Five medical tests you often don't need

Five medical tests you often don't need - Forty-five tests and procedures routinely performed on patients are often unnecessary, according to a report released Wednesday by nine physician groups, the Consumers Union, and the American Board of Internal Medicine Foundation.

“Many of the things that are routinely done are things that patients have come to expect and doctors have routinely ordered,” said Dr. Christine Cassel, president and CEO of the ABIM Foundation. “These are not things that should never be done, but they are things that are often overused.”

It's more ammunition to ask your doctor whether your tests and treatments are necessary, especially given that patients request many of them.

“Often the doctors will say the patients are asking for these things,” Cassel told CNN.

The groups looked at the scientific rational for performing each of the tests and procedures listed in the report. According to the doctors, here are five tests you often do not need:

1. A CT scan or MRI scan after fainting

If your behavior is normal (no seizures or neurological problems) then a brain scan is unlikely to improve your outcome.

2. An annual cardiac stress test

If you're otherwise healthy, repeating the test every year or so rarely changes the course of your treatment. But additional tests could lead to more invasive tests and unwanted radiation, according to the American College of Cardiology.

3. A chest x-ray before outpatient surgery

If you have a moderate to good functioning heart you probably don’t need the scan as part of your assessment before a low risk surgery.

“There’s good evidence that adding a chest x-ray before you have the surgery doesn’t pick up abnormalities that the doctor needs to know about before the operation,” Dr. Cassel said.

4. A back scan within the first six weeks of lower back pain

When a physical exam of your back fails to find the source of your pain, a back scan isn’t likely to reveal the source of your pain and therefore won't improve the outcome – but it will drive up costs.

5. A repeat colorectal cancer screening

Beginning at age 50, one high-quality colonoscopy every 10 years is all you need if your results are normal.

The website ChoosingWisely.org lists all 45 tests and procedures featured in the report. It was developed by these doctors' groups along with Consumer Reports and the American Board of Internal Medicine Foundation to help doctors control the cost of U.S. health care.

“This is about getting rid of the fat in the system," said Cassel. "Getting rid of waste." ( cnn.com )

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Why More Chinese Singles Are Looking for Love Online

Why More Chinese Singles Are Looking for Love Online - "It's the accuracy of the photos compared to real thing that's the biggest problem," says Power Li, a 32-year-old civil servant. "You see a girl on the website who you quite like the look of, but then when you ask her out you find they look nothing like their online photos."

Ah, modern love. With a steady career and his own house and car, the 32-year-old Beijinger is settled, successful, upwardly mobile and part of a new craze sweeping china - online dating. Li says his subscription to online dating site Jiayuan.com offers the perfect solution to the one area of his life where he has yet to find success. "I'm always busy at work, and my social circle is very small," Li says. "It would be too awkward to ask my colleagues out. So the internet offers a much broader circle of people, and many more choices."

Power is just one of millions of Chinese people who are turning to online dating as a solution to relationship woes in a society where the social pressure to find a partner can be oppressive. Chinese parents commonly expect their sons or daughters to be married by the time they're 30. There is even a word for those who are 'left on the shelf' in their thirties: shengnan and shengnv, literally a "left-over man" or "left-over woman."

The pressure to find a mate at all costs has been blamed for rocketing divorce rates, which reached a new peak in 2010. According to the Ministry of Civil Affairs, close to two million couples registered for divorce last year, or 1.5 divorces per one thousand people. It's still low compared to, say, the U.S., where there are 5.2 divorces per thousand, but the figure in China is rising fast.

Dating pressure is also driving a major boom in online dating, as millions of China's singletons log on to find love, particularly for men. According to research by the National Women's Union and Jiayuan's competitor Baihe.com, China currently has 180 million bachelors, up to half of whom are thought to be looking for love online. And after three decades of the 'one child policy', a societial bias towards male progenies has meant that for every 100 females there are 119.45 males, an imbalance that is driving competition for partners among males. According to the Chinese Academy of Social Sciences, by 2020 there will be 24 million more men of marriage age than women.

Those numbers mean big business. It's estimated that online dating sites attracted three million paying customers last year, who collectively spent more than $150 million. Like their foreign counterparts, websites like Jiayuan.com, Baihe.com and Zhenai.com allow subscribers like Power to create online profiles, browse listings of thousands of potential partners around the country and attend offline mix-and-mingle events with like-minded singles for a monthly fee. For a little more, the websites offer targeted match-making services and will arrange dates for members without the time or inclination to browse through the multitudes of profiles of singles. "Revenues are rising fast. We expect to take in 200 to 300 million RMB ($30 to $45 million) this year," says Li Song, founder of Zhenai.com, one of China's three largest dating sites. Li says a six-month membership – more than half the average wage in Beijing - buys users the services of a professional matchmaker to arrange dates and provide feedback and advice to the client. "So far, we helped more than 2 million members find steady relationships," he claims.

But online dating websites are not the only players angling for a piece of this booming business. Chris "Tango" Wu, a 26 year-old self-styled "professional pick-up artist," spends his time teaching his many and varied pick-up tricks to single male students eager to learn how to meet women. His students pay a premium rate to attend Tango's intensive training sessions that last from 3 days to a full week and feature classroom-style lectures followed by practical experience 'in the field.' Business, says Tango, has never been better. "I had to take down my advertisement for my most recent class because it was so popular," Tango says.

That his services have been so successful came as no surprise to Tango, who sees rising standards of affluence, combined with the social stigma of being a single thirty-something, driving demand for creative solutions to problems of the heart. "When a man has enough food to eat, water to drink and air to breathe, the next thing he needs to find is a woman," Tango says. "A man in his 30s would be willing to pay you more than half of his savings - sometimes even his entire savings - if you can teach him how to get a girlfriend."

Since starting his online dating subscription almost a year ago, Power Li has gone out on a number of dates - "more than 5" he offers coyly - with women he met online. But, he says, he is still looking. "I did meet several girls that I thought I'd like to get to know better, but I have to wait for feedback from them to see if any of them liked me," he says. "So basically, I'm still searching for my future wife." ( time.com )

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Experts Say Don't Worry About Radiation In US Milk

Experts Say Don't Worry About Radiation In US Milk - So now Japan's radioactive fallout is showing up in milk on the U.S. West Coast. Not to worry, though. It turns out that traces of radioactivity are in many foods we eat, the air we breathe and the water we swim in.

Based on current radiation levels leaking from the stricken Japanese nuclear plant, experts say it's very unlikely that health problems will develop in the United States and other places far from Japan.

"This amount of radiation is tiny, tiny, tiny compared to what you get from natural sources every day," said John Moulder, a professor of radiation oncology at the Medical College of Wisconsin in Milwaukee who studies the effects of radiation exposure.

Milk waiting to be tested sit on shelves in a cooler at the Environmental Protection AgencyÂs National Air and Radiation Environmental Laboratory in Montgomery, Ala., Thursday, March 24, 2011. The laboratory has added a few extra contract workers because of the threat from Japan, officials say.

That radioactive fallout is turning up in food and water is hardly a surprise. Very low levels of radiation in the air connected to the Japanese plant have shown up coast to coast in the U.S., as well as in Iceland, Britain and Germany.

Most of the radioactive material disperses in the atmosphere, but some falls to the ground.

Radioactive iodine was found in the milk in California and Washington state, most likely after a cow ate tainted grass or drank puddles of rainwater containing it. Iodine-131, the type that was found, is short-lived and decays fairly quickly, becoming harmless.

Moulder said he wouldn't be surprised if leafy vegetables like spinach are next to show contamination, the source being rainwater. Again, the health risk "is about as close to zero as you can get," he said.

Since this type of iodine is manmade, it isn't normally found in the environment. But we're exposed to natural sources of radiation every day — most of it from radon in the air and, to a lesser extent, from cosmic rays.

Foods we eat also contain low levels of naturally occurring radioactivity, including bananas, carrots and red meat. Even beer has it.

"Once you understand that we swim in this low-level sea of radiation, then it's just a numbers game," said Mike Payne of the Western Institute for Food Safety and Security at the University of California, Davis.

The Environmental Protection Agency normally tests milk, rainfall and drinking water every three months for radiation.

Since the March 11 tsunami that devastated parts of Japan and crippled the nuclear plant, the EPA began testing more frequently and screened samples from milk producers this week.

A small amount of radioactive iodine was found in a March 25 milk sample from Spokane, Wash. The amount detected was 5,000 times below the federal recommended limit for exposure.

In separate testing, the California Department of Public Health found a similar trace amount Monday at a dairy in San Luis Obispo County, where the Diablo Canyon nuclear power plant is located.

The department has an ongoing program that checks milk for radiation levels and occasionally tests vegetables grown near power plants. Since the Japan nuclear crisis, it started testing milk samples in the county each week.

"It is safe to drink milk. It is safe to eat dairy products," county Health Officer Penny Borenstein said at a news conference Thursday.

The Food and Drug Administration, which oversees the safety of the nation's food supply, said that so far it has not found radiation in any other foods.

To the north, health authorities in British Columbia said radioactive iodine levels recently found in rainwater and seaweed do not pose a health threat.

The United States had already banned imports of dairy and produce from the region of Japan where the crippled plant is located. Other foods imported from Japan, including seafood, are still being sold but are screened first for radiation.

"People shouldn't be afraid to continue eating dairy products, vegetables, fish and other nutritious foods," said Christine Bruhn, who studies food safety at UC Davis. ( Associated Press )

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Benefits of Radiation Therapy Outweigh Risks of a Second Cancer

Benefits of Radiation Therapy Outweigh Risks of a Second Cancer -- The odds a second cancer will develop after radiation treatment for a first cancer are relatively low, U.S. National Cancer Institute researchers report.

In a long-term study of more than 600,000 cancer survivors, an estimated 8 percent of second cancers were attributable to radiation treatment for the original cancer, according to the study.

The results suggest that other factors, such as lifestyle risks and genetics, cause the majority of second cancers, the researchers say.

Benefits of Radiation Therapy Outweigh Risks of a Second Cancer

"The findings can be used by physicians to really put the risks into perspective when they are talking treatment options with their patients," said lead researcher Amy Berrington de Gonzalez, an investigator in the NCI's radiation epidemiology branch.

Patients should feel reassured, she added. "In general, the risks [of radiation therapy] are smaller than the benefits," she said.

The study, published online March 30 in The Lancet Oncology, is the first to quantify the cancer risks posed by radiation treatment for different malignancies.

Berrington de Gonzalez and colleagues collected data on 647,672 adult cancer survivors included in the U.S. Surveillance, Epidemiology and End Results cancer registries. All had survived five years or longer after cancer treatment, and follow-up ran from 1978 to 2007.

The researchers looked at outcomes for 15 different types of cancer for which radiation treatment is routine, including cancers of the rectum, larynx, lung, breast, cervix, testicles, prostate, eye and orbit, brain and thyroid.

Over the 30 years of follow-up, 9 percent of these participants developed a second cancer. Of these, about 3,300 (8 percent) might have been the result of radiation treatment, the study authors said.

Second cancers related to earlier radiation therapy varied by type, the researchers noted.

More than half of the second cancers developed in breast and prostate cancer survivors. Four percent of second cancers were in the eye, and 24 percent were cancer of the testicles, the researchers found.

Patients who had their initial cancer when young were at the greatest risk of developing a second cancer. Also at high risk were those whose organs received high doses of radiation. The likelihood of developing a secondary cancer increased over time.

When these data are put in perspective, the absolute risk for a second cancer is 3 in 1,000 over 10 years after radiation therapy and 5 in 1,000 over 15 years, Berrington de Gonzalez said.

"We know that radiation therapy can increase the risk of getting another cancer, but at the same time the benefits outweigh the risks," said Elizabeth Ward, national vice president for intramural research at the American Cancer Society.

Radiation therapy is an important and relatively safe treatment for cancer, she added.

Thanks to treatment advances, Ward said, radiologists today are better able to pinpoint treatment and limit exposure to healthy tissue than they were in the past.

Now, studies are needed to determine the cancer risks from newer radiation treatments, the authors noted.

Dr. Anthony D'Amico, chief of radiation oncology at Brigham and Women's Hospital in Boston, agreed that the NCI findings are encouraging.

"Despite people's concerns, radiation is relatively safe with regard to the issue of second cancers, because the number of cancers that result from it are very small," D'Amico said. ( HealthDay )

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The idiocy of text-message adultery

The idiocy of text-message adultery - Stop me if you've heard this one before: A woman says Tiger Woods had sex with her. No, really. Her name is Raychel Coudriet. It's the same story we've heard from other women: She liked Woods, he wanted her, he propositioned her, she said yes. He was sitting next to her at a party when he made his move. Did he touch her? Raise an eyebrow? Whisper in her ear? Nope. He texted her.

Woods may go down in history as the greatest golfer of all time. But he'll also be remembered as the king of sexting. He takes his place in a pantheon of lechers who have sated the world's oldest urge through the latest communications technology. Bill Clinton used the phone; Mark Foley used online chats; Mark Sanford used e-mail; Woods used text messages. Sitting right next to Coudriet, Woods went for his phone. He "texted her constantly," says the National Enquirer, echoing reports by other women. He was more addicted to texting than he was to sex.

Tiger Woods

The picture of Woods sitting there with Coudriet, discreetly sending her messages that would show up later in the Enquirer, captures the bottomless folly of extramarital sexting. Cheaters seem to think their phones send secret mating signals only their girlfriends can pick up. They couldn't be more wrong.

In the months since Woods' adultery was discovered, scores of his messages to various girlfriends have been leaked. So have the texts of Jesse James, the philandering husband of Sandra Bullock. If those aren't raw enough for your taste, try the X-rated pager messages between former Detroit Mayor Kwame Kilpatrick and his then-chief of staff, Christine Beatty. No detail is spared. You can find out exactly how Beatty debriefed Kilpatrick and which holes Woods liked to play.

But that's only half of what makes these messages creepy. The other half is the cheaters' constant worry about being caught. Their thumbs work the keypads, pleading for secrecy. "Don't text me back till tomorrow morning. I have [too] many people around me right now," Woods told Jaimee Grubbs, a cocktail waitress. To Joslyn James, a porn actress, he texted: "Don't come down here yet. Lots of people in the hall. I will let you know when it clears." Later, he chastised her: "You almost just ruined my whole life. If my agent and these guys would have seen you there, Fuck."

Fuck, indeed. Everyone with an Internet connection now knows plenty about Woods' sex life. But we don't know it from a bimbo getting caught in a hallway. We know it from his texts. His comments to Coudriet—"Are you touching yourself? I want to f--- you"—are reprinted verbatim in the Enquirer. He treated his phone as a private channel, a place where he could hide his darkest thoughts from the world. Instead, the phone manifested and published them. His trysts are gone. His marriage is on the rocks. But his texts? They're immortal.

Bullock's husband, Jesse James, made the same mistake. "I'm texting you in secret," he told one of his girlfriends. That message, along with 194 others, is now in her possession and is among several, "many of them extremely graphic," that she has reportedly shown to TMZ, the celebrity gossip site. Too late, he has learned that there's no such thing as texting in secret.

So has Kilpatrick. "THEY WERE RIGHT OUTSIDE THE DOOR. THEY HAD TO HAVE HEARD EVERYTHING," he told Beatty after a night together. When she joked that they'd been "busted," he replied, "DAMN THAT. NEVER BUSTED. BUSTED IS WHAT YOU SEE! LOL."

That's the folly of the cheating sexter. He thinks that to be busted, he has to be seen with his girlfriend. He has it backward. A physical encounter can be broken up in seconds, leaving only the uncorroborated memory of a putative eyewitness. But a text is objective and self-incriminating. Busted isn't being seen. It's being read.

In hindsight, the exposed sexters seem almost poignantly naive. James' electronic attempt at just-between-us intimacy—"*wink*"—has been pasted all over the Internet. Kilpatrick's and Beatty's frequent reminder to each other—"ERASE!"—has been preserved as a warning to all who think their messages were purged. And Woods' leaked promise to Grubbs—"secretively we will always be together"—has become a self-refuting joke. The promise was a fantasy. So was the secrecy.

Remember that the next time you wander off the fairway of marriage. Lust isn't love, and texting isn't whispering. Who knows what evil lurks in the hearts of men? The cell phone knows. Soon, the rest of us will know, too. ( slate.com )

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Pornography? No, just the latest NHS video to encourage teenagers to use condoms

Pornography? No, just the latest NHS video to encourage teenagers to use condoms - The NHS has been slammed after a video designed to encourage youngsters to use contraception was branded pornographic by outraged parents.

Several short videos uploaded to the YouTube website are modelled on the Channel Four programme Skins and targeted at teenagers.

But the graphic clips show a young woman having unprotected casual sex with a male in various positions while he films the trysts with a hand held camera.

Write caption here

Passion: The film shows the pair having sex on the girl's bed in what has been described as a 'pornographic' scene

Outraged YouTube viewers have flagged one of the videos as inappropriate - meaning only users who are over 18 can watch the clips.

The interactive video, 'Condon, No Condom', is promoted on the NHS website and is expected to be circulated virally online and used by teachers.

The style of filming is similar to that used by amateur pornographers. Scenes also mirror the controversial teen drama Skins in which youngsters regularly have casual sex.

Teenage boys are given the choice of how they behave in the bedroom with a girl they meet at a party.

In the first clip, a group of teenagers are preparing for a party from the point of view of an unseen male character.

They are given the choice of whether to buy condoms or not buy condoms when they visit their local newsagents.

The next clip allows viewers to choose the video 'whip out a condom'. The clip shows a graphic scene where the male character has sex with the young woman against a door in a hallway.

Another video, 'called Go Back to Jen's' shows the girl splayed across a bed while the filmer of the clip has sex with her.

Protection: A shop assistant offers to sell the boys condoms

Mistake: The young woman appears to be unhappy after unprotected sex

Bad news: The young male character is told that he has contracted an STD

In some scenarios the couple have unprotected sex. If the male tries to ignore the question of using a condom he is rejected by Jen.

A final video portrays the outcome of not using a condom as an unfullfilling event followed by the news that the teenage boy has contracted an STD.

Campaigners have complained that at no point in the video are teenagers advised that abstinence is the 'right option'.

Norman Wells, the director of the Family and Education Trust, said the NHS should not be sending out the message that casual sex 'leaves no regrets'.

He said: 'It is grossly irresponsible of the NHS to present a graphic portrayal of unbridled lust in which a young woman is depicted as no more that a sex object and then to tell young men that they have ''made the right choices'' simply because they have used a condom.''

Vivienne Pattisson, the director of Mediawatch, said she was concerned that there were no effective controls to prevent children from watching the clips.

Government officials are understood to be blocked from watching theclip because it breaches pornography filters.

But Rachel Drummond-Hay, who produced the video for Bristol-based Omni Productions, said that a friend's 15-year-old daughter 'loved' the film and that it was intended to be 'titillating rather than pornographic'. ( dailymail.co.uk )

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Smoking Bans Good for Non-Smokers

Smoking Bans Good for Non-Smokers. Report could get more states to pass laws to curtail secondhand smoke, experts say Bans on smoking in public places really do work at reducing heart attacks from secondhand smoke, a major study finds.

Smoke-free policies can reduce the risk of heart attack by up to 47 percent and significantly reduce the likelihood of other heart problems, according to a report released Thursday by the U.S. Institute of Medicine (IOM).

The report also found compelling evidence that even a brief exposure to secondhand smoke can trigger a heart attack.

"We did conclude a cause-and-effect relationship exists between heart disease and secondhand smoke exposure," Dr. Lynn R. Goldman, chairwoman of the IOM committee, said during a press conference Thursday.

Also, sufficient evidence exists to support a cause-and-effect relationship "between exposure to secondhand smoke and heart attacks or acute coronary events," said Goldman, a professor of environmental health sciences at Johns Hopkins Bloomberg School of Public Health.

Moreover, the more secondhand smoke you are exposed to, and the longer you're exposed to it, the greater the risk for heart problems or heart attack, Goldman said.

In the United States, about 43 percent of nonsmoking children and 37 percent of nonsmoking adults are exposed to secondhand smoke. Despite efforts to decrease exposure to secondhand smoke, about 126 million nonsmokers were still breathing others' smoke in 2000, according to the report.

In 2006, a U.S. Surgeon General's report confirmed the link between involuntary exposure to tobacco smoke and heart disease, and it determined that smoke-free policies were an inexpensive and effective way to reduce exposure.

But whether smoking bans actually reduced heart disease has been an ongoing debate, according to the IOM.

This new report puts that issue to rest, said Danny McGoldrick, vice president for research at Campaign for Tobacco-Free Kids. Not only does it document that smoke-free laws result in fewer heart attacks, it may also help get more states and localities to pass smoke-free legislation, he said.

"If policy makers are paying attention to the science, and this is one more piece of evidence that says 'you can actually save people's lives, save health-care costs,' then those states that have yet to act should do so," he said. "How many dramatic findings do you need before you are finally going to act to protect everybody's right to breathe clean air?"

To reach its conclusions, the IOM reviewed published and unpublished data and heard testimony about the association between secondhand smoke and heart problems.

Studies showed that smoking bans cut heart attacks by anywhere from 6 percent to 47 percent. Given the wide range, the IOM could not precisely determine the risk reduction, but said the benefits were obvious.

Other studies concluded that breathing secondhand -- or "environmental" -- smoke increased risk for heart problems by 25 percent to 30 percent, the report found.

While there was no direct evidence that brief exposure to secondhand smoke could trigger a heart attack, indirect evidence supported this conclusion, the study found.

Data on smoke from other pollution sources suggest that even a relatively brief exposure to particulate matter can cause a heart attack, and particulate matter is a component of secondhand smoke, the report noted.

"This report makes it increasingly clear that smoke-free policies are having a positive impact in reducing the heart attack rate in many communities," Dr. Clyde Yancy, president of the American Heart Association, said in a prepared statement.

"There's no question that secondhand smoke has an adverse health impact in workplaces and public environments. We must continue to enact comprehensive smoke-free laws across the country to save lives and reduce the number of new smokers," he said.

Dr. Stanton Glantz, a professor of medicine and director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, welcomed the findings.

Because the IOM is cautious and conservative, the report should be taken seriously, Glantz said. "This should shut up the people who have been whining and saying the evidence isn't there," he said.

"Not only do you get an immediate reduction in risk of heart attacks when you put these smoke-free policies into effect, but the effect grows over time," he said.

Glantz said he expects that the findings will influence policy and get more places to enact smoke-free laws. "If they want to prevent heart attacks, they should," he said. [ healthday.com ]

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Smoking Keeps Its Grip on Urban Poor

Smoking Keeps Its Grip on Urban Poor. Misconceptions, marketing are boosting rates to double the national average, researchers say . A full 42 percent of people in Milwaukee's poorest neighborhoods smoke -- more than twice the national U.S. average -- sacrificing $9 on a pack of cigarettes even while most of the households reported earning less than $15,000 a year.

Even more troubling is the fact that a large number of these low-income smokers hold beliefs that make them less likely to quit, according to ongoing research from the University of Wisconsin-Madison.

Over the past 40 years or so, the overall smoking rate in the United States has decreased to about 20 percent, but those gains have taken place largely among people with resources, namely money and education, said Bruce Christiansen, an associate scientist with the University of Wisconsin Center for Tobacco Research and Intervention in Madison, who is one of the researchers on what's known as the "ZIP Code" project.

"With public health, we got 80 percent of the people who were going to quit smoking to quit smoking. That's great, but the next 20 percent is going to be tough," added Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in New Orleans. "Smoking tends to be a disease of poverty and lack of education. Thirty years ago, 50 percent of the population smoked and now we're down to roughly 25 percent. What we have left is a very select group of people."

That select group includes people with mental health issues, which, according to the U.S. Substance Abuse and Mental Health Service Administration (SAMHSA), smoke 44 percent of all cigarettes.

Not only are these groups often specifically targeted by Big Tobacco, they also tend to reside in areas without extensive health care systems and don't have insurance, Christiansen said.

This study, a partnership between the University of Wisconsin School of Medicine and Public Health and the Salvation Army, sent five interviewers door-to-door in two of Milwaukee's poorest ZIP codes.

Interviews were conducted primarily between 9 a.m. and 4 p.m. on weekdays, catching the "poorest of the poor," those who don't work. Many in the group would be hard to capture in a regular survey as they often don't have phones, Christiansen said.

Responses from 654 smokers living in low-income neighborhoods revealed the following:

* People who smoked thought most other people smoked as well and, when asked, said that 73 percent of adults smoked, way higher than the 20 percent who actually do.
* Almost two-thirds thought it was okay to smoke as long as it didn't impinge on others.
* Almost half thought that medications intended to help people quit smoking were actually more dangerous and addictive than cigarettes.
* More than half (56 percent) had never heard of the free Wisconsin Tobacco Quit Line despite efforts to promote the service. In fact, Christiansen noted, some respondents said that going to jail was the best way to quit (at least temporarily).
* Thirty-eight percent had never actually tried to dispense of the habit. "It was amazing how many people said they hadn't tried to quit," Christiansen said. "They thought that everyone is doing it so it's okay."

Christiansen and his colleagues haven't finished analyzing the results yet but want to take the research a step further. "Can we change beliefs and, if we can change them, does that increase uptake of [quit-smoking] treatment?" he wondered. "Then we'll look at what it takes to change beliefs."

Christiansen's group has started an initiative called "Tobacco-Free Advocates," which trains individuals in the community to bring short (10-minute) messages to local groups.

"They talk about willpower, that it's a muscle you can build, dealing with urges, that medications can give willpower a chance to work," he said. "They're very brief messages. Then we made the advocates available to them."

And when the researchers come across households without any smokers, they offer them a bright green sign to place in the window that says: "Another smoke-free home in this community." [ healthday.com ]

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Impotence, Incontinence Risk Casts Doubt

Impotence, Incontinence Risk Casts Doubt on High-Tech Prostate Surgery. Heightened risks for post-operative incontinence and impotence may outweigh any benefits from minimally invasive "keyhole" surgery for prostate cancer, a new study suggests.

The presumed good stemming from the robotic technique are being oversold to a public that is all too willing to believe, said Dr. Jim C. Hu, a genitourinary surgeon at Brigham and Women's Hospital in Boston who led the study.

"Given the expense of the procedure and the hype around it, expectations are being raised that are too high," said Hu, whose team published the findings in the Oct. 14 Journal of the American Medical Association.

Men who have the prostate-removing surgery, which requires only a small incision and is helped along by robotic technology, do get out of the hospital faster than those who have the older operation, according to the report. Patients who underwent the more high-tech surgery spent an average of two days hospitalized rather than the three-days seen with traditional procedure. They were also less likely to require blood transfusions or suffer respiratory or surgical complications, researchers found.

But the study of more than 8,800 men also found a higher incidence of genitourinary complications, including impotence and incontinence, among those having the keyhole procedure (4.7 percent) versus those who got traditional surgery (2.1 percent).

And yet the popularity of minimally invasive prostatectomy, especially when done with robotic assistance, continues to grow. It accounted for more than 40 percent of all prostate operations in 2006, up from 1 percent in 2001, the report said.

That growth has been fueled by "widespread direct-to-consumer advertising," according to the report.

The minimally invasive technique is especially popular among patients in high-income areas, the research team said. This may be the result of a "highly successful robotic-assistant MIRP [minimally invasive radical prostatectomy] marketing campaign disseminated via the Internet, radio and print media channels, likely to be frequented by men of higher socioeconomic status," they wrote.

"Patients are demanding it," agreed Dr. Stephen J. Freedland, associate professor of urology and pathology at Duke University Medical Center, who performs prostate surgery but does not do the minimally invasive version. "In many cases, if the surgeon is not offering it, the patient will not come to you. So you have no choice. You do robotic surgery, or you don't do surgery."

Men who have been diagnosed with prostate cancer usually go directly to the Internet for information, and what they usually find are reports about the benefits of minimally invasive robotic surgery, Freedland said.

"But we are learning more and more that there are not all the benefits that have been touted," he said. "There are some benefits. But for long-term outcomes, there is no benefit and perhaps some detriment."

The numbers in the new study "are really worrisome," Freedland said. "They are finding an incontinence rate that is 30 percent higher and an erectile dysfunction rate that is 40 percent higher, and those are really important."

And the robotic technique is not readily mastered by surgeons, he said. "The learning curve is 150 to 200 patients, so the first 150 you do, you're practicing on them," Freedland said.

Men who are considering minimally invasive prostate surgery should first check carefully about the training of the surgeons doing the procedure, Hu said.

"They should go online to see how long the procedure has been available [at the clinic]," he said. "They should ask about how surgeons have been trained to do it, whether they have extensive training or just a standard three-day course."

Minimally invasive robotic surgery for prostate cancer is in an early stage of evolution, Hu said, and the surgical techniques needed to preserve urological function and prevent incontinence and impotence still have not been perfected. [ HealthDay.com ]

READ MORE - Impotence, Incontinence Risk Casts Doubt

Drinking Your Way to Health?

Drinking Your Way to Health?. Just about every month -- if not every week -- a new study emerges touting the health benefits to be gained from a daily glass of wine or a pint of dark beer.

The benefits related to cardiovascular health have become well-known. A study released in mid-July, for instance, found that moderate alcohol consumption reduces the risk of cardiovascular disease in women by increasing the amount of "good" cholesterol in the bloodstream and reducing blood sugar levels.

But other studies have linked a daily drink, most often wine, to reduced risk of dementia, bone loss and physical disabilities related to old age. Wine also has been found to increase life expectancy and provide potential protection against some forms of cancer, including esophageal cancer and lymphoma.

But don't invest in that case of Pinot noir just yet.

Experts with the American Cancer Society and the American Heart Association say that though these studies do show some benefits to moderate drinking, the health risks from alcohol consumption far outweigh the potential rewards.

Drinking any alcohol at all is known to increase your risk for contracting a number of types of cancer, said Susan Gapstur, vice president of epidemiology for the American Cancer Society. These include cancers of the mouth, pharynx, larynx, esophagus, liver, colon/rectum and breast.

"At the end of the day, if you are at very high risk for cancer, you might want to limit your alcohol consumption even further," Gapstur said. "It's a lifestyle modification you can make, and we don't have as many lifestyle modifications for preventing cancer as we do for coronary heart disease."

There also are other health risks from moderate drinking, including liver damage and accidents caused by impaired reflexes, said Dr. Jennifer Mieres, director of nuclear cardiology at the New York University School of Medicine and an American Heart Association spokeswoman.

The health benefits from drinking generally are related to the antioxidants and anti-inflammatories found in red wines and dark beers, Mieres said, but those substances can be found in a number of different fruits and vegetables.

"When it comes to disease prevention, you're better off changing your diet to include fruits and vegetables and get your antioxidants and anti-inflammatories from natural sources," she said.

For example, people can get resveratrol -- the antioxidant found in red wine that's believed to provide most of the drink's health benefits -- from drinking grape juice just as well as from drinking wine, Mieres said.

"For people that don't drink, not drinking is important," Mieres said. "You can get the same benefits of drinking from leading a heart-healthy lifestyle. To me, it's not worth the risk to start drinking. But for people who enjoy a glass of red wine or enjoy drinking, the key is to stick to the definition of moderation," she said.

Moderate drinking is defined as one drink a day for women and two drinks a day for men. What counts as one drink are:

• 12 ounces of regular beer or wine cooler
• 8 ounces of malt liquor
• 5 ounces of wine
• 1.5 ounces of 80-proof distilled spirits or liquor

Drinking anything more than that on a daily basis is known to lead to a host of health problems that can reduce your life expectancy, Mieres and Gapstur said.

"I think the take-home message is, if you don't drink, don't start to help protect yourself from coronary heart disease because there are so many other things you can do," Gapstur said. "If you already drink, you might want to limit your consumption."

Though the studies touting the positive health effects of alcohol are scientifically accurate, they also appear to play into people's desires for quick fixes to complex problems, Mieres said.

"To prevent heart disease, 50 percent of the work has to come from you," she said. "Prevention is a big piece, and you have to be accountable. You have to make lifestyle changes, and that's very tough to do. People look for easy ways to get heart-healthy benefits, and drinking is an easy way to do that. It's a known human tendency: Let's find an easy way out that doesn't involve a lot of thought or work." [ healthday.com ]

READ MORE - Drinking Your Way to Health?