Propecia (finasteride) pills

Propecia is a remedy for baldness in men with mild to moderate hair loss on the top of the head and the front of the mid-scalp area. It increases hair growth, improves hair regrowth, and slows down hair loss. It works only on scalp hair and does not affect hair on other parts of the body. You may begin to see improvement as early as 3 months after you begin taking Propecia, but for many men it takes longer. The improvement lasts only as long as you take the drug; if you stop, new hair growth will cease and hair loss will resume.

Propecia is the first and only FDA-approved pill proven to treat male pattern hair loss on the vertex (top of head) and anterior mid-scalp area in men.

Propecia is for men only. Women who are or may potentially be pregnant MUST NOT use Propecia because of the risk that the active ingredient may cause a specific kind of birth defect. Likewise, women should avoid handling tablets that are crushed or broken. Propecia tablets are coated to prevent contact with the active ingredient during normal handling.

Vaccines are not only for children, but many young adults in the United States are unaware of the need to keep up with their shots, a new survey shows.

For example, while 84 percent of Americans over 50 know that tetanus causes lockjaw and that they need to get a new tetanus shot every 10 years, only 49 percent of adults aged 18 to 26 know this, according to a survey commissioned by the National Foundation for Infectious Diseases (NFID).

“Over 50,000 adults die in the United States each year as the result of diseases that are potentially vaccine-preventable,” Dr. William Schaffner, NFID president-elect, said during a Wednesday morning news conference.

“Many millions more become sick and require hospitalization and medical care,” Schaffner added. “Some may pass these illnesses on to others. The survey revealed that adults are complacent about vaccine-preventable diseases.”

While many adults are keeping up with some of their vaccinations, vaccination rates are still below national target levels, according to the survey.

“To me personally, the results [of the survey] are disappointing, but not surprising,” Dr. Anne Schuchat, director of the U.S. Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases, said during the news conference.

For example, only 20 percent of those surveyed knew about pneumococcal disease. This vaccine-preventable disease kills up to 4,500 adults in the United States every year.

Schaffner is concerned that as young adults have children, vaccine rates will drop even further and diseases that have been largely eliminated in the United States will re-emerge.

Especially troubling is the lack of vaccination awareness among 18- to 26-year-olds. Only 30 percent of young adults knew that the flu, which is preventable with a vaccine, kills almost 40,000 Americans a year, more than any other vaccine-preventable disease. However, 59 percent of those over 50 are aware of the benefit of flu vaccine, according to the survey.

For all Americans, vaccination levels are too low, experts say. For example, among those aged 60 and older influenza and pneumococcal vaccination levels remain at 66.6 percent and 60 percent, respectively.

Additionally, only about 10 percent of women aged 19 to 26 have been vaccinated against the human papillomavirus, which can prevent 70 percent of cervical cancers. And only 15 percent of those aged 19 to 64 have received the Tdap vaccine, which protects against tetanus, diphtheria and pertussis.

A Tdap booster is recommended in place of one tetanus-diphtheria booster vaccine, which should be given every 10 years.

Another concern is the racial and ethnic disparities in vaccination levels among those aged 65 and older. Among whites, the national average for having a flu shot is 69 percent, but for blacks and Hispanics the rates are 53 percent and 51 percent, respectively.

The same is true for pneumococcal disease. Whites have higher vaccination levels than blacks and Hispanics, at 64 percent, 44 percent and 36 percent, respectively.

“It’s clear we have a lot of room for improvement,” NFID medical director, Dr. Susan J. Rehm, said during the news conference.

Getting people to get their vaccinations is a matter of awareness, Rehm said, and it is incumbent upon doctors to make sure their patients have the necessary vaccinations and booster shots.

“The majority of adults [87 percent] are very likely to get vaccinated if their doctor or other clinician advises that they get vaccinated,” she said. “Our hope is that clinicians throughout the care continuum will become increasingly aware of adult vaccinations, and will spread the word to their patients.”

The number of older Americans with access to prescription drug coverage has ballooned since Medicare’s Part D program was rolled out almost four years ago, a new analysis finds, yet seniors’ ability to pay for needed medications remains a concern due to limitations in coverage and rising drug plan costs.

“Based on nearly four years of experience, the Medicare drug benefit has helped seniors by expanding access to prescription drug coverage and lowering out-of-pocket costs, particularly helping those who previously lacked drug coverage,” said Tricia Neuman, director of the Medicare Policy Project at the Henry J. Kaiser Family Foundation, who led the analysis. “But Medicare Part D is still a work in progress.”

Neuman’s review of the program, which assesses access and affordability, appears in the July 23 issue of the New England Journal of Medicine.

David Lipschutz, staff attorney for California Health Advocates, a nonprofit advocacy and education outfit, said the analysis of the program, while thorough, was “a little more positive” than he might have given. “I think when looking at Part D, you clearly have to acknowledge a lot more people have access to prescription drug coverage. But Part D has also had a significant impact, too, and has actually left some people worse off.”

He noted that low-income seniors who are “dually eligible” for both Medicare and Medicaid were switched from Medicaid drug coverage to Medicare Part D. In California, that shift resulted in seniors losing a relatively rich array of benefits. In general, the commercial plans in which they were forced to enroll offer more-limited drug formularies, greater cost-sharing and the potential for greater barriers to accessing care because of various utilization review techniques, he explained.

Unlike Medicare’s hospital and medical insurance programs, Part D benefits are offered through private insurers and drug plans that contract with the government. Often seniors must choose among dozens of plans in a region.

Enrollment in Part D began in November 2005. By the end of the first enrollment period, about 90 percent of all Medicare beneficiaries had drug coverage, according to the report. That’s up from 66 percent in 2004.

Today, 59 percent of Medicare’s 45.2 million beneficiaries are enrolled in Part D through a standalone prescription drug plan or a “Medicare Advantage” (HMO) drug plan. Thirty-one percent have retiree drug coverage or some other type of drug coverage. That leaves some 4.5 million without any coverage at all, the researchers report.

“People on Medicare who are still without drug coverage include beneficiaries who are relatively healthy and take few drugs who may not think they need this type of insurance,” Neuman explained. Others who lack coverage “would likely benefit from having Part D coverage, but for one reason or another are unaware that they need to sign up to get it or are stymied by the process.”

A recent University of Pittsburgh study, also published in the New England Journal of Medicine, found that seniors’ spending on drugs increased after enrolling in Part D, while spending on medical costs declined. Researchers said that suggests people are getting better control of their medical conditions.

Neuman’s paper highlights several concerns with the program, one being the infamous gap in drug coverage known as the “doughnut hole.” Once seniors reach an initial coverage limit, they are responsible for any additional drug costs incurred up to a “catastrophic” limit, at which point coverage kicks in again.

Studies show that seniors who hit the coverage gap start shirking on their medication regimens, posing serious risks for people with chronic conditions, Neuman observed.

And while low-income seniors may qualify for subsidies to help pay the Part D premium and cost-sharing, more than 2 million elderly and disabled people are not getting those subsidies, she found.

Meanwhile, premiums and cost-sharing are on the rise, suggesting that seniors may not be in the best plan for their particular needs. Between 2006 and 2009, the weighted average monthly premium rose 35 percent, with the steepest increases among some of the more popular plans.

Thomas Rice, a professor in the department of health services at the University of California, Los Angeles, School of Public Health, says more needs to be done to help Medicare beneficiaries make better choices.

“People are not choosing the plan that’s cheapest for them,” said Rice, who noted that many older Americans have difficulty navigating the Medicare Web site to compare benefits and costs. Seniors focus too much on the premium instead of the total cost of coverage, and very few switch plans from year to year. Rice guesses that plan sponsors know this and “try to make sure their premiums look pretty cheap.”

Lipschutz’s best advice for seniors: Contact your State Health Insurance Assistance Program for help walking though your options. “Do your homework each and every year,” he said. “It’s not a one-time deal.”

Children and adults who like to crank up the volume on their music would turn down the sound level or use ear protection if they were told to do so by a health-care professional, a new survey has found.

Nearly half of the respondents said they experienced symptoms such as tinnitus or hearing loss after being exposed to loud music, and 32 percent said they considered hearing loss a problem, the survey found.

The survey was conducted by Vanderbilt University researchers in conjunction with MTV.com and is published online July 13 in the Journal of Pediatrics.

About 75 percent of those surveyed said they owned an MP3 player, and 24 percent listened to it for more than 15 hours a week. Nearly half said they use a music player at 75 to 100 percent of its maximum volume, which exceeds government regulations for occupational sound levels.

When surrounded by external sounds, such as subway or traffic noise, 89 percent of the respondents said they increase the volume on their music player, the study found.

Respondents said the media is the most informative source about hearing loss prevention, and the health care community was considered the least likely source. However, people taking the survey said they would change their music listening behavior if advised to do so by a health-care professional.

“Hearing loss is so prevalent that it has become the norm,” study author Dr. Roland Eavey, chairman of otolaryngology at Vanderbilt, said in a university news release. He noted that studies “show that 90 percent of males age 60 and over now have hearing loss.”

Since the researchers’ last survey about loud music and hearing loss, which they conducted in 2002, “we have learned that enough people still are not yet aware, but that more are becoming aware, especially through the help of the media,” Eavey said.