Who Should Avoid NSAIDs?
Nonsteroidal antiinflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin, Advil), ketoprofen (Actron, Orudis) and naproxen sodium (Aleve) are excellent pain killers available without a prescription. Some persons, however, are at risk of adverse side effects from regular or heavy use of NSAIDs. These include:

• persons with ulcers, stomach problems, bleeding disorders, congestive heart failure or kidney disease;
• persons taking blood-thinning heart medications such as coumadin or warfarin or those taking herbal supplements such as ginkgo biloba;
• diabetics on oral medication;
• persons taking steroids such as prednisone for asthma or arthritis;
• injury patients with bleeding or bruising.
  Acetaminophen (Tylenol), which works by inhibiting pain

stimuli in the brain rather than by antiinflammatory action, is a better choice of painkiller for such persons. Neither acetaminophen nor the NSAIDs should be mixed with alcohol, particularly at high doses.
[SOURCE: Arthur A. Levin, Popular Painkillers Risky to the Heart,” HealthFacts, April, 2000; “Painkillers Plus These Drugs Don’t Mix,” Prevention, October, 1998; Peggy Morgan, “Relieve Pain Now. How To find the Perfect Painkiller without Spending 2 Hours in Aisle 12,” Prevention, July, 1997]

Gender-Specific Painkillers?
Laboratory studies with mice have found huge differences in the way individuals perceive pain. Some are supersensitive to pain while others are relatively indifferent. Males and females even have different pathways for the perception of pain.
If these laboratory findings hold true in human clinical studies, drug companies may one day market gender-specific painkillers.
[SOURCE: Nigel Hawkes, “Painkillers ‘May Need To Be Sex Specific,’” British Medical Journal, February, 26, 2000]

COX-2 Inhibitors May Up Heart Risk
COX-2 inhibitors such as celecoxib and rofecoxib have been highly popular because they reduce pain without causing the unwanted bleeding or stomach problems associated with other nonsteroidal antiinflammatory drugs (NSAIDs). A recent study conducted at the Cleveland Clinic, however, found that persons taking these drugs had a slightly higher incidence of heart attacks than healthy subjects taking a placebo.
[SOURCE: “Painkillers May Damage Hearts,” Science News, September 15, 2001]

Foods That Protect against Toxins
A number of specific foods have been shown in studies to be particularly effective in protecting the body against toxins:

• Cruciferous vegetables, including broccoli, cabbage, cauliflower and brussels sprouts, are known to contain phytochemicals that help the body fight cancer-causing toxins.
• Garlic and other members of the allium family (onions, shallots, leeks and chives) are rich in protective sulfurous compounds.
• Rosemary blocks the ability of certain toxic compounds to build DNA.
• Turmeric, a spice commonly used in Indian cooking, contains curcumin, an antioxidant that has been shown to prevent tumors in animal studies.
• Unfermented green tea has high levels of polyphenols that act as antioxidants, increasing the body's natural detoxification system.

Physical Inactivity Is Major Killer
Among lifestyle decisions you can control, four have a major bearing on your health and longevity: physical inactivity, cigarette smoking, high cholesterol and high blood pressure. Physical inactivity is at least as important as the others and is believed to account for 12 percent of all deaths in the United States.
[SOURCE: Jari A. Laukkanen, Timo A. Lakka, Rainer Rauramaa, Raimo Kuhanen, Juha M. Venalainen, Riita Salonen and Jukka T. Salonen, “Cardiovascular Fitness as a Predictor of Mortality in Men,” Archives of Internal Medicine, March 26, 2001]

Team Approach Helps Prevention Too
The health care team approach that works so well in the treatment of diabetes can also be a useful prevention tool. That was the conclusion of the Diabetes Prevention Program (DPP).
Of more than 3,000 subjects with impaired glucose tolerance in the DPP study, those following a lifestyle intervention of regular exercise for 30 minutes a day and minor changes in diet were able to effectively delay the onset of diabetes for at least three years. This group was monitored by a team including a doctor, a dietitian, diabetes educators and others.
[SOURCE: “Diabetes Prevention Program Is a Landmark Trial with Dramatic Implications,” Diabetes Week, September 10, 2001]

Many at Risk Unconcerned about Diabetes
Most doctors are concerned about the rapidly increasing incidence of obesity in this country and the associated risk of type 2 diabetes. But the majority of Americans are apparently unaware of the link.
A recent survey found that 39 percent of Americans consider themselves overweight but fewer than a third of these individuals are concerned about their risk of diabetes. A majority indicated, however, that they would be “very likely” to alter their diet and exercise patterns if they thought that would help them avoid diabetes.
[SOURCE: C.W.. Henderson, “Most Americans Not Concerned about the Risk of Type 2 Disease,” Obesity, Fitness & Wellness Week, January 27, 2001]

BP Drug May Help Prevent Diabetes
Subjects in a recent study who took ramipril, an ACE inhibitor widely used to treat high blood pressure, had a 30 percent reduced risk of eventually developing diabetes than did those taking a placebo. Researchers believe the relaxing effect the drug has on blood vessels may improve the body’s release of insulin and the action of insulin on muscle tissues. More studies are planned on ramipril and other ACE inhibitors and their potential usefulness in preventing or treating diabetes.
[SOURCE: “Blood Pressure Drug May Prevent Diabetes in Some People,” Mayo Clinic Health Letter, February, 2002]

Hearing Loss Linked to Painkiller Combo
Prolonged or excessive use of painkillers that combine acetaminophen with hydrocortone–including Vicodin, Hydrocet, Lorcet and Norco–has been linked to the risk of progressive and permanent hearing loss.
[SOURCE: Possible Permanent Hearing Loss from Extensive Use of Painkillers,” Drug Week, November 9, 2000]

Age Increases Risk of TB
The risk of active tuberculosis infection greatly increases with age. In developed countries, more than 80 percent of active TB cases occur in individuals over age 50.

Due to chronic illnesses, poor nutrition and a weakened immune system, older persons are vulnerable to a new TB infection and they are also more likely to have a latent one reactivated. Seniors living in nursing homes–particularly in cramped, enclosed quarters–have an even greater risk.

In older persons, tuberculosis is difficult to diagnose and frequently confused with age-related illnesses. Since it is also difficult to treat effectively, prevention and early detection offer the best approach.
[SOURCE: Shobita Rajagopalan, “Tuberculosis and Aging: A Global Health Problem,” Clinical Infectious Diseases, October 1, 2001]

Who Should Avoid NSAIDs?
Nonsteroidal antiinflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Motrin, Advil), ketoprofen (Actron, Orudis) and naproxen sodium (Aleve) are excellent pain killers available without a prescription. Some persons, however, are at risk of adverse side effects from regular or heavy use of NSAIDs. These include:

• diabetics on oral medication;
• persons taking steroids such as prednisone for asthma or arthritis;
• injury patients with bleeding or bruising

Acetaminophen (Tylenol), which works by inhibiting pain preventive protection against TB as well as anthrax.
[SOURCE: “Terror by Mail Brings Hassles for TB World: Still, Cipro Provides Good ‘Collateral Damage’,” TB Monitor, January, 2002]

TB in Southeast Linked to Poverty
The highest rates of tuberculosis in the United States are in the Southeast, and the majority of cases occur in African-Americans. According to one 1998 study, more than 50 percent of this increased incidence of TB among the black population can be attributed to poverty and lower socioeconomic status.
The Southeast also has the nation’s highest rates of hypertension, diabetes and heart disease.
[SOURCE: “TB Rates among Blacks Get an Overdue Look: As a Region, Southeast’s Rates Highest in Nation,” TB Monitor, January, 2002]

TB and AIDS–A Lethal Combination
Among the 40 million individuals worldwide living with HIV infection, more than 12 million have tuberculosis as well. Tuberculosis is the No. 1 cause of both serious illness and death for HIV/AIDS patients.
After a new infection with mycobacterium tuberculosis or a reactivated infection, a person with HIV has 30 to 50 times the risk of developing active TB compared to a healthy person. By the same token, active TB is highly likely to speed the progression of AIDS. Successful efforts to combat this dual epidemic requires an integrated approach.
[SOURCE: “Alliance Urges Joint Approach to AIDS and Tuberculosis,” Medical Letter on the CDC & FDA, December 23, 2001]