There are approximately 430 million bald or balding men in the world. Losing your hair is probably on everyone's list of worst-case scenarios. More than 66 percent of men will experience some hair loss (alopecia) during their lifetime. Those who become bald usually have significant hair loss by the age of 35. 1 of every 4 women will also experience hair loss.  The human head has about 100,000 hairs and the average person loses approximately 100 to 200 hairs a day with more men than women losing their hair. Under normal circumstances, about 90 percent of hairs are in a growing stage all of the time, so no hair loss is usually evident.  Hair loss can have many causes including chemotherapy and radiation, self-induced hair loss from pulling or tugging at the hair, from sudden stress, and from scarring related to infections and lupus. One type, alopecia areata, is believed to be an autoimmune disorder.  The most common cause of hair loss is androgenetic alopecia, most commonly known as male pattern baldness or female pattern baldness. 95 percent of hair loss can be attributed to this type. It starts when an enzyme called 5-alpha reductase in a hair follicle combines with testosterone. The enzyme changes testosterone into a hormone called dilhydrotestosterone, or DHT. It is believed that DHT causes the hair follicle to shrink until the hair grows thinner and smaller, eventually disappearing altogether.  Men in their early twenties can begin losing their hair. The younger you are when hair loss begins, the more likely you are to become bald. If your mother's father or her male relatives were bald, you are likely to go bald, too, because hereditary male-pattern baldness usually passes through the mother's genes.  Although Finasteride (Propecia) and Minoxidil (Rogaine) are the only currently approved non-surgical treatments for hair loss, other treatments are on the horizon. Studies continue on various medications, gene therapy, and even cloning. One such prospect is known as RU 58841, a non-steroid antiandrogen. When applied to the skin, it has shown to affect androgen production at the follicle site, but not to affect other organs. An oral drug known as GI198745 may be available for men in the years to come. It is similar to Finasteride (Propecia), but may be more effective. Women in their childbearing years may not use, handle, or touch Propecia under any circumstance as there is a risk of systemic absorption of the drug and potential damage to a fetus. Post-menopausal women and women who have undergone hysterectomies or tubal ligations may use Propecia with success. Many shampoos, gels and styling products are currently on the market with varying degrees of success. Many experts believe that the future will bring better, more specific agents to treat alopecia with fewer side effects and better results.  Options such as hairpieces and sprays that combine with your own hair to make it look fuller are also available as cosmetic options.  Some drugs, whose primary use has been to treat another medical condition, may also grow hair in some cases. They include oral contraceptives for women, a diuretic called spironolactone, a systemic antiandrogen called flutamide, the hormone progesterone, cyproterone acetate and cimetidine (Tagamet).  In advanced baldness, a procedure is available called scalp reduction, which removes areas of bald scalp if the skin is very loose. This procedure may be used in conjunction with hair transplantation, so that the person's available hair can provide more coverage. New hair can not be created, but the existing hair may be relocated to help cover bald areas.  Hair transplantation has become a common procedure in the past three decades and many improvements to the technique have been developed. The use of micrografts and minigrafts now gives a natural permanent change in appearance. You can engage in activities such as swimming, working out, and riding against a strong wind, without fear of dislodging a hair piece or a comb-over hairstyle. Hair restoration is considered minor surgery, much like a dental procedure. General anesthesia is rarely necessary, except during the most aggressive form of hair restoration called the flap technique, which is not commonly performed.  Many surgeons feel that surgical procedures are more appropriate for patients 30 years old and up, because the pattern of future hair loss will be more predictable by then. Surgical procedures will be more likely to yield satisfactory results if the surgeon can anticipate the patient's future pattern of baldness. It is also wise to wait because there are new techniques being introduced all the time. The longer you can wait, the more likely you will benefit from the latest techniques in surgical hair transplanting. Dr. Gho in the Netherlands is experimenting with a technique that can split a single follicle into several follicles, multiplying the total number of grafts that can be transplanted. However, it will probably be years before this technique becomes available to the public. 

Tallahassee - The Florida Department of Health's (DOH) Bureau of Chronic Disease Prevention has received funds from the Centers for Disease Control and Prevention for a statewide planning grant to develop an obesity prevention program. The Bureau's Cardiovascular Health Program and Diabetes Control Program will work closely with this grant to develop strategies and activities to combat obesity. In October of 2001, the DOH released findings from "The Obesity Epidemic in Florida" report. The data details the major public health threat that obesity has become. Since 1986, when weight and height were first monitored in adults, the rate of obesity has nearly doubled. Today, nearly one of every five Florida adults is obese. The sharp increase of overweight and obesity observed in adults has also been seen in children, who have experienced a near doubling in the rate of obesity, as well. Currently in Florida, 38.3 percent of adults are overweight and an additional 18.5 percent are obese, representing increases of 17.5 percent and 94 percent since 1986. Among young adults between the ages of 18 to 29, the prevalence of obesity has increased by 110 percent. One-third of Americans are obese, and two-thirds are overweight. 25 percent of children are overweight. 40 million adults are 20 percent or greater than their ideal weight. Eating too much and not getting enough physical activity are the main causes of obesity. 24 percent of Americans are completely sedentary, 54 percent do not get enough exercise and only 20 percent of Americans get enough exercise to have a positive effect on health and weight. Since 1977, men have increased the number of calories consumed by over 200 a day. In the same time period, women have increased their calorie intake by over 110 each day. In general, calorie intake has increased by 6 percent since 1979. This translates into a weight gain of 22.5 pounds a year for men, and almost 12 pounds a year for women, if those extra calories were stored as fat. Obesity has increased 55 percent since 1980. Morbid obesity is a term applied to people who are 60 percent above their ideal weight and at least 100 pounds overweight. Obesity is defined as a body mass index of 30 or more or a person who is 20 percent or greater than his ideal weight. Overweight is defined as a body mass index of 25 or more. Weight reduction is advised for a body mass index 27 or greater. If you carry fat mainly around your waist, you are more likely to develop obesity-related health problems. Women with a waist measurement of more than 35 inches, or men with a waist measurement of more than 40 inches have a higher health risk because of their fat distribution. Each fat cell can balloon to more than 10 times its original size, but if the available cells get filled to the brim, new ones will form. As the body stores more fat, weight and girth increase. At any time, 45 percent of women and 25 percent of men are trying to lose weight. Americans spend $30 to $40 billion annually trying to lose weight. In 1996, Americans spent $467 million on prescription diet pills and another $32 million on over-the-counter diet pills. Medical costs associated with obesity exceed $100 billion per year. Obesity results in 300,000 premature deaths in the U.S. annually, second only to smoking. Obesity triples the risk for asthma and increases the risk of diabetes, gallstones, arthritis, asthma, kidney failure, stroke, heart attacks, and some cancers. In overweight young adults ages 20 to 45, the prevalence of hypertension is 6 times that of normal-weight people. Dying from a heart attack is 3.5 more likely for someone who is obese. Diabetes is up to 26 times more likely in people who are obese. Musculoskeletal problems, such as low back pain and arthritis, are common among the obese. Sleep apnea and depression have been linked to being overweight. Increased stomach pressure from abdominal fat results in a high rate of gastro-intestinal reflux. Urinary incontinence may result from a large, heavy abdomen weakening the urinary bladder valve. Overweight men have a significantly higher mortality rate for colorectal and prostate cancers, compared to men of average weight. Obesity may be responsible for female hormone abnormalities resulting in infertility, ovarian cysts and irregular menstrual periods. Menopausal women with upper body fat localization have an increased risk of developing breast cancer. Overweight women also have higher rates of cancer of the uterus and ovaries. The treatment for obesity depends on the level of obesity, a person's overall health condition, and the motivation to lose weight. A combination of diet, exercise, behavior modification and, sometimes, weight-loss drugs may be used. In cases of severe obesity, gastrointestinal surgery may be performed. Remember, weight control is a life-long effort. For more information about overweight and obesity, visit the Department of Health website at www.doh.state.fl.us. 

Skin cancer is now more common than all human cancers combined. Over a million people are expected to be diagnosed this year with either basal or squamous cell skin cancer. Actinic keratoses, a precancerous condition, is also very common in older people. Melanoma, although less common than the other two major skin cancers, is the most dangerous.  The greatest risk factor for skin cancer is exposure to ultraviolet (UV) radiation, although other factors include a family history of the disease, a suppressed immune system, and chronic exposure to toxins. Skin cancers are most prevalent among those with lightly pigmented skin and rare among dark-skinned blacks. Redheaded people have the highest risk, followed by blondes.  Everyone should give themselves a monthly self-examination of all areas of the skin, including back, scalp, armpits, palms, feet, and spaces between the toes. Use a mirror or have a partner check hard-to-see places. If any suspicious areas are found, a dermatologist or doctor trained in detecting skin cancers should be consulted.  Malignant melanoma, the most serious of skin cancers, is increasing at an alarming rate, faster than any other cancer. If detected in the early stages, melanoma can be cured in 90% of patients. Signs include oozing, crusting, redness or swelling of the surrounding skin and tenderness or pain. Individuals most at risk for melanoma tend to have a fair or freckled complexion, blond hair with blue, green or gray eyes, skin that burns easily, a history of sunburn, especially as a child or teenager. Treatment consists of surgery, which can be effective if the cancer has not yet spread to the lymph nodes and to other sites in the body. The American Academy of Dermatology's ABCD checklist is the suggested tool for determining if a lesion is malignant. Moles with any one of these features have melanoma potential: ASSYMETRY: one-half doesn't match the other BORDER: irregularity (ragged, notched, or blurred edges) COLOR: variation (shades of tan, brown, and black - or even red, blue, or white) DIAMETER: greater than ¼-inch (the size of a pencil eraser) E......A recently proposed amendment to this rule includes "E" for ELEVATION or ENLARGEMENT.  Basal cell carcinoma is the most common skin cancer. Lesions usually develop later in life in areas that have received the most sun exposure, but about a third of basal cell carcinomas appear in areas not exposed to the sun. They usually appear as a round area of thickened skin that does not change color or cause pain or itching. The lesion spreads out slowly and develops a slightly raised edge. Eventually, the center becomes hollowed and covered with a thin skin, which can become sore and open. Late treatment can cause disfigurement, so early treatment is advised.  Although squamous cell cancer has a low mortality rate, it kills about 1700 people each year. These cancers begin as small firm nodules that may become inflamed, especially around the edges. The nodules develop crusts and may eventually ulcerate. The majority occur on sun exposed areas. Prompt treatment is desirable because they are more likely to spread to local lymph nodes than are basal cell carcinomas.  Actinic keratoses are red, scaly, and tender lesions, which range in size from microscopic to several inches in diameter. They are often flesh-colored and are more easily felt than seen. They are the most common of all precancerous skin lesions.  Effective sunscreens should provide protection against UVA rays, which are blocked by window glass, and UVB rays, which pass through window glass. UVA rays are the primary cause of sunburn and skin cancer, but UVA rays penetrate deeper into the skin layers and also contribute to skin burning and skin cancer. Both types of rays are known to supress the immune system.  A sunscreen with an SPF of at least 15 should be used year round for all skin types. SPF stands for Sun Protection Factor, a classification for sun screens, which ranges from 2 to 60. These numbers refer to the product's ability to screen out the sun's burning rays. The SPF rating is calculated by comparing the amount of time needed to cause a sunburn on the unprotected skin to the amount of time need to cause sunburn on the protected skin. For example, if a fair-skinned person would normally turn red after 10 minutes of exposure to the sun, this person could take 40 minutes in the sun before turning red if they used a sunscreen with a SPF of 4 (10 minutes x 4 SPF).  Sunscreen should be applied to dry skin 15 to 30 minutes before going outdoors. Water resistant sunscreen needs to be reapplied about every 2 hours, mmediately after swimming, or after strenuous activity. Gels need to be reapplied frequently, because they sweat and wash off most easily. One ounce, enough to fill a shot glass, is considered the amount needed to cover the exposed areas of the body properly. Lips get sunburned, so apply a lip balm that contains sunscreen with an SPF of 15 or higher. Sun exposure occurs all the time, even while you're taking a short walk on a cloudy day.  PABA, or para-aminobenzoic acid, was the original compound which was the basic ingredient of sunscreens, but it stained clothing. Today's PABA has been refined and the newer ingredient called PABA ester rarely stains clothing. People, sensitive to PABA and its esters, should seek products that contain other chemicals such as benzophenones (oxybenzone), cinnamates (octylmethyl cinnamate and cinoxate) and salicylates. 

A combination drug treatment that has been successful in advanced breast cancer will be tested in early-stage breast cancer in a large international clinical trial. 25 percent of women with breast cancer have the aggressive HER2-neu gene and this will be the focus of one of the studies. A second study will focus on early aggressive treatment in women without this gene.  A drug named Herceptin has helped to provide a 24 percent increase in survival in women with advanced breast cancer. This study will focus on Herceptin being used in combination with different chemotherapeutic agents in women whose breast cancer is still in its early stages, hoping to get even better results.  Over 600 medical institutions on 5 continents will be involved in the Phase III trial which is being co-ordinated by the Breast Cancer International Research Group (BCIRG) and in another study aimed at early breast cancer in women who do not have the HER2-neu gene. The BCIRG is a global co-operation of cancer researchers at academic institutions.  Eligible patients entering the study will be randomly assigned to one of three treatment groups: (1) A standard chemotherapy regimen called AC; Adriamycin and Cytoxan, followed by Taxotere. (2) AC followed by Taxotere and Herceptin. (3) Taxotere and Herceptin. Taxotere is currently approved for locally advanced or metastatic breast cancer after failure of prior chemotherapy. The study will compare disease-free survival rates among these 3 groups of patients.  The combination of Taxotere and Herceptin seems to avoid the potential for cardiac complications seen with certain standard chemotherapy regimens.  The other trial compares two chemotherapy regimens in the adjuvant treatment of 3000 women. (Adjuvant therapy is the use of medicines for treatment after the removal of a tumor.) These patients will receive AC followed by Taxotere or AC in combination with Taxotere. This therapy aims to eradicate any tumor cells that might remain, hoping to avoid a recurrence of the cancer. If effective, this therapy might be crucial in women whose cancer has spread to the lymph nodes in the underarm area, as there is a high probability of these cancers returning within 10 years. 

 Following the tragic events on September 11, 2001 and the continuing high state of alert that our country remains in, the Levy County Board of Commissioners feels that it is necessary to provide safety information to its residents.  Due to the Anthrax cases and concerns regarding potential biological or chemical threats, law enforcement agencies and fire departments statewide have received numerous requests for information and for assistance in picking up suspicious packages or letters.  Anthrax is an infectious disease caused by the spore-forming bacterium Bacillus anthracis. Anthrax is very rare in humans and cannot be transmitted from person to person. It can appear as a crystalline or powdery substance that may or may not be seen. Infection comes from contact with anthrax-infected animals or infected animal products. The spores are found widely in soil. Therefore, animals that feed on the ground, such as cows, sheeps and goats, tend to be infected. Humans can contract one of three forms of Bacillus anthracis: cutaneous (skin), intestinal and respiratory. Most commonly, infected people have been exposed through their work, for example, farmers, butchers and veterinarians, and those who sort raw wool and tan animal hides. Symptoms vary, but can include cold and flu-like symptoms. Doctors prescribe antibiotics for treatment of the disease, but to be effective, treatment should be initiated early.  The likelihood of receiving a package or letter containing suspicious substances is remote. However, it is important for citizens to be aware of characteristics that are common to suspicious packages. Some indicators may include the following: mailed from a foreign country, excessive postage, misspelled words, the package being addressed to a title without a name, the package having the wrong title with the name, rigidity or bulkiness, poor typing or handwriting, restrictive markings, no return address, a strange odor, a lopsided package or a package with a protruding item or stains on the paper the package is wrapped in.  If you receive a suspicious item, leave the letter or package alone. Do not move the item. Leave the vicinity immediately, along with any other individuals. Contact your local law enforcement agency and explain what has occurred. Your local law enforcement agency will notify the County Health Department to conduct appropriate testing. Results of the test will be available, in time, to determine what, if any, treatment should be implemented. Individuals who open or have contact with a letter or package containing an unknown substance should thoroughly wash their hands with soap and water. There is no need to start antibiotics prior to the analysis of the letter or package. Information such as names, addresses and phone numbers should be collected on all individuals who might have been exposed, and these individuals should be reassured that they will be contacted as soon as results are known.  For further information on how to stay informed on preparedness issues please contact the Levy County Health Department at (352) 486-5300 or the Levy County Emergency Management Citizen Information Line at (352) 486-5155 or visit the Centers for Disease Control and Prevention (CDC) website: www.cdc.gov. [Back to Top]  Olive Oil Every Day May Keep the Doctor Away and Cancer at Bay A Mediterranean meal and dietary supplements of olive oil may cut your risk of cancer. Mediterranean populations have much lower death rates from heart disease and certain cancers than people in the U.S. and the consumption of olive oil may be a contributing factor. People who eat a Mediterranean diet actually eat as much fat as people from other countries, but they get their fat calories primarily from olive oil which is largely composed of monounsaturated fat which can lower blood cholesterol. Components of olive oil, such as oleic acid, vitamin E, flavonoids, squalene and polyphenols, may help protect against colon, breast and prostate cancer because flavonoids and polyphenols are antioxidants which help prevent cell damage from oxygen containing chemicals called free radicals. Consumption of monounsaturated fats also may be beneficial in preventing breast cancer. Several studies have shown that olive oil consumption could reduce the risk of cancer by up to 45 percent, which implies that women who consume olive oil have lower rates of breast cancer than women who do not consume olive oil. Olive oil may contribute to a healthy prostate in men. Fish cooked in olive oil may be the answer for men concerned about prostate cancer. A study published in The Lancet medical journal suggests that eating moderate amounts of oily fish might cut the risk of prostate cancer in half. Swedish men who ate fish fried in olive oil rarely on not at all were twice as likely to develop prostate cancer as those men who ate fish fried in olive oil frequently or moderately. A University of Oxford research study shows that olive oil is as effective as fresh fruit and vegetables as a cancer preventive measure. A team of researchers at the Institute of Health Sciences, led by Dr. Michael Goldacre, compared cancer rates, diets and olive oil consumption in 28 countries, including the United States, Brazil, Colombia, Canada and China. Countries with a diet high in meat and low in vegetables had the highest rates of cancer and the consumption of olive oil was associated with a decreased risk of colon cancer. The researchers suspect that olive oil protects against colon cancer by influencing the metabolism of the gut. 

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