Current Events in December 2007

People with restless legs syndrome (RLS) are twice as likely to have a stroke or heart disease compared to people without RLS, and the risk is greatest in those with the most frequent and severe symptoms.

That's according to research published in the January 1, 2008, issue of Neurology, the medical journal of the American Academy of Neurology.

The study, the largest of its kind enrolling both men and women, involved 3,433 people with an average age of 68 who were enrolled in the Sleep Heart Health Study.

Participants were diagnosed with RLS by detailed questionnaire and asked if they had been diagnosed with a variety of systemic diseases including cardiovascular disease and cerebrovascular disease. Of the participants, nearly seven percent of women and three percent of men had RLS.

The study found people with RLS were more than twice as likely to have cardiovascular disease or cerebrovascular disease. The results remained the same after adjusting for age, sex, race, body mass index, diabetes, high blood pressure, high blood pressure medication, HDL/LDL cholesterol levels, and smoking.

"The association of RLS with heart disease and stroke was strongest in those people who had RLS symptoms at least 16 times per month," said study author John W. Winkelman, MD, PhD, with Harvard Medical School in Boston. "There was also an increased risk among people who said their RLS symptoms were severe compared to those with less bothersome symptoms."

Winkelman says although this study does not show that RLS causes cardiovascular and cerebrovascular disease, a number of potential mechanics for such a process exist.

In particular, most people with RLS have as many as 200 to 300 periodic leg movements per night of sleep and these leg movements are associated with substantial acute increases in both blood pressure and heart rate, which may, over the long term, produce cardiovascular or cerebrovascular disease.

Winkelman says there are limitations to the study, including that the diagnosis of RLS was self-reported by questionnaire rather than by clinical interview.

To read the headlines, June 25 was a banner day for cold sufferers:

Echinacea, the North American flower widely used to protect against colds, actually works - and works well - a scientific review found, read the Bloomberg News. The plant, also called the purple cornflower, cut the chances of getting a cold by nearly two- thirds compared with a placebo.

But before you rush out to buy some Echinacea, it pays to double-check those statistics.

First of all, the study Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis (Shah, S.A. et al., Lancet Infectious Diseases 7 (July), 2007) didnt show that Echinacea cut the chance of getting a cold by nearly two-thirds.

The accurate number is less than one third. Unfortunately, every major news organization that gave figures about the studys claims for Echinaceas effectiveness made the same mistake, including the New York Times and the Los Angeles Times.

Furthermore, this scientific review is nothing more than a rehash of old data, sliced and diced to provide a different and less-than-convincing result. Thats not to say that the study is without value, but its far from a definitive proof of Echinaceas efficacy as even the author of the study admits.

Were not saying without doubt that Echinacea works, says Dr Craig I. Coleman of the University of Connecticut School of Pharmacy, an author of the study. Ultimately, what were trying to suggest is that more studies should be done.

Thats a bit of a let down from the definitive statement that Echinacea actually works and works well. In fact, the best study to date has found that Echinacea does not have a statistically significant effect, and this new study does little to revise that perspective.

The problem with the medias reports boils down to statistical illiteracy: Few reporters who covered the story understood the difference in significance between a top quality, randomized, double-blinded, controlled study and a questionable meta-analysis. And apparently none of them had the basic statistical knowledge necessary to report the claims of Echinaceas effect accurately.

Making a hash of the data

So what is a meta-analysis, and why do researchers do them?

Think of a meta-analysis as a powerful but tricky microscope. If used correctly, it reveals details you cant see otherwise. But if used incorrectly, it can distort the picture so much that it becomes unrecognizable.

Chance is the fundamental problem that obscures medical researchers ability to see the effects of a treatment. For example, antihistamines may work great for my allergies but leave my friend just as allergic and sleepy to boot.

If someone studying an antihistamines effectiveness against allergies happens to get a group of folks mostly like me, the antihistamine will look like it works terrifically, much better than it actually does. But if the researcher gets patients who are mostly like my friend, the drug will look like a dud.

One way of protecting against this problem is to study lots of patients. After all, if a researcher studies ten thousand people, its pretty unlikely that the great majority of them will all respond unusually strongly or unusually weakly to the treatment.

Small studies can still show definitively that a treatment works if its effect turns out to be really big. Suppose, for example, that a study of a cancer drug contained only twenty patients but their tumors all vanished after receiving the drug. In that case, the researcher would be pretty sure the drug was doing something.

But the smaller the number of patients, the bigger the effect has to be for the researcher to be sufficiently confident.

This is why statisticians developed the notion of statistical significance. For any size population, statisticians figured out how big an effect you need to see in order to be 95% sure that youre not just seeing random variations. An effect that is smaller than that is said to be statistically insignificant.

So in a small study, a treatment may seem to have a sizable positive effect but still be statistically insignificant. Then the researcher is left wondering whether the effect was real but the study was too small to detect it with confidence, or whether the treatment just didnt work.

Thats just the situation that meta-analyses can sometimes help with.

If several small studies have been conducted on a single treatment, a researcher can combine the data from all the studies together and analyze them as if they were from a single large study. Then the researcher can see small effects that were invisible in the individual studies.

Lots of traps

Its a great idea, and if done carefully, it can be revealing. But meta-analyses can fall into lots of traps.

Combining studies is only legitimate if theyre really studying the same thing, but most of the time, studies have important differences in design. Furthermore, if the original studies are poorly designed, the meta-analysis will be lousy too.

Another problem is publication bias: If a treatment has a small effect, some studies will probably, by chance, show a negative effect. But studies that get negative results very rarely get published, so the researcher doing the meta-analysis will get an artificially positive collection of studies.

The result of all of these things is that the quality of the meta-analysis depends largely on the judgment of the researcher selecting the studies. Different meta-analyses that include different studies can come to strikingly different conclusions.

Skepticism common

As a result of that, most doctors and researchers view meta-analyses with a fair bit of skepticism.

One good experiment controlled, randomized, double-blind, with a reasonable number of subjects beats a meta-analysis of any number of observational studies, says Philip Stark, a statistician at the University of California, Berkeley.

The recent Echinacea meta-analysis has been criticized for all the weaknesses meta-analyses so often have.

The original studies vary widely. Some administered the cold virus to the participants and some just observed whether the participants got colds on their own. Some used one species of the plant and some another. Some studied Echinacea mixed with other products like vitamin C or propolis. And, the critics say, some were well done and some were simply badly designed.

Back in 2005, Ronald B. Turner of the University of Virginia School of Medicine and his colleagues performed the most careful study of Echinacea to date. They created their own tincture of Echinacea so that they could carefully control the potency. Then they divided 437 participants at random into two groups and gave half of them Echinacea and half a placebo for a week.

Neither the participants nor the nurses administering the treatments knew which was which. Then the nurses inoculated them with a cold virus. The patients stayed in hotel rooms for the next five days, and the nurses monitored their symptoms.

To everyones disappointment, the effect of the Echinacea was not statistically significant. And this study met all of Starks criteria and more it was randomized, double-blind, and placebo-controlled.

Even as carefully as Turner had designed and performed his study, there were still criticisms of it.

Turner used Echinacea angustifolia, and some say that a different species, Echinacea purpurea, is more effective. Furthermore, some argued that Turner should have used a higher dosage of Echinacea than he did.

So despite the disappointing results of Turners study, its not unimaginable that some form of Echinacea, in some dosage, is effective.

But it hasnt been proven. And Colemans meta-analysis isnt enough to outweigh Turners careful study. At most, it suggests exactly what Coleman says it suggests: that more studies should be done.

Looking at the numbers

In general, if a meta-analysis shows a surprising result, something is fishy. And if it shows that a treatment has a surprisingly, large effect, something is even fishier. Remember that a meta-analysis is like a microscope: it helps to show small effects that cant be seen by smaller studies.

As the press reported it, Echinacea reduced colds by 58 percent an enormous amount. If Echinacea were really that effective, previous studies would have clearly shown it.

That should have been enough to set off some alarm bells. And an inspection of the numbers shows that the press simply didnt know enough statistics to read the study correctly.

Computing how much Echinacea reduced the chance of getting a cold is pretty straightforward from the data in the study. The participants who received Echinacea got a cold about 65 percent of the time, whereas the participants who got a placebo instead got a cold about 45 percent of the time. So those who took Echinacea got about 30 percent fewer colds ((65-45)/65), not 58 percent fewer colds.

So why did all the news reports say 58 percent?

Because the study stated that Echinacea reduced the odds of getting a cold by 58 percent. In regular speech, we use the words odds to mean the same thing as the word chance, but in statistics, theyre different.

The odds of something happening are defined as the chance of it happening divided by the chance of it not happening. Gamblers tend to talk about odds, but not many of the rest of us do. Instead, we keep it simpler and just talk about the chance that something happens.

The study was absolutely right that the odds were 58 percent lower for the Echinacea users (though one might suspect that the researchers chose to report the odds rather than the probability because of the more dramatic percentage).

Among the participants who took Echinacea, about 45 percent got a cold and 55 percent didnt. So the odds of getting a cold were 45/55, or .81. Among those who received a placebo, 65 percent got a cold and 35 percent didnt, so the odds were 65/35, or 1.88.

The reduction in odds, then, was (1.88 - .81)/1.88, or 58 percent. But that 58 percent does not mean that the Echinacea-users got 58 percent fewer colds. In fact, it doesnt mean much of anything that an ordinary person can relate to.

I think Im getting the sniffles

What does all this mean for the regular person who is trying to decide what to do at the first sign of a cold?

First, science hasnt proven that Echinacea works.

Turners study shows pretty definitively that 900 milligrams a day of Echinacea angustifolia doesnt help significantly. The most positive studies have been done on the leaves and flowers of Echinacea purpurea, but none of these studies are of the size and quality of Turners study.

So the evidence for it is pretty weak, though its also true that even placebos, which have no active ingredient, often make people feel better. If youve been taking Echinacea and you feel like its helped you, you may be right even if it isnt having a direct biological impact.

Echinacea's risks

Echinaceas questionable benefit has to be weighed against its risks. The safety of Echinacea hasnt been extensively studied, though it seems to be well tolerated by most people.

Even so, some people definitely shouldnt take it, like those with auto-immune disorders like asthma or lupus. Echinacea also may well interact negatively with many common prescription drugs, like statins, antidepressants, and protease inhibitors for HIV.

Consulting with your doctor before taking it would be wise. And, if you do decide to take it, you should only do so for short periods, either at the first sign of a cold or for a few days before a situation where exposure to a virus is likely, such as air travel.

You might also want to consider that native Echinacea species are dwindling because of habitat reduction and over-harvesting. But, in any case, you shouldnt take it on the basis of false claims in over-hyped news reports.

---

Julie Rehmeyer is a freelance math and science writer and the math columnist for Science News. She has a Master's degree in mathematics from the Massachusetts Institute of Technology and taught mathematics and the classics at St. John's College in Santa Fe. This article originally appeared at STATS.org.

A. Marijuana can help your glaucoma and it could definitely get you in trouble because its illegal.

Marijuana refers to the parts of the Cannabis sativa plant, which has been used for medicinal purposes for more than 4,800 years. Doctors in ancient China, Greece and Persia used it as a pain reliever and for gastrointestinal disorders and insomnia.

Cannabis as a medicine was common throughout most of the world in the 1800s. It was used as the primary pain reliever until the invention of aspirin.

The United States, in effect, made prescriptions for Cannabis illegal through the Marijuana Tax Act of 1937. The only opponent to the legislation was the representative of the American Medical Association.

Marijuana contains at least 60 chemicals called cannabinoids. THC is the main component responsible for marijuana's mind-altering effect. Marinol (dronabinol), a prescription drug taken by oral capsule, is a man-made version of THC

One of THC's medical uses is for the treatment of nausea. It can improve mild to moderate nausea caused by cancer chemotherapy and help reduce nausea and weight loss in people with AIDS.

Older people, especially those with no marijuana experience, may not tolerate THCs mind-altering side effects as well as young people. Doctors generally prescribe several kinds of newer anti-nausea drugs with fewer side effects before resorting to Marinol.

Glaucoma increases pressure in the eyeball, which can lead to vision loss. Smoking marijuana reduces pressure in the eyes. Your doctor can prescribe other medications to treat glaucoma, but these can lose their effectiveness over time.

Researchers are trying to develop new medications based on cannabis to treat pain. THC may work as well in treating cancer pain as codeine. A recent study found that cannabinoids significantly reduced pain in people with multiple sclerosis, a disease of the nervous system.

Though some doctors and patients suggest marijuana has a legitimate use, the federal government disagrees.

The law classifies marijuana as one of the most dangerous drugs that have no recognized medical use. The penalties for possession of marijuana can range from a small fine to a prison sentence.

Along with the legal implications of smoking marijuana are the health problems such as memory impairment, loss of coordination and the potential for withdrawal symptoms and hallucinations. And, inhaling marijuana smoke exposes you to substances that may cause cancer.

One study has indicated that the risk of heart attack more than quadruples in the first hour after smoking marijuana. The researchers suggest that a heart attack might be caused by marijuanas effects on blood pressure, heart rate and the capacity of blood to carry oxygen.

Most polls show that about three out of four people approve of medical marijuana. This has led to the introduction of bills in Congress which would eliminate federal controls in states which approve medical marijuana. None of these bills has been voted into law.

There is legislation on the books in the majority of states allowing the medical use of marijuana. Most require that it be prescribed. This provision presents a problem because federal agencies control the power to prescribe.

All Rights Reserved © 2007 by Fred Cicetti

Regulators at the National Highway Traffic Safety Administration (NHTSA) are siding with the Ford Motor Co., ruling that claims by the consumer group Public Citizen that some flex-fuel Ford and Mercury vehicles are defective are not substantiated.

Public Citizen asked NHTSA in October 2006 to investigate Ford flex-fuel claims for several models but NHTSA rejected the petition.

Headed by former NHTSA Administrator Joan Claybrook, Public Citizen claimed that 2003-05 Ford Taurus and Mercury Sable vehicles do not perform up to standards when fueled with E85 which is composed of 85 percent ethanol and 15 percent gasoline.

Public Citizen argued that the engine stalling in the Fords was a safety hazard.

The consumer group asked that NHTSA revoke the extra fuel economy credits Ford received for building 228,000 of the cars.

In justifying the decision, NHTSA said repairs recommended by Ford fix the performance problems in the vehicles.

NHTSA said that while the Ford models encountered a problem starting when using E85, stalling in the vehicles was rare.

NHTSA reported no crashes related to the complaints and said the decision does not prevent the agency from taking action if new evidence of a safety defect emerges.

Concerns about toxins in pet toys -- the focus of a ConsumerAffairs.com investigation in September -- continue to be raised nationwide.

The latest concerns surfaced in a recent investigation by WFLD-TV in Chicago, which had a private laboratory test 15 Chinese-made pet products for lead.

Tests conducted by Trace Laboratories, Inc. of Palatine, Illinois, revealed the ink logo on a Paws 'N Claws tennis ball for dogs contained 27,200 parts per million of lead. That's 45 times higher than the national level allowed for lead paint in children's toys. Federal law sets that limit at 600 parts per million.

There are, however, no national standards for lead and other toxins in pet toys.

Trace Laboratories also analyzed a ceramic pet bowl and discovered the paint on the bottom of that product contained 2,890 parts per million of lead nearly five times the 600 parts per million benchmark.

"I was surprised (by these results) because of all the exposure right now regarding lead in toys," Mitchell Sas, general manager of Trace Laboratories, told us. "You'd think suppliers would be more cautious and get an independent lab (to test the products)."

WFLD purchased the pet products from a Dollar General store and said it could not reach the manufacturers.

The station's tests come on the heels of a recent ConsumerAffairs.com investigation that brought the issue of toxins in pet toys to light.

Standards needed

Our investigation also triggered calls for national "acceptable standards and levels" for lead and other toxins in pet toys from the American Pet Products Manufacturers Association, veterinarians, and dog and cat owners across the country.

Earlier this month, the director of the Animal Poison Control Center (APCC) for the American Society for the Prevention of Cruelty to Animals also urged pet toy makers to test their products and publicly disclose their findings.

As we reported, we hired a private laboratory in Texas to analyze four Chinese-made pet toys -- two for dogs and two for cats -- for lead and four other heavy metals.

ExperTox Inc. Analytical Laboratory discovered one of the dog toys -- a latex one that looks like a green monster -- contained what the lab's forensic toxicologist called high levels of lead and the cancer producing agent chromium.

A cloth catnip toy also tested positive for "a tremendous amount" of the toxic metal cadmium. Two veterinarians, however, told us the levels of toxic metals in the toys did not pose a health risk to dogs or cats.

ExperTox also analyzed two other Chinese-made pet toys a cloth hedgehog for dogs and a plastic dumbbell toy for cats. The lab detected cadmium in those toys, but said the levels were "about the amount you'd find in one cigarette" and not considered significant.

We purchased the toys from a Wal-Mart in Kansas City, Missouri. All the toys had a tag attached that read "Marketed by Wal-Mart stores and Made in China."

The levels of lead and other toxins in the dog and cat toys we tested were significantly lower than those found in the pet products Trace Laboratories analyzed. Nonetheless, ExperTox's forensic toxicologist called his lab's findings concerning and even suggested that Wal-Mart pull the products off the market.

"Or put a warning label on them that says if you put this (toy) in your mouth you will get poisoned," Dr. Ernest Lykissa, a forensic toxicologist and director of ExperTox, told us. "There is nothing good about the agents (in these toys) that I'm reporting to you."

Green monster

The green monster toy, Dr. Lykissa said, contained 907.4 micrograms per kilogram of lead.

"That's almost one part per million," he said. "With that kind of concentration, if a dog is chewing on it or licking it, he's getting a good source of lead."

The green monster toy also contained what Dr. Lykissa considered high levels of chromium -- 334.9 micrograms per kilogram.

"With that kind of chromium in there you have what can be an extremely toxic toy if they (animals) put it in their mouths. And dogs put things in their mouths. If a dog puts this in his mouth, he runs a big chance of getting some type of metal toxicity that may shorten his life."

ExperTox also detected other toxic metals in the green monster toy.

"There's cadmium, arsenic, and mercury in there," Dr. Lykissa said. "This is not a clean toy. This is toxic. Bank on it."

ExperTox's tests on the catnip toy detected "concerning" levels of cadmium 236 micrograms per kilogram. "That one is worrisome to me," Dr. Lykissa said. "That's a big number. It's a good dose of cadmium."

Toxins come right off

There's another reason Dr. Lykissa expressed concerns about the heavy metals in these chew toys.

"These (toxic) materials came off the toys freely, like with the lick of the tongue from a dog or cat," he said. "They were readily liberated from these toys. We didn't take a sledge hammer and pound on them. I just did what a dog or cat would do by licking it. That's why this is so serious."

Dr. Lykissa said toxicologists cut off a small piece from each of the toys, weighed the samples, and put them in acidic water.

"We left the samples for a while and then heated them up to body temperature," he said. "Then we put them in a machine (called an ICP-MS- or Inductively coupled plasma mass spectrometry), and that machine told us this is lead and this is chromium . . .

"We didn't dissolve the toys," he added. "These materials were leeching off the toys. Whatever leeched off the toys is what I'm reporting to you. The material came right off. Somebody's saliva or the sweat in their hands would freely pick up these materials. And that's absorbing it. If you ate the materials, like a dog might, it would be worse."

Physicist agrees

A physicist who reviewed ExperTox's findings echoed Dr. Lykissa's concerns.

"The fact that these (toxins) were leeching off the toys makes this much worse," said Jim Norling, an Ohio physicist. "He (Dr. Lykissa) was testing how much lead leeched out of the toys. That sounds like water soluble lead, which is more toxic than solid lead that is encapsulated. Water soluble lead is easily absorbed by the body, so this ups the ante on being toxic."

He added: "There's a big difference between lead that is contained and lead that is leeching in water."

Trace Laboratories used a different procedure to test the pet products it analyzed for WFLD-TV. That lab used what's called an X-ray fluorescence analyzer.

"It basically shoots a beam (at the area tested) and reads back the material content in the product," said the lab's General Manager, Mitchell Sas. "In this case, we only screened for lead."

Meanwhile, ExperTox's findings struck a personal chord with Norling and his wife, Karen.

Their two Miniature Schnauzers -- Angus and Taylor -- have repeatedly played with Wal-Mart's green monster toys. The dogs, they said, chewed on the toys for days and eventually tore the squeakers out of them.

Karen is worried about lead building up her dogs' bodies and the long-term affects that could have on their health.

"I wish to God he (Dr. Lykissa) was wrong about all this because if he's not my dogs will inevitably suffer, which will cause me to suffer deeply in the long run."

Her husband shares those concerns for their dogs and himself and his wife.

"Our dogs love that (toy)," Norling said. "We throw it to them and our hands get wet. Now I wonder how much lead we were exposed to. I work with my hands and if I had a cut, that lead would go directly into my blood and that's very bad."

Wal-Mart dodges

Wal-Mart, however, defended the pet toys we tested and said they were safe. The company also criticized Dr. Lykissa, saying he "severely misinterpreted" the results.

"After reviewing these test results provided to usthe results of these tests actually prove the products are VERY safe," said Wal-Mart's hired spokeswoman, Melissa O'Brien. She works for a private public relations firm called Edelman. "If these measurements are in fact the results, as you have reported, they have been severely misinterpreted by the director of ExperTox's lab, if he is reporting these levels to be 'high' or dangerous.

"The conclusions drawn in this article appear to have been based on incorrect interpretations of the data, and based on the opinions of a person (who is) not an expert in consumer product testing," O'Brien said.

O'Brien did not cite any scientific credentials and did not refer us to any scientific employees or consultants to back up her statements.

ExperTox said Dr. Lykissa is an expert at testing consumer products. The lab also called its findings "rock solid."

A veterinary toxicologist who reviewed ExperTox's results said the levels of toxic metals in the toys did not pose a health risk to dogs or cats.

"I don't see any of those numbers being a toxicity concern for dogs or cats," said Dr. Mike Murphy of the University of Minnesota's College of Veterinary Medicine. "Latex paint can contain one-half to one percent of lead, which is 10,000 parts per million.

"I disagree with the interpretation that's being made (by Lykissa)," added Dr. Murphy, who holds a Ph.D. in toxicology. "I consider these to be extremely low numbers and they are not a toxicological concern for pet owners."

After learning about Trace's findings, however, Dr. Murphy told the American Veterinary Medical Association that pet owners should be careful about lead exposure in their dogs and cats.

"If your pet is chewing and swallowing a toy then maybe that's not something you should allow the animal to play with," Dr. Murphy said, adding there are other -- more toxic -- sources of lead in many households, including old lead paint, fishing weights, curtain weights, and some older molded-metal toys.

More testing needed

Dr. Steven Hansen, director of the Animal Poison Control Center (APCC) for the American Society for the Prevention of Cruelty to Animal, said his lab fielded more than 200,000 hotline calls in the past two years. And none of those calls came from pet owners worried about a toy causing lead poisoning in their pets.

Dr. Hansen, however, urged pet toy makers to test their products for lead and other toxins.

"To reassure pet owners, we encourage manufacturers to test pet products for lead and other contaminants and post findings on their corporate Web sites," he said.

An Illinois pet owner, who in August paid to have 24 of her dogs' Chinese-made toys tested for lead, agrees.

Nancy R. of Orland Park, Illinois, hired a laboratory at the Illinois Department of Agriculture to run the tests.

"The only reason I tested these dog toys is because I have lost three Shelties in the last four years and I can only figure out why one of them died," said Nancy, who is also a nurse.

Tennis ball

The Illinois Department of Agriculture's lab found the highest levels of lead in a PetSmart tennis ball -- 335.7 parts per million. It detected the lowest levels of lead in a Hartz Rubber Percival Platypus 0.02 parts per million.

"These are all within the acceptable limits for lead content in children's toys in Illinois," the lab's director, Dr. Gene Niles, told us. The veterinarian is a Diplomate of the American Board of Veterinary Toxicology (DABVT). "There are no levels for lead content in pet toys. Are these numbers high or low? All I can tell you is that in Illinois, the state allows up to 600 parts per million for lead in kid's toys and these are all within that guideline."

Nancy, however, says new guidelines are needed specifically for pet toys. And these latest findings by Trace Laboratories illustrate her concerns.

"I want standards for safe levels of lead and other toxins for pet toys," she said. "And I want to know what they (those in the pet industry or with legislative authority) are going to do about getting these standards.

"Originally, my lab convinced me all my toys were safe. But now, I don't knowI don't know if I feel safe with the toys out there. I hope everybody stops blaming each other and starts solving the problem. And the problem is we have no standards for pet toys."

Symptoms

In the meantime, how can pet owners tell if their dogs or cats have lead poisoning?

Dr. Frederick Oehme, professor of toxicology and diagnostic medicine at Kansas State University, said symptoms can include a slightly anorexic appearance, loss of appetite, and behavior changes like twitching and whining in their sleep.

In more advanced cases, he said, there are neurological symptoms that include mild to severe seizures.

Pet owners who notice any of these symptoms in their dogs or cats should immediately contact their veterinarian, Dr. Oehme said.

"Veterinarians are in a very unique position because, when they see lead poisoning in a pet, the veterinarian can then ask if other members of the family -- particularly children -- have been checked for lead poisoning since they live in the same environment," he said. "I've seen a dog that tested with high levels of lead ... from lead soldering, and, when the owner was tested for lead, he also had high blood levels of lead."

More about pets ...

December 27, 2007
Clicking on Web links in holiday-related e-mail messages is a dangerous practice that could put your identity or your computer in the hands of criminals.

"Last year security researchers saw the creation of the world's largest 'botnet,' or collection of personal computers being controlled by hackers, according to Gary Warner, director of Research in Computer Forensics at the University of Alabama at Birmingham.

This botnet, called "the Storm Botnet," has at various times included more than 3 million infected computers, Warner said. One of the primary ways machines became infected was by users clicking on e-mails that were often associated with holidays, including Valentine's Day, Labor Day, Fourth of July and others.

Over the Christmas holiday, the creators of the "Storm Worm" sent e-mails with dozens of Christmas and New Year's-related greeting messages.

A computer whose owner clicks on the link in the e-mail message will be attacked by malware, which tries to join the computer to the criminal's Botnet. Once joined, the computer begins sending spam messages for the criminals, and may be used in other types of cybercrimes.

The same advice that we normally give applies here, Warner said. Clicking on Web links in e-mail messages is a dangerous practice, which could give your identity, or in this case, your computer, to the criminals.

More Scam Alerts ...

Chances are, when you opened your presents this year there was at least one gift card. The National Retail Federation projected the average consumer would spend $123 on gift cards this year.

If you got one, dont let it gather dust, experts advise.

A study conducted earlier this year for Consumer Reports found that 27 percent of gift card recipients have not used one or more of the cards, up from 19 percent at the same time last year. And among consumers with unredeemed cards from last season, 51 percent have 2 or more.

When cards are not used, the value can sometimes decline, due to fees and other charges, making the cards a bigger gift for the retailers than the recipient.

Its easy to understand the appeal of gift cards. Theyre the perfect no-muss, no-fuss gift for the finicky family member or friend. Its a no-brainer... said Todd Marks, senior editor at Consumer Reports.

But gift-givers and recipients alike need to be aware of the pitfalls and make sure that precautions are taken so that the recipient gets the gift and not the retailers, he said.

Marks suggests spending the gift card quickly, as some carry an expiration date. Some even have a maintenance fee.

Also, spend it to the last penny. If the card balance gets so low that theres nothing to buy, ask a merchant to do a split-tender transaction. That involves using the remaining card balance for part of the transaction and another form of payment for the rest.

One the entire balance has been spent, dont throw the card away just yet. Some merchants require it for returns.

While government statistics show consumer spending is holding steady, some economists fret about the rising level of debt Americans are putting on credit cards, and whether or not theyll ever be able to pay it off.

The Associated Press reported this week that its analysis of data from credit card lenders shows a big spike in the number of accounts more than 90 days in arrears. Thats the delinquency period when most debt is turned over to collection agencies.

As more consumers fall behind on credit payments, states are grappling with increasing activity of so-called debt counselors and debt settlement services.

In West Virginia, Attorney General Darrell McGraw has won a court order temporarily forbidding a Florida law firm from offering debt settlement services in the state.

McGraw says the firm, Hess Kennedy, of Coral Springs, Florida, claims to assist consumers who are struggling financially to make payments to their creditors. McGraw said he has seen more of this increasingly common, and sometimes controversial business as consumer credit card debt has ballooned in the past few years.

Debt settlers such as Hess Kennedy make repayment plans to help consumers repay outstanding debts, at a deep discount, to avoid being sued or filing for bankruptcy. Monthly payments are then made by consumers to the debt settlers in turn for which the debt settlers claim to negotiate with creditors to reduce the amount of debt owed.

Although debt settlement services are unrestricted in some states, West Virginias law regarding debt settlement only permits for-profit companies to charge a monthly service fee of two percent of the payments made by consumers.

Although McGraws investigation is incomplete, the attorney general says it appears that Hess Kennedy was charging more than the two percent fee allowed by state law.

"Although the debt settlement approach to debt relief may work for some persons, the service has legal consequences and should only be offered by persons licensed to practice law in West Virginia, McGraw said.

My office will continue to scrutinize the debt relief industry in an effort to protect consumers who are already facing dire financial circumstances from paying excessive fees for services that may leave them in worse shape than before."

Q.Can eating oatmeal really lower your cholesterol or are the cereal companies selling us a story?

The short answer is yes, oatmeal can lower your cholesterol. Now for the long answer.

There are two types of fiber, soluble and insoluble. Soluble fiber is acted upon by the normal bacteria in your intestines. Insoluble fiber is not digested by the body and promotes regularity and softens stools.

Wheat bran, whole grain products and vegetables are good sources of insoluble fiber.

Soluble fiber appears to reduce your body's absorption of cholesterol from the intestines.

Oatmeal contains soluble fiber that reduces your low-density lipoprotein (LDL), the "bad" cholesterol that can increase your risk of heart attacks and strokes. This type of fiber is also found in such foods as kidney beans, brussels sprouts, apples, pears, barley and prunes.

The American Dietetic Association recommends a healthy diet include 25 to 35 grams of fiber a day, including both soluble and insoluble fiber. (Soluble fiber should make up 5 to 10 grams of your fiber intake.) However, Americans only consume about half that amount.

There are other foods that work against cholesterol.

Soy protein, found in such products as tofu, soy nuts, soy milk and soy burgers, can help lower blood levels of LDL cholesterol, particularly when it's substituted for animal protein.

Ingesting 25 to 50 grams of soy protein a day lowers LDL cholesterol by 4 percent to 8 percent. Thats a lot of soy. People with the highest cholesterol levels seem to benefit the most from soy protein.

Women with breast cancer or who are at high risk of breast cancer should consult with their doctors before eating a soy, because it is not clear how these plant estrogens might affect them.

Studies have shown that walnuts can significantly reduce cholesterol levels in the blood. Rich in polyunsaturated fatty acids, walnuts may also help keep blood vessels more healthy and elastic.

When walnuts represent 20 percent of the calories in a cholesterol-lowering diet, they reduce LDL cholesterol by 12 percent. Almonds appear to have a similar effect.

All nuts are high in calories, so use them as replacements for high-calorie foods with high levels of saturated fats.

Omega-3 fatty acids in fish are noted for lowering triglycerides, another form of fat in your blood. They also benefit the heart in other ways.

The highest levels of omega-3 fatty acids are in mackerel, lake trout, herring, sardines, albacore tuna and salmon. Other good sources of omega-3 fatty acids include flaxseed, walnuts, canola oil and soybean oil.

Some foods are fortified with plant substances called sterols or stanols, which are similar in structure to cholesterol; this helps them block the absorption of cholesterol in the intestines.

Margarines and orange juice that have been fortified with plant sterols can help reduce LDL cholesterol by more than 10 percent.

The American Heart Association recommends foods fortified with plant sterols only for people who with high levels of LDL cholesterol.

You may want to try eating more soluble fiber, soy protein, walnuts and fatty fish. The next step would be the addition of foods fortified with plant sterols. Eating a combination of these cholesterol-lowering foods increases the benefit.

Of course, if youre a geezer and you plan to make a change in your habits that could affect your health, it is recommended that you consult your doctor first.

All Rights Reserved © 2007 by Fred Cicetti

A. Uh-huh. Sensitivity to caffeinethe pick-me-up in coffeetends to increase as you get older. Children metabolize caffeine quicker than adults.

About 90 percent of Americans consume caffeine daily. More than half of all American adults consume more than 300 milligrams of caffeine every day, making it America's most popular drug.

Caffeine occurs naturally in many plants, including coffee beans, tea leaves and cocoa nuts. It is therefore found in a wide range of food products. Caffeine is added artificially to many others, including a variety of beverages.

The most common sources of caffeine for Americans are coffee, tea, colas, chocolate and some over-the-counter medications.

Here are some useful numbers to help you determine how much caffeine you take in:

• A 6-ounce cup of coffee100 mg
• A 6-ounce cup of tea70 mg
• A 12-ounce can of cola50 mg
• An ounce of chocolate6 mg
• One tablet of Extra Strength Excedrin65mg
• One tablet of Anacin32 mg
• One tablet of Maximum Strength NoDoz200 mg

For most people, 200 to 300 milligrams a day aren't harmful. But, if you are sensitive to caffeine or use of certain drugs, you may want to cut down or eliminate caffeine from your diet. Your caffeine consumption is worth discussing with your doctor.

Caffeine can cause restlessness, anxiety, irritability, muscle tremors, sleeplessness, headaches, nausea, diarrhea and abnormal heart rhythms.

Some medicines and supplements interact negatively with caffeine. These include some antibiotics and bronchodilators. Talk to your doctor or pharmacist about whether caffeine might affect the medicines you take.

In the practice of medicine, caffeine is useful as a cardiac stimulant and also as a mild diuretic. Caffeine is an addictive drug. It stimulates like amphetamines, cocaine, and heroin.

If you feel you have to have caffeine every day, then you are addicted to it. Eliminating caffeine suddenly can cause withdrawal symptoms, such as headaches and fatigue. These symptoms usually pass after several days.

Here are some tips if you want to chase the caffeine monkey:

• Read labels carefully for ingredients and keep track of the caffeine you consume.

• Gradually reduce the amount of caffeine you take in. This will enable you to acclimate to less caffeine and reduce the effects of withdrawal.

• Start drinking decaffeinated coffee, tea and soda.

• Brew your tea for less time to cut down on caffeine. Or try herbal teas which are caffeine-free.

• Check the caffeine content in over-the-counter medications that you take. If you can, switch to caffeine-free forms of the medications you need.

All Rights Reserved © 2007 by Fred Cicetti

The group says the mislabeled fur garments are being sold at six major retailers: Bloomingdale's, Neiman Marcus, Lord & Taylor, Dillard's, Saks Fifth Avenue and Yoox.com.

Certain jackets sold by these companies, under the brand names Burberry, Andrew Marc, Marc New York, Preston & York, Aqua, Ramosport and Adam & Eve, were found to be falsely advertised or mislabeled as faux fur or "ecological" fur when in fact they are trimmed with real animal fur, the Human Society said in a statement.

This isnt the first time this has happened, the group claims. It says its investigation last winter found the same stores selling real fur as fake fur.

"Shoppers should be outraged that companies continue to sell as fauxwhat is actually real fur, perhaps from animals skinned alive in China," said Kristin Leppert, director of The HSUS's fur-free campaign. "Congress and the Federal Trade Commission need to take swift action to protect consumers and animals."

Yoox.com customer service indicated that garments advertised as "ecological fur" are fake fur, the group said.

The HSUS said it identified the fur as real through laboratory testing and by cutting open the lining of the trim to reveal skin. In contrast, the hairs of fake fur contain a fabric or mesh backing.

Loopholes and labels

Falsely advertising or mislabeling a real fur product is a violation of the federal Fur Products Labeling Act, which the Federal Trade Commission is empowered to enforce by seizure of false or deceptively advertised or labeled garments, the initiation of proceedings for injunctive relief, and the imposition of monetary penalties, which can range up to $5,000 per violation.

Despite the groups charges, the retailers may not, in fact, be in technical violation of the law. And therein, according to HSUS, lies the rub.

Among the alleged violations pointed out by HSUS is a Burberry brand jacket advertised online by Saks Fifth Avenue as "faux." The group says the jacket's label does not indicate that it contains fur, but laboratory tests reveal that it is trimmed with rabbit fur. The Fur Products Labeling Act currently requires the labeling of fur apparel only if the garments contain more than $150 worth of fur.

"Because of this loophole, consumers don't even realize they've been duped into buying real fur," said Leppert.

Of the two jackets falsely labeled "trim: polyester," one is a size-four girl's jacket bought in the children's section of Neiman Marcus. Test results reveal that the coat actually contains raccoon dog fur, the group said.

Not the first time

Last winter, of 25 fur-trimmed jackets tested by The HSUS, the group says every single one was falsely advertised, falsely labeled, unlabeled or had a combination of these problems. Twenty were identified by laboratory testing as raccoon dog and three as domestic dog.

Raccoon dogs and domestic dogs are both raised for their fur in Chinaa country HSUS says has no functioning animal welfare laws, and where investigators have documented animals being skinned alive for their fur. Like many other species, rabbits raised for their fur spend their entire lives in tiny wire cages. Much of the worlds fur is processed in China, where environmental problems associated with the industry are receiving scrutiny.

In the Congress, Representatives Jim Moran (D-Va.) and Mike Ferguson (R-N.J.) have introduced the Dog and Cat Fur Prohibition Enforcement Act, that would require labeling of all fur garments, regardless of value. The legislation also prohibits the sale of raccoon dog fur. The bill has more than 150 co-sponsors in the House, and a Senate version is expected to be introduced soon.

More Scam Alerts ...

The TJX Corporation, parent to discount chains TJ Maxx and Marshalls, has settled a series of lawsuits with banks over the data breach that compromised the credit card accounts of nearly 100 million shoppers.

Terms of the settlement between the coalition of banks, led by the Massachusetts Bankers' Association (MBA), and TJX were undisclosed but TJX said the $107 million reserve fund it set aside to cover payments and legal expenses from the breach would cover the banks' agreement.

"The TJX experience underscores broader challenges facing the U.S. payment card system that require urgent action by merchants, banks, payment card companies and associations, and we look forward to greater cooperation in order to better serve and protect customers," said TJX president and CEO Carol Meyrowitz.

MBA president Daniel Forte said that the TJX data breach "and the ensuing litigation have clearly initiated an important nationwide dialogue on the importance of improving the security of the U.S. payment card system."

The banks' lawsuits suffered a setback on Nov. 30 when a Massachusetts judge ruled that they could not band together as a class and had to seek restitution from TJX individually. TJX, which admitted no fault in the settlement, urged the banks to accept a separate settlement it had negotiated with Visa on Nov. 30. Under that settlement, TJX would pay up to $40.9 million to plaintiff banks in exchange for their dropping lawsuits against the company.

Not every bank in the coalition is on board with the settlement. Alabama-based Amerifirst bank is proceeding with its own lawsuit, and TJX must contend with lawsuits filed by several state Attorneys General as well.

Although industry insiders viewed the settlement as a mutual agreement to put litigation aside in time for the holiday shopping season, the real victims of the breach--consumers whose data was exposed to potential identity theft--have been largely forgotten about. TJX offered a consumer settlement that consisted mainly of a special three-day sale and reimbursement for damages only after submitting extensive documentation.

Both TJX and the plaintiff banks have accused the other of failing to provide proper security for their payment transactions, and both have claimed greater compliance with industry standards since the breach was made public, but neither side is willing to make the results of their improvements public.

The TJX breach took place when hackers using laptops with wireless connections pirated information from TJX's payment network, including the credit and debit card numbers of 94 million Visa and Mastercard users. The breach has been called "the biggest ever."

December 19, 2007
Bombardier Recreational Products is recalling nearly 500 Ski-Doo model year 2008 MXZ X 600 RS snowmobiles.

A defect in the carburetor can prevent the throttle from freely returning to the idle position. This can result in an unexpected loss of control leading to a collision and cause serious injuries or death.

The firm has received three reports of snowmobiles with stuck throttles. No injuries reported.

The recall involves Ski-Doo model year 2008 MXZ X 600 RS snowmobiles. The model name is located on the side panels. The snowmobiles were sold in yellow or black/slate.

The units were sold by Ski-Doo dealers nationwide during November 2007 for about $9,500. They were made in Canada.

Consumers should stop using these vehicles immediately and contact any Ski-Doo dealer to schedule a free repair. Consumers with recalled snowmobiles are being sent direct notices from Bombardier.

Consumer Contact: For more information, call Bombardier Recreational Products toll-free at (888) 638-5397 between 8 a.m. and 6 p.m. ET Monday through Friday, or visit the firm's Web site at www.ski-doo.com.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

With Nevada leading the nation in the rate of foreclosures, that states attorney general is cautioning consumers about an alarming incrase in foreclosure rescue scams.

Catherine Cortez Masto said that in nearly every case, these scam operations will promise to intercede with the homeowners lender to stave off foreclosure, but will require consumers to sign contracts which involve turning ownership of a home over to the foreclosure relief company.

The scammer then promises to lease the home back to the consumer with a buyback option at some future date. These plans never work, and consumers will lose their homes to the foreclosure rescue company.

Unfortunately, home foreclosures are on the rise in Nevada and that has given scam artists fertile ground for cheating those desperate to keep their homes, Masto said. If you are facing foreclosure, I encourage you to talk with your mortgage lender before accepting help from an outside party.

Nevada led the nation in foreclosures for the 11th month in a row, with one filing for every 152 househilds. Florida was second with one out of 282 homes and Ohio was third with one out of every 307 homes.

Mail solicitation

In one scam known to be operating in Nevada, Masto says the perpetrator solicits victims directly through the mail with promises to help a homeowner from foreclosure by saving their credit and negotiating directly with their lender.

The perpetrator will offer to buy the house for the total amount owing on the house, plus some small amount of cash. The perpetrator will require the victim to sign a deed, a transfer tax form, and a contract of sale.

The deed provides that the seller (the victim) is selling the house to a corporation. The perpetrator pays the cash to the victim and assures him he will take care of paying off any mortgages on the home.

After the victim moves out of the house, the perpetrator rents the house, does not pay the mortgages, and the house goes into foreclosure. The perpetrator can continue to collect rent until the foreclosure process is completed. The victim collects none of the rent, and, once foreclosure is completed, the renters are evicted.

What to do

Homeowners in distress must talk directly to their lender and not rely on a third party, Masto said. It's also important to make contact as early in the process as possible.

Assistance is also available from licensed credit counselors, government agencies, and legal services. But by all means, said Masto, seek advice from qualified professionals who do not have a personal interest in your decision.

More about avoiding foreclosure ...

The number of U.S. homes going into foreclosure totaled nearly 202,000 in November, a 68 percent rise year over year, but down slightly from the previous month.

In its monthly report, the real estate tracking firm RealtyTrac, Inc., said foreclosure activity likely peaked for the year in August.

This could indicate that foreclosure activity has topped out for the year, but the true test of whether this ceiling will hold will come at the beginning of next year -- when we anticipate that a seasonal surge in foreclosure filings and another possible wave of resetting mortgages could place further pressure on the housing market, said RealtyTrac CEO James J. Saccacio.

The report shows a total of 201,950 foreclosure filings, which can include everything from default notices to actual bank repossessions. That number is 10 percent lower than Octobers total, but amounts to a national foreclosure filing rate of one for every 617 households.

Foreclosure activity remains concentrated in a handful of states. Nevada led the nation for the 11th month in a row, with one filing for every 152 househilds. Florida was second with one out of 282 homes and Ohio was third with one out of every 307 homes.

California had the highest number of foreclosure notices, at 39,992. In terms of Metro areas, Stockton, California led the nation with the highest foreclosure rate, recording a staggering one out of every 99 households heading into foreclosure.

While Saccacio says foreclosure activity appears to have leveled off for 2007, he says it could start back up again in 2008.

The reason?

Homes sold with subprime mortgages during the still-red hot real estate market of 2006 will begin to reset to higher interest rates. When that happens, monthly payments often go up by as much as several hundred dollars a month.