On occasion, I find myself trapped in a tiny exam room with a mom and her small, loud children. As long as it's not my kids carrying on, neither of whom are small and only one of whom continues loud, I really don't mind the fuss.

And breathing. I hear a wind tunnel's worth of that through the work day, some of it wheezy and a lot of it congested. As long as it's not issuing from the other side of my bed, I'm okay with that as well.

Scientists are interested in what makes a bad vibration, as in which noises make whose hair stand on end. Would you like to participate in some annoying research? Check out
Bad vibes.

Luxuriant Flowing Hair Club for Scientists

As many of you are aware, I spend not a small amount of time bemoaning the state of my aging mane. Moreso now that I've discovered a club to which I aspire but alas may never join.

I kid you not; there really is a LFHCfS. And if this guy can be a member, maybe I can too!

Check out these honorary historical members:


Dmitri Mendeleyev

Albert Einstein, "A bold experimentalist with hair"



Sir Isaac Newton, "arguably history's greatest physicist, the inventor of the calculus, and hair like a rock star."

[We] behave nicely when we're being watched.
--Melissa Bateson, behavioral biologist

This was no news to my junior high algebra teacher. Mr. Duran donned a pair of reflecting sunglasses during exams. Never sure just who was under surveillance, we all kept our eyes glued to our test papers.

Ms. Bateson tried a little observation test of her own in the University of Newcastle upon Tyne psychology department. She alternately posted pictures of flowers or eyes near the donation box by the office coffee pot.

During the weeks where eyes gazed down on the scene, donations to the office kitty nearly tripled. She also found that judgmental male eyes elicited a more generous donation compared with flirty female eyes. And the departmental drinkers went back to their ungenerous ways altogether when pretty posies were posted.

I'm going to post eyes by the kitchen sink!

The volume is shocking: equivalent to 33 double-decker buses.
--Gavin Harper*, University of East London

Mind-boggling news from Cadbury. The chocolate manufacturer was forced to dump 250 tons of their chocolate due to possible bacterial contamination.

Mr. Harper, however, was intrigued by the potential power of such an enormous chunk of chocolate. He presented a paper this month at a 'sustainable science' symposium proposing that if the candy had been burned instead for energy, it could have provided enough to run a town of 90,000 people for a week.

Gaynor Hartnell of the Renewable Energy Association in London notes, "Chocolate is biomass. It is also very calorific."

No kidding, Gaynor!

*Author of 50 Awesome Auto Projects for the Evil Genius.

Gad, was it something I ate?

Have you ever wondered on a down day with the kid whether you did something wrong during pregnancy that is now coming back to haunt you? Here's reassuring news out of Johns Hopkins University. Now, however, you can fret that maybe you just weren't stressed out enough while the teen was under construction.

Maryland researchers theorized that pregnancies complicated by psychological distress resulted in dysfunctional offspring. They analyzed the development of children whose mothers reported anxiety, depression, and non-specific stress during otherwise low-risk type pregnancies. Rather than finding signs of bad behavior and ill temperaments in the kids, the investigators found the children were more advanced in both motor and mental skills.

It's not your fault. Take the teen's advice and chill.

No more thermoneutrality for me!

Read this and rejoice in the heat:

Experts gathered round for a little discussion on the causes underlying the obesity epidemic at a workshop held in Washington, DC this past March. While the main focus of the meeting was the association between weight and sleep ("Sleep loss and obesity may be interacting epidemics"!), Dr. David Allison of the University of Alabama's clinical nutrition center had a few thoughts on temperature and obesity.

He noted that the availability of home heating and air conditioning in the past few decades has reduced human energy expenditure. Prolonged exposure to cold is known to improve insulin sensitivity, and both humans and animals eat less when too hot or too cold. Conversely, we all eat more in thermoneutral zones.

Please don't hate me because I don't have air-conditioning.

I reallly want to see if we can get out of mice and into humans for some of these interesting herbs for cancer, and I think we will.
---Dr. Mary Hardy, Center for Dietary Supplement Research, UCLA

All right you mousies, back away from the tea. While animal studies suggest that tea is useful chemoprevention against cancer, now it's our turn to tea off the tumors.

Indian researchers are conducting an ongoing study of 82 patients with oral leukoplakia (a pre-cancerous conditon of the mouth characterized by white patches, often associated with cigarette use). Oral cancer is the number one malignancy in East Indian men.

The investigators checked out the sturdiness of the DNA from these leukoplakic hotbeds of chromosomal chaos. The subjects then were treated for a year with 4-5 daily cups of black tea.

Of the first 15 patients who completed the study (that's at least 21,600 cups quaffed for you tea-totallers), all showed a significant decrease in the chromosomal equivalent of split ends.

Dr. Hardy points out that "This is not a toxic or difficult intervention." Why wait then for the final report from this study to make tea your caffeinated beverage of choice?

'D'-fend against breast cancer

I hate to belabor the point, but the evidence in favor of an increased intake of D keeps growing.

Statistics were flying at the annual conference of the American Association for Cancer Research. Keep in mind as you read on that the recommended daily allowance of vitamin D is 400 international units (IU)--the amount in a basic multivitamin pill.

In one meta-analysis (a study of studies) on vitamin D concentrations in the blood and subsequent breast cancer development, researchers found that an extra 1,000 IU a day over the normal background intake lowered a woman's risk of breast cancer by 10%.

Investigators at the University of California San Diego found a strong correlation between rising vitamin D levels and decreased breast cancer risk. Those whose serum vitamin D concentrations exceeded 52 ng/ml, a level that would require an intake of more than 2,700 IU per day, had a 50% lower breast cancer rate compared with the 'D'-less individuals whose puny little levels fell below 12.

Hack your way home

Dr. Leonard Roberts suggests the cough over coffee approach to late-night driving.

When returning home from hospital work in the wee hours of the night, Dr. Roberts has discovered that coughing buys a "lucid moment and a little time to avoid a disaster." Per Dr. Roberts, here's how you might hack your alertness back:

The increased intrathoracic pressure is transiently transmitted to the superior vena cava and cerebral venules and capillaries, perhaps leading to a brief increase in oxygen availability."

In other words, the sleepy driver coughs up the blood pressure in the large veins of the head and neck which may increase blood supply to the fading brain.

Vertical Strip Breast Exam

No more running circles around your breasts. The three-finger, three-pressure, 'Vertical Strip' method is now the exploration of choice according to both the CDC and the American Cancer Society.

This is definitely not your palpate-and-run technique, requiring 3-5 minutes per breast whether it's you or your clinician checking you out. Using the pads of your first 3 fingers, apply light touch in overlapping vertical strips from your collarbone to the ridge below your breasts, from your breastbone to the lymph nodes under your arm. Then do it again with medium pressure, and yet again with firm pressure.

Does that seem like a heap of a lot of palpating? Be reassured, Dr. Elizabeth Steiner of the North American Primary Care Research Group tells us, "In our study, for every 15 seconds you took, it made you 29% more likely to find a 3-mm. mass."

Fruit information loops

You've probably heard that the shape of your inner fruit influences your risk for heart disease. The pears with heavy hips have it all over the apples with expanding waistlines.

Doctors at Columbia University checked out waistline measurements on nearly 7,000 women from 18 to 93, adding further credence to conventional wisdom. Those women whose waistlines topped 35 inches were significantly more likely to have associated hypertension, elevated cholesterol, and blood sugar troubles.

Get out the tape measure. If you measure up in an unfortunate way (check at the level of your midsection that is first to enter a room), ask your doctor to measure your blood pressure, fasting cholesterol, and pre-breakfast blood sugar.

Many of you may know that I am a bit of a wimp in my enthusiasm for medical procedures. I finally got my colonoscopy, but it's been 25 years since my last tetanus shot. After all, in my many years of medical practice, I've never seen a case of tetanus or diphtheria, and frankly shots creep me out.

Time to reconsider the strategy, however, now that Adacel is available. This vaccine not only protects against the theoretical case of tetanus and diphtheria, it also is "arming more people against pertussis."

I do see a hack of illnesses each year involving a show-stopping mega-cough. Many of these seasonal upper respiratory infections have been proven in population studies to be whooping cough (pertussis). Furthermore, studies indicate that the series of shots that we received against this illness--which can cause months of coughing--does not confer lifelong immunity.

The shot is recommended for teens and adults 11 through 64 years of age, particularly health care personnel and parents of small children. Thankfully no small children here, but I share a small exam room each winter with a grip of grippe.

Catchy slogan, nice ad campaign (smiling folks baring arms with bandaids on them), good shot. I'm getting mine this week!

Menopause Management, one of many magazines sitting in stacks in my office, periodically poses 'interesting clinical questions and dilemmas' to their Editorial Advisory Board. Last month, they asked "How have you changed your clinical practice since publication of data from the Women's Health Initiative?"

The WHI was the landmark study of older women and hormone therapy (HT) that rocked the world of menopausal medicine after its publication in 2002. Here' what two gynecologists answered:

Post-WHI, I no longer consider it mandatory to discuss HT with all menopausal women.
--Margery Gass, MD

Since publication of the first data from the WHI, I have spent more time carefully evaluating the literature in order to be prepared to provide a balanced view on the benefits and risks of HT to women and their family physicians--many of whom have benn confused by scary media stories.
--Robert Reid, MD

Which doctor would you choose to go to?

Exercise is associated with mortality benefits but simply expending energy through any activity in an individual's free-living environment may confer survival advantages.
--Todd Manini, PhD et al, JAMA, July 12, 2006

Why am I glad my son dribbled lemonade across the kitchen floor? Three words--free-living energy, as in my energy spent cleaning up his sticky mess (he was long gone for the evening). While some energy expenditures are more fun than others--say dancing compared to mopping--expending energy at any activity improves survival, and now we've got the scientific proof.

Researchers at the National Institute of Aging studied a grip of high-functioning old folks over six years to see who made it to the end of the study in the upright position as a function of how generally active they were through the years. They did not, however, depend on those unreliable old memories to determine who moved and who didn't. They fed the seniors 'heavy water' where extra neutrons are somehow added to the hydrogen and oxygen atoms. The heavy oxygen goes in as water and comes out as CO2 at a rate dependent on the amount of heavy breathing the oldsters do while house-cleaning etc.

The group of participants in the lowest one-third of energy spent per day were twice as likely to be carried out of the study feet first compared to those in the highest one-third.

So perhaps I will not only survive Mike's adolescence, I will thrive as a result of it. Pacing the floor and wringing the hands counts as activity, right?

For those of you who fuss about your liver, and we should always be mindful of and grateful for our liver, here's some good news.

Surgeons know that the liver has remarkable regenerative properties. They can remove more than two-thirds of this powerhouse organ, and within weeks, it's back to its previous size.

Here's what George Michalopolous of the University of Pittsburgh Medical Center has to say about the overlapping systems that the liver uses to reassemble itself in response to the various slings and arrows of liver fortune: [It's] like a car with 20 cylinders. You crank up the engine, all 20 cylinders fire. These are cylinders 21 and 22.

Here's scientific proof that sunshine on your shoulders makes you healthy. This map correlates ovarian cancer rates by region, showing a strong association between available sunshine and cancer protection. For more reassurance that a little sun is good for the body as well as the soul, check out other such maps on the home page of Sunarc.org.

Of rain and pain and aging knees

What is with this weather? It's more like springtime in the Northeast than July in Denver out there. Whether or not it's appropriate to Colorado, it's cold and damp here, and hell on old joints. I've just checked; researchers have looked for a correlation between osteoarthritis and weather-related pain, and the results are mixed. They did not, however, ask me. I tossed and turned most of the stormy night with knees and back complaining.

I thought about getting up and taking a glucosamine plus chondroitin tablet. I chose to stay in bed instead, and a recent issue of The New England Journal of Medicine suggests I made the right choice.

Investigators in Utah and elsewhere studied a large group of arthritis victims to see if glucosamine hydrochloride (note most supplements are glucosamine sulfate) and/or chondroitin sulfate improved pain compared with Celebrex or nothing at all. The answer was 'no,' the supplements did not decrease pain scores.

Other research suggests, on the other hand, that getting up and taking an Actonel might've been a better choice. Postmenopausal women on this drug or Fosamax for osteoporosis not only had a good response to the medications with respect to less bone breakdown, they also reduced their levels of cartilage breakdown products, suggesting that these agents save cartilage as well as bone.

It's a wonder I get anything done. My task du jour was to prepare a brief, amusing talk about aging skin. Along the way, I got lost on the dermatological information highway and found the following important bits of information on rashes:

On the anti-inflammatory properties of milk:
Make a compress soaked in half milk and half water and apply it to the rash. Just rinse off afterward, so that the milk doesn't turn bad. You don't want to smell like sour cream.
--Amy Newburger, MD

On ginkgo, an herb that is good for your brain and bad for your behind
The rash related to ginkgo particularly appears in the perianal region, so be sure to query your patients about their use of this agent if they present with such an eruption.
--Mary Ruth Buchness, MD

The affable professor is a generously large man. Over his tall-and-big-store tummy this day stretch a bright yellow shirt and a red, yellow, blue, purple, white, and green tie, all bustling stripes and darts. Flashy rings sparkle on his fingers, and his Mercedes-Benz carries a vanity plate: "Wiseguy."
---Peter Monaghan on Bernardo Carducci of the Shyness Research Institute

Doesn't Mr. Carducci sound like the very sort to school us all on shyness? In fact, he wrote the book! Several of them, including Shyness: A Bold New Approach and The Pocket Guide to Small Talk which is truly pocket-sized so you can consult it on the sly the next time that you attend a party at which you know no one but the host.

A couple of days ago I mentioned a web-site faceblind where you could see if you suffered from an inability to distinguish your partner from the milkman (unless of course your partner is the milkman!). If you check out shyness, you can find out both your ShyQ and how your uneasiness in social situations compares to the world at large. Check out Dr. Carducci's web-site at The Shyness Research Institute to read his sensible five step approach to small talk.

"Nothing in life is quite as important as you think it is
while you are thinking about it."
--David A. Schkade & Daniel Kahneman on life satisfaction

I am out-of-sorts and grumpy today over a lack of barbeques in my life. July 4th looms large, and everyone but me, it seems, has a date for grilling with friends. How timely, then, to come across some research that reassures me that barbeques attended (or dates, income, age, close supervision at work, and fringe benefits) are not good measures of an overall sense of well-being.

These authors asked "Does living in California make people happy?" They found that large samples of students in the Midwest and California self-reported life satisfaction at a similar level no matter their region. In another part of the qustionnaire, however, these same participants felt that Californians, on average, would outshine Midwesterners in a day-to-day happiness sort of way.

In other words, my neighbors, currently barbequeing on their small patio below my window, are no happier than I am sitting here grill-less in Denver. Nevertheless, I would like to be on a beach right now in California cooking hamburgers over an open fire with a fun bunch of Midwesterners.

Who was that masked man?

Ah, it's....you. I'm always on my toes at the grocery store, ready to recognize and greet patients that I may have met only once in my life. I usually remember the faces and something personal, like where their children go to school, or where they work. But names? That's a problem mostly because new names seem to me like random tags without any associated memories to link them with a face.

What, however, of persons who can't recognize faces? This problem, dubbed prosopagnosia, can be so severe that these people have trouble identifying their nearest and dearest. Once thought to be rare as can be, researchers now believe that 2% of the general population have face blindness severe enough to affect their daily lives.

Are you in the facial know? Check out faceblind.org for two little recognition quizzes. The first presents an array of famous faces that does require a certain visual knowledge of the famous and the infamous. During the second, you will have a small amount of time to familiarize yourself with twenty women, then will be asked to recognize them as they appear on your screen amongst a host of never-before-seen ladies. It's fun! If you're truly a prosopagnostic, they may want you to participate in a research study.

Of crow's feet and liver spots

The patient should never be dismissed with glib remarks about growing old gracefully.
--Mary Ruth Buchness, MD

All right, sorry, no more glib dismissals out of me. I take back the "Buck up! Quit whining! Consider Helen Hays!" remarks.

Activity of the muscles of facial expression causes creases of the overlying skin, which become permanent after may years, much like the creases in unironed fabric.
--Dr. Buchness, again

Believe me, I take this unironed skin thing very seriously. If I put on my reading glasses and look in the mirror, I can even see these folds and puckers in my own facial linen. So that you can join me in the know, calling wrinkles and liver spots by their proper names, check out my fancy skin glossary at:

Skin Aging