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Breast Implants: #1 Plastic Surgery Procedure

"But if the numbers are clear, the reasons behind them are not. Women have varied motives for wanting implants, which have just gotten a boost from the FDA."

The statistics of cosmetically enhanced breasts are what pop culture suggests they are – eye popping. Last year, there were 329,000 operations in the United States to rebuild, enhance, enlarge, uplift or otherwise change breasts. That made breast enhancement the No. 1 form of plastic surgery, up 55 percent from six years previous.

And there is no statistic – or prognosticator – suggesting the popularity of breast surgery is likely to abate anytime soon.

But if the numbers are clear, the reasons behind them are not. Experts offer a variety of answers, from looks to better jobs, when asked why breast enhancement is such a boom industry.

"Why do women's breasts have so much cultural power?" asks Marjorie Jolles, assistant professor in the women's studies program at Cal State Fullerton. "It's a topic that scholars devote whole careers to studying."

Sex – or at least the hint of it – clearly is part of the equation.

"Women who are 40 years old and divorced think larger implants lead to richer men," says Jason Pozner, M.D., assistant professor of surgery at the University of Miami School of Medicine. But other women want breast implants to avoid being overlooked in other areas of life. "Society rewards women for their looks," says Mary Gilly, professor of marketing at UCI's Merage School of Business. "Men can get by with money and power – Hugh Hefner doesn't get all those young girlfriends based on his looks. But women need to look good to be noticed."

Some suggest that women get breast implants to improve their self-image.

Robert Grant, president of the Allergan Medical division at Irvine-based implant maker Allergan Inc. says surveys show that women "aren't getting them to attract men, but to feel greater confidence in their femininity."

Ava Shamban, a Santa Monica dermatologist and consultant for the "Extreme Makeover" TV show says large breasts are part of society's feminine ideal, which women accept and try to achieve.

"We're supposed to look like Barbie dolls. We're supposed to have these huge breasts, waists of 22, and hips of a young man. Is that fair? No," she says.

Cal State Fullerton's Jolles takes an approach that borders on the anthropological, saying breasts are important in American culture as visible symbols of maternity and sexuality.

Not only do they function as a mother's intimate bond to their babies, they also "have a rather public side as well," Jolles says, adding that people feel entitled to "comment on" women's breasts.

And, because men's attention is a potential source of power, Jolles adds, many women – though not all – consciously or subconsciously care what their breasts look like because men care.

"Looking good means looking good to men," Jolles says.

The recent surge in breast implants comes despite cautions from the U.S. Food and Drug Administration about medical problems that implants can cause.

The FDA approved the use of more natural-feeling silicone breast implants in November 2006 for patients age 22 and up. That approval ended a 14-year moratorium during which doctors, implant manufacturers and regulators watched for any complications caused by the implants.

The agency concluded that silicone implants are probably not linked to disease but might cause problems such as chronic pain, especially when they rupture. For that reason, the FDA said patients who choose silicone implants need to have an MRI scan to look for leaks after three years and every two years after that.

Despite that extra burden, patients are now choosing silicone over saline-filled models by about 3-to-1, says Donald Altman, chief of plastic surgery at Irvine Regional Hospital and Medical Center.

The surge in implant operations was well under way even before the U.S. Food and Drug Administration lifted its moratorium on silicone implants late last year. Last year's total of implant procedures was up 23 percent from 2005.

Now the pace of breast enhancement surgeries is likely to increase, since silicone models are so popular, says Dr. Roxanne Guy, president of the American Society of Plastic Surgeons.

2008 — The Biggest Year Yet for Plastic Surgery!

This year is promising to be the biggest ever in terms of numbers of people having cosmetic surgery.

Dr. Kevin Light, a leading cosmetic surgeon in the Dallas area, offers advice on procedures that continue to be in demand today, and gives his predictions for the coming year.

"People are taking better care of themselves today than ever before," stated Dr. Light. "The Internet, television and other media have made plastic surgery an every day topic. People know their options, and they are demanding the best when it comes to choices and results."

Dr. Light predicts that the top trends in cosmetic surgery for this year will be:

"Mommy" Makeovers:

Because women are having children later in life, the desire to look and feel as young as possible will continue to rise. As women complete their families, they desire to return to their active lifestyle and their pre-pregnancy shape.

A mommy makeover is more than sculpting the body to improve a woman's looks; it's also about restoring her youthful personality and giving her the energy she had in the past. A mommy makeover combines two or more procedures, and is customized for the desires and the lifestyle of each woman.

Breast Augmentation:

Over the past few years, breast augmentation has gone through a variety of changes, and will continue to do so. Silicone implants have returned to the market and are safer than ever before. They give superior results and now comprise over 50% of our breast augmentation implants.

Minimal Incision Facelifts:

Facelifts will continue to grow this year as more options become available. The popularity of reality shows and lifestyle facelifts will continue to make facelifts one of the most desired procedures. The minimal incision facelift will give people the results associated with a more traditional facelift, with shorter recovery and less down time.

Non-Invasive Treatments:

Non-invasive cosmetic procedures like Juvederm, Botox and Radiesse will continue to grow as the demand for "lunchtime" procedures rises. These non-surgical procedures help hydrate your skin and replenish its natural volume. They are great for your laugh lines and smile lines, and can produce lasting results over a short period of time.

Cosmetic Surgeries — Recent Trends

The facts and figures about cosmetic surgery provide us with very thought provoking and often amusing facts. If you go through one of them you will be astonished to find the extent of monetary involvement in the sphere of cosmetic surgery. One point stands out clearly and that is people are today more concerned about their looks and how they present themselves before the world. A princely amount of $12.2 billion was what the Americans spent to discover more presentable features on the other side of the mirror. According to an ASPS survey, some 11.5 million cosmetic procedures were performed overall in the United States in 2006. There are many more interesting facts that reflect on the recent trends in the sphere of cosmetic surgery.

The most popular cosmetic surgical procedures: eyelid surgery and rhinoplasty or reshaping of nose. Since the year of 1997, the numbers of nose jobs increased by some 46% and people are often ready to travel 50 miles or more to get plastic surgery, if they do not find a satisfactory plastic surgeon nearer.

Men often hold that having a plastic surgery is a career related decision,. While women seem to be more honest to confess that they need it because they want to look younger.

For women, breast augmentation was proved to be the most popular cosmetic surgical procedure, and some 384,000 women undergone the procedure in the United States in 2006.

Men however found liposuction to be their ideal surgical procedures, with more than 53,000 men taking up the procedure last year.

However, the most interesting trend involves patients increasingly shifting reliance from surgical procedures to minimally invasive procedures. This increasing interest in the non invasive procedures has two important reasons behind them: the first relates to man’s instinctive fear of going under knife and second relates to the comparatively far lower cost of non- invasive procedures.

Among several non- surgical cosmetic procedures, both men and women seem to rely most on Botox injection. Some 2.8 million women undergone Botox procedure last year where for men, the number was 300,472.

The trend reflects on the use of other popular non surgical treatments too. Use of hyaluronic acid and other fillers to give a fuller look to the face and to reduce wrinkles has also become very common. The laser hair removal and skin resurfacing are other two non invasive procedures that have become extremely popular. And interestingly, both men and women are getting these treatments in almost equal proportion.

Another interesting trend of cosmetic surgery relates to the age factor. There was a time when, cosmetic surgery was regarded as the monopolized domain of the rich ladies having enough cash to blow off in fancy things. But today, more and more people are opting for cosmetic improvements in an early age and often their decisions are guided by their career ambition. It is mainly the non-invasive procedures like skin peel that people are opting at an early age while reserving the more complicated procedures like face lift for a riper age.

Last but not least, the studies have found out that only third of patients who undergone some form of cosmetic procedure complained of complicated side effects; 80% of them were happy with the outcome.

More Youthful Hands with Hand Rejuvenating Fat Transfer

When Luisa Moore realized a few years ago that she was nearing her 60th birthday, she decided to make some changes, aesthetically speaking. She hired a trainer. She lost 20 pounds. She got a face-lift. And by the time she hit the big milestone, she couldn't have been happier. Except for one thing — her hands didn't quite match her new-and-improved look!

"I didn't have much sun damage in my face, but I had it in my hands, and that was giving my age away," said Moore, of Marina del Rey. "So I thought, you know, after having a face-lift, if I don't get my hands done, what's the point?"

It's a common concern. In the quest to look younger longer, more and more women are finding that when it comes to looking youthful, it's not just all about a pretty face.

"After the face, hands are the second-most-visible, telltale sign of one's age," president-elect of the American Society of Plastic Surgeons, said in a written statement. "Looking younger after your face-lift or eyelid surgery can conflict with aged hands that simply do not match the face.

"If your goal is to look more youthful, and you are bothered by the appearance of your hands, you may seriously want to consider hand rejuvenation. "Some people have very young faces, but their hands give them away."

In fact, according to a study published in the June issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons, most people can accurately tell a person's age by viewing only their hands.

In the study, participants were given unaltered photographs of female hands and asked to estimate the women's ages. In the majority of cases, participants were able to accurately guess the age, citing prominent hand veins as the biggest clue to aging.

"As the face ages, we lose fat. We lose elasticity to the skin," Bucky said. "The same thing happens to the hands."

As it turns out, hand rejuvenation isn't all that different from facial rejuvenation. Options range from chemical peels to minimally invasive procedures including injectable fillers such as fat.

For people concerned about prominent hand veins, which can give hands an aged look, fat transfer can plump up the skin and thus diminish the appearance of bulging veins.

The actual procedure of fat harvesting and transfer is quick and easy. It is done under local anesthesia. Fat is taken from the hips, thighs, abdomen or anywhere else that stubborn unwanted fat tends to collect. Dr. Kevin Light can is very experienced in fat transfer techniques and will happily answer any questions you may have.

New, Better Understanding of Facial Aging

The longstanding idea that the entire human face ages uniformly is in need of a facelift, say researchers at UT Southwestern Medical Center who have found that multiple, distinct compartments of fat in the face age at different rates.

The findings, published in a recent issue of Plastic and Reconstructive Surgery, challenge previously held theories regarding aging and may offer new ways to help turn back the clock, UT Southwestern plastic surgeons say.

"For hundreds of years, everyone has believed that the fat on the face is one confluent mass, which eventually gets weighed down by gravity, creating sagging skin," said Dr. Joel Pessa, assistant professor of plastic surgery and the study's lead author. "In our studies, however, we were surprised to find that this is not the case; the face is made up of individual fat compartments that gain and lose fat at different times and different rates as we age."

Dr. Pessa said the face resembles a three-dimensional puzzle, with fat divided into distinct units around the forehead, eyes, cheeks and mouth. Facial aging is, in part, characterized by how these separate compartments change as we grow older.

A youthful face is characterized by a smooth transition between these compartments. As people age, contour changes occur between these regions due to volume losses and gains as well as repositioning of the compartments. Eventually, this can result in sagging or hollowed skin and wrinkles.

"This is a revolutionary way of viewing facial anatomy. It not only tells us how we age, it shows us why we age the way we do, and why every part of the face, from the eyelids to the cheeks, ages differently," said Dr. Rod Rohrich, chairman of plastic surgery and senior author of the study. "This will help plastic surgeons around the world not only understand how we can better rejuvenate the face, but how people age as a physiological process."

This breakthrough could have tremendous implications in helping plastic surgeons target facial 'trouble' areas and use injectible fillers to add volume to individual sections of the face. It could also aid in developing new and improved cosmetic and reconstructive surgery techniques, Dr. Rohrich said.

"Understanding how fat is compartmentalized will allow us to be very accurate and precise in how we approach facial rejuvenation," Dr. Pessa said. "This gives us an algorithm, or scientific approach, to help ascertain what areas of the face may need extra fat to combat the aging process. It also is a major breakthrough in facial anatomy that will have major implications for future studies on aging and possibly hold clues to the study of other diseases such as obesity, diabetes and cancer."

HURRY! Valentine's Day is Here!!

Okay, it's Valentine's Day already, and let me guess? You have NO idea what you are getting for the apple of your eye, right?

You will ALWAYS win hearts (and love and kisses) with the gift of beauty.

TIFM Aesthetics offers a wide range of treatments that are the perfect way to say "I love you" - botox, facial peels, lip enhancement, skin rejuvenation, and so much more!

We have so many great ways to give the gift of beauty. Call today and purchase your gift certificates. They're good for Valentine's Day and every day.

Let your lover know just how much you really care!

Cosmetic Surgery – The Growing Trend

Cosmetic plastic surgery has just exploded in the last 10 years. It is simply amazing to see what today's doctors and technology can do to alter your image and create a whole new you. So, just how popular has cosmetic surgery become here in the United States? Here's a quick look with some statistics that may surprise you.

According to the American Society for Aesthetic Plastic Surgery, in 2006 there were approximately 11.5 million cosmetic surgeries just in America.

Why the increase? For one, reality TV has bombarded us with shows that take an average person and change them into a beauty queen. We are also seeing a dramatic rise in TV commercials advertising these types of procedures. Finally, costs have come down to where procedures are affordable to almost everyone now.

Another factor to the rise in cosmetic surgery is the baby-boomers. These massive groups of people are all trying to look younger and recapture their youthful appearance. And they have the discretionary income to do so.

What are the most popular procedures? In 2006 here is what the top 5 surgical procedures looked like:

1. Liposuction
2. Breast Augmentation
3. Eyelid Surgery
4. Tummy Tuck
5. Breast Reduction

It seems like we have an almost equal number of women who want larger breasts and those who want smaller breasts.

The most common non-surgical procedure is far and away the Botox procedure. Over 2.5 million Botox procedures were done on women in 2006. Amazingly, only 300,000 men opted for this procedure.

The most popular cosmetic surgery procedure for men is liposuction. In 2006 there were more than 50,000 of these procedures done on men.

Another point that illustrates just how popular cosmetic surgery has become in this country is the fact that since 1997, there has been a 446% increase in the number of procedures performed in the United States.

There is no denying that cosmetic plastic surgery has exploded in our nation, and the trend looks to continue and further grow for years into the future.

Botox Safety – Myth versus Reality

The sensational news reports from January 24, 2008—typical for the press—struck fear in the hearts of the Botox using community: Death from Botox!: In Wake of 16 Deaths, Advocates Urge FDA to Improve Botox® Warnings.

As always, though, the devil is in the details and those are conspicuously absent from these news articles. Based on the reports, none of these tragic deaths were among patients receiving Botox Cosmetic for their facial wrinkles. Rather, those who died were patients receiving injections on their neck muscles and vocal cords.

The American Society for Dermatologic Surgery has just released an e-mail which states that the single patient who was cited as the only patient who died from the cosmetic use of Botox actually died from complications of Staphlococcus pneumonia which had nothing to do with the Botox which was given seven weeks previously.

Botox (botulinum toxin type A) from Allergan is used for more than just wrinkles. For many years, and long before it was approved for cosmetic use, Botox was and is used for the treatment of muscle tension disorders, such as vocal cord spasmodic dysphonia and for a neck muscle disorder called cervical dystonia ("wry neck"). In both instances, Botox is injected into these hyperactive muscles to weaken them, generally to the suffering patient's great satisfaction.

The vocal cords most important function is protecting the airway (the windpipe and lungs) from food, liquids, saliva, etc., from going down the wrong way. But imagine the patient who's received a little too much Botox in their vocal cords during treatment for their voice disorder. As the paralysis kicks in, they become unable to protect their airway. This provides the perfect setting for conditions known as aspiration pneumonia or chemical pneumonitis from food, liquids, secretions, etc. getting into the lungs. These are potentially fatal complications.

In the situation where a child with cervical dystonia needs his or her neck muscles relaxed to relieve distorted anatomy resulting in a twisted neck, larger quantities of Botox are needed to relax these large muscles. But just fractions of an inch from it lies the esophagus though which we swallow. If enough Botox is injected around the esophageal or pharyngeal muscles of the throat, the resulting paralysis can make swallowing difficult or impossible. And where does that food go when it won't go down the esophagus? It obstructs the esophagus or spills into the airway, possibly choking the patient.

So, does that mean Botox is dangerous? Of course not. A death associated with Botox for reporting purposes does not mean Botox was the cause of death. For example, if a person got Botox then was unfortunately hit by a car, that death could be reported as Botox related.

Could Botox migrate from the forehead muscles, frown lines, or crow's feet far enough and in sufficient quantity to cause death? No! The lethal dose of Botox is estimated at about 3,000 units which is 30 vials. Typical cosmetic doses are about 5 to 40 units of Botox..(less than ½ a vial). — that is less than 1/60 of a dangerous dose.

There are thousands of drugs that 60 times the normal dose could be lethal, including plain aspirin. In fact over 100 people die every year from eating a peanut — the odds of a random person dying from eating a peanut is certainly greater than the odds of dying from getting a cosmetic Botox injection.

Additional points made by the ASDS:

• Botox® Cosmetic has been FDA-approved and in continuous use since 1989 with rare reports of adverse effects, most of which were minimal and transitory.
• In 2005, almost 575,000 Botox® injections were performed by ASDS members with no reports of deaths or other major complications.
• The patient whose death was linked to Botox® by Public Citizen did not have any symptoms of an adverse reaction after injection. Her death was from infectious pneumonia, seven weeks after the injection, and was not causal.
• Surgeons are aware of the potential of side effects of Botox® and thoroughly inform patients of them when administering the drug.
• The ASDS and surgeons are not aware of any deaths that have occurred as a direct result of the use of Botox® throughout the history of the product's cosmetic use.
• Many of the people who receive Botox® for non-cosmetic reasons have underlying health issues and co-morbidities that may also contribute to the adverse effects that were reported.
• The AERS database is intended to encourage physicians to report any drug reaction. A report of an event does not by itself mean that the drug caused the event; just that the event occurred after the drug was administered.
• In its petition, Pubic Citizen cites adverse effects culled from the AERS database over a ten year period, but explicitly states that "causality cannot be proved" with respect to these adverse event reports.

Draw your own conclusion about FDA and your hormones

I'm going to provide a link so that the timeline stays intact as additional news becomes available:

CLICK HERE AND DRAW YOUR OWN CONCLUSION

It is a real interesting read, and shows events that have occurred in compounding medicine, bio-identical hormone, and synthetic hormones in the United States dating back to the 17th Century all the way up to the current day.

Studies tie brain aging to lead exposure

Long-ago exposure may make brain work as if it's older

NEW YORK – Could it be that the "natural" mental decline that afflicts many older people is related to how much lead they absorbed decades before?

That's the provocative idea emerging from some recent studies, part of a broader area of research that suggests some pollutants cause harm that shows up only years after exposure.

The new work suggests long-ago lead exposure can make an aging person's brain work as if it's five years older than it really is. If that's verified by more research, it means that sharp cuts in environmental lead levels more than 20 years ago didn't stop its widespread effects.

"We're trying to offer a caution that a portion of what has been called normal aging might in fact be due to ubiquitous environmental exposures like lead," said Dr. Brian Schwartz of Johns Hopkins University.

"The fact that it's happening with lead is the first proof of principle that it's possible," said Dr. Schwartz, a leader in the study of lead's delayed effects. Other pollutants like mercury and pesticides may do the same thing, he said.

The notion of long-delayed effects is familiar – tobacco and asbestos, for example, can lead to cancer. But in recent years, scientists are coming to appreciate that exposure to other pollutants in early life also may promote disease much later on.

Hard to study

Studying delayed effects in people is difficult, because they generally must be followed for a long time. Research with lead is easier, because scientists can measure the amount that has accumulated in the shinbone over decades and get a read on how much lead a person has been exposed to.

Lead in the blood, by contrast, reflects recent exposure. Virtually all Americans have lead in their blood, but the amounts are far lower today than in the past.

The big reason for the drop: the phasing out of lead in gasoline from 1976 to 1991. Because of that and accompanying measures, the average lead level in the blood of American adults fell 30 percent by 1980 and about 80 percent by 1990.

That's a major success story for environmentalists. But work by Dr. Schwartz and Dr. Howard Hu of the University of Michigan suggests that the long-term effects of the high-lead era are still being felt.

In 2006, Dr. Schwartz and his colleagues published a study of about 1,000 Baltimore residents. They were ages 50 to 70, old enough to have absorbed plenty of lead before it disappeared from gasoline. They probably got their peak doses in the 1960s and 1970s, Dr. Schwartz said, mostly by inhaling air pollution from vehicle exhaust and from other environmental sources.

The researchers estimated each person's lifetime dose by scanning their shinbones for lead. Then they gave each one a battery of mental ability tests.

In brief, the scientists found that the higher the lifetime lead dose, the poorer the performance across a wide variety of mental functions, like verbal and visual memory and language ability. From low to high dose, the difference in mental functioning was about the equivalent of aging by two to six years.

Dr. Hu and his colleagues took a slightly different approach in a 2004 study of 466 men with an average age of 67. Those men took a mental-ability test twice, about four years apart on average. Those with the highest bone lead levels showed more decline between exams than those with smaller levels, with the effect of the lead equal to about five years of aging.

Other influences

Nobody is claiming that lead is the sole cause of age-related mental decline, but it appears to be one of several factors involved, Dr. Hu stressed.

If so, it would join such possible influences as high blood pressure, diabetes, stroke, emotional stress and maybe education level, said Bradley Wise of the National Institute on Aging. Nobody knows exactly what causes mental decline with age, he said.

Although the studies by Dr. Hu and Dr. Schwartz suggest lead is involved, Dr. Wise and others say they don't prove the link.

"I think many things impact how we age, but I think right now it's maybe premature to be giving lead a huge role in our age-related cognitive decline," said Dr. Margit L. Bleecker, director of the Center for Occupational and Environmental Neurology in Baltimore. Still, she called the lead hypothesis "a very interesting idea" deserving more study.

Others were more impressed.

"The new evidence from these studies should concern people," said epidemiologist Andrew Rowland of the University of New Mexico. "These two research groups are finding adverse effects on the aging brain at low levels of lead exposure. More work needs to be done, but these studies are raising important questions."

GASOLINE ISN'T ONLY DANGER

NEW YORK – Researchers are finding that lead absorbed early in life may affect brain function in old age. While some sources of lead, such as leaded gasoline have dropped, there are others. For example:

• Deteriorating lead paint can produce lead dust and chips that children swallow. The federal government banned lead paint from housing in 1978, but older homes may have it.
• Soil can become contaminated and be carried indoors.
• Drinking water can pick up lead from pipes or solder in older homes.
• Traces of lead can be brought home on hands or clothes from jobs that involve working with the metal.
• Food and liquids stored in lead crystal or lead-glazed containers may pick up the metal.
• Some folk remedies contain lead.
• Lead is used in some hobbies, such as making pottery or stained glass, or refinishing furniture.

Originally published on 1/27/2008 by Associated Press and shown on the shared content section of The Dallas Morning News website here.

Great Drug, but Does It Prolong Life?

Statins are among the most prescribed drugs in the world, and there is no doubt that they work as advertised — that they lower not only cholesterol but also the risk for heart attack.

But in the fallout from the headline-making trial of Vytorin, a combination drug that was found to be no more effective than a simple statin in reducing arterial plaque, many people are asking a more fundamental question about statins in general: Do they prolong your life?

And for many users, the surprising answer appears to be no.

Some patients do receive significant benefits from statins, like Lipitor (from Pfizer), Crestor (AstraZeneca) and Pravachol (Bristol-Myers Squibb). In studies of middle-aged men with cardiovascular disease, statin users were less likely to die than those who were given a placebo.

But many statin users don’t have established heart disease; they simply have high cholesterol. For healthy men, for women with or without heart disease and for people over 70, there is little evidence, if any, that taking a statin will make a meaningful difference in how long they live.

“High-risk groups have a lot to gain,” said Dr. Mark H. Ebell, a professor at the University of Georgia who is deputy editor of the journal American Family Physician. “But patients at low risk benefit very little if at all. We end up overtreating a lot of patients.” (Like the other doctors quoted in this column, Dr. Ebell has no ties to drug makers.)

How is this possible, if statins lower the risk of heart attack? Because preventing a heart attack is not the same thing as saving a life. In many statin studies that show lower heart attack risk, the same number of patients end up dying, whether they are taking statins or not.

“You may have helped the heart, but you haven’t helped the patient,” said Dr. Beatrice Golomb, an associate professor of medicine at the University of California, San Diego, and a co-author of a 2004 editorial in The Journal of the American College of Cardiology questioning the data on statins. “You still have to look at the impact on the patient over all.”

A 2006 study in The Archives of Internal Medicine looked at seven trials of statin use in nearly 43,000 patients, mostly middle-aged men without heart disease. In that review, statins didn’t lower mortality.

Nor did they in a study called Prosper, published in The Lancet in 2002, which studied statin use in people 70 and older. Nor did they in a 2004 review in The Journal of the American Medical Association, which looked at 13 studies of nearly 20,000 women, both healthy and with established heart disease.

A Pfizer spokeswoman notes that a decline in heart disease death rates reported recently by the American Heart Association suggests that medications like statins are having an impact. But to consistently show a mortality benefit from statins in a research setting would take years of study. “We’ve concentrated on whether Lipitor reduces risk of heart attacks and strokes,” says Halit Bander, medical team leader for Lipitor. “We’ve proven that again and again.”

This month, The Journal of the American College of Cardiology published a report combining data from several studies of people 65 and older who had a prior heart attack or established heart disease. This “meta-analysis” showed that 18.7 percent of the placebo users died during the studies, compared with 15.6 percent of the statin users.

This translates into a 22 percent lower mortality risk for high-risk patients over 65. A co-author of the study, Dr. Jonathan Afilalo, a cardiology fellow at McGill University in Montreal, says that for every 28 patients over 65 with heart disease who take statins, one life will be saved.

“If a patient has had a heart attack,” Dr. Afilalo said, “they generally should be on a statin.”

Of course, prolonging life is not the only measure that matters. If preventing a heart attack improved the quality of life, that would be an argument for taking statins even if it didn’t reduce mortality. But critics say there’s no evidence that statin users have a better quality of life than other people.

“If you can show me one study that people who have a disability from their heart are worse off than people who have a disability from other causes, I would find that a compelling argument,” Dr. Golomb said. “There’s not a shred of evidence that you’ve mitigated suffering in the groups where there is not a mortality benefit.”

One big concern is that the side effects of statins haven’t been well studied. Reported side effects include muscle pain, cognitive problems and impotence.

“Statins have side effects that are underrated,” said Dr. Uffe Ravnskov, a retired Swedish physician and a vocal critic of statins. “It’s much more frequent and serious than has been reported.”

Dr. Ebell acknowledges that there are probably patients with heart disease who could benefit from a statin but who aren’t taking it.

But he added, “There are probably more of the opposite — patients who are taking a statin when they probably don’t need one.”

Originally published on 1/29/2008 by Tara Parker-Pope at The New York Times website here.

More Testing of Seafood to Address Mercury Concerns

A NUMBER of restaurants and retailers in different parts of the country have started testing the fish they sell in response to concerns about the amount of mercury in seafood, and the Environmental Protection Agency is beginning to examine the mercury content in fish sold in the New York City region.

The regional office of the federal agency, which began the study because the city found high levels of mercury in the blood of New Yorkers last spring, will examine the 20 most commonly eaten fish in the region, including tuna.

Recent laboratory tests reported last week in The New York Times found so much mercury in some sushi made with tuna, particularly bluefin, that a long-term diet of even two or three pieces a week would exceed the levels considered acceptable by the Environmental Protection Agency.

The National Fisheries Institute, a trade association for the seafood industry, said it was sending fish sellers leaflets offering information on seafood safety. Some retailers said they also received faxes from the institute criticizing the article in The Times.

Mary Anne Hansan, the vice president of the National Fisheries Institute, said it was sending out the leaflets because “what we are hearing is a lot of consumer confusion about what to believe when it comes to seafood.” The association, she said, is letting people know about “the well-documented benefits” of seafood.

The group said that the mercury levels found in seafood eaten in the United States did not present a health risk. But many scientists suggest that it is best for people to choose fish with low mercury levels and high levels of beneficial fatty acids.

A chain of five stores in New York, Gourmet Garage, sold tuna that in the Times test had mercury concentrations above one part per million, the Food and Drug Administration’s “action level,” at which the fish can be taken off the market. The company said it would now carry only yellowfin tuna with no more than 0.4 parts per million. Yellowfin tuna is generally lower in mercury than bluefin.

The company’s seafood is tested for mercury by Micro Analytical Systems, in San Rafael, Calif. The test it uses takes only a minute, Micro Analytical Systems said, allowing it to test fish before it reaches the consumer. Other mercury tests take four to five days or longer, so the results are typically useful mostly for future purchasing decisions.

Some stores said they were not changing their patterns of ordering fish, although they noted some lessening interest in tuna sushi. At Eli’s Manhattan, on New York’s Upper East Side, sales of tuna sushi were down 30 percent in the past week, said Joe Catalano, manager of the fish department.

A spokeswoman for Wegmans, a supermarket chain with 71 stores on the East Coast, said it had been conducting its own mercury tests on swordfish and tuna for several years. The company also said it required its suppliers to test swordfish; now it will require them to test tuna as well.

Wegmans, which uses the test that takes four or five days, stops buying from any country whose fish exceeds the limit.

Legal Sea Foods, which has more than 30 restaurants along the East Coast, began testing for mercury about three years ago, rejecting anything above the F.D.A. action level. “Most of our fish is at 0.5 parts per million,” said the chain’s president, Roger Berkowitz. Now, he said, he is planning to let the public know the fish is tested.

Despite some consumer concern about mercury levels, many diners do not worry about it and some restaurants said they would not be making any changes.

At Tsunami Sushi and Sake Bar, in San Francisco, the office manager, Michaela Griner, was not surprised by the levels of mercury found by The Times.

“These things have been known for a long time,” she said. “Tuna is one of the most popular fish in any sushi restaurant. If people order it, then of course we are going to sell it.”

Kenji Tamida, general manager of Sushi Roku at Caesars Palace in Las Vegas, said: “There hasn’t been any scare from consumers, no feedback from our purveyors. We serve bigeye and yellowfin, only once in a while bluefin.”

The restaurant Megu Midtown has been selling Kindai tuna, farm-raised bluefin, for several months. In the fall the public relations company for Megu claimed that Kindai tuna was “almost completely mercury-free.”

For its study, The Times ordered two pieces of Kindai tuna from the Midtown Megu in October, and a laboratory analysis showed that they contained mercury at levels of 0.79 and 0.87 parts per million.

Hiro Nishida, the president of Food Scope America, which owns Megu, said he was not surprised. The average concentration of mercury in Kindai tuna is 0.6 parts per million, he said, but producers are “trying to decrease the parts per million to 0.2 by different feeding, and they will become much healthier to people who enjoy tuna.”

Speaking of tuna in general, he added, “If you eat the appropriate portion you should not consider it a problem.”

Originally published on 1/30/2008 by Marian Burros at The New York Times website here.

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