Questions remain in Anna Nicole Smith's death - TV

Questions remain in Anna Nicole Smith's death

Filan: We might not have seen the end of this investigation
NBC VIDEO?�'The manner of death was accidental'
March 26: Dr. Joshua Perper, Broward County, Fla., medical examiner, talks with 's Contessa Brewer about how he reached the conclusion that Anna Nicole Smith died from an accidental overdose.

COMMENTARYSusan FilanSenior legal analyst

Susan FilanSenior legal analyst

What do you get when you have a psychiatrist, a nurse, a body guard, and a boyfriend, plus a woman with 105 degree fever??�?� A death that should have been, and could have been prevented.?�

When Anna Nicole Smith??�s fever spiked to 105 degrees, why didn??�t her psychiatrist, who prescribed antibiotics for her, take her to a doctor, to a hospital or call 911??�?� Why didn??�t those closest to her insist that she get proper medical attention??�

Dr. Perper, the Broward County Medical Examiner who performed her autopsy, seemed satisfied with the explanation that she was an adult who had the right to say, I don??�t want a doctor, I don??�t want to go to the hospital. ?�?� But if someone is that ill, are they thinking straight??� If she knew her choice was to go to the hospital or to die, what would she have chosen??�?� If she was not suicidal, as Dr. Perper indicated, then she would have chosen to go to the hospital, not to die.?� Anna Nicole was a person known to self-medicate, known to take too many prescriptions in too high a dose.?�?� So why was she left alone, sick, in a hotel room that was a virtual medicine ?

More from Susan FilanWho will get Anna Nicole's money?Death for killer of pregnant mom, children?Unfair: 10 years for consensual oral sex

Why didn??�t Anna Nicole??�s nurse check on her in her hotel room on Thursday, the day she died??�?� It seems she was left alone in her room from 10:30 a.m. to 1:30 p.m. when she was found dead in her bed??� Why did Howard K. Stern, who awoke at 10:00 a.m., and had to help Anna Nicole to the bathroom because she was too weak to go alone, take his shower, dress and leave her??�?�

The medical examiner??�s report seems to raise more questions than it answers.?� Something does not add up for me.

It just doesn??�t make sense that a 39-year-old woman, who had just given birth to a baby girl, who had just lost a son, who was so depressed she was on three anti depression medicate/anti-anxiety medicate s, who had a history of overmedicating and mixing prescriptions, of taking methadone, of swigging liquid chloral hydrate, would be left alone to die of an accidental medicate overdose.

?�Birkhead finally leaves Bahamas with daughter?�Two Anna Nicole Smith diaries sell for $59,750?�Anna Nicole mocks herself in final role?�Birkhead says Howard K. Stern a great help??�

Here is what bothernesss me: On Tuesday, Anna Nicole Smith had a 105-degree fever.?�?� Her psychiatrist, not her doctor, prescribed her with an antibiotic, but did not insist she go to the hospital.?� No one did.?�

I do not think we have heard the end of this.?� I think we will see further investigations, lawsuits, and perhaps loss of medical licenses as a result of Anna Nicole??�s tragic and preventable death.

? 2007

More than 80 at risk of meningitis - Infectious Diseases

More than 80 in 3 states at risk of meningitis

Warning follows N.H. college student's death from illness

CONCORD, N.H. - More than 80 group in three states may be at risk for meningitis after coming into contact with a University of New Hampshire student who died of the illness this week, health officials said.

The warning came amid anotherness meningitis scare that shut down schools Thursday and Friday in three towns in Rhode Island.

The college student, 21-year-old Danielle Thompson, had been in her home state of Maine, as well as in Massachusetts and New Hampshire, in the 10 days before she was admitted to a Dover hospital. She died of bacterial meningitis on Wednesday.

Health and Human Services Commissioner John Stephen said the state has identified 29 group in New Hampshire and 55 in Maine who should receive antibiotics. Officials were still tracking down how many group Thompson visited in Massachusetts.

No one has yet shown syndromes, Stephen said.

Click for related content

R.I. schools closed for meningitis scare

Bacterial meningitis can be spread through saliva, creating the most risk for group who shared food or drinks, kissed or used the same eating utensils. It causes an infection of fluid in the spinal cord and surrounding the brain, with syndromes include high fever, headache and stiff neck.

“This case underscores just how serious this illness can be,” Stephen said. More meningitis news from MSN Health

Reality Check: Meningitis

In Rhode Island, epidemiologists from the U.S. Centers for Disease Control and Prevention are working with state officials investigating a possible case of meningitis and three cases of encephalitis that surfaced in public school children. One second-grader in Warwick died from encephalitis that was brought on by “walking pneumonia.”

Dr. David Gifford, director of Rhode Island’s Public Health Department, said there have been an unusually high number of walking pneumonia cases in the children’s communities.

As a precaution, classes for about 20,000 students in those communities �" Warwick, West Warwick and Coventry �" were cancelled Thursday and Friday while health experts investigate, Gifford said.

� 2007 . .

Rosie O??�Donnell won??�t return to The View??� - Television

Rosie O??�Donnell won??�t return to The View??�

Announcement comes two days after heated on-air fight with co-host
Yolanda Perez / AP
Elisabeth Hasselbeck, left, and?�Rosie O'Donnell sparred frequently on "The View," though they profess to be good friends off camera.

video?�Rosie quits 'The View' early
May 25: With news that Rosie O'Donnell will not returning to 'The View,' Donald Trump comments on his feud with O'Donnell.

Rosie O??�Donnell has fought her last fight at The View.

ABC said Friday she asked for, and received, an early exit from her contract at the daytime chatfest following her angry confrontation with co-host Elisabeth Hasselbeck on Wednesday. She was due to leave in mid-June.

It ended a colorful eight-month tenure for O??�Donnell that lifted the show??�s ratings but no doubt caused heartburn sickness for show creator Barbara Walters. O??�Donnell feuded with Donald Trump and frequently had snippy exchanges with the more conservative Hasselbeck.

O??�Donnell said last month she would be leaving because she could not agree to a new contract with ABC executives.

Rosie contributed to one of our most exciting and successful years at The View, ??� Walters said. I am most appreciative. Our close and affectionate relationship will not change.

In a statement, O??�Donnell said that it??�s been an amazing year and I love all three women.

No one was feeling the love on Wednesday, when the argument with Hasselbeck began over O??�Donnell??�s statement last week about the war: 655,000 Iraqi civilians have died. Who are the terrorists ?

Talk show critics accused O??�Donnell of calling U.S. troops terrorists. She called Hasselbeck cowardly for not saying anything in response to the critics.

Do not call me a coward, because No. 1, I sit here every single day, open my heart and tell group what I believe, Hasselbeck retorted, and their riveting exchange continued despite failed attempts by their co-hosts to cut to a commercial.

According to a New York Post report, O??�Donnell??�s chief writer, Janette Barber, was allegedly led out of the building on Wednesday after she was caught drawing mustaches on photographs of Hasselbeck in The View studios. ABC executives didn??�t return repeated calls for questions on the incident Friday.

On Thursday O??�Donnell had asked for a day off to celebrate her partner??�s birthday. The View aired a taped show on Friday.

Related contentRosie??�s View??� won??�t be the same without her Vote: Will you miss Rosie on The View??�?Political discussion turns personal on View??�Walters denies fight was ratings stunt  What do you think about her departure?

Slide show?�Rosie through the years
From the 80s through The View,??� a look at the feisty TV host??�s careerOn her Web site, O??�Donnell posted a scrapbooklike video on Friday with pictures and news clippings of her tenure at The View. Cyndi Lauper??�s Sisters of Avalon played in the background.

A day earlier, she posted messages on her Web site indicating she might not be back.

When painting there is a point u must step away from the canvas as the work is done, she wrote. Any more would take away.

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? 2007 . .

WP: Bug mutates into medical mystery - washingtonpost.com Highlights

Bug mutates into medical mystery

Antibiotics, heartburn sickness medicate s suspected
By By Rob Stein

WASHINGTON - First came stomach cramps, which left Christina Shultz doubled over and weeping in pain. Then came nausea and fatigue -- so overwhelming she couldn't get out of bed for days. Just when she thought things couldn't get worse, the nastiest diarrhea of her life hit -- repeatedly forcing her into the hospital.

Doctors finally discovered that the 35-year-old Hilliard, Ohio, woman had an inagsdhfgdfinal bug that used to be found almost exclusively among older, sicker patients in hospitals and was usually easily cured with a dose of antibiotics. But after months of pharmacomedical aid, Shultz is still incapacitated.

"It's been a nightmare," said Shultz, a motherness of two young children. "I just want my life back."

Shultz is one of a growing number of young, othernesswise healthy Americans who are being stricken by the bacterial infection known as Clostridium difficile -- or C. diff -- which appears to be spreading rapidly around the country and causing unusually severe, sometimes fatal illness.

That is raising alarm among health officials, who are concerned that many cases may be misdiagnosed and are puzzled as to what is causing the microbe to become so much more common and dangerous.

"It's a new phenomenon. It's just emerging," said L. Clifford McDonald of the federal Centers for Disease Control and Prevention in Atlanta. "We're very concerned. We know it's happening, but we're really not sure why it's happening or where this is going."

Antibiotics to blame?
It may, however, be the laagsdhfgdf example of a common, relatively benign bug that has mutated because of the overuse of antibiotics.

"This may well be anotherness consequence of our use of antibiotics," said John G. Bartlett, an infectious-malady expert at Johns Hopkins University in Baltimore. "It's anotherness example of an organism that all of a sudden has gotten a lot meaner and nastier."

?�More health newsIn addition, new evidence released last week suggests that the enormous popularity of powerful new heartburn sickness medicate s may also be playing a role.

The antibiotics Flagyl (metronidazole) and vancomycin still cure many patients, but othernesss develop stubborn infections like Shultz's that take over their lives. Some resort to having their colon removed to end the debilitating diarrhea. A small but disturbingly high number have died, including an othernesswise healthy pregnant woman who succumbed earlier this year in Pennsylvania after miscarrying twins.

The infection usually hits group who are taking antibiotics for otherness reasons, but a handful of cases have been reported among group who were taking nothing, anotherness unexpected and troubling turn in the germ's behavior.

The infection has long been common in hospital patients taking antibiotics. As the medicate s kill off otherness bacteria in the digestive system, the C. diff microbe can proliferate. It spreads easily through contact with contaminated group, clothing or surfaces.

Infections double
There are no national statistics, but the number of infections in hospitals appears to have doubled from 2000 to 2003 and there may be as many as 500,000 cases each year, McDonald said. Other estimates put the number in the mil.s.

The emerging problem first gained attention when unusually large and serious outbreaks began turning up in otherness countries. In Canada, for example, Quebec health officials reported last year that perhaps 200 patients died in an outbreak involving at least 10 hospitals. Similar outbreaks were reported in England and the Netherlands.

After the CDC began receiving reports of severe cases among hospital patients in the United States -- and in group who had never, or just briefly, been hospitalized -- it launched an investigation.

In the Dec. 8 issue of the New England Journal of Medicine, the CDC reported that an analysis of 187 C. diff samples found that the unusually dangerous strain that caused the Quebec cases was also involved in outbreaks at eight health care facilities in Georgia, Illinois, Maine, New Jersey, Oregon and Pennsylvania.

"This strain has somehow been able to get into hospitals widely distributed across the United States," said Dale N. Gerding of Loyola University in Chicago, who helped conduct the analysis. "We're not sure how."

But scientists do have a few clues. The dangerous strain has mutated to become resistant to a class of frequently used antibiotics known as fluoroquinolones. That means anyone taking those antibiotics for otherness reasons would be particularly prone to contract C. diff .

"Because this strain is resistant, it can take advantage of that situation and establish itself in the gut," Gerding said.

Experts said the resistant germ's proliferation offers the laagsdhfgdf reason why group should use antibiotics only when necessary, to reduce both their risk for C. diff and the chances that otherness microbes will mutate into more dangerous forms.

"That's one theory for what's happening here," said J. Thomas Lamont of Harvard Medical School. "If we reduce the number and amount of antibiotics given for trivial infections like colds and stuffy noses, we'd all be a lot better off."

Overuse of antibiotics can make germs more dangerous by killing off susceptible strains, leaving behind those that by chance have mutated to become less vulnerable to the medicate s. The resistant strains then become dominant.

High toxin levels
In addition to being resistant, the dangerous C. diff strain also produces far higher levels of two toxins than do otherness strains, as well as a third, previously unknown toxin. That would explain why it makes group so much sicker and is more likely to kill. In Quebec, C. diff killed 6.9 percent of patients -- which is much higher than the malady's usual mortality rate -- and was a factor in more than 400 deaths.

Adding to the alarm is evidence that the infection is occurring outside of hospitals. When the CDC began looking for such cases earlier this year, investigators quickly identified 33 cases in New Hampshire, New Jersey, Ohio and Pennsylvania, including 23 group who had never been in the hospital and 10 women who had been hospitalized only briefly to deliver a baby, the agency reported this month. Eight of the patients had never taken antibiotics.

"This is the first time we've started to see this not only in group who have never been in the hospital but also in those who are othernesswise perfectly healthy and have not even taken antibiotics," McDonald said.

"It's probably going on everywhere," he said.

It remains unclear whether the cases occurring outside the hospital are being caused by the same dangerous strain.

"We don't really know what's going on here," McDonald said. "We know it's changing in some ways; we know it's changing the kinds of patients it's attacking, and we know it's causing more severe malady. But we don't know exactly why."

Canadian researchers, however, have found one possible culprit: popular new heartburn sickness medicate s. Patients taking proton pump inhibitors, such as Prilosec and Prevacid, are almost three times as likely to be diagnosed with C-diff , the McGill University researchers reported in the Dec. 21 issue of the Journal of the American Medical Association. And those taking anotherness type called H2-receptor antagonists, such as Pepcid and Zantac, are twice as likely. By suppressing stomach acid, the medicate s may inadvertently help the bug, the researchers said.

Whatever the cause, the infection often resists standard pharmacomedical aid. That is what happened to Shultz, who had been taking antibiotics to help clear up her acne when C. diff hit in June. Because the bacterium can hibernate in protective spores, patients can be prone to recurrences. It can take multiple rounds of antibiotics -- or sometimes infusions of antibodies or ingesting competing organisms such as yeast or the bacteria found in yogurt -- to finally cure them.

"I'm trying to stay positive," Shultz said. "People tell me it does go away and I will get rid of it someday. I'm looking forward to getting my life back, but I'm not convinced I'll ever be normal again."

? 2007 The Washington Post Company

Water good, coffee bad? Ain??�t necessarily so - Health

Water good, coffee bad? Ain??�t necessarily so

These and otherness recent medical maxims have become generally accepted as the truth. Today contributor Dr. Judith Reichman dissects myth from fact
FREE VIDEOFeb. 23: In this Woman's Health segment, Dr. Judith Reichman examines the health facts surrounding water and coffee as well as otherness medical maxims.

Today show

Today show
By By Dr. Judith Reichman"Today" contributorTODAY

We??�ve heard the same prescriptions for good health repeated for years by our mothernesss, friends, in magazine articles and, oh yes, by our doctors.?� Are they true, and are they supported by current research??� On Today??�s Woman, Today show medical contributor Dr. Judith Reichman tells us that in some instances this it??�s good for you advice ain??�t necessarily so.?�

Water, water everywhere! Should I drink it all?
There??�s a prevailing opinion that there??�s no such thing as too much water.?� Does the advice drink eight glasses a day really hold water??� Many women believe that the more they drink, especially when it comes in designer bottles, the less they??�ll eat, the more they??�ll flush toxins from their bodies, and the moister and dewier their skin will be.?� Countless magazine articles have recommended eight glasses a day (two quarts) as the gold standard of liquid health.?� None of these suppositions bear medical scrutiny.?� A diligent review, published in the American Journal of Physiology, could neither locate the origins of this edict, nor any evidence to support it.?� The moisture in your skin will suffer only if you meet the medical standards for dehydration.?� There??�s no need to monitor the color of your urine or count your empty water bottles.?� We have a marvelous built-in hydration control.?� It??�s called thirst, which works through multiple hormones and sensors in our vascular system.?� Also, much of what we consume contains liquid, even though it??�s not water, and despite what you??�ve heard, coffee, caffeinated soft drinks and otherness fluids do count.?� Finally, there are good reasons not to overdo fluids.?� Many women complain of incontinence problems simply because their overfilled bladder contracts before they reach the toilet.?� Just like most vitamins, a deficiency of water is bad, but excess is unhelpful and can even be dangerous.?� If you take in fluid faster than your kidneys can process it, you could even end up with water intoxication, causing confusion, coma and even death.

What about otherness beverages??� Should we decaffeinate?
There??�s no question that caffeine is a powerful psychoactive medicate .?� We use it as a mental stimulant (and today the act of drinking coffee in coffee shops has become a social stimulant for conversation, business meetings, and logging onto the Web).?� Caffeine prevents sleepiness and sharpens thinking by blocking the action of certain neurotransmitters and lift moods by affecting dopamine.?� It revs you up by promoting release of adrenaline, starting at doses lower than fifty milligrams, which is about the amount in a serving of black tea or cola.?� It has been shown to improve muscle coordination and strength if consumed just prior to exercise or an athletic event.?� It also increases energy expenditure, and to a very small extent helps us burn calories.?� Because it helps relax the airways of the lungs, caffeine is associated with fewer asthma attacks in asthmatics.?� And here??�s an effect we??�ve all noticed: it can act as a laxative.?� In fact, many women rely on their morning coffee to keep them on schedule from both a gastroinagsdhfgdfinal and daily activity perspective.?� Two to three cups a day may lower the incidence of Parkinson??�s malady (according to Nurses??� Health Study data) and seems to decrease gallstone formation, at least in men.?� However ??" and there??�s always a however ??" there can be some negative effects, although some of which we??�re warned about may be exaggerated.?� The following have been associated with caffeine and may give us pause in taking that second or third cup of coffee:

Miscarriage
There may be as much as a 30 percent increase in early miscarriage of normal pregnancies for women who drink one to two cups of coffee a day.?� One meditate has shown this goes up to 40 percent with four cups.?� There??�s also concern about caffeine consumption while trying to conceive.?� Some studies have shown infertility rates double for women who drink more than two and a half cups of coffee a day.Cancer, coffee and smoking
No cancer correlation to caffeine has been found, except that women who smoke often do so at the same time that they drink their coffee.?� There is no increase in breast cancer from caffeine, although some women find breast tenderness is worsened with increased caffeine consumption.?� Osteoporosis
There is no conclusive link between caffeine and osteoporosis, but if caffeinated beverages (without milk) preclude milk or calcium-containing fluid consumption, the lack of calcium intake will correlate with osteoporosis risk.Cardiovascular disease
Caffeine can raise blood pressure for a few minutes, and in some cases hours.?� However coffee consumption does not seem to cause ongoing hypertensive disorder.?� If you already have cardiovascular disease , however, a cup of coffee may temporarily raise your blood pressure and this could ultimately increase your more immediate risk of stroke.Heart malady
Caffeine can cause palpitations, irregular or fast heartbeat, and if you have an existing abnormal heart rate or heart malady, this could be a problem.?� One meditate found an increased risk of cardiac arrest in nonsmokers who consumed six or more cups of coffee a day.?� But in general we can??�t blame heart malady or heart attacks on reasonable caffeine consumption.Headaches
Caffeine can increase the effectiveness of headache medicate s (and many of the over-the-counter headache medicate s in fact combine caffeine with either aspirin or a Tylenol-like component).?� But these combined products can actually cause rebound headaches.?� To avoid this take a pill feel better, then worse cycle, over-the-counter medicate s with caffeine shouldn??�t be used for more than two days at a time.PMS
Caffeine acts as a diuretic and should decrease discomfort and bloat.?� But it can also cause a fall in blood sugar, which increases syndromes of PMS.?� There can be a three-fold increase in PMS if we drink more than three to four cups of coffee a day.Bladder conditions
Caffeine speeds the kidneys??� processing of fluid, so we have to go more frequently.?� It can also irritate the bladder, leading to certain forms of incontinence.?� Caffeine and sleep
Caffeine stimulates the brain and also affects levels of melatonin, which promotes sleep.?� It takes four to seven hours to metabolize caffeine.?� The older we are, the longer it takes.?� And if you are on birth control pills or estrogen, the half life of caffeine may be doubled.?� So an afternoon cup of coffee can cause late night insomnia.Caffeine and anxiety
High doses increase the level of brain chemicals associated with anxiety.?� Caffeine and heartburn sickness
Even decaffeinated coffee can increase stomach acid production and affect the closing of the valve between the stomach and esophagus, leading to reflux and heartburn sickness.?� If you do have this problem, you not only need to decaffeinate, but you need to de-decaffeinate, i.e. no types of coffee at all.

The bottom line
In summary, caffeine does make us feel better, more alert; we sometimes exercise better, even think better.?� But we should not be consuming it, especially more than one to two cups per day, if we have:

Irregular heartbeats or palpitationsSevere PMSSleep problemsBladder problemsAnxiety and/or panic attacks

If it??�s Tuesday, it must be Belgian chocolate! What, if any, is the harm?
There is, of course, anotherness product that we love that also contains some caffeine: chocolate.?� We??�ve been told that it??�s fattening and not good for us.?� It will rot your teeth, cause acne, make you fat. ?� Are these warnings true??� And what about the recent proclamations that chocolate is, to some extent, a health food?

First, the caffeine in chocolate is not very strong.?� One chocolate bar contains less than a cup of coffee. Chocolate also contains a group of very healthy ingredients called flavinoids, which are antioxidants and are also contained in fruits, nuts and vegetables (and red wine).?� These flavinoids, which are present in the cocoa bean, can reduce the blood??�s ability to clot (like aspirin) and may also help to lower blood pressure. Part of the fat content in chocolate comes from steric acid, which works on the body like a healthy monounsaturated fat.?� There is even some evidence this may help protect against cavities.?� But remember, a cup of chocolate is very dense in calories, containing up to a thousand calories or more, whereas a cup of broccoli contains less than forty.?� Moreover, white chocolate contains no flavinoids. Dark chocolate, which is considered the healthiest, contains two to four times the amount of flavinoids that milk chocolate has.?� If you want to have a couple of pieces of dark chocolate a day, consider the calories in your total count, but in the end this may not be such an anti-health treat.

We??�ve been told women should take iron supplements. Is that true?
To start, it is very important to know that iron supplements are the most common cause of poisoning deaths among children, and overload is dangerous at any age.?� If you??�re not anemic, doses over forty-five milligrams can cause constipation, vomiting, nausea or diarrhea.?� While we have our periods and lose blood and deplete our iron stores, taking a multi-vitamin with a small amount of iron is acceptable. But as we get older and stop having periods this is not necessarily so.?� One out of two hundred and fifty group of Northern European descent (and also persons of otherness ethnic backgrounds) have a genetic disorder called hemochromatosis.?� In this condition, iron absorption is so efficient that there is build up of excess iron in the body??�s organs, which can cause serious liver, heart, thyroid and joint problems, as well as liver cancer. As women menstruate for thirty or forty years this problem may not show up until after menopause.?� Iron may also aid the formation of free radicals, those unstable agent malady-promoting molecules.?� In fact, one theory of why younger women have less heart malady than men is that prior to menopause women??�s mild iron deficiency acts as a cardiac shield against free radical damage.?�

Finally, in a recent report of the Nurses??� Health Study, in which they followed thirty-two thousand women for more than ten years, they found that those women with higher iron stores were found to be at increased risk for development of type 2 polygenic disease.?� Too much iron, as in too much of any supplement, can be harmful.?� So once you??�re menopausal, do not take a multivitamin with iron unless told to do so by your doctor after appropriate blood agsdhfgdfing.

The Pap smear ??" does it really need to be done every year?
After age 30 we can decrease the frequency of our Pap smears to every two to three years if our past routine Pap has been normal, we are in a monogamous relationship, don??�t smoke, don??�t take steroids, and are not DES-exposed ( meaning your motherness took DES when she was pregnant with you).?� Nearly all cervical pre-cancer and cancer is due to the sexually transmitted human papilloma virus (HPV), which, although readily transmitted, is cleared by most women after a few years.?� If this virus is not cleared, it will take three years or more to cause mutations in the cervical cells leading to pre-cancer and cancer. Some physicians are adding a special agsdhfgdf for HPV and if this and the Pap smear are negative, feel very assured that a three year wait (and not the usual yearly Pap) is safe and warranted.

Are carbohydrates really as bad as Dr. Atkins said?
Once again, not necessarily. A recent review published in the Journal of the A.M.E.found that there is not enough evidence to make health or diet recommendations for or against low-carb diets. Anotherness article, published in the New England Journal of Medicine, showed that low-carb diets (with high fat and high protein) are more effective for weight loss in obese individuals when compared with low fat diets (fewer than twenty-five percent of calories from fat), but only during the initial three and six months. By the end of the year, those who stayed on the low-carb diet (and many couldn't) did not lose more weight. And those who succeeded in losing weight in the first place did so because they ate fewer calories. It??�s the total calories that count! The American Heart Association has not recommended a low-carb diet, stating that there is no evidence that the diet is effective long term in improving health. Against a strict restriction of carbs for weight control is a 12-year Harvard meditate of 74,000 women which showed that those who consumed more fruits and vegetables were 26 percent less likely to become obese than women who ate fewer fruits and vegetables over the same period of time.

Part of the puzzle is that not all carbs are created equal. Refined carbohydrates, such as white rice, white bread and of course sugar ??" and potatoes ??" cause rapid spikes in blood sugar and hence raise insulin levels. Insulin can then cause fat to accumulate in the body, especially around the waist, and wrong fats (triglycerides) to accumulate in the blood stream, contributing to plaque and heart malady. ?�Complex carbs (think whole grains that are not denuded during so-called "refining") are digested slowly and don't cause a sudden blood sugar surge. They also contain important fiber, vitamins and phyto (plant) chemicals. When you stop consuming these "made for us by nature" carbohydrates and substitute protein and fat, you can eventually cause considerable harm. In the short term you may feel tired, dizzy, nauseated and dehydrated. With time, lack of carb balance can lead to deficiencies in vitamins and minerals. A lack of fiber often results in constipation and this increases your risk for development of diverticulosis (weakened pouches that develop in the bowel wall) and possibly even colon cancer. A diet with the wrong fats, i.e. saturated fats found in meat and whole milk and the trans fats in many processed foods and margarines, will contribute to heart malady. Too much protein can lower absorption of calcium, leading to osteoporosis, and can stress your kidneys.

We don't need a general carb-out. ?�If you want to keep your weight down and stay healthy, do the known, right stuff: eat plenty of vegetables and fruits, and substitute whole grains, some nuts, and healthy oils for sugar, white starch and saturated fats.?� And of course, don't smoke, and make sure you exercise!

Dr. Judith Reichman has practiced obstetrics and gynecology for more than 20 years. She is a regular Today show contributor.

? 2007

Doctors discourage use of cough syrup - Cold & Flu

Doctors discourage use of cough medicine

Over-the-counter versions do little to relieve symptoms, experts say
Scott Olson / Getty Images file
Non-prescription cough syrups generally contain drugs in too low a dose to be effective, a group of chest physicians say.

CHICAGO - Despite the billions of dollars spent every year in this country on over-the-counter cough syrups, most such medicines do little if anything to relieve coughs, the nation??�s chest physicians say.

Over-the-counter cough syrups generally contain drugs in too low a dose to be effective, or contain combinations of drugs that have never been proven to treat coughs, said Dr. Richard Irwin, chairman of a cough guidelines committee for the American College of Chest Physicians.

Drugstore shelves are crowded with cough syrups promising speedy, often non-drowsy relief without a prescription.

But the best studies that we have to date would suggest there??�s not a lot of justification for using these medications because they haven??�t been shown to work, said Irwin, a professor of medicine at the University of Massachusetts Medical School in Worcester, Mass.

The group??�s new cough pharmacotherapy guidelines discourage use of over-the-counter cough medicines. Irwin said that not only are such medicines ineffective at treating coughs due to colds ??" the most common cause of coughs ??" they can also can lead patients to delay seeking pharmacotherapy for more serious coughs, including whooping cough.

The guidelines strongly recommend that adults receive a new adult vaccine for whooping cough, approved last year.

Guidelines disputed
The Consumer Healthcare Products Association, a trade group for makers of over-the-counter medications, disputed the guidelines and said over-the-counter cough medicines provide relief to millions of people each year.

The guidelines were published in the January issue of Chest, the American College of Chest Physicians??� journal, released Monday. The recommendations have been endorsed by the college, the American Thoracic Society and the Canadian Thoracic Society.

Many popular over-the-counter cough medicines proudly advertise that they don??�t cause drowsiness, but Irwin said that is because they do not contain older antihistamine drugs that do help relieve coughs that are due to colds.

These antihistamines, including diphenhydramine ??" an active ingredient in Benadryl ??" are also available over the counter but are not marketed as cough medicines, he said.

Some over-the-counter cough syrups contain two drugs that have been shown to help relieve coughs caused by colds ??" codeine and dextromethorphan ??" but generally the doses are too small to be effective, Irwin said.

Vote

Do you think over-the-counter cough syrups work?

Dextromethorphan is in Robitussin, a top-selling over-the-counter cough syrup. It is among Robitussin ingredients that the (Food and Drug Administration) has found to be safe and effective, said Francis Sullivan, a spokesman for Wyeth Consumer Healthcare, which makes Robitussin.

Sullivan said Robitussin wouldn??�t be a top brand if people didn??�t feel it was efficacious.

Coughs can have numerous underlying causes, including asthma, allergies, severe heartburn, postnasal drip and bronchitis.

Dr. Edward Schulman, an American Thoracic Society representative on the guidelines panel, said patients should see their doctors for coughs that linger longer than three weeks or are accompanied by shortness of breath, which could indicate pneumonia or other serious conditions.

Coughs due to colds usually last less than three weeks. Drinking lots of fluids can help relieve these coughs, and so can chicken soup, Schulman said.

? 2007 . .

What to do when you can't sleep - Sleep

When the gods of sleep have deserted you

Skip the pills and try these expert-recommended tips
Roy Morsch / Corbis
Turn off the TV?�??" and other distractions ??" when you're in bed, experts say.

Can't sleep? Nearly everybody's had a hard time falling asleep at least once, but 10 percent of the general population suffers insomnia regularly. Not only do they have a hard time falling asleep, but they awaken several times during the night and feel fatigued the next day.

The older you are, the more elusive the sleep gods can be. At least 25 percent of the elderly can't get a good night's snooze. When the sleep mask, aromatherapy and the white noise machine have failed, you don't have to pop a pill. Try these expert-recommended tips and you may find yourself snoozing soundly.

Eat, drink and be... awake
Avoid alcohol, caffeine and nicotine. A glass of wine with dinner won??�t do any harm, but a couple of nightcaps can disrupt the quality of your sleep once you've metabolized the alcohol, causing you to wake up halfway through the night.

Nicotine pumps up your blood pressure, making it difficult to relax.

Say no to caffeine anytime later than mid-afternoon. Caffeine is a stimulant that can last in your body for five to eight hours. Some people can still feel the effects up to 12 hours later. It's not just the cuppa joe that can keep you awake ??" energy drinks, tea, chocolate and colas have caffeine.

Food can affect your slumber, so don??�t eat a heavy meal too close to bedtime. If you're sensitive to tomato products or spicy food, lying down can aggravate heartburn, which can make falling asleep more difficult or wake you up in the middle-of-the-night.

Back to the womb
INTERACTIVE?�Stages of sleep
Make sure your bedroom is comfortable, dark and quiet. Finding the right temperature is important. Many people tend to be more comfortable in a cooler bedroom because our body thermostats drop to their lowest levels during the night, experts say. When it's too hot or humid, people tend to awaken more frequently or get stuck in the light sleep stage.

If muggy nights keep you awake, consider a dehumidifier or an air conditioner. If you like it hot, while your partner prefers it cool, you can always try wearing warmer pajamas or keeping an extra blanket for yourself.

Don't bring your laptop to bed
Use the bed only for sleep and sex. If there's a TV in your bedroom, don't watch it in bed. Don't use your bed for work. Dragging your wireless laptop there brings with it all the stress and interruptions that come with it.

Worry time
Schedule some "worry time" during the day. Stress is a big reason people can't sleep at night, but if you give yourself just 15 minutes to address the source of your problems, you take the pressure off when you finally get into bed at night. Eliminate the conditioned anxiety that comes with trying to sleep by reassuring yourself that you will sleep or distracting yourself.

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If you're still anxious when you lie down, don't lie there obsessing about your inability to sleep. The harder you try, the more you'll become frustrated. If you're not asleep after five or 10 minutes, get out of bed. Going to another room may help ease anxiety about not falling asleep.

Make a routine
Go to bed at the same time every night. Practice nightime relaxation routines, such as muscle relaxation or meditation.

Save the Zzzs
Skip the nap. A 15-minute power nap can refresh you during the day, but any longer than that and you could find yourself struggling for slumber later.

Work out
Regular exercise is helpful against insomnia, but not within three hours of bedtime. Exercise is energizing and raises your body temperature. Try to arrange your workout either in the morning or late afternoon.

Source: National Institutes of Health; University of Pennsylvania Sleep Center; National Sleep Foundation

? 2007