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Fat liver, not belly, may be best indicator of health problems
They
said people with wide girths are more likely to have visceral or
intra-abdominal fat, which increases their risk of diabetes, heart
disease, stroke and some types of cancer.
But
new research presented Sunday at the annual meeting of the Obesity
Society shows that belly fat may not be the biggest bad guy behind some
of the medical issues. "Fat in the liver is a more important indicator
of health problems," says Samuel Klein, director of the Center for
Human Nutrition at Washington University School of Medicine in St. Louis.
Klein
and colleagues recruited 31 obese men and women and looked at their
visceral fat, which surrounds the organs in the belly, and their liver
fat. Some people had high amounts of liver fat; others had normal
amounts. A normal liver contains 5% fat or less, but a severe fatty
liver may contain up to 50%, Klein says. The latter is referred to as
non-alcoholic fatty liver disease.
Using several different medical tests, the researchers found that people with fatty livers:
•Make more triglycerides, which are released from the liver into their bloodstream and can increase the risk of heart disease.
•Are
more likely to be resistant to the action of their own insulin, meaning
their bodies don't regulate blood sugar properly, which can lead to
type 2 diabetes, Klein says. Over time, high sugar levels damage large
and small blood vessels, leading to heart disease, stroke, nerve
damage, amputations, blindness and kidney disease.
"We
do not yet know whether the liver fat is causing these health problems
or is simply a very good indicator of health risk," he says. "Even
though it looks like visceral fat itself might not cause harm, it is
often high in people with increased liver fat."
About
30% of adults and a third of overweight children and adolescents have
too much liver fat, he says. If you are obese, 30 or more pounds over a
healthy weight, you are at a higher risk of having non-alcoholic fatty
liver disease.
The bottom line: If you're too
heavy, it's a good idea to trim down, he says. A weight loss of as
little as 2% to 5% can cause a marked reduction in liver fat.
In
a related study, Elisa Fabbrini of Washington University School of
Medicine found that severely obese people who lost weight after gastric
bypass surgery significantly lowered the fat in the liver.
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Annual Physicals Can Pay Unexpected DividendsAnnual Physicals Pay Unexpected Dividends - WSJ.com
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Lab Acknowledges Problem With Vitamin D TestLab Acknowledges Problem With Vitamin D Test - NYTimes.com
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By RHONDA L. RUNDLEEyelash Enhancer Gains Approval - WSJ.comAllergan Inc. said it received Food and Drug Administration approval to market Latisse, a beauty treatment that increases the length, thickness and darkness of eyelashes by using a drug the company developed to treat glaucoma.Latisse, which Allergan plans to launch in February, represents a new use for its seven-year-old glaucoma drug, bimatoprost, which is sold under the brand name Lumigan. The drug's use as a beauty aid was discovered by patients and eye doctors, who have reported for years that a side effect of the Lumigan drops is enhanced eyelashes.To protect its turf, Allergan is already waging a legal battle with competitors who marketed their own eyelash products based on bimatoprost and similar ingredients.[Allergan Latisse eyelash photo] skin1.comPhotos on a doctor's Web site showing eyelash growth from bimatoprost."Latisse exemplifies our continuing commitment to developing innovative treatments that are studied in well-controlled clinical trials, manufactured to pharmaceutical standards, appropriately labeled for use, and available to consumers as a prescription product," said Scott Whitcup, Allergan's executive vice president of research and development. Latisse will be sold by physicians in states that allow them to dispense drugs. In other states, Latisse will be available at the pharmacy.
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By RHONDA L. RUNDLEBotox Treatments Remain Popular Despite Economic Downturn - WSJ.comVanity appears to be trumping frugality in a looks-conscious society.Despite the dismal economic climate, most women -- and men -- who undergo appearance-enhancing treatments such as Botox injections are spending hundreds or even thousands of dollars a year to maintain the regimen, aesthetic physicians say. Meanwhile, some older patients who are putting off or forgoing expensive facelifts are instead opting for less-costly injections and laser treatments.[Keeping Up Appearances In a Downturn] Ben Baker/Redux PicturesDoctors say a weak economy hasn't curtailed demand for Botox injections.Maralyn Burr of Omaha, Neb., in June lost her job as a district sales manager for bookstore chain Borders Group Inc. Ms. Burr, who is $140,000 in debt from her 22-year-old daughter's musical education, says she has slashed spending and all but stopped eating out. But she hasn't given up her Restylane and Botox injections. "It's like comfort food," she says.Nearly three out of four plastic surgeons who responded to a survey this fall reported that demand has increased or held steady for minimally invasive procedures, including Allergan Inc.'s Botox antiwrinkle drug, dermal fillers used to plump up lips and smile lines, and skin-smoothing chemical peels, according to the American Society of Plastic Surgeons, a professional group representing 6,700 surgeons. The survey also found a steep drop in demand for plastic surgeries ranging from breast augmentation to nose reshaping.To be sure, makers of aesthetic medical treatments are bracing for a challenging year ahead. While many established patients are sticking to their beauty regimens, it's tough to entice new patients in the current economic environment. In late October, Allergan said that dermal-filler sales were up 18% through September, but the company reduced its 2008 Botox sales guidance, citing overall "subdued demand." Medicis Pharmaceutical Corp. recently has been offering a $100 consumer rebate on its Restylane family of products.Most of the products used for so-called facial rejuvenation weren't available in the U.S. when the last downturn hit, so there's no historical precedent to estimate their sales performance in the current economic environment. While Botox has been on the market for nearly 20 years, it didn't receive regulatory approval for cosmetic use until 2002, at the tail end of the dotcom-led stock-market bust. Allergan's dermal filler, Juvéderm, which competes with Restylane, has been on the market for about two years.Joel Schlessinger, Ms. Burr's dermatologist in Omaha, says the number of his patients seeking dermal fillers began to increase on a year-over-year basis in the last few months, after posting declines earlier in the year. "Things are so bad [in financial markets] that investments aren't even worthwhile anymore, so people are investing in themselves," he suggests.[Keeping Up Appearances in a Downturn]Malcolm Z. Roth, a plastic surgeon in New York City, says that even people with good jobs and robust savings are worried about the future and are afraid to miss work for surgery. They come in, he says, knowing that they need a facelift but asking if there's "something I can do to tide them over." Botox and fillers, he responds. "I think that's probably something we'll be seeing more of next year," he adds.Pay as You GoPatients also like the idea that with aesthetic treatments, they can pay as they go, Dr. Roth says. The treatments cost his patients between $500 and $2,000 for a visit, rather than perhaps $15,000 for a facelift. "Botox lasts about four months, but if you can't afford to come back, you don't have to," he says. By contrast, patients are reluctant to run up credit-card debt on a big ticket item like surgery.Increasingly, many aesthetic patients view their treatments as professional self-preservation rather than as a personal indulgence. Appearances make a difference, says Kathleen Hudson, a 57-year-old marketing consultant in Falls Church, Va. "If you're in the business world and you want to be competitive with the younger people, you need to stay on top of your game," she says.Ms. Hudson says it costs her between $300 and $400 every six months to have a syringe of Restylane or Juvéderm injected in a few places around her mouth and smile lines. She says she considers the injections "maintenance" and compares them to the $300 cost of hair styling with color highlights. Her plastic surgeon, Roberta Gartside in Reston, Va., says she is remodeling her office and adding staff to accommodate more patients like Ms. Hudson who are seeking minimally invasive treatments rather than surgery.Media and political consultant Julie Buckner says that looking good gives her confidence to focus on her message when she appears on television. Now that the election season has passed, business is slowing and she expects money to be tight next year. The 41-year-old single mom, who lives in Los Angeles, is cutting spending and delaying a home remodeling project, but she isn't skipping her beauty injections. It's "part of my cost of doing business," she says. She says she is trying to stretch out the interval between visits to her injecting physician, Robert Kotler, who charges about $1,000 for her regimen of Botox, Restylane and Juvéderm shots.Aggressive promotions and discounts, mostly by retailers, are common in some regions, especially Southern California and Florida. A sandwich board outside the entrance to Pure Med Spa in Sherman Oaks, Calif.'s Fashion Square mall, for instance, promotes Botox for the highly competitive price of $9 a unit, based on a minimum purchase. The Anushka Cosmedical Centre Spa & Salon in West Palm Beach, Fla., is offering a "Buy 2 get 2 free Restylane package." According to the shop's Internet ad: "You and a friend receive four syringes of Restylane to share for the price of two."Wendy Lewis, a plastic-surgery consultant who sees clients in New York, London, and West Palm Beach, says she also advises physicians to adopt some of the same sales-promotion strategies as retailers. This holiday season, for the first time in over 11 years in business, she is offering her consumer clients a complimentary additional consultation if they purchase one between now and Valentine's Day.Client IncentivesIf high-end stores "can send out gift certificates the week before Christmas, Ritz Carlton has deals all over, and B.R. Guest restaurants offer 20%-off gift cards, it seems only reasonable that our clients deserve a bonus, too," she tells physicians.Doctors typically shun discussions of price cuts, but many offer them to longtime patients in a pinch. Dr. Schlessinger says he recently helped a local "news person" after she was laid off and was about to interview for a new job. He also gave Ms. Burr, the 61-year-old former sales manager in Omaha, a Botox discount. She has since landed a new job in sales for Verizon Wireless.Write to Rhonda L. Rundle at rhonda.rundle@wsj.com
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# Saudi Arabia's royal family spent enough to give Rochester, Minnesota, a lift# King Abdullah bin Abdulaziz came November 15 for a checkup at Mayo Clinic# Brought five princes, hundreds of others who spent at least $1.5 million# Officials say that should offset the area's economic woesSaudi royals' Mayo Clinic trip buoys local economy - CNN.com
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FDA Panel Backs Theravance's MRSA Antibiotic - WSJ.com
WASHINGTON -- A federal advisory panel backed a proposed Theravance Inc. antibiotic designed to treat serious skin infections, including some caused by a type of staph bacterium known as MRSA that is resistant to many antibiotics.The drug, telavancin, was considered Wednesday by a Food and Drug Administration panel of outside medical experts that was called to make recommendations to the agency about whether it thinks the drug should be approved.The panel voted 21 to 5 in favor of a question asking whether the data presented demonstrated the safety and effectiveness of telavancin for the treatment of skin infections, which amounts to a recommendation the agency approve the drug. Such skin infections can be caused by MRSA, or methicillin-resistant staph aureus, as well as other types of bacteria. MRSA has sparked concern as the "superbug" has moved into community settings like schools and locker rooms in recent years after once being largely confined to hospital settings.
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