DrugsBoat.com Online Pharmacy http://www.drugsboat.com/articles Online Pharmacy, Prescription and non prescription drugs without a prescription Mon, 19 Mar 2012 13:17:49 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.4 Warfarin for Heart Disease Prevention http://www.drugsboat.com/articles/warfarin-for-heart-disease-prevention.html Mon, 19 Mar 2012 13:17:29 +0000 http://www.drugsboat.com/articles/?p=106 In another piece of aspirin-related news, British researchers reported in the January 24 Lancet that taking low doses of both aspirin and warfarin (Coumadin) — another anti-clotting drug — prevents a first heart attack or fatal heart problem better than either drug alone. This is the first study to show that warfarin might be useful for heading off coronary artery disease as well as treating it.

The authors randomly assigned nearly 5,500 men at high risk for heart disease to take one of four drug combinations daily: warfarin and aspirin, warfarin and placebo, aspirin and placebo, or two placebos. The researchers tracked the men for an average of seven years, counting how many had heart attacks or fatal heart problems during that time.

At the study’s end, the warfarin group had 21 percent fewer heart attacks or heart-related deaths than the placebo-only group; the aspirin group had 20 percent fewer of these events. But the men who took both aspirin and warfarin had the best record of all, with 34 percent fewer heart attacks or cardiac deaths. The effects of each cheap drugs seemed to be different: Aspirin was better at preventing nonfatal heart attacks, while warfarin prevented more deaths. Men who took both drugs appeared to have the best of both worlds.

Should anyone on aspirin therapy run to the doctor for a low-dose warfarin prescription? Not yet. This is the first study to show any benefit from taking warfarin to prevent a first heart problem, and it looked only at high-risk men (and it’s not clear which of their risk factors mattered). Right now, statin drugs are the only drugs besides aspirin clearly shown to prevent first heart attacks.

Also, warfarin itself can be risky: It can cause dangerous bleeding in some people, especially if they’re taking aspirin at the same time. That means frequent blood tests are necessary for anyone taking even the low warfarin doses used in this study — which drove half the participants to drop out.

So it’s too early to recommend that most people take warfarin to ward off a first heart problem. But men 45 and older at high risk for heart disease who are allergic to aspirin should discuss with their doctors whether the potential benefits of warfarin may outweigh the risks.

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Does ‘NutraJoint’ Support Joint Health, or Does It Merely Support Knox http://www.drugsboat.com/articles/does-nutrajoint-support-joint-health-or-does-it-merely-support-knox.html Tue, 31 Jan 2012 10:47:15 +0000 http://www.drugsboat.com/articles/?p=102 The company that makes Knox gelatin, a division of Nabisco, is once more plying the airwaves with an advertising campaign, touting the health benefits of Knox NutraJoint. Many senior citizens are familiar with these advertisements from Modern Maturity, the magazine of the American Association of Retired Persons. Similar ads have appeared in other magazines, radio, television and food brochures.

According the Knox Company, NutraJoint can “help keep … joints flexible”; but this claim has no basis in scientific fact. The gelatin manufacturer alleges in these ads that “clinical studies” support the claims being made for NutraJoint, advising consumers that after two months of daily NutraJoint use, “you may notice results.”

“This stuff is just gelatin with a few amino acids, calcium, and vitamins thrown in,” says American Council on Science and Health (ACSH) Director of Nutrition, Ruth Kava, Ph.D. “The ads promise far more than the product can deliver.” Kava explained further, that the European studies alluded to in the NutraJoint ads involved small study populations and had vague end-points. “None of these so-called ‘studies’ would have been accepted for publication by a peer-reviewed U.S. journal,” she notes.

NutraJoint supplies its product at a significantly higher price than its individual ingredients sold separately. “Older consumers — Modern Maturity’s target audience — who fall for the Knox Company’s NutraJoint line will be left with false hopes and empty pocketbooks. Retirees won’t find relief from their joint pain, but they will find they have squandered their precious financial resources,” according to Kava.

By advertising this product as a “dietary supplement” while simultaneously alluding to its ability to act as a drug to “improve cartilage health” and “improve joint flexibility,” Knox/Nabisco tries to sidestep Food and Drug Administration (FDA) regulations on health claims. Their advertisements mislead consumers into believing that NutraJoint will alleviate symptoms “in as little as two months.”

Since Congress removed “nutritional supplements” from the regulatory oversight of the FDA, this ambiguous category has become a maze of extravagant health claims. Even major pharmaceutical companies are jumping on the bandwagon of “nutraceuticals,” foods with alleged beneficial health effects.

Kava points out that “they cloak these claims cleverly in a web of other, more valid claims, such as: ‘Certain amino acids and vitamin C are required for healthy cartilage, and calcium is required for healthy bones.'” Knox wants us to believe that the human joint is like a chemical reaction, in which the more amino acids you put in, the more healthy cartilage will grow. Interestingly, the amino acids to which they attribute this stimulus are themselves non-essential: the body produces as much as it requires naturally, without supplementation.

Dr. Elizabeth Whelan, president of ACSH, says, “Of course, this ‘miracle’ comes at a price: the cost of Knox NutraJoint is almost 3-fold what the plain gelatin costs. I doubt the addition of small amounts of calcium and vitamin C explain this difference.”

Dr. Whelan suggests, “Rather than wasting money on this useless product, I would advise senior citizens to seek competent medical advice for their arthritis pain and suffering.”

Purchasing prescription drugs without a prescription is easy, safe from our reliable internet drugstore. You will save a lot of money, energy, time.

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New Drug Can’t Beat Aspirin http://www.drugsboat.com/articles/new-drug-cant-beat-aspirin.html Tue, 13 Dec 2011 09:33:22 +0000 http://www.drugsboat.com/articles/?p=99 In new research published in the Jan. 29 issue of The Lancet, sibrafiban, a new drug that inhibits blood platelet clumping, showed no benefit over aspirin for treatment of patients who had just had a heart attack.

The study investigated whether sibrafiban would prevent more cardiovascular events than aspirin when given within seven days of and sustained for 90 days after an acute coronary syndrome event, defined as acute chest pain (angina) or heart attack (acute myocardial infarction). Dr. Kristin Newby from Duke University Medical Center in Durham, N.C., led the international study, called a SYMPHONY trial.

Over 9,000 patients were randomly assigned to take either 80 milligrams of aspirin (one baby aspirin) twice daily, low-dose sibrafiban or high-dose sibrafiban. The patients were assessed for recurrence of cardiovascular events after 90 days.

The results of the study showed no significant difference in the rates of heart attack or cardiac-related death between the groups assigned aspirin, low-dose sibrafiban and high-dose sibrafiban. Major bleeding was more common with high-dose sibrafiban than with aspirin or low-dose sibrafiban.

The investigators concluded that sibrafiban showed no additional benefit over aspirin for prevention of further major events after an acute coronary syndrome and was associated with more dose-related bleeding. Patients with bleeding disorders, severe asthma or aspirin allergy are not eligible to take aspirin for heart disease treatment or prevention without careful evaluation of these risks by medical caregivers.

In order to reduce the severity of acute myocardial infarction, or AMI, patients with angina are often advised to take an aspirin, while simultaneously getting immediate medical care. Other agents that also work against AMI by interfering with platelet clumping, or adhesion, are given intravenously in the hospital emergency room. Sibrafiban is a similar agent that can be given orally.

Aspirin lowers the risk of heart attack and death in patients with acute coronary syndromes, such as unstable angina. One way aspirin works is by interfering with platelet adhesion, which is part of the process that leads to the formation of clots in coronary blood vessels. The result of a coronary arterial clot, or thrombosis, is often a heart attack, or even death.

Use of stronger inhibitors of platelet adhesion, substances called glycoprotein 2b/3a receptor antagonists, also reduces the rate of complications immediately after a heart attack. Sibrafiban is one such agent. However, there is no long-term benefit. Since aspirin is an anti-inflammatory agent, and inflammation of the coronary arteries is now thought to be a factor in the process of thrombosis and AMI, this mechanism may also play a role in aspirin’s effectiveness.

In an editorial accompanying the study, Dr. Christopher Heeschen of Stanford University and Dr. Christian Hamm of Germany’s Kerckhoff Heart Center discuss possible explanations for sibrafiban’s lack of additional benefit. They suggest that some of aspirin’s effect may be through its other properties (for example, its anti-inflammatory effects). Also, the safe and effective levels of drugs such as sibrafiban are not yet known. Another possibility is that the patients studied were not at particularly high risk of having another coronary event, so any sibrafiban or aspirin effect would be very small.

But it seems the last word should belong to the study authors, who state: “? given the substantial benefits of aspirin alone and its low cost and lower bleeding risk, none of the completed studies provide evidence that would justify use of an oral glycoprotein 2b/3a inhibitor.”

Aspirin use in suspected or documented AMI has increased significantly over the past decade, which is part of the reason why the in-hospital death rate from AMI has decreased as well. Other reasons for the lower death rate also include the more widespread use of other prescription drugs such as beta-blockers, ACE-inhibitors and intravenous thrombolysis (“clot-busting” drugs), as well as wider use of catheterization and revascularization procedures.

Preventing the development of coronary artery disease has also been a major public-health gain. This has been the result of better control of risk factors such as high blood pressure, high cholesterol levels and especially lowered rates of adult smoking.

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New Osteoporosis Drug http://www.drugsboat.com/articles/new-osteoporosis-drug.html Thu, 22 Sep 2011 12:09:19 +0000 http://www.drugsboat.com/articles/?p=95 Q.Do you have any information on the new hormone therapy for osteoporosis called Evista?

–Karen

A.”Evista” is the brand name for a new drug called raloxifen. Raloxifen is a selective estrogen receptor modulator (SERM), meaning it acts like estrogen in some parts of the body, but not others. Evista recently won approval from the Food and Drug Administration, but only for the prevention of osteoporosis in postmenopausal women. That’s very important to remember because it is NOT a substitute for estrogen. Instead, it is an alternative for women who cannot take estrogen. Evista, unlike estrogen, has not been approved for prevention of cardiovascular disease, nor has it been evaluated for decreasing the risk of Alzheimer’s, another possible benefit of estrogen.

In studies, Evista was shown to preserve bone mass when compared with a placebo. The amount of bone mass preservation compared favorably with that achieved with estrogen. It was also shown to decrease total cholesterol, which is beneficial, but it did not raise HDL (the “good” cholesterol) as estrogen does. More research needs to be done to show whether this reduction in total cholesterol can improve cardiovascular health in postmenopausal women.

Another potential benefit of Evista is that fact that it does not increase the thickness of the uterine lining; it appears to be an anti-estrogen here, which is good. In studies on mice and rats (not humans!), it has been shown to decrease the rate of estrogen-induced breast cancers. However, on the downside, again in rat and mice studies, raloxifen increased ovarian tumors. It also may make hot flashes worse. Leg cramps are also fairly commonly reported, and a rare, but serious side effect is increased blood clots in legs.

Evista is not a panacea, nor is it a replacement for estrogen. But it is an excellent addition to our arsenal for treating osteoporosis. It is another option for women at risk for osteoporosis who cannot, or will not, take estrogen. The decision to use Raloxifene (Evista) or Alendronate (Fosomax) (another new non-estrogen bone building cheap drug) or estrogen must be made by you and your doctor, taking into account such things as your overall health, family history and symptoms.

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Folic Acid Supplements Don?t Increase Risk of Miscarriage http://www.drugsboat.com/articles/folic-acid-supplements-don%d1%82t-increase-risk-of-miscarriage.html Tue, 19 Jul 2011 09:54:36 +0000 http://www.drugsboat.com/articles/?p=91 Authorities in nutrition and healthcare? recommend that women who plan to become pregnant take supplements of the B vitamin, folic acid or folate, both before becoming pregnant and through early pregnancy to prevent birth defects — especially neural tube defects (NTDs) — in their babies. NTDs include birth defects occurring when the spinal cord and/or brain fail to form normally during pregnancy.?

That there might be a downside to such advice was suggested by studies that found slight increases in the risk of miscarriages in women who took folate along with other vitamin/mineral supplements. A new study reported in the September 8 issue of the British medical journal, The Lancet, however, found no such association between folic acid supplementation and risk of miscarriage.

Jacqueline Gindler, MD, from the Centers for Disease Control and Prevention (CDC) in Atlanta, collaborated with other researchers from the CDC, and with a number of colleagues from Chinese institutions to examine data from the Jiaxing City Collaborative Project on Neural Tube Defect Prevention.

The researchers used data collected by the Chinese Ministry of Health, which in 1993 began a program to prevent NTDs in women who had a premarital examination or were planning to become pregnant for the first time. They were all asked to take a pill containing 400 mcg of folic acid only starting as soon as possible and continuing until the end of the first trimester of pregnancy. Neural tube defects occur during this period because that is when the brain and spinal cord are forming. Compliance with the pill-taking protocol was monitored.

The study lasted two years, and included information on 23,806 women. Of these, 1,871 women did not take any folic acid pills, for a variety of reasons. Compared to the women who did take folic acid, the non-users were slightly older (23.8 vs 23.5 years); had slightly higher education levels; and were less likely to be farm or factory workers.? Otherwise, there were no significant differences in body size or ethnic group.

Dr. Gindler and colleagues found that the overall rate of miscarriage was 9.1 percent.? Importantly, there was no difference in the rate of miscarriage between those women who never took folic acid supplements and those who either took them regularly or who took them at any time. Compared to women who never used the supplements, those who took them regularly had a 3 percent increased risk of miscarriage — a slight difference that was not statistically significant.? In addition, the researchers noted that folic acid supplementation did not affect the stage of pregnancy at which miscarriages occurred, a finding that had been reported in other investigations.

In their discussion, the authors noted that the earlier studies which had found increased rates of miscarriage associated with folic acid supplementation studied women who were using multiple vitamin/mineral supplements. Thus, they suggest that it may have been inaccurate to ascribe such increases to folic acid alone.

In their summary, Dr. Gindlen and coauthors state?” these findings do not support concerns about an increased risk for miscarriages associated with consumption of folic acid during pregnancy.”

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Cardio Training Guidelines http://www.drugsboat.com/articles/cardio-training-guidelines.html Thu, 23 Dec 2010 18:21:58 +0000 http://www.drugsboat.com/articles/?p=83 Frequency: 3-5 times/week
Intensity: “Somewhat hard.” You can also use the following ACSM guidelines (but we think it’s just as easy and effective to use perceived exertion): 55% to 90% of maximum heart rate or 40-85% of maximum heart rate reserve
Time: 20 to 60 minutes continuous exercise, or two to six 10-minute bouts accumulated throughout the day.

Cardiovascular fitness is the ability of the heart, lungs, and blood vessels to provide oxygen to working tissues in order to sustain prolonged exercise. As cardiovascular fitness increases, many favorable side effects also take place. A few of them are listed in the table on the right.

Cardiovascular fitness is improved by participating in activities that elevate the heart rate and move large muscle groups continuously. The table below contains a list of some common cardiovascular activities.

Common Cardiovascular Activities

Walking

Jogging

Cycling

Jumping rope

Swimming

Aerobic dance

A proper cardiovascular workout consists of three phases: warm-up, training period, and cool down.

WARM UP
Allow 5-10 minutes of easy exercise before you begin the training period. By starting out slowly and gradually increasing the workload, you allow your heart rate and blood pressure to gradually increase. It also allows your arteries to dilate, which will let them accommodate the increased blood flow during exercise.

TRAINING PERIOD
During this period of at least 20 minutes, you’ll work at an intensity that will improve your cardiovascular fitness. There are several ways to monitor the intensity of the exercise you are performing:

One way is to use your training heart rate range. Use one of these two formulas:

By using your maximum heart rate:

[220 – (your age)] = your maximum heart rate

.55 x [220 – (your age)] = 55% of your maximum heart rate

.90 x [220 – (your age)] = 90% of your maximum heart rate

Or,by using your maximum heart rate reserve:

[220 – (your age) – (your resting heart rate)] = your heart rate reserve

{.4 x [220 – (your age) – (your resting heart rate)]} + (your resting heart rate) = 40% of your max. heart rate reserve

{.85 x [220 – (your age) – (your resting heart rate)]} + (your resting heart rate) = 85% of your max. heart rate reserve

If you keep your heart rate “in range” (55-90% of max. heart rate or 40-85% of max. heart rate reserve), you can be sure that you are working at the correct intensity.

Perceived Exertion Scale

1. At rest
2.
3. Easy
4.
5. Moderately Hard
6.
7. Somewhat Hard
8.
9. Very Hard
10. Maximal

Don’t like figuring out those formulas? A much simpler way to measure intensity is to use the talk test. Can you carry on a light conversation while you are exercising? If you are too breathless to talk, reduce the workload. If you feel like you could talk forever, work a little harder.

Finally, you can determine the workout intensity by using perceived exertion. How does the work feel to your body? It should feel “somewhat hard.” Use the Perceived Exertion Scale as a guideline. You should feel like you are working between a “5” and an “8.”

COOL DOWN
Allow 5-10 minutes of easy exercise after the training period to cool down. Your heart rate and blood pressure will gradually decrease. If you stop exercising immediately after the training period, you may feel light-headed due to blood pooling in your legs. By the end of the cool-down period, your heart rate and blood pressure should be very close to their resting levels.

HIGH INTENSITY VS. LOW INTENSITY
Many people have been led to believe that low-intensity cardiovascular exercise burns fat while high-intensity cardiovascular exercise burns carbohydrate. As a result, they believe that they will not lose fat if they work out at a higher intensity. That’s not the case. First of all, when you burn calories, you always burn both fat and carbohydrate, regardless of the intensity. It’s true that at higher intensities of exercise, a greater proportion of carbohydrate is expended, and at lower intensities of exercise, a greater proportion of fat is expended. However, the most important factor to look at is the total amount of calories burned, not which type of calories have been burned. Even if you work at a very high intensity and burn mostly carbohydrate calories, your body will eventually need to tap into its fat stores to replace that burned carbohydrate. That means that you will still lose fat if you work out very hard. Common sense says that the harder you exercise, the more calories per minute you’ll burn. So if you can maintain a high intensity throughout the whole workout, do so. You’ll burn more calories that way.

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A Smoker’s Quitting Experience With The Patch http://www.drugsboat.com/articles/a-smokers-quitting-experience-with-the-patch.html Mon, 21 Jun 2010 09:04:04 +0000 http://www.drugsboat.com/articles/?p=67 I was a fairly heavy smoker for many years. (2 to 3 packs a day!) When I began smoking, I thought it was the “cool” thing to do

Over the last few years, I came to realize that smoking is very “UNcool” and that more and more people were quitting and there were less and less places where smokers were allowed to light up. I also realized how addicted I was and how terrible smoking was for my health. I knew it was time to quit.

During the past few years, I made a few attempts to break the habit using various methods. I tried cold turkey. That was impossible for me. The cravings were way too strong and my will power was much too weak. I found myself sneaking cigarettes, knowing I was fooling only myself. I tried weaning myself off cigarettes by gradually cutting down on the amount I smoked each day. I failed at that, too. I even went so far as to try hypnotism. Not a one-on-one type of thing, but in a group session.

This “mass” hypnotism was held at a very reputable local hospital so I placed a lot of credence in it. The session cost $60 and at the end of it, I felt like a sucker. For my $60, I wound up with a stiff neck, a pen imprinted with the name of the hypnotist, and a little metal stone attached to a clear nylon thread which I was supposed to use for self hypnotism. Needless to say, I lit a cigarette as soon as I left the session.

At that point, I was ready to give up, believing that I would never be able to quit. But almost a year ago, I met someone who is now a very close friend of mine. (Hey! I met him online!) He gave me the faith in myself that I could quit if I really wanted to. He made me see that there is no easy way and there is no miracle cure.

I did some research online and learned whatever I could about nicotine addiction and the various methods of quitting. I also learned that most people fail at their attempts several times before they succeed, and the important thing is to keep trying.

After everything I read, it seemed like the patch was the way for me to go. This is a program which weans your body off of nicotine gradually over a 10 week period. (8 weeks for light smokers) For step 1 of the program, you use an adhesive nicotine patch (you attach it to any hairless part of your body) which contains 21 mg of nicotine. The nicotine is delivered to your bloodstream through your skin, known as the transdermal method.

Every morning you remove the old patch and put a fresh one on. Step 1 lasts for 6 weeks. Then you begin step 2 which lasts for 2 weeks. Those patches contain 14 mg of nicotine. Then comes the final step. Step 3, which also lasts for 2 weeks, but those patches contain only 7 mg of nicotine.

For those of you who are concerned about the rather steep price (over $50 for a 14 day supply), just think of how much money you’ll save in the long run by not smoking! (The cost of cigarettes is ridiculous now.) I ordered my entire patch supply online from drugsboat.com and I wound up saving over $100 compared to regular drugstore prices.

The best thing about the patch system is that your body doesn’t go through sudden and drastic withdrawal of nicotine like it does when you try to quit cold turkey. It gives you 10 weeks to deal with the psychological withdrawal, while the physical withdrawal isn’t too bad since you’re still getting small doses of nicotine in your bloodstream. I’ve been on the patch and smoke-free for 8 days now! That’s the longest I’ve ever gone without a cigarette since I began smoking. The first few days were the toughest, but each day I feel a little better, and this time, I KNOW I CAN DO IT. Like I said earlier, there is no easy way to quit, but the patch is definitely helping me.

*Note- This was written 18 months ago. I successfully completed the patch program and can proudly call myself to an ex-smoker!

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What is COMMON about the Common Cold? http://www.drugsboat.com/articles/what-is-common-about-the-common-cold.html Wed, 09 Jun 2010 10:15:55 +0000 http://www.drugsboat.com/articles/?p=78 When the common cold has you in its clutches, it’s not a welcome guest to say the least. Sore throat, sneezing, aching body and runny nose are the infamous signs of a cold.

We all recognize the symptoms. “Tough it out,” and “it will last just a few days,” are not particularly comforting words to us while undergoing the common cold’s punishment.

We are quite aware from past experience, it will only last a week or less but what about those miserable 7days or so? Curl up under a warm blanket, with something hot to drink, turn on a good movie, “feed the cold, starve the fever” … whatever!

The economic impact of the common cold carries quite a punch. The National Institute of Allergy and Infectious Disease states, “in the course of a year it is estimated that people in the USA have 1 billion colds,” they go on to note that this “causes about 24 million days of limited activity.”

This illness effects children’s schooling and lost days of work for adults. The stay at home mom or dad is burdened as well; all of their important tasks are curtailed transforming the entire family’s activities to an “on-hold status.”

The causes of the cold may be one of many identified types of viruses or rhinoviruses. These viruses are most active in the beginning of fall and continue into winter. Being exposed to cold weather or getting too hot, are not the causative factors (as many people assume). A more likely rationale is psychological stress, sometimes even the menstrual cycle and allergies. This condition plays a part in irritating the membranes of the nose and throat, which makes one more susceptible to catch a cold.

Fall and winter bring about certain particulars that promote colds. School starts, children are exposed to bacteria and winter means we stay inside our homes more often. Germs will more likely be passed from one person to another. The cold and low humidity in the winter season is drying to the nasal passages, thus inviting the growth of viruses.

After being infected, you will begin to see symptoms of the common cold within 3 or 4 days-breathing that is obstructed by swollen nasal passages, discharge, sneezing, sore throat, headache and cough. Fever can be unsubstantial, however in very small children temperature could elevate up to 102 degrees.

At times, colds result in secondary infections of the middle ear or sinuses. If the fever is high with swollen glands, and if there is facial pain around the area of the sinuses, be sure to visit or call your physician.

Before the deplorable symptoms and resulting infections occur, if may behoove us to consider how these colds are spread.
Common transmissions of the cold virus type are:

* Breathing in minute drops of infectious particles that hang in the air.

* Inhaling larger infectious particles that are in the air, after an infected person has sneezed or coughed.

* Infectious secretions that have been deposited on exteriors such as in tissues, on bathroom surfaces, telephones, the list goes on…consequently are touched and then transferred through the nose mouth or eyes.

Viruses can live up to three hours on objects and skin, a disinfectant cleanser or spray can be used to clean and kill most viruses. Soap and handwashing are the greatest deterrent to the spread of germs, is simple and effective. Those who are infected are advised to use tissue, then throw it away, along with washing their hands right away. They should refrain from spreading germs by coughing or sneezing into the air. It is best to avoid overexposure to those who have colds. Do not be rude, just stay in your space for a few days.

If the common cold has not turned into an infection, only treatment of the symptoms will suffice. Drink plenty of fluids, rest, gargle with warm salt water and use Vaseline to relieve the pain of an irritated nasal passage. Acetaminophen or aspirin will help relieve fever and headache.

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Homocysteine and Cardiovascular Disease http://www.drugsboat.com/articles/homocysteine-and-cardiovascular-disease.html Fri, 21 May 2010 10:10:28 +0000 http://www.drugsboat.com/articles/?p=75 Cardiovascular disease remains by far the leading cause of premature death for men and women in the U.S., the disease itself the consequence of a variety of factors, both hereditary and environmental.

Of the major risk factors, namely, high low-density lipoprotein (LDL), cholesterol and/or low high-density lipoprotein (HDL) cholesterol, old age, male gender, premature menopause in women, hypertension, smoking, diabetes mellitus and a family history of heart attack, three are related to diet: HDL and LDL cholesterol levels, hypertension and diabetes. Much research time has been spent exploring potential dietary intervention strategies and preventative measures.

For several decades, the debate on diet and cardiovascular disease has been dominated by the classic diet-heart hypothesis that proposes an adverse effect of dietary saturated fat and cholesterol and a beneficial effect of polyunsaturated fatty acid (PUFA) intake. However, recent research suggests that the diet-heart relationship is much more complex than previously recognized. No doubt, dietary lipids play a significant role in the development and prevention of this chronic disease, however, it is becoming clear that myriad of other dietary factors work synergistically and may prove to be just as, if not more, important in maintaining the health of the heart.

Antioxidants are emerging as protective factors, as well as numerous other phytochemicals often overlooked in fruits and vegetables. Moreover, deficiencies and/or excesses in certain vitamins, minerals and trace elements appear to effect the health status of the heart. There is also increasing evidence that high levels of homocysteine, an amino acid partially regulated by folic acid and vitamin B12, may contribute to the development of cardiovascular disease.

Coronary Heart Disease (CHD) is the most common form of cardiovascular disease and involves both atherosclerosis and hypertension. A heart attack (myocardial infarction) is usually the consequence of three events: 1) the narrowing of coronary arteries by atherosclerosis, 2) the rupture of an atheromatous plaque and 3) the formation of a blood clot (thrombus) in a narrowed artery. Atherosclerosis is the accumulation of cholesterol-rich deposits along the inner walls of the arteries. It first appears in arteries as fatty streaks, slightly raised yellow areas which contain foam cells. Over time, these fatty streaks collect minerals and they enlarge to form fibrous plaques which stiffen the arteries and tighten their passage. Arteries narrowed by plaques are unable to expand normally with each heartbeat, thereby causing blood pressure to rise with each pulse and the artery walls to undergo further damage. When the body’s tissues are injured, platelets and several clotting factors known as eicosanoids are released into the blood to stimulate coagulation. Consequently, soluble fibrinogen is converted into insoluble fibrin which, along with the platelets and red blood cells, aggregates at a damaged point in the artery wall to form a thrombus. The blood clot gradually expands until it reaches a narrow artery where it is blocked from passage. Consequently, the heart is robbed of oxygen and nutrients resulting in myocardial infarction.

Evidence is rapidly accumulating which suggests that elevated blood levels of homocysteine, a sulfhydryl-containing amino acid formed by the demethylation of methionine, may increase the risk of vascular disease. Several recent studies have established that moderately elevated levels of homocysteine are associated with CHD, independent of other risk factors (1). Epidemiological studies have been invaluable in delineating this relationship; more than 20 case-controlled and cross-sectional studies of more that 2000 subjects have demonstrated that subjects with stroke, hypertension and/or atherosclerosis tend to have relatively high blood levels of homocysteine compared to individuals free of disease (2). Aronow et al. found plasma homocysteine to be an independent predictor of new coronary events in elderly persons (3). Likewise, in a recent prospective study, men with homocysteine levels above 15.8 umol/liter (the 95th percentile for controls) were found to have a 3.4 fold excess risk of myocardial infarction (4)It has been estimated that mild homocysteine elevation (>15 umol/L) occurs in 20 – 30 % of patients with atherosclerotic disease (5). Findings from other related studies indicate that the association might be linear rather than present only above a certain threshold (6,7).

Carotid artery intimal-medial wall thickening is a known predictor of CHD and has been shown to be associated with plasma homocysteine levels (8). Moreover, elevated homocysteine levels have been associated with endothelial dysfunction, or reduced arterial wall elasticity, an independent CHD risk factor. In fact, plasma homocysteine levels have been associated with most standard vascular risk factors. Whether an elevation in homocysteine is a cause or an effect of CHD remains unknown.

Several potential mechanisms for this association have been suggested including enhanced uptake of LDL in the vascular wall, promotion of arterial cell growth and alterations in vascular coagulant systems (9). In particular, homocysteine thiolactone, a reactive form of homocysteine, has been shown to alter LDL, concomitantly leading to aggregation and increased uptake of LDL by macrophages. When released from the LDL within the artery wall, homocysteine causes damage to the wall and effects vascular coagulation mechanisms (10). It has also been suggested that homocysteine may also promote vascular smooth muscle growth, at the same time inhibiting endothelial cell growth; both changes may lead to atherosclerosis (11). Finally, elevated levels of homocysteine may interfere with nitric oxide-dependent reactive vasodilation (12). Reduced arterial vasodilation is an indication of increased risk for CHD.

The relevance of the relationship between hyperhomocysteinemia and diet is gradually becoming recognized. Among the enzymes in the metabolic pathway of homocysteine, two are dependent on vitamins that must be obtained from the diet, namely vitamin B12 and folate. Intracellular homocysteine is metabolized by either the transsulforation pathway or by remethylation to methionine (13). Remethylation requires folate and vitamin B12 as cosubstrate and coenzyme, respectively.

The prevalence of hyperhomocysteinemia is between 5 and 10% in the general population, and possibly higher among the elderly (14). It has been suggested that elevated levels of homocysteine may be responsible for up to 10% of CHD events. While the most severe elevations in blood homocysteine are caused by rare enzymatic defects along the metabolic pathway, hyperhomocysteinemia may also result from deficiencies of dietary vitamin B12 and folate. In addition, it has been proposed that inadequate intake of vitamin B6 or excessive intake of methionine may also result in elevated homocysteine levels (15).

Numerous studies have found that homocysteine levels are significantly higher in subjects with the lowest plasma folate, vitamins B12 and B6 (13,16,17). Dietary intakes of folate, vitamins B12 and B6 appear to be inversely related to plasma homocysteine levels (17). Likewise, supplementation trials have shown that homocysteine levels stabilize at a low level following supplementation with 400 ug or more per day (2,18,19). Moreover, 20% of the subjects in the Framingham Heart Study had hyperhomocysteinemia and correspondingly low intakes of vitamin B6 and folate (15). Therefore, homocysteine may be an important and potentially modifiable risk factor for CHD. While these studies lend credence to the notion that homocysteine is directly involved in the pathogenesis of CHD, the evidence is still inconclusive and requires further research. Only placebo-controlled intervention studies with clinical outcomes can provide conclusive evidence for homocysteine as a causal CHD risk factor.

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Exercising With Diabetes http://www.drugsboat.com/articles/exercising-with-diabetes.html Tue, 11 May 2010 10:02:27 +0000 http://www.drugsboat.com/articles/?p=73 There are three types of diabetes: type I diabetes, type II diabetes and gestational diabetes. Each form shares some defect in relation to insulin. Insulin affects the way the body uses food for fuel and is an essential hormone that regulates glucose, fat and protein metabolism.

Carbohydrate, or glucose, is the fuel most readily available for uses by the cells and is the body’s main energy source. In people with diabetes, the pancreas produces little or no insulin or the body’s cells do not respond to the insulin that is produced.

Diabetes impairs the body’s ability to burn the fuel of glucose it gets from food for energy. Diabetes is a disease in which the body is unable to produce or use its own insulin. This results in abnormally high levels of sugar and acetone, a liquid found in the blood when fats and glucose aren’t properly oxidized. In addition to high blood pressure levels, it can damage ones eyes, nerves and kidneys. Damage to nerves can promote foot sores, problems with digestion and blood vessels, which results in an increased risk of heart attack and stroke.

There is no cure for diabetes although one can control it through various treatments. In order to control diabetes, a person must measure their blood sugar levels. This can be done through a procedure called blood-glucose monitoring; this allows the diabetic to determine if their blood sugar ranges are too high (hyperglycemia), too low (hypoglycemia), or just right.

Common symptoms of diabetes include blurred vision, unusual thirst, frequent urination, drowsiness, insatiable hunger, weakness, irritability and nausea. The main risk of diabetes lies in the long-term complications such as retinopathy (eye damage), joint alterations and kidney disease, just to name a few.

Research indicates that exercise shows improvement in glucose tolerance and overall metabolism, improvement in blood glucose control, cholesterol and strength. Pointing out these facts to a diabetic may help change his or her way of thinking about making diet and exercise a priority in his or her life.

The beginning workloads for a diabetic as suggested by the American College of Sports Medicine (ACSM) is to start with exercise that the person can sustain with reasonable comfort and increase the duration and intensity of exercise according to their tolerance.

According the International Sports Sciences Association (ISSA), glucose levels less than 100 or greater than 300 mg/dl prior to exercise is not advised until food or insulin is administered. Any outward signs of blisters on hands or feet, cardiac problems, high lipid levels, excessive amounts of weights lifted (less than 50 percent of estimated maximal voluntary contraction) for persons with overt complications, and in addition, performing Valsalva’s Maneuver while training is also not advised.

A diabetic should try to fit regular exercise into his or her daily routine at about the same time each day, recording blood sugar levels using a glucose monitor before and after each exercise session to ensure blood glucose levels are within normal limits, they should have available some form of glucose solution (candy, juice) and know when to use it (any signs of dizziness, faint, drunk-like state).

A resistance exercise program should be a gradual one. Lower starting levels may be appropriate depending on his or her tolerance. Light to moderate weights can help improve muscle tone, posture and also improve blood sugar control. Aerobic training should consist of low to moderate impact to guard against injury to lower legs and feet. A mild walking program, starting at five minutes a day and slowly progressing each week, would be beneficial. Diabetes must be under control prior to beginning any exercise regimen.

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