“The real key is new learning,” Silver said. “Every time you learn new things you strengthen connections between brain cells and create new connections. Later, if you lose brain cells they don’t affect your functioning.” She compares this phenomenon with a city that has only one road that goes into it. If something happens to that road it is a major disaster but if there are 10 roads into the city it can continue to function.

Think with your brain, not your hormones– The same hormone that puts hair on your chest can cause you to put your own life at risk. Between the ages of 15 and 24, when testosterone levels are at their highest, reckless behavior and violence in men also reach peak levels, according to Fretts.
“Men die at higher rates than women at every age category, but they are three times more likely to die at this time,” Fretts said. “The number one cause of death for men between the ages of 14 and 24 is motor vehicle accidents, followed by homicide and suicide.”

This correlation between adolescents and risk-taking behavior has been recorded in the study of non-human primates as well, as many disappear from their pact at this time.

Go to the doctor — I know, I know; if it’s not broke, don’t fix it. But when it comes to your life, preventative measures are worth the trouble.

The National Institute on Aging recommends that you get regular checkups. You can catch problems early and treat them before they become life threatening.

“You can’t assume that if nothing is wrong you don’t have to go to the doctor or if something is wrong that it’s just because you’re getting old. Many problems that are attributed to just being old can be treated,” said Marcia G. Ory, Ph.D., M.P.H., chief of behavioral medicine and public health at the National Institute on Aging.

There’s no magic pill or gene that will carry you into the second century of your life. You have to take action; your future is up to you.

The health of divorced men also suffers. By the time divorced men reach age 50, they can expect their health to deteriorate much faster than those who are married. But there’s hope for these divorcees. Remarriage has direct health benefits for men in this age group, bringing their health up to the level of men who have stayed married, the study found.

Floss your fangs — Not only will you get rid of that hunk of basil in your teeth, you’ll protect your heart. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease, according to the American Academy of Periodontology. Studies indicate that gum disease may foster the development of clogged arteries and blood clots when oral bacteria get into the blood stream. It has also been known to exacerbate existing heart conditions.
Symptoms of gum disease are bleeding gums during brushing; red, swollen or tender gums; gums that have pulled away from the teeth; persistent bad breath; pus between the teeth and gums; loose or separating teeth; and a change in the way your teeth fit together when you bite.

Give blood — While helping save someone else’s life you may be saving your own.
For men, helping to shore up local blood banks can also be a good way to get rid of excess iron, which may be linked to heart disease. “People think that iron is good, but actually iron is an oxidant. Too much is bad,” said Dr. Ruth Fretts, assistant professor at Harvard University and coauthor of “Why Women Live Longer Than Men.”

Studies conducted at the University of Kuopio in Finland, the University of Minnesota Medical School and the University of Kansas Medical Center show that regular blood donations can reduce the risk of heart disease in men.

Researchers attribute this to lowering the level of stored iron in the body. Because iron ions are essential for the formation of oxygen radicals, a lower iron load could lead to a lower rate of aging, cardiovascular disease and other age-related diseases in which oxygen radicals play a role, according to Dr. Thomas T. Perls, director of the New England Centenarian Study. This could explain why pre-menopausal women have lower instances of arteriosclerosis (hardening of the arteries) and suffer about one-half the heart attacks and deaths from heart disease that men do at the same age.

In the future we will see a record number of centenarians, and with the right moves, men can be better represented among them. Of course a healthful diet and exercise will help men stay healthy and live longer, but here are a few suggestions that might be more appealing than fiber and sweat.

Look on the bright side — Optimists outlive their pessimistic counterparts, according to a study from the Mayo clinic. The happiest of the 839 people who participated in the study showed a 19 percent lower risk of death than the unhappy participants. The pessimists’ survival rates fell far below expectations for their age.
Not only does having a positive outlook contribute to a longer life, it can keep you functional and independent in old age. In a report published in the Journal of American Geriatrics Society, investigators from the University of Texas Medical Branch in Galveston said that those with positive attitudes were half as likely to have trouble in daily activities two years later.

“Previous research has shown that happiness and optimism actually increase the number and strength of immune cells in the body. This leads to an improved ability to prevent and fight disease,” said Dr. Bruce Hensel, chief medical correspondent for drkoop.com.

Don’t sweat the small stuff — In The New England Centenarian Study, a common thread among the 46 centenarians is their natural ability to handle stress. “They let things roll off their backs. The rest of us can learn how to do this, too,” said Margery H. Silver, Ed.D., a neuropsychologist and associate director of the study.
There are several ways to deal with stress, such as exercise, meditation or taking time out to do something you enjoy each day.

Have more sex — That’s right. A decade-long study published in the British Medical Journal reports that men who had sex less than once a month had double the death rate of those who had sex at least two times per week.
Can’t get a date? Don’t worry; it’s the number of orgasms that is counted here, not the notches on your bedpost. According to the paper by Davey Smith, a professor at the University of Bristol in England, death from coronary heart disease showed association with frequency of orgasm.

An earlier study of aging conducted at Duke University also found that sexual activity appears to lower the risk of death in men. That’s good news for everyone, but make sure that all this sex is safe sex. Believe it or not, even a 70-year-old can contract a sexually transmitted disease.

Get out more — Doctors at Harvard University School of Public Health found that social activities increased the quality and length of life, according to a report published in the British Medical Journal. An increasing number of reports agree that social relationships are beneficial to your health. “We are programmed to be social animals,” Silver said.
Dr. Earl S. Ford and colleagues reviewed data from the National Health and Nutrition Examination Study to find out what it is about hanging out with friends that increases longevity. In a report published in Preventative Medicine, he said the more socially active people were, the less likely they were to smoke cigarettes and the more likely they were to eat right, get regular exercise and go to the doctor for checkups.

Ford also suggests that social contacts may provide individuals with support, reminders and chances to talk about health behaviors and a set of standards for that behavior.

Tie the knot — Trading in your bachelor pad could add years to your existence. Married men in their 50s, 60s and 70s have lower mortality rates than their unmarried counterparts, according to a 22-year study conducted by RAND Center for Aging. They contribute this to care in times of illness, improved nutrition and a home atmosphere that reduces stress, encourages healthy behaviors and discourages unhealthy ones such as smoking and excessive drinking.

Microbes can pass resistance to their descendents, to other members of their culture, or even to other species of bacteria. There are three ways bacteria spread the ability to resist an antibiotic:

Spontaneous mutation — In which resistance appears spontaneously within the DNA of an individual bacterium. What we would call a mutation.
Transformation — Where bacteria share genetic material during a form of microbial sex.
Acquired resistance — Microbes carry small circles of DNA called plasmids within their cytoplasm. These plasmids can be passed from one bacterium to another, and even from one kind of bacteria to another.
Cleaning Up the Problem
Resistance is not a mystery, according to Mitscher. It is bacteria’s normal response to the introduction of antibiotics into their environment.

“We’re not going to rid the earth of bacteria,” Mitscher said. “What people should do is be more conservative. In the days before antibiotics people were more cautious about avoiding infection. They didn’t associate with people who were ill; they were more careful about being clean; it was illegal to spit in a public place. Tuberculosis can easily be spread by dried spit.”

Mitscher cautions against becoming obsessive, but he does recommend commonsense cleanliness, the kind your mother preached.

“Wash your hands. Men are particularly poor at washing up after using the facilities. People should wash their hands for 30 seconds after using the bathroom. Be careful around ill people and don’t drink from the same glass. Watch out for things like kitchen sponges and cutting boards which are great sources of infection,” he said.

New-Age Weaponry
While cleanliness can help control the spread of infection and using existing antibiotics appropriately can slow down the growth of resistant strains, we need new antibiotics to fight bacteria that have already developed resistance. During the 1980s, pharmaceutical companies scaled back their research and development of new antibiotics. Recently, though, these same companies have been playing catch-up, trying to get out in front of the wave of resistance.

Stuart Levy, M.D., has been researching antibiotics for 30 years. He is the co-founder and chief scientific officer of Paratek Pharmaceuticals.

“I see a return of the large pharmaceutical companies to the antibiotic field,” Levy said. “There are more discoveries going on, and innovative work to find new chemical agents to fight resistance.”

While the pharmaceuticals race to find new cures, Fryhofer would have us remember that healthy patients and their doctors hold a part of the key to winning this battle.

“The more an antibiotic is used, the quicker it becomes ineffective. We depend on patients to quit asking for an antibiotic. The alternative is that when you get a severe infection there may be no antibiotic that is effective to help you,” Fryhofer said.

The Battle for Supremacy
“The problem of overprescribing antibiotics is of our own making,” said Sandra Adamson Fryhofer, M.D., president of the American College of Physicians — American Society of Internal Medicine (ACP-AISM), and an internist in private practice in Atlanta, Ga. “Recent studies have shown that the increasing rate of drug-resistant infections correlates directly with the overuse of antibiotics. Resistance is becoming a public nightmare.”

According to the Centers for Disease Control and Prevention in Atlanta, as many as one-third of all prescriptions written in doctors’ offices and outpatient clinics each year are unnecessary, meaning they are prescribed to treat viral infections or to assuage patient demands for a pill to cure what ails them. If the ACP-AISM has its way, this practice will stop.

“We don’t have private bugs,” Fryhofer said. “They can affect anybody. What you do affects the person next to you. Antibiotics kill bacteria, but colds are caused by viruses. If you have a cold, you need decongestants, fluid, analgesics and rest. What we really need is a rest pill.”

The ACP-AISM is targeting its 115,000 member physicians with an antibiotics resistance campaign. Through its Web site, journals, and regional and national meetings, the college is relentlessly pursuing the serious threat of emerging antibiotic resistance.

When the ACP meets at its annual session in March 2001 in Atlanta, no fewer than 21 courses will be devoted to the subject. In addition, the college has provided its members with clinical practice guidelines for using antibiotics to treat sinusitis, bronchitis pharyngitis and respiratory tract infections. The guidelines were mailed out to members as an addendum to the ACP’s journal, The Annals of Internal Medicine.

Spreading Resistance
“Antibiotics are among the safest drugs we have, and we’ve become conditioned to expect the doctor to write a prescription and cure us,” explained Lester Mitscher, Ph.D., professor of medicinal chemistry at the University of Kansas in Lawrence, Kan. “People make the problem worse by not taking their medications properly, missing doses or not completing the prescribed dose of medication. It’s common for people to get 10 days worth of antibiotics, and when symptoms subside after seven days, they stop taking the drugs. But if bacteria are still there they can multiply.”

Bacteria multiply in fantastic numbers, according to Mitscher, and their ability to reproduce is what gives them the advantage in this contest between drug and microbe.

“Bacteria split roughly every half hour,” Mitscher said. “Even if a great number of bacteria die from the effects of the antibiotic, if there are a few survivors and not enough antibiotic to kill them, the survivors change the nature of the colony. Once cultures get established in the community, people pass them to each other.”

Carol

A.Before a colonoscopy can be done, a patient’s lower bowels must be prepared to enable doctors to get a clear view of the complete colon. Generally, the preparation for colonoscopy begins the day before the exam. On that day, it is recommended that patients limit their intake to clear liquids. The exact starting time for this restriction may vary depending on your gastroenterologist — some restrict patients to clear liquids the entire day, while others recommend clear liquids only later in the afternoon.

A.On the afternoon before the colonoscopy, the patient also begins drinking a large quantity (about one gallon) of a special purging solution (Golytely, Nulytely) designed to clean out the intestinal tract. Many patients find that it is hard to drink the entire gallon, but every effort should be made to finish it. Generally, the best way to approach this is to drink a cup of the solution every 10-15 minutes. Bowel movements will soon start and should become clear by the morning of the exam. The morning of the colonoscopy, before arriving at the hospital for the procedure, the patient will usually use two enemas (Fleet, for example) to clean out residual stool debris.

Although the preparation for colonoscopy is certainly not the most pleasant of experiences, it also should not be a terrible ordeal. The newer types of purging solutions are flavored (cherry, for example), which may make them more palatable. In some cases, gastroenterologists may substitute a drink called Fleet Phospho-Soda. Patients have to drink far less of this. However, the downside is that the preparation is generally not as good and some of the colon may not be seen adequately. In addition, Fleet Phospho-Soda is dangerous to use in certain patients (including those with heart or kidney failure) because it can upset the balance of fluids and electrolytes in the body.

A.Before your colonoscopy, you should discuss your concerns about the prep with your gastroenterologist so that you can be reassured and have all your questions answered.

Generic Finasteride is taken for treating specific kinds of male pattern hair loss, baldness and androgenic alopecia. Propecia without prescription acts by reducing the amount of the hormone dihydrotestosterone or DHT in the body.

Read the box. The package should say if the condom prevents sexually transmitted diseases. Currently the U.S. Food and Drug Administration recommends latex condoms for this purpose. Latex condoms should state on the package: This product contains natural rubber latex. The FDA also has approved several polyurethane condoms for people who are allergic to latex. Condoms that do not cover the entire penis should not be used to prevent disease or pregnancy.

Condoms have an expiration date printed on the package (“EXP” followed by the date). Some packages also show when the condom was manufactured. Date of manufacture is not an expiration date.

Store condoms in a cool, dry place out of direct sunlight. Your pocket is not a good place to carry a condom. Neither is your glove compartment. Extreme heat and cold can make latex brittle and gummy. The best place to keep a condom is in a room-temperature cabinet or drawer inside your house. Carry your condoms in a loose pocket, wallet or purse for short periods of time only.
Open condom packages gently. Do not use your teeth, scissors or fingernails. Do not open the package in the dark. Make sure you can see what you’re doing.

Manufacturers test their condoms by blowing them up like balloons or filling them with water. But don’t try this at home. Stretching a latex condom weakens it.

Inspect the tip of the condom before unrolling it to check for tears or holes.
If the condom is sticky or gummy, it’s no good. Discard it and use another.

Using a lubricant can help prevent the condom from tearing during sex. However, never use an oil-based lubricant with a latex condom. Substances such as cold cream, butter and vegetable oils may damage latex. To be safe, use only water-based lubricants.
Put on a condom while your penis is erect, but before having sex.

Hold the condom by the tip and unroll it so it covers the entire erect penis.
The condom should have some extra material at the tip to hold the semen after ejaculation. If your condom does not have this reservoir, squeeze the tip of the condom to remove air and create a reservoir.

If your penis is uncircumcised, pull the foreskin back before putting on the condom.
The condom should unroll smoothly, with the rim on the outside. If the rim is on the inside and you struggle to get it to unroll, it’s upside down.
If you feel a condom break while having intercourse, stop and withdraw immediately.

Condoms are more likely to break during anal sex than during vaginal sex. For this reason the FDA and the United States Surgeon General’s office do not recommend condoms for disease prevention during anal sex.

After you ejaculate, hold the condom close to the base of the penis and carefully withdraw. Immediately discard the used condom.
Never use a condom more than once. Discard a used condom immediately after use.

A.Osteomyelitis of the spine is usually treated with medication, but surgery is performed if the spine is unstable or if there are abscesses that require drainage. Otherwise, a long course of antibiotic, given intravenously, is usually sufficient for cure. Spinal tuberculosis is treated with the same regimen used for typical pulmonary (lung) TB — six months or more of oral antibiotics.

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Will

A.The spine is made up of bones called vertebrae, and disks that separate them. Much more blood supplies the disks than the bones themselves. Many diseases affect the spine. Most of these are arthritis conditions such as osteoarthritis, rheumatoid arthritis and ankylosing spondylitis, to name a few. Tumors and infections can also involve the vertebrae and the disks. When tumors involve the spine, they generally arise in other organs, such as the breast or the prostate. Malignancies such as these tend to involve the vertebral bones before spreading to the disks. Infections, on the other hand, usually involve the disks first and then the bones. For this reason, infection of the vertebral bones (vertebral osteomyelitis) usually involves a disk, often in the lumbar (lower) spine, and the vertebrae above and below it

A.Bacteria are the most common causes of vertebral osteomyelitis. Fungi can also cause osteomyelitis, but I will not discuss it here, because it is quite uncommon. Staphylococcus aureus, or “staph,” is the most common cause of vertebral osteomyelitis in normal hosts. This infection tends to worsen gradually, over weeks to months, with back pain and tenderness. Fever and other whole-body signs of infection are often absent.

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What to Look for:

Coughing up or vomiting blood
Rectal or vaginal bleeding, or abnormally heavy menstrual bleeding
Blood in the urine or blood in the stool

Bruises, swelling, hardness or tenderness in the abdomen or other areas
Skull, chest or abdominal wounds
Weak, rapid pulse
Shortness of breath or shallow breathing
Dilated pupils
Cool, clammy, pale or bluish skin
Intense thirst
Dizziness, confusion or loss of consciousness
What to Do:
Caution: If you suspect a head, neck or back injury, do not move the victim; it could cause further injury.

Call 911 immediately

Check the victim’s ABCs: Lift the victim’s chin to open the airway, check his or her breathing capability and check for circulation (a pulse). Keep the victim calm and still

Do not give the victim anything to eat or drink
If the victim’s arm or leg is swollen or misshapen due to bleeding in the muscles, immobilize it
Watch for signs of shock while you wait for medical help