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Salmon. You put it on the bbq in the summer, you treat yourself to it at your local sushi joint in the winter, and if you're lucky enough you keep a stash of it on hand for Sunday morning bagels and cream cheese. But salmon is a whole lot more than food; it's an iconic species that is a key link in the chain between environment, recreation, jobs and the economy.

For the last 15 years, federal agencies have continued to put politics before science, circumventing the Endangered Species Act and pushing Columbia-Snake River salmon to the brink of extinction and hurting salmon communities across the Pacific Coast.

The plan in question is called a Biological Opinion (BiOp) and it was originally submitted to the court by the Bush Administration. Rather than toss it out, the Obama team made some additions, known as an Adaptive Management Implementation Plan. The State of Oregon, salmon advocates and the Nez Perce tribe of Idaho are suing the agencies, saying the plan doesn't do enough to protect endangered salmon from the harmful impact of dams in the region, and that removal of the four lower Snake River dams in Eastern Washington must be on the table to recover imperiled fish.

Independent scientists agree. Last week the Western Division of the American Fisheries Society (WDAFS) released a scientific review of the Obama administration's proposed additions to the federal salmon plan for the Columbia-Snake River Basin.

The society's assessment concludes that the addendum, issued by NOAA Fisheries last September and known as the Adaptive Management Implementation Plan (AMIP), is not aggressive, rigorous, or specific enough to help bolster imperiled runs of wild salmon and steelhead.

“With this review, the independent scientists of the American Fisheries Society have shed some much-needed light on a topic that has already generated quite a bit of heat,” said Jim Martin, former chief of fisheries for the Oregon Department of Fish and Wildlife. “These experts looked at the AMIP and asked two all-important questions: does it do enough to help struggling salmon, and does it utilize the best science? Unfortunately, the answer to both questions appears to be no.”

The American Fisheries Society is the world's largest and oldest organization of fisheries professionals; its 3,500-member Western Division covers the 13 Western states and British Columbia, including the entire Columbia Basin.

From the Public News Service:

Leanne Roulson, WDAFS president, says if fish numbers continue to decline, her group has determined the plan isn't aggressive enough to save them.

“We're all about preserving and conserving the fisheries resource, while the political aspects of it are not really relevant to the stances we take or the opinions we put out there.”

Ed Bowles, chief of fisheries for the Oregon Department of Fish and Wildlife, agrees:

“The State of Oregon's concern is that, just including the Adaptive Management Implementation Plan into the BiOp does not even come close to fixing the fatal flaws of the BiOp.”

Bowles says recent predictions of the biggest salmon runs in years are mostly hatchery fish, and the wild fish remain on the endangered list.

The Obama administration announced last week that it will, in fact, revise its plan for recovering Columbia River salmon, accepting U.S. District Judge James A. Redden's offer of a voluntary three-month remand, in which he specified that NOAA is obligated by the Endangered Species act to use the best available science.

From Judge Redden's letter:

I will not sign an order of voluntary remand that effectively relieves federal defendants of their obligation to use the best available science and consider all important aspects of the problem. This court will not dictate the scope or substance of federal defendants' remand, but federal defendants must comply with the [Endangered Species Act] in preparing any amended/supplemental biological opinion.

A coalition of conservation and fishing groups agrees. “The first order of business with the Endangered Species Act is to use the best science,” said Nicole Cordan, policy and legal director for the Save Our Wild Salmon Coalition.

Between WDAFS's review and last week's court decision, the Obama Administration now has one last chance to hit the reset button on salmon; we hope they'll take this opportunity to truly fix their plan, and do so in a transparent, open way, using sound science that incorporates the work of WDAFS and other federal salmon biologists such as the experts at the U.S. Fish and Wildlife Service.

With true recovery of wild salmon and steelhead in question, fishing and river communities have been left to bear the brunt with unprecedented closures and restrictions from Southeast Alaska to Monterey Bay, California.

“We've said it before and we'll say it again: following the science is the only path to a successful, legal salmon plan, and it's also the best way to restore our struggling fishing communities,” said Liz Hamilton, executive director of the Northwest Sportfishing Industry Association.

A thoughtful, science-based plan will allow for the rebuilding of recreational and commercial fishing jobs, while also protecting other stakeholders throughout the Basin. It's science, but it's not rocket science; we can do this, provided we put salmon biology in the driver's seat where it belongs.

With yet another for the Obama administration to revamp its plan, the question is: will the revised version be enough to save these fish from extinction?

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Everyone gets sick once in a while. It's waited. That's why they have sick time at job. Therefore there are doctors and insurance organizations. However there are a lot of general things to make sure you be in general perfect health. You should wash your hands. In general, not enough people do this. When taking the restroom. Studies have been done and a shockingly low %% of men and women wash their hands after taking the restroom or before meals.

I always say: Drink liquid. Water treat all ills. Deprivation of water is the guilty of many general ill health such as acne challenges and plus bloating. Eight cups of liquid is the minimum so make sure you're getting at least that much. Keep in mind that fruits and vegetable juices count towards your daily dose of hydrating beverages. Sport. Sport doesn't have to mean hours on the treadmill sweating away to emaciation. Sport can be as simple as walking across the parking lot to the grocery store or doing housework. That's true! Airless get off calories! The more active in general you are the more exercise you're doing. Think getting a passometer. Pedometer's have shown that people who wear pedometer's are more active than those who do not.

When people look for ways to loose weight, most want the secret to shedding pounds fast. Losing too much weight too quickly is very unhealthy, but seeking to lose 10 pounds in just a few days will not hurt. Follow the techniques below to drop those first few pounds and set up methods for long term weight loss as well!

Keep a log of everything you eat or drink each day for one week. Include the portion size. At the end of the week, reflect on your recordings. Writing down what you are consuming will make you realize all the unhealthy foods you take in daily.

Cut your intake of fats in half. Start using half the amount of mayo on your sandwich, half the amount of butter on your toast, and half of the vegetable oil each time you cook. This tiny reductions will add up in the long run!

Significantly limit the amount of sugar you eat and drink. Cut back by allowing yourself one dessert and one sugary beverage daily, and continue to reduce until you are only eating them once a week.

Choose sources of protein that are low in fat, such as chicken, fish, and beans. Reduce your egg, nuts, and red meat consumption to every other day at the most.

Plan meatless meals one to two days each week. Prepare things such as whole grains, green vegetables, and beans to boost your fiber intake while reducing fat.

Start consuming dairy products with a lower fat content. Whole milk is the worst for you, while skim milk is the best. Many people cannot handle the taste of skim milk, so 2% is a good settling point for milk and cheese.

Increase your daily servings of fresh fruits and vegetables. Start with a goal of 2 fruits and 3 vegetables, and include each goal by 1 once you have gotten into the habit of eating such foods.

Increase your daily water intake, if you are not already getting 6-8 glasses each day. Drinking water rather than sodas promotes weight loss and a healthy urinary tract.
Plan your meals in advance. Create a weekly meal plan that includes three main courses and a couple of snacks. Never go to the supermarket without a list, and stick to the list!

Eat slowly. It takes 15 to 20 minutes for your stomach to realize you are eating, so chowing down can lead to overeating quickly. Allow 30 seconds for each bite, and take your time!

As you can see, there are many small ways you can cut back on an unhealthy eating lifestyle, and promote fast weight loss. Incorporate these tips to boost your weight loss plan, or to simply lose a few unwanted pounds.

What a crazy, hectic 48 hours it’s been. I almost feel exhausted by all of the Apple iPad news, analysis, polls and commentary that have flooded my system. If I had to peg the overall sentiment about Apple’s new product, I’d guess it to be two to one with the majority of folks disappointed. I can understand that due to the belief that Apple would exceed expectations. Honestly, I think they mostly met expectations — my basic predictions mainly came true. I never expected Apple to reinvent the Tablet PC and handwriting recognition on a slate, so perhaps that’s why I didn’t feel let down. Clearly, however, folks wanted more.

But if you step back from those “wants” and simply look at the device and the use case scenario, one could argue that Apple just introduced one of the first commercially available smartbooks to the masses. Did Cupertino just pull a fast one and corner the smartbook market before anyone else could get that market off the ground?

Let’s look at the loose definition of a smartbook for a second. Granted, this isn’t defined in stone, but I think most folks will agree with these characteristics. And for clarification, I’m taking much of list directly from Qualcomm’s Smartbook site, since they coined the term.

• Instant-on access – smartbooks should wake up instantly and be ready to go.
• 3G connectivity — mobile broadband allows for smartbook usage in places outside of the home and Wi-Fi hotspots.
• Ultra-portable design — Qualcomm defines this as less than 20mm thick and under two pounds in weight.
• All-day battery life — 8 to 10 hours on a charge with standby times of at least a week.
• Built-in GPS — location is important and desirable for LBS.
• Customizable interface — “intuitive, one-touch navigation to your favorite applications,” says Qualcomm.

So that’s how Qualcomm defines a smartbook. Of course, they make ARM processors which power smartphones today and smartbooks are essentially mobile devices that use the guts of a smartphone but on a bigger display. Having said all that, which attributes would you say don’t apply to the Apple iPad? I don’t see a single one — all of these smartbook characteristics are attributable by Apple’s newest mobile device.

My personal take on the device — after digesting the information over the past two days — is that the iPad is evolutionary and not revolutionary. Apple essentially evolved their iPhone ecosystem beyond handsets and into smartbooks. I’d even go out on a limb and say that every company with thoughts of entering the smartbook market is already fighting an uphill battle for three reasons.

• Most consumers don’t yet know what a smartbook is. And yet Apple is ready to provide them one without even using the new device class name. In one fell swoop, they “reinvented” a market that was waiting to get started. One could even argue that the term “smartbook” won’t even take off if the iPad becomes a runaway success.
• All of the smartbooks I’ve seen use very similar guts to power the device, but they all use different operating systems. And by different, I mean “unfamiliar” to your average mainstream audience. The iPad uses the easy recognizable iPhone operating system which tens of millions of consumers already recognize and use. Back in June, I said this of operating systems on smartbooks: “Linux is definitely capable for this type of device, but for your average consumer to use it on a device, it needs to be slick, intuitive and have a familiar feel to it.” Aside from the Linux reference, my statement applies fairly well to the iPhone OS, no?
• Any smartbooks to hit the market now will be compared to the iPad. And if they don’t offer seamless media sync, intuitive interfaces that people understand and a wide array of software applications out of the box, they won’t compete well.

Summing up all three of those reasons indicates the challenges that smartbooks were — and still are — expected to face. Yet Apple has just leap-frogged right over those challenges and turned them into the strengths of their latest creation. For the first time that I can remember, Apple hasn’t waited for others to create a market with marginal products and then jump in with latest iWhatever that improves upon the failures of others. Instead, Cupertino leveraged a familiar mobile operating system, created their own silicon to power it and took it upon themselves to lead a market — all while others have futzed about for over a year trying to determine if such a market would even take shape. And here’s the ultimate irony — 12 months ago when I saw an early smartbook prototype, it was actually a tablet form factor; a convertible tablet, yes, but still a tablet.

I’ve said in the past that I’m actually an ideal candidate for a smartbook because I mainly need a decent web browser to use to consume information. All the apps that I’m already using on my iPhone are just the icing on the smartbook cake. When I look at the iPad in that light, it actually becomes appealing to me. But if you’re one of those that has already condemned the iPad, that’s OK. However, I think you’ll have to condemn the entire smartbook market by proxy too at this point.

Posted by Neil Miller (neil@filmschoolrejects.com) on January 30, 2010

The moment after The Kids Are All Right bursts open with a feverish soundtrack, it is easy to see that this movie has great energy. And energy alone can make a movie survivable. It’s a good sign to have it all up front. But the sign of a movie that is truly worth your time is one that can maintain that energy, convince you that its characters are worth caring about and perhaps move you in some way emotionally. This isn’t anything new — in fact, it’s been the focus of many of my reviews from this year’s Sundance Film Festival. There have been more than a few films that have been on one side of the energy spectrum or the other. Lisa Cholodenko’s modern alt-family comedy has this energy from the start, and it carries it throughout.

The film follows a Nic and Jules (Annette Benning and Julianne Moore), a middle-aged couple trying to raise their two teenage children Joni and Laser (Mia Wasikowska and Josh Hutcherson) in suburban Los Angeles. And everything seems to be going just fine until the moment Joni turns 18 and is convinced by her brother to reach out to their biological father. Hesitating at first, Joni eventually puts in a call to the sperm bank, who puts her in touch with Paul (Mark Ruffalo), a restaurant owner and all around “cool dude” who seems willing to meet the kids he never knew he had.

As Paul comes into their lives, the entire family is thrown into disarray. The kids take to Paul in different ways, as to Nic and Jules, all creating a very sticky situation that threatens the otherwise normal existence of their family.

If there’s one thing to be gleaned from this film right off the bat, it is the quality of chemistry between Annette Benning and Julianne Moore. They are a very believable, charming couple of middle age lesbians who have clearly had a good, long relationship and are focused on raising their kids. This situation also benefits from having two great actresses in these roles. Both Benning and Moore are dynamic actresses, and this feels like a perfect showcase for their talent.

Also on the plus side are the performances from the kids, who are in fact all right (excuse my pun, it was there). Mia Wasikowska is not only delightful, but full of depth. As her character connects and disconnects with Paul, she carries the weight of a teen coming of age, trying to find her exact place (socially, sexually and within her own family) before departing for college. Josh Hutcherson is also quite good, continuing his development as an actor. Though, this is yet another angsty role for him, something that has become a trend (though for now, it works). The final piece to the puzzle is Ruffalo, who is as good as ever.

The Kids Are All Right is a sweet film that plays relatively fast and loose with sexuality, but never loses focus on it’s core story. It is a richly drawn portrait of a very modern family that is grounded, imperfect and told with a very keen eye from Cholodenko, who was last at Sundance in 2003 with Laurel Canyon. Her ability to keep the story moving as she unwraps the vulnerable nature of each character, all while delivering a lot of great little comedic moments (especially driven by great back and forth between Ruffalo and Benning) makes the film a very easy, enjoyable experience.

The only problem to be found is that the film stumbles around a bit as it comes to a sweet close. But its a sweet, moving close either way. Driven by a tight, well-rounded story and performances that drive comedy and tension, The Kids Are All Right is yet another smooth winner of this year’s Sundance Film Festival. It is also certainly one of those movies that should find success beyond the fest circuit, as it is as accessible as a story about two lesbians trying to raise their teenage children can be.

Read more articles by Neil Miller

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I'm in week five of the Money Diet, where I try to lose weight by counting how much I'm saving every week by not eating junk food. And it's still working. I'm really pretty shocked by my weight loss. When I started this, if anyone had asked me to be truthful, I would have admitted that I was full of bravado and would have predicted that, by now, I'd have stormed a White Castle, scarfed down 132 of their little burgers and would have been waving the white flag.

But I've managed to resist the temptation, and I've lost weight again this week. I'm losing it slowly, which is frustrating, but I know that's what you're supposed to do.

Anyway, here's how I'm doing:

My weight when I began: 264
My weight last week: 250.5
My weight this week: 248

I still have a long way to go before I'm dancing a jig — without running out of breath, anyway — but I'm definitely encouraged. And I'm sure that posting my weight on WalletPop isn't hurting. It certainly helps keep me accountable.

Dieting for all the online world to see has been a trend for awhile now, from what I can tell — people are blogging and Tweeting about their weight loss. For fun, I just typed in the word “diet” in Twitter's search engine, and then “lost” and “pounds.” Here are a few of the posts (for better or worse, mostly unedited) that popped up:

“I'm on that special K diet. And there is nothing special about it!! I need some bacon!!!!!”

“I think diet soda tricks your body and makes it think it's sugary anyway and still makes you fat. Might as well drink regular.”

“Have been on the weight watchers diet for 2 weeks and have lost 4 pounds so far, why is it so easy to put on but bloody hard to lose.”

“Guys I lost 4 pounds in 2 days!! Ow watch out.”

“Just weighed in at WW, lost another 2.”

A lot of people are posting their progress on the web in hopes of getting encouragement from the blogosphere. There's even a scale that debuted last year that, when you weigh yourself, will automatically post your weight to all your followers on Twitter. Good grief.

Anyway, here's my “saving money, losing weight” journal for the week:

• Bag of my favorite pretzels that I used to buy weekly (and sometimes twice a week) but still haven't. Actual savings: $3.29. On pretzels alone, I've saved over $15 in 2010.
• I didn't raid any of my wife's stash of Coca-Cola. In the old days, when I ran out of diet soda, I'd swipe a few cans of her regular soda. I haven't yet, so I'm sure I've saved spending money on at least one case of pop this week. Estimated savings: $8.
• I've been eating a lot of grown-up, healthy cereal like, well, Special K (unlike that Twitter user, I like it pretty well), and I haven't added any sugar to my cereal. Let's say that I had six bowls of cereal this week. My old self would have put maybe two (okay, three) teaspoons of sugar into the cereal, so let's assume each teaspoon of sugar costs 3 cents, so that's 9 cents per bowl multiplied by six bowls. So right there, I saved…54 cents.
• I skipped the fast food outlets, although I did go to a Subway, if that counts. Still, I probably saved at least $5.
• I saw a few candy bars at various convenience stores during the week but didn't buy them. Estimated savings: $3.
• I've been skipping late night snacks (mostly) and second helpings and, um, thirds at dinner. That has to count for something, so let's say, I've racked up an estimated savings of $6.

And that's the gist of how this week went. Not to say I've been ideal at weight loss. For my daughter's sixth birthday, for instance, we took her and some of her friends to Dairy Queen, where I weakened and blew $3 on a small Blizzard. Since I still managed to lose some weight this week, though, I look at that as money well spent. Or at least not wasted.

My total saved this week so far: $25.83
Total saved this year so far: $122.38

The slightly less rotund and slightly wealthier Geoff Williams is a regular contributor to WalletPop as well as co-author of the new book Living Well with Bad Credit.

Some dieters want to drop a few pounds to look better in a bathing suit. Others are trying to undo years of bad eating and exercise habits and are in need of education. Still others seek weight loss on a doctor’s orders to avoid serious illness, such as heart disease or diabetes.
 
All of these people may find things to like about “The Mayo Clinic Diet,” a new book from the respected medical institution. But those in the last two groups could find its program –- the first diet developed by Mayo Clinic — especially helpful.
 
There are no claims to magic fat-burning ingredients in this book, no nutritional supplements to buy. “The Mayo Clinic Diet” offers sound, health-focused information on how to eat better, move more and change ingrained habits that contribute to overweight and obesity.

The book leads off with "Lose It," a quick-start plan to help dieters drop 6 to 10 pounds in two weeks. In this phase they add five habits (such as eating a healthy breakfast), break five habits (eating in front of the TV) and adopt five bonus habits (keeping food and activity records). The second phase, "Live It," is a lifetime plan designed for weight loss of a pound or 2 a week until the desired weight is reached and can be maintained.
   
The book offers the usual good dieting and exercise advice, but it goes further. 

Mayo Clinic proposes its own healthy weight pyramid, making fruits and vegetables the foundation and putting exercise at the center. (Studies show that people who lose more than 30 pounds and keep it off for five years exercise an hour each day, mostly by walking, according to the book.) 

One chapter gives strategies for getting through weight-loss plateaus and relapses. Another is devoted to sticking to the diet when eating out and includes suggestions on how to eat at ethnic restaurants (avoid the fatty spareribs at Chinese restaurants; go for the hot and sour soup). A photo spread on portion control shows common foods eaten at breakfast, with pictures illustrating typical serving sizes compared with Mayo Clinic-suggested servings (8 ounces of orange juice versus 4).

There's an illustrated guide to reading nutrition labels and a checklist of warning signs for when to stop exercising (pain in an arm or the jaw, an irregular heartbeat). An endocrinology specialist, one of several Mayo Clinic professionals who contribute essays to the book, explains in easy-to-understand language some of the science behind nutrition and weight control. 

"The Mayo Clinic Diet" is written in a conversational, no-nonsense tone. It's colorful and graphically pleasing with lots of photos, sidebars and tips in bite-size chunks. Also available is "The Mayo Clinic Diet Journal," to use for tracking goals and progress.

– Anne Colby

Photo: “The Mayo Clinic Diet,” Mayo Clinic, Good Books, $25.99 hardcover. Not pictured: “The Mayo Clinic Diet Journal," Mayo Clinic, Good Books, $14.99 plastic comb binding.

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Healthy weight loss is a concern to millions of dieters in America. People want to lose weight quickly, but want to be healthy in doing so. There are five things you need to consider when building your own healthy weight loss diet plans.

Healthy Weight Loss Diet Plans Consideration #1

When building your very own healthy weight loss diet plan, you need to understand your current state of health. Before starting a diet plan, a good thing to consider doing is obtaining a biometric screening. Recently, my employer offered complimentary biometric screenings to all employees interested in learning how to live a healthier life style. A biometric screening will help you build a healthy weight loss diet plan by showing you your true weight, blood pressure, cholesterol levels, lipid and glucose levels, and BMI. You may be a healthy weight, but have high cholesterol. Once you know the results of your biometric screening, you can build a healthy weight loss diet plan that considers any specialized diet needs.

Healthy Weight Loss Diet Plans Consideration #2

The second thing you need to consider when building your own healthy weight loss diet plans is your current activity level. If you live a sedentary life style, you will not need as much energy as you would if you were an avid runner. Likewise, if you are starting a fitness regimen you will need to make sure you are eating enough food to fuel your activities.

Healthy Weight Loss Diet Plans Consideration #3

Consider what you like and dislike. I know this healthy weight loss diet plans consideration seems a bit odd, but think about it for a minute. Don't undertake a diet that is going to prohibit you from eating your favorite foods. If you love bread, don't go on the Atkins diet. Why not? Because you will occasionally slip up and eat extra carbs. Don't set yourself up for failure. Find a diet plan that helps you live a healthier lifestyle without denying yourself of occasional treats.

Healthy Weight Loss Diet Plans Considerations #4

Consider your current lifestyle when constructing your healthy weight loss diet plan. If you work 80 hours a week, do not put yourself on a diet that requires you to spend a lot of time cooking and preparing foods. If you have four kids and a husband to cook for, try to consider a healthy weight loss diet that doesn't require you to cook for yourself in addition to your family. While eating better does require some lifestyle changes, making changes that are too drastic might cause you to give up before you see great results. Pick a healthy weight loss diet plan that fits your schedule.

Healthy Weight Loss Diet Diet Plans Consideration #5

Before changing your diet or eating less, consider adding a workout regimen before making drastic diet changes. Taking 30 minutes out of your day to take a brisk walk might just be what you need to meet your fitness goals. Sometimes it seems easier to eat less than to exercise more. A great way to start a healthy weight loss diet plan is to start with exercise and then tweak your diet as you go along.

The key to healthy weight loss diet plans is starting something you can live with for the rest of your life. Fad diets and drastic changes may produce rapid results, but chances are you won't keep off the weight you lose. Make sure that you develop your healthy weight loss diet plans tailored to your personal needs and that fits your lifestyle.

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You've been planning a vacation for months and suddenly find out that you're pregnant. Or you are five months into your pregnancy and it's that time of year you usually go on a vacation. Should you go? Most doctors would say yes, but there are a few things you should consider before you decide to go.

High or low risk pregnancy

Have you had a hard time with this pregnancy or have you been breezing through it? If you've experienced problems with your pregnancy from diabetes, bleeding, hypertension, excessive swelling or have had a history of miscarriage you should consult your physician before traveling.

Timing is everything

Consider what trimester you are in before leaping on a plane, ship or long car ride. The first trimester is generally filled with nausea and fatigue while the third trimester can be uncomfortable. Traveling usually means a lot of sitting and carrying heavy items like oversized purses and suitcases. This can cause swelling of the ankles and legs and pressure on your already tired back.

The second trimester is probably the best time for travel for most women. Usually the nausea is over and you haven't grown too large to maneuver around comfortably. If you have a choice of dates for your vacation, this would be a good time to plan it.

Most doctors will agree that the time to not travel is after 36 weeks of pregnancy. At this point it is best to stay home and near your health care professional.

Type of travel

If you are planning a car trip be sure to plan ahead to make it as comfortable as possible. Bring snacks and plenty of water to stay hydrated. Stop for bathroom breaks as often as necessary and try to walk a few minutes each time to ensure healthy circulation in your legs. Most important of all, wear your seatbelt. Placing the bottom belt below your abdomen and across your hips will be more comfortable.

If you are traveling by airplane, check with the airlines first for their rules about pregnancies. While most doctors agree that air travel is safe until 36 weeks, airlines may have stricter rules. Wear comfortable clothing and shoes and try to stretch or walk around at least every hour to decrease the risk of blood clots in your legs.

Taking a cruise can be relaxing and much easier than sitting in a car or on a plane. Like air travel, the cruise line may have restrictions on late-term pregnancies so be sure to check ahead. If you are prone to getting sea-sick this may not be the time to take a cruise. Being sick for several day can wear you down and not be good for the pregnancy. Also, confirm that there is a doctor on board during the trip in case of an emergency. Otherwise, a cruise is a good way to get away and still be able to enjoy light exercise and rest.

Healthcare Facilities

If you are going to another country or a remote area it is best to check ahead on the healthcare facilities available in the areas you are going to. Find out if your health insurance will cover you in these places as well. If you are not going to be in an area with trustworthy medical care you may want to reschedule your trip after your pregnancy.

Activities

Appropriate activities while on vacation will depend upon how late into the pregnancy you are. Walking, hiking, and swimming, all at moderate paces are acceptable. Sun-bathing for long periods of time may be dangerous if you become over-heated. This applies to hot tubs and saunas too. Over-heating your central core can cause damage to the fetus, so do these activities in moderation also.

Scuba diving should be avoided because of the water pressure changes. Water-skiing is also potentially harmful because water can be forced up into the cervix. Just use common sense when it comes to activities and you can still enjoy your vacation.

Immunizations

Some overseas travel requires special immunizations that can be harmful to the fetus. Live viral vaccines such as measles, mumps or rubella (MMR) should be avoided because of their risk to the baby. Live bacterial vaccines such as tetanus-diphtheria boosters or Immune Serum Globulin (ISG) for hepatitis A prevention can be safely administered during pregnancy. Some antibiotics such as Bactrim or Cipro that are used to treat diarrhea can be dangerous. Check with your doctor on all immunizations and medications before proceeding with them.

Traveling while pregnant can be an enjoyable experience if you plan ahead and take a few precautions. Do your homework, check with your doctor and enjoy your vacation.

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In a new study that will be published in the July 17th issue of the journal Circulation, Canadian researchers reveal that the erectile dysfunction drug Viagra (Sildenafil), may likely be effective in the treatment of patients with right-sided heart failure, principally because their study shows that only the hearts of these patients exhibit the target molecules that can be blocked by these types of drugs.

The study was led by Drs. Jayan Nagendran, a cardiac surgery resident and Evangelos Michelakis, professor in the Department of Surgery and the Department of Pharmacology at the University of Alberta in Canada.

The researchers wanted to gain insight into the mechanism of how Viagra may benefit patients with pulmonary hypertension (high blood pressure in the lung vessels). This devastating condition usually leads to right-sided (right ventricle) heart failure.

In their study, the researchers evaluated heart specimens from 9 patients to assess their phosphodiesterase type-5 (PDE-5) activity and their response to specific type-5 PDE inhibitors such as Viagra.

PDE-5 is an enzyme that degrades the activity of cGMP, a chemical that relaxes smooth muscle cells. In the vasculature, relaxation of smooth muscle cells causes vessels to dilate thereby increasing blood flow.

PDE-5 is preponderant in the corpus cavernosum of the penis. When it's inhibited, it leads to higher cGMP levels and less dilation (more constriction) of the blood vessels that let blood escape from the corpus cavernosum and thereby leading to a sustained erection.

The researchers essentially found that PDE-5 was not expressed in heart samples from patients that were healthy. Conversely, they did discover that patients with enlarged right heart ventricles had marked increased PDE-5 activity.

When the research team used Viagra (the PDE-5 inhibitor) in their experiments, they found that it increased the activity of isolated cardiac cells and the strength of heart contractions only in unhealthy samples and patients and not in any of the healthy controls.

In the press release from the University of Alberta, Dr. Nagendran stated that “there are a number of medical conditions in both children and adults for which there is a need to boost the performance of the right ventricle, and this drug can be clinically and immediately relevant to help these patients”

Dr. Michelakis also added that “We have a number of drugs and therapies available to treat the left ventricle of the heart to prevent it from failing or to treat it after it has failed, bet we don't have anything for the right ventricle. The phosphodiesterase type-5 inhibtors, which include Viagra, Cialis, and Levitra, may offer some important benefits in this case.”

Viagra (Sildenafil) has been recently approved in the treatment of pulmonary hypertension.

Sources:

Medline/PubMed:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17606845&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

University of Alberta Express News: http://www.expressnews.ualberta.ca/article.cfm?id=8591

Upon further reflection on the comforting assertion that:

“23. Stayart has never engaged in a promiscuous lifestyle or other overt sexual activities.”

This makes complete sense really.

That is why there is -NO SUCH THING- as the Bev Stayart Angry Dragon, the Bev Stayart Arabian Goggles, the Bev Stayart Bait N' Tackle, the Bev Stayart Bear Claw, the Bev Stayart Beef Curtain, the Bev Stayart Blumpy, the Bev Stayart Bronco, the Bev Stayart Brown Bagging It, the Bev Stayart Brown Necktie, the Bev Stayart Brunski, the Bev Stayart Bullwinkle, the Bev Stayart Butter Face, the Bev Stayart Canine Special, the Bev Stayart Carpet Cleaner, the Bev Stayart Chili Dog, the Bev Stayart Chocolate Pizza, the Bev Stayart Cleveland Steamer, the Bev Stayart Cold Lunch, the Bev Stayart Concoction, the Bev Stayart Cop's Delight, the Bev Stayart Corkscrew, the Bev Stayart Daisy Chain, the Bev Stayart Davey Crockett, the Bev Stayart Dirty Sanchez, the Bev Stayart Dirty Swirly, the Bev Stayart Dog In A Bathtub, the Bev Stayart Donkey Punch, the Bev Stayart DVDA, the Bev Stayart Electric Chair or the Bev Stayart Fish Eye.

Nor is there any Bev Stayart Fish-Hook, the Bev Stayart Fire Island, the Bev Stayart Flaming Amazon, the Bev Stayart Flooding the Cave, the Bev Stayart Flying Camel, the Bev Stayart Flying Dutchman, the Bev Stayart Fountain Of You, the Bev Stayart Fur Ball, the Bev Stayart Gobstopper, the Bev Stayart Golden Shower, the Bev Stayart Greek, the Bev Stayart Ham And Cheese Sandwich, the Bev Stayart High Dive, the Bev Stayart Hindenburg, the Bev Stayart Hogging, the Bev Stayart Hole In One, the Bev Stayart Hotdog In A Hallway, the Bev Stayart Hot Karl, the Bev Stayart Hot Karl Candy Cane, the Bev Stayart Hot Lunch, the Bev Stayart Hummer, the Bev Stayart Indian Cock Burn, the Bev Stayart Jedi Mind Trick, the Bev Stayart Jelly Donut, the Bev Stayart Juanita Special Bean Dip, the Bev Stayart Kennebunkport Surprise, the Bev Stayart Landshark, the Bev Stayart Lorena Bobbit, the Bev Stayart Menthol, the Bev Stayart Mellon Dive, the Bev Stayart Monkey Wrench, the Bev Stayart Mork, the Bev Stayart Moses or Bev Stayart Motorboat that I know of.

And I certainly have never heard of the Bev Stayart Mushy Biscuit, the Bev Stayart New Jersey Meat-Hook, the Bev Stayart New York Style Taco, the Bev Stayart Nixon, the Bev Stayart Oyster, the Bev Stayart Pasadena Mudslide, the Bev Stayart Pattycake, the Bev Stayart Paying the Rent, the Bev Stayart Peanut Butter And Jelly Sandwich, the Bev Stayart Pearl Necklace, the Bev Stayart Pig Roast, the Bev Stayart Pink Glove, the Bev Stayart Pirate's Treasure, the Bev Stayart Plating, the Bev Stayart Popcorn Trick, the Bev Stayart Purple Mushroom, the Bev Stayart Ram, the Bev Stayart Rear Admiral, the Bev Stayart Red Wings, the Bev Stayart Resuscitation, the Bev Stayart Roddy Piper, the Bev Stayart Rodeo, the Bev Stayart Rose Creeper, the Bev Stayart Rusty Trombone, the Bev Stayart Sandbag, the Bev Stayart Seatbelt, the Bev Stayart Shirley Temple, the Bev Stayart Shocker, the Bev Stayart Shop Vac or Bev Stayart Shrimping.

But mostly it is refreshing and uplifting to know that the Bev Stayart Skiing, the Bev Stayart Slumpbuster, the Bev Stayart Snerd Nurgling, the Bev Stayart Snoodling, the Bev Stayart Snowball, the Bev Stayart Snuff, the Bev Stayart Stingy Nut, the Bev Stayart Sud N' Fud, the Bev Stayart Surfing, the Bev Stayart Swimmer's Ear, the Bev Stayart 3-Eyed Turtle, the Bev Stayart Tortoise, the Bev Stayart Tossing Salad, the Bev Stayart Tropical Wind, the Bev Stayart Tuna Melt, the Bev Stayart Twisted Sister, the Bev Stayart Vegetarian Hot Lunch, the Bev Stayart Wake Up Call, the Bev Stayart Walrus, the Bev Stayart Western Grip, the Bev Stayart Westside Glaze, the Bev Stayart Woody Woodpecker and the Bev Stayart Zombie Mask simply do not exist.

Because if overt sexual activities like these did in fact exist, I'm sure a Google, Yahoo or perhaps even a Bing search would find references to such abominations.

Whew! I'm sure glad that'll never happen. I would be very, very dissapointed in Bev.

Wouldn't you?

.

(reply to this comment) (link to this comment)

Upon further reflection on the comforting assertion that:

“23. Stayart has never engaged in a promiscuous lifestyle or other overt sexual activities.”

This makes complete sense really.

That is why there is -NO SUCH THING- as the Bev Stayart Angry Dragon, the Bev Stayart Arabian Goggles, the Bev Stayart Bait N' Tackle, the Bev Stayart Bear Claw, the Bev Stayart Beef Curtain, the Bev Stayart Blumpy, the Bev Stayart Bronco, the Bev Stayart Brown Bagging It, the Bev Stayart Brown Necktie, the Bev Stayart Brunski, the Bev Stayart Bullwinkle, the Bev Stayart Butter Face, the Bev Stayart Canine Special, the Bev Stayart Carpet Cleaner, the Bev Stayart Chili Dog, the Bev Stayart Chocolate Pizza, the Bev Stayart Cleveland Steamer, the Bev Stayart Cold Lunch, the Bev Stayart Concoction, the Bev Stayart Cop's Delight, the Bev Stayart Corkscrew, the Bev Stayart Daisy Chain, the Bev Stayart Davey Crockett, the Bev Stayart Dirty Sanchez, the Bev Stayart Dirty Swirly, the Bev Stayart Dog In A Bathtub, the Bev Stayart Donkey Punch, the Bev Stayart DVDA, the Bev Stayart Electric Chair or the Bev Stayart Fish Eye.

Nor is there any Bev Stayart Fish-Hook, the Bev Stayart Fire Island, the Bev Stayart Flaming Amazon, the Bev Stayart Flooding the Cave, the Bev Stayart Flying Camel, the Bev Stayart Flying Dutchman, the Bev Stayart Fountain Of You, the Bev Stayart Fur Ball, the Bev Stayart Gobstopper, the Bev Stayart Golden Shower, the Bev Stayart Greek, the Bev Stayart Ham And Cheese Sandwich, the Bev Stayart High Dive, the Bev Stayart Hindenburg, the Bev Stayart Hogging, the Bev Stayart Hole In One, the Bev Stayart Hotdog In A Hallway, the Bev Stayart Hot Karl, the Bev Stayart Hot Karl Candy Cane, the Bev Stayart Hot Lunch, the Bev Stayart Hummer, the Bev Stayart Indian Cock Burn, the Bev Stayart Jedi Mind Trick, the Bev Stayart Jelly Donut, the Bev Stayart Juanita Special Bean Dip, the Bev Stayart Kennebunkport Surprise, the Bev Stayart Landshark, the Bev Stayart Lorena Bobbit, the Bev Stayart Menthol, the Bev Stayart Mellon Dive, the Bev Stayart Monkey Wrench, the Bev Stayart Mork, the Bev Stayart Moses or Bev Stayart Motorboat that I know of.

And I certainly have never heard of the Bev Stayart Mushy Biscuit, the Bev Stayart New Jersey Meat-Hook, the Bev Stayart New York Style Taco, the Bev Stayart Nixon, the Bev Stayart Oyster, the Bev Stayart Pasadena Mudslide, the Bev Stayart Pattycake, the Bev Stayart Paying the Rent, the Bev Stayart Peanut Butter And Jelly Sandwich, the Bev Stayart Pearl Necklace, the Bev Stayart Pig Roast, the Bev Stayart Pink Glove, the Bev Stayart Pirate's Treasure, the Bev Stayart Plating, the Bev Stayart Popcorn Trick, the Bev Stayart Purple Mushroom, the Bev Stayart Ram, the Bev Stayart Rear Admiral, the Bev Stayart Red Wings, the Bev Stayart Resuscitation, the Bev Stayart Roddy Piper, the Bev Stayart Rodeo, the Bev Stayart Rose Creeper, the Bev Stayart Rusty Trombone, the Bev Stayart Sandbag, the Bev Stayart Seatbelt, the Bev Stayart Shirley Temple, the Bev Stayart Shocker, the Bev Stayart Shop Vac or Bev Stayart Shrimping.

But mostly it is refreshing and uplifting to know that the Bev Stayart Skiing, the Bev Stayart Slumpbuster, the Bev Stayart Snerd Nurgling, the Bev Stayart Snoodling, the Bev Stayart Snowball, the Bev Stayart Snuff, the Bev Stayart Stingy Nut, the Bev Stayart Sud N' Fud, the Bev Stayart Surfing, the Bev Stayart Swimmer's Ear, the Bev Stayart 3-Eyed Turtle, the Bev Stayart Tortoise, the Bev Stayart Tossing Salad, the Bev Stayart Tropical Wind, the Bev Stayart Tuna Melt, the Bev Stayart Twisted Sister, the Bev Stayart Vegetarian Hot Lunch, the Bev Stayart Wake Up Call, the Bev Stayart Walrus, the Bev Stayart Western Grip, the Bev Stayart Westside Glaze, the Bev Stayart Woody Woodpecker and the Bev Stayart Zombie Mask simply do not exist.

Because if overt sexual activities like these did in fact exist, I'm sure a Google, Yahoo or perhaps even a Bing search would find references to such abominations.

Whew! I'm sure glad that'll never happen. I would be very, very dissapointed in Bev.

Wouldn't you?

.

(reply to this comment) (link to this comment)

The need for medicine in every culture around the world has arisen whenever a people recognized imbalanced lifestyles. Sophisticated methods of dealing with ailments came to prominence with time and experience. The Chinese began dealing with medical concepts during the Shang dynasty (1751-1128 B.C.) and refined them during the Zhou dynasty (roughly 1128-221 B.C.). The Shang believed that their ancestors were “directly associated with God, and therefore could be used as mediators to ask for favors from God.” Unlike the Shang, the Zhou believed in human virtue, or de, moral deeds, and “personal effort.” They were also the first dynasty to establish the idea that tian, or “sky/heaven,” represented “the ultimate spiritual reality.” The Zhou not only made the state religion more sophisticated and practical, but they also refined—and drastically improved—the practice of medicine. The Shang are famous for their divinations via oracle bones (tortoise shells and animal bones), but the Zhou created a meritocracy that was rooted in virtue and the overarching principle of tian.Perhaps the greatest achievement of the Zhou dynasty lay in their early conception of homeostasis: “even a slight impairment in blood flow restricts the distribution of nutrients, defensive substances, vitality substances, and vital air.” During the Zhou dynasty, the Chinese people experienced the greatest sense of achievement through progress in medicine.

This essay will endeavor to explicate the need for medicine in both ancient China and Greece, particularly dealing with wound trauma (a redundant phrase, as we shall see shortly) and the methods of healing. China developed a symbiotic, flowing, and specifically internal way of dealing with wounds and diseases whereas the Greeks developed an external and static medicinal curriculum. The Chinese and Greeks did not always, however, develop these methodologies as contemporaries, but in comparing them we will discover that though they did not know of each other's existence, they shared more than may meet the eye. Greece and China were medical contemporaries during the 6th and 5th centuries B.C. since China's scientific and medical knowledge reached its height from 600-300 B.C. Interestingly enough, Greece's maps did not yet have China on them; not even Alexander would reach China, though he would get to India.

So what is meant when it is said that Chinese medicine was symbiotic, constantly in flux, and internal? The Chinese primarily developed methods of approaching wounds and disease from an internal point of view, as with ch'i and acupuncture. Needles were placed at specific meridians which corresponded with different organs of the body so that they could be healed. The main principles were in fact xie (”to drain off”) and bu (”to mend”). Indeed, “the complexities of determining the cause of the problem: which internal organ is affected; the possible impairment of blood, nutrients, immune substances, vital air, or biologically active substances, or whether the problem is due to impaired functional activity.” Perhaps this symbiotic—connected—, internal approach existed because of the Zhou's belief in moral goodness and virtue—themselves innate qualities. In fact one of the principal works of Chinese medicine was entitled Yellow Emperor's Internal Classic, which was compiled “sometime between 600-300 B.C.” This work was thought to be written in some sort of verse, which tells us that it was passed down orally, much like Homer's Iliad. On the other side of the world, the Greeks were developing a “hands on,” intimate approach to medicine.

When it was said that the Greeks focused on external remedies, that was meant to invoke the actual ancient Greek word cheirurgein, or “to work with one's hands.” This is understandable considering the world the Greeks inhabited; their country was consistently divided and at war with themselves as much as they were at war with the Persians. Their realities were deep arrow-wounds, spear-thrusts to the gut, severe hemorrhages from the thigh, and boxer blows to the head. Indeed, this was a war-like culture, albeit one obsessed with arête, time, and philosophia (”excellence, honor, and love of wisdom”). But the Greek conception of moral goodness was connected to one's polis, the city-state and precursor of the modern city. It was called a city-state for a reason, for one's polis was self-contained and was indeed its own entity. Unlike the Chinese, who were at least united by an emperor, the Greeks had no hegemon—at least until Philip II and his son Alexander came along in the 4th century. So this essay will work to compare the different healing methods of the Chinese and the Greeks. Specifically, we will be looking at a case-study of the famous arrow wound which Alexander received in 325 B.C. in India—both from the Greek approach and the Chinese approach. One commonality that the different healers will share is their Indian influence, since both the Greeks and the Chinese came into contact with Indians, but not each other! We shall observe how a Chinese yang I and a Greek iatros (both healers or anachronistically called “physicians”) approach the wound, and how they intend to heal it. Ultimately, we should come away with an understanding of these two culture's need for medicine (or healing), method of approaching wounds, and a better appreciation of our modern medicine. First a short introduction of the yang I and iatros is in order, then we shall set the scene of the injury, then we will begin our study with the Chinese.

It is first essential to understand that the Chinese and Greeks both regarded healing very highly. Both the Chinese and the Greeks had an understanding of how the natural world and its elements affected individual's homeostasis and constitution. The Chinese developed the Wu-Sheng, or the “Five Phases,” as a perpetually changing and moving concept of how the five elements affected the human body. There was metal, water, wood, fire, and earth, and there existed both a “mutual generation” and “mutual conquest” effect between them. The large intestine, skin and hair, nose, smell, and mucus (one of the Greek's Four Humors) all belonged to the element of metal whereas the small intestine, vessels, tongue, speech, ear, and sweat corresponded with the element of fire. Furthermore, two of the five principal viscera—the heart and the lungs—belonged to the elements of fire and metal respectively. Between these two viscera and various bodily functions and appendages, there existed an “insulting (conquest) mode” and a “victory (generation) mode” through which one element affected the other, the lungs insulted—or counteracted—the heart and the heart acted upon the lungs, and the large intestine counteracted the small intestine. The Greek's four humors did not come close to this sort of layered, constantly changing concept. For the Greeks, the four humors' “success suggests that it was perfectly suited to the needs of mankind. Its fourfold symmetry had the appeal of an order that could also embrace the whole of nature: the four seasons, four tastes, four temperaments.” The four humors were blood, yellow bile, black bile, and phlegm, and “any pain or lump could be explained as a 'distemper' or disharmony of the blend.” Here we have more similarities between the Chinese and the Greeks. We see that the Greeks' love of static order—embodied in their Doric, Ionic, and Corinthian architectural columns—and their belief that any disruption of these four humors was a disharmony is in line with the Chinese wu-sheng. One organ could act upon or counteract another just as one humor out of whack could mean that another humor was “low,” for example. The Greek treatment of this disharmony was as follows: Bleed, to get rid of bad humors, starve, to prevent new ones from forming, purge, to get rid of the rest, 'from above and from below,' or from any other exit. The Greek iatros and the Chinese yang I both had to be very familiar with these concepts in order to address the wound or disease of a patient. So who were the Greek iatroi?

The Greek iatroi were healers who managed healing houses called iatreion. They were well-versed in the concept of the four humors and had a versatile knowledge of wine's antiseptic properties, healing herbs and vegetables such as the onion and celery root, and knew a wound when they saw one. They were men who also knew how to bind wounds in such a way that anticipated modern styptics. For a severe hemorrhage, the iatros would raise a wounded appendage, wrap the wound with a cold linen cloth very loosely, then wrap a warm cloth around the patient's head to draw the blood to the heated area, then apply a plug of wool dipped in fig sap over which a clean white linen drenched in red wine would be applied “with an adroit play of both hands.” The fig juice was believed—erroneously—to coagulate blood, and the red wine—in great, great quantities—served as an antiseptic for the gaping wound. This was the iatroi way! An iatros had to be very hands-on, dexterous, and efficient to deal with a rapidly hemorrhaging wound. What of the Chinese yang i? This word yi actually means medicine, not physician, and this character is an amalgam of very intriguing symbols.

“The complete character conveys that the priest uses strong weapons to fight off the demons of disease,” write Guido Majno M.D., who wrote a comprehensive study of ancient medicinal practices. Another pause for a comparison between these two cultures is noteworthy. Within this character is a quiver full of arrows. Arrows—in both cultures—were seen as weapons of both destruction and healing. Apollo was both god of the plague and the god of healing, and his arrows could either “drive this killing plague from the armies” or sweep “a fatal plague through the army.” We have already seen that arrows in Chinese culture were the weapons of medicine. It is time to observe the patient in waiting; his name is Alexandros and he is the monarch of the Macedonians, the Greeks, the Egyptians, the Bactrians, the Babylonians, and many, many other cultures across most of the entire known world at the time of the middle 4th century B.C. He has just been forced to abandon his campaign further east—which might have brought him into contact with the Chinese—and he is sailing down the Indus River to subdue a rowdy tribe called the Mallians. The story is told by Quintus Curtius Rufus, a 2nd century A.D. Roman history whose account of the tale is the most detailed of all of Alexander's historians. First our Greek iatros will observe the patient and using a combination of the new Indian medicinal practices Alexander's armies have picked up and the homespun remedies of Greece, our healer will attempt to remove a barbed arrow from Alexander's pierced lung and stop a severe hemorrhage. Our Chinese healer will then attempt to do the same. Let us pay close attention to the differences in the healer's approaches, as the Chinese will have less experience in dealing with such grievous wounds, but will have more experience in returning Alexander's body to its balanced and functional state after the arrow is removed and while he is in recovery. Here we will see the external-internal approaches and how they differ and also how they complement one another.

The story told by Quintus Curtius Rufus, who was a Roman historian of Alexander the Great, explains that the young king isolated himself from his men atop a parapet during a siege. Alexander had been forced—due to a mutiny on the Hyphasis River—to sail down the Indus River and into the Indian Ocean to return to Greece. He certainly was not pleased with this, as he wanted to push further east into the unknown lands of myth. Alexander had already suffered numerous injuries to all parts of his body; he had murdered his best friend and commander of his cavalry a few years prior; he had asked obeisance as a god-man figure from his army, and he had just been forced to return home.

Along the Indus River many tribes existed whose medicinal knowledge was great—especially when it came to arrow wounds since the tribes always fought one another. These Indian medics were called vaidya, and their lands were being invaded by an impetuous and foreign monarch. Alexander's baggage train was great, however, and so cultural stimulation between Greeks and Indians was profound. By the this time, too, the Indians had already come into contact with the Chinese, whose Zhou dynasty was currently fighting amongst themselves. In fact, they had been fighting since 476 B.C. and would continue until 221 B.C. when a leader would unite all of China. What if Alexander had reached Chinese soil—would he have incorporated this sophisticated and experienced culture into his empire?

Alexander stopped along the coast of the Indus to subdue a tribe called the Mallians, whose Indian archers inflicted him with a most grievous wound which almost killed him. Guido Majno M.D. says that there was a special Indian style for “firing arrows with great force, noticed by the ancient Greeks and still in use in 1860…Perhaps it was a shot of this kind that pierced the breastplate of Alexander the Great, bowled him over, and almost killed him.” The arrow fired, and Arrian, another of Alexander's historians says that bubbles of air arose from the blood which spurted after the arrow sank in—proof that a lung had been punctured. To prevent Alexander's body from going into anemic shock, two of his closest companions fought to recover and treat his body. This is the scene for our Chinese and Greek physician to enter. It is a mythological space, if you will, but in order to illustrate the similarities and differences between Greek and Chinese medicinal practices, it is valuable to provide such a unique case-study. As we have said, the Greeks developed a very external-internal, confrontational methodology of treating wounds.

The iatros would first call an assistant or two and perhaps even demand a local healer who defected to the Greeks to help identify the foreign arrow. The assistants would ask the Indian vaidya if he thought the king was mortally injured, since the vaidya and the Chinese physicians shared a common belief that there are special meridians which are vulnerable to exogenous pathogenic influences; in the example of Indian medicine, the vaidya would examine Alexander to see if the arrow hit a fatal marma. The iatros would then wrap a cold towel around Alexander's upper torso to help staunch the hemorrhage and a warm towel around his head to draw the blood away from the wound. If the arrow had been continuing its path through the body, then the iatros and vaidya present would have deemed the injury an anuloma wound. If the arrow needed to be pulled out, it would be a pratiloma wound. The vaidya and iatros could not retrieve the arrow from Alexander's body, so the vaidya, who were more experienced with these type of injuries than the Greeks were, tied a branch to the shaft of the arrow and let it fly, thus ripping the arrow out pratiloma style. This is the Greek way—confrontational, external, bandages, perhaps even a little impetuous. To insure proper healing, Alexander's gaping wound would have had a generous “scoop of honey-butter paste” bandaged on by a vaidya or a large, clean white linen cloth dipped in red wine wrapped around his upper torso by the iatros. How, then, would a Chinese physician approach this same situation? There is, in fact, an interesting folktale from the Zhou dynasty that will elucidate.

“The Chinese approach to pain is epitomized in the traditional story of the surgeon Hua T'o operating on General Kuan Yu, whose arm had been pierced by a poisoned arrow. While the knife went hsi, hsi, scraping the bone, the general played chess—and drank cups of wine.” Indeed, this story illustrate that the Chinese did not approach wounds in the same fashion as the Greeks or even their vaidya neighbors did. The general is imbibing wine, but not using it as an antiseptic like the Greeks did. There are no cloth bandages, no butter substances, no cheirurgein (”hand-work” in ancient Greek)—just an attitude to grin and bear the wound sustained. Why is that? Because the Chinese approached the human body from the inside first, preferring methods such as acupuncture, moxa, or prescription diets instead of hand-wrapped bandages. The following comes from the Nei Ching (”inside manual”), and describes the job of the physician in China: “The superior physician helps before the early budding of the disease. He must first examine the three regions of the body and define the atmosphere of the nine subdivisions so that they are entirely in harmony…therefore he is called the superior physician.” It goes on to say that the inferior physician only begins to help once the disease has set in, and because of this, he is labeled ignorant. Already we can clearly see how far set apart these cultures are in the way they approach wounds. The Chinese physician would not know, it appears, how to deal with such a grievous arrow-wound. His services would instead need to come after the injury so that he could advise Alexander on how to rest: “The Emperor asked: 'When the body is worn out and the blood is exhausted, is it still possible to achieve good results?' Chi' Po replied: 'No, because there is no more energy left…that is the way of acupuncture: if man's vitality and energy do not propel his own will, his disease cannot be cured.'” So the patient's getting better actually depends on his will to survive and also the way he manages his energy. It is ignorant to say that Alexander died two years later (he received the arrow injury in 325 B.C. and died in 323 B.C.) because he lacked such knowledge or physicians, but it is worthwhile to pose the question: Could Alexander have lived on if he had not been so reckless, if he had not utterly spent all of his energy, if he had known also how to manipulate the internal factors of the human body? Well, that is why we can say these two cultures are different. But perhaps the Indian vaidya's methodswere a meeting of the ways for these two medicinally opposite cultures?

To come full circle, the conclusion to this short comparative essay is this: that the Greeks and Chinese were, as reflected in their divine geographical placement and socio-political circumstances, very different in the way they approached the human body. This study should be pursued more actively in academia since it may be possible to find commonalities in the meeting ground that is India—China's neighbor and Greece's land of myth. Following studies should aim to produce evidence that these two cultures actually shared more in common (medicinally) than was shown in this short essay. But comparative studies are valuable because they impel the reader to think critically and actively search for a common, humanistic meaning.

Sources Used:

Donald Edward Kendall. The Dao of Chinese Medicine. Oxford University Press, August 2002.
Guido Majno, M.D. The Healing Hand: Man and Wound in the Ancient World. Harvard University Press, 1991.
Homer. The Iliad, translated by Robert Fagles. Penguin Books, 1998.

Kendall, 18.

Mongolian culture in the 12th and 13th centuries also believed in a great sky, and believed that Burkhan Khaldun, their sacred mountain was the conduit to this astounding power—and a meditative sanctuary.

Kendall, 19.

Kendall, 25.

Kendall, 25. From now on, this work will be referred to as the Neijing.

Majno, 150.

Majno, 232.

Majno, 178.

Majno, 179.

Majno, 179-180.

Majno, 150.

Iliad Book 1 Lines 543-544 and Lines 10-11 of Robert Fagles' translation.

Majno, 268. The archer would fire an arrow with his left foot applying pressure to the bow shaft while his right arm would pull the bowstring itself taught; all this was down sitting “Indian Style.”

Majno, 271. Marma's are similar to the Chinese conception of the meridian lines; they are various points located throughout the body which are vulnerable to injury and/or healing.

Majno, 251.

Majno, 242.

Majno, 243.

 

Other information you can find at Online Pharmacy in Ontario.
Aspirin might prevent your risk for colorectal cancer according to a study that appears in the August 2007 Journal of General Internal Medicine. The study, lead by Elizabeth Lamount, MD, MS, of the Massachusetts General Hospital Cancer Center, provides evidence that non-steroidal anti-inflammatory drugs (NSAIDs) lower the risk for developing colorectal cancer.

Although earlier studies provided some evidence that NSAIDs reduced the development of colorectal cancer tumors, scientists could not know for certain if other preventative measures were clouding the results.

“This is good news for people who take NSAIDs regularly for osteoarthritis,” said Lamount in a press release published by Massachusetts General Hospital. “Although patients face risks such as bleeding or kidney damage from this therapy, they probably are at a lower risk of developing colorectal cancer.”

However, because of these risks, Lamount cautions against using current NSAIDs solely to prevent cancer. The study focused on Medicare patients with osteoarthritis taking NSAIDs, who had already assumed the risk of taking high dosages of the drugs.

“The magnitude of colorectal cancer risk reduction between patients with and without osteoarthritis is completely consistent with the risk reduction for pre-cancerous polyps reported in clinical trials of NSAIDs,” Lamont said in a press release published by Massachusetts General Hospital. “Confirming this association supports the need for further research to identify NSAID agents safe enough to be used for regular, preventive therapy by the general population.”

The NSAID treatment appeared to reduce the patient's chances for developing precancerous colorectal polyps. It is unknown whether or not the same therapy could also reduce the risk of invasive colorectal cancer.

The researchers compared medical information on 4,600 people with colorectal cancer to information from 100,000 controls. A history of osteoarthritis was linked with a 15 percent reduction that the patient would be diagnosed with colorectal cancer. It was determined that patients with osteoarthritis were four times more likely to use NSAIDs.

A similar correlation was also found when patients who had undergone total knee replacement were examined. A total knee replacement would require the regular use of NSAIDs.

Other trials that used low doses of aspirin showed no difference in colorectal cancer rates between the placebo and aspirin groups. Observational studies have also suggested a protective effect of NSAIDs against colorectal cancer, but these results were called into question because of the possible affects of other healthy behaviors of the study's participants.

SOURCES:

“Study confirms that NSAIDs treatment can reduce colorectal cancer risk: Safer drugs needed before regular preventive therapy can be recommended” Massachusetts General Hospital. URL: (http://www.massgeneral.org/news/releases/072307lamont.html)

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• Physicists Investigate Possibility of an 'Unhiggs'

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  (PhysOrg.com) — One of the biggest goals of the LHC is to discover the Higgs boson, the only particle in the Standard Model that has not yet been observed. In general, physicists are pretty confident that …

Scientists in Texas are reporting development of a first-of-its-kind cloth that releases nitric oxide gas – an advance toward making therapeutic socks for people with diabetes and a wrap to help preserve organs harvested for transplantation. The study is in ACS' Chemistry of Materials, a bi-weekly journal.

Kenneth Balkus and Harvey Liu note in the new study that nitric oxide (NO) helps increase blood flow and regulates a range of other body functions. Scientists have tried for years to find practical ways to store and deliver NO for use in medicine. However, they have had difficulty finding a suitable material that allows controlled delivery of NO. Recent studies suggested that zeolites could work. These porous materials soak up and store large amounts of gases like NO.

The scientists describe development of a new bandage composed of nitric oxide-absorbing zeolites embedded in a special water-repellant polymer. In experiments with laboratory rats, the bandage slowly released nitric oxide and increased blood flow. “The bandage could be used to wrap a donor organ ensuring intimate contact and direct delivery of nitric oxide,” the report states. “Additionally, these interwoven fabrics could also find applications in smart textiles such as NO-releasing socks for diabetic patients, who have been shown to produce less nitric oxide than healthy patients.”

Article: “Novel Delivery System for the Bioregulatory Agent Nitric Oxide” http://pubs.acs.org/stoken/presspac/presspac/full/10.1021/cm901358z

Source: Michael Bernstein

American Chemical Society

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Walgreens Wal-itin 24 Hour Allergy Relief is a non-drowsy, over-the-counter formula of original prescription strength allergy relief–meaning what you can now buy in stores is just as strong as what used to be available to allergy sufferers by prescription only. Distributed by Walgreens, each Wal-itin tablet has 10mg of Loratadine USP, the same active ingredient in Claritin.

To treat my chronic allergies, I have been taking Wal-itin for the last 30 days now. Before I started using this over-the-counter allergy medicine, I had been taking two prescribed alternatives: Fexofenadine (a generic form of Allegra) and Singulair. Because of the change in my insurance, those prescriptions were no longer an option and I needed to find something else.

I turned to Wal-itin knowing it as Walgreens' version of Claritin, a brand once recommended to me by my doctor for some throat problems. Having taken the Walgreens' allergy relief for 30 days now, I can say that I really like Wal-itin. It doesn't compare to taking both Fexofenadine and Singulair, since taking those medicines in conjunction with one another is effectively taking a double dosage of allergy medicine. But, taking a single dose of Wal-itin, for me, feels just as effective as taking Allegra by itself and even more effective than taking Singulair by itself.

Priced at $27.99 for 90 tablets, with smaller and larger bottles available, Wal-itin is extremely reasonably priced and a great option for allergy sufferers. I'll include below the important product information that is listed on the Wal-itin packaging.

Wal-itin Allergy Relief–Drug Facts

Adults and children 6 years of age and over–1 tablet daily; not more than 1 tablet in 24 hours. Active Ingredient–Loratadine USP, 10 mg (antihistamine). Inactive ingredients–Corn Starch, Lactose Monohydrate, Magnesium Stearate, Pregelatinized Starch.

Wal-itin Allergy Relief–Uses

“Temporarily relieves these symptoms due to hay fever or other respiratory allergies–runny nose; itchy, watery eyes; sneezing; itching of the nose or throat.”

Wal-itin Allergy Relief–Warnings

“Do not use if you have ever had an allergic reaction to this product or any of its ingredients. Ask a doctor before use if you have liver or kidney disease. Your doctor should determine if you need a different dose. When using this product do not take more than directed. Taking more than directed may cause drowsiness. Stop use and ask a doctor if an allergic reaction to this product occurs. Seek medical help right away. If pregnant or breast-feeding, ask a health professional before use. Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center right away.”

Sources:

“Wal-itin 24 Hour Allergy Relief.” Walgreens.com.

Wal-itin 24 Hour Allergy Relief Packaging.

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Benign Prostatic Hyperplasia – I will not be spending as much time on benign prostatic hyperplasia (BPH) as I did on prostate cancer, but they are still very prevalent diseases among men and worthy of some discussion. BPH is a benign growth of the prostate. It results from an over production of prostate cells. They multiply beyond normal limits, but are not cancerous. Indeed, if this disease did not cause such irritating symptoms, it would not require treatment most of the time. There is no clear explanation as to why the prostate continues to grow over a lifetime like it does. Like heart disease and clogged arteries, an enlarged prostate seems to be a function of aging and is just one of those things that men have live with.

In men aged 55, 25% will have symptoms of BPH, while in men over 75, 50% will have symptoms of BPH. In addition, nearly 90% of men will have BPH, with or without symptoms, by the time they reach 80 (1). As with prostate cancer, this is a very common disease and one that nearly all men will have to deal with at some point in their lives. As such, it is important to understand the symptoms and the treatment options that are available.

Symptoms

Symptoms of BPH include the same obstructive and irritative symptoms we discussed for prostate cancer. Regardless of whether it is a tumor or simply too many prostate cells pushing on the urethra and bladder, the outcome is the same.

Most men experience hesitancy, decreased force/caliber of urine stream, sensation of incomplete bladder emptying, double voiding (stopping and starting urination), straining and dribbling. In addition, urgency, frequency, and nocturia are very common symptoms.

Tests

The tests for diagnosing BPH are pretty much the same as those for diagnosing prostate cancer. In fact, the purpose and performing tests in a patient for whom you suspect BPH is to rule out prostate cancer. Other conditions that may mimic BPH include urethral stricture, bladder neck contracture, and bladder stone.

It is in the diagnosis of BPH that we reach the limits of PSA testing. As we discussed earlier, PSA is responsible for making semen more liquid and is a normal product of the prostate. PSA is produced by regular prostate cells as well as by cancer cells, and PSA produced by each is indistinguishable from the other. Hence, whether your prostate is simply enlarged or cancer is present, you will have an elevated PSA. Recall that we discussed several ways of interpreting the PSA that can help make the distinction between prostate cancer and BPH. These methods include the rate of rise PSA, the ratio of free to complexed PSA, and the PSA density. While all of these methods can help distinguish BPH from prostate cancer, they are not foolproof. This means that sometimes the diagnosis of BPH cannot definitively be made until biopsy is performed. While no physician wants to put a patient through the pain and risk of a biopsy, it is important rule out cancer, as a missed diagnosis means the patient's life. Thus, in some cases a biopsy is necessary even if the suspicion is that the enlargement is due to BPH and not prostate cancer. Please refer to the earlier sections on PSA and biopsy for more information regarding these tests.

Treatment

There are three basic treatment options for BPH: medications, phytotherapy, and surgery. We will discuss medications and surgery at length, leaving phytotherapy for last.

Before we begin a discussion of treatment options, it is important to go over some simple things you can do to greatly reduce the symptoms from an enlarged prostate. While none of these suggestions can do anything to actually shrink the prostate, they may be enough to relieve symptoms and prevent the need for medications or surgery.

To help decrease nocturia, try to limit the amount you have to drink in the two to three hours right before bed. This can help prevent you from waking in the night to urinate. Avoid caffeine and alcohol. Caffeine has a diuretic effect on your kidneys, making you produce more urine. As we all know, alcohol makes us pee more as well.

Diuretics, or water pills, are obvious offenders. Talk to your doctor about reducing the dose or switching to a milder diuretic. Try to avoid decongestants and antihistamines. Both of these drugs have anticholinergic effects, which refers to the fact that they antagonize acetylcholine in the body. Acetylcholine is responsible for relaxing the muscle that surrounds your urethra when you need to pee, allowing urine to exit the bladder. Drugs like Benadryl and over the counter cold medications can make it more difficult to urinate.

Getting yourself on a schedule is important as well. If you can schedule the times that go to the bathroom at intervals throughout the day, even if you don't feel the immediate need, then you will avoid problems where you experience urgency and are in a setting where a bathroom is not near.

Medications

Medications used to treat BPH fall into two main classes, the alpha blockers and 5-α reductase inhibitors. We start with the alpha blockers.

Alpha blockers

Alpha blockers work on certain receptors in the body referred to as alpha receptors. Alpha receptors are found on most organs throughout the body, including the heart, bladder, lungs, and blood vessels. Drugs designed to block these receptors can have great therapeutic effect on the prostate but, as you may have guessed, their ubiquitous nature in the body can also lead to certain side-effects. Alpha blockers work by relaxing the muscle around the bladder neck and thereby making it easier to urinate. They are very effective for men who are early in the course of BPH. They do not shrink the prostate. There are five alpha blockers on the market right now:

- Prazosin – a short acting drug that must be taken twice per day

- Terazosin (Hytrin) – a long acting drug that is taken at bed time

- Doxazosin(Cardura) – a long acting drug that is taken once per day

- Tamsulosin (Flomax) – a long acting drug that is more specific for the bladder musculature than those above and thus less often produces the side-effects seen below. This, of course, makes it a more expensive drug. Found to be more effective than finasteride in treating BPH (6).

- Alfuzosin (Uroxatral) – similar to Tamsulosin

Above information modified from Epocrates Online: Available at: www.epocrates.com

Common side-effects of all the alpha blockers include decreased semen release during ejaculation, low blood pressure, dizziness (especially upon standing), headache, and stuffy/runny nose. Flomax and Uroxatral have their own special side effect called floppy iris syndrome. This disorder only affects men who are undergoing eye surgery, so if you are planning eye surgery and are taking Flomax or Uroxatral, make sure your doctor is aware. Due to their effects on blood pressure, alpha blockers must be used carefully in conjunction with drugs for erectile dysfunction, such as Viagra (2).

5-alpha-reductase inhibitors

These drugs are designed to shrink the prostate. 5α-reductase is responsible for converting testosterone to dihydrotestosterone (DHT), which is the most active form of testosterone. DHT is directly responsible for the development and growth of the prostate. By blocking the conversion of testosterone to DHT, 5α-reductase inhibitors prevent the growth of prostate cells. There are two 5α-reductase inhibitors on the market:

- Finasteride (Proscar)

- Dutasteride (Avodart)

Both drugs work the same way, by inhibiting 5α-reductase. They are more expensive than the alpha blockers and are probably less effective than the alpha blockers as well. However, their side-effect profile is significantly less than those of the alpha blockers and so they are better tolerated.

Side-effects of 5α-reductase inhibitors include decreased libido, decreased ejaculate volume, impotence, low blood pressure, and gynecomastia. These side-effects are not common and the 5α-reductase inhibitors have lower overall rate of adverse effects than alpha blockers do. In addition to the side-effects, it should be noted that these drugs must be taken for life. While both classes are expensive and the costs do add up over time, the 5α-reductase inhibitors are the more expensive of the two classes (2).

Of important note, pregnant women should not handle these 5α-reductase inhibitors. DHT is necessary for the proper development of the male genital tract in the womb. If a pregnant female is carrying a male fetus and handles these drugs, there is the potential for birth defects. This is a relatively simple problem to avoid.

It is worth mentioning that finasteride has been shown to reduce the risk of developing prostate cancer. This makes sense given that DHT, the active form of testosterone, is needed for prostate cells and prostate cancer cells to grow. However, it has also been shown that prostate cancer that does develop in men taking finasteride tends to be more aggressive. Thus, the routine use of finasteride to prevent prostate cancer is not recommended at this time. There is ongoing testing to determine the best use of finasteride in the prevention of prostate cancer.

These drugs can be used together in patients who do not achieve adequate control of symptoms with a single drug alone. If a two drug combination does not work, then it may be time to consider surgery.

Surgery

Brace yourself for another helping of alphabet soup because when it comes to procedures there is nothing doctors like to do more than abbreviate. In this section we will discuss two general categories of surgery: minimally invasive and more traditional surgery. Now, how each physician determines what constitutes traditional surgery and what constitutes minimally invasive can vary from one location to the next and sometimes from day to day. To me, it is more important that we meet the patient's definition of minimally invasive if we are going to call a procedure by that name. In all of these procedures tissue is cut, burned, or otherwise damaged in order to alleviate symptoms and improve bladder function. What you call minimally invasive may sound intensely invasive to the next person. With that said I will tell you what each procedure entails and let you decide for yourself which is minimally invasive. I will, nonetheless, try to organize them in a scheme that moves from generally less invasive to relatively more invasive.

Transurethral Microwave Therapy (TUMT): In this procedure, a catheter that emits microwave energy is inserted into the urethra. The microwaves then heat up the prostate cells causing them to die. The urethra is protected by a constant flow of cooling irrigation fluid and no actual incision is made in the urethra. The procedure takes about an hour and is performed on an outpatient basis. It takes several weeks for symptoms to improve as it takes that long for the cells to completely die and be reabsorbed by your body. You will likely need a catheter for 2-3 days following the procedure. Long-term consequences include stricture of the urethra, urinary tract infection, and decreased semen volume. Impotence is a rare side-effect. Retrograde ejaculation occurs in about 20% of patients. Retrograde ejaculation can cause infertility as the semen is not ejected from the penis. There are drugs that can be used to treat this condition with moderate success.

Radiofrequency ablation: This procedure uses a cystoscope, which is simply a microscope of sorts that is inserted into the urethra. Needles are then placed into the prostate and radio waves pass through the needles to heat up and destroy prostate tissue. It is, in effect, the same as TUMT, with a slightly different anatomical approach. The procedure takes about an hour, but requires more anesthesia as it is more painful. A catheter will remain in place for a few days after the procedure. Side-effects are generally the same as for TUMT. This procedure is also referred to as Transurethral Needle Ablation (TUNA).

Laser Therapy: In this procedure a cystoscope is again passed through the urethra. Next a laser is inserted through the cystoscope and several small holes are made in the urethra as the laser is passed into the prostate. Once again, heat is used to destroy prostate tissue. In this case the catheter may have to stay for several weeks as some trauma is made to the urethra. Urinary tract infections are common. Retrograde ejaculation and impotence are rare.

Stents: Just like stents that are placed in the coronary arteries around the heart, stents can be placed into the urethra to help keep it open. These stents are very similar to those used in the heart and look like flexible metal scaffolding formed into tubes. They can be temporary or permanent, are done in an outpatient setting, and take about a half of an hour to place. They are usually reserved for men who cannot undergo surgery because of the risks. They are generally not good long-term options as they tend to become obstructed. Complications include urinary tract infections, painful urination, and shifts in position

Transurethral Resection of the Prostate (TURP): In this surgery, a resectoscope, very similar to a cystoscope, is placed into the urethra. Through this a wire loop is passed that uses electricity to create heat that then allows the loop to be used for cutting without significant blood loss. The resection is made through the urethra, so some damage is done. It takes approximately 90 minutes and requires general anesthesia. There is generally a one to two day hospital stay. Outcomes are very good, but side-effects include semen in the bladder, erectile dysfunction, painful urination, urethral stricture, and blood in the urine. It is important to discuss with your doctor how commonly he or she encounters these problems as they are very dependent on the skill of the surgeon. In general urinary tract infections occur in about 2 % of men, urinary retention in 3%, urinary incontinence in 1%, urethral stricture in 3%, and TUR syndrome in 1%. TUR syndrome occurs when too much volume and not enough salt are absorbed during the procedure from the fluid used to irrigate the urethra. This syndrome is treated in the hospital and is generally not dangerous (2).

Prostatectomy: This procedure is very similar to the prostatectomy performed for removal of prostate cancer. The big difference, however, is that only the middle portion of the prostate is removed, leaving the outer shell (and the nerves necessary for erection) intact. This process is sometimes referred to as enucleation. The procedure, anesthesia, and recovery time are otherwise the same.

What is not the same is the rate of side-effects. While impotence and urinary problems are more common with surgery for BPH than for some of the less invasive methods of treating BPH, they are not as common as when the entire prostate is removed for the treatment of prostate cancer. One of the advantages of having open surgery is that the parts of the prostate that are removed can be sent to pathology to be examined. This is the best way to ensure that there is no cancer present and that the enlargement is due to BPH alone. There is a lower likelihood of needing retreatment with surgery and there is less need for medications like alpha blockers and 5α-reductase inhibitors.

Often times, the decision of medication vs. surgery can only be made on a trial and error basis. You have to try the medications and see if they work because currently there is no test that can be done to tell if they will. It can be a frustrating process if the initial attempts at therapy fail. It is up to you to work with your doctor to determine how much trial and error you are willing to put up with and how much risk you are willing to assume b y undergoing surgery. As always, the choice is personal and one only you can make in conjunction with the guidance of a dedicated physician.

Phytotherapy

Phytotherapy refers to the use of natural, plant-based products that have not been processed or chemically altered for the treatment of medical conditions. Several plant-based therapies exist for the treatment of BPH. In some cases, there is evidence that they work and in some cases no evidence exists to support their use. In this section we will discuss the common natural and herbal remedies used treat BPH and examine the evidence supporting their use. Whether you choose to take medications, undergo surgery, or try phytotherapy, it is important that you always consult with a physician. Never try to treat symptoms of an enlarged prostate without first obtaining an accurate diagnosis. Remember, we are trying to catch cancer while it is still treatable and before it spreads. If you spend time treating symptoms you think are due to BPH, but later turn out to be due to cancer, you will have lost valuable time and potentially lost a cure. Always obtain a diagnosis before starting therapy, even if you intend to self-treat with alternative medicines. Even if you have an accurate diagnosis, a doctor can help you determine if alternative treatments for your BPH will interfere with any medications you might be taking for different conditions such as erectile dysfunction or blood pressure.

The National Institutes of Health runs a fantastic website that provides evidence for alternative and complementary medicine. This site is free for public use and provides accurate, unbiased information about a variety of alternative treatments including herbs, acupuncture, and more. It is worth investigating any treatment you intend to use through this website before partaking. The website belongs to the National Center for Complementary and Alternative Medicine. It is paid for with tax-payer money, and can be found at http://nccam.nih.gov.

It is important to keep in mind that supplements are not regulated by the Food and Drug Administration (FDA). As a result, there are no standards for the preparation of any natural remedies that can be purchased without a prescription. This means that there is variation in effectiveness from brand to brand and even from batch to batch within a brand. Contaminants and other health hazards are a potential problem. If you intend to use alternative therapies, it is important to keep this in mind and carefully research a company before using their product.

Saw Palmetto: Saw Palmetto comes from the fruit of the American dwarf palm tree that grows in the southeast portion of the United States. It has been used to treat symptoms of enlarged prostate as well as pelvic pain and, decreased sex drive, and hair loss.

In placebo controlled trials, no difference was found in symptoms between men taking saw palmetto and those taking the placebo. Saw palmetto does to affect PSA readings and thus will not interfere with the detection of prostate cancer. While several small studies support saw palmetto's use for treating prostate enlargement, there is no large, well-controlled trial that supports it use. At this point there is no evidence to support its use in treating BPH. Side-effects include stomach discomfort and decreased sex drive(3).

Pygeum Africanum: Little evidence exists regarding the use of this supplement. Small studies of short duration suggest that it has some effect in improving urinary symptoms. Large, standardized trials have not been performed. Side-effects include constipation, diarrhea, and nausea. Anaphylaxis is a potential side-effect. Interactions with other drugs are unknown (4).

Stinging Nettle: Native to Europe, this plant can now be found throughout the United States and Canada. There is some evidence supporting the use of this supplement in the treatment of BPH. Studies have shown that it increases the flow of urine and decreases the number of times men need to get up at night to urinate. It is an accepted treatment for BPH in Europe.

Diabetics should avoid this herb as it can raise blood sugar. Digestive upset and rare anaphylactic reactions have been reported (5).

1. Presti JC Jr. Chapter 23 – Neoplasms of the Prostate Gland. In: Tanagho EA, McAninch JW. Smith's General Urology 15th ed. New York: Lange/McGraw-Hill; 2000. p414.

2. Namiki S, Egawa S, Terachi T, Matsubara A, Igawa M, Terai A, Tochigi T, Loritani N, Saito S, Arai Y. Changes in quality of life in first year after radical prostatectomy by retropubic, laparoscopic, and perineal approach: multi-institutional longitudinal study in Japan. Urology. February 2006;67:321-327.

3. National Center for Complementary and Alternative Medicine. Bethesda (MD). Herbs at a Glance: Saw Palmetto. 2008 Oct 22. [cited 2008 Nov 19]. Available at: http://nccam.nih.gov/health/palmetto/.

4. Shani A, Macdonald R, Nelson D, Rutks I, Wilt TJ. Pygeum africanum for the treatment of patients with benign prostatic hyperplasia: a systematic review and quantitative meta-analysis. The American Journal of Medicine, Vol 109, Iss 8, p 654-664.

5. Bear S. The People's Pharmacy with Joe and Terry Graedon. Stinging Nettle. 2008 Apr. [cited 2008 Nov 19]. Available at: http://www.peoplespharmacy.com/archives/herb_library/stinging_nettle.php

6. Hoffman BB. Chapter 10 – Catecholamines, sympathomimetic drugs, and adrenergic receptor antagonists. In: Hardman JG and Limbird LE. Goodman & Gilman's The Pharmacological Basis of Disease 10th ed. New York: McGraw-Hill; 2001. p242.

Public release date: 30-Dec-2009

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Journal of the National Cancer Institute

Fewer left-sided colorectal tumors observed after colonoscopies

The prevalence of left-sided advanced colorectal neoplasms was lower in participants in a community setting, but not right-sided advanced neoplams, who had received a colonoscopy in the preceding 10 years, according to a new study published online December 30 in the Journal of the National Cancer Institute.

Effectiveness of colonoscopy in preventing colorectal cancer has been studied, but evidence from community settings is sparse, especially with respect to anatomical site.

To study this, Hermann Brenner, M.D., MPH, of the Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, in Heidelberg, Germany, and colleagues conducted a cross-sectional study among 3,287 participants of screening colonoscopy aged 55 years or older from the state of Saarland between May 2005 and December 2007. Previous colonoscopy history was obtained by standardized questionnaire, and its association with prevalence of advanced colorectal neoplasms was estimated.

Advanced colorectal neoplasms were detected in 308 (11.4%) of the 2,701 participants with no previous colonoscopy compared with 36 (6.1%) of the 586 participants who had undergone colonoscopy within the preceding 10 years. Prevalence of left-sided advanced colorectal neoplasms, but not right-sided advanced neoplasms, was substantially lower within a 10-year period after colonoscopy in this community setting.

“Although a strong protective effect of colonoscopy from colorectal neoplasms has been established through previous studies, our results add to the evidence that this effect is much stronger in, if not confined to, the left colon and rectum, at least in the community setting,” the authors write.

In an accompanying editorial, Nancy N. Baxter, M.D., Ph.D., of the Division of General Surgery at St Michael's Hospital, University of Toronto, and Linda Rabeneck, M.D., MPH, of the Department of Health Policy, Management, and Evaluation at the University of Toronto and Odette Cancer Centre, Sunnybrook Health Sciences Centre Toronto, note that these results are an important contribution to the growing body of literature of colonoscopy effectiveness research but still leave questions about the incremental benefits of screening colonoscopy. The editorialists point to some of the limitations of the literature.

“Simply put, is the effectiveness of colonoscopy 'good enough' for population-based screening?” they write. “As more observational evidence accumulates, the answer to this question becomes less certain.”

The prevalence of left-sided advanced colorectal neoplasms was lower in participants in a community setting, but not right-sided advanced neoplams, who had received a colonoscopy in the preceding 10 years, according to a new study published online December 30 in the Journal of the National Cancer Institute.

Effectiveness of colonoscopy in preventing colorectal cancer has been studied, but evidence from community settings is sparse, especially with respect to anatomical site.

To study this, Hermann Brenner, M.D., MPH, of the Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, in Heidelberg, Germany, and colleagues conducted a cross-sectional study among 3,287 participants of screening colonoscopy aged 55 years or older from the state of Saarland between May 2005 and December 2007. Previous colonoscopy history was obtained by standardized questionnaire, and its association with prevalence of advanced colorectal neoplasms was estimated.

Advanced colorectal neoplasms were detected in 308 (11.4%) of the 2,701 participants with no previous colonoscopy compared with 36 (6.1%) of the 586 participants who had undergone colonoscopy within the preceding 10 years. Prevalence of left-sided advanced colorectal neoplasms, but not right-sided advanced neoplasms, was substantially lower within a 10-year period after colonoscopy in this community setting.

“Although a strong protective effect of colonoscopy from colorectal neoplasms has been established through previous studies, our results add to the evidence that this effect is much stronger in, if not confined to, the left colon and rectum, at least in the community setting,” the authors write.

In an accompanying editorial, Nancy N. Baxter, M.D., Ph.D., of the Division of General Surgery at St Michael's Hospital, University of Toronto, and Linda Rabeneck, M.D., MPH, of the Department of Health Policy, Management, and Evaluation at the University of Toronto and Odette Cancer Centre, Sunnybrook Health Sciences Centre Toronto, note that these results are an important contribution to the growing body of literature of colonoscopy effectiveness research but still leave questions about the incremental benefits of screening colonoscopy. The editorialists point to some of the limitations of the literature.

“Simply put, is the effectiveness of colonoscopy 'good enough' for population-based screening?” they write. “As more observational evidence accumulates, the answer to this question becomes less certain.”

Study limitations: Previous colonoscopies were self-reported and performed in the community setting by many endoscopists. Histopathologic examination was performed by various pathology laboratories. Numbers of advanced neoplasms at specific sites were rather small.

Link to article

Link to editorial

Source
Journal of the National Cancer Institute