“Although patient satisfaction is a complex issue, improvements in recognition of GERD can improve management of the disease as well as patient satisfaction with their care and treatment,” said Peter Bytzer, MD, PhD, of Copenhagen University and lead author of the study. “Patient satisfaction can be influenced by a number of factors including treatment regimen, general level of well-being, the ‘bedside manner’ of the physician, the patient’s expectations and the quality of patient/physician communication.”

The researchers found that patients who were given prescriptions for proton pump inhibitors (PPIs) tended to be more satisfied than those given H2-receptor antagonists. Partial responders were likely to be more dissatisfied than patients whose symptoms were fully resolved. In addition, a decrease in health-related quality of life (HRQoL) was associated with greater dissatisfaction. In fact, decreasing HRQoL was correlated with decreasing satisfaction with medical care in general. Patients were more likely to be satisfied if they were taken seriously by their physician and if their symptoms were investigated. They were also more likely to be satisfied if the patient/physician consultation was interactive.

“Of the various factors influencing patient satisfaction, the quality of patient/physician communication is probably the most amenable to improvement. This can be done by using validated questionnaires to help physicians identify more effectively which symptoms patients have, and the impact of these symptoms on the patient’s well-being,” added Dr. Bytzer.

Researchers reviewed the possible reasons why patients were dissatisfied with the way their disease is managed. Studies published between 1970 and 2007 were identified from PubMed, EMBASE and the author’s existing database; 11 studies were found to be appropriate for use in this review. A key strength of this review was the fact that the searches identified a wide range of studies with varying methodologies.

Typically characterized by frequent or troublesome heartburn and/or acid regurgitation, GERD is a chronic, painful condition that impairs HRQoL. GERD may result in disturbed sleep, reduced productivity at work and impaired daily activities. Despite the efficacy of PPIs as therapeutics for patients with GERD, a number of studies have shown that a proportion of patients with the disease are not satisfied with their treatment. In fact, population-based surveys show that at least one-third of individuals taking medication for GERD are not satisfied with their treatment. This is particularly true for those taking over-the-counter medicines to relieve symptoms.

To learn more about heartburn and GERD, read the AGA patient brochure on this topic at www.gastro.org/patient.

About the AGA Institute

The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. www.gastro.org.

About Clinical Gastroenterology and Hepatology

The mission of Clinical Gastroenterology and Hepatology is to provide readers with a broad spectrum of themes in clinical gastroenterology and hepatology. This monthly peer-reviewed journal includes original articles as well as scholarly reviews, with the goal that all articles published will be immediately relevant to the practice of gastroenterology and hepatology. For more information, visit www.cghjournal.org.

]]> http://genericpharmacydrug.org/?feed=rss2&p=8 http://genericpharmacydrug.org/?p=9 http://genericpharmacydrug.org/?p=9#comments Sat, 01 Aug 2009 04:00:00 +0000 admin health http://genericpharmacydrug.org/?p=9 Westchester, Ill. - A study in the Aug. 1 issue of the journal Sleep indicates that self-reported worsening in initiating and maintaining sleep over a five-year period was significantly associated with poorer mental quality of life, and increasing daytime sleepiness symptoms were associated with both poorer physical and mental quality of life.

Adjusted models show that an increase in difficulty initiating and maintaining sleep was significantly associated with a change in Mental Component Summary (MCS) scales, while increasing severity of excessive daytime sleepiness measured by the Epworth Sleepiness Scale was associated with a change in both MCS and Physical Component Summary (PCS) scales. Although severity of sleep disordered breathing (SDB) measured by mean respiratory disturbance index (RDI) increased from 8.1 at baseline to 10.9 at follow-up, multiple linear regression models show no significant association between change in RDI and changes in PCS or MCS. The authors suggest that in patients with SDB, the presence of excessive daytime sleepiness determines whether there will be an impact on quality of life.

According to lead author Graciela E. Silva, PhD, assistant professor in the College of Nursing and Health Innovation at Arizona State University, the results provide important and surprising insights regarding the relationship between sleep and quality of life.

“While we were expecting an association between quality of sleep and quality of life, it
was surprising that we did not find a significant association between objective measures of quality of sleep and quality of life, but that only subjective measures of sleep were associated with quality of life,” said Silva. “These findings signal to the importance of perception of quality of sleep on quality of life.”

The cross-sectional, retrospective study obtained polysomnographic and clinical data from 3,078 patients who were included in the baseline examination of the Sleep Heart Health Study (SHHS), a multi-center longitudinal study of participants over the age of 40.

The mean age of participants was 62 years at baseline and 67 years at follow-up. Fifty-five percent were women, and most were Caucasian (75 percent) and married (77 percent). Coronary heart disease was more prevalent in men, and respiratory disease was more prominent in women. Measures of quality of life were obtained using the PCS and MCS scales of the Medical Outcomes Study Short-Form Health questionnaire. The primary exposure was change in the RDI obtained from unattended overnight polysomnograms performed approximately five years apart.

Results show that the mean PCS dropped from 48.5 at baseline to 46.3 at follow-up, while the mean MCS increased slightly from 54.1 to 54.8. Significantly lower scores for women than men were seen at baseline and follow-up for the PCS and MCS. Hispanics/Mexican Americans had lower baseline MCS and PCS scores compared with the other ethnic groups. Obese subjects had lower PCS scores than non-obese participants at baseline and follow-up; however, no difference was found for MCS at either survey. Scores for both summary scales were lower for subjects with respiratory diseases and those taking sleeping pills, while PCS but not MCS scores were significantly lower for subjects with coronary heart disease.

Findings suggest that physical limitations imposed by the presence of obesity, coronary heart disease and respiratory disease adversely impact physical components of quality of life. The authors state that primary treatment to reduce morbidity and symptoms related to these conditions would ultimately improve sleep quality.

Sleep is the official journal of the Associated Professional Sleep Societies, LLC (APSS), a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The APSS publishes original findings in areas pertaining to sleep and circadian rhythms. Sleep, a peer-reviewed scientific and medical journal, publishes 12 regular issues and 1 issue comprised of the abstracts presented at the Sleep Meeting of the APSS.

For a copy of the study, “Longitudinal Evaluation of Sleep-Disordered Breathing and Sleep Symptoms with Change in Quality of Life: The Sleep Heart Health Study (SHHS),” or to arrange an interview with the study’s author, please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research. As the national accrediting body for sleep disorders centers and laboratories for sleep related breathing disorders, the AASM promotes the highest standards of patient care. The organization serves its members and advances the field of sleep health care by setting the clinical standards for the field of sleep medicine, advocating for recognition, diagnosis and treatment of sleep disorders, educating professionals dedicated to providing optimal sleep health care and fostering the development and application of scientific knowledge.

]]> http://genericpharmacydrug.org/?feed=rss2&p=9 http://genericpharmacydrug.org/?p=10 http://genericpharmacydrug.org/?p=10#comments Fri, 31 Jul 2009 04:00:00 +0000 admin health http://genericpharmacydrug.org/?p=10 Boulder, CO, USA - GEOLOGY studies include some curious associations: air hockey and plate tectonics; calcite and Earth’s orbit; Columbia River Flood Basalts and the Congo Fan; and rock hyrax middens and global climate change. Also in Geology: briny eruptions on Mars; the only basin known to have both a marine and terrestrial P-T boundary; a major Silurian fish die-off; and mapping naturally occurring asbestos in the Sierra Nevada. GSA TODAY illustrates the Klondike goldfields and megafauna of Beringia.

High Cu grades in porphyry Cu deposits and their relationship to emplacement depth of magmatic sources

John M. Proffett, P.O. Box 772066, Eagle River, Alaska 99577, USA. Pages 675-678.

In porphyry copper (Cu) deposits, which produce most of the world’s copper, Cu-sulfides are disseminated along small veins and fractures associated with small bodies of porphyritic-textured granitic rock. These are emplaced above larger bodies of granitic magma, which are the sources of both mineralizing fluids and the porphyritic rock. Average copper grades of these deposits are relatively low, but zones of higher grades contained within them are important economically, and for an understanding of their origin. The paper by Proffett identifies two types of higher-grade copper mineralization, one or the other of which may be dominant in different deposits. He shows that the type that is dominant correlates with the depth of emplacement of the underlying magmatic source. Deposits in which most high Cu grades are associated with small, early, granular quartz veins are found above magmatic sources emplaced to depths of about 4 km or less. Those in which most high Cu grades occur in narrow halos of altered rock along early fractures are located above magmatic sources emplaced to depths of about 5 km or more. Fluids with water, salt, and sulfur concentrations typical for magmatic sources would exist as separate brine and vapor phases at pressures corresponding to the shallower depths, and proportions of sulfur occurring as hydrogen sulfide should be relatively low. Such fluid behavior appears to be consistent with characteristics of the quartz vein-related high-grade zones. At greater depths, fluids would exist as one supercritical phase, with a higher proportion of hydrogen sulfide, which appears to be consistent with characteristics of high-grade zones related to alteration halos.

Elevated fluid pressure and extreme mechanical weakness of a plate boundary thrust, Nankai Trough subduction zone

Harold J. Tobin and Demian M. Saffer, Dept. of Geology and Geophysics, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA. Pages 679-682.

Global observations indicate that the faults that lie between tectonic plates slip far more easily than is predicted based on measurements of rock strength. The cause of this mechanical weakness may be a key to understanding earthquake rupture processes and tsunami generation. The presence of trapped, pressurized fluids is one hypothesis widely invoked to explain these “weak faults,” yet it has been notoriously difficult to test. Tobin and Saffer have detected such pressurized fluids and quantified their extent, using acoustic images of a plate boundary fault system from a subduction zone under the Pacific Ocean offshore Japan. Their results show that the strength of the plate boundary fault zone remains very low and almost constant for at least 20 km as it slides down into the subduction zone. Like a puck on an air-hockey table, the upper plate glides over the lower one on a cushion of high-pressure pore water trapped in sediments thrust beneath the fault zone.

Mid-Cretaceous seafloor spreading pulse: Fact or fiction?

M. Seton et al., EarthByte Group, School of Geosciences, Madsen Building F09, University of Sydney, NSW 2006, Australia. Pages 687-690.

Profound changes occurred on our planet during the mid-Cretaceous (80-120 million years ago): sea level was higher, continents were inundated, the climate was warmer, ocean basins were oxygen poor, voluminous volcanism occurred, and Earth’s magnetic field underwent a period of relative stability. In the past, the cause of these substantial changes was believed to be due to a rapid pulse of seafloor spreading. However, it has also been suggested that new mid-oceanic ridges, created after the breakup of the supercontinent Pangea, were responsible. To resolve this debate, Seton et al. have reconstructed the world’s ocean basins and obtained estimates of seafloor spreading rates and mid-oceanic ridge lengths from the Cretaceous to the present day. They have found that these planetary-wide changes were not related to a sudden change in global mid-oceanic ridge length, but rather were related to higher seafloor spreading rates and the changing age-area distribution of oceanic lithosphere.

Salt tectonics and collapse of Hebes Chasma, Valles Marineris, Mars

J.B. Adams et al., Dept. of Earth and Space Sciences, University of Washington, Seattle, Washington 98195, USA. Pages 691-694.

Planetary scientists have debated the origin of the great canyons of Valles Marineris on Mars ever since their discovery. Hypotheses have included erosion by giant floods, tectonic rifting, and collapse. Intense interest has been focused on the huge flood channels that drained some of the canyons, and on the materials that are exposed to depths of over 8 km. At stake in the debate is whether large volumes of water shaped the early history of Mars, and how much of that water might still be trapped below the surface. This study by Adams et al. presents evidence that Hebes Chasma, a 310-km-long canyon that has no surface outlet, was formed by collapse and draining of brines and entrained solids into sink holes. The study was based on scaled laboratory models of Hebes and on satellite images and spectra. The authors conclude that a salt and ice-rich regolith at Hebes dissolved and melted when the region was heated early in the planet’s history. They suggest that a similar geologic history may apply to other parts of Valles Marineris. The study supports the conclusions of previous studies that brines derived from hydrous salts and ice moved through a pressurized aquifer and erupted in the giant outflow channels. The emerging picture is that the Martian regolith still may be rich in water.

A lacustrine carbonate record of Holocene seasonality and climate

Chad A. Wittkop et al., Dept. of Chemistry and Geology, Minnesota State University, Mankato, Minnesota 56001, USA. Pages 695-698.

Sediments from a small lake in Michigan contain millimeter-sized layers of organic matter and the mineral calcite, deposited in pairs each year for the past 9000 years. The amount of the mineral calcite in these layers varies through time, and Wittkop et al. show how these variations are linked to long-term changes in the Northern Hemisphere growing season as controlled by dynamics of Earth’s orbit around the sun. Short-term variations in calcite abundance also occur on a scale of decades. While the cause of the short-term variations is more difficult to determine, comparison with other climate records from the same region and time period suggest changes in precipitation and temperature may be the cause. These short-term cycles share similarities with other records documenting the pattern of El Niño events over the past 5000 years, which suggest that such events have become more frequent and intense in this time.

Middle Miocene oxygen minimum zone expansion offshore West Africa: Evidence for global cooling precursor events

S. Kender et al., British Geological Survey, Keyworth, Nottingham NG12 5GG, UK. Pages 699-702.

The Middle Miocene Climatic Optimum (16 to 14 million years ago), considered generally to be the warmest period in Earth’s history within the past 25 million years, saw a major shift in climate from global warming to cooling. This reversal of climatic warming has proven difficult to understand because of the limited range of available records. The first records of this time interval from the Congo Fan, West Africa, may shed light on the events preceding the major cooling at 14 million years ago. The results of Kender et al. reveal two acidification events in the deep sea off West Africa about 16 and 15.5 million years ago, coincident with massive flood basalt release in the Columbia River basin, USA. The Columbia River Flood Basalts represent the largest group of eruptions to occur on Earth since the Paleogene, over 50 million years ago, and Kender et al. now suggest that they had a significant effect on the climate at this time. The acidification events, which dissolved carbonate organisms on the seafloor, probably resulted from the accumulation of dead organic matter on the seafloor. Stronger offshore winds and increased primary productivity in the surface ocean off the west coast of Africa is likely to account for the accumulation and burial of this organic matter, which ultimately removed CO2 from the atmosphere, leading to long-term cooling. The implications of this study are that Columbia River volcanism likely triggered climatic cooling by sulphuric acid-induced volcanic winters, which would have increased the tradewinds off West Africa and, in turn, fertilized the ocean by transporting more nutrients such as sulphates to the ocean. Large extinctions in deep-sea organisms (benthic foraminifera) associated with this time interval imply that increasing ocean productivity may have dramatic consequences for ocean ecology.

A record of rapid Holocene climate change preserved in hyrax middens from southwestern Africa

B.M. Chase et al., Arid Environmental Systems Research Group, School of Geography and the Environment, University of Oxford, Oxford OX1 3QY, UK. Pages 703-706.

The paper by Chase et al. details the discovery of sensitive indicators of past environmental change in the stratified fecal deposits (known as middens) of rock hyraxes in the Namib Desert of Namibia. The records they have obtained, derived from stable carbon and nitrogen isotope signals, show that hyrax middens have extraordinary potential to preserve high-resolution records of rapid climate change, and that over the last 11,700 years, the Namib Desert has experienced highly variable climates, marked by abrupt shifts in moisture availability. These shifts include events such as the Little Ice Age, the Medieval Warm Period, and the 2700 B.P. event, indicating strong links with atmospheric and oceanic circulation dynamics as well as cycles of orbital and solar forcing. These data are critical to the evaluation of processes and feedbacks within the global climate system, particularly the relative importance of high- vs. low-latitude insolation forcing of tropical systems. Their findings indicate that the long-held hypothesis that the Inter-Tropical Convergence Zone has migrated southward during the Holocene following precessional variations in summer insolation cannot be applied to southern Africa. The implications of this in terms of understanding regional- to global-scale climate dynamics and developing general circulation models that can adequately predict future climate scenarios cannot be overstated.

Decoupled geochemical behavior of As and Cu in hydrothermal systems

Artur P. Deditius et al., Commonwealth Scientific and Industrial Research Organisation (CSIRO), Exploration and Mining, 26 Dick Perry Avenue, Perth, WA 6151, Australia. Pages 707-710.

Deditius et al. describe alternating zones of copper- and arsenic-rich pyrite from gold-deposits at Pueblo Viejo (Dominican Republic) and Yanacocha (Peru). Arsenic-rich zones are enriched in gold, silver, antimony, tellurium, and lead, while copper-rich zones are depleted in these elements. These zones are interpreted to result from invasion of the pyrite-forming fluid by magmatic vapors. The close association of arsenic with gold and silver strongly suggests that these three elements may be transported by hydrothermal vapor separately from copper-rich vapor. Comparison of the analytical data to experimental studies of elemental partitioning, and analyses of fumaroles and fluid inclusions from magmatic-hydrothermal systems, suggests that the arsenic-rich vapor formed at high and possibly magmatic temperatures, whereas the copper-rich vapor formed at lower temperatures, possibly during migration of the original magmatic vapor.

Paradox of late Paleozoic glacioeustasy

Daniel E. Horton and Christopher J. Poulsen, Dept. of Geological Sciences, University of Michigan, Ann Arbor, Michigan 48109, USA. Pages 715-718.

The ice age of the late Paleozoic (326-267 million years ago) was a period of dynamic climatic fluctuation, a time period in which southern Pangea saw the waxing and waning of massive continental ice sheets while low-latitude Pangean sedimentary sequences recorded multiple 100-m eustatic fluctuations. This cyclicity is thought to have been driven by changes in Earth’s orbit with relation to the sun. Horton and Poulsen employ a coupled ice sheet-atmospheric general circulation model in an attempt to simulate both observed glacioeustatic changes and inferred ice sheet volumes. Their simulations present paradoxical results. While ice volumes of similar size to those implied by proxy evidence are simulated, sea-level changes brought about by cyclic variations in Earth’s orbit are minuscule. It is only with large perturbations to atmospheric greenhouse gas concentrations that observed sea-level changes are simulated. Current geological evidence does not support such drastic greenhouse gas fluctuations, leaving the driving factors of dynamic late Paleozoic climate change up for debate.

U-Pb zircon ages from the southwestern Karoo basin, South Africa — Implications for the Permian-Triassic boundary

Andrea Fildani et al., Chevron Energy Technology Company, 6001 Bollinger Canyon Rd, San Ramon, California 94583, USA. Pages 719-722.

The most extreme biological crisis on Earth, the end-Permian mass extinction, is recorded in terrestrial vertebrate fossil assemblages and paleosol horizons of the spectacularly preserved Karoo Basin, South Africa. By analyzing and dating 205 zircon grains extracted from deep-marine ash beds of the western Karoo (using an high-resolution microprobe [SHRIMP-RG] at Stanford University), Fildani et al. have discovered that the important Permian-Triassic boundary is marine in the southwestern sector of the basin, making the Karoo the only basin known to have a Permian-Triassic boundary identified in both marine and terrestrial sections. This discovery offers the unique opportunity to study, in close vicinity, impacts of the end-Permian crisis across an environmental spectrum.

Geological and archaeological implications of strontium isotope analysis of exposed bedrock in the Chicxulub crater basin, northwestern Yucatan, Mexico

Adrian Gilli et al., Geological Institute, ETH Zurich, Sonneggstrasse 5, 8092 Zurich, Switzerland. Pages 723-726.

The existence of a large buried impact crater beneath the Yucatan Peninsula of Mexico has been known for almost two decades. This crater, named after the town Chicxulub, was formed by a giant meteorite impact about 65 million years ago. The impact may have been responsible for the great extinction event that occurred at the Cretaceous-Paleogene boundary, including the extinction of dinosaurs. Although a several-kilometer-thick cover of sedimentary rocks buries the crater, the outline of the crater is still visible at the surface by a semicircular ring of water-filled sinkhole lakes, known by the Maya as cenotes. Older geologic maps showed no surface expression of the buried crater. Gilli et al. present new strontium isotope (87Sr/86Sr) dates of outcropping limestone, revealing a change in the age of the sediment inside and outside the ring of cenotes, with the youngest sediment deposited inside the ring between about 6 and 2.3 million years ago. The new strontium isotope map of northwestern Yucatan compiled by Gilli et al. shows a terrain of near uniform strontium isotope ratios inside the cenote ring that will offer new possibilities for both geochronology and archaeology. The study also constructed detailed strontium isotope maps around the archaeological sites of Mayapán and Chichén Itzá. These base maps are valuable for documenting local strontium isotope ratios and will be used to unravel the migration history to and from these ancient Maya cities.

Natural and anthropogenic sources of East Asian dust

Gaojun Li et al., State Lab of Mineral Deposits Research, Institute of Surficial Geochemistry, Dept. of Earth Sciences, Nanjing University, Nanjing 210093. Pages 727-730.

Densely populated East Asia is often hit by severe dust storms. It has been suggested that the dust particles are blown from the arid lands of northern China. However, scientists know little about the accurate source regions and the role of anthropogenic activities in the production of these dust particles. Li et al. constrain the origin of dust-storm particles by the isotopic tracers of neodymium and strontium. They collected samples of loess — a natural eolian deposit of East Asia dust that has accumulated over the past few million years — spanning northern China.

They analyzed the isotopic composition of the samples and found that the natural background of East Asia dust is dominated by binary sources from the arid lands around the northern boundary of China and the deserts on the northern margin of the Tibetan Plateau. However, the modern spring dust in Beijing is characterized by totally different isotopic compositions, which indicate an additional contribution (about 50%) from the desertified lands in its adjacent north and west, due to anthropogenic activities. The new finding is not only critical in planning long-term strategies for dust control but also is a significant benefit to researches of environmental change-based eolian deposits.

Vertebrate extinctions and reorganizations during the Late Silurian Lau Event

Mats E. Eriksson et al., Dept. of Geology, GeoBiosphere Science Centre, Lund University, Solvegatan 12, SE-223 62 Lund, Sweden. Pages 739-742.

During the Silurian Period (about 443-416 million years ago) fish faunas were struck hard by extinctions caused by the so-called Lau Event. This globally recognized event had significant effects on marine life, oceanic chemistry, and the sea-floor sediments deposited. Eriksson et al. show that the Lau Event had a profound impact on the early evolutionary history of vertebrates, wiping out almost two-thirds of the fish species and causing major ecological reorganizations over an estimated time span of 200,000 years. Immediately prior to the event, the jawed acanthodians dominated the fish faunas, whereas the event led to a diverse fauna and a brief but marked dominance of the jawless thelodonts. Both these groups of fish are now extinct but were common inhabitants in the Silurian seas. The stepwise changes observed among the fish faunas resemble those of conodonts, another extinct group of vertebrates, suggesting a similar mode of life and response to the Lau Event.

Super-heavy pyrite (34Spyr > 34SCAS) in the terminal Proterozoic Nama Group, southern Namibia: A consequence of low seawater sulfate at the dawn of animal life

Justin B. Ries et al., Dept. of Marine Sciences, 333 Chapman Hall, CB# 3300, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27599, USA. Pages 743-746.

Sulfur isotope ratios (34S/32S) in marine limestones tell us a great deal about sulfur and oxygen cycles in the ocean at the time that those limestones were deposited. Sulfur isotopes in marine limestones are recorded in two ways: (1) as carbonate-associated-sulfate, or sulfate that is substituted for the carbonate ion in calcium carbonate; and (2) as pyrite. Carbonate-associated sulfate is an oxidized form of sulfur and is interpreted as a proxy for sulfate dissolved in seawater at the time of limestone deposition, while pyrite is a reduced form of sulfur that is used as a proxy for sulfide in sedimentary porewaters at the time of limestone deposition. The primary way that sulfate is reduced to sulfide in seawater is through bacteria, a process known as bacterial sulfate reduction. Because bacteria are more efficient at converting isotopically lighter sulfate (32SO4) to sulfide, sulfide — and the pyrite that it forms — tends to be lighter, on average, than the original sulfate. Additionally, experiments have shown that the more sulfate there is in seawater, the greater the isotopic offset between the sulfate and sulfide will be. In modern seawater, which has relatively high sulfate concentrations compared with the geologic past, the offset will typically be between 20 and 50 parts per thousand. As sulfate concentrations in seawater decline, the isotopic offset between sulfate and sulfide declines toward zero. Geologists use the amount of this offset, as recorded in carbonate-associated sulfate and pyrite in marine limestones, to reconstruct sulfate levels in the ancient ocean and, therefore, oxygen levels in the ancient atmosphere (since seawater sulfate is formed primarily from the oxidation of sulfides on land). Ries et al present a very intriguing record of sulfur isotopes from carbonate-associated sulfate and pyrite within a well-preserved, 10 million year limestone sequence from the Precambrian-Cambrian boundary in southwest Namibia. Surprisingly, this 10 million year sequence of limestones contains sulfur isotopes in pyrite that are consistently heavier than the sulfur isotopes in co-deposited sulfate — which is the inverse of the normally observed trend resulting from bacterial sulfate reduction. This is the first documented occurrence of sulfide that is consistently isotopically heavier than coeval sulfate, and challenges our entire paradigm for interpreting the geologic record of sulfur isotopes. Ries et al. interpret this inverted isotopic offset as evidence for extremely low sulfate concentrations at the Precambrian-Cambrian boundary, most likely driven by very low levels of atmospheric oxygen. Apparently, these low levels of atmospheric oxygen persisted tens of millions of years beyond the origin of animals — much later than previously reported — but probably rose prior to the major diversification of animals in Early Cambrian time.

Pore-fluid Fe isotopes reflect the extent of benthic Fe redox recycling: Evidence from continental shelf and deep-sea sediments

W.B. Homoky et al., National Oceanography Centre, University of Southampton, Southampton SO14 3ZH, UK. Pages 751-754.

New research by Homoky et al. highlights the potential utility of iron isotopes for addressing important questions in ocean and Earth science. Different biological and chemical processes can leave behind characteristic isotopic “fingerprints.” Of specific interest here, iron isotopes in sediment pore fluids may be a unique tracer of bacterial processes that contribute to the input of iron to seawater; an important process contributing to natural carbon sequestration in the oceans. The research shows that iron cycling in the deep sea produces a different iron isotopic fingerprint in the pore fluids compared with previous studies on the coastal shelves. This study confirms the unique isotopic fingerprint of pore-fluid iron in coastal shelf settings, highlighting the potential for future research to use iron isotopes as a tracer of shelf-derived iron inputs to seawater. The findings will also aid future interpretations of ancient ocean iron cycling processes in the rock record.

Predicting delta avulsions: Implications for coastal wetland restoration

D.A. Edmonds et al., The Pennsylvania State University, Dept. of Geosciences, University Park, Pennsylvania 16802, USA. Pages 759-762.

Avulsions are the natural process by which flow is diverted out of an established river course and onto the adjacent floodplain. Avulsions are significant natural hazards because they produce extensive flooding as water is diverted over the floodplain. In other areas, like river deltas, avulsions are the natural process that constructs wetlands. Currently there is considerable interest in wetland restoration, especially in the Mississippi deltaic plain, where rapid disappearance of wetlands may have exacerbated damage caused by Hurricanes Katrina and Rita. Until now, the timing and location of avulsions has been notoriously difficult to predict. Using scaled-physical experiments of deltas at the Exxon Mobil Research Lab, Edmonds et al. determined that the avulsion location can be predicted by finding the location on the levee that has experienced the greatest stress for the longest period of time. For five different experimental deltas, they were able to predict the avulsion location with 93% accuracy. These results represent the first mechanistic understanding of avulsions that allows for accurate prediction of their location.

Mapping potentially asbestos-bearing rocks using imaging spectroscopy

G.A. Swayze et al., U.S. Geological Survey, Denver, Colorado 80225, USA. Pages 763-766.

Rock and soil that may contain naturally occurring asbestos (NOA), a known human carcinogen, were mapped in the Sierra Nevada, California, using an airborne imaging spectrometer, to determine if these materials could be uniquely identified with reflectance spectroscopy. Such information can be used to prepare or refine maps of areas that may contain minerals that can be asbestiform, such as serpentine and amphiboles, which were the focus of the study by Swayze et al. Although thick vegetation can conceal underlying rock and soil, use of modeled spectra of dry grass and serpentine allowed detection of serpentine in some parts of the study area with up to about 80% dry-grass cover. Chaparral vegetation, which was dominantly, but not exclusively, found in areas underlain by serpentinized ultramafic rocks, was also mapped. Practical applications of this technology for mapping areas that may contain NOA include locating roads that are surfaced with serpentine aggregate, identifying sites that may require enhanced dust control or other safety measures, and filling gaps in geologic mapping where field access is limited.

GEOLOGY abstracts are available for review at http://geology.gsapubs.org/content/current.

GSA Today Science Article
The Klondike goldfields and Pleistocene environments of Beringia

Duane Froese et al., Dept. of Earth and Atmospheric Sciences, Univ. of Alberta, Edmonton, Alberta, T6G 2E3, Canada

Declining sea level during the last great glacial event resulted in the exposure of a continuous land bridge extending from Siberia in the west to Yukon in the east. Lying in the rain shadow of the St. Elias Mountains, this great region, now known as Beringia, was cold but too dry for the development of glaciers. Instead, the region consisted of a great Arctic steppe, bound by mountains to the south and continental glaciers to the north, west, and east. This vast plain was a veritable Serengeti, host to megafauna like the steppe bison, woolly mammoth, Yukon horse, western camel, American mastodon, American lion, the short-faced bear and the helmeted musk-ox. But how did this remote Arctic region support such a diverse array of grazing megafauna? This is the question addressed by Duane Froese of the University of Alberta and his international team of colleagues. They focus on the Klondike region of Yukon, one of North America’s most productive localities for the recovery of late Pleistocene mammal fossils. By using numerous volcanic ash beds that characterize the fossil-rich strata to determine the age and correlations of disparate rock layers, they have been able to demonstrate that, unlike today’s Arctic tundra, Beringia consisted of a well-drained, vegetated steppe that was continuously replenished by wind-blown loess. Having now developed a well-constrained stratigraphic record of Beringia, Froese and his team hope to further resolve questions concerning the relationships between mammals, glacial vegetation, and Pleistocene climate.

Representatives of the media may obtain complimentary copies of Geology articles by contacting Christa Stratton at the e-mail address above.

GSA TODAY articles are open access. Access GSA TODAY by clicking on the issue cover icon at http://www.geosociety.org/pubs/.

Please discuss articles of interest with the authors before publishing stories on their work, and please make reference to GEOLOGY or GSA TODAY in articles published. Contact Christa Stratton for additional information or assistance.

Non-media requests for articles may be directed to GSA Sales and Service, gsaservice@geosociety.org.

www.geosociety.org

]]> http://genericpharmacydrug.org/?feed=rss2&p=10 http://genericpharmacydrug.org/?p=7 http://genericpharmacydrug.org/?p=7#comments Thu, 30 Jul 2009 04:00:00 +0000 admin health http://genericpharmacydrug.org/?p=7 July 30, 2009—A study published online ahead of press in the Gerontology Society of America’s Journal of Gerontology: Medical Sciences reports that the condition of frailty in older adults is associated with a critical mass of abnormal physiological systems, over and above the status of each individual system, and that the relationship is nonlinear. This research is the first evidence that frailty is related to the number of abnormal physiological systems, rather than a specific system abnormality, a chronic disease, or chronological age. It suggests significant alterations in system biology with aging, and underlying frailty. Clinical implications are that prevention and treatment may be more likely to be effective if any given intervention improves multiple systems, not just one.

According to the report, three or more systems at abnormal levels were significant predictors of being frail, and the dominating predictor was the number of systems abnormal, not any particular system. The study was based on data of women aged 70 – 79 years from the Women’s Health and Aging Studies I and II and assesses the association of eight physiological measures with frailty. Abnormality in each system (anemia, inflammation, insulin-like growth factor-1, dehydroepiandrosterone-sulfate, hemoglobin A1c, micronutrients, adiposity, and fine motor speed) was significantly associated with frailty status. However, adjusting for the level of each system measure, the mean number of impaired systems significantly predicted frailty; only one system, fine motor speed, remained an independent predictor when the mass of systems abnormal was considered.

The data indicate that half of those frail had three or more systems at abnormal levels, compared with 25% of the pre-frail and 16% of the non-frail. Less than 21% of the frail had zero or one system abnormal (of eight).

Frail older adults are a group at increased risk of serious adverse clinical outcomes, including mortality, disability, falls, and loss of independence. Through the work of Dr. Fried and her colleagues at Johns Hopkins University, frailty has been defined to function as a distinct medical syndrome, which is clinically recognizable when a critical mass of symptoms and signs emerge. Frailty is recognized as the concurrent presence of three or more of the following: low strength, low energy, slowed motor performance, low physical activity, or unintentional weight loss. The findings outlined in the current paper build on Dr. Fried’s body of work around frailty, and have significant applicability for the design of therapeutics, such as new drugs.

“We found that the likelihood of frailty increases in relationship to the number of abnormal physiological systems, and the number of abnormal systems was strongly predictive of the likelihood of frailty, whereas the individual systems were not,” says Linda P. Fried, MD, MPH, dean and DeLamar Professor of Public Health at the Columbia University Mailman School of Public Health and lead author. She adds, “It further suggests that therapeutic replacement of any one deficient system, such as testosterone, estrogen, or growth hormone, is unlikely to ameliorate or prevent frailty, unless it improves multiple physiologic systems. This may explainthe public health import of remaining physically active as we get older, since activity improves many aspects of biology and health.”

Given that many of the physiological systems evaluated affect or regulate each other, alteration of one may not be independent of another. These data suggest that acceleration of the likelihood of frailty may occur as the number of abnormal systems escalates, and suggests that there could be a threshold beyond which there is an adverse downward spiraling nature to the progression of frailty and its consequences. “The systems studied here have numerous physiological interconnections with each other,” says Dr. Fried, “which would be consistent with the concept of ‘majority rules’ in systems biology—that past a critical level of dysregulation in physiological systems, the impaired systems may adversely affect other systems functioning at a normal level and bring the whole system to a more dysregulated state, with frailty as an outcome of a dysregulated complex system.”

“This research provides evidence of the interaction of a number of factors that contribute to frailty in older people,” said Richard Suzman, PhD, director of the Division of Behavioral and Social Research at the National Institute on Aging, which funded the research. “It emphasizes the importance of considering frailty holistically.”

The number of chronic diseases was also a predictor of frailty, independent of the number of physiological systems at abnormal levels. This supports frailty as a final common pathway of multiple causes and that the burden of disease is a factor as well as aging-related physiological dysregulation.

The research was supported by the National Institute of Health’s National Institute on Aging (NIA), Older Americans Independence Center grant P30 AG021334, NIA grant R37 AG019905, and NIA MERIT award funding. To access the study online: J Gerontol A Biol Sci Med Sci. doi:10.1093/gerona/glp076.

About the Mailman School of Public Health

The only accredited school of public health in New York City and among the first in the nation, Columbia University Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting millions of people locally and globally. The Mailman School is the recipient of some of the largest government and private grants in Columbia University’s history. Its more than 1000 graduate students pursue master’s and doctoral degrees, and the School’s 300 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as infectious and chronic diseases, health promotion and disease prevention, environmental health, maternal and child health, health over the life course, health policy, and public health preparedness. www.mailman.columbia.edu

It’s the first big study to directly compare angioplasty procedures with drug therapy alone as a way to prevent heart attacks and deaths in non-emergency cases.

If the research reaches the conclusion many analysts and doctors expect — that angioplasty offers little or no lifesaving benefit over drugs for these patients — the finding would be the latest dose of bad news for makers of stents. The tiny mesh scaffolds are used in most angioplasties to keep vessels open after blockages have been cleared.

After new-model drug-coated stents reached the market in 2003, the global stent market including older bare-metal stents grew from about $2 billion a year to about $6 billion in 2005.

Drug-coated stents have been implanted in more than 6 million people worldwide — a modern record for fastest use of a new medical device.

But use has fallen since new evidence emerged that drug-coated stents carry a slightly higher risk of triggering blood clots months or years later. Many doctors have returned to using the older bare-metal stents or doing bypass surgery instead of angioplasty until more is known.

The drug-coated stent market shrank last year and is expected to erode at a faster rate this year, due in part to anticipation of the newest heart study.

A stent is typically inserted into a heart artery during angioplasty, a procedure in which a miniature balloon is guided through a vessel in the groin and then inflated to flatten a clog and restore blood flow to the heart.

The stent keeps the artery open, and drug-coated ones ooze medication to keep scar tissue from forming and the vessel from squeezing shut again.

Angioplasty, with a cost ranging from about $10,000 to $38,000, is the top treatment for people suffering heart attacks. But as many as 85 percent of angioplasties are non-emergency and done for people with less severe blockages that cause recurrent chest pain.

The big study to be reported on Tuesday compared angioplasty plus optimal heart medications — aspirin, beta blockers, ACE inhibitors and statins to lower cholesterol — with medications alone. Results are to be presented Tuesday at the American College of Cardiology’s annual meeting in New Orleans, Louisiana.

Dr. John Lopez, a cardiologist at the University of Chicago Hospitals, noted that the new study followed only patients whose heart conditions were stable, rather than those facing imminent risks. He believes that it’s primarily higher-risk patients who benefit more from the artery-opening procedure.

“I’d be very surprised if there was a reduction in mortality,” said Dr. William Maisel, a cardiologist at Beth Israel Deaconess Medical Center in Boston. “I suspect the bottom line we will be left with is that both options (angioplasty versus drugs only) are reasonable.”

That result would mirror findings in recent studies — including two within the past month — that examined smaller groups.

If patients can’t expect a better chance of long-term survival, angioplasty’s cost may loom larger when it’s elective, said Dr. David Cohen of St. Luke’s Mid America Heart Institute in Kansas City, Missouri.

Cohen said patients with stable heart problems, such as the ones in the latest study, “probably should not be receiving this therapy (angioplasty) on a first-line basis.”

Dr. Donald Baim, Boston Scientific’s chief medical officer, said doctors should look beyond survival rates and consider whether angioplasty with stents relieves chest pain.

“The decision should be driven by the desire to limit chest pain with the least invasive alternative that’s practical,” Baim said.

Drug-coated stents accounted for about 89 percent of all stents implanted early last year, according to a study by Millennium Research Group, a Toronto-based firm that surveys doctors.

But that proportion fell to just 70 percent in February after more doctors opted for bare-metal versions because of the blood-clot fears from the drug-coated models.

Prices for oral contraceptives, or birth control pills, are doubling and tripling at student health centers, the result of a complex change in the Medicaid rebate law that essentially ends an incentive for drug companies to provide deep discounts to colleges.

“It’s a tremendous problem for our students because not every student has a platinum card,” said Hugh Jessop, executive director of the health center at Indiana University.

There, he said, women are paying about $22 per month for prescriptions that cost $10 a few months ago. “Some of our students have two jobs, have children,” Jessop said. “To increase this by 100 percent or more overnight, which is what happened, is a huge shock to them and to their system.”

At some schools women could see prices rise several hundred dollars per year.

About 39 percent of undergraduate women use oral contraceptives, according to an estimate by the American College Health Association based on survey data.

Many students could shift to generics but experts said they might still pay twice the previous rate.

“It’s terrible, because these are students who are working very hard to pay for their tuition and books at a time when tuition costs are edging up as well,” said Linda Lekawski, director of the university health center at Texas A&M, where the old price for birth control pills of about $15 per month is expected to triple. “This is one thing they’ve been able to benefit from for years.”

The change is the result of a chain reaction started by a 2005 deficit-reduction bill that focused on Medicaid, the main federal health insurance program for the poor. College health officials say they had little idea the bill would affect them.

Before the change, pharmaceutical companies typically sold drugs at deep discounts to a range of health care providers, including colleges. With contraceptives, one motivation was attracting customers who would stay with their products for years.

Another reason the discounts made business sense was that they didn’t count against the drug makers in a formula calculating rebates they owed states to participate in Medicaid.

But in its 2005 bill — which went into effect in January — Congress changed that. Now the discounts to colleges mean drug manufacturers have to pay more to participate in Medicaid.

The result: Fewer companies are willing to offer discounts.

Many colleges kept prices low for a few months by buying in bulk before the new law took effect, but have now run through their stockpile and started increasing prices. Also, many students fill the prescriptions quarterly so are only now seeing the increase.

Some students said they doubted the price increases would dissuade many students from buying contraceptives, but said it would be noticed.

“I feel like if an individual’s going to seek it, they’re going to seek it and try to find the resources for it,” said Betsy Henke, student body president at Indiana University. But, she added: “Anything that is an increase in what a student is paying is going to have some type of impact.”

The price hikes will “definitely have an effect on students,” said Lindsay Hicks, a Sexual Health Awareness Peer Educator at Kansas State University, where she said prices were rising from about $10 to about $30 per month.

The ACHA contends the federal Centers for Medicare and Medicaid Services should have added college health centers to the exemptions lists and has supported a proposed rule change that would do so. A spokesman for the agency said it is reviewing that proposal.

The “RFID Issues in Health Care” luncheon panel is Tuesday 27 March from 11:45 a.m. to 1:30 p.m. at the Gaylord Texan Resort and Convention Center in Grapevine, Texas.

Dr. Daniel Engels, program chair, IEEE RFID 2007, and assistant professor and director of the Radio Frequency Innovation & Technology Center at the University of Texas at Arlington, will moderate. Dr. Engels is the former director and founder of the MIT Healthcare Research Initiative in Cambridge, Mass., a program designed to employ RFID technology to improve patient safety.

“RFID technology is already employed by many healthcare practitioners in a variety of applications,” Dr. Engels said. “The discussion about how to incorporate RFID technology in healthcare delivery systems is gaining in volume, as is the debate about how to provide adequate, affordable healthcare. We hope our experts can shine some light on the significant opportunities for RFID technology in the healthcare industry.“

Panelists include Dr. John K. Stevens, chairman of Visible Assets, Inc., and chair of the IEEE RuBee Standards Working Group; Michael Meistrell, president of Healthcare Informatics & Management Consultancy; and Peter Spellman, co-founder and senior vice president of products and services for SupplyScape Corp.

About IEEE RFID 2007:

Sponsored by IEEE-USA, the IEEE New Technology Directions Committee and IEEE Region 5, IEEE RFID 2007 is co-located with RFID WORLD 2007, the largest trade show and exhibition for the worldwide RFID industry, 26-28 March 2007 at the Gaylord Texan Resort in Grapevine, Texas. With more than 370,000 members in over 160 countries, the IEEE (Institute of Electrical and Electronics Engineers) is the world’s leading professional association for the advancement of technology. IEEE-USA advances the public good and promotes the careers and public policy interests of more than 220,000 engineers, scientists and allied professionals who are U.S. members of the IEEE. For more information and to register, see www.ieee-rfid.org.

The team, led by Page Caufield, a professor of cariology and comprehensive care at NYUCD, discovered that Streptoccocus mutans, a bacterium associated with dental caries, has evolved along with its human hosts in a clear line that can be traced back to a single common ancestor who lived in Africa between 100,000 and 200,000 years ago.

S. mutans is transmitted from mothers to infants, and first appears in an infant’s mouth at about two years of age. Caufield’s findings are reported in an article in the February issue of the Journal of Bacteriology.

In his analysis of the bacterium, Caufield used DNA fingerprints and other biomarkers that scientists have also employed to trace human evolution back to a single common African ancestor, known as “ancestral Eve.”

“As humans migrated around the world and evolved into the different races and ethnicities we know today,” Caufield said, “this oral bacterium evolved with them in a simultaneous process called coevolution.”

“It is relatively easy to trace the evolution of S. mutans, since it reproduces through simple cell division,” says Caufield, who gathered over 600 samples of the bacterium on six continents over the past two decades. His final analysis focused on over 60 strains of S. mutans collected from Chinese and Japanese; Africans; African-Americans and Hispanics in the United States; Caucasians in the United States, Sweden, and Australia; and Amazon Indians in Brazil and Guyana.

“By tracing the DNA lineages of these strains,” Caufield said, “We have constructed an evolutionary family tree with its roots in Africa and its main branch extending to Asia. A second branch, extending from Asia back to Europe, traces the migration of a small group of Asians who founded at least one group of modern-day Caucasians.”

Additional branches, tracing the coevolution of humans and bacteria from Asia into North and South America, will be drawn in the next phase of Caufield’s analysis.

Caufield’s coauthors were Deepak Saxena, adjunct associate professor of basic science and craniofacial biology; Yihong Li, associate professor of basic science and craniofacial biology, both at NYU College of Dentistry; and David Fitch, an associate professor in NYU’s Department of Biology.

Editor’s Note:

Founded in 1865, New York University College of Dentistry (NYUCD) is the third oldest and the largest dental school in the United States, educating more than 8 percent of all dentists. NYUCD has a significant global reach and provides a level of national and international diversity among its students that is unmatched by any other dental school.

The reading of erotic literature
was already a social activity 300 years ago.

Jenny Skipp’s three-year PhD study examined, catalogued and categorised every known erotic text published in eighteenth-century Britain: “I tried to get a grip on just how many were published, detail the various types of sexual behaviour portrayed and find out who was doing what – and to whom.” It proved a surprisingly rich field: “Most people have heard of Fanny Hill, but there was a huge amount of erotic literature published in the 18th century.”

And despite earlier work suggesting that these texts were only for solitary consumption – at home, alone, and behind closed doors – Skipp’s work throws up a surprising image of how these works were used. “They would be read in public – everywhere from London’s rough-and-ready alehouses to the city’s thriving coffee houses, which weren’t quite the focus of polite society in the way we sometimes think,” she explained. “Some texts even came as questions and answers and were clearly intended for groups of men to read together, with one asking the questions and the others answering them.”

Much of the work is derogatory in its references to women. They are subordinates, courtesans, prostitutes, carriers of venereal disease and bearers of deformed children. “When men write this way, or read these texts, it gives them a context for asserting their authority over women,” Skipp added. Yet some texts portray women altogether differently, discussing the nature of female sexuality or describing lascivious aristocratic females.

One group predominant in this literature is the Libertines – whose all-in hedonistic, smoking, drinking, swearing, pleasure-seeking lifestyle was typified by their subjugation of women. Literature aimed at this group, encouraging men to assert their dominance, translated the repressive attitudes of Libertinism further down the class structure.

And Skipp’s analysis of the pricing of these works revises earlier studies to show that rather than being solely targeted at the gentry, much of this work was cheap and widely available. Though many from the poorer sections of society are considered illiterate because they were unable to sign their name, they may still have been able to read: “Many more people could read than write,” she said. “In London, for example, we believe about 70 per cent of men could read.”

The works range from books, down to single-sheet pamphlets. “The price and content of this material suggests it was available to merchants, traders, skilled and semi-skilled men and even labourers,” Skipp went on. Its accessibility allowed sexual attitudes to percolate down the social strata.

Dr Simon Burrows of the University’s school of history, one of Skipp’s PhD supervisors, described the study as “pioneering work.” He said: “Jenny has shown that erotic texts are about much more than sexual fantasy. They can give us genuine new insights into cultural attitudes, sexual norms and social customs.”

And Skipp describes a literary quality to the writing which you might struggle to find in modern erotic fiction or top-shelf pornography. “It is very different to today’s erotica,” she said. “It is more humorous, more literary and more engaged with the wider issues of the life and politics of the times.” Its metaphors mirror the passions of the age: “At a time when military power was equated with virility, armed conquest is often used as a metaphor for sex – in phrases such as ‘unsheathing the weapon’, ’storming the fort’ and ‘releasing the cannon’.”

By the 1770s, the transcripts of adultery trials became a new source of titillation. To secure a divorce, a man would first have to successfully sue a rival for ‘violating his property’, before petitioning Parliament to dissolve the marriage. “There is something rather voyeuristic about these trials,” said Skipp. “Often servants would give evidence while innkeepers would testify about lovers taking rooms together.”

“The appetite for this kind of material shows readers were interested in gossip about their social betters and fascinated by the sordid details of marital breakdown – just like modern-day readers scanning the tabloids for a juicy scandal.

“The production of erotica was frequently stimulated by intrigues in the lives of well-known public figures – the aristocracy, politicians, writers, playwrights and actresses and occasionally the monarchy. The wives and mistresses were both celebrated and derided in erotic texts – they were the WAGS of their day.”

As Skipp said: “Eighteenth century readers were just as fascinated with public figures as we are today – especially when they had skeletons in their closet!”

Notes to editors

Jenny Skipp is available for interview about the work. For further information contact Simon Jenkins, press office, University of Leeds on 0113 3435764 (w), 07791 333229 (m), s.jenkins@leeds.ac.uk

Pictures of her are also available for publication. High resolution images are available on request.

Nearly 11 million cosmetic plastic surgery operations were performed in the United States in 2006, up by 7 percent from 2005, the group said.

It also said more than 5.2 million reconstructive plastic surgery procedures were performed last year, mostly removal of tumors.

The most popular cosmetic choice was breast augmentation, with 329,000 reported in 2006. This is the first time “breast jobs” have passed nose reshaping surgery, performed on 307,000 people in 2006.

Liposuction followed in a close third place, with 302,000 procedures.

The group reported an 8 percent rise in minimally invasive cosmetic procedures such as injections to fill out wrinkles, with more than 9 million such operations. Botox treatments were by far the most common, with more than 4 million treatments in 2006.