PSORIATIC ARTHRITIS NEWSLETTER NO. 49

August 30, 2003

PSORIATIC ARTHRITIS NEWS AND VIEWS

VOL. 3 ISSUE 15 - August 31, 2003

PSORIATIC ARTHRITIS MEDICAL NEWS

COMBO ARTHRITIS THERAPY HAS NO LONG-TERM BENEFIT

By - NEW YORK (Reuters Health)

In the long term, methotrexate and sulfasalazine administered in combination

appear to be no more beneficial than either drug administered alone for the

early treatment of rheumatoid arthritis, French researchers report in the August

issue of the ls of the Rheumatic Diseases.

It has been suggested that rheumatoid arthritis patients who receive early

intensive combination therapy with a class of drugs known as disease modifying

antirheumatic drugs, such as methotrexate and sulfasalazine, may have a slower

rate of disease progression and that this effect may be sustained, Dr. Maxime

Dougados of Cochin Hospital, Paris, and colleagues note.

To investigate, the researchers continued to follow 146 rheumatoid arthritis

patients who had taken part in a one-year trial in which they had been

randomly assigned to receive methotrexate and sulfasalazine alone or in

combination.

Over the next four years, the patients were in the care of their own

rheumatologist who was free to specify further treatment.

At the end of five years, 62 percent of the subjects were deemed to be in

remission. However, at the start of the trial and after five years, patients

primarily receiving single or combined drug treatment had similar disease

activity

scores, X-ray scores and health assessment questionnaire responses.

Thus, the investigators conclude that combined therapy during the first year

" did not influence the long-term inflammatory status, or disability, or

structural changes compared with single early intensive combination therapy with

disease modifying antirheumatic drugs. "

Nevertheless, prompt therapy is urged. Dougados told Reuters Health that

physicians should " consider the treatment of inflammation as an emergency. "

" There is a lot of evidence showing that a delay in the initiation of a

disease modifying antirheumatic drug is deleterious. Moreover, the initiated

treatment should have the quickest onset of action, permitting control of the

reserved.

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IBUPROFEN-LIKE DRUGS MAY CUT ASPIRIN'S BENEFIT

NEW YORK (Reuters Health) 8/25/03- Regularly taking a nonsteroidal

anti-inflammatory drug (NSAID) appears to negate the benefit taking aspirin to

prevent a

heart attack, a new study indicates.

However, occasionally taking an NSAID (such as ibuprofen in Advil or naproxen

in Aleve, for example) does not interfere with aspirin therapy.

Aspirin most likely reduces heart attack risk by irreversibly blocking the

enzyme COX-1, thereby impairing the ability of platelets in the blood to form

clots, Dr. Tobias Kurth of Brigham and Women's Hospital, Boston, and others

explain in the American Heart Association's journal, Circulation.

NSAIDs also lock on to COX-1, but the effect is reversible. The investigators

propose that NSAIDs win out over aspirin in the competition for COX-1, and so

the protection of the heart is diminished.

To test this theory, they analyzed data on the use of NSAIDs by more than

22,000 men participating in the Physicians' Health Study. The men were

originally

assigned randomly to take a standard aspirin on alternate days or an inactive

placebo pill.

During an average of 5 years, there were 139 heart attacks in the aspirin

group and 239 in the placebo group.

Taking an NSAID up to 59 times during the course of a year had no effect on

the likelihood of a heart attack in either group, the report indicates. Also,

taking an NSAID more often had no effect -- good or bad -- among the men taking

a placebo.

However, in the group taking aspirin, those who also took an NSAID on at

least 60 days per year had a 2.8-fold higher risk of having a heart attack.

Kurth's team notes that the results should not necessarily be taken as

gospel, because not many men took a regular NSAID and the number of heart

attacks in

rights reserved.

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DRUG MAY PREVENT PROSTATE CANCER

Washington - ASSOCIATED PRESS

Dr. Greenwald, spoke about his role as a participant in the NCI's

prostate cancer prevention trial with the drug finasteride at the National Press

Club in Washington.

Scientists have discovered the first drug that promises to prevent prostate

cancer, but deciding who should use it won't be easy: Sexual side effects

aside, it may actually increase aggressive tumors in some men. The drug is

finasteride, already sold as a treatment for enlarged prostates under the brand

name

Proscar and, in a much lower dose, as Propecia for baldness.

'This trial proves prostate cancer, at least in part, is preventable. It's a

huge step forward.' says Dr. Greenwald,

Cancer prevention chief at the National Cancer Institute. Men who took

Proscar daily for seven years cut their chances of getting prostate cancer by

nearly

25 percent compared with men given a dummy pill, reported in the New England

Journal of Medicine. The results were strong enough that the study of 18,000

men age 55 and older, originally scheduled to run for another year, was stopped

this month.

Because 220,000 U.S. men are diagnosed annually with prostate cancer, Proscar

has " extraordinary public health potential, " said lead researcher Dr. Ian

of the University of Texas Health Sciences Center in San .

Proscar works by preventing testosterone from changing into another hormone

that fuels prostate enlargement and cancer growth. In the study, it worked

equally well for men at low risk of cancer, and those at high risk - black men

and

those whose fathers and brothers had the disease.

But some troubling findings have critics questioning just how often Proscar

should be used: Men who developed prostate cancer while taking Proscar were

more likely to have tumors that appear aggressive, what doctors term " high

grade. " Some 6.4 percent of Proscar patients were diagnosed with those

aggressive

tumors, compared with 5.1 percent of men given a dummy pill. No one knows if it

was a fluke - or if Proscar, a hormonal treatment, alters the prostate in a

way that favors growth of more aggressive tumors.

The medical importance of the overall cancer reduction isn't clear because of

another quirk - researchers diagnosed prostate cancer in four times more

placebo patients than expected. Many were small, early-stage tumors found only

because every study participant received a prostate biopsy even if blood tests

for cancer-signaling PSA were normal - biopsies that in the real world never

would have occurred.

" It looks like Proscar prevented little tiny, insignificant cancers, but did

nothing for high-grade cancers or maybe even allowed them to become more

common, " said Dr. Scardino of New York's Memorial Sloan-Kettering Cancer

Center, who wrote a cautionary editorial accompanying the research. " That

doesn't

sound like a very good trade-off to me. "

Nearly 220,900 U.S. men each year are diagnosed with cancer of the prostate,

a walnut-sized gland at the base of the penis that is involved in semen

production. After skin malignancies, prostate cancer is the second most common

cancer in males.

An estimated 28,900 American men will die from prostate cancer in 2003. After

lung cancer, it is the second most common cause of cancer mortality in U.S.

men, accounting for 11 percent of cancer deaths. About 90 percent of men with

prostate cancer survive at least five years after diagnosis, and two-thirds

live 10 years or more. Early detection and treatment boost survival.

Prostate cancer occurs when malignant cells form and spread through the

prostate gland. The malignant cells develop when changes occur in DNA, the

genetic

material containing the " instructions " for all types of cells. When DNA is

altered, normal cells can grow abnormally and form cancer. Exactly how DNA is

altered in prostate cancer remains unclear. However, a number of factors have

been implicated in prostate cancer development, including advancing age,

African-American race, a family history of the disease and a high-fat diet.

Most cases of early prostate cancer cause no symptoms and are identified only

by routine screening tests. However, some patients may experience a slowing

or weakening of the urinary stream or the need to urinate more often. Symptoms

of advanced prostate cancer include blood in the urine, impotence, and pain in

the pelvis, spine, hips or ribs.

The uncertainty about the causes and controllable risk factors for prostate

cancer complicates prevention. The best evidence available relates to dietary

habits. Following a balanced diet that is low in fat and emphasizes fruits,

vegetables and grain products may help reduce cancer risk.

The American Cancer Society and other groups recommend annual prostate cancer

screening for all men beginning at age 50. Such screening involves a blood

test for prostate-specific antigen (PSA), a protein produced by the prostate, as

well as a digital rectal exam, in which a physician palpates the gland. Men

who have an increased risk for prostate cancer (such as African-Americans and

men with a family history of the disease) are advised to get tested earlier,

usually at age 45. However, due to some conflicting evidence on the benefits of

these tests for all men, not all doctors recommend widespread screening. If

certain symptoms or the results of early detection tests have raised the

possibility of prostate cancer, biopsies and possibly other tests will be

performed

to confirm a diagnosis.

Prostate cancer may be treated with prostatectomy (surgery to remove the

prostate), radiation, chemotherapy, hormone therapy or a combination of

treatments. Depending on a man's age and the stage of the cancer, doctors also

may

recommend " watchful waiting " - leaving the cancer untreated until it shows signs

of

becoming more aggressive or spreading. This latter approach is most commonly

recommended for elderly men who have slow-growing tumors. Treatment side

effects can include impotence and urinary incontinence. SOURCES: American Cancer

Society; Oncology.com

DRUG'S USEFULNESS DEBATED - The study didn't test whether taking Proscar

helped men live longer, added Dr. Herman Kattlove of the American Cancer

Society.

He predicted a " huge debate " about its usefulness.

" If it were free of side effects, it would be another story, " he said, citing

impotence and loss of libido that were more common among Proscar users. " If

it's not going to save your life and it's just going to ruin your sex life, I

won't " take it.

How effective is Proscar? Track 1,000 men starting at age 63, and 60 will get

prostate cancer by age 70. Eighteen of those cancers will be high-grade. Give

those same 1,000 men Proscar every day, and only 45 would get prostate cancer

- but 22 of them would be high-grade, the NCI estimated.

Other considerations: Impotence and loss of libido are common in older age,

but more common in Proscar users. However, Proscar users suffered fewer of the

urinary problems common in aging prostates. " There are very few prevention

strategies that are not trade-offs, " said . Whether to use Proscar is an

individual decision men must make based on their own risk of prostate cancer

and tolerance of side effects, stressed NCI's Dr. Ford, who monitored

the study.

" Take the time to review this data and make informed choices, " she advised.

Prostate cancer kills almost 29,000 U.S. men each year. The risk of cancer

increases with age. Treatment causes major side effects such as incontinence and

impotence, and there's no good way to predict who needs aggressive therapy

and who has a slow-growing, unthreatening tumor.

Men already taking Proscar to treat enlarged prostates shouldn't stop because

of the aggressive-tumor concern - just get regular prostate exams, Scardino

cautioned. Researchers will track Proscar users diagnosed with high-grade

tumors to see if they fare poorly - or if the drug falsely made it appear their

cancer was more aggressive, which hormonal treatments sometimes do,

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METHOTREXATE VERSUS CYCLOSPORINE - PSORIASIS DRUGS SEEM TO WORK EQUALLY WELL

- NEW YORK (Reuters Health) 8/18/03

Methotrexate is an antimetabolite while cyclosporine is an immunosuppressant.

Both are commonly used in daily practice to treat psoriasis. But which of

these two drugs is more effective?

Methotrexate and cyclosporine appear to work equally well for people with the

skin disorder psoriasis, new research suggests.

Dr. Menno A. de Rie and colleagues, from the University of Amsterdam in the

Netherlands, explain that drug regimens are frequently changed in patients with

severe psoriasis to minimize possible side effects.

While treatment often involves alternating between methotrexate and

cyclosporine, no studies have ever compared the effectiveness, ease of

treatment, and

patients' quality of life with these two drugs, the investigators note.

In the new study, reported in The New England Journal of Medicine, 44

patients with severe psoriasis were randomly selected to receive methotrexate or

cyclosporine for 16 weeks.

Regardless of which drug was received, patients experienced a similar

improvement in their skin lesions. Moreover, quality of life, interval to

remission,

and rates of remission were nearly the same with the two drugs.

Given these results, the researchers conclude, " differences between the

treatments in terms of side effects, long-term adverse effects, ease of

administration (once-daily vs. twice-daily treatment) and costs " can be used to

determine

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

CHOLESTEROL, HOW LOW? - AGGRESSIVE LIPID LOWERING DOES NOT SLOW

ATHEROSCLEROSIS - NEW YORK (Reuters Health) 8-04-03

The rate at which plaque builds up in the coronary arteries seems to be

unaffected by how much LDL ( " bad " ) cholesterol is lowered using so-called statin

drugs such as Zocor or Lipitor.

As Dr. Harvey S. Hecht of Beth Israel Medical Center, New York, told Reuters

Health, " the question of whether or not 'lower is better' for LDL cholesterol

is unresolved. " His research suggests that " lower is not necessarily better, "

at least in patients who have hardening of the coronary arteries but who do

not yet have symptoms.

Dr. Hecht, along with Dr. S. Harman of Kronos Longevity Research

Center, Phoenix, Arizona, came to this conclusion after studying 182 patients

with " subclinical atherosclerosis. "

The duo measured the amount of calcified plaque in the participants' coronary

arteries, using a technique called electron beam tomography, before and after

a year of lipid-lowering treatment with statins alone or in combination with

niacin.

As the researchers explain in the American Journal of Cardiology, treatments

that aimed to lower LDL cholesterol to 80 milligrams per deciliter (mg/dL) or

less were deemed more aggressive, those with a target of greater than 80 mg/dL

were deemed less aggressive.

Despite a greater improvement in LDL levels in the more aggressively treated

group, the researchers found that annual rate at which plaque increased (9.3%)

was no different from that in the less aggressively treated group (9.1%).

" We know that the statins do help, " Dr. Hecht explained, so he infers that a

big part of their benefit comes from a direct effect on the artery,

All

rights reserved.

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

DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS - " DISH " OR FORESTIER DISEASE

BY Medical Author: C. Shiel Jr., MD, FACP, FACR

Diffuse idiopathic skeletal hyperostosis (DISH) has also been called

Forestier's disease. It is considered a form of degenerative arthritis. DISH is

characterized by flowing calcification along the sides of the vertebrae of the

spine. It is also commonly associated with inflammation (tendinitis) and

calcification of tendons at their attachments points to bone. This can lead to

the

formation of bone spurs, such as heel spurs. In fact, heel spurs are common

among

individuals with DISH.

What are symptoms of diffuse idiopathic skeletal hyperostosis? - Symptoms of

DISH include intermittent pains in the areas of the bony changes of the spine

and inflamed tendons. Stiffness and dull pain, particularly in the upper and

lower back, are common. Sometimes pains in these areas can be sharp with

certain body movements, such as twisting or bending over.

DISH is only slowly progressive. Calcifications between the vertebrae occur

over many years. This calcification can lead to limitation of motion of the

involved areas of the spine.

Does diffuse idiopathic skeletal hyperostosis damage organs? - There is no

associated threat to any internal organs with this disorder. Rarely, large bone

spurs can form in front of the spinal vertebrae of the neck. These spurs

occasionally interfere with the passage of food through the upper esophagus

(swallowing tube).

How is diffuse idiopathic skeletal hyperostosis treated? - Because areas of

the spine and tendons can become inflamed, anti-inflammatory medications

(NSAIDs), such as ibuprofen and Naproxen, can be helpful in both relieving pain

and

inflammation of DISH. It is hoped that by minimizing inflammation in these

areas, further calcification of tendons and ligaments of the spine leading to

calcific bony outgrowths (osteophytes) will be prevented. Written by C.

Shiel Jr., MD, FACP, FACR

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DRUG FOR COMPULSIVE SHOPPERS

By Bill Langbein NEW YORK (Reuters Health)

The fascinating concept of this VERY preliminary study is that compulsive

shopping may be a manifestation of depression. Perhaps shopping behavior can be

used to help identify individuals who need psychiatric attention.

A daily dose of a drug used to treat depression--citalopram--reduced the

buying impulses of 15 subjects diagnosed with compulsive shopping disorder,

according to study findings from Stanford University researchers.

To enter the study, subjects had to be at least 18 years old, to record a

score of more than 17 on the Yale-Brown Obsessive-Compulsive Scale-Shopping

Version (YBOCS-SV) scale, and to have been diagnosed with the disorder for at

least

one year.

Dr. Lorrin Koran and colleagues initially tested citalopram in a study of 24

patients (23 women and one man) for seven weeks. Fifteen of the 24 who

experienced a decrease of at least 50% in their YBOCS-SV scores were classified

as

responders and then continued to participate in the double-blind study.

In the current study, the 15 patients were randomly assigned to receive

citalopram or a sugar pill. As reported in the July issue of the Journal of

Clinical Psychiatry, five of the eight relapsed after 9 weeks as their average

YBOCS-SV scores rose from 2.3 to 18.4.

In contrast, none of the seven patients who continued to receive citalopram

relapsed during the nine weeks of receiving treatment. The YBOCS-SV scores of

the seven patients decreased to 1.6 from 3.7 at the start of the 9-week trial.

The patients who remained on citalopram for 16 weeks also reported they could

stop browsing for items on the Internet or television shopping channels, as

well as the ability to enter stores without making impulsive purchases.

" The results strongly suggest the patients' response was not the result of a

placebo affect, " Dr. Koran told Reuters Health. " There is treatment for

compulsive shopping disorder. Some patients improved within one or two weeks. "

Earlier studies of another antidepressant of the same drug class,

fluvoxamine, and citalopram indicated the drugs may be effective for compulsive

shopping

disorder, but fluvoxamine subsequently faltered in two double-blind trials.

Patients in the two fluvoxamine trials kept shopping logs to monitor

behavior, Dr. Koran explained. Patients who received fluvoxamine and those who

received a sugar pill relapsed, suggesting the drug provided just a placebo

effect.

In the current citalopram study, the investigators started began by

administering a 20-mg/day dose of citalopram to all patients. The dose was

escalated

every two weeks to 60 mg/day, in the absence of significant response or limiting

side effects. If patients could not tolerate 20 mg/day, the dose was

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PAINKILLERS & THE KIDNEYS - Analgesics include aspirin, acetaminophen

(Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDS). There is general

agreement that overuse of analgesics can damage the kidneys. But how about an

occasional or moderate use of analgesics?

Based on a 14-year study involving almost 4,500 doctors, occasional or

moderate use of analgesics is not associated with a decline in kidney function.

Comment: Do you have any idea how many aspirin or Tylenol you have taken over

the last 14 years?

MODERATE ANALGESIC USE DOES NOT DAMAGE THE KIDNEYS

NEW YORK (Reuters Health) 8/13/03

Occasional or moderate use of aspirin, acetaminophen (Tylenol), or

nonsteroidal anti-inflammatory drugs (NSAIDs) is not associated with a decline

in kidney

function, according to a report in the August issue of the American Journal

of Kidney Diseases.

Studies that use a single reading of creatinine, a measure of kidney

function, have yielded inconsistent results on analgesic use and kidney

function, Dr.

Tobias Kurth, of Brigham and Women's Hospital, Boston, and colleagues note. To

look into the issue, the researchers examined data from 4494 male doctors who

gave blood samples in 1982 and 1996.

Outcome measures included an increase in creatinine levels and decline in

glomerular filtration rate (GFR), another measure of kidney function, during the

14-year study period. The investigators classified self-reported analgesic use

as never (less than 12 pills during the study period), 12 to 1499 pills, 1500

to 2499 pills, and at least 2500 pills.

Over the 14 years, creatinine levels increased in 242 subjects (5.4%) and

GFRs decreased in 224 subjects (5%).

Compared with never use, the odds of having increased creatinine levels were

similar in subjects who used 2500 or more pills of aspirin, acetaminophen, and

other NSAIDs. The odds of having a decreased GFR were also similar among the

different groups, Kurth and colleagues found.

The researchers observed a reduced risk for change in kidney function with

aspirin use, but not acetaminophen or other NSAIDs, in subjects without

cardiovascular risk factors. Among those with cardiovascular risk factors, there

was a

possible but nonsignificant increase in risk.

In a hospital statement, Kurth pointed out that the public and many kidney

specialists believe that the overuse of analgesics can damage the kidneys, and

there is good evidence for this. However, " sensible use of them is not

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PAINKILLERS MAY RAISE MISCARRIAGE RISK -Women May Want to Avoid

Anti-Inflammatory Drugs While Trying to Get Pregnant

Aug. 14, 2003 -- Taking aspirin or other anti-inflammatory painkillers around

the time of conception or early in pregnancy increases the risk of

miscarriage by as much as 80%, according to a new study.

Although these findings need to be confirmed by further studies, researchers

say that in the meantime, it may be wise for women who are trying to get

pregnant to be aware of this potential risk and avoid using anti-inflammatory

painkillers around conception.

Doctors already recommend that women avoid anti-inflammatory drugs during

pregnancy but this study shows that taking them while trying to get pregnant may

also be ill advised.

Anti-inflammatory painkillers include prescription and over-the-counter

medications that contain the active ingredient ibuprofen (Advil, Motrin, and

others), naproxen (Aleve), and ketoprofen (Orudis KT).

Acetaminophen is a different type of painkiller -- not anti-inflammatory --

and was not found to carry this same miscarriage risk. The study appears in the

Aug. 16 issue of the British Medical Journal.

Researchers interviewed 1,055 women who had recently become pregnant about

their use of painkillers, including aspirin, other anti-inflammatory drugs, and

acetaminophen (the active ingredient in Tylenol). About 5% of the women

reported using anti-inflammatory painkillers around conception or early in

pregnancy.

After adjusting for other risk factors for miscarriage, the researchers found

that anti-inflammatory drug use increased the women's risk of miscarriage by

80%. The miscarriage risk was strongest when the painkillers were taken around

the time of conception or if anti-inflammatory drug use lasted more than a

week.

The miscarriage risk for aspirin use around conception or early in pregnancy

was similar, but researchers say it's harder to draw conclusions because there

were only a small number of aspirin users in the study.

Use of acetaminophen, which works in a different way in the body, had no

affect on miscarriage risk.

Anti-inflammatory drugs suppress inflammation in the body by blocking the

production of substances called prostaglandins, and researchers suspect this

function may also increase miscarriage risk.

Researcher De-Kun Li, of the Kaiser Foundation Research Institute in Oakland,

Calif., and colleagues say animal studies have shown that prostaglandins are

necessary for successful implantation of an embryo into the wall of the

uterus. Prostaglandins are also thought to play an important role in ovulation.

The researchers say the new class of anti-inflammatory drugs known as -2

inhibitors -- Bextra, Celebrex, and Vioxx -- are not recommended for use by

pregnant women because of embryo implantation problems found in animal studies.

But these effects have not yet been well studied in older anti-inflammatory

drugs, such as ibuprofen.

Many thanks to our member Szczygiel, better know as " Micky from

London " for sending me this information.

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NEW CREAM CLEARS PSORIASIS

Researchers claim topical drug reduces severity, duration of lesions

THURSDAY, Aug. 21 (HealthDayNews) -- Boston University Medical Center

researchers say they've developed the first successful topical peptide drug to

treat

psoriasis.

They combined the parathyroid hormone analog PTH (1-34) with Novasomer A

cream, which enhanced the absorption of the peptide drug into human skin. The

study appears in the August issue of the British Journal of Dermatology.

The drug was tested in a trial of 15 adults with chronic plaque psoriasis.

Lesions treated with PTH (1-34) showed a marked improvement in scaling, redness

and duration.

" The study concluded that patients who were resistant to at least one

standard therapy for psoriasis had a remarkable improvement in their psoriasis

when

they applied PTH (1-34) in Novasomer A cream to their lesion, " Dr.

Holick, a professor of medicine, physiology and dermatology, says in a news

release.

" This pilot study suggests that topical PTH (1-34) encapsulated in Novasomer

A cream is a safe and effective novel therapy for psoriasis, " he says. SOURCE:

Boston University, news release, Aug. 11, 2003

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LEISURE TIME PHYSICAL ACTIVITY ASSOCIATED WITH REDUCED RISK OF HEART DISEASE

NEW YORK (Reuters Health) - Findings from a new study offer more evidence

that leisure-time physical activity (LTPA) helps ward off coronary artery

disease, while work-related physical strain (WRPS) appears to promote it.

The reason for the second finding is unclear, the study authors note, but

other investigators have reached similar conclusions.

" The different characteristics of physical activity associated with work and

leisure-time physical activity might be one explanation for the opposite

relations with (heart disease) risk, " they write in the May 26th issue of the

Archives of Internal Medicine.

Physical strain on the job, they note, " is probably long-lasting and mainly

static, " while exercise on one's own time is " mainly short-lasting and dynamic

in nature. "

The study involved 312 people, 40 to 68 years of age, with heart disease and

479 similarly aged control subjects. All were asked about leisure-time

physical activity during summer and winter and any physical strain at work.

Overall, people with coronary heart disease reported less leisure-time

exercise and more physical strain on the job than those with healthy hearts,

study

author Dr. Wolfgang Koenig, from the University of Ulm in Germany, and

colleagues note.

For example, exercising more than 2 hours a week in the summer was associated

with a 61% lower risk of heart disease when compared with not exercising at

all. In contrast, heavy physical strain on the job was associated with a nearly

five-fold increased risk of heart disease compared with no strain at all.

Blood tests of the study participants revealed that those who exercised

during leisure time had lower levels of inflammatory markers, such as C-reactive

protein. This finding provides further support to the idea that exercise

protects against heart disease by reducing inflammation, the researchers note.

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PLENTY OF FLU VACCINE THIS YEAR, U.S. CDC SAYS

WASHINGTON (Reuters) 8/21/03 - Plenty of influenza vaccine will be available

this year, so there will be no need to let older and more vulnerable people

get their flu shots first, the U.S. Centers for Disease Control and Prevention

said on Thursday.

Everyone who wants a flu shot will be able to get one in October, giving

their bodies time to develop immunity before the flu season starts, the CDC

said.

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

Please remember that any information published in this newsletter is intended

for your general knowledge only, and is not a substitute for medical advice

or treatment for specific medical conditions.

When I first began to publish this newsletter in August of 2001, our

website listed approximately 650+ members. Today we have 1,500+ members from all

over the world.

Let's just keep on doing what we do best, which is trying to help each other

every day, so the next day might be a little bit easier to deal with.

It's been said that a family is like a tossed salad - each ingredient is

distinct and identifiable. Our group is a pretty terrific global salad, and I am

proud to be just one of the ingredients.

Good Health to all,

Jack

Newsletter Editor

Cornishpro@...

Issue 2003 8/31/03-15

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