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  • Rehab Reality Check

    The time is coming-- perhaps even within the decade--when doctors will treat alcoholism with a pill. As they improve their understanding of the biochemistry of addiction, researchers will find new ways to interrupt the neurological sequence that begins with pulling the tab on a can of beer and ends with sobbing on the phone to someone you dated twice in 1987. It will be a paradigm shift as profound as the one wrought by Prozac in the treatment of depression, says Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism: people with drinking problems will get a modicum of counseling and prescriptions from their family doctors. This will be a great boon to most people except for athletes, congressmen and movie stars, who will lose one of the defining rites of passage of modern celebrity: the all-absolving, career-rejuvenating, Barbara Walters-placating ritual of checking into rehab.It has been a fixture of our culture since as far back as 1983, when Elizabeth...
  • Hot Flashes and Hormones

    Here's what you and your clinician should talk about before deciding whether to take estrogen.
  • Midlife Guide for Women: Sex

    I've heard that sex gets better for some women during the menopause transition but worse for others. What can I do to increase my chances of being in that first category?
  • Midlife Guide for Women: Mood

    I'm usually a pretty upbeat person, but lately I've been barking at everyone I know and shifting from neutral to supercranky in less than five seconds. I know I'm being unreasonable, but I can't seem to help myself.
  • Midlife Guide for Women: Heart

    My doctor says I need to watch my cholesterol, even though I'm only 47. I thought only men had to be concerned about heart disease. Does menopause change things?
  • Midlife Guide for Women: Eyes

    I've been wearing contact lenses since I was 13, but lately they feel uncomfortable. I'm constantly taking them out, cleaning them and reinserting them. Why are my eyes so dry and irritated?
  • Midlife Guide for Women: Sleep

    Lately, I've been having a lot of trouble sleeping no matter how tired I am. Is there a connection between menopause and insomnia?
  • The Great Diet Debate

    I’ve known Dr. Arthur Agatston for many years. I like him very much and greatly respect his pioneering work on developing the heart scan, which is a way of screening for heart disease using a special CT scanner that can detect calcium in coronary arteries. I’ve also appreciated his books that educate people about the need to distinguish between unrefined “good carbs” and refined “bad carbs.”However, I have some concerns about his new book, “ The South Beach Heart Program ,” which claims to “detect, prevent and even reverse heart disease.” It’s based on the only published research study he authored on his program which, surprisingly, showed that LDL (“bad”) cholesterol levels did not come down significantly at all on this diet. Also, the South Beach Diet has never been shown to reverse the progression of coronary heart disease and may be too high in saturated fat and cholesterol to prevent heart attacks for many people unless a lifetime of cholesterol-lowering drugs are added.These...
  • Nap Quest

    Print out this article and hand it to your boss. Tell them Harvard thinks you should take a nap. Honest.Researchers at the Harvard School of Public Health and the University of Athens Medical School have just released findings from a large study that shows how mid-day napping reduces one's chance of coronary mortality by more than a third. So go ahead and nap—a short daily snooze might ward off a heart attack later in life.Researchers studied 23,681 individuals living in Greece who had no history of coronary heart disease, stroke or cancer when they first volunteered. The researchers also controlled for risk factors such as diet and exercise, going beyond prior studies that have tried to explore the benefits of napping but ended up with conflicting results. More than six years later, the exemplary nappers, men and women who napped at least three times per week for an average of at least 30 minutes, had a 37 percent lower coronary mortality risk than those who took no siestas. The so...
  • What's Up With Stents, Docs?

    It's not often that the New England Journal of Medicine devotes most of its editorial content to a single subject—and releases the information early online. That's exactly what it did Monday with a series of five studies and several commentaries on drug-eluting coronary stents. As the editors explained, "Our motivation is the recent concern that the implantation of drug-eluting stents, as compared with bare-metal stents, may be associated with a small increased risk of late stent thrombosis, a potentially fatal complication."Drug-eluting stents were hailed as a "breakthrough technology" in 2003 and 2004, when the FDA approved the Cypher and Taxus stents, respectively. Like the bare-metal stents that preceded them, these tiny wire-mesh scaffolds were designed to prop open narrowed blood vessels (a problem known as stenosis), reducing the chest pain known as angina. Unlike bare-metal stents, however, the Cypher and Taxus devices were coated with drugs, the purpose of which was to...
  • CDC Raises Autism Estimate

    As the debate over autism's cause continues, the CDC raises its estimate of how many children are affected.
  • Let Them Eat … CSB?

    Chef Heinz Beck’s kitchen at Rome’s exquisite La Pergola restaurant is arguably one of the best in the Eternal City, serving up innovative cuisine like cannelloni with duck, foie gras in kuzu béchamel, and venison in a pistachio crust with chestnut purée and persimmon jam to a discerning international clientele. But there may soon be a new item on the menu: crème brûlée made with “CSB” and topped with pineapple gelato. Far from a trendy new acronym for the latest in haute cuisine ingredients, CSB stands for corn soya blend, the same vitamin-enriched food-ration substance that humanitarian aid workers truck through mine fields in Afghanistan and air drop from C-130s into Sudan. It is generally distributed in 25-pound canvas bags and made into mush or porridge under the dire conditions of war, famine and natural disaster. On its own, it has virtually no flavor, but it does provide crucial daily nutrition with little more than a few drops of water and even the most rustic mortar and...
  • House Of Healing

    Pennies from kids who thought they were giving a fortune. Checks written in modest amounts from ordinary families. And one eye-popping anonymous contribution of $22.5 million. It was private donations like these from more than 600,000 Americans that paid for a comprehensive new rehabilitation center for wounded troops that opened Monday at Fort Sam Houston in San Antonio. Military brass and privates shuffling on crutches joined senators, actresses and country-music stars under a chilly South Texas winter sky at the ribbon cutting for the Center for the Intrepid, which opened along with two new Fisher House suites that house the families of the recovering troops. The pomp and pageantry, including a fighter-jet flyover and the crooning of singer John Mellencamp, was meant to pay tribute to the wounded and fallen and to the citizens who tried to repay their sacrifices with world-class medical and support facilities."Today is a celebration of life, heroism, duty, honor and commitment,"...
  • When Best Intentions Aren’T Good Enough

    I am a gym rat. And my gym, like gyms all over the country, has been really crowded lately. I used to get a little peevish about this January surge in traffic on the treadmill and Stairmaster, but I no longer do. As a regular, I know that most of these newly dedicated fitness buffs will be gone by February.This is not arrogance. I’ve had my share of relapses. The fact is, it’s really hard to keep the promises we make to ourselves, including New Year’s resolutions. Not only will the January joggers soon be drifting back to their couches, others will be restocking their liquor cabinets, tossing their nicotine patches and bingeing on Chunky Monkey—in short, giving up on all those optimistic visions of healthy living.Why are we so bad at adhering to our most well-intended commitments? Psychologists are very interested in this question, because of the obvious public-health implications, and they recently have been probing beyond the common and unhelpful answer: weak willpower. What does...
  • No Child Left Untested?

    The White House Office of National Drug Control Policy announced last week that it will be holding four regional summits promoting random student drug testing in public middle and high schools. The controversial program, which has already been implemented in nearly 1,000 middle and high schools across the country, requires that kids submit to random drug testing if they want to participate in competitive extracurricular activities like athletics. The Department of Education offers grants to schools that want to develop or expand a drug-testing programs for children in grades 6-12, but decisions about whether to test and which drugs to test for are made on an individual school level. The testing is usually done by a school nurse with a urine sample taken on school premises. If there's a positive result, the sample is sent out for verification by a lab. Tests can also be done with blood or saliva. Samples are generally tested for cocaine, marijuana, ecstasy, opium-based substances,...
  • New Sensible Eating Rules for Kids

    Every day at 6:15 p.m., 4-year-old Payton and 7-year-old Avery Lumeng sit down for dinner with their parents, who let them eat as much or as little as they'd like. They're free to be excused when they're finished—even if it's after only 15 minutes. If they're hungry when it's not mealtime, they eat snacks—including occasional cookies and candies. "If you have all these hard and fast rules—'My children are never going to eat candy'—it makes it all the more tempting," explains their mom, Dr. Julie Lumeng of the University of Michigan's department of pediatrics and Center for Human Growth and Development. She should know: she worked on "Healthy From the Start," a new booklet on healthy eating just out from the nonprofit group Zero to Three (zerotothree.org) and endorsed by the American Academy of Pediatrics.In the booklet, Lumeng and her colleagues redefine the rules of healthy eating for kids. Faced with a childhood-obesity epidemic (about one in six U.S. kids is fat), experts are...
  • The Big Sleep

    Hi, my name is Sarah and I am a narcoleptic.OK, while I haven’t announced my condition with brazen acceptance to a semi-circle of strangers drinking watered-down coffee from Styrofoam cups, the term “narcoleptic” has wriggled its way onto my list of defining characteristics, right there with “recent college graduate” and “dog lover.”I’ve had the symptoms for about eight years. For years, I would routinely sleep for 14-plus hours and still nod off during “Desperate Housewives.” If my presence was not required somewhere (school, work), getting out of bed seemed pointless since I would fall asleep again within an hour. Friends knew better than trying to coax me out of bed, and even my dog learned to hold her bladder for a surprisingly long period of time. Further hindering my motivation was a diagnosis of depression pinned to my shirt at age 18.  Eventually, I resigned myself to being a chronically slothful person.I made decent grades in college, and was offered a good job at a well...
  • A Call For ‘Radical Change’

    President Bush’s State of the Union address may not have done much to improve his popularity. But it did succeed in jump-starting debate over one of the leading—and most contentiously lobbied issues—on his domestic agenda: health-care reform. In his speech, the president proposed offering tax subsidies to encourage more people to buy their own health insurance. The goal: to provide equal treatment to those who buy insurance on their own, and those who get it through their employers. Under the Bush plan, the administration estimates that 80 percent of workers with employer-based health plans would pay lower taxes—while 20 percent of those with more costly workplace plans (branded “gold-plated” by Bush) would see a tax hike, unless they decreased their coverage.Democrats on Capitol Hill, along with labor unions and consumer groups, pilloried the Bush plan, arguing his proposal would do little to help America’s nearly 47 million uninsured—and could wind up hastening the demise of...
  • The Latest in Battlefield Surgery

    The military has rewritten the book on wartime surgery to combat the wave of injuries in Iraq and Afghanistan. The latest strategies for helping fallen warriors.
  • The Threat From Within

    This may be the first generation in which children live a shorter life span than their parents. If this were caused by a new virus or pathogen, or if some madman was harming our children, there would be a call to action from most parents, an uprising and an uproar. But it's not some external germ or sinister force that's eating our young; it's what our young are eating—too much fat, salt and sugar. And it's not only what they're doing, but also what they're not doing—a lack of regular exercise.So many kids in our country are overweight, they're getting sick and dying prematurely. Overweight kids suffer disproportionately from diabetes, asthma, high blood pressure and other serious health problems. A study last summer in the Annals of Internal Medicine found that being overweight at 18 is associated with an increased risk of premature death in younger and middle-aged women.Since 1970, the percentage of kids who are overweight or obese has risen almost fourfold, from 4.2 percent to 15...
  • Don’T Forget The Artificial Tears

    When our book, “Is it hot in here? Or is it me? The Complete Guide to Menopause” ( Workman ), was released a few weeks ago, “The Today Show” invited us on to talk about the topic and put together a “menopause survival kit.” After the show ran, we got lots of e-mails asking for a list of the contents. While this “kit” is not all-inclusive, these items will help you weather the menopause transition more successfully. Here’s a breakdown of our purchases:Face wipes. Stow these in your purse or desk drawer. They’re great for mopping up after a sweaty hot flash.Water bottle. Drinking some ice water helps many women reduce the severity of hot flashes. Keep it handy.Nightwear made of fabric that wicks away moisture. We have a friend who sleeps in a flannel nightgown and then complains of night sweats. A simple solution is to buy T-shirts or sleepwear made of wicking fabric. That way, you won’t feel so cold and clammy. Look for the same fabric you see in athletic wear.Cream moisturizer....
  • More Political Science

    Last summer President Bush invited several scientists to the Oval Office to revisit one of his earliest--and most contro-versial--decisions: to fund, but strictly limit, stem-cell research. Bush wanted to explore the impact of his 2001 policy to approve research only on existing stem cells drawn from human embryos. So he asked the scientists about the viability of the 21 approved stem-cell lines. And he quizzed them about possible contamination with mouse cells. One month later, he issued the first veto of his presidency against an expansion of stem-cell research.With a new Democratic-led Congress, Bush is now facing a greater political challenge than he was then. Last week House Democrats voted once again to approve funding for research using stem cells drawn from embryos slated for destruction at fertility clinics. The final vote fell short of a veto-proof majority, and the White House promised to block it again.But this time around, Bush's aides feel far more confident about...
  • Escaping A Moral Mess

    Stem-cell research is divided into two major camps: one focused on cells from adults, the other on the controversial technique that destroys embryos. Now there may be a third way--a new category of stem cells that are readily available, perhaps ethically trouble-free and possibly as powerful and as flexible in function as their embryonic counterparts: amniotic-fluid stem cells, found in both the placenta and the liquid that surrounds growing fetuses.The cells are "neither embryonic nor adult. They're somewhere in between," says Dr. Anthony Atala, a tissue-engineering specialist at Wake Forest University, who led a team that published the findings last week in the journal Nature Biotechnology. The "AFS cells" rival embryonic stem cells in their ability to multiply and transform into many different cell types, and they eventually could be hugely helpful to doctors in treating diseases throughout the body and building new organs in the lab. At the same time, the amniotic cells can be...
  • When The Body Attacks Itself

    The immune system is what keeps most people's bodies healthy and free of disease, but for as many as 23 million Americans, it is a cause of disease, too. In autoimmune disorders, the system goes haywire, mistaking the body's own tissues for foreign invaders and destroying them. Drugs for these conditions, which include type 1 diabetes, multiple sclerosis and lupus, have been elusive. But on Sunday, scientists are reporting in the journal Nature that they have found a set of 30 genes that go awry in autoimmune disorders—and that could be potential targets for cures. NEWSWEEK's Mary Carmichael spoke with two of the discoverers, Richard Young, a biologist at the Massachusetts Institute of Technology's Whitehead Institute, and Alexander Marson, an M.D./Ph.D. student in Young's lab. Excerpts:NEWSWEEK: What do these 30 genes normally do in a healthy person's body?Richard Young: There was a very, very important discovery made about a decade ago, which was that a specialized class of ...
  • The Gender Gap in Cancer Death Rates

    A new report details a historic drop in cancer death rates. But in recent years, the decline for women has been half that for men. What's behind the gender gap?
  • To Your Health: Cancer: A Fresh Diagnosis

    On Wednesday, after decades of grim news, the American Cancer Society reported the steepest decline in United States cancer deaths in the 70 years since nationwide data has been compiled. In 2004, there were 3,014 fewer cancer-related deaths than in 2003—which was the first year the society had ever recorded a drop in cancer deaths. The back-to-back decreases have specialists hoping that they may at last be gaining the upper hand in their long battle against the disease."Our work over the years is finally paying off," says Ahmedin Jemal, Ph.D., a specialist in cancer occurrence and the lead author of the report. He pointed to medical advances, early detection and antitobacco campaigns as key factors in the progress made.But the report also underscores a stark disparity between men and women when it comes to surviving cancer. Death rates are falling about twice as fast for men as for women. Between 1990 and 2003, mortality rates for men fell by 16.3 percent; the comparable figure for...
  • Is Male Menopause Real?

    You're a guy in your late 50s. You've just awakened and are looking at yourself in the bathroom mirror--as you do every morning. Only today you notice for the first time what must have been there for a while: the love handles, the once bulging pecs that now sort of sag. It gets you thinking. You realize that for some time you haven't had as much energy as you used to, you don't have as much interest in sex, there are times when you feel down and discouraged, and your friends tell you that you're more irritable than you used to be. Is this just aging? Is it simply the inevitable price of your nutritionally rich and exercise-poor lifestyle? Or is it a medical condition--one for which there might be a treatment?Are you entering "male menopause"? You've heard the phrase, but is there really such a thing?Like women, men experience a drop in the levels of sex hormones as they age. But in men, the pace of these changes is quite different. In women, levels of the main female sex hormone,...
  • Hot Flashes and Hormones

    Hormone therapy is an appropriate choice for some, but not all, women. On the benefit side, hormone therapy relieves hot flashes, night sweats and vaginal dryness, and it may improve sleep, mood and concentration. It also preserves bone density and protects against fractures. But there also are risks, including higher rates of breast cancer, stroke, blood clots in the legs and lungs and, for older women, coronary heart disease. What questions do you and your doctor need to answer to make an informed decision about hormone therapy? And if you choose hormone therapy, how can you minimize the risks? Here are the key elements of that conversation.Moderate to severe symptoms, which affect about one in five newly menopausal women, are the only compelling reason to take hormone therapy. If you're bothered by vaginal dryness only, consider low-dose vaginal estrogen rather than pills or patches.Mounting evidence indicates that a woman's age and time since menopause (on average at the age of...
  • Cancer

    Let's start with the basics. Menopause doesn't cause cancer. It doesn't even increase your risk of getting cancer. But the levels of hormones in your body (what your body produces naturally, as well as what you take via pills, creams, gels, rings and patches) have a complicated relationship to your chances of getting certain cancers. Over the course of your life, hormones appear to be protective against some kinds of cancer while increasing your risk of developing others. ...
  • The Basics

    Remember when you were 13 and your girlfriends shared their complaints of menstrual aches and pains with you? Around that time, you probably realized that not everyone's periods were the same. Some got on a regular schedule pretty quickly, while others were so erratic they never knew when their "friend" was going to surprise them. Others were constantly popping aspirin for cramps, while a few were really troubled by PMS, making them difficult to live with for about a week each month. In some respects, menopause is back to the future: many of the same experiences, with a lot of individual variation.As the name implies, natural menopause starts without your intervention; that's why it's sometimes called "spontaneous." You might detect subtle hints of what's coming 10 years or more before your periods stop. Your periods may become shorter and come closer together as the follicles (egg sacs) in your ovaries produce less progesterone. (This shortens the period of time when the uterine...
  • Diet

    Probably a little of both. Whether you've been a health nut or a couch potato, you're going to find menopause a challenge. Your metabolism slows down as you get older, so you will gain weight if you don't cut calories and increase your level of exercise. No wonder women add an average of a pound a year during perimenopause. Many women find the extra weight is landing in places that are new for them, like the tummy. Part of the explanation is that after menopause, women tend to accumulate fat where men do--in the neck, chin and abdominal areas--perhaps because of shifting hormone levels. Your genes also help determine where fat accumulates on your body, as does your activity level. Even if you haven't gained weight, flabbiness could come from lack of exercise. As we get older, we tend to be more sedentary, which means less muscle and more fat. Changes in skin tone that come with the loss of estrogen can also make your abdominal area seem looser and flabbier.You can improve much of...
  • Hot Flashes

    More than three quarters of American women suffer from hot flashes during the menopause transition. This means, of course, that a lucky minority of women don't. Our question is: who are these women, and where are they hiding? Everyone we know has experienced the unwelcome sensation of sudden heat more than once, and often in an embarrassing situation: in the middle of a conversation, during an introduction to someone new, rushing to meet a deadline. The heat spreads from your torso to your face. Some women appear flushed; many experience rapid heartbeat and a rush of anxiety. This can happen a few times a day or almost every hour. There's no rule. You may feel as if you're on fire, but your internal body temperature doesn't change. What does heat up is the temperature of your skin, and it can rise as much as seven degrees, although between one and four degrees is more typical. Generally, you'll cool down in a few minutes, although some women have individual hot flashes that last as...
  • Mood

    While you might think everyone gets a little irritable (OK, bitchy) during menopause, research proves that menopause doesn't cause a major mood problem in most midlife women. While women are twice as likely to suffer from depression as men, you're more likely to be diagnosed with depression before the age of 44 than when you're older. In fact, here's a surprise: the majority of women between 45 and 55 describe these years as the best of their lives.But there's no denying that some of us are in for a bumpy ride, even clinical depression, maybe for the first time in our lives. Some women's moods are much more sensitive to hormonal changes than others, and they have a particularly rough time during perimenopause, when zig-zagging hormones are the rule. Hot flashes, night sweats and insomnia have been known to leave more than a few women moody and depressed. Side effects of medications or an undiagnosed thyroid problem could be the culprits. Or maybe the stresses that many of us are...
  • Heart

    If you're like many midlife 'women, you're probably more worried about breast cancer than heart disease at this point. Chances are you have more than one friend who is struggling with that devastating illness. But breast cancer, as terrible as it is, pales before the leading killer of women: heart disease. Every year, more women die of heart disease than of all kinds of cancer combined. True, at this point in your life, you probably know more women who have been diagnosed with cancer than heart disease, but that will soon change. Before menopause, your odds of a heart attack or stroke are much lower than those of a man your age. After menopause, the odds shift and the risk gap narrows. Women over 65 are just as likely to die of a heart attack as men of the same age. But here's some hopeful news. Recent research shows that even if you haven't been particularly kind to your heart in the past, starting healthy habits now can make a big difference in the years ahead.Your risk for heart...
  • Eyes

    Whether you wear contact lenses or not, dry eyes may be one of the first changes you notice around menopause. A decade ago many eye doctors dismissed complaints of dry eyes without much thought. But these days doctors are recognizing that dry eyes can lead to bigger problems: chronic inflammation, increased risk of infection, blurred vision, scarring and, in rare cases, corneal damage and vision loss. More commonly, dry eyes interfere with daily life, making it harder for you to read, drive a car (especially at night), work at a computer and even go out into the sunlight.Your eyes may be feeling gritty because you're not producing enough tears, or the tears you have evaporate too quickly. Sometimes this is related to aging, a malfunction of the tear glands or illness. Dry eyes are associated with rheumatoid arthritis, lupus, Sjögren's syndrome, diabetes, Parkinson's and thyroid disease. But there's lots of evidence that dry eyes are related to fluctuations in hormones, especially...
  • Bones

    Plenty of women share these challenges, but it's way too early to declare yourself a lost cause. After menopause, women are much more vulnerable to osteoporosis, a thinning of bones that leaves them susceptible to fracture. Estrogen slows bone loss; as levels fall, a woman's bone mass can drop as much as 20 percent in the years around menopause. While there are no guarantees that lifestyle changes will prevent you from getting osteoporosis, you can substantially increase your odds. The truth is that because of genetics, some people who do everything right spend decades fighting an uphill battle against the disease. Others, born with bigger bones and inheriting a slower pace of bone loss, will have far more wiggle room--even if they aren't doing everything right. But few people know for sure which category they're in. Even if you have a bone-mineral-density test, there's much you still won't know about the overall quality of your bones. You have nothing to lose and everything to gain...
  • Sleep

    Lately, I've been having a lot of trouble sleeping no matter how tired I am. Is there a connection between menopause and insomnia?
  • Counterinsurgency: The Great Goat War

    On Isabela Island, the feral goat used to be public enemy No. 1. No creature has done more to sully the pristine ecology of the biggest island of the Galápagos. First introduced by whalers back in the 1700s, a handful of goats migrated over a wide expanse of nearly impassable lava terrain to the northern end of Isabela in the mid-1980s, and by 2000 some 120,000 were tearing up the landscape. The goats overgraze on the same native plants that support the giant tortoise and other species, turning forests into virtual deserts. As late as the '80s, the tortoises, which live as long as 200 years, were endangered and well on the path to extinction.The goat is now gone. The private Charles Darwin Foundation, which set out to exterminate the goat in 1998, announced last July that it had succeeded completely. The foundation has been battling invasive species on the islands since 1959, but the removal of the goats from Isabela is its greatest victory. "Almost nobody thought we could do it....
  • To Your Health: Another Piece of the Puzzle

    To paraphrase Winston Churchill, Alzheimer’s disease is a riddle wrapped in a mystery inside an enigma. Thousands of researchers in labs around the world are hard at work every day trying to unlock its secrets. But how does one begin to unravel the cause of a disease that arises from the interplay of dozens of genes plus a number of environmental factors? To date, 900 scientific papers have identified 350 candidate genes that may be involved in late-onset Alzheimer’s, the form of the disease that accounts for roughly 95 percent of cases. Yet researchers have reached a consensus on only one of them—the APO E4 gene variant. That’s why a paper appearing Sunday in the online version of the journal Nature Genetics is drawing attention. In it, an international team of 41 scientists has provided strong evidence for the involvement of another gene, called SORL1. The new gene appears to confer only a modest degree of susceptibility for Alzheimer’s, but simply knowing that it is involved in...