The importance of Vit A and the developing nervous system. Could this be a reason for SIDS ? This needs to be studied more deeply.

From WSJ.com

If you%u2019re taking a daily aspirin for your heart, you may want to reconsider.

For years, many middle-aged people have taken the drug in hopes of reducing the chance of a heart attack or stroke. Americans bought more than 44 million packages of low-dose aspirin marketed for heart protection in the year ended September, up about 12% from 2005, according to research firm IMS Health.

Podcast
Ned Calonge, the chair of the U.S. Preventive Services Task Force, explains the new guidelines for recommending aspirin therapy.

Jon Protas/The Wall Street Journal
Now, medical experts say some people who are taking aspirin on a regular basis should think about stopping. Public-health officials are scaling back official recommendations for the painkiller to target a narrower group of patients who are at risk of a heart attack or stroke. The concern is that aspirin%u2019s side effects, which can include bleeding ulcers, might outweigh the potential benefits when taken by many healthy or older people.

%u201CNot everybody needs to take aspirin,%u201D says Sidney Smith, a professor at the University of North Carolina who is chairing a new National Institutes of Health effort to compile treatment recommendations on cardiovascular-disease prevention. Physicians are beginning to tailor aspirin recommendations to %u201Cgroups where the benefits are especially well established,%u201D he says.

Doctors generally agree that most patients who have already suffered a heart attack or ischemic stroke, the type caused by a clot or other obstruction blocking an artery to the brain, should take regular low-dose aspirin. But for people without heart disease, the newest guidelines from the U.S. Preventive Services Task Force spell out much more clearly than before when aspirin should be administered.

The guidelines, announced last year, suggest aspirin for certain men 45 to 79 years old with elevated heart-disease risk because of factors like cholesterol levels and smoking. For women, the guidelines don%u2019t focus on heart risk. Instead, the task force recommends certain women should take aspirin regularly if they are 55 to 79 and are in danger of having an ischemic stroke, for reasons that could include high blood pressure and diabetes.

The panel urged doctors to factor in conditions that could increase a patient%u2019s risk of bleeding from aspirin, which tends to rise with age. The group didn%u2019t designate a dose, but suggested that an appropriate amount might be 75 milligrams a day, which is close to the 81mg contained in low-dose, or %u201Cbaby,%u201D aspirin. The task force didn%u2019t take a position on aspirin for people who are 80 and older because of a lack of data in this age group.

Aspirin Advice
Doctors have been scaling back their aspirin recommendations for people who don%u2019t already have heart disease. Here are the current guidelines from the U.S. Preventive Services Task Force.

Aspirin recommended for:

Some men 45 and older with risk factors for heart disease, assuming no history of ulcers or other bleeding dangers.Some women 55 and older with risk factors for stroke, and no history of bleeding danger.Aspirin not recommended for:

Men younger than 45, and women younger than 55.Anyone 80 and older.Other medical researchers dispute the idea that there should be different guidelines for men and women. Still, many experts agree that doctors may have been recommending aspirin to people for whom the risks might outweigh the benefits.

Aspirin acts as a blood thinner, which is believed to account for much of its benefit of protecting against heart attacks and strokes. But that same action, along with a tendency to deplete the stomach%u2019s protective lining, can lead to a danger of gastrointestinal bleeding and possibly bleeding in the brain.

The task force issued its latest guidelines after reviewing the evidence from a number of studies on aspirin%u2019s benefits and risks. The recommendations update the panel%u2019s previous guidelines from 2002, which were more broadly written. Those suggested aspirin use for people of any age who were at elevated risk of heart disease.

%u201CWe would like doctors to re-look at their patients who are on aspirin and consider recommending stopping it where the chance of harm outweighs the benefit,%u201D says Ned Calonge, a Colorado public-health official who serves as the task force%u2019s chairman. He notes, however, that in studies of healthy people taking aspirin, the actual rates of bleeding and of prevented heart attacks were very low.

Not all patients accustomed to taking aspirin will want to stop. Maxine Fischer, 55 years old, recently figured out that under the new U.S. guidelines, she wouldn%u2019t be encouraged to continue with the drug. Using an online calculator, which factored such data as her age, blood pressure and medical history, she learned she had just a 1% likelihood of a stroke in the next 10 years. Under the guidelines, only women in her age group with at least a 3% or higher stroke risk should take aspirin.

Ms. Fischer, who works as a manager for seniors%u2019 lobby AARP in San Diego, has taken aspirin daily for two years after reading it could reduce the risk of stroke. For the moment, she says she%u2019ll keep it up, partly because she%u2019s more worried about strokes than ulcers. Strokes are %u201Cthe big scary thing,%u201D she says.

Other patients say they would stick with aspirin because of other benefits attributed to the drug; past research has suggested that regular aspirin may reduce the risk of colon cancer, for instance. Virginia Douglas, 64, a retired trade-association executive, takes aspirin a few times a week. In addition to the possibly reduced risk of stroke, Ms. Douglas hopes to avoid colon cancer, which affected her father and grandfather. %u201CThere%u2019s always a new study with a new recommendation,%u201D says Ms. Douglas, of Sacramento, Calif. %u201CYou have to do what%u2019s best for you.%u201D

In a separate analysis, published in medical journal Lancet last May, an international group of scientists reached a broadly similar conclusion as did the U.S. task force%u2014that doctors may have been recommending aspirin too widely. %u201CYou really have to have a clear margin of benefit over hazard before you should be treating healthy people,%u201D says Colin Baigent, a professor at Oxford University who coordinated the Lancet analysis.

What Aspirin Does
Aspirin%u2019s effects in the body can have good and bad implications.

Blood thinner: It inhibits clotting, which helps reduce the risk of heart attack and ischemic stroke but increases the danger of bleeding.Inflammation reducer: It lessens pain and fever by preventing production of the hormone-like substances called prostaglandins. But this can also deplete a protective layer in the stomach and increase the risk of ulcers.What You Can Do
If you want to figure out if the newest guidelines recommend aspirin for you, here%u2019s where to check:

At ahrq.gov, type %u2018aspirin and prevention%u2019 into the search box, and the new guidelines will come up in the results. Click on %u2018clinical summary%u2019 for a table that explains what people of different ages should do, and includes links to online calculators to help you figure out your risk of heart attack or stroke. You should also speak to your doctor.An analysis published in the British journal the Lancet, which reached somewhat different conclusions.A letter from the task force responding to the Lancet authors%u2019 findings.Still, the Lancet authors disagreed with the U.S. panel on some important details, particularly about who should be taking aspirin. The two groups examined evidence largely from the same studies of the drug, although the international team analyzed the data differently. In the end, the international team of scientists, unlike the U.S. officials, concluded that aspirin%u2019s effects on men and women were mostly the same.

Another disagreement between the two groups also emerged: The U.S. task force said that age is the biggest factor determining a person%u2019s risk of internal bleeding from aspirin. But the international team said other factors, such as diabetes and high blood pressure, also play a significant role. Unfortunately, the scientists noted, the same factors that increase patients%u2019 risk of bleeding also increase their risk of developing heart disease. This, in turn, can make it more difficult to calculate whether the benefits of aspirin would outweigh the risks of side effects.

The U.S. task force responded with a letter to the Lancet, defending its finding that men and women%u2019s results did appear different. There is a %u201Cwealth of evidence that men and women have different cardiovascular disease manifestations and respond differently to aspirin,%u201D the letter said. The panel also reiterated its position that bleeding risk is best parsed by age.

Amid the debate, some individual doctors are finding their own position. Rodney Hayward, who codirects a Veterans Affairs research center in Ann Arbor, Mich., says he%u2019s not convinced that aspirin%u2019s effects on men and women are so different. He says he continues to recommend aspirin for certain patients of both sexes with significant heart risk.

There are several natural alternatives to aspirin that will help thin the blood and keep the coagulation down. Omega 3 fish oils(molecularly distilled) and certain enzyme combinations will help thin the blood and keep the coagulation down. These natural alternatives don't pose the same G.I bleeding risks that aspirin does.

Here are some good food tips for those of you who might be confused about Food labels.

If you know some one with MS you might want to have them read this study.

I have been telling pt. and friends about Resveratrol as an ant-aging supplement for years. The other supplement that I take and is the only known one to increase your Glutathione levels with out I.V is NAC. They have found pt.'s with neurodegenerative diseases to be very low in glutathione. NAC turns into glutathione in the body. Glutathione is very important in detoxifying the cells and protecting them from oxidative stress.NAC is short for N-Acetyl-Cysteine so go google it and check it out.

This is some of the most amazing cutting edge technology we may ever see! I read just awhile back in The Body Electric how our bodies can regenerate, but who ever thought we would be doing this.This is phenomenal science.

From WebMD:

High doses of vitamin D dramatically cut the relapse rate in people with multiple sclerosis, a study shows.

Sixteen percent of 25 people with multiple sclerosis (MS) given an average of 14,000 international units (IU) of vitamin D a day for a year suffered relapses, says Jodie Burton, MD, a neurologist at the University of Toronto. In contrast, close to 40% of 24 MS patients who took an average of 1,000 IU a day %u2014 the amount recommended by many MS specialists %u2014 relapsed, she says.

Also, people taking high-dose vitamin D suffered 41% fewer relapses than the year before the study began, compared with 17% of those taking typical doses.

People taking high doses of vitamin D did not suffer any significant side effects, Burton tells WebMD.

The findings were presented at the annual meeting of the American Academy of Neurology.

In contrast to many vitamins, no recommended dietary allowance (RDA) has been established for vitamin D. Instead, the Institute of Medicine has set a so-called adequate intake level; the recommendations are 200 IU daily for people under 50, 400 IU daily for people 50 to 70, and 600 IU for those over 70.

John Hooge, MD, an MS specialist at the University of British Columbia in Vancouver who was not involved with the research, says he recommends MS patients take at least 1,000 IU and %u201Cprobably 2,000 IU%u201D day.

%u201CThis is an impressive study that shows that even higher doses are probably safe and even more effective. Maybe next year, I%u2019ll be recommending higher doses,%u201D he tells WebMD.

Vitamin D vs. Relapsing MS
Most of the people in the study had the relapsing form of MS, characterized by repeated relapses with periods of recovery in between. They suffered from the disease for an average of eight years.

%u201CThey had very mild disease, with an average score of 1.25 on the Extended Disability Status Scale, where zero corresponds to normal and 10 to death,%u201D Burton says. Participants suffered one relapse every other year, an average.

People in the high-dose group were given escalating doses of vitamin D in the form of a concentrate that could be added to juice for six months, to a maximum of 40,000 IU daily. Then doses were gradually lowered over the next six months, averaging out to 14,000 IU daily for the year.

The rest of the participants were allowed to take as much vitamin D as they and their doctors thought was warranted, but it averaged out to only 1,000 IU daily.

Everyone also took 1,200 milligrams of calcium a day. Vitamin D is essential for promoting calcium absorption in the gut and together with calcium, helps promote bone health.

High doses of vitamin D dramatically cut the relapse rate in people with multiple sclerosis, a study shows.

Sixteen percent of 25 people with multiple sclerosis (MS) given an average of 14,000 international units (IU) of vitamin D a day for a year suffered relapses, says Jodie Burton, MD, a neurologist at the University of Toronto. In contrast, close to 40% of 24 MS patients who took an average of 1,000 IU a day %u2014 the amount recommended by many MS specialists %u2014 relapsed, she says.

Also, people taking high-dose vitamin D suffered 41% fewer relapses than the year before the study began, compared with 17% of those taking typical doses.

People taking high doses of vitamin D did not suffer any significant side effects, Burton tells WebMD.

The findings were presented at the annual meeting of the American Academy of Neurology.

In contrast to many vitamins, no recommended dietary allowance (RDA) has been established for vitamin D. Instead, the Institute of Medicine has set a so-called adequate intake level; the recommendations are 200 IU daily for people under 50, 400 IU daily for people 50 to 70, and 600 IU for those over 70.

John Hooge, MD, an MS specialist at the University of British Columbia in Vancouver who was not involved with the research, says he recommends MS patients take at least 1,000 IU and %u201Cprobably 2,000 IU%u201D day.

%u201CThis is an impressive study that shows that even higher doses are probably safe and even more effective. Maybe next year, I%u2019ll be recommending higher doses,%u201D he tells WebMD.

Vitamin D vs. Relapsing MS
Most of the people in the study had the relapsing form of MS, characterized by repeated relapses with periods of recovery in between. They suffered from the disease for an average of eight years.

%u201CThey had very mild disease, with an average score of 1.25 on the Extended Disability Status Scale, where zero corresponds to normal and 10 to death,%u201D Burton says. Participants suffered one relapse every other year, an average.

People in the high-dose group were given escalating doses of vitamin D in the form of a concentrate that could be added to juice for six months, to a maximum of 40,000 IU daily. Then doses were gradually lowered over the next six months, averaging out to 14,000 IU daily for the year.

The rest of the participants were allowed to take as much vitamin D as they and their doctors thought was warranted, but it averaged out to only 1,000 IU daily.

Everyone also took 1,200 milligrams of calcium a day. Vitamin D is essential for promoting calcium absorption in the gut and together with calcium, helps promote bone health.

I have been taking 2,000-4,000 i.u of vitamin D for several years. Most of my patients that have been tested showed low levels of vitamin D. Everyone reading this should have their levels checked. The studies on vitamin D are showing it may help with tumor suppression, immune function, bone absorption,dementia,Alzheimer, and a slew of other health problems.

In Treating Ear Infections, a Push to Avoid Antibiotics; Persuading Parents to Wait and Watch

From NYTimes.com:

When Latonia Best’s teenaged kids were little, doctors always prescribed antibiotics for their ear infections. But when her youngest son, 5-year-old Justin, was diagnosed with one recently, she heard something new: The pediatrician asked if she wanted to try waiting a few days to see if he would get better on his own.

Ear Debate
Here are studies and other background about the use of antibiotics for ear infections.

The current treatment guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians. Recent research in the journal Pediatrics showed that doctors continue to prescribe antibiotics for the vast majority of kids’ ear infections.A number of studies have found that kids can generally recover from ear infections without an antibiotic. Here’s one from JAMA. Here’s an analysis that argued certain groups of children with ear infections need antibiotics, while others may not.However, doctors have long disagreed over when it’s OK to go without an antibiotic. Here’s one back-and-forth from the journal Pediatrics that came out after the last set of guidelines emerged.Ms. Best, a mental-health aide who lives in LaGrange, N.C., opted to hold off on the drug, since her son wasn’t in pain and the doctor promised to phone in a prescription if needed. Two days later, he was fine. “I’d rather it heal itself,” says Ms. Best. She’s concerned that overuse of antibiotics will lead to powerful bacteria that resist the drugs, she says.

Ear infections are a rite of childhood, affecting more than three-quarters of kids before the age of 5. They’re also one of the most common reasons for visits to pediatricians, as parents seek relief for their crying, fussy young ones. But doctors and parents are deeply divided about how to treat them.

Current guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians say that many patients, except the youngest and the sickest, can safely go without an antibiotic. Still, American doctors continue to prescribe the drugs very broadly for ear infections—to 84% of the kids they diagnose with them, according to a new analysis published in this month’s issue of the journal Pediatrics.

Giving the debate fresh urgency: the pediatrics academy is preparing to update its guidelines, aiming for the new version to come out later this year.

A U.S. pediatricians group recommends prescribing antibiotics to children diagnosed with ear infections if…..
… the child is 2 or younger
Robert Neubecker
…a child of any age appears seriously ill, with symptoms that could include moderate to severe pain and/or a fever of 102 F or higher.
Robert Neubecker
A growing number of studies have shown that most children with ear infections recover well without antibiotics, with little risk of more serious complications. Research in the journal BMJ in June even suggested that children who got antibiotics might be more likely to have recurrent infections.

Online and in the pages of medical journals, doctors have are debating the issue. For instance, an online summary of the BMJ finding by one doctor drew harsh rejoinders from other physicians, including William Corporon, a family-practice doctor in Overland Park, Kan., who works in hospital emergency rooms.

“I’m not looking at a study, I’m looking at a patient,” says Dr. Corporon, who says that when he diagnoses a bacterial ear infection, he recommends an antibiotic.

Doctors who typically prescribe antibiotics point to evidence that they can help infected children recover faster, though the difference often amounts to a day or less. They also question the methodology of many of the clinical trials, particularly that they may have included patients who didn’t have true bacterial ear infections. That would tend to dilute the evidence of the antibiotics’ effectiveness.

“There were methodological limitations to each of these previous studies,” says Alejandro Hoberman, a professor of pediatrics at the University of Pittsburgh who led a major new National Institutes of Health-funded study of the issue.

According to the new analysis in Pediatrics, the most common antibiotic prescribed for children’s ear infections is amoxicillin. Doctors say a 10-day course of the drug is typical.

Doctors and parents can take a wait-and-see-approach if…..
… the child is otherwise healthy and has only mild symptoms.
Robert Neubecker
…and there’s a way to follow up in case the condition lingers or worsens.
Robert Neubecker
Some parents say that once a bacterial infection has been diagnosed, they’re not comfortable leaving it untreated. Some also push for the quickest possible recovery so their children can return to school or day care. In a survey of primary-care doctors published in 2007, 65% said parents’ demand for antibiotics was the most important barrier to holding off on prescriptions.

If a doctor refused to prescribe an antibiotic and his 5-year-old son was still feeling the effects of an earache overnight, James Hill of Starkville, Miss., says he would likely seek out another doctor. “I just can’t imagine going without it,” says Mr. Hill, a federal research lab employee. “We want him getting better as fast as possible.” His son Matt gets frequent ear infections and is fussy with the ache, he says.

Still, some doctors say that when they explain the options to parents, many opt to wait on antibiotics.

Allan S. Lieberthal, a pediatrician at Kaiser Permanente in Los Angeles who is chairman of the current guidelines-writing effort, tells parents that the chance of a child getting better within a few days without an antibiotic is about 80%, while with the drug it is around 90%. If parents decide to hold off, he gives them a prescription that they can fill if the child has a high fever or worsening pain after 48 hours.

He also suggests they treat the pain with ibuprofen, following the current guidelines to use painkillers in children with earaches.

“I want them to walk out of my office feeling comfortable,” he says.

Some parents are worried about possible side effects from antibiotics, with diarrhea being the most common, and about resistant bacteria.

When Jennifer Collins’s 12-year-old daughter Naomi complained of ear pain a few months ago, she held off on a doctor visit. Instead, she gave the girl Tylenol and had her press a hot washcloth against the ear, a home remedy that doctors say isn’t proven but doesn’t seem to do any harm. The pain went away on its own.

View Full Image

D.L. Anderson for The Wall Street Journal

Latonia Best with her son Justin who recovered from an ear infection without taking antibiotics.
“We’ve developed these superbugs,” says Ms. Collins, who says she takes their effects seriously because she saw them in one of her other children, who had an infection after a cat scratch that resisted a 10-day course of amoxicillin, requiring another antibiotic to cure it.

The new research can help doctors “target the antibiotics better,” for kids who need them, who seem to include children under the age of 2 with infections in both ears, as well as those whose ear drums are oozing pus, says Richard Rosenfeld, chairman of otolaryngology at Long Island College Hospital in Brooklyn, N.Y.

Ultimately, physicians say they have to decide based on the patients in front of them.

“You consider the age of the child, and how the child looks, and is she running a fever,” among other factors, says Dave Tayloe Jr., a pediatrician in Goldsboro, N.C., who is a past president of the pediatrics academy.