Researchers have identified a gene that can cause symptoms of major depression and said it may be possible to use gene therapy to counteract its effects.

They have been testing a similar gene therapy technique in the brains of patients with Parkinson's disease and may be able to quickly adapt it to depression, Michael Kaplitt of Cornell Medical College and colleagues reported Wednesday.

"We potentially have a novel therapy to target what we now believe is one root cause of human depression," Kaplitt, a neurosurgeon, said in a statement.

Depression affects about 121 million people worldwide, according to the World Health Organization, and is diagnosed in at least 13 million U.S. adults each year. It is the main factor in suicide and at least 27 million Americans take antidepressant drugs.

The causes are complex and different patients respond to different treatments.

Kaplitt's team looked at the activity of a gene called p11 in a part of the brain called the nucleus accumbens.

"This is the center of the brain for reward satisfaction," Kaplitt said in a telephone interview.

"One of the major problems in depression is what is called anhedonia -- an inability to be able to be satisfied or happy or content with normally pleasurable activities in life."

The p11 gene helps regulate signaling of serotonin, a brain chemical tied to mood, sleep and memory. Many antidepressants target serotonin.

The research team used mice that lacked active p11 and acted depressed.

DEPRESSED MICE

"If you hold a mouse up by its tail, it tends to fight to get away. A mouse showing depressive behavior will just lie there," Kaplitt said.

Kaplitt's team has been testing gene therapy for another brain disease, Parkinson's, in people. They used the same vector -- the virus used to carry the new gene into the body -- to make a gene therapy replacement for p11.

It transformed the behavior of the depressed mice, they reported in the journal Science Translational Medicine. But taking out a gene and then replacing it in mice does not prove that gene causes human symptoms, or that boosting its production would alter human depression.

So they looked at brain samples taken from people with depression who had died and compared them to samples from people without depression.

Levels of p11 in the nucleus accumbens region -- the reward center -- were significantly lower in the depressed patients, they found.

Gene therapy for depression is a long way from being tested in people, Kaplitt noted, although he said the Parkinson's trials show it could be safe.

Gene therapy -- replacing or boosting the activity of a faulty gene to correct disease -- is still considered highly experimental, although there has been some success in treating forms of blindness and immune deficiency.

"One of the next key steps is to try and test this in non-human primates," he said. He said his team was collaborating with a team at the National Institute of Mental Health, one of the National Institutes of Health, to test the idea in monkeys.

The study was paid for by the U.S. and Swedish governments as well as private foundations, but Kaplitt has founded a company called Neurologix Inc, which has licensed intellectual property rights to p11 gene therapy for behavioral disorders.

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"Improv comedy is so stimulating, it's kind of like vitamins for the brain." So says 85-year-old Lois Peltier, who is a resident and a member of an improv group at the Vi at The Glen, a continuing care retirement community (CCRC) in Glenview.

"We're often called the 'World's Oldest Improv Group' because most of us are primarily in our 80s, and we have a couple [members] in their 90s," said Peltier, who lives in a two-bedroom residence at the Vi with her husband, Noel, 87.

The senior improv group has 10 members and practices every Wednesday afternoon at the retirement community with students (from freshmen to seniors) from nearby Glenbrook South High School.

"We love working with the students," Peltier said. "Plus, it does seem to be good for the students to work with us because when they see us doing improv it helps them to appreciate that life doesn't end with high school or college and that grandparents can have a good time, too. Surprise! Surprise!" Peltier said. "Over the years many of them have gone on to college and some come back and visit us."

Peltier has been a member of the improv group since she moved to the Vi seven years ago. Sometimes the troupe performs at local events, but most often for residents of the retirement community.

"Improv keeps me young. It's a challenge like any puzzle or game although we don't win at this. But you still want to do well and have others do well too," said Peltier, who is a retired nursing home activities director.

To help practice, the senior improv troupe often starts with a location and then each member has to start from there and develop a character.

"Seniors here are amazing because they've retained their sense of humor, ability and flexibility," Peltier said. "I'll work with maybe three other people at one time and we learn to feed off each other [for the comedy]."

"Not everyone shows up every week, but sometimes that's good because fewer people seems to help seniors who are little more timid than others. They have to get up and do it and find they are very capable," Peltier said.

Meanwhile, residents at the Vi at the Glen have plenty of other activities to enjoy.

"We offer so many recreational options -- fitness classes, aqua aerobics, tai chi, yoga, walking groups, golf outings, poker nights, socials, themed parties, concerts, book and current events discussion groups and computer instruction," said Andrea Agazim, lifestyle director at the Vi. "We have a play reading group, memoir writing workshops, book clubs, arts and crafts and a knitting group that makes blankets for charity. There's even a garden here, so residents can do their own gardening.

"Improv is great, but there are so many other things to do here, too," Peltier said.

Vi at The Glen is a retirement community that offers its residents a combination of housing, dining, and certain amenities and health care services in return for a monthly fee and an entrance fee. Residents do not purchase their apartments. The entrance fee and monthly fees give the resident the right to occupy his/her apartment for life and cover the services while residing at the community.

The community consists of a three-story main building with common areas and 251 one- and two-bedroom apartments. There also are 45 free-standing villas surrounding the main building.

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As 4-year-old Liam O'Meara participates in the Clarendon Hills Park District's Pee Wee Start Smart Golf program on a recent Thursday afternoon, he swings a club, gets instruction, and has fun. He is just like any other class member.

But underneath his white polo shirt, Liam is not the same. He bears the scars of three surgeries already in his young life.

The Clarendon Hills youth was born in 2006 with half a heart. Stricken with Hypoplastic Left Heart Syndrome, Liam had doctors at Children's Hospital of Wisconsin reconfigure his heart to operate with a single ventricle.

From first finding out about Liam's condition at 22 weeks into the pregnancy to his prognosis for the future, Liam's parents, Brian and Bridget O'Meara, didn't get a lot of answers along the way because there are not a lot of answers out there. A lot of what they heard from medical specialists was "We don't know."

"So much of everything was out of our hands," Bridget O'Meara said.

Despite not a lot of clear answers, Bridget couldn't speak highly enough of the staff at Children's Hospital of Wisconsin.

"They held our hands. They gave us a lot of support," she said.

She also said they were blessed to have a lot of family and friend support.

Knowing that everyone does not have such a strong support system, the O'Mearas created the Mend a Heart Foundation to support initiatives that extend and enrich the lives of young heart patients. They said they wanted to create a resource for other parents of heart patients and be a funding mechanism for research.

"We wanted to take back some of the fight and that is how the idea (for the foundation) was born," Brian O'Meara said.

The foundation will have its fourth fund-raiser Saturday, Oct. 16 in the gym at Notre Dame School, 66 Norfolk Ave., Clarendon Hills. The O'Mearas hope to raise as much as $50,000 with the one-night fundraiser.

The first three fund-raisers netted a total of $90,000, much of which has gone to fund heart studies.

Coordinating an annual fund-raiser while raising three boys keeps the Clarendon Hills couple on their toes.

"I don't get much sleep this time of year," Bridget admitted, quickly adding that she has a lot of help from friends in organizing the event.

"You do something four years in a row and you get to know the lay of the land," Brian said.

Through their work with the foundation, the O'Mearas have met many other parents and individuals with family members with heart conditions.

"A lot of people have told us their stories," Brian said. "Someone will tell us 'My cousin has a heart condition.' We now know of kids in town who have heart conditions."

Liam's right ventricle will eventually wear out, making a heart transplant the likely course of action. However, the O'Mearas hope that their fund-raising efforts will pay dividends for their son when that time comes. Whether it be by creation of another ventricle through stem cells or some other process, the O'Mearas hope the research they fund can find an answer for when the atrophy occurs.

Brian O'Meara noted that 20 years ago Liam's condition was almost always fatal. He said the research done since then has helped save his son's life.

"I hope that 20 years from now, doctors and families will be using equipment and procedures identified in the research we are funding," Brian said. "I hope that because of what we are doing now that 20 years from now we will have come along with medical solutions to these problems."

Mend a Heart has funded research into the effect of exercise on heart patients, as well as looking at a drug that could keep heart transplants from being needed. The organization also has helped fund Camp Odayin, a Minnesota summer camp for youth with heart conditions. The camp has a cardiologist in each cabin to monitor youth.

"Our mission statement says we aim to extend and enrich the lives of children," Brian said. "We have worked on extending lives through the research. We wanted to include enrichment and we included the summer camp."

The O'Mearas have a medical board of directors that examines the half-dozen applications the foundation receives for funding annually.

"I like to give individuals hope," Brian said. "People long ago helped save Liam's life through the research that was done. I would like to give someone else that piece of mind."

Bridget noted that doctors have put few rules and regulations on Liam at this point.

"Other than keeping him out of contact sports, he doesn't have many restrictions," Bridget said.

"The doctors said he will be self-regulating," Brian said. "His body will tell him what he needs to know."

Bridget said Liam's two brothers, Finn, 6; and Seamus, 2, don't treat him any differently because of his condition.

"He is always trying to keep up with his older brother," Bridget said.

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On the first day of basketball practice, Elizabeth Pearlman passed out with a heart condition, but an AED saved her life. “What if it happened somewhere where an AED wasn’t available?” she asked.

Chicago native Elizabeth Pearlman was taking part in a conditioning drill with her college basketball team last October when she collapsed.

If an automated external defibrillator -- an AED is a portable device that can detect cardiac arrhythmias and shock the heart back into rhythm -- hadn't been available, she likely would have died. Pearlman hopes that by sharing her story she might raise awareness -- and ultimately help save others.

"It was the first day of practice," the Aurora University senior said. "At the end of practice, we were doing sprints. On the last sprint, I suddenly felt like I had to stop running. Did I feel faint? No. I just knew that I didn't feel right. The next thing I saw was the floor coming to my face."

Fortunately, Aurora head athletic trainer Terry Smith was at the practice. He saw Pearlman go down. Was she just tired? He doubted that. He sensed something was wrong, and went directly over to her. He saw that she was having a hard time breathing and was hyperventilating. Then he saw her eyes roll back in her head.

"It went downhill real quick," Smith said.

He told one coach to call 911, and told another to get an AED. He immediately began performing CPR. But Pearlman didn't respond to the CPR. Smith had to use the AED to restore her heart rhythm. He had to shock her twice.

"I don't know how much time passed," Smith said. "But time flew. Then the ambulance came."

Pearlman, 21, remembers being in a state of euphoria before regaining full consciousness in the ambulance.

"I was in a great place -- it was deep and solid," she said. "Then I started feeling pricks and pokes, and I woke up to [the paramedics] putting needles in my veins."

Pearlman would spend the next week in the intensive care unit. She would learn that she suffers from a previously undiagnosed genetic heart disease called arrhythmogenic right ventricular dysplasia. She also had suffered a pulmonary embolism. In the months that followed she would undergo several medical procedures, including having an implantable cardioverter defibrillator, or ICD, put in her chest. She has become an expert on her heart condition. She knows she had a close call. Make that a very close call.

"If not for the AED, you're dead," she said. "Growing up, I played basketball in some pretty tough city neighborhoods. I played pick-up games with guys, and we were always running. What if it had happened then? What if it had happened somewhere where an AED wasn't available?"

If it were up to organizations such as the American Red Cross, you would find an AED on every playground and in every home. Because CPR alone isn't always enough. AEDs are not useful for every arrhythmia, but they can detect two that are frequently implicated in sudden cardiac arrest, ventricular fibrillation and ventricular tachycardia.

"If you have an AED, it can increase your chance [of survival]," said Theresa Rees, manager of instruction and development for the Red Cross of Greater Chicago.

Fortunately, you can find AEDs in more places than ever before. They're small, light and easy to use.

"They are in all sporting facilities, government buildings, airports, schools, police cars, ambulances [and other places, as well]," Rees said.

Even those without training should not hesitate to use one in a crisis. But ideally everyone would learn from a professional.

Paramedic Lisa Krch, the CPR training coordinator for Advocate Christ Medical Center's Center for Prehospital Care in southwest suburban Oak Lawn, has taught thousands of people how to use an AED.

"You can teach anyone to use them," Krch said. "I've taught Boy Scouts -- 8-year-old kids. You just follow the prompts. Turn the machine on, then one prompt at a time. It won't go to the next step until you've completed the step you're on."

Advocate Christ has for the past two years gone into high schools to teach CPR, AED and basic first aid.

"Last year alone we taught 1,000 people," Krch said. "I wish they would make it a requirement of high school graduation that you need to know CPR and AED. It's less than eight hours, and it could save a life."

Twelve months ago, Pearlman's life changed drastically. She can no longer play basketball -- her heart condition won't allow it. But she's on target to graduate with her class, and she hopes to attend veterinary school. She's not only alive, she is full of life. Spread the word.

"AEDs are very, very important," she said.

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A little mystery with smog, Pham Anh Thu (VietNam) - Bronze Supermodel 2010 with standard configuration has moments of real photos bikini sexy outfits.

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Katherine Heigl's plan to kick her cigarette addiction by turning to the electronic version of butts may just go up in smoke.

Heigl, demonstrating for David Letterman last week how she puffs on an e-cigarette, said it has worked for her where nicotine gum, nicotine patches and a prescription drug did not.
"You blow out water vapor so you're not harming anyone around you and you're not harming yourself," she said. "I'm essentially humidifying the space."

"I know it’s ridiculous, but it’s helping me not to actually smoke real cigarettes," Heigl said in an interview with Parade.

But e-cigarettes not only contain nicotine, but whatever chemicals leach out of the plastic tubing that is part of the device, Dr. Len Horovitz, internist and pulmonary specialist at Lenox Hill Hospital told the News.

Electronic cigarettes, which unlike regular cigarettes don't burn tobacco, are smoked with the aid of a battery-operated device. The smoker inhales a vapor that contains nicotine in liquid, which comes in a replaceable cartridge.

"Medically it is exactly like a nicotine addiction," he says. "And inhaling fumes from the plastic tubes can be carcinogenic."

Electronic cigarettes "are not a good way or an approved way to quit smoking," says Dr. Jonathan Whiteson, medical director of the Cardiac and Pulmonary Wellness and Rehabilitation Program at NYU Langone Medical Center.

"They have never been proven to be effective at smoking cessation," he says. "There are many claims, none of which have been substantiated."

Besides the nicotine itself, some of the chemicals in the propellant that helps to vaporize the nicotine are dangerous, too, Whiteson notes.

Electronic cigarettes are not FDA approved, and aren’t currently subject to strict regulation, notes Kathy Garrett Szymanski, respiratory therapist in the thoracic center at Long Island College Hospital, where she directs the smoking cessation program.

"At this point, they are a drug delivery service," she says. "It’s a little cigarette that lets you inhale nicotine. And inhalation is the fastest route of drug delivery. I do not recommend them."

Bottom line? "It’s nicotine, it’s a drug, it’s addictive and it has health consequences," Whiteson says.

With 70% of those who try to kick the habit thwarted in their efforts, smoking remains a tough addiction to beat. But the best way to quit, Horovitz says, is with the nicotine patch and, if necessary, the chewing gum.

"These have been found to be superior to all the pills that are out there," he said. "But there is no magic way to quit smoking anymore than there is a magic way to diet."

Heigl told Letterman that she warn her daughter against the dangers of smoking.

"The one thing I would say to my kid is, "It’s not just that it’s bad for you. Do you want to spend the rest of your life fighting a stupid addiction to a stupid thing that doesn’t even really give you a good buzz?' "

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A hepatologist and assistant professor of medicine at Mount Sinai, Dr. Charissa Chang specializes in treating patients with liver diseases like viral hepatitis and fatty liver disease.

Who's at risk

About 30% of Americans have fatty liver, a condition whose name says it all. "Fatty liver is a condition where there's excess fat accumulation in the liver," says Chang. "A subset of patients who have fat in their liver have fat plus additional damage, which we call nonalcoholic steatohepatitis (NASH)."

If left unmanaged, NASH can lead to cirrhosis, liver transplant or liver cancer. "A liver biopsy is the only way to tell whether someone with fatty liver has the more severe NASH, although sometimes we can make an estimation without having to perform a liver biopsy," says Chang.

Doctors estimate that 2% to 9% of Americans have NASH. "Fatty liver disease is now a common cause of liver abnormalities and the most common cause of abnormal liver tests in the United States," says Chang. "We're seeing more patients for transplant or cancer with the fatty liver disease as the underlying cause."

At this point, fatty liver disease is even more prevalent than hepatitis C, which affects 1.5% of the population.

The main risk factors for fatty liver are obesity and metabolic syndrome. "Fatty liver is the liver manifestation of metabolic syndrome," says Chang. "So it's associated with all the other features of metabolic syndrome: high blood pressure, diabetes, high cholesterol and an increased waistline."

A minority of patients with fatty liver don't have metabolic syndrome. "Some medications can cause fatty liver, and there are genetically inherited disorders of fat metabolism, including a rare condition called congenital lipodystrophy that can be associated with fatty liver," says Chang.

The cause of fatty liver disease is still unclear and is an area of active research. Fatty liver is a condition that increases with age, although young people and kids can be affected. "The prevalence increases with age for a few reasons," says Chang. "Some of it is weight gain over time, and some of it is that the longer you've had fat in the liver, the more years you've had to develop liver damage."

Signs and symptoms

Fatty liver is often a stealth disease. "The early signs and symptoms are often silent," says Chang.
"It's usually an incidental diagnosis picked up by having blood drawn as part of a routine check-up." Most primary-care physicians run liver tests as part of a yearly physical, but it's worth asking to make sure your doctor tests for fatty liver.

Liver damage only begins to show symptoms when it reaches the point of end-stage liver disease. "At this point, the patient progresses to cirrhosis, which can cause symptoms a patient could note on his own — things like fluid retention and jaundice," says Chang.

"Another big concern or end-stage complication is liver cancer," she says. As more patients develop fatty liver disease, doctors are seeing increased amounts of liver cancer that developed in the presence of fatty liver disease. "The goal is to prevent fatty liver from progressing to cirrhosis," says Chang. "Or better yet, preventing it in the first place."

Traditional treatment

The first step for patients diagnosed with fatty liver is to develop a plan with their primary care physician to address obesity and related issues like diabetes and cholesterol. "Losing weight and keeping diabetes under control can improve fatty liver or keep it from causing damage," says Chang.

"I advise patients to limit both saturated fat and high-fructose-containing food products like sodas, both of which are associated with obesity," she says.

About a third of patients who have fatty liver get better, one third stay the same and one third get worse. The focus is on prevention and containment, because doctors don't have many options for patients whose disease worsens to the point of nonalcoholic steatohepatitis (NASH).

"Right now we have no FDA-approved medications to treat NASH," says Chang. "While there has been research using diabetes drugs, weight-loss medications and cholesterol medications to treat NASH, there is not enough evidence at this time to show that these drugs can be used to treat NASH directly."

Patients whose disease continues to progress can develop cirrhosis, an outcome doctors work very hard to prevent. "Once there is cirrhosis in a patient with NASH, there aren't a lot of options to reverse the damage," says Chang.

"Short of a liver transplant, there isn't much we can do besides advise to lose weight and keep diabetes and cholesterol under control," she says. Even liver transplant isn't a perfect cure, because the disease can come back after a transplant.

Research breakthroughs

One recent study had promising results for using vitamin E to fight fatty liver. "Last year, a National Institutes of Health multi-site collaboration called the PIVENS trial published its findings that using vitamin E improved liver tests and reversed scarring in the livers of patients with NASH," says Chang. "We need more supporting studies, but it's worth asking your doctor if vitamin E could help."

Questions for your doctor

Because this disease is usually asymptomatic, it's all the more important for patients to ask, "Could I have fatty liver disease?"

If you've been diagnosed, then the question becomes, "What can I do to keep my fatty liver from progressing?"

Eating a healthy diet and exercising regularly can go a long way toward keep fatty liver disease under control.

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The specialist: Dr. Scott Nguyen on diverticulitis.

A gastrointestinal surgeon specializing in laparoscopic surgery, Scott Nguyen performs 300 to 400 operations a year. Ten percent of his patients at Mount Sinai have diverticular disease.

Who's at risk

You may never have heard of diverticular disease, but there's a fair chance you have it if you're over 60. Thirty percent of those over 60 have diverticula — pouches in the lining of the large intestine or ­colon.

"The good news is that the pockets themselves only cause problems for 20% to 30% of patients," says Nguyen. "When the pockets cause complications like localized inflammation or infection, we call it diverticulitis."

Another form of diverticular disease is diverticular bleeding, when pockets erode into the blood vessels of the colon and cause bleeding.

As of now, there's no known genetic component to diverticular disease. The primary cause of the disorder is thought to be the modern diet.

"This is a disease of developed countries," says Nguyen. "A low-fiber, high-fat diet is the biggest risk factor, so the obese and people who eat a lot of red meat and other fats are at elevated risk."

Because of the links to fiber, diverticular disease is also possibly associated with constipation.
Your odds of developing diverticular disease increase as you age. Both men and women develop the disease, but often at different points in their lives.

"Most people who develop diverticular disease before age 40 are men, and after age 70 are women," says Nguyen.

Signs and symptoms

The symptoms of both diverticulitis and diverticular bleeding can be extremely disabling.

"The red flag is the acute onset of lower abdominal pain, usually persisting for several hours, up to several days," says Nguyen. "The pain is relatively severe and often associated with a fever,
because it's a type of infection."

If left untreated, the pain often spreads throughout the abdomen and the infection can worsen into a severe infection like sepsis. In some cases the inflammation is so severe that it forms an abscess, erodes into organs like the bladder or blocks the colon.

"Most people have an attack or two of diverticulitis and go to see their doctor for relief," says Nguyen.

Diverticular bleeding is even easier to diagnose, and patients usually head to the hospital immediately. "The sign of diverticular bleeding is the sudden onset of painless rectal bleeding," says Nguyen, "This is profuse bleeding that often leads people to call 911."

The blood tends to be a bright, fresh red, but can also be darker old blood. In some cases, the bleeding is severe enough to cause fainting.

Traditional treatment

The first course of action for preventing or treating diverticular disease is lifestyle modification.

"That means changing your diet, getting exercise, losing weight," says Nguyen. "Unfortunately, it's very hard to change these habits."

During an acute attack, doctors use antibiotics to calm the infection. "Many people respond really well to this," says Nguyen. "But the standard of care is that if you have two or more attacks, you need surgery to remove the diseased area of the colon."

Surgical intervention is called for because these patients are more likely to have a recurrence and to develop complications like abscesses or serious infection.

"For people who had multiple attacks, surgery is successful and prevents another attack about 90% of the time," says Nguyen.

"If we can do it as an elective operation, where we can cool people off with antibiotics, they are usually in and out of the hospital within a week." The results of emergency surgery are much less ideal: Patients usually spend weeks in the hospital for recovery and often need an ostomy bag afterward.

Diverticular bleeding usually calls for admission to the hospital for intravenous fluids and possibly blood transfusions until the bleeding stops. Sometimes a colonoscopy or a special radiologic procedure can be used to halt the bleeding.

"If the bleeding doesn't stop, then we do emergency surgery to remove that section of the colon," says Nguyen.

Research breakthroughs

Doctors are still figuring out how diverticulitis works. "In the past, the traditional school of thought was that diverticulitis in people under 50 was a more virulent form of the disease, so we advocated earlier surgery," says Nguyen. "But now evidence shows that diverticulitis acts the same in young and old — that's a big change in dogma."

Another improvement is in surgical technique. "Laparoscopic surgery is becoming the preferred method, because it has a shorter recovering time and fewer complications," says Nguyen.

Questions for your doctor

If you have an attack of diverticular disease, ask: "What can I do to prevent this from happening again?"

A better lifestyle can protect you against recurrence.

Another essential question is, "Should I get a colonoscopy?" This test will both evaluate the extent of your diverticular disease and check for co-existing cancers.

"Diverticular disease is a sign that it's time to change your life, and it's never too late," says Nguyen. "Even at 90, improving your diet will do its best to correct diverticular disease."

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Not only do the lines of unique and progressive leap of achievements, Yu Ram Cha also known for his bold oriental beauty.

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Helen Mirren claims that her secret to looking young is holding in her stomach and wearing platform high heels.

But now that she's shilling for Nintendo's Wii Fit, she's got another fitness trick up her sleeve.

"The Wii is fun, and it's infinitely varied. You can hula, jog, yoga, step, all in one session, she said, according to the Daily Mail. "You need never get bored as every day you can tailor a new workout.

"It challenges you, and you do it at home, so nobody need see you in those old yoga pants and torn T-shirt."

Helen Mirren looking sleek and chic at the 2010 Toronto International Film Festival.

The 65-year-old Oscar winner, who famously posed nude in New York magazine this year, has claimed to be as body-conscious as the next woman.

"Holding your tummy in is another trick for making you look and feel good," Mirren said. "I don’t know why, but I do, by nature, hold my tummy in."

Bits of my body are all right, but bits of me are horrible," she told Woman and Home last month. "To be honest, anything from the waist down I don't really like."

Mirren recently gave 24-year-old actress Megan Fox a run for her money, nearly beating her out for Esquire magazine's 2010 Sexiest Woman Alive. She told the magazine that she was "gobsmacked" by the honor.

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In 1969, Carol McDonald was 28, married and the mother of two young children, out for an evening of fun with a couple who smoked marijuana. By the end of the evening she was on her way to a 19-year addiction.

"Within a few months, I was smoking every day," said McDonald, a retired bookkeeper, now 69. "I had to smoke before going to work. If something was upsetting, I smoked over it. If there was a celebration, I smoked over it."

People like McDonald may be largely overlooked in the statewide debate over legalizing marijuana. The drug has a benign reputation: Many baby boomers smoked and emerged unscathed, and medical marijuana facilities with their friendly images of seven-fingered leaves have popped up all over Los Angeles.

That might be why Proposition 19, the Nov. 2 ballot measure that would legalize marijuana and regulate it similarly to alcohol, has generated scores of reports and debates regarding the potential effect on business revenue, tax dollars and law enforcement but scant discussion on the potential fallout on people's health.

In California, addiction counselors are split on the legalization issue largely because of their long-standing support of treatment over jail and legal penalties for marijuana addicts. Yet nationally, public health experts mostly are against legalization. They say it will increase the number of people who become addicted to the drug, contribute to more automobile accidents and erode school performance.

"It's bizarre to me when people say, 'Make marijuana legal, and we'll have no problems with it,'" said Keith Humphreys, a professor of psychiatry and behavioral science at Stanford University who recently served as a White House senior adviser on the nation's drug control policy.

Because the science of marijuana's health effects is in many cases unclear, experts on each side of the legalization debate can point to scientific studies that support their own position.

They do agree that marijuana should be avoided during pregnancy and that it is harmful for people with mental illness or who are at risk for developing a serious mental illness, such as schizophrenia.

And they agree, too, on some basic statistics: Marijuana is addictive for about 9 percent of adults who use it (compared with about 15 percent who use alcohol and 15 percent who use cocaine), according to federal data. Because it is the most widely used illegal substance in the country, marijuana dependence is more common than addiction to either cocaine or heroin despite its lower addiction potential.

"We generally think the problems with marijuana aren't as serious as the problems you tend to see with cocaine or heroin," said Alan J. Budney, a leading researcher on marijuana at the Center for Addiction Research at the University of Arkansas for Medical Sciences who opposes legalization. "But they are still pretty substantial."

The science of marijuana becomes murky when one steps beyond addiction statistics to examine effects on health.

A series of studies conducted by the National Highway Traffic Safety Administration published in 1998 found that the effects of marijuana alone on driving were small or moderate, but severe when combined with alcohol. But other studies show little impairment from a moderate dose.

The data on lung damage and smoking-related cancers are similarly mixed, in part because a large portion of heavy marijuana users also smoke tobacco, which muddies the picture of marijuana's effects.

Several studies have also dismissed the fear that marijuana is a "gateway" drug that will lead children and adolescents to experiment with harder illicit drugs - although numerous studies suggest that the earlier in life someone uses marijuana, the riskier it becomes.

Among 14- and 15-year-olds who start to smoke, 17 percent will be dependent within two years, said Dr. Tim Cermak, an addiction psychiatrist and president of the California Society of Addiction Medicine.

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Is the so-called "one-stitch face-lift" really a fast pass to a youthful appearance?

The wrinkle-free results may not be as long-lasting as with a traditional operation, but the minimally invasive procedure is a hot ticket right now in cosmetic surgery.

Two reasons. It's quicker and cheaper than a traditional face-lift, which requires more inpatient care time.

"There's a strong trend right now to perform less invasive procedures for facial rejuvenation," Dr. Jennifer Walden, a plastic and reconstructive surgeon at Lenox Hill Hospital told the Daily News. "People want instant results and minimal down time, so there is a demand for these procedures. No one can take two or three weeks off from work to recover."

The "instant" face-lift consists of four stages, Walden explained: the insertion of the barbed thread, then the deployment of the suture material, followed by the anchoring of the soft tissues and then the fixation into place.

There's one superlong, supersneaky suture. And yes, the needle is big.

Angelica Kavouni, 47, told the Daily Mail that she was unhappy with her "increasingly jowly" appearance. She decided to give the "one-stitch face-lift" -- also called a thread lift or an iGuide -- a try with plastic surgeon.

Hardy experienced minimal side-effects from the 40-minute procedure and said that with makeup, she could return to work that day.

So can one stitch hold up, or hold back all those years?

Not exactly, according to Angelo Cuzalina, president-elect of the American Academy of Cosmetic Surgery.

The face, he notes, "has a lot of ligaments and tissues that tend to pull back down, so it’s not like a single suture could ever hold up a face or a portion of the face."

But the technique is getting better and better all the time, Walden says. "Our methods are getting better so they will last longer."

In the meantime, Hardy told the Mail that if she didn’t like her "new" face, the surgeon had said that the face-lift was reversible. Basically, it was a matter of pulling out the suture.

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Pulling off the production on the CBS hit "Undercover Boss" takes a lot of work, but even with extensive preparation, slipups happen.

"There was one employee who did recognize me," says Kim Schaefer, the chief executive officer of Great Wolf Resorts, which is featured Sunday at 9 on CBS.

"I know most of our management team, and they were either absent, had the day off or had an assignment outside the lodge," Schaefer told the Daily News.

Yet one staffer did spot her. That employee wasn't part of the group Schaefer worked with during the filming, however, so viewers won't see the encounter.

However, it does expose the difficulty of pulling off a show built around having a top executive go undercover within a company. Schaefer, it should be noted, is the first female boss in the show.

"What this show gave me is the opportunity to be somebody else and listen and learn and participate," she says.

If Schaefer had been there as the boss, she says she would have wanted to fix little problems. But with the cameras on, and in the guise of a regular employee, she was able to watch.

"The biggest challenge was keeping quiet," she says. "Definitely in the middle of a shift, or at the end of the shift, I wanted to do more with the information I had."

But she couldn't.

During the show, she worked in one of the day-care centers at a Great Wolf Lodge and also in the water park. At another site, she staffed the front desk, and in yet another she worked as a waitress.

Schaefer says the producers of the show had urged her to take part in it, and says there were not a lot of active discussions on whether to do it.

"I knew this was a once-in-a-lifetime opportunity," she says.

Indeed, one upside to the show has been a boon to the featured businesses. Schaefer says she expects some uptick after the program airs.

Locally, she says, the Great Wolf Lodge in Pennsylvania's Pocono Mountains, generates roughly 68% of its business from New Yorkers.

The season premiere last week averaged 11.54 million viewers, up against tough football competition on NBC. Last year, including a big night after the Super Bowl, "Undercover Boss" averaged more than 17 million viewers and became one of the hottest series on TV, and the rare show that families can watch together.

Schaefer says she didn't find anything terribly wrong with her operations, just some things to tweak along the way, like the length of time it takes to check in and how hot it is for employees at the water park.

"My expectations were that I was going to come in as a CEO and look at it through the eyes of the CEO," she says. "It ended up being about the people, and me as a working mom."

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For the past 30 years, Peter Gorevic, now director of rheumatology at Mount Sinai, has been treating patients with immune and arthritis-related disorders. One of his main research interests is looking at what causes the group of disorders known as amyloid diseases, and what doctors can do to treat them.

Who's at risk

Amyloid disease is hardly a household word, despite the fact that one of the 26 types is Alzheimer’s disease — which affects about 4 million Americans. "Amyloid diseases, or amyloidosis, are conditions in which the abnormal amyloid proteins build up in organs and tissues," says Gorevic. "During a biopsy, the pathologist sees a pinkish amorphous material that is the sign of an unhealthy mutation," he says.

These amyloid deposits can occur anywhere in the body and cause different symptoms, depending on which organ is primarily affected. Doctors divide amyloid disease into systemic and localized disease, with localized disease often related to Alzheimer’s.

"Systemic amyloid falls into three groups: primary, secondary and familial amyloid," says Gorevic, "While these diseases are relatively uncommon, they do occur in certain settings more often than others."

For instance, one type of amyloid is a frequent complication resulting from long-term dialysis.

"Some researchers think that 60%-80% of patients who are on dialysis for more than 10 years may have amyloid," says Gorevic. "We estimate that about 250,000 Americans fall into this high-risk category."

Another common disease linked to amyloid is chronic inflammatory arthritis, which can cause secondary amyloid disease. "As many as 5%-10% of those people might develop amyloid if their arthritis isn’t kept under control," says Gorevic.

Familial amyloid is the rarest disorder, with only 10,000 to 15,000 people affected worldwide.

"The genetic mutation that causes it is widely represented in Western Africa, and as a result more prevalent in African-Americans," says Gorevic. "Some researchers think 1 million people carry the mutation that can lead to familial amyloid."

Signs and symptoms

Amyloid diseases present themselves differently, depending on the system that is primarily affected.

"Often patients end up with symptoms related to the kidney, heart, nervous system or GI tract," says Gorevic. "The symptoms may not be specific to amyloid, but they would lead the patient to come to the doctor, who runs a biopsy that catches the amyloid," he says.

For instance, amyloid patients commonly see a nephrologist if they are retaining fluid, losing protein in their urine or experiencing shortness of breath. Cardiologists more often find amyloid in patients who have swollen legs, chest palpitations and shorter and shorter breath. "Sometimes they can’t lie flat because fluid accumulates in their lungs," says Gorevic.

Neurological symptoms can include neuropathy (which cause numbness and tingling in the legs), carpal-tunnel syndrome or weakness in the legs and arms. In the GI system, red flags can come from the sense that the stomach fills up too quickly, trouble swallowing, dry mouth, diarrhea or constipation.

Traditional treatment

A thorough diagnosis is the key first step to treating amyloid disease.

"Traditionally, treatment is, first of all, figuring out what organ is involved and how it should be handled," says Gorevic. "For instance, if heart failure, what could you do? If the kidneys, how do we conserve function?" In this approach, cardiac patients might be helped by certain drugs and the need to avoid others.

Kidney patients would take "standard meds" like ACE inhibitors or ARBs (angiotensin receptor blockers). In both cases, organ transplant can be an option down the line. One of the primary objectives is that the treatment has to be tailored to the particular type of amyloid.

"For primary amyloid, we must first evaluate the patient for the bone marrow cancer multiple myeloma, which occurs in 10% of these patients," says Gorevic. "The treatment is chemotherapy."

In secondary amyloid, the amyloid results from another health problem, such as chronic inflammatory arthritis. Treating the underlying disease aggressively has great results in managing the amyloid." Familial amyloid is the most frustrating," says Gorevic. "It affects the nervous system or heart, and until recently we had no therapeutics."

New drugs are rapidly changing the landscape of treatments available for all three types of amyloid, with more rapid chemo and an improved understanding of bone marrow transplantation changing the prognosis for patients with primary amyloid.

New therapeutics can prevent secondary amyloid from forming, or prevent the need for kidney transplant.

Research breakthroughs

Doctors expect that two new drugs approved for rheumatoid arthritis will dramatically cut down on the resulting amyloid. In the past year, doctors have discovered a new therapeutic, diflunisal.

"It seems to inhibit this form of amyloid from occurring," says Gorevic. "It’s going through testing now, and we're very optimistic."

Questions for your doctor

If you’re diagnosed with amyloid disease, start out by asking "How much of my body is affected?" Be sure to consider the range of treatments by asking "What are my options?"

If your doctor recommends a medical treatment, ask, "What side effects can I expect from these drugs?" Many of the drugs that doctors prescribe to patients can be part of a study or involve an off-label use, "so it’s important for the patients to understand the risks and benefits," says Gorevic.


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Alcohol abuse is the third leading cause of preventable death in the U.S., and it contributes to countless diseases, car crashes, injuries, and crimes.

How can we solve these thorny problems? Making booze more expensive might be a good start, a new study suggests.

Doubling the current state taxes on alcohol -- which would tack on as much as 50 cents to the price of the average six-pack or bottle of wine -- could be expected to reduce alcohol-related deaths by 35 percent, fatal car crashes by 11 percent, and the rates of sexually transmitted disease by 6 percent, according to the study.

Higher taxes on booze would also lead to 2 percent less violence and 1.4 percent less crime, the researchers estimate.

Health.com: Do you have a drinking problem?

"What is surprising is the consistency of the effect across a broad range of health outcomes that kind of don't have anything to do with each other," says Alexander C. Wagenaar, Ph.D., the lead researcher and a professor of epidemiology and health outcomes at the University of Florida, in Gainesville.

If state alcohol taxes were doubled, the tax on a six-pack or bottle of wine would increase by anywhere from a few pennies to 50 cents, depending on the state, and the tax on a standard bottle of liquor could go up by as much as a few dollars.

Health.com: Survey: More Americans drinking alcohol

Though modest, these tax hikes would add up over time and may ultimately curb the heavy drinker who's seeing his weekly alcohol budget rise, the college student stockpiling booze for a party, and even the social drinker.

"Studies show that all these groups respond to price," Wagenaar says.

Even a slight decrease in drinking could have a large impact on public health. If millions of people living in an area consumed half a drink less per week, on average, the small differences in alcohol intake -- and intoxication -- could lead to big drops in the area's overall injury and death rates, Wagenaar says.

There is some evidence that raising taxes can reduce unhealthy behaviors, even for people who are addicts. Increased taxes on cigarettes and other tobacco products have been shown to reduce smoking rates and influence heavy smokers to cut back or quit.

Health.com: How much money are you spending on cigarettes?

In the new study, which was published in the American Journal of Public Health, Wagenaar and his colleagues re-analyzed data from 50 studies that investigated the link between increases in alcohol taxes and the rates of drinking-related problems including death, diseases, car crashes, STDs, violence, crime, and suicide. Most of the studies, which were conducted between 1955 and 2004, looked at alcohol tax increases in American states.

One of the studies -- led by Wagenaar himself -- focused on Alaska, one of the few states to have implemented substantial alcohol tax increases. The researchers found that the state's alcohol-related deaths dipped in 1983 and 2002, immediately following tax increases. The 1983 increase, which upped the tax on a bottle of beer from four to six cents, was associated with 23 fewer deaths -- a 29 percent drop.

Alcohol abuse has been linked to an increased risk of liver disease, heart disease, stroke, depression, and some cancers, in addition to causing the impaired judgment that leads to risky sexual behavior and drunk driving.

Sara Markowitz, Ph.D., an associate professor of economics at Emory University, says that even small increases in the price of alcohol are likely to result in measurable gains in public health and safety.

Some health problems are likely to respond more than others to a tax increase, depending on how closely linked they are to alcohol abuse.

"The proportion of crime and suicide that are alcohol-related would be far smaller than diseases such as liver cirrhosis," says Markowitz, who has researched alcohol taxes but was not involved in the new study.

Indeed, the only health measure in Wagenaar's analysis that did not show a significant drop following higher alcohol taxes was suicide.

Health.com: Booze, drugs, and bipolar disorder

Higher taxes on alcohol could provide a much-needed source of revenue for state and local governments reeling from budget shortfalls and cost-cutting. But the willingness of elected officials to increase the tax on alcohol is questionable, says David Jernigan, Ph.D., an associate professor and alcohol policy expert at the Johns Hopkins School of Public Health.

Alcohol tax increases have lagged behind the inflation rate since the 1950s, which Jernigan attributes to the nation's anti-tax climate. There have been very few federal and state alcohol tax hikes in the past several decades, he says, and states like California and Maryland that have proposed increases have faced opposition from the restaurant and beverage industries.

What's more, a proposed tax increase during a sluggish economy would almost certainly be unpopular among drinkers, including those who limit their intake to the occasional glass of white wine and those who'd never dream of getting behind the wheel after drinking.

Health.com: Is drinking actually good for you?

But boosting the tax on alcohol would be a "win-win for government" by increasing revenue and decreasing costs, Jernigan says.

In Maryland, Jernigan has estimated, a 10-cent-per-drink tax increase would save the state $214 million in healthcare costs and generate $249 million in revenues, in addition to reducing alcohol consumption by 5 percent.

"In terms of the analysis we did, there's nothing that makes Maryland stand out from other states," Jernigan says.

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Walter Breuning is 114 years old today – the oldest man in the world.

On this day, as he did last year when he also held the title, he is preparing a speech that he will deliver to friends, fans and residents of the Rainbow Retirement Community in downtown Great Falls, Mont., reports the Great Falls Tribune.

State Gov. Brian Schweitzer is set to attend the speech as well as the following cake and festivities, along with representatives from the Guinness Book of World Records, public television, and Masonic, Shrine and Scottish Rite groups.

While he is certainly a local celebrity, his fellow neighbors also hold a sincere admiration for him – for more than just living to an advanced age. Residents mention his dignified air, his preference for pinstriped suits and his modesty, considering his world fame.

Resident Ray Stingley, 87, told the Tribune that he admired the fact Breuning never used a cane or walker to help him move around until the last few years.

"I think he's a great man, to be honest with you," Stingley said.

Margie Arganbright, 80, said she thought having him live at the Rainbow was "wonderful".

"He's such a gentleman," Arganbright said.

Breuning was born in 1896, in the Minnesota town of Melrose but moved to Great Falls in 1918 to work for the Great Northern Railway, according to the Tribune.

He married a girl from Butte named Agnes, who died in 1957. The couple had no children.

His parents died young at 50 and 46 but his paternal grandparents lived into their 90s. One of his own siblings lived to be 100.

He told the Tribune that his greatest regret was being too old to serve his country. When World War I broke out, he was already in his 40s.

He may be an extremely old man but to many of his elderly friends and neighbors, he’s just a man.

"I didn't know he was a celebrity; he's just lived a long time," Ray Milversted, 92, told The Herald.

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Could consuming too much caffeine make someone crazy enough to commit murder?

Lawyers for Woody Will Smith, whose murder trial in Newport, Ky., starts today, plan to argue that the 33-year-old defendant had ingested excessive caffeine before he allegedly strangled his wife and so was temporarily insane, according to The Associated Press.

Shannon Sexton, the defense attorney, plans to state that Smith was not even able to form the intent of committing a murder, although prosecutor Michelle Snodgrass will say that Smith tested negative for substances containing amphetamines after the killing.

Smith is charged with killing his wife, 28-year-old Amanda Hornsby-Smith, in May 2009, by strangling her with an extension cord.

He could receive a sentence of life in prison if convicted. Smith told a psychologist hired by the defendant that he recalls taking his kids to school, but little else, about the morning of the murder.

In the previous weeks, he told psychologist Dr. Robert Noelker, he had not been sleeping, partly because he was afraid his wife would leave him and take their two children.

During this period, according to reports and case records, the defendant was consuming five or six energy drinks and soft drinks daily, along with diet pills.

In all, he was taking more than 400 milligrams of caffeine each day. An overdose of caffeine is defined as more than 300 milligrams (about three cups of coffee), according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

Smith could have had a "brief psychosis" due to sleep deprivation caused by heavy caffeine ingestion, according to Noelker. It is my opinion that this disorder was the direct result of psychosis due to severe insomnia," said a report filed by Noelker for the defendant.

The unusual strategy is not unlike one involving Daniel Noble, a University of Idaho Foundation budget analyst, who woke up last December after many nights of working long hours and drove to a Starbucks to down two large coffees. He was accused of mowing down and injuring two pedestrians with his car.

His attorney, Mark Moorer, got the charges dismissed.

Noble had a rare form of bipolar disorder brought on by excessive caffeine consumption, according to medical records. Charges were dismissed when the judge concluded that Noble could not form the mental intent necessary to even commit a crime.

"We referred to it as a temporary insanity defense," Moorer told The AP. "If you sat down and talked with him now, you’d think he’s as normal as you and I."
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Fi StarStone, a British woman who runs a child-care advice website, posted constant updates after going into labor last Friday, according to the Daily Mail.

Her decision to tweet about her labor was to "dispel some of the myths of childbirth," she told The Daily Mail.

After posting nine updates that were followed by hundreds of people online, she gave birth Friday afternoon to a baby boy in a birthing pool at home. Oscar John Michael Victor Stone, weighing 7 pounds and 9 ounces, was born following a labor during which his mom used no pain relief.

When she went into labor, she posted, "Here we go lovelies! Contractions started at 2:30am! Baby decided he wants to come to his sister’s 1st birthday party on Saturday!"

Her final tweet before the birth was, Still going my lovelies. Still no pain relief."

And just 20 minutes after the birth of her son, the mom posted another update: "Introducing Oscar John Michael Victor Stone. Thanks so much for all your support. I’m shattered and sore but the happiest mummy on the planet."

Her husband, Richard, said his wife had decided to send updates during labor because so many mothers follow her through her website, Childcare is Fun.

And the proud mom of two told The Daily Mail, "I did it this way to show them the positive side of childbirth and to show it could be done without pain relief and while tweeting the whole time."

No word yet on when Oscar will be getting his very own Twitter account.

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