PSORIATIC ARTHRITIS NEWSLETTER NO. 111

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PSORIATIC ARTHRITIS NEWS AND VIEWS

VOLUME- 6 ISSUE- 12

October 31, 2006

PSORIATIC ARTHRITIS MEDICAL NEWS

ANKYLOSING SPONDYLITIS: HUMIRA APPROVED FOR REDUCING SIGNS AND SYMPTOMS

XagenaMedicine2006

The FDA (Food and Drug Administration ) has approved Humira ( Adalimumab )

for reducing signs and symptoms in patients with active ankylosing spondylitis.

Ankylosing spondylitis is an autoimmune disease affecting the spine and

large peripheral joints that causes inflammatory back pain and stiffness and

also

can be associated with other inflammatory diseases of the skin, eyes and

intestines. In its severe form, ankylosing spondylitis over time can result in

complete spinal fusion, causing extreme physical limitation and reduction in

health- related quality of life.

Ankylosing spondylitis is the third of six autoimmune diseases targeted for

Adalimumab therapy that has received FDA approval. Humira also is approved by

the FDA to treat rheumatoid arthritis and psoriatic arthritis.

Ankylosing spondylitis affects young adults and commonly develops during the

second and third decades of life. Because the pain and stiffness of

ankylosing spondylitis are hard to distinguish from other common causes of back

pain,

patients may go undiagnosed for many years from the onset of their symptoms.

Ankylosing spondylitis is one of the most overlooked causes of persistent

back pain in young adults.

The recommended dose of Humira for ankylosing spondylitis is 40 mg every

other week, by subcutaneous injection.

The approval of Humira for the treatment of patients with active ankylosing

spondylitis is based on data from the ATLAS ( Adalimumab Trial Evaluating

Long-Term Efficacy and Safety in AS ) trial.

ATLAS was a randomized, placebo-controlled, double-blind, Phase III study

conducted in Europe and the United States. Results showed that Adalimumab was

successful in reducing pain and inflammation in patients with ankylosing

spondylitis after 12 weeks of treatment, the study's primary endpoint. Other

findings demonstrated significant improvement in measures of disease activity

for

many patients treated with Adalimumab that were first observed at week two

and maintained through 24 weeks.

ATLAS also explored the impact of Adalimumab on enthesitis, a condition in

ankylosing spondylitis characterized by inflammation of the ligaments that

attach to the bone. At week 24, the mean change in the enthesitis symptom score

as measured by Maastricht Ankylosing Spondylitis Enthesitis Score ( MASES ) in

patients treated with Adalimumab showed significant reduction. MASES is an

index that assesses enthesitis in certain locations, such as the rib cage,

lower back, and Achilles tendons.

In the ATLAS trial, a similar rate of treatment-emergent adverse events

leading to discontinuation of study drug was observed among placebo-treated (

1.9

percent ) and Adalimumab-treated ( 1.4 percent ) patients.

The overall incidence of adverse events reported by patients treated with

Adalimumab was higher than the placebo-treated patients. The most common

adverse events included nasopharyngitis, injection site reactions and headache.

Source: Abbott Laboratories, 2006

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PSORIASIS CURE NOW CELEBRATES HEALTH CARE ADVOCATE OF THE YEAR WINNERS

KENSINGTON, Md., U.S. Newswire

" Psoriasis Cure Now, " a nonprofit patient advocacy group, today announced

its 2006 " Health Care Advocates of the Year. " The recipients are Congressman Jim

Gerlach of Pennsylvania, and Tom and Joy Murdough of the Murdough Foundation

of Hudson, Ohio.

These three leaders took action to ensure that funding for psoriasis

research is increased. Rep. Gerlach worked in bipartisan fashion on efforts

urging

the National Institutes of Health (NIH) to focus more attention on this

painful and often debilitating disease. Psoriasis research funding at NIH has

lagged behind other research areas. Even as NIH funding doubled over the last

decade, psoriasis research funding fell 22%, receiving just $6.5 million last

year out of a federal medical research budget approaching $30 billion. The

Murdough family, through their foundation, single-handedly nearly doubled this

year's national commitment to psoriasis research with a $5 million gift for

psoriasis research to University Hospitals of Cleveland, Ohio, the largest known

dermatology gift to a U.S. academic medical center.

" Helping people with psoriasis will not land you on the nightly news, nor

enable you to hobnob with the Hollywood elite- in fact, no entertainment star

will even admit having the disease, " said Paranzino, president of

Psoriasis Cure Now. " This makes it all the more wonderful that these community

leaders have put themselves on the line to help the as many as 7.5 million

Americans with psoriasis. Their hard work and sacrifice will advance our

understanding of the disease and speed the day when we will finally have a cure

for

psoriasis and psoriatic arthritis. "

Psoriasis is an incurable, recurring disease of the immune system that can

first strike at any age, causing dry, painful skin lesions that can crack,

bleed and itch. Many people with psoriasis also have psoriatic arthritis, a

chronic, progressive inflammatory disease that causes joint pain, stiffness and

swelling, and can damage bones. Recent studies have found a higher risk of

heart attack and higher incidence of cardiovascular death among patients with

severe psoriasis. People with psoriasis also have higher rates of depression

and

suicidal ideation.

In honor of this year's winners, Psoriasis Cure Now is making a contribution

to Camp Horizon in Millville, Pennsylvania, part of the American Academy of

Dermatology's Camp Discovery program for children with chronic dermatologic

conditions. Last year's Health Care Advocate of the Year winners were Senator

Arlen Specter of Pennsylvania, and Representatives Ralph Regula of Ohio and

DeLauro of Connecticut. For more information on psoriasis, visit

http://www.psoriasis-cure-now.org

http://www.usnewswire.com/© 2006 U.S. Newswire

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FALLS SPELL HEALTH DANGER FOR ELDERLY

HealthDay News

A simple slip in the tub or on a loose mat can be a health disaster for

elderly Americans, experts say.

Each year, more than 1.6 million seniors are treated in U.S. hospital

emergency rooms for fall-related injuries caused by incidents such as slipping

on a

wet bathroom floor, loss of balance on stairs, or tripping on a throw rug,

according to the U.S. National Institute on Aging (NIA).

Among older adults in the United States, falls are the leading cause of

fractures, hospital admissions for trauma, loss of independence, and

injury-related deaths.

But falls are not an unavoidable part of aging, the NIA says. Information

about the risks of falling and how to prevent falls was recently added to the

NIHSeniorHealth Web site. There's advice about eliminating hazards at home,

exercising, and other lifestyle changes that can reduce the risk of falls.

The Web site is a joint effort of the NIA and the National Library of

Medicine. Both are part of the U.S. National Institutes of Health.

" Falls can have devastating effects in older people, " Dr. J. Hodes,

NIA director, said in a prepared statement.

In older people, even a simple fall can cause a serious fracture of the arm,

hand, ankle or hip. For example, only about half of older adults who are

hospitalized for a broken hip return home or are able to live on their own after

the injury.

Preidt - SOURCE: U.S. National Institute on Aging/U.S. National

Institutes of Health - Copyright © 2006 ScoutNews LLC. All rights reserved. ©

1996-2005 MedicineNet, Inc. All rights reserved. Copyright and Legal Disclaimer.

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PROTEINS HOLD CLUES TO CHRONIC PAIN

Patients with ongoing discomfort showed low blood levels of two cytokines,

study finds

HealthDay News -- Low blood levels of two anti-inflammatory proteins could

be key to chronic pain, researchers report.

Low concentrations of two cytokines, IL-4 and IL-10, were found in patients

with chronic widespread pain, according to a German study published in the

August issue of Arthritis & Rheumatism.

Cytokines are proteins that act as messengers between cells.

The study included 40 patients who'd received intravenous immunoglobulin

(IVIG) as a novel treatment for pain that hadn't responded to standard therapy

and another 15 patients who did not receive IVIG. The study also included a

control group of 40 healthy people.

Blood samples were collected from all the study volunteers, and the pain

patients were asked to rate their pain, fatigue, mood and cognitive function.

Compared with the control group, the 40 pain patients had significantly

lower levels of IL-4 and IL-10. The 15 patients in the second group had similar

results, although the difference in their levels of IL-10 compared to people in

the control group was not statistically significant.

Several factors may be involved in low levels of these cytokines and how

they influence pain, the study authors said. They noted that previous studies

have shown that IL-10 reduces sensitivity to pain and that IL-4 can also dull

pain response.

Genetic variations in different cytokine genes are associated with certain

diseases. For example, IL-4 gene variations are associated with asthma, Crohn's

disease and chronic polyarthritis, the researchers said.

" The low levels of IL-4 and IL-10 we observed in the patients with chronic

widespread pain might therefore also be caused by genetic alterations either in

the cytokine genes themselves or in regulatory elements, although other

factors may be involved, " they explained.

SOURCE: Wiley & Sons Inc., Copyright © 2006 ScoutNews LLC. All rights

reserved.

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GENES MAY HELP SOME PEOPLE BEAR PAIN

People who tolerate pain better may just be blessed with better genes.

HealthDay News

Scientists say levels of a molecule called BH4 -- required for the

production of major neurotransmitter chemicals -- influence the body's

sensitivity to

pain.

The team of international researchers, based at Massachusetts General

Hospital (MGH), Boston, say BH4 levels might also determine a person's

vulnerability to chronic pain.

Reporting in the November issue of Nature Medicine, they found that a

certain set of variations in a gene that's involved in producing BH4 appear to

reduce a person's pain sensitivity.

" This is the first evidence of a genetic contribution to the risk of

developing neuropathic pain in humans. The pain-protective gene sequence, which

is

carried by about 25 percent of the population, appears to be a marker both for

less pain sensitivity and a reduced risk for chronic pain, " study senior

author Dr. Clifford Woolf, director of the Neural Plasticity Research Group at

MGH, said in prepared statement.

" Identifying those at greater risk of developing chronic pain in response to

medical procedures, trauma or diseases could lead to new preventive

strategies and potential treatments, " Woolf said.

In research involving hundreds of volunteers, the scientists concluded that

people with a protective GCH1 haplotype -- a set of variations in the gene

that are inherited together -- were less sensitive to pain. This GCH1 haplotype

reduces production of BH4.

" Our results tell us that BH4 is a key pain-producing molecule -- when it

goes up, patients experience pain, and if it is not elevated, they will have

less pain, " Woolf said.

" The data also suggest that individuals who say they feel less pain are not

just stoics but genuinely have inherited a molecular machinery that reduces

their perception of pain. The difference results not from personality or

culture, but real differences in the biology of the sensory nervous system. "

Preidt - SOURCE: Massachusetts General Hospital, news release, Oct.

22, 2006 Copyright © 2006 ScoutNews LLC. All rights reserved.

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BECOME AN OPTIMIST AND LIVE LONGER

Genes and health behaviors contribute to the length and quality of your

life, but so do your attitude and beliefs about aging.

Wisdom of the Ages

A happy person is not a person in a certain set of circumstances, but rather

a person with a certain set of attitudes.

-- Hugh Downs, 85

I don't believe in pessimism. If something doesn't come up the way you want,

forge ahead. If you think it's going to rain, it will.

-- Clint Eastwood, 76

While we may not be able to control all that happens to us, we can control

what happens inside us.

-- lin, 84

Optimism is the faith that leads to achievement. Nothing can be done without

hope or confidence.

--Helen Keller, 88

I have become my own version of an optimist. If I can't make it through one

door, I'll go through another door--or I'll make a door. Something terrific

will come no matter how dark the present.

-- Joan Rivers, 73

A stumbling block to the pessimist is a stepping-stone to the optimist.

-- Eleanor Roosevelt, 78

A man is happy so long as he chooses to be happy.

-- Solzhenitsyn, 88

An optimist is someone who goes after Moby Dick in a rowboat and takes the

tartar sauce with him.

-- Zig Ziglar, 80

Americans are living longer than ever. Over the past century, the average

American lifespan has increased a whopping 27 years. What’s the secret to a

long

and healthy life?

Good genes help. You get them from your parents. And since you can't pick

your parents, this avenue to a longer life is out of your control. Besides, the

value of good genes is in question. New research from Yale University found

that genes contribute only 25% to the length of your life. This seems to mean

that other factors, such as health behaviors and mental health, play a role

in longevity, too.

The Yale study claims that a good attitude helps keep your heart pumping and

your feet tapping an additional 7.6 years on average. An optimistic outlook

adds more years to your life than low blood pressure (4 years or less), low

cholesterol (4 years or less), a healthy weight (1 to 3 years) and regular

exercise (1 to 3 years).

" These Are the Good Old Days "

The Yale study suggests that people who believe negative stereotypes about

growing old may face a reduced life expectancy. If you think old people are

frail and sickly, you'll probably see yourself as frail and sickly when you get

old.

Landry, a 79-year-old retired dentist from New England, didn't grow up

with these negative stereotypes. He watched his elders remain active and

involved as they aged. And he's followed their example. His long list of

activities includes working as a hospice volunteer and fundraiser and helping

the

Rotary Club support widows and widowers. " Some people sit down and won't do

anything, " he says. " I think you have to accept what you have and work with it. "

The Yale researchers would likely agree. They point to a series of studies

that looked at the relationship between death rates and holidays. There were

more deaths in the month after the holiday than in the month before it.

According to the study authors, these findings imply that people who have

something

to look forward to, such as a holiday or special event, want to stay alive

to mark the occasion. Helping others through volunteer work or simply staying

busy with social activities, hobbies, travel and grandkids may have the same

effect.

" We Shall Overcome "

You know what you're supposed to do to stay healthy and live long: eat well,

exercise regularly and stay away from smoking and excessive drinking. These

behaviors require dedication and self-discipline.

People who are optimistic are better able to stick to good behaviors because

they know that good habits are the result of smart choices they make. People

who don't have an optimistic outlook are likely to take a more passive

approach to health. They may believe that they have no control over their weight

or diet so they don’t make the effort to practice good health habits.

When faced with a health crisis, optimists adapt and recover more quickly

because they actively participate in their treatment and recovery. They believe

their actions directly contribute to improved health.

Finally, optimists do not feel the sense of hopelessness so typical of

pessimists. As a result, optimists experience less stress and less depression

overall.

" Put On a Happy Face "

To stay optimistic as you age or to create an optimistic point of view, take

these steps:

Realize that setbacks are a part of life

No one can escape hard times. When you find yourself in a stressful

situation, tell yourself that time passes. There can’t be valleys without

peaks. Look

for the next peak.

Visualize a positive outcome

The movie " Field of Dreams " taught us “If you build it, they will come.â€

The same can apply to your health. If you aim for the best outcome, your

actions will likely follow.

Reject negative messages about aging

Media and advertising would have us believe the world is filled only with

youth. Just because TV often depicts age as being equal to infirmity doesn't

mean you have to buy that message. Once you spot these falsehoods, you'll be a

lot less susceptible to them.

Find examples of people who have aged gracefully

Newman isn’t letting age slow him down. He’s still racing cars at age

80 and running a food company. Martha , at age 64, is busier and more

successful than ever, with an empire that includes magazines, TV and

products. Picture them the next time you think your age is a roadblock to an

accomplishment.

Develop a strong social network

Friends play a key role in helping you through any crisis, health or

otherwise. Your network can also include counselors, clergy and support groups.

Even

optimists need help sometimes. When Landry's first wife died of

cancer, he was devastated. " I decided to take whatever help I could get, " he

says.

" I joined two grief support groups and accepted counseling. I was in a hole

and that brought me out and made it possible for me to live again. "

If you dread the thought of growing old, work now to change your perceptions

and develop a more optimistic outlook. It may lead to a healthier, longer

life.

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SHINGLES VACCINE TO BE ROUTINE AT 60

Federal Advisory Panel Acts to Reduce Painful Disease and Complications

By DeNoon - WebMD Medical News and Reviewed By Louise Chang, MD

The CDC's vaccine advisory panel today voted to make shingles vaccination

routine for all Americans 60 and older.

Shingles is a painful disease caused by reactivation of dormant varicella

zoster virus, or VZV. Best known as the virus that causes chickenpox, VZV is a

herpes virus that can come back with a vengeance when a person's immunity

wanes with age, disease, or immunity-suppressing drugs.

Without vaccination, about 20% of people who have had chickenpox eventually

will get shingles. A person who lives to be 85 has a 50% chance of getting

shingles.

Shingles is a bad enough disease to be a good reason to get vaccinated.

But in about a third of cases, shingles turns into an excruciatingly painful

disease called postherpetic neuralgia, or PHN. A smaller percentage will get

a painful, blinding disease called ophthalmic zoster.

The new vaccine, Merck's Zostavax, won FDA approval last May.

Now the main U.S. vaccine advisory panel -- the Advisory Committee on

Immunization Practices (ACIP) -- officially recommends routine use of the

vaccine

for everyone 60 and older.

The committee voted not to make shingles vaccination routine for people

under 60, citing a lack of clinical data on vaccination in that age group.

Similarly, the panel said there was too little data for it to recommend that

doctors offer the vaccine for people about to undergo immunity-suppressing

treatments.

Good Vaccine, Terrible Disease

A major clinical trial shows the vaccine is more than 60% effective in

reducing shingles symptoms. Perhaps most importantly, it reduces painful PHN by

at

least two-thirds.

" Reducing PHN is the motivation for most of us working on this clinical

trial, " N. Oxman, MD, of the University of California, San Diego, said

in

a presentation to the ACIP. " For people with severe PHN, their lives are

blighted and the lives of their families are blighted. "

PHN pain can last for years. Sudden, lancing pain can quite literally bring

patients to their knees. Each year, there are more suicides due to PHN pain

than due to cancer pain.

And PHN isn't the only bad complication of shingles. Some 15% of shingles

patients get ophthalmic zoster -- shingles that affects one or both eyes.

In a public comment, Herbert Kauffman, MD, former chairman of ophthalmology

at Louisiana State University, offered the ACIP a graphic description: " This

is not going blind in peace and quiet, " Kauffman told the ACIP. " This is an

all-consuming pain patients live with every moment of every day for years. "

The ACIP recommendation means insurers will be more likely to pay for

shingles vaccination in 60-and-over patients.

Medicaid will not cover shingles vaccination under part B. However, major

Medicaid part D plans will provide coverage, Kelman, MD, chief medical

officer of the Centers for Medicare and Medicaid Service, told the ACIP.

SOURCE: Advisory Committee on Immunization Practices meeting, Oct. 25, 2006,

Atlanta.

© 2006 WebMD Inc. All rights reserved.

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ACUPUNCTURE, TURMERIC MAY EASE ARTHRITIS

By Alan Mozes - HealthDay Reporter (HealthDay News)

Acupuncture and an extract of turmeric -- the spice that gives curry its

kick -- may both offer significant pain relief to some arthritis patients, two

new studies suggest.

Reporting in the November issue of Arthritis & Rheumatism, a German team

says a combination of acupuncture and conventional medicine can boost quality

of

life for patients suffering from osteoarthritis.

And in a second study in the same issue, American researchers say the

ingestion of a special turmeric extract could help prevent or curb both acute

and

chronic rheumatoid arthritis.

The findings should be heartening to the roughly 40 percent of arthritis

patients in the United States who say they've turned to some form of alternative

medicine.

" If I had arthritis, I would be very excited about this, " said Dr. Janet L.

Funk, the lead author of the turmeric study and an assistant professor of

physiological sciences at the University of Arizona in Tucson.

According to the Arthritis Foundation, nearly one in five Americans (46

million) suffers from one of the more than 100 various joint diseases that

constitute arthritis. An additional 23 million have chronic joint pain that has

yet

to be formally diagnosed.

Osteoarthritis is caused by a progressive degeneration of bone cartilage and

is the most common type of arthritis in the United States. Rheumatoid

arthritis is an immunological disorder characterized by a painful inflammation

of

the lining of the joints.

In her study, Funk built on earlier research she had conducted with rats.

Those efforts suggested that turmeric might prevent joint inflammation.

In her current work, she first broke down the specific contents of commonly

sold turmeric dietary supplements.

In the lab, she and her colleagues then isolated a turmeric extract that was

free of essential oils and structurally similar to that found in commercial

varieties. The extract was based largely on curcuminoids -- a compound they

believed to be most protective against arthritic inflammation.

Funk's group administered the extract to female rats both before and after

the onset of rheumatoid arthritis. They then tracked changes in the rodents'

bone density and integrity.

The turmeric extract appeared to block inflammatory pathways associated with

rheumatoid arthritis in rats at a particularly early point in the

development of the disease. The extract had a beneficial impact if given three

days

after arthritis set in, but not if given eight days after disease onset.

Investigations in the laboratory revealed that turmeric stops a particular

protein from launching an inflammatory " chain reaction " linked to swelling and

pain. The expression of hundreds of genes normally involved in instigating

bone destruction and swelling was also altered by the turmeric.

Funk stressed, however, that the findings are preliminary, and the extract

needs to be tested in people.

" I feel an obligation to make clear that people should not run out to buy

and consume turmeric powder, " she cautioned. " First of all, a very small percent

of the ground-up root that we buy in the grocery store is the protective

part of the root, so it's not going to get you anywhere. " In fact, the compound

used in the study probably makes up only about 3 percent of the weight of

current store-bought turmeric supplements, Funk said.

" That means that if this pans out in further studies, patients will be

taking a purified extract, and this is all really exciting, " she said. " But we

still need conclusive proof that this extract is safe and efficacious. "

In the second study, researchers led by Dr. M. Witt of Charite

University Medical Center in Berlin spent three years tracking the treatment

results of 3,500 male and female osteoarthritis patients suffering from either

knee or hip pain.

For six months, all the participants were permitted to continue whatever

conventional western medical treatments they had been undergoing prior to the

onset of the treatment trials.

However, in addition, over 3,200 of the patients also received up to 15

sessions of needle-stimulation acupuncture during the first three months of the

study. The remaining 310 patients received no acupuncture in the first three

months. They were offered such treatment in the final three months of the study

period, however.

All acupuncture sessions were administered by physicians who had received a

minimum of 140 hours of certified training.

Symptom and pain questionnaires were completed at the onset of the study and

at three months and six months of therapy.

Patients with chronic osteoarthritis pain who underwent a combination of

routine medical care plus acupuncture demonstrated significant quality of life

improvements, the researchers found. This included increased mobility and pain

reduction above and beyond that experienced by patients who did not receive

acupuncture.

For those who began their acupuncture treatments immediately, osteoarthritis

improvement held steady three months after cessation of the sessions. For

those patients who had begun acupuncture three months into the study period,

comparable improvements occurred by the time they ended their sessions at the

six-month mark.

The authors said acupuncture appeared to be a safe medical intervention with

minor side effects observed in just over 5 percent of patients.

The study, one of the largest of its kind, demonstrated that acupuncture was

a viable therapeutic option for people suffering from osteoarthritis, the

German team said.

" I'm not surprised that people can be treated with acupuncture and get

better, " said Marshall H. Sager, a Bala Cynwyd, Pa.-based doctor of osteopathic

medicine, acupuncturist, and past president of the American Academy of Medical

Acupuncture.

" Using acupuncture adjunctively with western medicine is very common,

because if you can do both approaches, you're way ahead of the game, " he said.

" Some people are not amenable to medication, either because of allergenic

effects

or because they just don't want to consume artificial things. And so, this

is a way to start the healing process by engaging and stimulating the body's

own inherent ability to heal itself. "

However, Sager cautioned that American patients who consider this

alternative route should choose carefully when they seek out acupuncture care.

" 'Medical acupuncture' is acupuncture as practiced by a physician, which is

much different than acupuncture as practiced by non-physicians in the east,

such as in China, " he noted. " And I would most definitely recommend that

patients in the west deal with a physician that's properly trained and a member

of the American Academy of Medical Acupuncture, " Sager said.

SOURCES: Janet L. Funk, M.D., assistant professor, physiological sciences,

department of medicine, University of Arizona, Tucson; Marshall H. Sager, D.O.,

past president, American Academy of Medical Acupuncture, and acupuncturist,

Bala Cynwyd, Pa.; November 2006, Arthritis & Rheumatism Copyright © 2006

ScoutNews LLC. All rights reserved.

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INTERNET’S LURE ENSNARES 1 IN 8 AMERICANS: SURVEY

By Randy Dotinga - HealthDay Reporter (HealthDay News)

Research is shedding new light on the often-controversial topic of Internet

addiction, suggesting that online usage has significantly disrupted the lives

of millions of Americans.

About six percent of people surveyed by Stanford University researchers said

their personal relationships have suffered as a result of their Internet

use, and nine percent reported actively hiding their online habits at home or at

work.

The findings don't confirm that Internet addiction is an actual mental

disorder, but they " should start the conversation about the subset of the

population for whom the Internet is not so wonderful, " said study lead author

Dr.

Elias Aboujaoude, an assistant clinical professor in psychiatry and behavioral

sciences and director of Stanford University's Impulse Control Disorders

Clinic.

Mental-health specialists have worried about Internet addiction for about a

decade, although the condition hasn't become an accepted psychological

diagnosis. Some specialist lump it in with " impulse-control " disorders.

" Is Internet addiction a unique mental disorder, or is it just a symptom of

another, more 'traditional' type of disorder? Research has yet to determine

this, " said Suler, a professor of psychology at Rider University in

Lawrenceville, N.J., who began writing about the condition in 1996.

The new study tries to get a handle on how serious the problem is.

Researchers interviewed 2,513 American adults by phone in the spring and summer

of

2004 and asked about their Internet usage.

About 69 percent of the respondents were regular Internet users. Of all

respondents, four percent said they were preoccupied by the Internet while

offline, 14 percent said they had trouble staying offline for several days, and

12

percent stayed online more than they wanted to, either often or very often.

The findings were published in the October issue of CNS Spectrums: The

International Journal of Neuropsychiatric Medicine.

Aboujaoude said the numbers are important because there has been little in

the way of a " structured study " into troublesome Internet use. Much attention

has been " sensationalistic, " looking at online pornography or gambling, he

added.

The findings do reflect the experiences of psychiatrists, Aboujaoude said.

" We see patients coming in, saying things, like, 'My wife will divorce me

because I wait until she goes to sleep and I go online.' Or 'I've been fired or

disciplined because of my Internet activity at work.' They're starting to

present with problems directly related to their Internet habits. "

The new research should inspire further studies to see how the numbers

" correlate with real-life distress and disability, " he said.

But, even then, it may be difficult for Internet addiction to get officially

recognized by the mental-health establishment.

" The researchers conclude that impulse-control problems are related to

excessive Internet use, but the study does not prove that such use is a type of

impulse-control disorder or a unique disorder, " said Suler, who's familiar with

the study findings. " Demonstrating the validity of a brand new diagnostic

disorder involves a great deal of research, and even then the final decision

about a new disorder can be political, " he added.

If Internet addiction is a real disorder, what can be done for the

sufferers?

" You start by carefully diagnosing them, making sure there aren't any other

issues going on that should be treated, such as major depression, " Aboujaoude

said. " When it's identified as an independent entity, then psychotherapy

would be the place to start. You [give] the patient tools to gradually limit

their online activities and deal with symptoms of anxiety, restlessness and

irritability as they resist going online for non-essential Internet use. "

The study was funded by Forest Laboratories, a pharmaceutical company.

SOURCES: Elias Aboujaoude, M.D., assistant clinical professor in psychiatry

and behavioral sciences, and director, Impulse Control Disorders Clinic,

Stanford University, Palo Alto, Calif.; and R. Suler, Ph.D., professor of

psychology, Rider University, Lawrenceville, N.J. October 2006, CNS Spectrums:

The International Journal of Neuropsychiatric Medicine Copyright © 2006

ScoutNews LLC. All rights reserved.

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LIFESTYLE CHANGES

The lifestyle choices to keep your heart healthy are similar to what you

should do to help prevent many other diseases, such as diabetes and certain

types of cancer. If you have coronary heart disease or are at high risk to

develop it, you should do the following:

Eat plenty of vegetables and fruits while avoiding trans fats and saturated

fats.

Keep blood pressure in the normal range, ideally with a systolic blood

pressure of less than 120 millimeters of mercury (mm Hg).

Don't smoke.

Get your low-density lipoprotein, or LDL (bad), cholesterol under 100

milligrams per deciliter (mg/dL) and perhaps as low as 70 mg/dL. This usually

requires medications such as a statin drug.

Maintain a healthy weight.

Strive to keep your blood sugar levels normal.

Manage stress.

Become more physically active, and make daily exercise a priority at an

intensity level recommended by your doctor.

High LDL cholesterol is one of the major risk factors for heart disease, and

the risk increases as the bad cholesterol level rises. Other major risk

factors are smoking, high blood pressure and diabetes. Your cholesterol level

is

determined by your genetic makeup and the amount of saturated fat and

cholesterol in the foods you eat. The liver manufactures cholesterol, so even

if you

never eat cholesterol, your body can make all it needs.

Several factors contribute to high blood cholesterol:

Diet: Reduce your blood LDL cholesterol level by eating less fat,

particularly saturated fat (as found in whole milk, cheese and meat). Low

cholesterol

foods are important, too. Studies have shown that your total cholesterol and

your bad cholesterol levels may begin to drop two to three weeks after you

begin your lower you intake of fat, calories and cholesterol.

A healthy diet:

Contains healthy fats. Once you've cut way back on saturated fats and trans

fats (the unhealthy fats), you can start adding healthy fats to your diet.

Healthy fats are polyunsaturated and monounsaturated.

Contains healthy sources of carbohydrates. Eat more whole grains — foods

like whole-wheat bread, brown rice and oatmeal — to help lower cholesterol,

improve blood sugar and insulin levels, control weight, protect the heart, guard

against diabetes and keep your digestive system healthy.

Relies on healthy sources of protein. For a healthier heart, cut back on red

meat and switch to fish. Why? The good fats in many types of fish help

protect the heart against erratic rhythms and may prevent blood clots. The

American Heart Association now recommends that people eat fish (especially

fatty

fish) at least two times per week. Beans, nuts and seeds are also excellent

sources of protein.

Includes plenty of fruits, vegetables and whole grains. These foods have

more powerful effects on your health than most pills.

Tastes great. If it doesn't, you probably won't stick with it for long.

Weight control: Obesity increases triglyceride and total blood cholesterol

levels, blood pressure and the risk of developing diabetes.

Exercise: Regular exercise may help a person control weight, lower blood

pressure and increase the level of high-density lipoprotein, or HDL (good),

cholesterol.

Genetic factors: Lowering your LDL cholesterol levels through diet often is

not enough to reach your goal. Many people are genetically programmed to

produce cholesterol in the liver no matter how strictly they follow a diet.

They

require cholesterol-lowering drugs to get their levels in shape.

Sex/age: Coronary heart disease is the leading cause of death and disability

for both men and women in the United States. Traditionally, coronary heart

disease has been associated much more with older men than women. However,

today, the importance of lifestyle changes is recognized for both sexes at all

ages.

Alcohol: In some people, modest amounts of alcohol can increase the amount

of good cholesterol (HDL). Modest intake means two or fewer drinks per day for

men and one drink per day for women. There is good evidence that moderate

alcohol intake lowers the risk of coronary artery disease, whether or not the

protection is due to increasing HDL levels. However, alcohol provides " empty

calories " that can add to your weight. Because drinking can have serious

adverse effects, present guidelines do not recommend drinking alcohol as a way

to

prevent heart disease.

Smoking: Smoking damages the heart by raising blood pressure, damaging blood

vessels, promoting the buildup of fatty plaque in arteries, lowering levels

of " good " cholesterol, making the blood more likely to clot and depriving the

heart of oxygen. Quitting smoking is the best thing you can do to prevent a

heart attack.

Stress: Stress can increase chemicals within the body that may increase the

risk of a heart attack. These fight-or-flight stress hormones, such as

cortisol and epinephrine, excite the heart and make it work overtime.

*******************************************

Good Health to All,

Jack

Newsletter Editor

Cornishpro@...

Issue 2006- 12

10/31/06