Current Events in April 2007

Lipitor is among the most widely prescribed drugs to lower cholesterol, but Consumer Reportssays doctors should consider its price before writing a prescription.

The consumer group says generic statins are as effective as high-priced brands for most people who need a statin drug, and can help consumers save more than $1,000 a year.

"The three generics available to lower cholesterol and help prevent heart attacks can save consumers significant amounts of money, and that is critical for those patients who have trouble paying for their medicines," said Gail Shearer, director of Consumer ReportsBest Buy Drugs. "A person is much more likely to continue taking a needed medicine if they can afford it."

"Generic statins are becoming increasingly less expensive over time," Shearer said. "Every person with high cholesterol or who is at elevated risk of heart attack or stroke should discuss generic statins with their physician, and determine which drug is best for their condition."

The group cites news reports saying that Pfizer, the maker of Lipitor, has been sending letters to doctors to slow the tide of patients switching from that drug to one of the three generic statins. In particular, Lipitor is competing with two new generics -- pravastatin and simvastatin -- that came onto the market late last year. The generics are versions of Pravachol and Zocor, respectively.

Consumer Reports Best Buy Drugs selected lovastatin, pravastatin and simvastatin as "Best Buys" for most types of cholesterol reduction. Lovastatin and pravastatin are recommended if "bad" cholesterol, or LDL, needs to be reduced by less than 30 percent.

Simvastatin is recommended if LDL reduction of 30 percent or greater is needed and/or the patient has had a heart attack or diabetes; or if the patient has had a heart attack and their LDL level is not highly elevated.

Lipitor is a recommended "Best Buy" for a select group of patients -- those who have had a heart attack or have acute coronary syndrome with a highly elevated LDL level. Consumer Reports recommends using the drug for two years and then reconfirming the need or switching to simvastatin after consulting with a physician.

A February analysis of the statin market by CR Best Buy Drugs found that despite the introduction of new generics, the brand-names retained a significant share of all statin prescriptions -- 71 percent. Lipitor alone accounted for an average 43 percent of all statin prescriptions in the latter half of 2006.

As a nursing student and single mom of two boys, Stephanie Orr doesn't like to pay for TV. The balls of tinfoil clumped around her antenna don't bother her because she gets free reception of her local stations without the expense of cable or satellite.

But on February 17, 2009, tinfoil may become obsolete for receiving local channels as the United States' television system switches to digital-only.

This means all analog TV sets will need a digital converter box (receiver), or a subscription to cable, telephone-company video, or satellite programming.

Although over-the-air television will continue to be free, the changeover won't be free for many consumers.

Those who have analog televisions and don't subscribe to programming services have two options: Buy a digital TV (DTV) and keep using a roof or set-top antenna, or purchase a digital-to-analog converter box, which decodes all digital broadcasts to analog TVs. The U.S. government will defer some of the cost of the converter box with a coupon program starting January 2008.

"The industry hasn't set a price yet, but converter boxes may run between $50 to $70," said Todd Sedmak, communications director for the National Telecommunications and Information Administration's (NTIA).

Between January 1, 2008 and March 31, 2009, consumers can receive up to two $40 coupons toward two converter boxes. Sedmak says consumers can apply for coupons through an NTIA 800-number, website or fax number. Details will be announced later this year.

The U.S. government allocated $990 million for the program, and coupons are given on a first-come, first-served basis. If this amount runs out, Congress may add additional funding, but coupons will be given out one per household. Coupons will be mailed to consumer's homes, are redeemable at select retailers, and can only be applied toward this program.

The out-of-pocket expense for a digital-to-analog converter box may be between $10 and $30, still far less than the cost of a new digital TV. Orr was relieved to find her television is digital and can continue to receive over-the-air channels without an additional expense. She will still need her antenna but hopes to retire the tinfoil.

The Reason for the Change

The digital TV transition is part of a worldwide campaign that began four years ago to free up airwaves to assist emergency first-responders.

In the U.S., Congress enacted the Digital Television Transition and Public Safety Act of 2005. The conversion helps public safety responders, such as police and fire agencies, contact each other faster and more reliably. This is especially critical during widespread emergencies, such as the 9/11 and Hurricane Katrina tragedies, when telecommunication airways overloaded.

All televisions and communication devices, like cell phones and Blackberries work on digital or analog bandwidth airwaves. Analog's magnetic waves were the standard since television entered the marketplace in the 1920s, but analog takes up more airway spectrum than digital.

Once digital broadcasting takes over, higher, more powerful frequencies will be opened up and auctioned off to telecommunications companies and given away to emergency service agencies by the Federal Communications Commission (FCC).

Dave Ebarle, support services manager for San Francisco Department of Emergency Management says the higher frequencies are more powerful and can penetrate walls, which enable police and fire agencies to communicate with, for example, firefighters trapped inside a building. Highway Patrol officers will be able to receive stronger signals for the long distances they travel.

In critical situations, emergency responders need to connect with ambulance services, utility companies, schools, airport security and government offices. Different agencies use different equipment depending on their needs.

"Some of this equipment doesn't work well together," Ebarle said.

Moving from 488 to 800 megahertz will put first-responders on stronger airwaves and will make it possible for them to communicate more readily with each other. One way to look at it is that public agencies will get some of the technology that has made consumer-grade cell phones so powerful and flexible.

Pros and Cons

Unlike Orr's foil-covered antenna, Noelle Tong-Villanueva uses a stereo speaker wire for her TV reception. Most of her local channels come in a little grainy, but the slim wires are more discreet than rabbit ear antennas. Unsure if her 2003 TV is digital, she placed a four-minute phone call to the set manufacturer. The customer service rep informed her it was analog.

If your set is older than 2003, chances are it's analog. Check your user's manual for the type of tuner or receiving system. Analog models are NTSC (TV insiders say this stands for "Never The Same Color"), and Digital/analog models are ATSC. HDTV models have analog, digital and high-definition receivers and are QAM. If you don't have a user's manual call your television's manufacturer customer support with the TV model number.

"If you get a decent analog picture than you should get gorgeous DVD-quality pictures" (with a converter box), said LG Electronics Vice President of Public Affairs, John Taylor.

LG Electronics is one of the converter box manufacturers and Taylor says the goal is to make connecting digital converter boxes "as simple as possible." Plug the box into an electrical outlet, one cord into the existing antenna, and another to the back of the TV. LGE and the NTIA will have toll-free numbers and customer support ready to answer any consumer installation questions.

However, consumers who continue to use an analog television with the converter box won't get the full benefits of digital broadcasting.

Digital TVs are wider, giving the movie-theater screen effect. Digital TVs have better sound and transmit twice as many horizontal resolution lines to give a superior picture, free of static and "ghosts" (or shadowing) that can appear on analog sets. Digital allows stations to broadcast more than one program over a single channel, which could lead to more channel choices.

In Berlin, the number of over-the-air channels increased from 12 to 27 when the switch to digital was made.

Most cable and satellite providers already transmit using digital airwaves; your service provider can confirm this.

Orr can still use the old analog TV in her son's room for video games and movies without change. Digital converter boxes cannot produce digital quality with analog video games, DVDs, camcorders and VCR's because they play to the devices' capabilities. Only a digital TV can produce the better quality and sound with analog devices.

By the February 2009 cutoff, Chris McCarty will need to decide what to do with the old TV set he keeps in his garage to play sports as background noise while he works outside.

Environmental Toll

Many consumers may be tempted to haul their old TVs to the dump. Be aware that your state or county has rules for disposing of electronic or hazardous waste and may charge a fee. Check the Environmental Protection Agency Web site for information.

This conversion may increase the plague of electronic waste worldwide.

Californians not only pay to dispose of electronic waste, but are also charged up to $10 at the time of purchase for most types of TVs, computer monitors and laptops for the "Advance Recovery Tax at Point of Sale." The program "hasn't been successful in achieving the recycling goals it promised," according to the Consumer Electronics Association

"California is the only state to charge this fee for electronic waste," said Jason Linnell, executive director for the National Center for Electronic Recycling. "In other states the manufacturer pays recycling costs."

It's Only $30

Unhappy with the idea of payign $30 to continue getting something that's been free all these years? You may want to consider the plight of German TV fans. They had to pay $200 for their conversion boxes.

For years, health researchers assumed that lifestyle had a lot to do with the disparity in the incidence of the form of skin cancer called sqamous cell carcinoma -- believing that men spend more time outside and are less likely to use sun protection than women.

While that may be true, scientists at Ohio State have shown that there may be another, even more critical factor involved -- gender-linked differences in the amount of naturally occurring antioxidants in the skin. The study appears in the April 1 issue of Cancer Research.

Inherent gender differences -- instead of more sun exposure -- may be one reason why men are three times more likely than women to develop certain kinds of skin cancer, say researchers at Ohio State University Medical Center.

Squamous cell carcinoma is the second most common form of skin cancer, accounting for nearly 200,000 new cases in the United States each year. While occurring more often than melanoma, squamous cell carcinoma is not nearly as worrisome. Still, it can be lethal in some patients, especially those with suppressed immune systems, including transplant recipients or people who are HIV-positive.

Dr. Tatiana Oberyszyn, an assistant professor of pathology and of molecular virology, immunology and medical genetics at Ohio State University Medical Center, has been studying non-melanoma skin cancers for years. She had a hunch there might be gender-related variables that accounted for the difference between male and female rates of developing these malignancies, and designed an experiment to find out what they might be.

A doctoral student in Oberyszyn's laboratory, Jennifer Thomas-Ahner, subjected male and female mice to a single, identical, acute exposure to UVB light. It is UVB rays, as opposed to UVA or UVC rays in sunlight, that cause the most damage to the skin. Even a single, prolonged exposure is enough to cause inflammation (sunburn) and its attendant redness, swelling and increased vascular flow.

Thomas-Ahner compared various measures of the inflammatory response in the male and female groups, noting the degree of swelling, antioxidant levels, DNA damage in the skin and the levels of myeloperoxidase in the tissue.

Myeloperoxidase is an enzyme that reflects the extent of neutrophil infiltration, the first step in the inflammatory response. Antioxidants help repair damaged DNA and also help clean up toxic byproducts of injured tissue.

She discovered significant differences between the two groups. The male mice registered a weaker inflammatory response than did the females, as measured by the thickness of their skin and myeloperoxidase levels. They also had more extensive DNA damage in their skin and lower antioxidant levels in their skin than the females.

In a second experiment, Thomas-Ahner exposed male and female mice to longer, chronic sun exposure, irradiating them three times weekly for 16 weeks. When the mice were 25 weeks old, she examined them for differences in tumor growth, size and number.

She found that male mice developed tumors earlier and had more tumors than did female mice. The tumors in the male mice also tended to be larger and more aggressive than were those in the female mice.

Oberyszyn and Thomas-Ahner also noted that the difference in the antioxidant capacity between male and female mice was present in the untreated skin as well as the treated skin. Oberyszyn, a member of the Ohio State University Comprehensive Cancer Center, believes that the greater amount of naturally occurring antioxidant capacity in the females accounted for their ability to thwart a certain degree of tumor growth and spread.

"This is the first time anyone has ever looked at the effect of gender on the development of UVB-induced skin cancers in such a controlled environment," says Oberyszyn. "It's given us clear evidence of a biological basis for the gender bias in developing squamous cell carcinoma."

Oberyszyn says other studies need to be done to validate the findings, but noted the data are compatible with other studies suggesting a potential biological basis for gender difference in the development of cancer and other diseases.

Del Monte is the latest to recall some of its pet food products. The company said it's recalling pet treats sold under the Jerky Treats, Gravy Train Beef Sticks and Pounce Meaty Morsels brands as well as select dog snack and wet dog food products sold under private label brands.

A full list of the recalled products appears below.

The company said it learned from the FDA that wheat gluten supplied to Del Monte Pet Products from a specific manufacturing facility in China contained melamine. Melamine is a substance used in floor tiles, kitchenware, and fire retardant fabrics, blamed for the massive recall of Menu Foods and other pet products.

The company said the recall affects less than one-tenth of one percent of Del Monte Pet Products' annual pet food and pet treat production. It said the adulterated ingredients were used over the last three months.

Earlier, and Nestle Purina added some of their products to the growing recall of products blamed for a wave of dog and cat deaths throughout North America.

Nestle Purina recalled all sizes and varieties of Alpo Prime Cuts in Gravy dog food marked with specific date codes. The company said some of the cans might be contaminated with melamine, the toxin suspected of causing the pet illnesses.

"We're very confident that we've isolated this problem," said Keith Schopp, a spokesman for Nestle Purina. "This is just one canned variety of Alpo, and it's one of many varieties of Alpo canned products. No dry products are involved. No cat products are involved."

But soothing corporate statements come as little comfort to affected pet owners, like Nicole of Key West, Fla.

"I have two small chihuahuas that ate Alpo Prime Cuts dog food. One of my dogs is currently in the hospital because her kidneys are failing. Sophie is only 6 months old and is very ill," she told ConsumerAffairs.com. "My other dog Charlie is beginning to show signs as well. This has caused me a great deal of stress, time off work, money and possibly the lives of my animals."

Del Monte Recall

Here are the products recalled by Del Monte, according to the company's Web site:

Del Monte said customers can call (800) 949-3799 for more information about the recall and for instructions on obtaining a product refund.

Recall Began Two Weeks Ago

The massive recall began two weeks ago, when Canada-based Menu Foods recalled 60 millions cans and pouches of "cuts and gravy" moist dog and cat food produced at its plant in Emporia, Kan., between Dec. 3 and March 6. It has since affected such national brands as Procter & Gamble's Iams and Eukanuba, Nestle SA's Purina Mighty Dog and others, including some sold at Wal-Mart and Safeway.

Joanne of Bentleyville, Penn., was an Iams customer. When her cat refused to eat the Iams Select Bites pouches Joanne brough home, she let her border collie eat them. The dog died a slow death from kidney failure.

"She loved cat food ... so I gave it to (her) as a treat she never gets. The following day I tried the food again with the cat but again he would not eat it so again I gave it to the dog. I had no idea that I thought the food was a treat for my dog was actually poison."

"My life will never be the same. I feel I poisoned one of my family," Joanne said in a complaint to ConsumerAffairs.com. "I trusted a company. I will never do that again."

Menu Food's President and CEO says his company still doesn't know how wheat gluten contaminated with a chemical commonly used in plastic wound up in its products.

President Paul K. Henderson also said the contaminated wheat gluten is not in any of its other product that are outside the scope of the company's massive recall of 60 millions containers of "cuts and gravy" style pet food.

Meanwhile, Hill's Pet Nutrition recalled its Prescription Diet m/d Feline dry cat food. The food included wheat gluten from the same supplier that Menu Foods used. The recall doesn't involve any other Prescription Diet or Science Diet products, the company said.

The Food and Drug Administration -- and an outside laboratory -- announced on Friday that tests found a chemical called melamine in samples of the tainted pet foods involved in the recall.

"Melamine has been found in the finished product that was the subject of recall and has not been found in other Menu Foods pet food outside of the recall," Henderson said at a press conference Friday afternoon.

Cornell University officials also confirmed they found melamine -- used in floor tiles, kitchenware, and fire retardant fabrics -- in the urine and kidney of a sick cat. New York officials say they've detected that chemical, too.

Henderson said the melamine-tainted wheat gluten came from a new supplier, who imported the ingredient from China. He said the company stopped using that supplier after dogs and cats across the country showed symptoms of kidney disease or died after eating Menu's pet foods.

"Needless to say, we have a great deal of interest in finding out why we were supplied with this kind of product," Henderson said of the tainted wheat gluten. "This is a subject of very great interest to us and our lawyers and you can expect that we will be following up."

He added: "For litigation purposes, we cannot elaborate at this time."

Grieving pet owners in the United States and Canada have filed lawsuits against Menu Foods, alleging the company was negligent and should have warned consumers about its tainted products before the March 16, 2007, recall.

Problem Solved?

Henderson said pet owners shouldn't worry about the safety of the cat and dog food the company is now producing.

"Let me be clear on this -- we have removed that (tainted wheat gluten) problem from our system," he said. "Our products are safe. We continue to engage in the highest levels of monitoring and testing in the pet food industry. These tests will be expanded as a result of this experience."

He also pointed out: "Melamine has not been found in the wheat gluten that we obtain from our other suppliers ... all of the testing that has been conducted, including the routine taste tests that were underway prior to the discovery of this problem, have demonstrated that those products not associated with the suspect wheat gluten performed very well and in a manner consistent with historic norms."

The tainted wheat gluten, however, might have been used to make dry dog food.

Stephen F. Sundlof, director of the FDA's Center for Veterinary Medicine, said the melamine-tainted ingredient was shipped to an unnamed company -- one that manufactures dry pet food.

The federal agency is now investigating whether that contaminated ingredient was used to make any dry pet foods.

When asked if pet owners could be feeding unsafe food to their animals, Sundlof said: "It is possible, but I think we've been following every lead that we can. My sense is that we have gotten most of it under control."

Last week, New York officials announced they discovered the toxin aminopterin -- used as rat poison in other countries and as a cancer drug in the United States -- in Menu's contaminated products.

But the FDA said its tests -- and those by the outside lab -- did not reveal the rat poison in the recalled pet food. Or in the wheat gluten.

Wheat gluten is used a thickening agent and source of protein in pet foods, but it's also used in some human foods.

The FDA said today that it has found no indication the contaminated ingredient is in any food humans eat. The agency said it would alert the public if it found melamine in any other foods.

The FDA has confirmed at least 16 deaths linked to Menu's contaminated pet foods, but officials expect that number to dramatically increase. The FDA said it has received calls from more than 8,000 veterinarians and pet owners.

Earlier this week, the Veterinarians Information Network, a Web site of 30,000 veterinarians and veterinary students, announced its members have reported 104 deaths linked to Menu Foods' contaminated products. The majority of those deaths -- 88 -- involved cats.

The Web site also received 11 reports of dogs dying after eating Menu Foods' tainted food. The remaining five deaths did not list a species.

In addition, VIN said its members have seen 471 cases of kidney failure since Menu Foods announced its massive recall on March 16, 2007.

The Web site PetConnection.com says it has -- as of March 30, 2007 -- received 2,400 unconfirmed reports of dog and cat deaths linked to Menu Foods.

Henderson offered his company's condolences to grieving pet owners.

"All of us at Menu Foods want to express our sympathy to those people who have suffered with sickness and loss of pets," he said. "We are pet-people and we have almost 1,000 caring employees who are dedicated to making food that is safe, nutritious and palatable."

He added: "We are angered that a source outside of the company has apparently adulterated the product causing this regrettable loss."

As the investigation continues, pet owners are advised to watch their dogs and cats for symptoms of kidney failure, including loss of appetite, lethargy, vomiting, excessive drinking and either excessive or no urination.

Veterinarians, however, warn that animals do not show symptoms until about 70 percent of the kidney function is lost.

A complete list of the recalled Menu pet foods is available at Menu Food's Web site: www.menufoods.com/recall or contact the company at (866) 463-6738 or (866) 895-2708.

As tax time looms, a new report by the Government Accountability Office (GAO) found that the Internal Revenue Service (IRS) has made "limited progress" in addressing significant security vulnerabilities, but many weaknesses "continue to threaten the confidentiality, integrity, and availability of IRSs financial and tax processing systems and information."

The GAO cited the IRS' failure to implement its information security program as a "primary reason" for the continued vulnerabilities.

"Until [the] IRS fully implements an agencywide information security program that includes...security plans, training, adequate tests and evaluations, and a continuity of operations process for all major systems, the financial and sensitive taxpayer information on its systems will remain vulnerable," the GAO said.

Among the GAO's findings:

• The IRS did not perform enough oversight of ensuring only authorized personnel had access to its systems. The GAO found evidence of personnel sharing usernames and passwords to access a database production server for the IRS' procurement system.

• The IRS often granted users more access than necessary for performing their duties to systems, and did not adequately police usage or receipt of anonymous e-mails, which increases the vulnerability to phishing scams.

• Physical security vulnerabilities at examined IRS offices included leaving the server for a procurement database in a cubicle, rather than a secured office, and handing out secure access cards to more employees than were necessary.

The GAO previously reported in March 2006 that the IRS had gaping holes in its security practices, such as leaving passwords for computers available for anyone to read, failing to verify photo identification of visitors as IRS employees, and not providing proper oversight and training for contractors in its employ.

The new report did note improvements on some of these fronts, such as improving password storage and creation policies, increased audits and monitoring for mainframe and Windows machines, and increased training for employees and contractors, particularly in the event of disaster.

IRS Commissioner Mark Everson acknowledged the failures of the IRS to provide a comprehensive security plan in his response to the report, but defended the steps the agency took, as he did last year.

"The IRS takes its security and privacy responsibilities seriously," Everson said. "While we have made significant progress, we recognize that continued diligence is required."

The GAO report comes on the heels of new evidence that the IRS is faltering in its ability to fill the "tax gap" of uncollected and underreported tax payments. National Taxpayer Advocate Nina Olson reported to Congress in January that noncompliance in tax collection forced compliant taxpayers to shoulder more of the burden. Many issues with taxpayer debt could be avoided through earlier negotiation with taxpayers, rather than waiting for debts to accrue interest and penalties, Olson said.

The IRS had planned to outsource data collection functions to an outside company, IAP World Services, as part of a large-scale privatization program, but eventually reduced the breadth of the program after IAP admitted it would not have many of the data centers ready in time for the upcoming tax season, and to ensure that the new employees would be properly trained.

The full GAO report is available as a PDF document.

Whenever financial troubles threaten the survival of a company, one of the first steps it takes to reduce costs is to downsize, which everyone knows is a corporate euphemism for layoffs.

But what if you're an individual in financial trouble? You can't lay yourself off. But you can downsize in other ways, in the process shedding expenses and, as they say in business school, enacting a strategy to move to the next level.

Personal downsizing certainly isn't a new phenomenon. Retirees and empty-nesters have been using this strategy for years as a way to simplify their lives and reduce their overhead. The difference today is that there are millions of Americans, many of them baby-boomers, who haven't retired yet but who still need to reduce costs because their expenses far outweigh their income.

We're not talking so much about people who are on the economic fringe, working as a Wal-Mart greeter or pulling the night shift at the 7-11. Chances are they don't have much room to downsize.

We're talking about people with first and second mortgages, who own two or three cars, who are having trouble keeping up with their credit card payments, who are paying huge college tuition bills and other costs for their children including teenagers or even adult children still in school, and who have just been hit with the added financial and emotional responsibility of caring for their aging parents.

If you're in this category and you're finding it hard to sleep at night because you are worrying about how you're going to pay for all this, then downsizing may be your best solution. It beats bankruptcy or foreclosure.

Your Assets

Your home is probably your greatest asset and therefore the cornerstone of your downsizing plan. So the first thing you need to do is to get a realistic independent appraisal of what your property is worth on the current market.

Then subtract how much you still owe on any mortgages, any realtor fees you may have to pay, the cost of any improvements you will need to make before you can even put your house on the market, such as painting, or repairs, as well as any legal fees related to the sale, and finally the cost of moving (which can vary widely depending upon how far you are moving as well as whether you are planning to move everything yourself or hiring a moving company to do it for you). What remains will be the amount you'll have to buy a smaller home.

Since your goal is keep as much of the money that you get from the sale of your home so you can use that income to live on or to invest for future expenses, you will now want to find the least expensive home that you can afford but that will still be comfortable for you and your family.

Chances are the new home will be smaller and in a less expensive community. You will be able to save even more money by downsizing since your mortgage payments on the new house will be smaller, as will your oil, gas or electric bills. (But remember to factor in the possible increased commuting costs -- train fares, tolls, and/or gasoline costs -- if you keep the same job but move farther away.)

Timing plays an important role in any downsizing decision. If your financial situation is very grave and you wait too long, you may not have time to sell your home before it goes into foreclosure. Also, you'll probably need to sell your home before you buy another one -- so put your time and energy into getting your current home or apartment ready for the assessment and the sale rather than the more fun task of finding a less expensive home or apartment to move to.

Getting Ready to Sell

You should get advice from a real estate attorney early in the process. Your attorney will help you prepare documents that will include several dates and conditions that will need to be met by both you and any buyer including those that could allow you to live in the house until you can move into your new home.

There are a number of options to consider when preparing to sell your home. One is to sell your home "as is," deducting from your asking price the cost of any necessary repairs such as a new roof, painting, or any problems detected by a licensed inspector. Another option is to pay for this work and include it in your asking price.

Some typical home improvement include a new paint job, inside and/or outside, upgrades to the electrical system and plumbing as well as changes in some of the rooms, especially in the master bathroom where a new, more modern sink, toilet or Jacuzzi could tip the scales in favor of a buy over a pass.

Realtors will often emphasize something called "curb appeal," which is how the home looks to someone passing by. It is the first time a potential buyer sees it, usually from the curb and before turning into the driveway. It falls into the category of first impression, and experts will tell you that those first impressions sometimes override any new interior improvements that you may have made.

So keep your property clean, well-landscaped and picture perfect. Put fresh mulch on beds around trees and trim lawns, shrubs and walkways. Pick up anything sitting on the lawn that could be an eyesore whether it's a broken old piece of summer furniture or old planters without any plants or flowers.

Inside, your home should be just as attractive and free of clutter. Clutter can kill a sale as easily as a leaky roof. So do a thorough house cleaning, removing from each and every room or hallway any item that gives even the hint of clutter which could imply that you lack enough room for storage.

Whether you sell the house yourself or use a realtor, set the right price so your house sells quickly. You will already have a realistic appraisal so any buyer should feel they are getting real value at a fair price.

A third option is to have an auction. You may want to hold off on this until your house has been on the market for a while but hasn't sold. Most auction services will charge a commission as well as any marketing costs such as newspaper advertisements, brochures and postcards.

There are some advantages to an auction. You sign a contract, there's a six-week marketing campaign, and after the auction is held, you close in 30 days.

Another advantage is that an auction is a cash transaction. You don't have to worry about the financing falling through. Any potential buyer has to arrange that ahead of time. One possible negative of an auction is that, chances are, you will have to accept a lower price than originally anticipated. But even here you can set a minimum acceptable price.

Where To Go?

Once you clear the hurdle of selling your existing home, you need to think about where to go next.

You may want to consider living in a condo instead of a standalone house. Condo living has certain advantages such as not having to worry about supervising lawn maintenance although you will probably still have to pay a maintenance fee, which will differ from property to property. Plus there's the noise factor of living so close to your neighbors and perhaps having to make do with less living space than in a standalone house.

If you decide to downsize by moving to a more affordable community, or even another state, you may actually find that you can move to a larger home or apartment while still paying far less.

For example, checking the current listings of the online site of a major real estate company (which includes listings from other companies as well) in the pricey Westchester, N.Y., suburb of Scarsdale, $369,000 will get you a 2-bedroom, 2-bath co-op measuring 1,350 feet. Or for $589,000, there is a 1,650-square-foot house for sale with 3 bedrooms and 2 baths on .11 acres of land.

By contrast, in Normal, Illinois, a house measuring 4,475 square feet with 4 bedrooms, 3 baths, an in-ground pool, and a large piece of property is listed for $375,000. (Normal might sound, well, abnormal but it's the home of Illinois State University and, like many college towns, offers not just inexpensive housing but cultural events, good medical care and lots of sporting events).

If moving several states away is not an option, even within commuting distance of most regions there are wide variations. For example, in Port Chester, New York, another community in Westchester which is not that far from Scarsdale, you could get a 1,584 square foot house, with 3 bedrooms and 1 bath, not just a condo, for $399,000.

Another option is to consider moving in with relatives after you sell your house rather than immediately rushing to buy something new. Whether you move in with your parents, adult children, extended family members, or even friends, if everyone agrees this is a temporary measure it could be an excellent way to get back on your feet financially.

You and your family member or friend will have to work out the details of your living arrangement and whether or not you will be expected to contribute to the monthly overhead or just pay your own food costs.

Whether you stay put or move to an exotic new locale, give serious thought to finding something more compact. After all, if you have less space you need less furniture and you should spend less on heating, air conditioning, utilities, insurance and so forth. Once you've found your new home, make sure you measure every room so you can determine which pieces of furniture will fit.

There are a number of options for the furniture you decide to leave behind. You can store it, sell it at a lawn sale or on eBay.com, or you can donate it to Goodwill or the Salvation Army.

If you donate your old furniture, many legitimate charities will come and cart it away for you -- and you get to claim it as a charitable donation on your tax return. Check what the procedures are with any charity you plan to donate to.

Speaking of tax returns, use the move as an opportunity to prune your files. Ask your tax adviser to let you know what tax returns and records you have to keep, going back how many years, and get rid of everything else.

If you're an empty-nester, you need to decide what to do with your children's toys, clothes and collectables. The best thing you can do is contact your children and ask them to take away the stuff they want to keep and then get rid of the rest, again either by selling or donating it.

Some people put whatever won't fit into their new home or apartment into storage. But unless you plan on moving into a larger house, you might as well get rid of those possessions now, especially if you can use the extra income from selling everything or you will get a tax deduction from the donation.

Storage, however, was a good choice for a friend of mine from college, who downsized by selling his house and buying a large RV (recreational vehicle) that he and his wife live in for most of the year, traveling throughout the country, although they do stop and park it for a couple of weeks at a time when they visit their grown children. Since my friend wasn't sure how long he and his wife would want to live this nomadic lifestyle, they put their furniture into storage so they could use it in the future. Storage is expensive, though, so think twice.

If you are leaving behind a lot of expensive furniture as well as other valuable objects, you may want to consider an auction. There are services that catalog furniture, silver, china, art works, and an assortment of other items to assist you in getting the best price. They will also conduct the auction either for a fee or a percentage of the profits. Another option similar to auction is to offer your items for sale on eBay.

If you don't have the time or patience to sell each item individually, there are eBay consignment stores that will do this for you and charge a commission.

For those items that you can't sell or even give away because of damage or simply because the object is too old to be useful anymore, there are refuse companies that will haul away your garbage. You can even rent a dumpster to put the stuff in. Some garbage companies let you leave items to be picked up with your regular garbage. Some municipalities have special cleanup days when residents can leave large items at the curb for pickup.

Moving into a smaller space takes some adjustment. One way to do that is to make multiple uses of items such as trunks than can also serve as coffee tables while being used for extra storage. You can also use rooms for more than one purpose such as putting a computer desk in your bedroom or dining room. Buy a washer and dryer that stack on top of each other. They'll will take up less space than side-by-side units.

Also, if it's now just you and your spouse, you can probably cut down on the amount of china, pots, pans and silverware that you need to have around.

Ditch the Hummer

Besides your home, you may be able to downsize your cars. You can consider trading in your gas guzzling SUV if you don't really need four-wheel drive for something more economical.

What about that expensive sports car, motorcycle, or $600 bicycle that you only rode once? Consider trading in or selling selling.

If you really want cheap wheels, you may actually drive for free if you're willing to display advertising on your vehicle. If you move to a metropolitan area with mass transit, you may not need a car at all. You can always rent one when you take a weekend drive or trip. Zipcar and Flexcar rent cars by the hour and day.

To round out your downsizing plan, think about whether you need so many phone lines. You may be able to survive with a single cell phone.

With fewer rooms, you'll also need fewer television sets and therefore fewer cable boxes. Now that you can download television shows on your computer, do you even need cable anymore (except for basic cable if that's a necessity for the TV and/cable as well as broadband reception)?

Be Ye Upbeat

The most pivotal aspect of the personal downsizing challenge is your attitude. If you see this as a necessary but exciting next step, you will convey that enthusiasm and positive attitude to your spouse and family. If, by contrast, you feel this is a symbol of your financial failure, that too will be communicated -- which will certainly not be in anyone's best interest, especially when you're trying to get the best price for your home or apartment.

You definitely do not want to give the impression that you're desperate, even if it's true. Or, as the poker players say, "Don't let them see you sweat."

The best way to look at it? The way businesses do.

The most successful companies, by and large, are the ones that are constantly implementing new strategies that make them more efficient and customer-centered. You're your own customer so you need to be as efficient as possible in meeting your needs, right?

If anyone asks what you're up to, just be honest and say that you've reevaluated your situation and decided that downsizing is the best step to take.

After all, you're taking control of your financial destiny before the banks or your mortgage company take your property away from you so pat yourself on the back for being pro-active in this new venture as you aim for better economic horizons down the road.

The Food and Drug Administration has told Novartis Pharmaceuticals Corporation that it wants it to suspend marketing of Zelnorm, used to treat irritable bowel syndrome. The agency said it requested the voluntary action based on recent findings of an increased risk of serious heart problems associated with use of the drug.

But Public Citizen says there's nothing recent about and notes that in March 2001, it petitioned the agency not to approve Zelnorm because it was only marginally effective and posed serious safety concerns. Besides heart problems, risks included ovarian cysts and fainting spells.

"We noted in this petition that receptors with which this drug interacts exist not only in the intestinal tract ... but also in the heart," said Dr. Sidney Wolfe, M.D., director of Public Citizen's Health Research Group.

"We pointed out that cisapride, a gastrointestinal drug which also caused fainting and was taken off the market because of cardiac arrhythmias, also affected this same receptor in the heart," Wolfe said.

"Once again, the FDA has approved a drug with marginal effectiveness in the face of serious questions about its safety -- putting at risk the millions of people who have already used it," Wolfe said.

He noted that the FDA has only asked the company to withdraw the drug from the market despite "even clearer evidence of harm.

"This again raises questions about both the adequacy of the FDA's pre-approval review and post-marketing surveillance," Wolfe said..

Zelnorm was approved by the FDA in July 2002 for short-term treatment of women with irritable bowel syndrome whose primary symptom is constipation. It was subsequently approved in August 2004 for treatment of chronic constipation for men and women under age 65. Zelnorm is currently marketed in 55 countries.

There were 2.13 million prescriptions issued for Zelnorm in 2005 alone, making it one of the top 200 drugs in the U.S., according to Public Citizen.

FDA said it advises patients who are using Zelnorm to contact their health care providers to discuss treatment alternatives. Patients who are taking Zelnorm should seek emergency medical care if they experience severe chest pain, shortness of breath, dizziness, sudden onset of weakness or difficulty walking or talking, or other symptoms of a heart attack or stroke, the FDA said.

FDA said it had only recently become aware of the drug's hazards. Its statement did not make any mention of the agency's ignoring Public Citizen's petition six years ago.

"This decision reflects the FDA's commitment to continuously monitor approved drugs throughout their marketing life, and take action when we believe the risks exceed the benefits," said Dr. Douglas Throckmorton, Deputy Director for the Center for Drug Evaluation and Research. "Here, a potential risk of very serious harm to patients who have this non-life-threatening condition was recently identified, making this action necessary."

Throughout February and March 2007, Novartis reported to FDA the results of a new analysis of 29 short-term randomized, controlled clinical trials of Zelnorm. FDA has concluded, based on these data that for most patients the benefits of this drug no longer outweigh the risks, the agency said.

The analysis included more than 11,600 patients treated with Zelnorm and over 7000 patients treated with placebo. The data showed that the risk of serious cardiovascular adverse events (e.g., angina, heart attacks, and strokes) associated with use of Zelnorm is higher than with placebo treatment.

Thirteen Zelnorm-treated patients (or 0.1%) had confirmed cardiovascular ischemic events, and only 1 placebo-treated patient (or 0.01%) with an event.