Yeshiva World News

Novartis AG plans to seek regulatory approval within 18 months for a pioneering tablet containing an embedded microchip, bringing the concept of “smart-pill” technology a step closer.

The initial program will use one of the Swiss firm’s established drugs taken by transplant patients to avoid organ rejection. But Trevor Mundel, global head of development, believes the concept can be applied to many other pills.

“We are taking forward this transplant drug with a chip and we hope within the next 18 months to have something that we will be able to submit to the regulators, at least in Europe,” Mundel told the Reuters Health Summit in New York.

“I see the promise as going much beyond that,” he added.

Novartis agreed in January to spend $24 million to secure access to chip-in-a-pill technology developed by privately owned Proteus Biomedical of Redwood City, California, putting it ahead of rivals.

The biotech start-up’s ingestible chips are activated by stomach acid and send information to a small patch worn on the patient’s skin, which can transmit data to a smartphone or send it over the Internet to a doctor.

Mundel said the initial project was focused on ensuring that patients took drugs at the right time and got the dose they needed — a key issue for people after kidney and other transplant operations, when treatment frequently needs adjustment.

Longer-term, he hopes to expand the “smart pill” concept to other types of medicine and use the wealth of biometric information the Proteus chip can collect, from heart rate and temperature to body movement, to check that drugs are working properly.

Because the tiny chips are added to existing drugs, Novartis does not expect to have to conduct full-scale clinical trials to prove the new products work. Instead, it aims to do so-called bioequivalence tests to show they are the same as the original.

A bigger issue may be what checks should be put in place to protect patients’ personal medical data as it is transmitted from inside their bodies by wireless and Bluetooth.

“The regulators all like the concept and have been very encouraging. But … they want to understand how we are going to solve the data privacy issues,” Mundel said.

A technology that ensures a patient takes his or her medicine and checks that it is working properly should deliver better outcomes and justify a higher price tag.

(Source: Reuters)

Annual screening for lung cancer with low-dose CT scans cut mortality rates in older, current or former heavy smokers by 20 percent, a major U.S. government study finds.

Given the large numbers of Americans who fall ill from lung cancer — the nation’s leading cancer killer — a 20 percent drop in deaths could be significant, experts noted.

And, unexpectedly, annual CT screening also cut deaths from any cause by 7 percent, according to the $250 million National Lung Screening Trial (NLST), sponsored by the U.S. National Cancer Institute (NCI).

That benefit has yet to be explained, NCI Director Dr. Harold Varmus said during a news conference Thursday.

The results, which were announced at the news conference and published in the Nov. 4 issue of Radiology, were significant enough to trigger an early halt to the trial once the scans’ benefits became clear.

“Lung cancer is a major cause of death from cancer in the U.S. and in the world . . . Over 85 percent of those victims are current or former smokers,” Varmus said Thursday. “These findings will be an important factor in subsequent efforts to protect tens of millions of current and former smokers in this country from the lethality of lung cancer.”

The researchers are assuming that the reason for the benefit lies in the scan’s ability to detect tumors earlier, when they are smaller and more treatable.

However, Dr. Michael Unger, director of the Pulmonary Cancer Detection and Prevention Program at Fox Chase Cancer Center in Philadelphia, cautioned that “researchers will have to pore over the paper and look at it for validity” before firm conclusions can be drawn.

And Varmus stressed that no concrete recommendations are being made until all the data has been published.

Lung cancer has the highest mortality rate of any cancer in the United States. According to the American Cancer Society, more than 220,500 new cases of lung cancer are diagnosed each year and the disease claims the lives of more than 157,000 people annually.

Lung cancer’s high mortality is largely due to the fact that there is no effective screening method “to detect lung cancer early,” Unger said. Prior research to assess whether standard chest X-rays might help reduce lung cancer deaths have not shown an effect.

The new study involved 53,500 current and former heavy smokers (an average of one pack a day for at least 30 years) aged 55 to 74 who were randomized to undergo either low-dose helical CT or a chest X-ray once a year for three years.

According to a news release from the NCI, chest X-ray “produces a single image of the whole chest in which anatomic structures overlie one another,” whereas helical CT produces “a multiple-image scan of the entire chest.”

Deaths from lung cancer and from other causes were lower in the CT screening than the X-ray group, the researchers found. By Oct. 20, 2010, 354 people in the group receiving CT scans had died from lung cancer versus 442 deaths in those receiving chest X-rays — a 20.3 percent drop in mortality rates.

However, there are downsides to low-dose helical CT screening, noted NCI Deputy Director Dr. Douglas Lowy. Those include radiation exposure (more than from an X-ray); cost, as most insurance carriers and Medicare do not reimburse for the CT scan; and a high rate of false-positives that could result in a lung biopsy or thoracic surgery to provide a true diagnosis — along with the worry to patients and their loved ones.

The NCI also notes that the participants in the trial were an urban, “highly motivated” group screened at major medical centers, and the results may not be the same among other populations.

In a statement released Thursday, Dr. Bruce Johnson, spokesman for the American Society of Clinical Oncology (ASCO), addressed the issue of expense.

“What has happened here is that the technology shows you can cut down on lung cancer deaths, the leading cause of cancer mortality, and save nearly as many lives as the number of people who die from breast cancer per year,” he said. “We as a medical community now need to figure out how to do this in a way that the cost is acceptable to the public.”

The findings also do not shed light on whether CT screening would be effective in other groups of people, such as light smokers, nonsmokers or younger people, said Richard Fagerstrom, one of the trial investigators.

“The application of these methods to a more general population may be difficult to decipher,” Varmus added. “We don’t yet have a recommendation for the scheduling of screening or for how many years it should be used. That will have to be left to others once the full dataset is available.”

Still, advocates for lung cancer patients expressed optimism.

“Now we have validation from the NCI that screening people at high risk for lung cancer with CT scans can significantly reduce mortality in lung cancer, which is causing more deaths each year than breast, prostate, colon and pancreatic cancers combined,” Laurie Fenton-Ambrose, president and CEO of Lung Cancer Alliance, said in a statement.

The larger public health message on lung cancer prevention should not be forgotten, however, Varmus added.

“No one should come away from this announcement believing that it’s safe to continue to smoke or start smoking,” he said. “Not smoking and quitting smoking remain the best defense against lung cancer.”

More information

There’s more on the study at the U.S. National Cancer Institute.

With a rising number of children showing signs of food allergies in the United States, it’s natural to wonder whether something that happens during pregnancy may contribute to it. Unfortunately, the evidence still isn’t clear one way or the other.

A new study in the Journal of Allergy and Clinical Immunology finds that children whose mothers ate peanut products during pregnancy were more likely to test positive for peanut allergies.

That doesn’t mean, however, that these children will actually show allergic symptoms, since the test does not indicate the strength of reaction, said Dr. Scott Sicherer, study author and pediatrician at Mount Sinai School of Medicine.

Most of the children in the study have not yet ingested peanuts, so it’s not known what whether they actually have negative reactions to peanut-containing foods, he said. The test merely indicates that the child could have a peanut allergy.

Another limitation of the study is that the researchers could not control or verify how much peanut the mothers actually ate.

Participants were 503 infants between 3 and 15 months of age. They all had likely milk or egg allergies or significant eczema, which are risk factors for peanut allergy.

Based on reports of peanut product consumption from the infants’ mothers, the researchers found an association between how much peanut they had eaten and the likelihood of a positive test for peanut allergy in the child.

In the past, the American Academy of Pediatrics has wavered on the issue. The organization said in 2000 that pregnant and breastfeeding women should avoid peanuts if the infant had an increased risk of peanut allergies based on family history. But it scrapped that advice in 2008 because there wasn’t enough evidence to back it up.

Large studies tend to find no effect of peanuts during pregnancy on allergy development, while some small studies such as this one suggest there might be a connection, Sicherer said.

Sicherer has had some patients who avoided peanuts but still have peanut-allergic kids, and others who ate peanuts and wonder whether that caused an allergy in the child.

“I would not tell parents to feel guilty about it,” he said.

His bottom line for pregnant women: Eat a healthy diet. There’s not enough evidence to support or caution against eating peanuts, so just do what’s right for you.

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(Source: CNN)

Alcohol ranks “most harmful” among a list of 20 drugs — beating out crack and heroin — according to study results released by a British medical journal.

A panel of experts weighed the physical, psychological and social problems caused by the drugs and determined that alcohol was the most harmful overall, according to an article on the study released by The Lancet Sunday.

Using a new scale to evaluate harms to individual users and others, alcohol received a score of 72 on a scale of 1 to 100, the study says.

That makes it almost three times as harmful as cocaine or tobacco, according to the article, which is slated to be published on The Lancet’s website Monday and in an upcoming print edition of the journal.

Heroin, crack cocaine and methamphetamine were the most harmful drugs to individuals, the study says, while alcohol, heroin and crack cocaine were the most harmful to others.

In the article, the panelists said their findings show that Britain’s three-tiered drug classification system, which places drugs into different categories that determine criminal penalties for possession and dealing, has “little relation to the evidence of harm.”

Panelists also noted that the rankings confirm other studies that say that “aggressively targeting alcohol harms is a valid and necessary public health strategy.”

The Lancet article was co-authored by David Nutt, a professor and Britain’s former chief drug adviser, who caused controversy last year after he published an article saying ecstasy was not as dangerous as riding a horse.

“So why are harmful sporting activities allowed, whereas relatively less harmful drugs are not?” Nutt wrote in the Journal of Psychopharmacology. “I believe this reflects a societal approach which does not adequately balance the relative risks of drugs against their harms.”

Nutt later apologized to anyone offended by the article and to those who have lost loved ones to ecstasy. He said he had no intention of trivializing the dangers of the drug and that he only wanted to compare the risks.

In the article released by The Lancet Sunday, ecstasy’s harmfulness ranking — 9 — indicates it is only one eighth as harmful as alcohol.

The study was funded by the London-based Centre for Crime and Justice studies.

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(Source: CNN)

Up to a third of U.S. adults could have diabetes by 2050 if Americans continue to gain weight and avoid exercise, the Centers for Disease Control and Prevention projected on Friday.

The numbers are certain to go up as the population gets older, but they will accelerate even more unless Americans change their behavior, the CDC said.

“We project that, over the next 40 years, the prevalence of total diabetes (diagnosed and undiagnosed) in the United States will increase from its current level of about one in 10 adults to between one in five and one in three adults in 2050,” the CDC’s James Boyle and colleagues wrote in their report.

“These are alarming numbers that show how critical it is to change the course of type-2 diabetes,” CDC diabetes expert Ann Albright said in a statement.

“Successful programs to improve lifestyle choices on healthy eating and physical activity must be made more widely available because the stakes are too high and the personal toll too devastating to fail.”

The CDC says about 24 million U.S. adults have diabetes now, most of them type-2 diabetes linked strongly with poor diet and lack of exercise.

Boyle’s team took census numbers and data on current diabetes cases to make models projecting a trend. No matter what, diabetes will become more common, they said.

“These projected increases are largely attributable to the aging of the U.S. population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer,” they wrote.

Diabetes was the seventh-leading cause of death in the United States in 2007, and is the leading cause of new cases of blindness among adults under age 75, as well as kidney failure, and leg and foot amputations not caused by injury.

“Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years,” Boyle’s team wrote.

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(Source: Reuters)

Whooping cough, also known as pertussis, has claimed the 10th victim in California, in what health officials are calling the worst outbreak in 60 years.

Since the beginning of the year, 5,978 confirmed, probable and suspected cases of the disease have been reported in California.

All of the deaths occurred in infants under the age of 3 months, says Michael Sicilia, a spokesman for the California Department of Public Health. Nine were younger than 8 weeks old, which means they were too young to have been vaccinated against this highly contagious bacterial disease.

“This is a preventable disease,” says Sicilia, because there is a vaccine for whooping cough to protect those coming in contact with infants, and thereby protect the infants.

However, some parents are choosing to not vaccinate their children. In other cases, previously vaccinated children and adults may have lost their immunity because the vaccine has worn off.

The vaccine “does not protect you for life,” explains Alison Patti, a spokesperson for the Centers for Disease Control and Prevention.

Sicilia says California Health Department epidemiologists estimate 50 percent of the children who have gotten sick were infected by their parents or caregivers.

According to the recommended vaccine schedule for infants, newborns don’t get their first pertussis vaccine until they are 2 months old, leaving them vulnerable to infection until then if the people surrounding them are infected.

“That’s why the real important message is — whether it’s a mom, dad, sibling, grandfather or grandmother that comes in contact with these really young babies — all the close contacts, including the health care professionals, need to vaccinated,” says Patti. It’s called the “cocooning strategy,” where the newborns are protected because the older people around them have been vaccinated and protected from pertussis, and therefore won’t pass it on to little babies.

Pertussis, or whooping cough, is a highly contagious disease caused by bacteria that can lead to severe upper respiratory infections. The bacteria is spread in tiny droplets when an infected person coughs or sneezes.

Initial symptoms are very similar to a cold, but a week or two later, a violent cough develops.

“If you’ve ever seen a child with pertussis, you won’t forget it” — that’s how the American Academy of Pediatrics explains what whooping cough is on its website. The academy says a child with the disease coughs so hard and so often “until the air is gone from his/her lungs and he/she is forced to inhale with the loud ‘whooping’ sound that gives the disease its nickname.”

The cough can last for weeks and children can cough so hard and rapidly,that blood vessels can burst and they have difficulty eating, drinking and breathing. According to the CDC, “about 1 in 5 infants with pertussis get pneumonia, and about 1 in 100 will have convulsions. In rare cases (1 in 100), pertussis can be deadly, especially in infants.”

Parents and doctors can often miss the initial symptoms of pertussis in the youngest patients because they often do not have the characteristic cough with a “whoop” says Patti.

According to the National Institutes of Health, “the whoop noise is rare in patients under 6 months and in adults.”

That’s why parents need to be alert to symptoms in themselves as well as their children, says Patti. If there’s a prolonged pause in breathing or they have trouble breathing, that’s an important sign and parents should seek medical attention immediately, she explains.

“It’s important to go to the doctor early on,” says Patti because, “antibiotics don’t help you later.”

Adults usually don’t have the “whoop” cough, so they may not think they have pertussis. Patti recommends if someone has a cough that doesn’t go away, they should get tested for pertussis.

Sicilia points out that the pertussis vaccine isn’t perfect and its protection wanes after about five years.

Health officials are urging everyone who hasn’t had a pertussis vaccine in the past five years or — doesn’t remember if they had one — to get the shot.

(Source: CNN)

It’s official: Mouth-to-mouth resuscitation died today.

The American Heart Association (AHA) today issued new guidelines for cardiopulmonary resuscitation, better known as CPR, making rapid chest compressions the mainstay of basic life support for bystanders trying to revive people whose hearts have stopped.

Doctors say the AHA’s change marks the end of the organization’s advocacy of a practice believed for at least half a century to be essential for saving victims of cardiac arrest or heart attacks. “Compression is the only way to go,” says AHA’s Michael Sayre, an emergency physician at Ohio State University. He added that rescue breathing is still recommended for children and anyone whose cardiac arrest is likely due to oxygen deprivation.

The AHA decision was driven by a growing body of research showing that bystanders are more likely to perform compression-only CPR on strangers and that it works better than conventional CPR.

“It’s a big deal,” says Corey Slovis, chairman of emergency medicine at Vanderbilt University in Nashville and an early advocate of the change. “People are standing around while others are dying, when all they have to do is pump on their chests.”

About 300,000 people suffer out-of-hospital cardiac arrest in the USA each year, either because they’ve had a heart attack or suffered a rhythm disturbance; fewer than 8% survive. An analysis of 3,700 cardiac arrests published Friday in the journal Lancet found that hands-only CPR saved 22% more lives than the conventional method. All told, the switch could save up to 3,000 additional lives a year in the USA and 5,000 to 10,000 in North America and Europe, says lead author Peter Nagele of Washington University in St. Louis.

A landmark study published Oct. 6 in The Journal of the American Medical Association found that bystanders who applied hands-only CPR were able to boost survival to 34% from 18% for those who got conventional CPR or none at all. In addition, the percentage of people willing to provide CPR rose from 28% in 2005 to 40% in 2009.

The new guidelines dictate that a bystander should compress the victim’s chest 100 times a minute to a depth of about 2 inches. That keeps blood and oxygen flowing to the brain, sustaining it until help arrives. Stopping for rescue breaths can interrupt blood flow, AHA’s Sayre says.

Studies also show that bystanders reluctant to perform mouth-to-mouth breathing often give up, thinking there’s nothing they can do. “Bystanders aren’t doing anything in two-thirds of cases,” Sayre says. “This is not hard; it’s really easy.”

Slovis says it’s natural to balk. “Doing artificial ventilation, risking getting infectious disease, is something that most of us are afraid of,” he says.

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(Source: USA Today)

Among adults whose heart had stopped beating, those who received ‘hands-only’ cardiopulmonary resuscitation (CPR) from a bystander were 60 percent more likely to survive than those who received no CPR or conventional CPR with mouth-to-mouth breathing.

This is good news, researchers said, because not only is ‘hands-only’ CPR — in which the rescuer does rapid, uninterrupted chest compressions — easier for the public to learn and remember, research shows bystanders are more likely to act when they don’t have to do mouth-to-mouth.

“Anyone can do ‘hands-only’ CPR and anyone can save a life,” contends lead study author Dr. Bentley J. Bobrow, medical director of the Arizona Department of Health Services’ Bureau of Emergency Medical Services and Trauma.

“You don’t have to have a special certification or take a special course,” said Bobrow, who is also an emergency physician at Maricopa Medical Center in Phoenix.

Researchers stressed the findings apply only to adults given CPR by the lay public. Children should still usually receive rescue breathing, Bobrow said, as well as anyone who was choking, drowning or having breathing trouble before becoming unconscious.

The study is published in the Oct. 6 issue of the Journal of the American Medical Association.

In 2005, Bobrow and his colleagues launched a statewide initiative in Arizona to improve rates of cardiac arrest survival, including a performance improvement program for emergency medical services and increasing rates of bystander CPR. With the help of fire departments, the initiative included training throughout the community, in schools, online and a mass media campaign.

From 2005 through 2009, 4,415 adults experienced out-of-hospital cardiac arrest in Arizona and were not treated by a medical professional. Of those, 2,900 received no CPR from witnesses, 666 (about 15 percent) received conventional CPR that includes rescue breathing and 849 (about 19 percent) received compression-only CPR.

About 13.3 percent of those who received compression-only CPR survived and were discharged from the hospital compared to only 7.8 percent of those who received conventional CPR, a 60 percent difference. Those who received no bystander CPR at all fared the worst — only 5.2 percent lived.

Over time, along with public education campaigns encouraging ‘hands-only’ CPR, the annual rate for bystanders attempting CPR improved from about 28 percent in 2005 to nearly 40 percent in 2009. That rise coincided with the shift to the compression-only technique — in 2005, only about 20 percent of lay rescuers did compression-only compared to nearly 76 percent in 2009.

Overall survival increased from about 3.7 percent in 2005 to 9.8 percent in 2009, the study authors reported.

About 300,000 Americans per year experience cardiac arrest, in which the heart stops beating, outside of hospital settings. Without CPR to continue to pump blood and oxygen to the brain, death occurs within minutes, Bobrow said.

Without a bystander to step in and start compressions, emergency responders often arrive too late, Bobrow said. And the longer a victim goes without oxygen, the less likely an automated external defibrillator will work to restart the heart rhythm.

But for a variety of reasons, bystanders often fail to act. Some are unsure what to do, afraid of doing CPR wrong or don’t want to do mouth-to-mouth breathing. “What we have tried to do with ‘hands-only’ CPR is take out all the reasons people don’t act when they see a cardiac emergency — fear, panic, indecision, confusion — out of the equation,” Bobrow said. “There is no reason not to try to do hands-only CPR.”

That’s a crucial message, said Dr. Michael Sayre, an American Heart Association spokesman and associate professor of emergency medicine at Ohio State University. The American Heart Association began recommending ‘hands-only’ CPR in March 2008.

“That Dr. Bobrow and colleagues could increase rates of bystander CPR through a public education campaign and making the instructions simpler is very encouraging,” Sayre said. “In the past, people felt they couldn’t intervene because they hadn’t taken a class or were confused about what to do . . . We’re hopeful that bystander CPR will become more common with simpler instructions. The Arizona study shows this is likely to happen.”

Yet more research needs to be done before it can be said definitively that compression-only CPR works better than CPR with mouth-to-mouth, when done correctly, Sayre said.

Two studies in the July 29 issue of the New England Journal of Medicine also found that when bystanders were instructed by emergency dispatchers to give either standard CPR or chest-compression-only CPR, survival rates were similar between the two techniques.

Why might compression-only CPR work better than conventional CPR for adults?

When doing mouth-to-mouth, the rescuer has to stop compressions, which can lead to a rapid loss of life-sustaining blood flow to the brain, Bobrow said. Also, rescuers may have a tendency to blow too much air into the lungs. Overinflating the lungs can make compressions less effective when they resume, Bobrow said.

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(Source: Healthfinder.gov)

September 23 marks the six-month anniversary of health reform. It’s also the date when several key insurance changes come into effect.

Here’s what you need to know about how your insurance is affected.

If you get insurance through your boss: Many people who are insured through work won’t notice immediate changes to their health plans until their health plans renew, which is tied to companies’ open enrollment periods. Health plans offered through large employers usually get renewed on Jan. 1.

But the mandates could kick in sooner for health plans sold to new entities or individuals after Sept. 23.

Here are some key changes coming into effect:

Coverage expansion for adult dependents until age 26. Employers will have to provide coverage for dependents of workers who don’t have access to other employer-based health care coverage ’till age 26. Some states already mandate this coverage until age 28 or 29.
This new provision could also push companies to look for ways to restrict the number of new people added to their health plans.

Children no longer denied coverage for pre-existing conditions: Insurance plans can’t deny coverage due to a pre-existing condition to children under age 19. For adults, the same provision goes into effect in 2014.

Prohibit insurers from rescinding coverage: It’s illegal for insurers to drop a customer when they become sick or search for an error on a customer’s insurance application and then deny payment for service when the person gets sick.

Free Preventive Care: All new plans must cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance. If individuals keep their existing plans or if a group plan doesn’t make major changes, the provisions won’t kick in until the plans get changed. [Health reform: What you're not getting]

No lifetime limits on coverage: Insurers no longer can impose lifetime dollar limits on essential benefits, like hospital stays or expensive treatments.

Unrestricted doctor choice: Plans must allow pediatricians and obstetrician/gynecologists to get primary care physician status. This eliminates the requirement for patients to get prior-authorization from their insurer or a doctor’s referral to see a pediatrician or OB/GYN.

Level charges for emergency services: Insurers must remove prior authorizations for ER services. Also, insurers can’t charge higher co-payments or co-insurance for out-of-network ER providers.

Patient-friendly appeals process: Insurers will have to establish new internal and external appeals processes for claims. This means that while a claim is under appeal, your insurer has to continue to pay your claims, and continue paying for subsequent treatment, until the matter is resolved.

Small business impact: The changes that kick in on Sept. 23 also apply to small businesses with 50 employees or more that already offered insurance coverage prior to reform.

Companies that didn’t offer coverage pre-reform and have no more than 25 workers will be given incentives such as tax credits and grants to encourage them to offer insurance coverage, said Dorothy Miraglia, director of benefits with AlphaStaff, a firm that manages employee benefits programs for small businesses.

The government estimates that 4 million small businesses will be eligible for health insurance tax credits. These include a credit of up to 35% of the premiums employers pay on worker plans. For small non-profit companies, the credit is up to a 25%.

Also, the 35% maximum credit is given to employers with 10 or fewer full-time employees, said Miraglia.

If you buy insurance yourself: For consumers who buy health insurance directly from insurers, some of the same key changes go into effect this month.

Most importantly, insurers can’t drop you when you get sick or because you made a mistake on your coverage application. Insurers also can’t set annual or lifetime limits.

If you have children under age 26, you can insure them if your policy allows for dependent coverage. Individual plans can’t deny or exclude coverage to any child under age 19 for pre-existing conditions.

If you’re a senior citizen: If you have Medicare prescription drug coverage and are affected by the donut hole, this year you will get a one-time tax-free $250 rebate to help pay for prescriptions.

The prescription drug coverage gap that develops when Medicare stops paying for drug coverage and patients can’t afford to pay for drugs out-of-pocket is called the “donut hole.”

In 2011, if high prescription drug costs put you in the donut hole, you’ll get a 50% discount on covered brand-name drugs while you’re in the donut hole.

Also in 2011, Medicare will cover certain preventive services without charging you Medicare Part B (coverage for doctors’ services, outpatient care, home health services) coinsurance or deductible.

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(Source: CNN)

Smokeless tobacco products are not safe alternatives to smoking and could increase not only the risk of certain cancers , but also the risk of fatal heart attacks or strokes, according to the American Heart Association.

Products like snuff and chewing tobacco can be addictive and increase the risk of relapse for those who have already quit smoking, said the AHA said in a policy statement release Monday.”No tobacco product is safe to consume,” said Mariann Piano, lead writer of the statement and a professor in the Department of Biobehavioral Health Science at the University of Illinois, Chicago. “Smokeless tobacco products are harmful and addictive – that does not translate to a better alternative.”

A recent study in the United States found smoking rates didn’t drop among people who used smokeless tobacco products, causing concern that smokers may use both cigarettes and smokeless products, according to the AHA.  

If you’re trying to kick the habit, studies have found that nicotine replacement therapy–products including gum or patches– is a safer alternative and had no increased cardiovascular risk.

Smokeless tobacco contains 28 known carcinogens and increases your risk of both oral and pancreatic cancer, according to the Centers for Disease Control and Prevention.  It’s also associated with gum disease and tooth decay and in men, it can cause reduced sperm count and abnormal sperm cells, the CDC reports.

Smokeless tobacco products come in a variety of forms and are made from finely ground, shredded or powdered tobacco. The AHA estimates about 7 percent of U.S. adults use these products, 8 percent of high school students and nearly 3 percent of middle schoolers currently use smokeless tobacco.

Steve Callahan, a spokesperson for Altria, the parent company of US Smokeless Tobacco Company and Philip Morris USA declined comment on the specific policy but said “Altria and it’s operating companies supported federal regulation of tobacco for over 8 years. We believe that the FDA is really the appropriate authority to make the science and evidenced based determinations about tobacco products that are potentially less harmful than cigarettes.”

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(Source: CNN)

To my loyal YWN readers,

Although this space is normally used for my weekly columns on health, fitness, and weight loss, I will allow myself the liberty once a year to use this space for a personal message.
Hashem granted us the gift of a healthy body and expects us to do our best to take care of it. This requires healthful eating, exercise, the proper amount of sleep and an active lifestyle. We all are capable of helping ourselves. When we don’t take care of ourselves and watch over our health, the end result is illness and incapacitation resulting in our inability to perform the will of the Ribono Shel Olam. When we are sick, we can’t do chesed, learn, daven or take care of our own families. Our nefesh, our soul, functions best when our guf, our body, is at its best!

Many years ago, I was not a fitness trainer; I was anything but fit and healthy. I led a sedentary life style, ate whatever I wanted to in whatever amounts I wanted to and was overweight with slightly high blood pressure that became high blood pressure. As a former musician playing the wedding in circuit in the Greater New York area, eating at the smorgasbord at weddings was an activity I greatly looked forward to every evening. A few years after I relocated to Eretz Yisrael, I was fortunate to meet someone who changed my life around. I went from being sedentary with a poor diet to being active and healthy. I began eating right, walking, doing weights and stretching and after a short while, became a runner/jogger. My blood pressure went down, my old clothes fit again and I felt like a new person.

As a personal trainer here in Yerushalayim for the past 14 years, I have been privileged to witness many people who have turned their health around. Even people in desperate straits, and with all types of health issues, have been very successful and no longer require medication for diabetes, high blood pressure and high cholesterol. Their weight is normal, and not only has their physical health improved, but they feel better about themselves.

Rosh HaShana is a time for thanking HaKadosh Baruch Hu for giving us life and health over the past year. It is also the time for praying that He will give us good health and long life for the upcoming year. At the same time, we must do our hishtadlus, our effort, in the area of health. Our non-Jewish brothers approach their secular new year with all kinds of resolutions that are never kept. We do T’shuva. We work hard to actualize real change. And if there is ever a time we CAN change, it is now.

A little over a year ago, I began writing a health column for Yeshiva World. I never dreamed I would get the responses I have gotten from all over the world, and the amount of inquiries and questions about health topics have been abundant. Baruch Hashem, these columns have been able to help and motivate many people to achieve good health and IY”H will continue to do so for a long time.

It is also one year since I teamed up with my associate, Linda Holtz M. Sc and opened the Lose It! Weight Loss and Stress Reduction Program, its unique approach integrating the three disciplines of nutrition, exercise/activity and just as importantly, behavior. We have seen excellent results across the board in the area of weight loss, but just as important, in almost all aspects of life. With Hashem’s help, Lose It! will continue to be of key to success for many, many more people both here in Eretz Yisrael and in Chutz La’aretz, helping them to lose weight permanently and attain a superior quality of life.

I wish you all a K’siva V’chasima Tova. May this be a year of health and abundant simcha for K’lal Yisrael.  
Alan Freishtat

Alan Freishtat is an A.C.E. CERTIFIED PERSONAL TRAINER and a LIFESTYLE FITNESS COACH with over 14 years of professional experience. He is the co-director of the Jerusalem-based weight loss and stress reduction center Lose It! along with Linda Holtz M.Sc. and is available for private consultations, assessments and personalized workout programs. Alan also lectures and gives seminars and workshops. He can be reached at 02-651-8502 or 050-555-7175, or by email at alan@loseit.co.il  
Check out the Lose It! website at www.loseit.co.il. US Line: 516-568-5027