 |
Generic Zocor 90 pills - 79.95$ USSimvastatin 20mg |
Generic Zocor 20mg x 120 pills - 99.95$ USD
Discount Generic Zocor (Simvastatin) with our pharmacy. No Prescription. Drug uses, dosage, side effects, warnings, and patient labeling.
www.cheaprxviagra.com
Although many wedding vows include the phrase “in sickness and in health,” a stroke can put that promise to the test by causing major relationship problems for married couples, according to British researchers.
The University of Ulster study included 16 married stroke survivors (nine males, seven females), aged 33 to 78. The time since their stroke ranged from two months to four years, with an average of 18 months.
The researchers found that the stroke significantly affected sexual activity, led to blurred relationship roles, and feelings such as anger and frustration were confounded by persistent fatigue and lack of independence.
Among the findings:
All but one of the stroke survivors experienced a reduction or total loss of sexual desire. Some believed this was due to the effects of medication or fear of another stroke.
Most of the females lost interest in their appearance, regardless of age.
All the survivors said they’d changed since their stroke. Many said they experienced irritability, anger, agitation and intolerance due to their frustration at not being able to perform daily activities. In some cases, over-protective spouses increased feelings of anger and frustration.
Many survivors were reluctant to resume social activities with their spouses because of fatigue, anxiety and swallowing problems.
Fatigue was often associated with reduced independence and guilt because survivors didn’t know how they’d feel from day to day and couldn’t plan ahead.
“All the participants perceived a stroke as a life-changing event. They faced a continuous daily struggle to achieve some sense of normality and that required huge amounts of physical and mental effort,” study co-author Assumpta Ryan, of the University of Ulster’s Nursing Research Institute, said in a university news release.
While there are plenty of good reasons to avoid obesity in your teens, a new study now suggests that extra weight in adolescence may increase your risk of multiple sclerosis (MS) later.
Reporting in the Nov. 10 issue of Neurology, Harvard researchers found that being obese at age 18 more than doubles a woman’s risk of developing MS later in life compared to her slimmer peers.
“This is one more study that shows obesity leads to another unhealthy outcome, and obesity during adolescence may be critical in determining MS risk,” said study author Kassandra Munger, a research associate at the Harvard School of Public Health in Boston.
Multiple sclerosis is a chronic disorder of the central nervous system, according to the National Multiple Sclerosis Society. Although no one is certain what the exact cause of the disease is, scientists believe it’s an autoimmune disease. That means the body’s immune system mistakenly targets its own cells. In the case of MS, the immune system destroys myelin, a fatty substance that covers nerve fibers, according to the MS society.
The current study included more than 238,000 women who participated in the Nurses’ Health Study or the Nurses’ Health II study between 1976 and 2002. The women were between 25 and 55 years old at the start of the study.
Body mass index (BMI) was calculated using information given by the women about what their height and weight were when they were 18 and at the start of the study. A BMI of 18.5 to 24.9 is considered normal, according to the U.S. Centers for Disease Control and Prevention, while 25 to 29.9 is overweight and above 30 is obese.
The women were also asked to look at pictures of nine different body silhouettes that ranged in size from very thin to extremely obese, and to identify which silhouette most closely matched hers at ages 5, 10 and 20.
Women who were obese at age 18 had a 2.25 times greater risk of developing MS, according to the study. Being overweight seemed to increase the risk slightly, but not to a level that was statistically significant, Munger noted.
A large body silhouette at age 20 increased the risk of MS by 96 percent, the researchers found. A large body size at age 5 or 10 was not associated with an increased risk of MS, provided that the woman had slimmed down by age 20.
Although this study wasn’t designed to find the reason behind the increase, Munger said low vitamin D levels have been suspected of playing a role in the development of MS, and that people who are obese may have lower circulating levels of vitamin D. Another possibility, suggested Munger, is that fat tissue secretes a lot of substances that can affect the immune system.
“We’re beginning now to get clues about things that might predispose a person to MS,” said Dr. John Richert, executive vice president of research and clinical programs at the National Multiple Sclerosis Society. “Up until recently, we’ve looked at MS as a disease for which the onset can’t be controlled, and though it’s still mostly that way, maybe there are circumstances where people might be able to lower their risk a little bit. If all the incoming data [from this and other studies] is correct, not smoking and maintaining an ideal weight might lower the risk of MS.”
But, of the current study, he added, “As with so many interesting observations, this study raises a lot more questions than it answers.”
Munger noted that the study was done solely in women, so the results may not hold true for men. And, additionally, she said, the study participants were almost all white, so it’s not clear if this association would hold up for other races.
Surgery is supposed to relieve pain from injury or disease, but new research finds that between 5 percent and 10 percent of patients don’t find pain relief after an operation, and they can experience chronic pain for many months afterward.
In a new study, researchers from Germany and Denmark tried to find out what makes some people more vulnerable to post-op pain than others. They studied 463 adult men who were about to undergo surgery to repair groin hernias and followed them after their operations.
After six months, 16 percent of patients who underwent open surgery and 8 percent of patients who had laparoscopic surgery reported pain that affected their daily activities, the researchers found.
“Through our analysis, we found that persistent pain could be predicted by pain impairment of daily activities before surgery, high pain response to heat stimulation, high pain intensity reports 30 days after surgery and signs of nerve injury,” study co-author Dr. Henrik Kehlet, of Copenhagen University, said in a news release from the American Society of Anesthesiologists.
Other factors — age, anxiety, depression, other pain problems and body mass index — weren’t linked to pain after the operations, the study authors noted.
“These findings prove that persistent pain following surgery is related to both surgical and patient-specific factors, suggesting that patients with high pain response before surgery should be operated laparoscopically — a procedure that is less likely to inflict nerve damage and resulting further pain development,” Kehlet said.
Kehlet is referring to laparoscopic procedures using glue fixation of mesh. The other procedure is called open Lichetenstein mesh repair — open sutured mesh repair — and men who underwent it had a higher rate of persistent pain.
The study findings were scheduled to be presented Monday at the annual meeting of the American Society of Anesthesiologists, in New Orleans.
Nerve stem cell transplants may help slow the progression of macular degeneration, the most common cause of blindness in the developed world, U.S. researchers said on Monday.
They said putting nerve stem cells from StemCells Inc near the retinas of rats with a form of macular degeneration helped keep the disease from advancing to blindness for several months.
“These cells improve the chemical environment in the back of the eye,” said Ray Lund of the Casey Eye Institute at Oregon Health & Science University in Portland, whose findings were presented at the Society for Neuroscience meeting in Chicago.
Lund said the mechanism is not clear, but he suspects that when immature nerve cells are placed near the retina, they produce growth factors that protect the cells from damage by the disease.
“It’s basically a chemical pump that is sitting in the right place and producing the right things,” Lund said in a telephone interview.
Where normally animals with eye disease lost their vision by three months old, rats that got the transplants kept their vision for at least seven months, he said.
“There is no evidence that they (the transplanted cells) do any damage,” Lund said, adding that the animals do not develop tumors, a key worry for stem cell transplants.
The findings raise hope for use of the treatment in humans with a range of diseases in which the retina become damaged, including age-related macular degeneration or AMD, which affects nearly 30 million people worldwide, including 15 million Americans.
People with AMD lose central vision when delicate light-sensing cells of the macula, a region at the center of the retina, become damaged.
In the rats, the researchers transplanted immature nerve cells into the space near the retina. Lund said the same could be done in people with retinal disease.
Dr. Stephen Huhn, head of the Central Nervous System research program at StemCells Inc, said the cells are adult neural stem cells. He said they are multipotent, meaning they can morph into different types of nerve cells.
The company has already tested the treatment in a study of six patients with Batten’s disease, a fatal inherited disorder of the nervous system.
“Having a cell that has already entered clinical testing that has been well tolerated at very high doses in the brain gives us a lot of confidence about exploring the same type of strategy in the eye,” Huhn said.
Huhn said he thinks the cells may be especially well suited for use in the retina, brain and spinal cord, which are less likely to reject the cells than other parts of the body.
Ultimately, he said the hope is to develop a treatment for the dry form of macular degeneration, which affects around 90 percent of patients diagnosed with AMD. No treatments are available for this form of the disease.
Huhn said treating this form of the disease may prevent some people from developing wet AMD, in which tiny new blood vessels grow between the retina and the back of the eye.
This form of the disease can be treated with modern drugs like Lucentis, from Novartis and Roche’s Genentech, and Pfizer’s Macugen.
Old-fashioned, common-sense advice to just relax may actually work to help some women get pregnant, doctors reported on Monday.
For years women seeking to get pregnant have been advised by friends and family to stop stressing about it — an idea that not all obstetricians and gynecologists have embraced.
But research presented at a meeting of the American Society for Reproductive Medicine in Atlanta suggests there may be something to it.
Alice Domar, who runs a fertility center in Boston and also works at Harvard Medical School, found that women who took part in a stress management program while having a second round of assisted fertility treatment had a 160 percent greater pregnancy rate than women getting IVF alone.
“Reproductive health experts have long wondered about the impact that stress may have on fertility, thus impeding a woman’s ability to conceive,” Domar said in a statement.
“This study shows that stress management may improve pregnancy rates, minimizing the stress of fertility management itself, improving the success rates of IVF procedures, and ultimately, helping to alleviate the emotional burden for women who are facing challenges trying to conceive.”
She and colleagues randomly assigned 97 patients at the clinic to take part in a 10-session mind/body program while undergoing in-vitro fertilization treatments.
The program had no effect on how many women conceived during the first try, Domar told the meeting, with 43 percent of the women getting pregnant.
But for women who failed the first time and were having a second try, 52 percent who took part in the mind/body program became pregnant, compared to only 20 percent of those who did not.
“It’s clear based on this carefully designed study, that a holistic approach to infertility care leads to better outcomes for patients,” said Dr. R. Dale McClure, president of the American Society for Reproductive Medicine.
But a second study found that while complementary and alternative medical therapy was popular among couples getting infertility treatments, it did not make women any more likely to get pregnant.
A team at the University of California, San Francisco questioned 431 couples undergoing infertility therapy and found that 28 percent had tried some kind of alternative medicine, mostly acupuncture or herbs, but they were not any more likely to achieve pregnancy.
Surfing the Internet just might be a way to preserve your mental skills as you age.
Researchers found that older adults who started browsing the Web experienced improved brain function after only a few days.
“You can teach an old brain new technology tricks,” said Dr. Gary Small, a psychiatry professor at the Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles, and the author of iBrain. With people who had little Internet experience, “we found that after just a week of practice, there was a much greater extent of activity particularly in the areas of the brain that make decisions, the thinking brain — which makes sense because, when you’re searching online, you’re making a lot of decisions,” he said. “It’s interactive.”
Small is co-author of the research, which was scheduled to be presented Monday in Chicago at the Society for Neuroscience annual meeting.
“This makes intuitive sense, that getting on the Internet and exploring and getting new information and learning would help,” said Paul Sanberg, director of the University of South Florida Center of Excellence for Aging and Brain Repair in Tampa. “It supports the value of exploring the Internet for the elderly.”
Most experts now advocate a “use-it-or-lose-it” approach to mental functioning.
“We found a number of years ago that people who engaged in cognitive activities had better functioning and perspective than those who did not,” said Dr. Richard Lipton, a professor of neurology and epidemiology at Albert Einstein College of Medicine in New York City and director of the Einstein Aging Study. “Our study is often referenced as the crossword-puzzle study — that doing puzzles, writing for pleasure, playing chess and engaging in a broader array of cognitive activities seem to protect against age-related decline in cognitive function and also dementia.”
The new study takes the use-it-or-lose-it concept into the 21st century.
For the research, 24 neurologically normal adults, aged 55 to 78, were asked to surf the Internet while hooked up to an MRI machine. Before the study began, half the participants had used the Internet daily, and the other half had little experience with it.
After an initial MRI scan, the participants were instructed to do Internet searches for an hour on each of seven days in the next two weeks. They then returned to the clinic for more brain scans.
“At baseline, those with prior Internet experience showed a much greater extent of brain activation,” Small said.
After at-home practice, however, those who had just been introduced to the Internet were catching up to those who were old hands, the study found.
“This is a demonstration that, over a relatively short period of time, patterns of brain activation while engaging in cognitive activities change,” Lipton said. “That is at least a first step toward gaining insight into the mechanisms that might allow cognitive engagement to influence brain function.”
But, Small said, beware how you use the Internet.
The timing and type of hormone replacement therapy women take to relieve menopausal symptoms seem to determine the degree of breast cancer risk they face, a new French study suggests.
Overall, starting estrogen-progestagen therapy soon after menopause appears to boost the risk of breast cancer, even when only used for short periods of time, according to the study, which was published in the Sept. 14 online issue of the Journal of Clinical Oncology.
Women who began the therapy in the three years after menopause and took it for two years or less had a 54 percent higher risk of breast cancer compared to those who never used the therapy, said study co-author Francoise Clavel-Chapelon, a researcher at the Institut Gustave Roussy in Villejuif, France.
However, they found an exception.
“This 54 percent increase in risk is an average, but does not seem to apply to estrogen-progesterone menopausal hormone therapy, for which no increased risk was observed when used two years or less, even close to menopause,” she said. But she noted the risk may still be present, and it was simply not found in the study due to such factors as lack of statistical power.
Many types of progestagens were taken by the women in the study; the finding that progesterone may be safer needs to be confirmed, she stressed.
The new study adds to a growing body of research that is sorting out the risks and benefits of hormone replacement therapy. Until the end of the 1990s, the therapy was viewed as largely beneficial, the authors noted. But with the release of the Women’s Health Initiative trial in 2002, research began to show the therapy boosted the risk for blood clots and breast cancer, and did not protect against heart disease, as originally believed.
Later on, some researchers hypothesized that the timing of therapy might affect patients’ heart disease risk. The French researchers decided to see if timing might affect breast cancer risk.
They turned to a large French study in which 1,726 invasive breast cancers were diagnosed among 53,310 postmenopausal women from 1992 through 2005.
They took into account hormone use, types of hormones, when the therapy was started and how long it was taken, along with comparing users and non-users.
In addition to finding a 54 percent increased risk for those who took hormone therapy for two years or less within three years of the start of menopause, they also found that short-term treatment of two years or less that was started more than three years after the beginning of menopause didn’t increase breast cancer risk. However, longer duration of use elevated risk, no matter when the therapy was begun.
The new study should serve as a warning, said Leslie Bernstein, director of the division of cancer etiology at the City of Hope National Medical Center in Duarte, Calif., who wrote an accompanying editorial.
“The missing piece is, ‘How safe is it to take right after menopause in terms of breast cancer risk?’” Bernstein said.
The French study provides some answers, but more research is needed, she said. The regimens typically taken in France are different than those taken by most U.S. women, Bernstein noted. And French women often use skin patches, not oral pills.
Any woman who is taking hormone replacement therapy should check with her doctor to see what hormone formulation is involved if she wants to more accurately assess her breast cancer risk.
While noting that the 54 percent elevated risk found by the French researchers is “worrisome,” Bernstein pointed to another study finding — that once a woman stops hormone therapy, her risk over time declines to that of the general population.
“I see this paper as a warning,” Bernstein said. “You want to take a conservative approach.”
People whose jobs bring them in regular contact with pesticides may be at increased risk for Parkinson’s disease, a U.S. study finds.
Researchers asked 519 Parkinson’s patients and 511 people without the disease about their work history and exposure to toxins, including pesticides and solvents. Working in agriculture, education, health care or welding wasn’t associated with Parkinson’s disease, nor was any other specific occupation after the researchers adjusted for other factors.
But the study found that 44 (8.5 percent) of Parkinson’s patients reported pesticide exposure, compared with 27 (5.3 percent) of those without the disease. The finding suggests an association between work-related pesticide exposure and increased risk of Parkinson’s.
“Growing evidence suggests a causal association between pesticide use and parkinsonism. However, the term ‘pesticide’ is broad and includes chemicals with varied mechanisms,” wrote Dr. Caroline M. Tanner of the Parkinson’s Institute in Sunnyvale, Calif., and colleagues. “Because few investigations have identified specific pesticides, we studied eight pesticides with high neurotoxic plausibility based on laboratory findings. Use of these pesticides was associated with higher risk of parkinsonism, more than double that in those not exposed.”
Three compounds — an organic (2,4-dichlorophenoxyacetic acid), an herbicide (paraquat), and an insecticide (permethrin) — were associated with a more than threefold increased risk of Parkinson’s, the study found. Laboratory tests have shown that all three compounds have effects on dopaminergic neurons, which are affected by Parkinson’s disease.
“This convergence of epidemiologic and laboratory data from experimental models of Parkinson’s disease lends credence to a causative role of certain pesticides in the neurodegenerative process,” Tanner and colleagues concluded. “Other pesticide exposures, such as hobby gardening, residential exposure, wearing treated garments or dietary intake, were not assessed. Because these exposures may affect more subjects, future attention is warranted.”
Older men diagnosed with prostate cancer who choose watchful waiting are doing better these days than in the era before screening with a test for prostate-specific antigen (PSA) became common, a new study finds.
“The most important message is that the long-term outcome for patients who don’t have surgery or radiation is pretty good,” said study author Dr. Grace L. Lu-Yao, an associate professor of medicine at the University of Medicine and Dentistry of New Jersey. Her report appears in the Sept. 16 issue of the Journal of the American Medical Association.
That message applies only to men over 65 when prostate cancer is diagnosed. Lu-Yao and her colleagues analyzed data on 14,516 such men whose diagnoses were made between 1992 and 2002, at an average age of 78, and who did not have surgery or radiation in the next six months. The researchers followed them for an average of 8.3 years.
The study separated men by their Gleason score, which measures the degree to which the prostate gland has lost its orderly structure. Greater disorder indicates greater danger from the cancer.
The 10-year death rate from prostate cancer was 8.3 percent for men with the least disordered tumors. Their death rate from all other causes was 59.8 percent. For men with moderately disordered tumors, the 10-year prostate cancer-specific death rate was 9.1 percent, compared to a 57.2 percent death rate from all other causes. The prostate cancer death rate for men with the most disordered tumors was 25.6 percent, compared to 56.5 percent for all other causes.
The cancer survival numbers are much better than for the pre-PSA screening era, possibly because “patients now are diagnosed at a much earlier stage compared to patients 10 and 20 years ago,” Lu-Yao said. Earlier detection translates to apparent longer survival simply because the cancer has a longer time to grow.
But the information in the study shouldn’t be applied to younger men, Lu-Yao stressed. The best available data indicate better survival with treatment for men under 65, she said.
So, the study might send the wrong message about PSA testing to those men, said Dr. Richard Greenberg, chief of urologic surgery at the Fox Chase Cancer Center in Philadelphia.
“My concern is that 50-year-old men with family histories of prostate cancer will be listening to these statements that there is too much screening, so they won’t have screening because they think it isn’t necessary,” Greenberg said.
He is skeptical about watchful waiting, except in carefully selected cases. “I don’t think anyone under 60 is a great candidate for watchful waiting unless they have another condition that is going to do them in within 10 years,” Greenberg said.
Every man diagnosed with prostate cancer should understand that watchful waiting is one possible option, he said. “But you have to individualize the decision for every patient,” Greenberg said. “If they have an aggressive cancer, they should be treated aggressively. You need to be very selective when you say when a conservative approach is appropriate.”
Treatment or watchful waiting for cancer in men 70 and older “is an important question, but probably not the most important question,” said Dr. Martin Sanda, director of the prostate cancer center at Beth Israel Deaconess Hospital in Boston.
Sanda recently reported a study of younger men whose average age when they were diagnosed with prostate cancer was about 60. That study indicated that “lower-risk tumors probably can be managed with watchful waiting in men anywhere from the 40s to the 70s,” Sanda said, but the key issue is the nature of the tumor.
“For patients with poorly differentiated tumors, there is a fair amount of cancer deaths unless they are treated aggressively,” he said.
More definitive information about watchful waiting versus treatment of prostate cancers is expected from a study recently started in Canada and now being done in medical centers there and in the United States, Greenberg said. But results of that study are not expected for at least 10 years, he noted, and meanwhile men and their doctors need to make treatment decisions based on each man’s characteristics.
“We need to individualize these decisions, even in the elderly,” Sanda said.