Stressed

Stress accounts for 80 % of all migraines, according to a study in the journal Cephalalgia. That's because it causes fluctuations in cortisol and adrenaline - the fight-or-flight hormones - which can lead to pain and nausea, says Sheena K. Aurora, MD, medical director of the Headache Center at Swedish Medical Center in Seattle. Stress can also make you clench your jaw and neck muscles, causing neck pain that, in turn, can set off tension headaches.

Trigger Tamer: Meditation, deep breathing, yoga, and massage can help. Or consider a mind-body technique called biofeedback - get more information from the Association for Psychophysiology and Biofeedback.

By Winnie Yu Scherer

Prescription Lawsuits in Abroad - Do They Really Affect You?

If an unsafe drug lawsuit is taken out in a country you don’t live in, does it affect you? Yes, if the drug in question is also prescribed or available in your country. Such a lawsuit can also have a knock on effect where it raises the issue of a certain drug or type of drug: so ultimately it depends on the precise kind of lawsuit that is being brought.

If a person successfully sues a company as a result of taking one of its prescription drugs or over the counter drugs, and either that drug or that type of drug is pending for approval in your country of residence – then you probably aren’t going to see it in a hurry. So if you were waiting for it to be approved so you could start taking it, the unsafe drugs lawsuit we give example of here is clearly going to affect you.

That said, of course, if the drug you wanted is proven to be dangerous then it will affect you in a good way – by protecting you from that potential danger.

If the drug is causing secondary side effects – i.e. side effects that occur as a result of the effect of the drug, rather than a result of the actual physical components of the drug – then a foreign lawsuit may also affect you, because it will raise awareness of a type of drug as being more dangerous than was previously supposed. You also find drugs with unknown long term side effects come into this area – Thalidomide being a major example. Without the unsafe drug lawsuit brought by thousands of Britons against the manufacturers of Thalidomide, the extraordinarily dangerous long term effects of its use would still be un-ratified.

That’s an important point, actually. Ratification is a big part of the efficacy of unsafe drug claims: once one is successful, the public suspicion of that drug or kind of drug is confirmed. Ultimately the unsafe drug trial, from this point of view, becomes a way for the public to protect itself against less scrupulous drug manufacturers as well as against the unlooked for side effects of particular drugs.

In other words: all dangerous drug claims, made anywhere in the world, have a bearing on your life. From this wider viewpoint, we all need unsafe drug lawsuits simply so that we can maintain a world in which it is possible to bring an unsafe drug lawsuit into being. Because without them we would have no sure fire way of taking the drug companies to account when something goes wrong, or is suspected of going wrong.

Drug companies are often driven by profit – we all know that. And in a world where the companies that make the pills and potions we rely on to stay healthy (and in some cases even to save our lives when things go wrong) are as motivated by money as they are by the urge to cure and palliate, then it’s up to us to fight for our rights as consumers. The best way to do that? By keeping the drug manufacturers afraid of losing big money if an unsafe drugs lawsuit is brought against them.

Taking too much paracetamol

Victims of 'staggered' overdoses often fail to realise the amount they are taking could be fatal over a few days, they say.

Experts have also pointed out, however, that many of us will be taking paracetamol or combination remedies containing the drug this winter to combat colds and flu, and that it is a safe and effective painkiller when the correct amount is taken.

A study shows the risk of dying from liver failure is higher from accidental overdose than deliberate suicide attempts.

This is because people report feeling unwell to GPs or accident and emergency departments without knowing the cause, making it difficult to diagnose and treat in time.

It is too easy to 'top up' the dose without realising the dangers, they warn.

Eight 500mg tablets a day – the equivalent of 4g – should be the maximum daily dose.

In the study, a team led by Dr Kenneth Simpson analysed data from 663 patients who had been admitted to the Edinburgh Royal Infirmary between 1992 and 2008 with liver damage caused by paracetamol.

Tragedy: Donna Bishop overdosed on paracetamol

Donna Bishop overdose in paracetamol

They found 161 people with an average age of 40 had taken a staggered overdose, usually to relieve stomach and back pain, headache or toothache.

Two out of five died from liver failure – a higher fatality rate than recorded for deliberate overdosing, says a report in the British Journal of Clinical Pharmacology.

Dr Simpson, of Edinburgh University and the Scottish Liver Transplantation Unit, said staggered overdoses can occur when people have pain and repeatedly take a little more paracetamol than they should.

He said: 'They haven't taken the sort of one-off massive overdoses taken by people who try to commit suicide, but over time the damage builds up and the effect can be fatal.

'They are often taking paracetamol for pain and they don't keep track of how much they've consumed over a few days.

'But on admission, these staggered overdose patients were more likely to have liver and brain problems, require kidney dialysis or help with breathing and were at greater risk of dying than people who had taken single overdoses.'

Hospital doctors may find low levels of paracetamol in the blood of people suffering from staggered overdoses even though they are at high risk of liver failure and death. Dr Simpson said some people reacted worse to a lower dose than others, with high alc0hol consumption exacerbating the problem – and it was not possible to identify them in advance.

He said 10g was the lowest amount in the study leading to death while 24g over 24 hours was a recognised fatal dose.

'The safest thing to do is monitor how much you're taking and do not exceed eight 500mg tablets in a day,' he said.

Normal quantities of the drug are broken down harmlessly by the body but excessive amounts can accumulate in the liver, leading to irreversible damage.

By JENNY HOPE

“energy” drinks skyrockets ER Visits for Energy-Drink Ills Soar in U.S.

As the popularity of non-alcoholic "energy" drinks skyrockets, so do related health problems, a new study finds.

In 2009, U.S. emergency rooms treated almost 10 times more cases of reactions to beverages such as Monster and Rockstar than they did in 2005, according to a new U.S. government report released Tuesday.

More than 13,000 ER visits related to the highly caffeinated drinks were reported in 2009, said researchers from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). Nearly half the emergencies occurred after the beverages were mixed with alcohol or other drugs, and young adults aged 18 to 25 accounted for more than half of those cases, the researchers found.

"A lot of attention has been paid to energy drinks that have alcohol in them and everybody understands that the effect of that can be pretty serious, but energy drinks by themselves can have adverse effects," said lead author Albert Woodward, project director of SAMHSA's Drug Abuse Warning Network.

Sales of these flavored drinks soared 240 percent from 2004 to 2009, Woodward said. Popular brands include Red Bull, Full Throttle (produced by Coca-Cola) and AMP, in addition to Monster and Rockstar.

The drinks contain stimulants such as caffeine, and the amount of caffeine in a can or bottle varies by brand. Whereas a five-ounce cup of coffee contains about 100 milligrams (mg) of caffeine and a 12-ounce cola about 50 mg, some energy drinks contain about 80 mg, others as much as 500 mg, according to the report.

"That's a huge dose of caffeine," said Dr. Jeffrey N. Bernstein, medical director of the Florida Poison Information Center at the University of Miami Miller School of Medicine.

High doses of caffeine can cause abnormal heart rhythms, high blood pressure, dehydration and other serious conditions.

"Many of the patients who come in have anxiety and their heart is pounding and they are just feeling sick," Bernstein said.

The drinks, sold in cans and bottles in grocery stores, vending machines, bars and other places, are marketed to young people. Up to 50 percent of children, teens and young adults use them, the researchers said in the report.

For the study, the investigators reviewed data from the Drug Abuse Warning Network, which monitors drug-related hospital emergency department visits reported throughout the United States. In 2005, more than 1,100 people sought emergency treatment for adverse reactions to energy drinks. By 2009, ERs treated over 13,000 energy drink patients. More than 16,000 such visits occurred in 2008, the most ever, the researchers found.

Alcohol, pharmaceuticals or illicit drugs were associated with 44 percent of the emergencies, and 52 percent of those visits involved patients 18 to 25 years old.

Overall, young adults between 18 and 39 years old made up more than three-quarters of all the ER visits, and 64 percent were men, the data showed.

Men were twice as likely as women to use alcohol and drugs along with an energy drink. But, more women than men combined energy drinks with pharmaceuticals, the researchers reported.

People who combine these energy drinks with substances of abuse have a raised risk of serious and potentially life-threatening injury, the study authors noted in a SAMHSA news release. In addition, there is a greater likelihood that they will engage in risky behaviors, including driving under the influence.

A group representing beverage makers took issue with the report, however.

"This paper is a troubling example of statistics taken out of context," said a statement released Tuesday by the American Beverage Association (ABA). "Of the more than 123 million visits made to emergency room facilities each year, less than one-hundredth of one percent involved people who consumed energy drinks according to this report."

The ABA goes on to note that, "energy drinks and their ingredients are safe and approved by the U.S. Food and Drug Administration," adding that the report "does not show that energy drinks cause misuse of alcohol."

Nevertheless, some people are especially susceptible to caffeine, Bernstein believes. "If you are susceptible to high blood pressure, it can also be a risk," he said. "If you overdo it, a night in the ER is no day at the beach," he noted.

By: Steven Reinberg

Screening has failed, the check it yourself breast cancer survival guide

There is growing disquiet in the medical community. The NHS breast-cancer screening programme, which invites all women to have three-yearly X-rays (mammograms) from the age of 50, has been said by some doctors to 'do more harm than good'.

This, coupled with the fact that one woman in eight now develops the disease 5,000 more diagnoses a year than a decade before and reports that many cases are dismissed by GPs who don't recognise symptoms, makes for confusing reading.

What all experts agree on is that early diagnosis is key to successful treatment. 'When a breast cancer is picked up through a routine screening mammogram, it's often cured,' says Lester Barr, a consultant breast cancer surgeon at the Christie Hospital in Manchester.

'When the disease is picked up through discovering a lump, the chances of a cure drop as the cancer is likely to be more advanced.'

Mr Barr admits that screening, which was introduced in 1988, could be improved but women should not be put off having mammograms. 'There is an argument that screening catches tiny tumours that would never have grown, meaning women go through unnecessary worry and treatment. And perhaps we need to better target women who are at risk.

'All women need to make sure they are doing enough themselves to ensure early detection. There are still women who know surprisingly little about how a breast should feel and look.' Here, Britain's leading experts give their essential guide that every woman should read.

LOOK FOR FAMILY PATTERNS
Breast cancer is hereditary in ten per cent of cases so it is vital for a woman to know her family history, says Professor Gareth Evans, consultant in genetic medicine at St Mary's Hospital in Manchester. 'Look for any patterns on one side of the family such as a mother, grandmother, aunt and first cousin who have been diagnosed with breast cancer. If there are at least two first-degree relatives – ie a mother and sister – who have had the disease, the risk is greater,' explains Prof Evans. The younger a woman is diagnosed the more likely it will be that her breast cancer has been caused by an inherited defective gene.

IF THERE IS HISTORY, GET A GENE TEST
The rogue genes, known as BRCA 1, BRCA 2 and P53, can be identified through a blood test. But this can be done only if a woman has a living relative who has had breast cancer and can provide a blood sample. Those who carry the genes have an 85 per cent risk of getting breast cancer. The options for women with a strong family history or who have been identified as carrying the faulty breast-cancer gene include yearly MRI scans and mammograms on the NHS. 'Together these can pick up 90 to 95 per cent of breast cancers early,' explains Prof Evans. 'But some women opt for a pre-emptive strike by having their breasts removed.'

Prof Evans is leading a study into the use of the drug tamoxifen, which may reduce the risk of breast cancer by 40 per cent. 'Do'’t take the contraceptive pill if you have a strong family history as the drug has been linked to an increase in risk,' says Dr Anne Trigg, a consultant medical oncologist at Guy's and St Thomas' Hospital, London.

ALL WOMEN MUST BE BREAST AWARE
Mammograms are not effective for women under the age of 50 as the breast tissue is still too dense. If there have been isolated incidents of breast cancer in the family, you can always consult your GP for an examination. 'Aside from lumps, they are looking for areas of the breast that feel subtly different from the rest  limpness, a harder area or a breast that feels more granular,' explains Mr Richard Sainsbury, consultant breast cancer surgeon.

Unexplained tiredness can be early symptoms of the disease. 'It's not necessary to do constant self-examinations,' says Mr Sainsbury. 'But be aware of any changes – particularly heaviness, distortions, or a change in size or shape.'

A RED RASH IS A RED ALERT
'Inflammatory breast cancer, which accounts for between one and five per cent of breast- cancer cases, can make the skin red and swollen, but it is often misdiagnosed as cellulite or a skin infection,' Dr Trigg says. 'Look out for a new and itchy rash around the nipple, discharge from the nipple or any difference in shape and size. It could be normal but always get it checked by your GP. And always check armpits for lumps.'

CHECK MONTHLY AFTER YOU HIT 30
Dr Trigg says: 'From the age of 30, self-examination should be done once a month, midway through the menstrual cycle.'

Using the pads of the fingers, feel in small circular motions round the breast and then move in smaller concentric circles until you reach the nipples.
Cover the entire breast from top to bottom, side to side.
Do this lying down, and then feel your breasts while you are standing or sitting.

'In the ten years leading up to the menopause, breast tissue begins to turn to fat and this can cause benign cysts,' adds Mr Sainsbury. 'Cancer can be ruled out by mammogram or biopsy. See your GP, who will refer you to a specialist.' Be familiar with the appearance of your breasts, checking that they are their usual shape, size and colour and appear symmetrical.

THE QUESTION: TO HRT OR NOT TO HRT?
At present women of 50 are called for a three-yearly mammogram through the NHS screening programme. But Prof Evans says: 'A third of breast cancers are picked up in the three years between mammograms.'

Self-examination is vital after the age of 50 when breasts may look different. A loss of volume can cause dimpling in the skin and as this can also be a sign of breast cancer, get it checked.
Prof Evans tells menopausal women with a family history to avoid hormone-replacement therapy as artificially raising hormone levels can increase risk of breast cancer. The hormone oestrogen, which can drive some forms of breast cancer, is produced by fatty tissue. So the fatter you are, the bigger the risk.

AFTER SCREENING STOPS . . .
Screening stops at the age of 70. If women wish to continue, then they can request it, explains Barr. He says: 'By the age of 80 any lump is likely to be breast cancer. Women should be aware of any changes.'

By ANGELA EPSTEIN

Can You Get Hooked on Diet Soda?

Lead writer: Denise Mann

First thing every morning, Ellen Talles starts her day by draining a supersize Styrofoam cup filled with Diet Coke and crushed ice. The 61-year-old from Boca Raton, Fla., drinks another Diet Coke in the car on the way to work and keeps a glass nearby "at all times" at her job as a salesclerk. By the end of the day she has put away about 2 liters.

"I just love it," she says. "I crave it, need it. My food tastes better with it."

Talles sounds a lot like an addict. Replace her ever-present glass of Diet Coke with a cigarette, and she'd make a convincing two-pack-a-day smoker. In fact, she says, she buys her 2-liter bottles 10 at a time-more if a hurricane is in the offing-because if she notices she's down to her last one, she panics "like somebody who doesn't have their pack of cigarettes."

Most diet-soda drinkers aren't as gung ho as Talles, but people who down several diet sodas per day are hardly rare. Government surveys have found that people who drink diet beverages average more than 26 ounces per day (some drink far more) and that 3% of diet-soda drinkers have at least four daily.

Are these diet-soda fiends true addicts? And if so, what are they addicted to? The most obvious answer is caffeine-but that doesn't explain the many die-hard diet drinkers who prefer caffeine-free varieties.

Factors besides caffeine are likely at work. Although diet soda clearly isn't as addictive as a drug like nicotine, experts say the rituals that surround diet soda and the artificial sweeteners it contains can make some people psychologically-and even physically-dependent on it in ways that mimic more serious addictions. And unlike sugared soda, which will make you gain weight if you drink too much of it, zero-calorie soda doesn't seem to have an immediate downside that prevents people from overindulging.

"You think, 'Oh, I can drink another one because I'm not getting more calories,'" says Harold C. Urschel, MD, an addiction psychiatrist in Dallas and the author of Healing the Addicted Brain. "Psychologically you're giving yourself permission."

How diet soda trains your brain
The simplest explanation for a serious diet-soda habit is caffeine. Many people who chain-drink diet soda may be caffeine addicts who simply prefer soda to coffee or energy drinks, though diet soda doesn't provide much of a kick by comparison. (A can of Diet Coke contains four to five times less caffeine than a small Starbucks coffee.)

Caffeine can't account for Steve Bagi's habit, however. The 44-year-old graphic designer from Chester Springs, Pa., gets his morning buzz from an enormous cup of coffee, yet he still buys caffeine-free Diet Pepsi by the case and downs six cans a day, "easy."

His Diet Pepsi cravings stem from a prior addiction to nicotine, not caffeine. "It's all tied to smoking," says Bagi, who smoked a pack a day for 20 years and started drinking diet soda to mask the aftertaste of cigarettes. He eventually kicked the smoking habit-but the Diet Pepsi one stuck.