MayoClinic.org - Many women - especially multitasking working mothers - know the overwhelmed feeling and stress caused by too much to do and too little time. Better time management can help you do more. And it has health benefits, such as less stress and a better quality of life.

The October 2008 issue of Mayo Clinic Women’s HealthSource offers tips to improve time management. The recommendation is to try one strategy for two to four weeks to see if it helps. If it does, add another. If not, try a different one.

Ten time management tips:

1. Plan each day. A schedule minimizes conflicts and last-minute rushes. Write a to-do list with the most important tasks at the top. Even if you don’t get through the list, you’ll know time was spent constructively.

2. Say no to nonessential tasks. Let priorities determine your schedule rather than letting guilt have the final say.

3. Delegate. Consider what you can eliminate or delegate from your to-do list. Be willing to let others do tasks differently from how you do them.

4. Take time to do a quality job. Doing something right the first time may take more time up front, but errors caused by rushing may require longer to correct.

5. Practice the 10-minute rule. Work on dreaded tasks for 10 minutes each day. Once a task is started, you may be able to finish it.

6. Evaluate how you are spending your time. Keep a diary for three days to track tasks. Look for time that could be used more wisely, freeing up time to spend exercising or with family and friends.

7. Get plenty of exercise and sleep. Improved focus and concentration help increase efficiency, so you can complete tasks in less time.

8. Take a time management course. Employers, community colleges and community education programs often offer these classes.

9. Take a break when needed. Too much stress can derail attempts at getting organized. When you need a break, take one. Take a walk. Do some quick stretches. Take time for a day of relaxation when you need it.

10. If you are too frazzled to manage your time better, and life feels out of control, ask for help. Consider discussing your situation with a doctor or mental health professional.

Rising unemployment rates, the worst Wall Street crises since the end of World War II, record home foreclosures. There is plenty of stress to go around. What effect is stress having on our health and what can we do about it?

“Prolonged stress, both emotional and physical, impacts the overall cardiovascular status of our patients, particularly their blood pressure,” said Keith Churchwell, M.D., executive medical director of the Vanderbilt Heart and Vascular Institute.

American and global stock markets on a daily rollercoaster ride, anxiety over the burden of the government’s bailout of Wall Street, and the added stress placed on all Americans by increased financial instability could be taking its toll.

Stress can cause increasing physical demands on the body, constriction of the coronary blood vessels and heightened electrical instability in the heart.

Emotional stress can lead to decreased heart rate variability and elevated blood pressure, making the heart work harder by putting even greater stress on the whole cardiovascular system. The long-term elevation of blood pressure can have a harmful effect on the heart and the entire vascular system. Stress hormones called catecholamines, including adrenaline, can have damaging effects on the heart muscle if exposed to elevated levels for a long time, Churchwell said.

A study of more than 10,300 civil servants found that employees under 50 who suffered chronic stress had a 68 percent higher risk of heart disease than those who were not stressed at work. The findings were reported in the European Heart Journal in January 2008 by researchers from University College in London.

This study demonstrates that stress at work can lead to coronary heart disease through direct activation of neuroendocrine stress pathways and indirectly through health behaviors, according to the report.

“It’s almost always multifactorial,” Churchwell said. “It’s not just the stress, but also how people adapt to stress.”

Many people react to stress by eating poorly, stopping exercise, smoking, drinking and missing medications.

If someone comes in to the Emergency Department complaining of chest pain, doctors will ask about emotional related stress, in addition to performing a medical evaluation to find the cause of the chest pain.

“We will see a number of people come through the Vanderbilt Heart and Vascular Clinic for an evaluation of chest pain, elevated blood pressure, and shortness of breath that are outward manifestations of the emotional currents going on in their work lives,” Churchwell said. “They will either be dragged in by a family member who is worried about them or by a co-worker.”

Churchwell added that he has not seen anyone whose heart troubles are caused by the recent stock market problems, but he wouldn’t rule it out as a possibility.

“We do see stress-related chest pain in people affiliated with the music business. They have been on the road doing 50 shows in 52 nights. They call from the road and ask if they can be seen this week, and they pull the tour bus up in front of the hospital.”

Churchwell offers these tips to avoid letting stress get the better of you:

• If you have a positive routine in terms of stress relief, such as exercise, stay on it.
• If you have to work 12 to 14 hours a day, take the time to eat healthy. Avoid junk food.
• Continue to take your medications as prescribed.
• Don’t resort to smoking and drinking alcohol as “stress relievers.”
• If you experience chest pain, seek the care of a health care professional (Newswise).

HBNS.org - Can honey treat a wound? Smeared on a burn, honey could reduce the time it takes for the wound to heal - up to four days, or sooner in some cases - a new review of studies suggests.

However, honey used with compression bandages does not significantly increase healing of venous leg ulcers and the jury is still out on honey’s effectiveness for other wounds, according to Andrew Jull and colleagues at the University of Auckland in New Zealand.

“The evidence currently does not support the use of honey on acute wounds such as abrasions and lacerations or on minor, uncomplicated wounds left to heal…following surgery,” Jull said.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews like this one draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Honey’s history as a topical ointment for wounds stretches back into antiquity. An Egyptian surgical text, written on papyrus between 2600 and 2200 B.C., recommends the treatment, as do the Greek, Chinese and Ayurvedic medical traditions. Later, caregivers used honey-soaked bandages until topical antibiotics became widely available after World War II.

Jennifer Eddy, M.D., a University of Wisconsin researcher who is completing a study on honey treatments for diabetic foot ulcers, says patients might consider honey as part of an interest in alternative medicine or following a bad reaction to other topical treatments.

“Topical honey is cheaper than other interventions, notably oral antibiotics, which are often used and may have other deleterious side effects,” she said.

Honey can draws moisture out of cells and contains hydrogen peroxide, both of which help kill off infectious bacteria. Some varieties of honey have other antibacterial properties as well, the Cochrane researchers note.

The review included 19 studies with 2,554 participants. Although the honey treatment healed moderate burns faster than traditional dressings did, Jull recommends viewing the findings with caution, since a single researcher performed all of the burn studies.

For the moment, Jull said, “health services should refrain from providing honey dressing for routine use” for most other wounds until there are more studies that show its effectiveness.

At present, people most often use honey after trying other treatments, “when the wound was not improving with standard therapy,” Eddy said.

The review discloses that Cochrane authors were researchers in one of the leg ulcer studies included in the review and that the research unit that employs the authors received a small cash contribution from a manufacturer of honey dressings to conduct the ulcer study.

HBNS.org - Lumbar spine (lower back) surgery is a common treatment for a herniated or “slipped” disk, and patients need to know whether it is better to sit still or get moving during their recovery period.

An updated review from the Netherlands suggests that exercise programs starting four to six weeks after the operation could lead to more rapid pain relief and a quicker recovery from disability - without increasing the risk of additional surgery.

“Many people are operated on because of a herniated lumbar disc but there is still controversy with regard to rehabilitation,” said lead author Raymond Ostelo, Ph.D., at the VU University Medical Center in Amsterdam. “[Although] many different rehabilitation programs are available and prescribed for patients, some surgeons say that patients don’t need rehabilitation programs at all once they are discharged from the hospital.”

However, the review findings support a more active approach.

“In general, it appears that patients who participated in exercise programs recovered somewhat faster than those who received no treatment and that patients who participated in high-intensity programs reported slightly less short-term pain and disability than those in low-intensity programs,” Ostelo said.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The updated review included 14 randomized controlled trials involving 1,927 participants.

There was a great deal of variation in the programs available following surgery, ranging from only stretching and strength training at home to 90 minutes of intensive aerobic, strength and stretching exercises three times a week.

The amount of support that patients received also varied widely: from a single two-hour training session to multiple visits with a team that included physiatrists, physical and massage therapists, and social workers. Because of the large differences in treatments, the authors were unable give guidance on which kind of exercise program works better.

None of the studies reported an increase in the number of patients who required additional surgery. There were also no indications that patients should restrict their activity after surgery.

“Given the ongoing controversy regarding the type - if any - and timing of rehabilitation programs, this review highlights that it seems to be a good idea to follow an exercise program and return to daily activities as soon as possible,” Ostelo said.

“It is hard to make sweeping generalizations about all the different types of back surgeries that are done,” said Joel Press, M.D., an associate professor of physical medicine and rehabilitation at Northwestern University’s Feinberg School of Medicine in Chicago. “These results show that there was no evidence suggesting that exercise programs were increasing the rates of re-operation. Sitting too long often will hurt the patient more than getting up and moving.”

Reference: Ostelo RWJG, et al. Rehabilitation after lumbar disc surgery (Review). Cochrane Database of Systematic Reviews 2008, Issue 4.

AACR.org - Moderate consumption of red wine may lower the risk of lung cancer in men, according to a report in the October 2008 issue of Cancer Epidemiology, Biomarkers and Prevention¸ a journal of the American Association for Cancer Research.

“An antioxidant component in red wine may be protective of lung cancer, particularly among smokers,” said Chun Chao, Ph.D., a research scientist at Kaiser Permanente Department of Research and Evaluation in Pasadena, California. Red wine contains a large amount of different polyphenols - natural phytochemicals found in dark fruits and vegetables as well as dark chocolate that often have antioxidant properties as well as gene-modulating chemical activity.

Chao analyzed data collected through the California Men’s Health Study, which linked clinical data from California’s health system with self-reported data from 84,170 men aged 45 to 69 years. Researchers obtained demographics and lifestyle data from surveys computed between 2000 and 2003, and identified 210 cases of lung cancer.

Researchers measured the effect of beer, red wine, white wine and liquor consumption on the risk of lung cancer. Adjustments were made for age, race/ethnicity, education, income, body mass index, history of chronic obstructive pulmonary disease or emphysema, and smoking history.

Among the study participants, there was on average a two percent lower lung cancer risk associated with each glass of red wine consumed per month. The most substantial risk reduction was among smokers who drank one to two glasses of red wine per day. The researchers reported a 60 percent reduced lung cancer risk in these men. Researchers warned men to stop smoking as the best way to reduce lung cancer risk; noting that even men who drank one to two glasses of red wine per day still face higher lung cancer risk than do non-smokers.

No clear associations with lung cancer were noted for consumption of white wine, beer, or liquor. “Red wine is known to contain high levels of antioxidants. There is a compound called resveratrol that is very rich in red wine because it is derived from the grape skin. This compound has shown significant health benefits in preclinical studies,” Chao said.

Chao said their findings should not be construed to recommend heavy alcohol consumption or drinking large amounts of red wine.

HopkinsChildrens.org - A young child arrives at the emergency room after several days of abdominal pain, vomiting, and diarrhea and is sent home with a diagnosis of viral gastritis and treatment for the symptoms. The child seems better for a while, only to return to the ER with worse symptoms and a ruptured appendix, a life-threatening complication of appendicitis.

The scenario is not uncommon, experts say, because children with appendicitis don’t usually have the classic symptoms of the condition, but pediatricians at the Johns Hopkins Children’s Center say there are ways for doctors and parents to tell the difference early on between a potentially deadly burst appendix - which can kill in a matter of days, even hours - and a stomach bug.

Past research has found that half of appendicitis cases are misdiagnosed when they first present at the emergency room or the doctor’s office and that up to 80 percent of appendicitis cases in children younger than 4 years of age end up in rupture.

Says emergency room pediatrician Jennifer Anders, M.D., of Hopkins Children’s, who has seen her fair share of burst appendixes, “appendicitis should always be near the top of the list of potential culprits when a child has any abdominal pain, vomiting, and malaise,” keeping in mind that many children don’t have fever or lose appetite the way adults might.

Doctors recommend that children with prolonged or severe abdominal symptoms that do not go away or improve should be evaluated for ruptured appendix. Consider the following questions:

• Do blood tests indicate elevated white cell count?
• Does the child have diarrhea? Diarrhea, which can be a marker of bowel inflammation resulting from the infection caused by the burst appendix, often distracts doctors and puts them on a different track. Diarrhea may not be a classic sign of appendicitis, but it may signal a ruptured appendix.
• Did the child have vomiting, which later stopped?
• Was there sharp pain in the lower right portion of the abdomen, which later subsided and became dull and spread across the abdominal area? Paradoxically, as appendicitis worsens and the appendix ruptures, the acute pain is alleviated and transformed into more diffuse abdominal pain.

“It’s counter-intuitive, but if that sharp pain improves or subsides and becomes more generalized, it’s actually a bad sign,” Anders says.

The appendix is a small tube extending from the large intestine, and infections and inflammation of the organ can be dangerous. The only absolute way to diagnose the condition is surgery, and each year, appendicitis sends 77,000 American children to the hospital. An estimated one-third of them suffer a ruptured appendix before they reach the OR.