes in lifestyle, including maintaining a healthy weight (often measured
by Body Mass Index (BMI) < 25), physical activity for 30 minutes of moderate
intensity several times a week and healthy eating habits. Dr.Kimball also
recommended that psoriasis patients who smoke stop smoking.
Depression
Psoriasis has long been known to
cause considerable emotional stress for patients, including a lack of
self-esteem and an increased incidence of mood disorders, such as
depression. One study estimates that approximately one-fourth (24 percent)
of psoriasis patients suffer from depression.
"Depression in patients with
psoriasis is a serious concern that should be addressed, as it may
significantly impact a patient's overall emotional and physical well being,"
said Dr. Kimball. "Another concern is that depression may be a contributing
factor to an increased risk of cardiovascular disease, which as we know is
already an increased risk in psoriasis patients."
Cancer
A number of studies have found an
increased risk of certain types of cancer in psoriasis patients, such as a
form of skin cancer known as squamous cell carcinoma and lymphoma. In some
instances, these cancers have been associated with specific psoriasis
treatments which suppress the immune system. "Following the recommended
routine health screenings for cancers and avoiding high-risk behaviors that
increase the risk of developing some cancers, such as smoking, alcohol
abuse, and intentional sun exposure, must be a high priority for
psoriasis patients who may be at an increased risk for these potentially
life-threatening diseases," said Dr. Kimball.
Article URL:
http://www.medicalnewstoday.com/articles/101524.php
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Shisha;
more dangerous than cigarette
June 01, 2008
A new study finds that the use of
water pipes may be on the rise among college students. Some believe that
smoking tobacco this way is less dangerous than smoking cigarettes
—which is not the case, the researchers say.
The study, which appears in the
May issue of The Journal of Adolescent Health, looked at water-pipe use
among students at Virginia Commonwealth University. It found that of
more than 700 students surveyed, more than 40 percent reported having
used a water pipe in the previous year.
The pipes, often called hookahs
or shishas, are perhaps best known in the Middle East and are used to
smoke flavored and sweetened tobacco. The tobacco is heated over
charcoal, and then is cooled as it passes through a bowl of water and is
inhaled from a hose.
Despite the belief of some
students, water pipes may expose users to more toxic materials than
cigarettes. Each puff has as much as 100 times the smoke as a puff from
a cigarette, the study said. And smokers are also inhaling fumes from
the charcoal.

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Robotic Hair
transplant
June 2008
A robot that
can pluck and move individual hair follicles on a person's head makes
hair transplants look more natural than those performed by humans, a US
company claims. 
The robot can
also perform the procedure twice as fast as human clinicians, with less
pain and scarring for the patient, says Restoration Robotics of Mountain
View, California.
Standard hair
transplants typically take 8 to 10 hours. A strip of healthy, hairy
scalp 1 centimetre wide and 15 cm long is removed from the back of the
head under local anaesthetic.
After the gap
is sewn up, medical staff then manually separate the strip into 2000
individual hair follicle "bulbs". These are painstakingly implanted in
1-millimetre wide incisions across bald parts of the head.
"It's a lot
like gardening," says Rogers. "Removing the strip is like pulling turf
and implantation is like planting bulbs."
But Frederic
Moll of Restoration Robotics says the expensive (from around £3000, or
$5800), time consuming and repetitive task needs automating.
Instead of
removing a strip of scalp, which is painful and carries the risk of
infection, his robot plucks healthy follicles individually, at a rate up
to 1000 an hour...
...The robot
has another advantage over manual transplants – the ability to design
somebody's hairline on a computer. This can help give the transplanted
hair a more natural look...

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Dark Circles
In
recent years, the drumbeat against under-eye circles
has grown louder.
“Dark circles
around the eyes can be unsightly,” declares one
advertisement for an eye cream. An advertisement for
Hylexin cream features a pale model with black
stripes under her eyes, like a football player, for
dramatic effect. And just in case you think you are
overreacting, the ad reinforces the notion that dark
circles are indeed a flagrant shortcoming.
Roughly 53
percent of the 13,000 Clinique users surveyed by the
company in 2006 cited under-eye circles and
puffiness as their No. 1 beauty concern.
“We were really
shocked,” said Dr. Mammone, who has a Ph.D in
molecular and cellular biology. “We knew many of our
people in distribution and sales suggested that it
was a concern, but we didn’t really know until the
survey that it is a major issue.”
Sales of
anti-aging skin care treatments, which include
products designed to get rid of dark circles,
increased to $1.08 billion in 2006, up from $588
million annually in 2001, according to Mintel, a
market research firm. No one specifically tracks the
market for dark-circle remedies.
Taming dark
circles is tricky.
There are a lot
of factors that contribute to quote-unquote dark
circles.
Most people
think dark circles are a telltale sign of tiredness,
or the unsightly evidence of a binge involving one
too many margaritas. That is true to a certain
extent, as fatigue makes skin dull, and drinking
alcohol dehydrates and thins the skin.
But the most
likely culprit causing chronic dark circles,
dermatologists say, is excess pigmentation in the
skin. Dark circles are prevalent on all skin colors
and types, but they especially trouble
African-Americans, Southeast Asians and Southern
Italians. Beach bunnies should note: sun exposure
exacerbates dark circles.
Dilated blood
vessels that sit close to the thin under-eye skin
are another cause, doctors said.
Aging, which
causes skin to thin, can darken the eye area, as can
certain medications such as birth control pills,
which can dilate blood vessels.
The problem is
that few, if any, of the creams on the market are
formulated for people with excess pigmentation or
dilated veins.
Multiple creams
are available, however it is unclear how effective
they are!
Source:

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Intensive
therapy to target normal glycated hemoglobin levels do not reduce major
cardiovascular events.
BACKGROUND: Epidemiologic studies have
shown a relationship between glycated hemoglobin levels and
cardiovascular events in patients with type 2 diabetes. We investigated
whether intensive therapy to target normal glycated hemoglobin levels
would reduce cardiovascular events in patients with type 2 diabetes who
had either established cardiovascular disease or additional
cardiovascular risk factors.
METHODS: In this randomized study,
10,251 patients (mean age, 62.2 years) with a median glycated hemoglobin
level of 8.1% were assigned to receive intensive therapy (targeting a
glycated hemoglobin level below 6.0%) or standard therapy (targeting a
level from 7.0 to 7.9%). Of these patients, 38% were women, and 35% had
had a previous cardiovascular event. The primary outcome was a composite
of nonfatal myocardial infarction, nonfatal stroke, or death from
cardiovascular causes. The finding of higher mortality in the
intensive-therapy group led to a discontinuation of intensive therapy
after a mean of 3.5 years of follow-up.
RESULTS: At 1 year, stable median
glycated hemoglobin levels of 6.4% and 7.5% were achieved in the
intensive-therapy group and the standard-therapy group, respectively.
During follow-up, the primary outcome occurred in 352 patients in the
intensive-therapy group, as compared with 371 in the standard-therapy
group (hazard ratio, 0.90; 95% confidence interval [CI], 0.78 to 1.04;
P=0.16). At the same time, 257 patients in the intensive-therapy group
died, as compared with 203 patients in the standard-therapy group
(hazard ratio, 1.22; 95% CI, 1.01 to 1.46; P=0.04). Hypoglycemia
requiring assistance and weight gain of more than 10 kg were more
frequent in the intensive-therapy group (P<0.001).
CONCLUSIONS:
As compared with standard therapy, the
use of intensive therapy to target normal glycated hemoglobin levels for
3.5 years increased mortality and did not significantly reduce major
cardiovascular events. These findings
identify a previously unrecognized harm of intensive glucose lowering in
high-risk patients with type 2 diabetes. (ClinicalTrials.gov
number, NCT00000620.)
SOURCE: New England Journal of Medicine.
2008; 358(24):2545-59 (ISSN: 1533-4406)

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