Sunday, May 3, 2009

Good Friends Are Good for You

Good Friends Are Good for You
They might get on your nerves at times, but good friends have bigger benefits than you may realize.
By Tom Valeo

WebMD FeatureReviewed by Brunilda Nazario, MD"You got to have friends to make that day last long," sings Bette Midler. But good friends may help your life last longer, too, according to an Australian study. Conducted by the Centre for Ageing Studies at Flinders University, the study followed nearly 1,500 older people for 10 years. It found that those who had a large network of friends outlived those with the fewest friends by 22%.

Why is this so? The authors suspect that good friends discourage unhealthy behaviors such as smoking and heavy drinking. And the companionship provided by friends may ward off depression, boost self-esteem, and provide support. Also, as people age, they may become more selective in their choice of friends, so they spend more time with people they like.

Close relationships with children and relatives, in contrast, had almost no effect on longevity. Lynne C. Giles, one of the four researchers who conducted the study, emphasized that family ties are important; they just seem to have little effect on survival.

The Health Benefits of Good Friends
Lots of research has shown the health benefits of social support.

One such study, reported in the journal Cancer, followed 61 women with advanced ovarian cancer. Those with ample social support had much lower levels of a protein linked to more aggressive types of cancer. Lower levels of the protein, known as interleukin 6, or IL-6, also boosted the effectiveness of chemotherapy. Women with weak social support had levels of IL-6 that were 70% higher in general, and two-and-a-half times higher in the area around the tumor.

In 1989, David Spiegel, MD, a professor of psychiatry at Stanford University, published a landmark paper in Lancet. Itshowed that women with breast cancer who participated in a support group lived twice as long as those who didn't. They also had much less pain.

Sheldon Cohen, PhD, a psychology professor at Carnegie Mellon University, in Pittsburgh, has shown that strong social support helps people cope with stress.

"Friends help you face adverse events," Cohen tells WebMD. "They provide material aid, emotional support, and information that helps you deal with the stressors. There may be broader effects as well. Friends encourage you to take better care of yourself. And people with wider social networks are higher in self-esteem, and they feel they have more control over their lives."

Other studies have shown that people with fewer friends tend to die sooner after having a heart attack than people with a strong social network. Having lots of friends may even reduce your chances of catching a cold. That's true even though you're probably exposed to more viruses if you spend a lot of time with others.

"People with social support have fewer cardiovascular problems and immune problems, and lower levels of cortisol -- a stress hormone," says Tasha R. Howe, PhD, associate professor of psychology at Humboldt State University. "Why? The evolutionary argument maintains that humans are social animals, and we have evolved to be in groups. We have always needed others for our survival. It's in our genes. Therefore, people with social connections feel more relaxed and at peace, which is related to better health."
Friends Can Be Stressful
Friends can be a source of stress, though. In fact, friends can cause more stress than others precisely because we care so much about them.

Julianne Holt-Lunstad, PhD, an assistant professor of psychology at Brigham Young University, has found that dealing with people who arouse conflicted feelings in us can raise blood pressure more than dealing with people we don't like.

"My colleagues and I were interested in relationships that contain a mix of positivity and negativity," she says. "For example, you might love your mother very much, but still find her overbearing or critical at times."

By attaching people to portable blood pressure monitors, Holt-Lunstad and her colleagues found that blood pressure was highest when people were interacting with someone they felt ambivalent about.

What she found really surprising was that these interactions caused higher blood pressure than those with people the research subjects felt completely negative about. "We suspect that people we feel positive toward can hurt us that much more when they make a snide comment or don't come through for us because they are important to us. Friends may help us cope with stress, but they also may create stress."

So would we be better off having no friends at all?

Hardly. "One thing research shows is that as one's social network gets smaller, one's risk for mortality increases," Holt-Lunstad says. "And it's a strong correlation -- almost as strong as the correlation between smoking and mortality."

The Impact of Loneliness
What about loners? Are they at greater risk of dying because they prefer to be alone?

Only if they feel lonely. One study found that drug use among young people was higher among those who said they were lonely. Older lonely people tended to have higher blood pressure and poorer sleep quality. They also were more tense and anxious.

Another study found that college freshmen who had small social networks and claimed to be lonely had weaker immune responses to flu vaccinations. They also had higher levels of stress hormones in their blood.

Unfortunately, Americans have fewer friends than they used to, according to a recent study, "Social Isolation in America," published in the American Sociological Review. The authors found that from 1985 to 2004, the number of Americans who feel they have someone with whom they can discuss important matters dropped by nearly one-third. The number of people who said they had no one they could discuss such matters with tripled to nearly 25%. The authors suspect that long work hours and the popularity of the Internet may contribute to the decline in close relationships.

The study also found that the percentage of people who talk about important matters only to family members increased from 57% to 80%. Those who depend solely on their spouse for these talks increased from 5% to 9%.
How Women's Friendships Are Different From Men's
In general, women are better at maintaining friendships than men. Women "tend and befriend," says Shelley E. Taylor, PhD, a psychology professor at UCLA. They respond to stress by protecting and nurturing others ("tending"), and by seeking support from others ("befriending"). This pattern regulates the seeking, giving, and receipt of social support, Taylor says. It produces health benefits by reducing psychological and biological stress.

And Margaret Gibbs, PhD, a professor of psychology at Fairleigh Dickinson University, found that men and women relate to others differently throughout life.

"We found that women seemed more geared to empathy, while male friendships are more geared to companionship and altruism," she tells WebMD. "Male friendships are more about helping each other -- mending the lawn mower, that sort of thing. Women's friendships tend to have a more emotional content -- listening to friends' stories and coming up with helpful solutions."

Monday, April 27, 2009

Mexico Swine Flu Epidemic Worries World

Mexico Swine Flu Epidemic Worries World
Swine Flu Deaths in Healthy Young People Raise Fears of Pandemic
By Daniel J. DeNoon

WebMD Health NewsReviewed by Louise Chang, MDApril 24, 2009 -- Mexico's deadly swine flu outbreak is caused by the same virus identified in the U.S., says CDC Acting Director Richard Besser, MD.

The CDC is analyzing 14 virus samples sent from Mexico. Seven of them, the CDC learned today, are very similar to the unusual swine flu strain isolated from U.S. patients.



Swine Flu Outbreak:
Get the Facts
Get the latest swine flu information from the WebMD and the CDC, plus other facts you need to know.

Swine Flu FAQ
CDC Swine Flu updates
Swine Flu Case Count Rising
Swine Flu Sickens 2 California Kids

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"People are concerned about this situation," Besser said at a news conference. "We are worried as well. Our concern has grown since yesterday."

Sixty people in Mexico have died of the flu -- and so far, 16 of the deaths are confirmed cases of swine flu, news sources quote Mexican officials as saying.

World Health Organization spokesman Gregory Hartl told the Canadian news agency CBC that there have been some 800 cases in Mexico City, where schools are closed due to the outbreak.

Alarmingly, the flu outbreak in Mexico is striking healthy young people -- a pattern that would be expected if a flu virus new to humans emerged.

"Because these cases are not happening in the very old or the very young, which happens with seasonal influenza, this is an unusual event and a cause for heightened concern," Hartl said in a CBC interview.

That's not the only eyebrow-raising feature of the swine flu outbreaks. Infections have occurred in Mexico, California, and Texas -- where warm weather should mean the end of the normal flu season, says William Schaffner, MD, president-elect of the National Foundation for Infectious Diseases and chair of preventive medicine and infectious diseases at Vanderbilt University.

"Will we see this flu virus transmitted in the warm months? That would give us heartburn," Schaffner tells WebMD. "And is this a harbinger of things to come during our next flu season?"

Another disconcerting feature of the outbreak is that it's probably too late to contain it to limited geographical areas.

"We are seeing cases in Texas and California with no connection between them. This makes us think there has been transmission from person to person through many cycles," Besser said. "For containment we need limitation to a confined geographical area, and we have not seen that here."

The World Health Organization is convening an expert panel to determine whether to raise its pandemic flu alert level. Because of bird flu, we're at level 3. If the panel finds evidence of "increased human-to-human transmission" it goes to level 4. If there's evidence of "significant human-to-human transmission," it goes to level 5.

A pandemic will be declared only if there is "efficient and sustained human-to-human transmission" of a new flu virus. That clearly has not happened yet.

"Whether or not this [swine flu] strain causes a widespread pandemic will depend on its transmissibility among humans. That has not yet been fully elucidated, but should be shortly," Pascal James Imperato, MD, MPH, professor and dean of public health at SUNY Downstate Medical Center, Brooklyn, N.Y., tells WebMD.

Should there be a pandemic -- something that is far from certain -- the CDC has already begun work on a vaccine. Would it be ready by next flu season?

"It would be an Olympic sprint -- a mammoth feat -- to produce a flu vaccine by October," Schaffner says.
What You Should Do Now
Infectious disease experts agree with the CDC that now is a good time to think about what you'd do if there were a widespread flu outbreak.

Here's what you can do right now: Wash your hands often and well.

The CDC has not yet warned travelers to avoid the San Diego or San Antonio areas, and it is not restricting travel to or from Mexico. However, travelers to or from those areas should be sure to use all normal precautions to avoid catching or spreading a cold or flu.

People who live in or visit those areas and who get flu-like symptoms should see a doctor to get tested for the swine flu virus.

Swine Flu FAQ

Swine Flu FAQ
WebMD Provides Answers to Your Questions About Swine Flu
By Daniel J. DeNoon

WebMD Health NewsReviewed by Louise Chang, MD The swine flu virus in the U.S. is the same one causing a deadly epidemic in Mexico. What is swine flu? What can we do about it? WebMD answers your questions.

What Is Swine Flu?
Like humans, pigs get the flu. Four different type A swine flu strains commonly circulate among pigs. Most recent swine flu viruses have belonged to the H1N1 and H3N2 subtypes. Pigs typically get sick but usually don't die from swine flu.

The new swine flu virus infecting humans is very unusual. It's somehow acquired genes from swine, bird, and human flu bugs. And it's also got genes from Eurasian swine flu viruses that aren't supposed to be in North America.

Do Humans Get Swine Flu?
Normally, swine flu bugs don't infect people. Historically, there's a case every year or two in the U.S. among people who have contact with live pigs.

But from December 2005 to January 2009 there was an uptick in swine flu cases. There were 12 human swine flu infections during this time. Eleven of these people had direct or indirect contact with pigs; in the twelfth case it was not known whether there was pig contact.

It's possible this uptick was due to improved reporting systems, but the CDC says "genetic changes in swine flu viruses and other factors might also be a factor."

The new swine flu virus is different. It's not yet clear that it's here to stay. But it is infecting humans, and that has world health officials keeping a close eye on it.

What Are the Symptoms of Swine Flu?
Swine flu symptoms are similar to regular flu symptoms and include cough, sore throat, fever, chills, headache, and fatigue. Some patients have also reported nausea and diarrhea. There is no easy way to distinguish swine flu from other types of flu or other germs. It takes a lab test to tell whether it's swine flu.

Can Swine Flu Spread From Person to Person?
The U.S. residents infected with swine flu virus had no direct contact with pigs. The CDC says it's likely that the infections represent widely separated cycles of human-to-human infections.

Have There Been Previous Swine Flu Outbreaks?
If swine flu sounds familiar to you, it's probably because you remember or have read about the 1976 swine flu outbreak at Fort Dix, N.J., among military recruits. It lasted about a month and then went away as mysteriously as it appeared. As many as 240 people were infected; one died.

The swine flu that spread at Fort Dix was the H1N1 strain. That's the same flu strain that caused the disastrous flu pandemic of 1918-1919, resulting in tens of millions of deaths.

Concern that a new H1N1 pandemic might return with winter led to a crash program to create a vaccine and vaccinate all Americans against swine flu. That vaccine program ran into all kinds of problems -- not the least of which was public perception that the vaccine caused excessive rates of dangerous reactions. After more than 40 million people were vaccinated, the effort was abandoned.
As it turned out, there was no swine flu epidemic

I Got a Flu Shot. Am I Protected Against Swine Flu?
No. There is currently no swine flu vaccine.

It's possible that the seasonal flu vaccine might provide partial protection against H3N2 swine flu bugs. But the strain that appeared in California is the H1N1 swine flu strain. It is very different from the H1N1 human flu strain included in the seasonal flu vaccine.

It's not known whether previous infection with human type A H1N1 flu might provide partial protection against the type A H1N1 swine flu in the current outbreak.

However, the CDC has made a "vaccine seed" from swine flu isolated from an infected person, and has begun the process of developing a vaccine should the need arise. Whether a vaccine could be produced in quantity by next flu season is a huge question.

How Serious Is the Public Health Threat of a Swine Flu Epidemic?
Any flu epidemic is worrisome, especially when a new strain of flu bug is involved.

"Influenza A viruses new to the human population that are able to efficiently transmit from person to person and cause illness may represent a pandemic threat," the CDC warns.

It's worrisome that, unlike seasonal flu, the swine flu outbreak in Mexico is attacking healthy young people. That's a hallmark of pandemic flu bugs.

But it takes more than a new virus spreading among humans to make a pandemic. The virus has to be able to spread efficiently from one person to another, and transmission has to be sustained over time. In addition, the virus has to spread geographically.

Is There a Treatment for Swine Flu?
Yes. While the swine flu bug is resistant to older flu medicines, it remains sensitive to Tamiflu and to Relenza.


Can You Get Swine Flu by Eating Pork?
No. You can only catch swine flu from being around an infected pig -- or, if it's the new swine flu virus, from an infected person.