In the Aug. 26 issue of the New England Journal of Medicine, an analysis of the exercise habits of 72,488 female nurses (between the ages of 40 and 65) during an 8-year period revealed that moderate exercise, such as walking as little as 1 to 3 hours per week, had as much as a 30 percent reduction in coronary events (heart attack and sudden death) during the study period. Longer periods of activity resulted in increased heart benefits.

Surprisingly, the reduced rate of heart attack in women who exercise moderately is similar to that observed in women who vigorously exercised for 90 minutes per week. While substantial health benefits were noted with brief periods and moderate intensity activities, the risk of heart attack decreased with additional length of time and intensity. According to the study, women who participated in both vigorous and moderate activity had an even more drastic reduction in their risk of heart attack than those who participated in either activity alone.

Seventy-eight percent of U.S. adults participate in less than the recommended level of physical activity; 60 percent participate in no regular physical activity at all.

Women who were at risk of heart attack due to other risk factors such as smoking, obesity and family history also had a reduced risk of heart attack when they incorporated a minimum of 3 hours per week of moderate intensity walking.

While those who choose vigorous exercise should not be discouraged from doing so, the authors at the Harvard Medical School point out the enormous public health benefits to be gained if women who are currently sedentary, or inactive, adopted even a moderate-intensity exercise program.

“Brisk walking is an excellent form of exercise for both women and men, especially as they age and their risk for knee or other injuries increases,” says Gerald Fletcher, M.D., national spokesman for the American Heart Association, and professor of medicine at Mayo Medical School in Jacksonville, Florida.

Why does this news sound familiar, yet distinctly new and promising? We all know about the health benefits of vigorous exercise, but this study demonstrates the fact that women need not spend an exorbitant amount of time, effort or money on fancy exercise equipment to achieve significant benefits from exercise; walking alone may be sufficient.

And walking is not only for women: A similar study conducted on elderly men has shown that walking 1.5 miles a day can cut their risk of heart disease by 50 percent.

Now that we know that something as simple as walking at a slightly faster than usual pace can reduce the risk of heart attack, why not jump on the heart attack reduction band-wagon? It’s as easy as a walk in the park, and less painful than running five miles before breakfast. Who knows, you may even enjoy it!

You know that sexual dysfunction can destroy a relations, but there’re effective, strong and safe premature ejaculation pills now! PE is the most common form of sexual dysfunction in men younger than forty years.

B.T.

A. It sounds as if you have a condition called seasonal allergic rhinitis. Sinus pressure is a common associated symptom. The sinus headache you describe is caused by swelling in the nose and sinuses triggered by allergy-producing substances in the environment. If you cannot avoid the pollen that triggers your symptoms, a trial of medications is the next step.

A number of over-the-counter medications can be very helpful, though some of the best drugs are prescription medications. The major classes of over-the-counter medications for your symptoms include antihistamines, decongestants and pain relievers. Keep in mind that many preparations are combinations of two or more classes of medicines. It’s important to consider both the beneficial effects and the side effects of the various medicines when deciding what to take.

Although antihistamines such as Benadryl (diphenhydramine) do not directly relieve sinus pressure, they can reduce sneezing, itching and the “wet” symptoms of pollen allergy — such as watery eyes and runny nose. The primary side effects of these medications include sedation, excessive mucous membrane dryness and potential aggravation of prostate problems or glaucoma. Try a few different products one at a time to see if any of them works well for you. After prolonged use of a drug, your body may become tolerant to it, and it may not continue to work well for you. If this happens, try changing to a different antihistamine.

Decongestants such as Sudafed (pseudoephedrine) constrict blood vessels and thus decrease the swelling in the nose and sinuses. These drugs can help unblock these passages and relieve the symptoms of sinus pressure that you describe. The primary side effects include insomnia, increased blood pressure, decreased appetite and cross-reactions with other drugs, especially antidepressants.

The most effective decongestants are topical nose sprays such as Afrin or Neo-Synephrine. Topical decongestants should not be used for more than two days, however. Longer use can result in a rebound effect, with worse swelling and irritation once you stop using the sprays.

Pain relievers can also relieve your headache, and they are a common addition to many over-the-counter allergy preparations. Tylenol (acetaminophen), Advil (ibuprofen) and aspirin can all be helpful. Each of these may have varying effectiveness, depending on your response to them, and they should be taken according to your doctor’s directions or those on the package.

If your headache persists, visit an allergist or otolaryngologist (ear, nose and throat specialist) for a complete evaluation and to see if you would benefit from a prescription medication. Several new prescription antihistamines are much less likely to cause drowsiness than the over-the-counter drugs. Another prescription medication that may work well to treat your symptoms is a nasal steroid spray. These sprays have few side effects and provide long-term relief of symptoms by blocking the inflammation associated with allergies.

It’s at this time possible to obtain drugs on the Internet plus many individuals have taken advantage of it. Our pharmacy no prescription is a perfect store for people to get their cheap generic medicines.

Cognitive behavior therapy (CBT), which combines education on the causes of insomnia with specific changes in bedtime behaviors, is among the most effective ways to combat sleep disorders, faring far better than the once-standard relaxation therapy, according to a new study in this week’s Journal of the American Medical Association.

“It works because it helps people understand why they can’t sleep and then teaches them the behaviors that can directly change their sleep habits, and ultimately, overcome their sleep problems,” says Jack Edinger, lead author of the study and a sleep expert at the VA Medical Center and Duke University Medical Center in North Carolina.

Some of what the study participants learned, says Edinger, was aimed at destroying long-lived myths about insomnia — legends that can aggravate and often perpetuate sleep problems.

“Many people believe that if they’ve had a bad night they should take a nap the next day, or that if they haven’t been able to sleep at night they should lay in bed longer in the morning or try to sleep in later, or if they don’t have a work schedule they can sleep whenever they want. But none of this is true,” says Edinger.

In fact, he says, trying any of these tactics is more likely to encourage insomnia and ingrain the kind of bad sleep habits that create a lifetime of nocturnal battles.

By comparison, reports Edinger, patients in the study were encouraged to standardize their wake-sleep schedule, avoid daytime napping, and avoid lying in bed when sleep doesn’t come, choosing instead to get up and do something until sleepy feelings hit.

“Our goal was to break the mental and behavioral cycle they get into when watching the clock and agonizing about tomorrow because they can’t sleep,” Edinger says, adding that this is something relaxation therapy can’t accomplish.

Other experts agree — and say the study findings are not surprising.

“Therapy which addresses the underlying behaviors behind the sleep problem, plus learning which bedtime habits affect sleep — such as smoking or eating or doing exercise — is bound to be far more successful than either relaxation or medication, mostly because it offers a more permanent solution,” says Dr. Anna Krieger, a sleep expert at New York University’s Sleep Disorders Center.

“The fact that this study also compared behavior therapy to relaxation therapy is significant because it helps us to see the importance in helping a patient understand why they can’t sleep — and how that understanding can contribute to a solution,” says Krieger.

What the Study Found

The Duke University-VA study involved 75 participants, average age 55, all of whom suffered from insomnia for at least 10 years. The study began with a questionnaire, followed by polysonography, a method of documenting physiological activity linked to sleep, like brain waves, eye movement and chin tension. Testing was administered at bedtime in each patient’s home.

The participants were then randomly assigned to receive one of three treatments: CBT, consisting of insomnia education and sleep-behavior modification; progressive-muscle relaxation therapy instruction; or placebo treatment consisting of mental exercises they were told would decrease sensitivity to nighttime awakenings.

The education portion of each treatment took place once a week for six weeks. All patients were asked to keep a sleep log, and additional questionnaires were distributed at the midpoint of the study and two weeks after treatment ended, when the patients were also given another polysonogram. Six months later they returned to the sleep center for a follow-up exam.

The outcome: Those in the CBT group showed a 50 percent reduction in their wake time after the onset of sleep. The group trying the relaxation therapy experienced a 16 percent change, and the placebo group saw a 12 percent difference in the amount of time they spent awake. Other factors related to insomnia, including overall sleep efficiency — essentially how well we sleep — were highest in the CBT group as well.

While this study did not compare CBT to drug therapy, a recent Canadian study did, and found behavior therapy also provided the highest quality and longest-lasting relief.

“The problem with using medication is that it just puts you back to sleep, it doesn’t address what’s keeping you up, ” Krieger says.

What To Do

Sleep disorders affect up to 5 percent of the population. Still, doctors say most insomniacs don’t seek help for at least a decade. The reason is often a simple lack of knowledge about what can help.

“The public’s sleep IQ still remains low — people are suffering needlessly because they simply don’t realize there are options other than drugs, and these options do work,” Edinger says.

Experts say everyone can expect a bad night’s sleep once in a while, or even have days or weeks when sleep seems elusive. But if the problems persist longer than a month, you should consult a sleep disorders center.

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This category of patient includes infants less than 6 months old, the elderly, those undergoing cancer treatments and persons with HIV infections. Healthy persons are not at risk for serious illness, but other segments of the population risk hospitalization if infected by contaminated food.

Food recalls by the Food and Drug Administration are at their highest levels since 1986, the Times reports. One of the problems with the recall system, according to the Times is that there are too few inspectors so that foods can only be recalled after illnesses are reported by consumers.

Last year 315 food products were recalled by the FDA. The CDC reports that 5,000 deaths, 325,000 hospitalizations and 76 million illnesses are caused by food poisoning every year, according to The New York Times.

Although the article by Greg Winter acknowledges that “Not all scientists agree with” the conclusions of the CDC, no specific sources or reasons for disagreement are cited.

One factor not discussed in the Times article that may argue against its focus includes increases in the number of immunocompromised persons in the United States population, such as the growing number of senior citizens. Modern access to cancer therapies which suppress functioning of the immune system was not available in 1968, nor were there any reported cases of HIV at that time.

A plausible alternative hypothesis might be that the incidence of food contamination has not risen. Rather, an increased susceptibility to serious illness in the population may be the significant variable worth addressing. The Times article does state that food industry representatives assert “the nation’s food supply…(is)…already the safest in the world…”

New safeguards, whether personal, medical, pharmaceutical or societal may reduce the incidence of disease for the expected increase in people whose immune systems are not functioning well.

Do antidepressants work for people who have been identified as having fibromyalgia? Even for individuals who have no symptoms of depression, studies show that anti-depressants can lower the fatigue and generalized aches that accompany fibromyalgia. In one study, fibromyalgia patients who received antidepressants were four times more likely to show an improvement in their symptoms.

A recent research paper published in the Journal of the American Medical Association confirms the benefits of using antidepressants for treating individuals diagnosed with fibromyalgia. Eighteen, credible, high quality clinical trials were analyzed by a group of German researchers, and they concluded that people with fibromyalgia can benefit from treatment with an antidepressant. Tricyclic antidepressants have been on the market since the 1960′s, and it is this category of antidepressants that seems to be the most effective in treating fibromyalgia. Less effective in fibromyalgia treatment are the newer and more commonly used SSRI antidepressants as well as other groups of antidepressants.

From this study it has been concluded that tricyclics are the very best type of prescription medication in treating fibromyalgia; they may be especially effective for improving the moodiness as well as sleep problems that often afflict individuals diagnosed with fibromyalgia. Although there are benefits to using tricyclic medications, the numerous side effects involved from the medication usage indicates that such usage should be implemented only after a series of lifestyle changes have occurred.

Many patients with fibromyalgia report that exercise, which includes 30 minutes of regular aerobic exercise done each day, helps alleviate symptoms and improves sleep. Eating less sugar and processed food might help. Caffeine should not be consumed, particularly if there are issues with insomnia. People have reported a decrease in pain and fatigue and a better mood, after using meditation and massage therapy. In some cases, these non-invasive treatments can reduce or eliminate the need for the drug therapy that can cause unwanted side effects.

People who are identified as having fibromyalgia might be helped with a tricyclic antidepressant if their lifestyle alterations don’t help with the symptoms, however a natural method is still better.

Let’s examine the reasons that sensible and conscientious BV treatment is critical, and even more so with our current recession.

It is critical to treat cases of BV because not doing so may result in complications, like developing susceptibility to HIV infection or other STDs. Even though BV signs occasionally clear themselves up, anyone with persisting symptoms should pursue medical attention.

The advised course of treatment for the condition of BV includes:

Metronidazole or Flagyl Medications

Metronidazole is administered by mouth or via the vagina for a period of a week. A pill of 500 mg is consumed twice a day with oral usage. Intravaginal dosing does not have as many side effects as using it orally. The application of it to the vagina once each day is another method of administration. To decrease the effects on the fetus, pregnant women are given a smaller dose of metronidazole. Among the typical negative side effects linked with treatment with metronidazole are diarrhea, feelings of nausea, and a metal-taste in the mouth. During treatment and for 24 thereafter, patients should not drink alcohol.

Cleocin or Clindamycin

Clindamycin lotion is administered vaginally at night for a period of a week. Alternative regimens include oral consumption for one week, or the use of vaginal ovules for 3 days. During the second half of pregnancy, clindamycin preparations that are topical should not be applied. The oil base in clindamycin lotion could cause deterioration of latex condoms or diaphragms for up to 5 days from use.

If the symptoms go away, then a follow up visit is not needed. If infection recurs, the next treatment will be different from the one that was tried previously.

Sexual transmission is not the only avenue of infection with BV, but it is associated with sexual interactions. Only in cases of recurring or resistant BV, is treating the male sexual partner advised, which is a common occurrence.

Armed with this information, you can make informed judgments about your course of treatment for vaginosis.