Have fewer and less intense migraine headaches by following the advice we are about to provide. A study conducted by the National Headache Foundation revealed that 28 million Americans suffer from migraine headaches. Of those, more than half suffer pain that is bad enough to interfere with their activities or make them take to their beds. Don’t let this happen to you. Get rid of the pain today.

The key to relieving your migraine headaches is to find out what triggers them in you. Be careful, as there could be a single trigger for your migraine, but most of the time, it is a combination of multiple triggers.

Some major causes of migraine headaches include caffeine, alcohol, aged cheese, and nitrates in meats. For two to four weeks maintain a diary to find out if there is a connection to the actual foods you enjoy eating and your migraine headaches.

Migraines are also caused by not getting enough sleep. Remember that. Just as you kept a food diary, now keep a sleep diary to find out if there is a relationship between the amount of sleep you get and the occurrence of migraine headaches.

As for female hormone alterations (now this is really beneficial) your body could specifically cause your headaches, so maintain a diary or record of dates for 3 to 4 months to find out if this basically occurs around the same time monthly. Remember this part, if it does.  This may prove that your cycle definitely is the culprit for your migraine headaches.

If you eliminate problematic foods and get some extra sleep and that does not help, you can try some natural remedies to relieve migraine headaches.

The best natural remedy for your migraine headaches is truly sleep, besides vitamins and herbs. Get comfortable (yes this really matters) in a quiet dark area for one hour, which is an effective migraine headache remedy that will help people to get back to normal without too much pain.

When you are up and going about your activities, you can keep the lighting levels low. Don’t assume this can’t be done, because it can. You could definitely place a thin cover on top of the lamps to make them darker. Your migraine headaches can be exacerbated by sunlight or other bright lights.

If the previous suggestions do not alleviate the problem, your doctor can prescribe pain killers to help provide relief from migraine headaches.

Genes are the chemical code that determines specific traits of all living things, from single-cell organisms to human beings. Genes make up DNA, the cell-level master plan that determines how living things will develop.

People have engineered foods for centuries through traditional plant breeding, when two plants are crossbred to create hybrid strains containing favorable traits from both of the original plants. The end result may be a prettier, more flavorful or hardier plant. The crossbred plants traditionally had to be similar, apples and pears, for example.

Genetic engineering is quite a different science. Genes from all biological things (bacteria, virus, plants, insects, animals, including humans) can be injected into other species. The hope being new, more desirable traits are obtained from that plant or animal gene. At this time, there are no plants approved for market with animal genes inserted. Currently, most GE crops have been bred with bacteria or virus for insect tolerance and herbicide tolerance.

The first transgenic animal could soon be available as the FDA is currently reviewing an application to market gene-altered salmon that grow much faster than normal.

Current crops approved for GE include canola (rapeseed), radicchio, corn, cotton, flax, papaya, potatoes, soybeans, squash, sugar beet and tomatoes. The most widely grown GE crops, accounting for approximately 97% of GE crops in North America, are soy, corn, cotton and canola (rapeseed).

Proponents of genetic engineered foods say it’s a way to boost food supply, reduce pesticide/herbicide use and possibly breed super-foods with exceptional nutritional profiles. World hunger can be remedied by producing crops that are more stable and possibly more nutritious.

Opponents say no one really knows the long-term effects of complex genetic manipulation and the potential dangers to humans and the environment could be substantial. Concerns include hidden allergens, the unintentional breeding of “superweeds”, and considerations for people who choose not to eat animal for moral or religious reasons. Also, the fact that once these foods enter the ecological system, there’s no taking them back and their effects will be life long.

Golden Rice is a new rice engineered to produce beta-carotene, a nutrient the body converts to vitamin A. The hope is that it will help feed malnourished people in third world countries. A recent article in The New York Times, however, states that an 11 year old boy would have to eat 15 pounds of cooked Golden Rice a day to meet his daily vitamin A requirement.

StarLink, a genetically engineered corn approved only for animal consumption, recently made headlines when it was found in taco shells in the retail market. Recalls and buybacks removed significant amounts of StarLink corn from the food supply but some still remained. In a different story, corn seed about to be sold to farmers for this year’s crop was found to be contaminated by small amounts of Starlink. The contamination does not pose any immediate health threat as none of the seed has been planted.

Currently there are no labeling laws required on GE foods. The FDA feels labels are unnecessary until there’s proof GE foods are less safe or of different nutritional value than traditional foods. Surveys report substantially different findings on whether people want to know if GE ingredients are in their food. Opponents feel at the very least labeling should be required so people can make an informed choice if they want to consume these foods.

Like it or not, the world of genetic engineering is part of our lives. The debate over genetically engineered foods is an intense one and will undoubtedly go on for some time to come. With many issues to consider, its important people learn the facts and decide what’s best for them. While proponents would like us to think it’s a no-brainer, there are far too many concerns for it to be taken lightly.

There are 5 foods that will help you lose weight by suppressing your appetite.

Pine nuts

Pine nuts will help suppress your appetite because they are extremely high in protein - in fact, higher than any other seed. Foods rich in protein let your brain know that you are full by sending hormone messengers. Eat some pine nuts every day. They will suppress your appetite and support your weight loss plan. Your hormones will get the message that you are full when you eat pine nuts because they contain pinolenic acid. This is a polyunsaturated fat that is full of protein.

Oatmeal

For weight loss and appetite suppression, oatmeal is a healthy food to add to any diet. Oatmeal is rich in fiber and an excellent food to support your weight loss program. When you eat foods that are high in fiber (like oatmeal) you will feel full quickly and stay full longer. Oatmeal is low on the glycemic index, so it helps you lose weight by suppressing your appetite. You will be less hungry if you eat foods that are low on the glycemic index. They slow down the speed at which sugar enters the blood stream.

Bananas

Suppress your appetite with bananas. They are an excellent and nutritious food. Stay healthy and lose weight by eating bananas. They have lots of vitamins, minerals and appetite suppressing fiber. Reach your weight loss goals quickly by eating bananas to suppress your appetite.

Whey Protein

Whey proteins are wonderful appetite suppressants for the serious dieter. Whey proteins work better than other proteins. To fight hunger cravings, be sure to include plenty of protein in your weight loss plan. Use low fat milk, soy or whey protein when you make shakes for a weight loss program. The weight loss and appetite suppressing results you will achieve will amaze you.

Apples

Apples are high in appetite suppressing fiber. That will really help you lose weight. Since it is fat-free and isn’t very caloric, an apple makes an excellent snack when you are trying to reduce your waistline. Apples are high in liquid, so they help you lose weight by helping you to feel fuller.

Hunger cravings are not a necessary part of weight loss. You can control cravings and lose weight successfully by using high fiber foods that are natural appetite suppressants. You can find protein in lean meat, poultry and fish. You can find fiber in fruits and vegetables. Drink plenty of water and eat these appetite suppressing foods to get good weight loss results.

Steam Distillation: Distillation is one of the older methods used for extracting the essence of a plant or flower. Basically, the process applies heat to water with the herb present in a confined area. The herb leeches its essence which becomes steam, the steam condenses, and the condensed droplets are then collected. There are other processes that are now applied to the collected material to further refine it so that only the essence itself remains.

Solvent Extraction: Solvent extraction is used for more delicate essences that would lose their quality with the application of heat as done in steam distillation. This is a more chemical process using hydrocarbons which are then removed from the resultant essence via distillation. There is alot of controversy over solvent extracted essences. The reason is that in using a toxic chemical to begin with, how can one be assured that the resultant essence does not contain some of the residue of the solvent? I feel that it is logical to say that solvent extractions (although serving of the purpose of extraction) probably cannot guarantee an organic result. Further, alot of solvents used in this process are harmful to the environment. It is up to each person to determine the quality of oil they want to use. Unfortunately, many oils you likely use now are solvent extracted. All absolutes, attars, and concretes are in fact attained via a solvent based process. Further on in my article, I address oil quality in brief and give links to some companies I feel are reputable in offering quality essentials for your use.

Enfleurage: Enfleurage, also a classic method, extracts the essences via fat. Typically, the plant material is left embedded in solid fat and left for a time to impart its essence into it. Once the plant is spent, fresh material is then added to the fat to continue increasing the intensity of the scent until eventually the fat is completely permeated with the aroma and essence of the plant. After this, further refinements are then made.

Maceration: Maceration is similar to enfleurage except that the plant material is immersed in liquid fat (oil) and heat is applied to expedite the process. Again, fresh plant material is continually added until the desired aromatic intensity is achieved. The resltant product is then refined.

Expression: Expression is a method of pressing out the valuable oil from its pliable non floral parts. Typically, expression is used for mainly citrus oils like orange, lemon and the like which contain their volatile oils in the rind part of their fruits.

Please know the above explanations are very brief to give you the general idea about oil processing.

There are thousands of synthetic scents as well as complex enhancers that one can buy from any reputable perfume supply house in addition to essential oils, concretes, absolutes and other ingredients. I myself use plants and essential oils to prepare my perfumes and scents. I also use grain alcohol and cold press carrier oils. As these are the mediums I work with I restrict my pages to these types of preparations. Feel free however to include other scent options in your own practice. I have also provided resource recommendations for buying quality supplies, texts for reference, as well as web links for further information.

Types of Scent Preparation

There are 3 main “types” of modern scent preparations (Essence or “Parfum”, Eau de Toilette, and Cologne), that are classified according to strength; that is the ratio of scent to diluting additives or base. There is another type of preparation called “Eau de Parfum” however, I do not see much difference between this in formulation than an eau de toilettes, so I do not address it specifically. Basically when it comes to strengths in “perfumes”, the more pure “scent” there is, the stronger the end result. (Again, “scent” is a general term that can mean pure organic essences as well as synthetics; it is the total amount of any ingredient natural or otherwise that is used to make a perfumes “aroma” specifically.) These 3 types are classed and defined in descending order. Following that are 3 other types of perfume preparation I also include that are in my view equally valid methods of preparation:

Essence: An essence in the purest sense is pure perfume. It is the unadulterated scent to begin with. A perfume you purchase at a store although it may be pricey, is still not a pure perfume or, essence. Pure essential oils however are essences, and may be considered a pure “perfume” in their own right. You could take a pure essence and apply it straight to your body if you wanted to. The reason why essences are cut, or diluted with a carrier base is mainly for cost savings (pure essences are extremely expensive), also, many essences applied straight to someones skin are irritating and overpowering. You could with care and skill blend pure essences together and wear it as a perfume. You would need to look into which ones are least agitating to the skin. Essences are the highest strength of “perfume” you can get and are thus first on this list of classification.

Eau de Toilette: Eau de toilette also called toilet water is basically a perfume that is cut with a base to decrease the amount of actual essence used. Most of the products you buy in a store are eau de toilettes. The common carrier for these preparations are typically different varieties of processed alcohols as well as synthetic stabilizers to keep the resultant “perfume” from altering over time. Eau de toilettes usually contain only about 20% actual scent to 80% total base.

Cologne: Cologne is just like a toilet water except that it is cut even further with dilutant. Colognes are often the term given for men’s “perfume”. Although a cologne is not a perfume, they are useful as refreshing splashes (remember Jean Nate?), body mists, after bath splash and the like. Of course they can be sprayed on or applied like a regular perfume but since they evaporate rapidly, they do not last very long. Colognes contain about 10% essence and are best used in conjunction with similar smelling powders to strengthen the smell and make them a bit longer lasting.

Perfume Oils: Now, here is where I may differ from textbook teachings. In modern times a perfume is usually identified as a scented alcohol type preparation. In fact, for thousands of years perfumes which were extracted from organic ingredients (leaves, roots, barks, flowers etc…) were blended with vegetable oils and wax as a carrier base. Only because of advancements in the methods of getting the “essence” from materials (see methods below) as well as making scent more affordable to the general public were other types of carriers or bases used. Some authorities may not consider a perfume oil as a real “perfume” as it seems a more “crude” form of perfumery. I personally disagree. Perfume oils made correctly can be nearly as strong as pure essence depending on how much base is added and also, they can last nearly as long as commercial varieties. They also eliminate any alcohol content in the end result which some people prefer.

Perfume Unguent: The above commentary above applies here. As for the formulation, a perfume unguent is similar to perfume oil except that the wax content is higher than the vegetable oil content resulting in a creamy, pomade type of preparation. Unguents, like oils, were the way scents for both body and ritual puposes were prepared in ancient times. I believe these are still valuable methods today not only for ease of preparation, but also, ecological reasons as well.

Perfume Powders: Perfume powders are generally composed of dry ingredients that have been imparted with pure essence. Nowadays, commercial powders also contain synthetic additives for flowing and preservative purposes. However, I find that long forgotten home made varieties posses every virtue of commercial varieties with the exception that they do not promote market appeal for the cosmetic companies (obviously) and are more wholesome.
to be continued…

1/4 cup seasoned breadcrumbs

2 tablespoons soy sauce

1 tablespoon olive oil

1/2 package frozen bell pepper and onion mix

1/2 package frozen green beans, French style

1 15 oz. can diced tomatoes

1 package shredded soy mozzarella cheese

1/3 bag elbow macaroni, prepared

Prepare macaroni according to package directions. Meanwhile, heat olive oil in pan, then place tofu and breadcrumbs in pan. Fry until semi-crispy; add soy sauce, and cook until soy sauce is gone. Add green beans and bell pepper/onion mix. Cook for 5-10 minutes, or until vegetables are not frozen, and are cooked thoroughly.

Add in tomatoes; cook 5 minutes. Add in soy cheese, and cook until cheese is melted. Drain macaroni; spoon onto plates. Use stir fry on top of macaroni.

Makes 4-6 servings.

Read more: Grilled or Baked Portobello Steaks

Holding your hand ..

And guiding you along..

Never think that your alone

Remember me..

I will help you walk your steps,

along your path with you..

Never be afraid 0f the dark..

Remember me..

I will hold your candle ,

to light your path..

along your way..

when your tears fall

remember me..

For I shall be there..

ready to wipe them dry…

Never be afraid to smile,

to laugh and to cry..

For always remember me ..

I’ll will always be there..

in spirit and in friendship..

Our journey has only just begun,

This disease has give us something ..

as well as it has taken …

it has given us ..

each other..

Here’s to you……

Just for you…..

For fitness, appearance, strength, and health, you should train the muscles of your chest and back. As a home trainee, you probably want to use the best and most productive exercises available. Fortunately, you can do most of these at home.

The largest muscles of the chest are the pectoralis majors (the pecs). You can divide the most popular pec exercises into presses and flies. Presses use the front part of the shoulder (anterior deltoid) and back of the upper arm (triceps) as assistance exercises, and flies isolate the pecs more. If you want to streamline your program, choose presses because they use more muscles, and thus allow you to train your whole body with fewer movements, and because they are more functional movements, being similar to everyday activities such as opening heavy doors or moving furniture around.

You can do either presses or flies in the flat (supine), incline, or decline positions. The muscle fibers actually run in a slightly different direction in the upper versus the mid-chest region. Incline movements target, but do not isolate, the upper pecs. This movement is more functional for many athletic movements, such as basketball shooting or most volleyball moves. There is a difference of opinion as to whether there really are lower pecs that can be targeted by decline moves. If so, most men would generally not want to overwork that area. If anything, women might want to develop that part of the chest. Depending on how extensive a program you want, favor flat movements, as they recruit more of the muscle, then add incline movements if you want to do more, as they will help improve both functional strength and aesthetics. Do declines only for an occasional change of pace.

If you have a home gym, it will probably have a chest press station. It may be in either a flat (lying down) or seated (vertical bench) position. If the movement on the seated press is straight out, it is like a flat press. If it angles upward on something of a diagonal, it is equivalent to an incline press. Decline press machines are rare, but not unheard of. Use it if that’s all you have. Your machine may have a pec deck in addition to, or in place of, a chest press. That movement will be equivalent to a fly (or butterfly) movement. If you’re seated straight up, it’s like a flat bench fly. If your seat angles back, it’s like an incline fly.

If you don’t have a home gym, use either barbells or dumbbells for your presses and dumbbells for your flies. If you want to do a barbell bench press, you should have either a bench with supports for the bar, or a partner who is strong enough to both hand you the bar and help you control it. If you are doing barbell bench presses that are at all heavy for you, you need to have a spotter assist you for safety sake. Ideally, you will have a bench that adjusts to both an incline and (less important) a decline position. You can do presses and flies on the floor, but it will limit your range of motion, as well as your comfort, especially with presses. Flies are easier to do on the floor, and you may want to make that your chest exercise if you don’t have a bench.

Here’s how to do a barbell bench press: Lie on your bench with your feet flat on the ground. (You can put your feet up on the bench if it makes your back feel better, but you will be less stable.) Keep your head, shoulders, feet, and buttocks down throughout the movement. Position yourself on the bench so the bar on its supports is over your eyes. Grasp the bar with your hands slightly more than shoulder width apart. When your upper arm is parallel to the floor, your forearms should be vertical. This is the best all-purpose grip, but you can vary the width somewhat for different goals. Take the bar off the supports, and extend your arms up with the bar over your mid-chest. Lower the bar slowly until it touches your chest, then push it up strongly until your arms are straight, and repeat. Do not arch your back, and don’t bounce the bar off your chest. If you don’t have a bench, you won’t be able to go down this far. If you have shoulder problems, stop when your elbows are even with your chest instead of bringing the bar to your chest. The movement is basically the same with dumbbells. Bring the dumbbells down until the inside part of the dumbbell touches the outside of your shoulders. Hold the dumbbells with your palms facing forward, as you do with a barbell. Stop when your elbows are even with your chest if you have shoulder discomfort or if you are trying a heavier weight. You need a spotter for heavy dumbbell bench presses or flies.

Incline presses are similar except that the barbell or dumbbell is lowered to the upper chest (do not lower it to your neck). Make sure you press the weight straight up toward the ceiling, not forward.

To perform flat bench flies, lie on the bench as you do for a bench press. If you have barbell supports, you will have to move down so they are not in your way. Start with a dumbbell in each hand, palms facing, and your arms extended straight up. Bring your arms down slowly to the side until your hands are at shoulder level, then bring them back up. Keep a slight bend in your elbows throughout, but do not move at the elbow during the motion. For an incline fly, set your bench to about a 45 degree incline, and do the same movement, being sure to bring your arms to a vertical position, up toward the ceiling, not going forward. Do not bounce at the bottom of the movement, and don’t lower your hands behind your body. If you don’t have a bench, you can do flies lying on the floor with your knees bent and feet on the floor.

You will be able to use more weight with presses than with flies, and with flat bench movements than with inclines.

Another exercise you should incorporate into your chest workout is the old-fashioned pushup. At the up position, your arms should be straight but not locked out, your body should be straight, and only hands and toes on the floor. If you can’t do these, do modified pushups from your knees instead of your toes. Still keep your body straight. You can go down until your chest is a few inches from the floor, but do not go so far that you feel discomfort in your shoulders. You can change hand position to vary the exercise. Give a little push at the top of the movement so that your back rounds a little. This will work the serratus anterior, the muscle on the side of your rib cage, which is important to posture and muscle balance.

It’s best to learn exercise technique from an experienced trainer, and there are a number of good books available. Good technique is key to good results.

Well the sun has grown hotter and it is time to go out and play. With summer comes ample opportunities for exercise and fun but fattening snacks are everywhere it seems. Whether it’s grilled hotdogs, greasy fair fries, salty margaritas, or a host of other high calorie favorites tempting us, we must remember that moderation is the key. Summer beach parties are also known to have plenty of alcohol. Here are a few tips for surviving this season in the sun without getting burnt!

Overeating at picnics and beach parties is a common mistake that many of us make during the summer months. Since fruit is in season and there are usually cool salads, there are usually a wide variety of choices, though. How about a few tips for eating less during the summer?

1. Stock up on all the fruits that you love. Not only are they low in fat, but these delights are also nutritious.

2. If you attend a covered dish buffet, why not bring a fruit salad or watermelon? A vegetable treat like baked green beans or a tossed salad goes well with almost anything too. Some other good choices are pasta salad, or a chicken taco dip or salad as well.

3. Drinking plenty of water is good for your skin and also your waistline. Not only do you feel fuller, but you will also keep yourself hydrated on those humid days too.

Drink plenty of water, but don’t make the mistake of indulging in alcohol in the same manner. As few as two drinks can effect your brain’s ability to function, so be cautious when drinking, especially in the hot sun. Here are a few common sense tips to keep you on an even keel this summer and all year long.

1. Eat before attending your summer party.

2. If you are drinking alcohol, eat some snacks as you imbibe.

3. A meal high in protein just before the party is your best bet.

4. Pace yourself! Spread the drinks out so that there is at least thirty minutes between drinks.

5. Do not plan on driving if you drink more than a few drinks.

6. It is a good idea to have a contingency plan.

a. This may include a designated driver.

b. You may also want to have hotel reservations at a nearby inn.

c. Make sure that there is taxi service available.

d. You may even want to “crash” at friends if you are too intoxicated.

Remember to stay cool and safe this summer season.

Remicade (Infliximab), Enbrel (Etanercept) and Arava (Leflunomide) are three FDA-approved drugs for the treatment of RA. They are among the first in a class of agents designed specifically to neutralize or inhibit two important components of the RA process; expression of cartilage- and bone-destroying enzymes and proliferation of thymus-derived lymphocytes (T-cells) within the synovial joint.

Remicade and Enbrel: Anti-TNF-Alpha Therapy

TNF-alpha is a cytokine that plays a critical role in RA because TNF-alpha induces pro-inflammatory cytokines such as interleukin-1 and interleukin-6, increases migration of inflammatory leukocytes into the synovial joint, activates polymorphonuclear leukocytes (PMNs), eosinophils and acute phase proteins produced in the liver, as well as inducing resident synoviocytes and articular chondrocytes to synthesize enzymes that when activated have the capacity to destroy the matrix of cartilage and bone. Activated PMNs also release enzymes capable of cartilage and bone destruction. Remicade neutralizes the biological activity of TNF-alpha by binding with high affinity to the soluble and transmembrane forms of TNF-alpha, which inhibits TNF-alpha binding to its receptor on the surface of inflammatory cells. This results in a decrease in the amount of TNF-alpha circulating in the peripheral blood. In contrast, Enbrel competitively inhibits the binding of TNF-alpha to the TNF-alpha receptor sites on cells. Since TNF-alpha must bind to its receptor with strong avidity, blocking this pathway neutralizes the downstream effects of TNF-alpha.

The safety and efficacy of Remicade has been assessed in RA patients treated with methotrexate. Several outcome measurements employed for assessing the destructive component of RA have been modified by treatment with Remicade. These include, a retardation of joint erosions and stabilization of joint space narrowing, the latter an indicator of cartilage loss. Other indicators of clinical effects include the Sharp score for hand and feet RA, which shows a stabilization of structural changes when compared to methotrexate alone.

Enbrel was the first in a new class of RA disease-modifying drugs approved by the FDA. Enbrel has shown efficacy in the treatment of RA and several clinical objective measures of its effectiveness have been indicated. These include, decreased pain, the number of tender joints and duration of morning stiffness. Enbrel has also been shown to slow the radiographic progression of cartilage and bone loss in RA.

The original statement of the manufacturer’s contraindications for Remicade and Enbrel clearly stated that patients with serious infections, including those with sepsis or those patients showing allergic reaction to these drugs, should not use them for RA therapy. A strong warning from the FDA (http://www.fda.gov/bbs/topics/ANSWERS/ANS00954.html) indicated safety concerns for Enbrel that extended the adverse reaction report to include any patients with active infection, including chronic or localized infections. It was also recommended by the FDA that their physician should closely monitor any RA patients receiving Enbrel who develop a new infection. Whether Enbrel therapy contributes to the incidence of significant infection must now be considered in the treatment management strategy for RA. However, controlled clinical trials have not shown an increase in serious infections in patients receiving Enbrel. It is worthwhile noting that both Remicade and Enbrel were approved by the FDA to treat patients with symptoms of moderate to severe RA who had not responded well to other more conventional therapies, including methotrexate. With the potential that more RA patients will commence anti-TNF-alpha therapy early in their disease, physicians and patients must work closely to ensure that any signs of infection be closely monitored.

Arava: An Inhibitor of DNA Synthesis

Proliferation of activated T-cells of the immune system is a critical step in the autoimmune process. Experimentally, elimination of T-cells from the inflamed synovial joint has been shown to reduce the severity of bone destruction in animal models of RA. Although the mechanism for the action of Arava is not fully understood, Arava is thought to inhibit T-cell proliferation by inhibiting the enzyme, dihydroorotate dehydrogenase (DHODH) whose activity is required for the synthesis of pyrimidines and the replication of DNA. Arava may also inhibit tyrosine kinase(s), a class of phosphorylating enzymes, whose activity is required for T-cell effector function.

Arava has been compared to methotrexate therapy for RA. While many RA patients improve on methotrexate therapy when compared to placebo in multi-center, randomized, double-blinded clinical trials, RA patients appeared to respond somewhat better to Arava. An elevation in liver enzyme levels in RA patients receiving Arava has been reported, but this is generally transient. Nevertheless, liver enzyme levels should be closely monitored. Arava is not recommended for patients with serious hepatic involvement or in patients with evidence of Hepatitis B or C viruses, or those patients immunocompromised from other treatments.

While additional clinical studies will be required to prove that aggressive early therapy of RA with DMARDs or anticytokine drugs will be more effective in controlling long-term disability and mortality from RA, it has been established that the longer active RA exists, the more destruction of cartilage and bone occurs and the more difficult it is to treat RA with DMARDs or anticytokine drugs. Thus, physicians and their patients must consider using these new agents earlier rather than latter in the treatment of active RA.