For a medicine to work for you—and not against you—you’ve got to take the right dose.
Many over-the-counter liquid medicines—such as pain relievers, cold medicine,
But the markings aren’t always clear or consistent with the directions on the medicine’s package. The Food and Drug Administration (FDA) has received numerous reports of accidental overdoses—especially in young children—that were attributed, in part, to the use of dosage delivery devices that were unclear or incompatible with the medicine’s labeled directions for use.
On May 4, 2011, FDA issued a guidance to firms that manufacture, market, or distribute over-the-counter liquid medicines. The guidance calls for them to provide dosage delivery devices with markings that are easy to use and understand.
Parents and caregivers can do their part, too, to avoid giving too much or too little of an over-the-counter medicine. Here are 10 tips:
Researchers have found what appear to be 2 key components of the long-sought-after mechanotransduction channel in the inner ear—the place where sound waves are transformed into the electrical signals that the brain recognizes as sound.
Sensory cells in the inner ear called hair cells are crucial for transforming sound into electrical signals. Hair cells also underlie our sense of balance. Sitting atop hair cells are tiny bristly structures called stereocilia. Microscopic tethers connect the tips of shorter stereocilia to the sides of adjacent taller stereocilia. Most scientists believe that as the stereocilia move, the tethers open ion channels—tiny openings in the cell that let electrically charged molecules (ions) pass in and out. The ions rushing inside begin an electrical signal that travels to the brain.
While researchers have gained many insights into mechanotransduction, the ion channels involved have remained elusive. A team of researchers led by Dr. Andrew J. Griffith of NIH's National Institute on Deafness and Other Communication Disorders (NIDCD) and Dr. Jeffrey R. Holt of Harvard Medical School decided to focus on 2 proteins. Griffith and other collaborators had previously found that mutations in the TMC1 gene cause hereditary deafness in both humans and mice. The TMC1 protein sequence suggests that it could span the cell's outer membrane and act as a channel. Another protein, TMC2, has a similar structure. The scientists deleted both genes in mice. Their findings appeared on December 1, 2011, in theJournal of Clinical Investigation.
Mice with no functional copies of TMC1 or TMC2 had the classic behaviors of dizzy mice—head bobbing, neck arching, unstable gait and circling movements. They were also deaf. The TMC1 deficient mice were deaf as well, but had no balance issues. Mice without TMC2 had no problems with hearing or balance.
The scientists examined when the TMC1 and TMC2 genes are expressed (turned on) in the inner ears of mice. The 2 genes were expressed from birth in hair cells in both the cochlea, which is responsible for hearing, and the vestibular organs, which are responsible for balance. When mice were a week old, TMC2 appeared to be turned off in the cochlea but not in the vestibular organs. TMC1 continued to be expressed in mature cochlear hair cells. Taken toghter, these findings suggest that TMC1 is essential for hearing, but TMC2 is not. For balance, however, TMC2 can substitute for TMC1.
In laboratory tests, hair cells lacking functional TMC1 or TMC2 had no detectable mechanotransduction currents, even though the rest of the cells' structure and function appeared normal. By using a gene therapy technique that adds proteins back into cells, the researchers were able to restore transduction to both vestibular and cochlear hair cells. This finding suggests that it might be possible to reverse these genetic deficits.
The researchers found that TMC1 and TMC2 cluster at the tips of the stereocilia, where one might expect to see proteins that play a prominent role in mechanotransduction. In future work, the scientists intend to explore how TMC1 and TMC2 interact with each other as well as with other known proteins at the stereocilia tip.
Have you ever read the Nutrition Facts label on food 
The Nutrition Facts label is divided into Two Main Areas:
Sections 1-5 provide product-specific information (serving size, calories, and nutrient information). These vary with each food product.
Section 6 is a Footnote with Daily Values (DVs). The footnote provides information about the DVs for important nutrients, including fats, sodium and fiber. The DVs are listed for people who eat 2,000 or 2,500 calories each day.
3 Easy Ways to Use the % Daily Value
Compare products – Use the %DV to compare one food product or brand to a similar product. Make sure the servings sizes are similar, especially the weight (e.g., gram, milligram, ounces) of each product so you can see which foods are higher or lower in nutrients.
Serving Size
This section is the basis for determining number of calories, amount of each nutrient, and %DVs of a food. Use it to compare a serving size to how much you actually eat. Serving sizes are given in familiar units, such as cups or pieces, followed by the metric amount, e.g., number of grams.
Amount of Calories
If you want to manage your weight (lose, gain, or maintain), this section is especially helpful. The amount of calories is listed on the left side. The right side shows how many calories in one serving come from fat. In this example, there are 250 calories, 110 of which come from fat. The key is to balance how many calories you eat with how many calories your body uses. Tip: Remember that a product that's fat-free isn't necessarily calorie-free.
Limit these Nutrients
Eating too much total fat (including saturated fat and trans fat), cholesterol, or sodium may increase your risk of certain chronic diseases, such as heart disease, some cancers, or high blood pressure. The goal is to stay below 100%DV for each of these nutrients per day.
Get Enough of these Nutrients
Americans often don't get enough dietary fiber, vitamin A, vitamin C, calcium, and iron in their diets. Eating enough of these nutrients may improve your health and help reduce the risk of some diseases and conditions.
Percent (%) Daily Value
This section tells you whether the nutrients (total fat, sodium, dietary fiber, etc.) in one serving of food contribute a little or a lot to your total daily diet.
The %DVs are based on a 2,000-calorie diet. Each listed nutrient is based on 100% of the recommended amounts for that nutrient. For example, 18% for total fat means that one serving furnishes 18% of the total amount of fat that you could eat in a day and stay within public health recommendations. Use the Quick Guide to Percent DV (%DV): 5%DV or less is low and 20%DV or more is high.
Footnote with Daily Values (%DVs)
The footnote provides information about the DVs for important nutrients, including fats, sodium and fiber. The DVs are listed for people who eat 2,000 or 2,500 calories each day.
—The amounts for total fat, saturated fat, cholesterol, and sodium are maximum amounts. That means you should try to stay below the amounts listed.
From the U.S. Food and Drug Administration
Making healthy food choices is one important thing you can do to reduce your risk of heart disease—the leading cause of death of men and women in the United States.
According to the American Heart Association, about 80 million adults in the U.S. have at least one form of heart disease—disorders that prevent the heart from functioning normally—including coronary artery disease, heart rhythm problems, heart defects, infections, and cardiomyopathy (thickening or enlargement of the heart muscle).
Experts say you can reduce the risk of developing these problems with lifestyle changes that include eating a healthy diet. But with racks full of books and magazines about food and recipes, what is the best diet for a healthy heart?
Food and Drug Administration nutrition expert (FDA's) Barbara Schneeman says to follow these simple guidelines when preparing meals:
The government’s newly released “Dietary Guidelines for Americans 2010” also says Americans should reduce their sodium intake. The general recommendation is to eat less than 2,300 mg. of sodium a day. But Americans 51 or older, African-Americans of any age, and people with high blood pressure, diabetes, or chronic kidney disease should restrict their intake to 1,500 mg. The government estimates that about half the U.S. population is in one of those three categories.
Schneeman, who heads FDA's Office of Nutrition, Labeling, and Dietary Supplements, says one way to make sure you’re adhering to healthy guidelines is by using the nutrition labels on the packaged foods you buy.
“Product labels give consumers the power to compare foods quickly and easily so they can judge which products best fit into a heart healthy diet or meet other dietary needs,” Schneeman says. “Remember, when you see a percent DV (daily value of key nutrients) on the label, 5 percent or less is low and 20 percent or more is high.”
Follow these guidelines when using processed foods or eating in restaurants:
The Food and Drug Administration (FDA) is urging consumers to carefully read the labels of liquid acetaminophen marketed for infants to avoid giving the wrong dose to their children.
A less concentrated form of the popular medication is arriving on store shelves, and giving the wrong dose of acetaminophen can cause the medication to be ineffective if too little is given or cause serious side effects and, possibly, death if too much is given.
In an attempt to reduce the confusion over different strengths that have been blamed for past overdoses, some manufacturers are voluntarily offering only the less concentrated version for all children.
Until now, liquid acetaminophen marketed for infants has only been available in a stronger concentration that doesn’t require giving the infants as much liquid with each dose.
But right now both concentrations of liquid acetaminophen are in circulation. Before giving the medication, parents and caregivers need to know whether they have the less concentrated version or the older, more concentrated medication. FDA is concerned that infants could be given too much or too little of the medicine if the different concentrations of acetaminophen are confused.
“Be very careful when you’re giving your infant acetaminophen” says Carol Holquist, director of FDA’s Division of Medical Error Prevention and Analysis.
Here’s what the agency wants parents and caregivers to do:
An April 2011 report from FDA’s Center for Drug Evaluation and Research (CDER) found that confusion caused by the different concentrations of liquid acetaminophen for infants and children was leading to overdoses that made infants seriously ill, with some dying from liver failure.
So to avoid dosing errors, some manufacturers voluntarily changed the liquid acetaminophen marketed for infants from 80 mg per 0.8mL or 80 mg per 1 mL to be the same concentration as the liquid acetaminophen marketed for children—160 mg per 5mL. This less concentrated liquid acetaminophen marketed for infants now has new dosing directions and may have a new dosing device in the box, such as an oral syringe.
But this is a voluntary change and some of the older, stronger concentrations of acetaminophen marketed for infants are still available and may remain available.
“There is still some on store shelves; there is still some in homes; and there is still some in distribution,” says Holquist.
If a pediatrician prescribes a 5 mL dose of the less concentrated liquid acetaminophen, but the parents administer a 5 mL dose of the more concentrated liquid acetaminophen, the child can receive a potentially fatal overdose during the course of therapy, Holquist explains.
Conversely, if a physician prescribes a dose based on the more concentrated liquid acetaminophen and the less concentrated medication is used, the child might not receive enough medication to fight a fever, she says.
FDA has issued a Drug Safety Communication with more information for consumers about how to avoid confusion and potential dosing errors with the different concentrations of liquid acetaminophen.
Adding to the confusion is the fact that that the box and the bottle may look much the same for both old and new versions of the medication, Holquist says.
Read the Drug Facts label to tell the difference between the two liquid acetaminophen products:
An analysis of five previous studies has uncovered additional evidence of the effectiveness of progesterone, a naturally occurring hormone, in reducing the rate of preterm birth among a high-risk category of women.
Pregnant women in this category, who have a short cervix, are at increased risk of delivering early. The cervix is the part of the uterus that shortens and opens during labor for the infant to pass through. Preterm infants, born three weeks or more before a full 40-week term, are at increased risk for death in the first year of life, as well as for breathing difficulties, cerebral palsy, learning disabilities, blindness and deafness.
A previous NIH study had earlier indicated that progesterone was effective in reducing the preterm birth rate.
The current study is a meta-analysis, a statistical technique that combines the data from several studies addressing a related research question. The study is published online in the American Journal of Obstetrics and Gynecology.
The researchers found that the treatment tested in the previous studies substantially reduced the risk of delivery in the 27th to 34th weeks of gestation. For example, progesterone reduced preterm delivery before week 28 by half. The researchers analyzed studies testing vaginal progesterone formulations, in doses ranging from 90 milligrams to 200 milligrams per day.
The researchers also concluded that even when the mother delivers before full term, progesterone treatment can reduce the likelihood that the infant will die (by 43 percent), have respiratory distress syndrome (by 52 percent), weigh less than 3.5 pounds (by 45 percent), be admitted for intensive care (by 25 percent), or require mechanical ventilation (by 34 percent).
Based on their findings, the researchers recommended that doctors screen pregnant patients with ultrasound of the cervix routinely at 19 to 24 weeks of gestation. If physicians detect a short cervix (10 to 20 millimeters) with ultrasound, the study authors recommended treatment with 90 mg per day of progesterone is recommended between weeks 20 and 37.
"These findings confirm that routine screening and treatment with vaginal progesterone can greatly reduce the rate of preterm birth in women with a short cervix and reduce the occurrence of the complications of prematurity among their infants," said first author Roberto Romero, M.D., chief of the Perinatology Research Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the NIH institute that led the study.
Dr. Romero and colleagues at the NICHD Perinatology Research Branch collaborated with 14 co-authors from institutions elsewhere in the United States and in Austria, Brazil, Denmark, India, South Africa, Turkey, and the United Kingdom.
Combining information from the five studies, the researchers analyzed data from 775 women. Comparing women who received progesterone treatment with those who did not, the researchers separately calculated the rate of preterm delivery at each week of gestation.
Preterm delivery is known to raise the risk of a preterm birth in subsequent pregnancies. However, the researchers found that women with a short cervix who previously had given birth preterm benefitted from progesterone treatment as much as did those who did not have a history of preterm delivery.
Differences in the rate of preterm birth were seen in the weeks shown in the chart below. The original studies did not have sufficient data to compare results for infants born before week 32.
Multiple sclerosis (MS) disrupts communication between the brain and other parts of the body. In the worst cases, it can bring partial or complete paralysis. Researchers don’t yet know what causes this disease or how to cure it, but they’ve been making progress on both fronts.
Symptoms of MS arise most often between the ages of 20 and 40. It often begins with blurred or double vision, color distortion, or even blindness in one eye. It can cause muscle weakness, vision loss, numbness or tingling, and difficulty with coordination and balance. MS can bring many other symptoms as well.
In some people, doctors may not be able to readily identify the cause of these symptoms. Patients may endure years of uncertainty and multiple diagnoses while baffling symptoms come and go. The vast majority of patients are mildly affected, but in the worst cases, MS can leave a person unable to write, speak or walk.
MS is a disease in which the body’s immune system inappropriately attacks the brain and spinal cord. Specifically, the immune system targets the fatty insulating material around nerves called myelin. When myelin is damaged, the messages that nerve cells send and receive can be interrupted.
Researchers estimate that 250,000 to 350,000 people in the United States have been diagnosed with MS. Scientists don’t yet understand what triggers the immune system to attack myelin in these people. But researchers do know that whites are more than twice as likely as others to develop MS, and women almost twice as likely as men.
Geography seems to play a role in MS. The disease is much more prevalent in temperate climates than in tropical regions. Your risk for MS seems to depend on where you live
before the age of 15. Some studies have found that a person who moves before the age of 15 tends to adopt the risk of the new area. People moving after age 15 seem to maintain the risk level of the area where they grew up. Some researchers believe that vitamin D, which the body makes when sunlight strikes the skin, may lower the risk of MS and help explain these findings, but studies haven’t yet confirmed this link.
Some microbes, such as the Epstein-Barr virus, have been suspected of causing MS. But researchers haven’t been able to prove for certain that any microbes raise your chances of getting MS. Cigarette smoking, however, does appear to raise your risk.
Genes clearly affect how likely you are to develop MS. Having a sibling with MS raises your risk of getting MS to about 4% to 5%; having an identical twin raises your risk to about 25% to 30%. These facts suggest a strong genetic component to MS. However, although some studies have linked specific genes to MS, most of the results haven’t been definitive. Researchers are now working on more detailed studies.
There’s no cure yet for MS, but various therapies can treat it. Researchers are continuing to develop new and better therapies for MS, with several now in the pipeline.
With the winter holidays upon us, you’ll likely be surrounded by family, friends and plenty of good food. Many of these foods, though, can be high in fat. Learn which fats are naughty and which are nice to your health. Then you can make smarter food choices.
We need a certain amount of fat in our diets to stay healthy. Fats provide needed energy in the form of calories. Fats help our bodies absorb important vitamins—called fat-soluble vitamins—including vitamins A, D and E. Fats also make foods more flavorful and help us feel full. Fats are especially important for infants and toddlers, because dietary fat contributes to proper growth and development.
“Fats are really the most concentrated source of energy in the foods we eat, and our bodies need that energy,” says NIH nutritionist Dr. Margaret McDowell. “Fats are truly an essential nutrient.”
Problems arise, though, if we eat too much fat. Dietary fats have more than twice as many calories per gram as either proteins or carbohydrates like sugar and starch. Excess calories, of course, can pack on the pounds and raise your risk for diabetes, cancer and other conditions.
Eating the “wrong” kinds of fats can trigger additional health hazards. “Some fats are better for our bodies than others,” McDowell says. “We should really aim to eat the right types of fats.”
Foods can contain a mixture of different fats. Unsaturated fats are considered “good” fats. They’re sometimes listed as “monounsaturated” and “polyunsaturated” fat on Nutrition Facts labels. These can promote health if eaten in the right amounts. They are generally liquid at room temperature, and are known as oils. You’ll find healthful unsaturated fats in fish, nuts and most vegetable oils, including canola, corn, olive and safflower oils.
The so-called “bad” fats are saturated fats and trans fats. They tend to be solid at room temperature. Solid fats include butter, meat fats, stick margarine, shortening, and coconut and palm oils. They’re often found in chocolates, baked goods, and deep-fried and processed foods.
“When we eat too many solid fats, we put our bodies at risk. These fats tend to raise total blood cholesterol, as well as the part of cholesterol known as low-density lipoprotein (LDL) cholesterol,” says McDowell. “When those cholesterol levels are out of whack and too high, it’s a risk factor for cardiovascular disease.”
“When there’s too much cholesterol in the blood, the excess can get trapped in artery walls and build up,” adds Dr. Catherine Loria, an NIH expert on nutrition and heart health. “The buildup can develop into atherosclerosis, or hardening of the arteries, which can lead to coronary heart disease.”
Experts say that the total fat intake for adults ages 19 and older should be 20% to 35% of the calories eaten each day. For children ages 4 to 18, it should be 25% to 35%.
Experts also say you should get less than 10% of your calories from saturated fatty acids. NIH-funded studies have shown that replacing the solid fats in your diet with healthful unsaturated fats can have a positive impact. “When you look at total fat intake, using unsaturated fats in place of some of the saturated fats actually lowers your total cholesterol levels, and mainly your LDL cholesterol levels, which is a good thing,” says Loria.
Other NIH-funded research found that, when it comes to weight loss, the source of calories—whether from fat, protein or carbohydrate—isn’t as important as the number of calories you consume. But when it comes to risk factors for heart disease, replacing some carbohydrates with protein or unsaturated fats can greatly improve blood cholesterol. In a specialized diet designed to lower blood pressure, using unsaturated fats in place of some carbohydrates boosted blood levels of “good” cholesterol (HDL cholesterol) and caused a more healthful drop in blood pressure.
“It’s about becoming a label reader,” says Joanne Gallivan, a registered dietitian who heads NIH’s National Diabetes Education Program. To eat healthy, she says, “you need to read the Nutrition Facts label to learn the amount of fat and calories in the food, the amounts per serving, and what percent of calories come from fat.” The nutrition label also shows the amounts of unhealthy saturated and trans fats.
Eating healthy fats and less total fat can be especially challenging over the holidays, however. “You want to enjoy the foods and the celebration. You shouldn’t think of the holidays as a time to deprive yourself,” says McDowell.
One way to cut fat at holiday gatherings is to simply reduce your portion sizes. “Choose more lean meats, like poultry without the skin. Eat more fruits, vegetables and whole-grain foods,” says Gallivan.
When preparing recipes, try to use lower-fat ingredients. “Low-fat and fat-free yogurt and milk still contain the important proteins and minerals found in the full-fat versions, but you’re getting less saturated fat and cholesterol,” McDowell says. “In some recipes, you can use applesauce or egg whites, instead of oil. In general, bake, broil or grill instead of frying.”
Learn to read between the lines on Nutrition Facts labels. “If a food is labeled ‘low-fat,’ that doesn’t necessarily mean it’s low in calories,” says Gallivan. Nonfat cookies, crackers and other products may contain added sugar and salt to boost their flavor. Added sugar can add calories, and too much salt can raise blood pressure.
“If you indulge a bit over the holidays, just be sure that the next day you go back to following a healthy meal plan and being active,” says Gallivan. And remember, when it comes to saturated or trans fats in your diet, you’ll help your health if you choose wisely and trim the fat.
And then there are reckless ways to shed pounds—fads and diet aids that promise rapid weight loss, but often recommend potentially dangerous practices. These include HCG weight-loss products marketed over-the-counter (OTC) that are identified as "homeopathic" and direct users to follow a severely restrictive diet.
The Food and Drug Administration (FDA) is advising consumers to steer clear of these "homeopathic" human chorionic gonadotropin (HCG) weight-loss products. They are sold in the form of oral drops, pellets and sprays and can be found online and in some retail stores.
FDA and the Federal Trade Commission (FTC) have issued seven letters to companies warning them that they are selling illegal homeopathic HCG weight-loss drugs that have not been approved by FDA, and that make unsupported claims.
(For the list of manufacturers, distributors and products—and more information about FDA’s concerns about HCG—visitwww.fda.gov/hcgdiet.)
HCG is a hormone that is produced by the human placenta during pregnancy.
Products that claim to contain HCG are typically marketed in connection with a very low calorie diet, usually one that limits calories to 500 per day. Many of these popular HCG products claim to “reset your metabolism,” change “abnormal eating patterns,” and shave 20-30 pounds in 30-40 days.
“These products are marketed with incredible claims and people think that if they're losing weight, HCG must be working,” says Elizabeth Miller, acting director of FDA’s Division of Non-Prescription Drugs and Health Fraud. “But the data simply does not support this; any loss is from severe calorie restriction. Not from the HCG.”
HCG is approved by FDA as a prescription drug for the treatment of female infertility, and other medical conditions. It is not approved for weight loss. In fact, the prescription drug label notes there “is no substantial evidence that it increases weight loss beyond that resulting from caloric restriction, that it causes a more attractive or ‘normal’ distribution of fat, or that it decreases the hunger and discomfort associated with calorie-restricted diets.”
HCG is not approved for OTC sale for any purpose.
