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Possible link between shoulder problems and heart disease risk

Shoulder pain appears to be associated with risk factors for heart disease. Researchers found that people with the most heart disease risk factors, like high cholesterol, high blood pressure, and diabetes, were almost five times more likely to also have shoulder trouble. 

Is there hope for leg cramp sufferers?

Despite the lack of a universally recognized therapy for nighttime leg cramps, a few approaches may be worth trying.


Image: Monkey Business Images/Thinkstock

Few things are more jarring to a night's sleep than shooting calf pains. If you have nocturnal leg cramps, you have lots of company. Although they can strike people at any time of life, they become more common with age. Among people over 60, almost half report having leg cramps, a third say they are awakened by cramps at night, and 15% report weekly episodes.

What causes leg cramps?

Preventing cramps

There are no FDA-approved medications for leg cramps, and the U.S. Preventive Services Task Force hasn't issued guidelines for treating them. However, the American Academy of Neurology (AAN) has issued the following advice on common therapies, based on scientific evidence of effectiveness.

Stretching exercises. The AAN says that there are not enough data to say for sure that stretching helps reduce the frequency of muscle cramps. That doesn't mean that the exercises are ineffective or harmful, and doing them can help contribute to the flexibility of your legs.

Quinine. There is solid evidence that quinine and quinine derivatives are effective in reducing the frequency of muscle cramps, although the magnitude of benefit is small. However, quinine is out-of-bounds for most people. The FDA has issued repeated warnings against using quinine (which is approved only to treat certain types of malaria) to prevent or treat leg cramps because it may cause serious side effects, including bleeding and kidney damage. Although doctors can still prescribe quinine, it is recommended only when cramps are disabling and when the person can be carefully monitored for side effects.

Vitamin B complex. There is some evidence that taking a daily capsule containing eight B vitamins—B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, B7 (biotin), B9 (folate), and B12—may prevent cramps.

Calcium-channel blockers. Evidence indicates that one calcium-channel blocker—diltiazem (Cardizem, Dilacor XR)—is possibly effective.

Ineffective therapies. The AAN found enough evidence to indicate that magnesium supplements and gabapentin (Neurontin) aren't likely to help.

Other remedies

In situations like nighttime leg cramps, where there are no widely accepted treatments, unproven remedies may be worth a try. The following are low-risk and have enthusiastic proponents.

  • Soap. If you don't mind sharing the bed with a bar of soap, you might want to try securing one under the bottom sheet near where your legs usually rest. Despite scores of testimonials to its effectiveness in letters to news media and comments on websites, no one has offered a hypothesis for how soap might work. Yet it's inexpensive and harmless.

  • Mustard or pickle juice. Swallowing a teaspoon of mustard or an ounce of pickle juice before bedtime also has enthusiastic advocates. In fact, the pickle juice preventive has become a staple among athletes who want to avoid being sidelined by cramps. However, if you have gastroesophageal reflux disorder or are trying to cut back on salt, you might want to check with your doctor before trying this approach. Scientists think the foods might stimulate ion channels in the mouth, esophagus, and stomach to send signals to the central nervous system that inactivate overexcited neurons.

  • HotShot . This 1.7-ounce dose of cinnamon, ginger, lime juice, sweeteners, and capsaicin (the active compound in chili peppers) was developed by Dr. Bean and Dr. Rod MacKinnon, a Nobel Laureate in Chemistry at Rockefeller University, as a remedy for cramping during rigorous exercise. It works along the same principle as mustard and pickle juice, but has longer-lasting effects. It is currently available commercially as a sports beverage. "Although I am aware of people using it for nocturnal leg cramps, it has not yet been formally tested for that use," Dr. Bean says.

Look on the bright side and maybe even live longer

Studies suggest that adopting a sunnier outlook may improve your health and even extend your life.


Image: © lzf /Thinkstock

In these turbulent times, it's sometimes a struggle to maintain a glass-half-full view of life. But if you can, it may serve you well. A growing body of research links optimism—a sense that all will be well—to a lower risk for mental or physical health issues and to better odds of a longer life.

One of the largest such studies was led by researchers Dr. Kaitlin Hagan and Dr. Eric Kim at Harvard's T.H. Chan School of Public Health. Their team analyzed data from 70,000 women in the Nurses' Health Study who, in 2004, had answered questions about how they viewed their futures

White wine linked to higher risk of certain melanomas

Data from more than 200,000 people indicates that the risk of developing melanoma increases by 13% for every glass of white wine consumed per day. Drinking beer, red wine, or liquor was not associated with increased risk.

Emergencies and First Aid - Emergency Checklist

This list describes your priorities in an emergency situation. Follow these steps:

  1. Evaluate the scene to protect yourself and others from injury or danger.
  2. Be calm and reassuring.
  3. Do not move the person unless he or she is in imminent danger or unless you cannot provide assistance without moving the person.
  4. Get help. Call out for someone to phone 911 or, if the person does not need immediate assistance, make the call yourself.
  5. If the situation is a choking emergency, perform the Heimlich maneuver (see Choking).
  6. Look, listen, and feel for breathing (see Breathing Difficulties).
  7. Feel for a pulse to determine if the heart is beating.
  8. Control bleeding with direct pressure.
  9. Treat for shock.
  10. If the person is unconscious, move him or her into the recovery position.
 
 

Emergencies and First Aid - Recovery Position

Adult Recovery Position

This position helps a semiconscious or unconscious person breathe and permits fluids to drain from the nose and throat so they are not breathed in. If the person is unconscious or semiconscious after you have done everything on the Emergency Checklist, move the person into the recovery position while waiting for help to arrive.

Do not use the recovery position if the person has a major injury, such as a back or neck injury

Emergencies and First Aid - Removing a Stuck Ring

Removing a Stuck Ring

1 Pass an end of fine string or dental floss under the ring. With the other end, begin tightly wrapping the string around the finger. Ensure that the string is wrapped evenly and smoothly past the lower knuckle.2 With the end that was passed under the ring, begin unwrapping the string in the same direction. The ring should move over the string as the string is unwrapped. If the ring cannot be removed, unwrap the string and immediately seek urgent care.
 
 

Emergencies and First Aid - Choking

Choking


A person who is choking will instinctively grab at the throat. The person also may panic, gasp for breath, turn blue, or be unconscious. If the person can cough or speak, he or she is getting air. Nothing should be done.

Immediate care
If the person cannot cough or speak, begin the Heimlich maneuver immediately to dislodge the object blocking the windpipe. The Heimlich maneuver creates an artificial cough by forcing the diaphragm up toward the lungs.

Emergencies and First Aid - Cardiopulmonary Resuscitation

When you are alone and have to perform cardiopulmonary resuscitation (CPR), your primary effort should be compressing the chest to help the person's heart pump blood. If there is a second person helping, providing breaths can be done at the same time as compressions are performed.

The brief review of CPR on the following pages can help you in an emergency; however, this information should not take the place of a certified course in CPR.

Emergencies and First Aid - Mouth-to-Mouth Resuscitation

Mouth-to-Mouth Resuscitation

Mouth-to-Mouth-and-Nose Resuscitation on a Child Under Age 8 or on an Infant

 

  • Place the child on a hard, flat surface.

  • Look into the mouth and throat to ensure that the airway is clear. If an object is present, try to sweep it out with your fingers. If unsuccessful and the object is blocking the airway, apply the Heimlich maneuver. If vomiting occurs, turn the child onto his or her side and sweep out the mouth with two fingers.

  • Tilt the head back slightly to open the airway.

  • Place your mouth tightly over the nose and mouth. Blow two quick, shallow breaths (smaller breaths than you would give to an adult). Watch for the chest to rise.

  • Remove your mouth. Look for the chest to fall as the child exhales.

  • Listen for the sounds of breathing. Feel for the child’'s breath on your cheek. If breathing does not start on its own, repeat the procedure.

Mouth-to-Mouth Resuscitation on a Child Age 8 or Older or on an Adult



1. Make sure the person is lying on a hard, flat surface. Look into the mouth and throat to ensure that the airway is clear. If an object is present, try to sweep it out with your fingers (wear disposable surgical gloves if they are available). Apply the Heimlich maneuver if unsuccessful and the object is blocking the airway. If vomiting occurs, turn the person on his or her side and sweep out the mouth with two fingers. Do not place your finger in the mouth if the person is rigid or is having a seizure.

2. Tilt the head back slightly to open the airway. Put upward pressure on the jaw to pull it forward.


3. Pinch the nostrils closed with thumb and index finger. Place your mouth tightly over the person’'s mouth. Use a mouthpiece if one is available. Blow two quick breaths and watch for the person’'s chest to rise.

4. Release the nostrils. Look for the person’'s chest to fall as he or she exhales. Listen for the sounds of breathing. Feel for the person'’s breath on your cheek. If the person does not start breathing on his or her own, repeat the procedure.

 

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