Promising Results of Drug Trial Could Herald a Replacement for Popular Blood Thinner

20090901-2, August 31, 2009  —  ‘First Breakthrough in 60 Years for Preventing Stroke in Patients with Atrial Fibrillation,’ Says Dr. Michael Ezekowitz


New Drug Shows Great Potential in Reducing Risk of Stroke for Nearly 3 Million

Americans with Atrial Fibrillation – and Comes Without Monitoring and

Interaction Challenges



WYNNEWOOD, Pa.–(Business Wire)–

Researchers today published promising results for a drug that could lead to a

replacement for the very effective but difficult-to-use blood thinner Coumadin

(sold generically as Warfarin), currently taken by millions of Americans to

reduce their risk of stroke. Writing in the New England Journal of Medicine,

lead U.S. researcher, active clinical cardiologist and Vice President of the

Lankenau Institute for Medical Research, Dr. Michael Ezekowitz hailed the study

results as “the first breakthrough in 60 years for preventing stroke in patients

with atrial fibrillation.”


The three-year study by German pharmaceutical manufacturer Boehringer Ingelheim

(BI) was the largest stroke prevention trial ever conducted among patients with

atrial fibrillation. Involving 18,113 patients in 44 countries, the clinical

trial compared results of the new drug against those of Coumadin / Warfarin.

About 5,000 of these patients were from the U.S., including participants

recruited from Lankenau Hospital.


“The magnitude of these results cannot be understated,” Dr. Ezekowitz said. “For

years, the primary drug option cardiologists have had in preventing strokes in

patients with atrial fibrillation is the anticoagulant Warfarin. Although it is

highly effective, it is a very difficult drug to control in most patients. Many

factors, including food, prescription drugs and over-the-counter medication, can

interfere with its effectiveness. In addition, patients on Warfarin must be

closely monitored through monthly blood tests.


“This study points to another anticoagulant solution that is potentially more

effective and safer. This should be welcome news for any patient with atrial

fibrillation who has been identified as being at risk for stroke.”


Atrial fibrillation, estimated to affect as many as three million people in the

U.S. alone, is the leading heart arrhythmia. It is caused by a malfunction of

the electrical signals that direct the heart’s pumping action. The result is a

rapid and chaotic contraction of the atria, or upper chamber of the heart.

Individuals with the condition often experience shortness of breath, fatigue and

palpitations. In some cases, atrial fibrillation can lead to stroke. Because

blood does not move normally through the heart, clots can form. If a clot breaks

off, a stroke can occur.


According to Dr. Ezekowitz, clinical trial results for the new drug, Dabigatran,

established it as a user-friendly, effective treatment for atrial fibrillation –

one that favorably impacts patient care.


“While highly effective at reducing the incidence of stroke, Warfarin can be

problematic in many patients. Patients need to be careful about eating salads,

drinking alcohol or taking over-the-counter cold medications, all of which can

interfere with the drug’s effectiveness.


“Another remarkable aspect of this trial is that we identified precisely the

correct dosage of Dabigatran to give to patients. If the dosage of a blood

thinner is too high, the patient can experience bleeding. If it’s too low, a

stroke can occur. This trial not only identified a drug that is more effective

than Warfarin, it also revealed the precise dosage that needs to be administered

to prevent strokes.”


Dr. Ezekowitz listed the following attractive features of Dabigatran:


* Like Coumadin / Warfarin, it can be taken by mouth, but unlike Coumadin /

Warfarin – which takes about four days to have an effect – Dabigatran acts

within hours after ingestion

* Dabigatran, as compared to Coumadin / Warfarin, has fewer drug-to-drug

interactions and, unlike Coumadin / Warfarin, does not require monitoring

* In addition, the trial shows that Dabigatran is superior to Coumadin /

Warfarin at the higher dose without compromising safety, and is a lot safer than

Coumadin / Warfarin at the lower dose without compromising effectiveness


As one of the trial’s leading research institutions, the Lankenau Institute for

Medical Research brings a unique “community of science” approach to research,

combining bench researchers, physician and nurse researchers, as well as

incubating biotechnology companies – all working towards finding new and better

ways to treat patients with diseases and conditions such as atrial fibrillation.

In addition to Dr. Ezekowitz and the Lankenau Institute, other trial leaders

included Stewart Connolly and Salim Yusuf, of Canada’s McMaster University and

Lars Wallentin, of Uppsala in Sweden.


About the Lankenau Institute for Medical Research


Founded in 1927, the Lankenau Institute for Medical Research (LIMR) is an

independent, nonprofit biomedical research center located in suburban

Philadelphia on the campus of the Lankenau Hospital. Part of Main Line Health,

LIMR is one of the few freestanding, hospital-associated medical research

centers in the nation. The faculty and staff at the Institute are dedicated to

advancing an understanding of the causes of cancer, heart disease and diabetes.

They use this information to help improve diagnosis and treatment of these

diseases as well as find ways to prevent them. They are also committed to

extending the boundaries of human health and well-being through technology

transfer and the training of the next generation of scientists and physicians.

For more information, please visit


About Lankenau Hospital


Lankenau Hospital, a member of Main Line Health, in suburban Philadelphia is one

of the nation’s leading heart centers. The 331-bed teaching hospital is located

on a campus that also includes the Lankenau Institute of Medical Research, a

freestanding biomedical research institute that specializes in cardiac and

cancer research. Lankenau Hospital’s nurses are MAGNET-certified, and the

hospital has consistently been recognized as a Top 100 Cardiovascular Hospital

by Thomson Reuters. Additionally, Lankenau has been named as a HealthGrades

America’s 50 Best HospitalTM for 2009, placing it in the top one percent of all

hospitals in the nation for quality outcomes.


About Dr. Michael D. Ezekowitz


Dr. Michael D. Ezekowitz, lead U.S. researcher for the Dabigatran study, is the

Vice President of Lankenau Institute for Medical Research (LIMR) and Vice

President of Clinical Research for Main Line Hospitals. He is also a practicing,

non-invasive clinical cardiologist and attending physician with affiliations at

Bryn Mawr, Lankenau, and Paoli Hospitals of Main Line Health. In addition to

being the lead U.S. researcher for the Dabigatran study, Dr. Ezekowitz was also

responsible for trial design and oversight.


Dr. Ezekowitz focuses his research on atrial fibrillation and the development of

new drugs to treat the heart malfunction. He is a world authority on atrial

fibrillation, and an internationally renowned speaker and published author on

the subject. He was previously the June F. Klinghoffer Professor of Medicine

(Cardiovascular) and Chairman of the department of Medicine at Drexel University

College of Medicine, Tenured Professor of Medicine in Cardiology at the Yale

University School of Medicine and the Director of the Medical School Clinical

Trials Office.


Dr. Ezekowitz attended medical school at the University of Cape Town Medical

School in South Africa, interned at the Groote Schuur Hospital in South Africa

and completed his fellowship at Johns Hopkins University Hospital.


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Michelle at DWJ Television, 1-800-766-1711, extension 209 or email

New possibilities: A drug that could revolutionize stroke sufferers’ lives has been discovered, August 31, 2009, by Jenny Hope  —  A new blood-thinning drug to prevent strokes could replace a commonly used treatment based on rat poison for thousands of patients. The drug called Pradaxa is one-third more effective at reducing the risk of stroke and blood clots in at-risk patients than warfarin, and cuts deaths by 15 per cent.

Warfarin, which is still used in large doses to kill vermin, has been a routine medication for preventing strokes since the 1950s. But it is inconvenient for patients because careful monitoring and regular blood tests are needed to prevent excessive bleeding from cuts or stomach ulcers, requiring frequent clinic visits.

It can also interact badly with other drugs and certain foods, including green vegetables and grapefruit. The new drug, Pradaxa, works by reversing and inhibiting  the effects of thrombin, which is the substance responsible for clotting.

Patients taking capsules twice a day do not have to be constantly checked for signs of overdosing, can eat what they like and it is much easier to use alongside other medicines.

Results from a major trial today showed Pradaxa was 34 per cent better at reducing the risk of stroke and blood clots in at-risk patients than well-controlled warfarin.

Fatal strokes were also reduced by 15 per cent when patients were given the drug More than 18,000 patients aged around 71 from 44 countries took part in the three year RE-LY (randomised evaluation of long term anticoagulant therapy) trial.

All suffered from atrial fibrillation, a heart rhythm disorder that greatly increases the risk of stroke. They were randomly assigned to treatment either with Pradaxa or warfarin.

The findings were presented yest(sun) at the European Society of Cardiology’s annual meeting in Barcelona, Spain, and published online in the New England Journal of Medicine.

Professor Stuart Connolly, one of the leading investigators from McMaster University in Hamilton, Canada, said ‘The results exceeded all our expectations.

‘We now have an oral treatment which offers superior protection from stroke with less bleeding and without the need for routine monitoring.’

At present the drug, also known as dabigatran, is only licensed in the UK for the treatment of orthopaedic patients at risk of clotting after surgery and taken for up to four weeks.

The drug’s makers Boehringer Ingelheim are planning to apply next year for permission to use it for the prevention of stroke when patients would have to take it for life. However, the high cost of Pradaxa means it will have to assessed by the Government’s drug rationing body to determine whether it can be widely used in the NHS.

Daily treatment will cost around £4.20 at current prices whereas warfarin costs around £1 for a month’s supply, plus clinic visits. Dr Adrian Brady, consultant cardiologist at Glasgow Royal Infirmary, said ‘This is the greatest step forward in anticoagulation therapy for over 50 years.

‘The results presented today could mean the end of warfarin, known by many as rat poison, for many patients – no more anticoagulation clinics, no more blood tests, no more watching what you need to eat and drink.

‘Patients and their doctors will be eagerly examining these findings with a view to switching from warfarin to this new drug once it is licensed.’

Atrial fibrillation (AF) affects more than half a million people in the UK and is a leading cause of stroke. Around 150,000 people in the UK suffer a stroke each year.

Professor Peter Weissberg, medical director of the British Heart Foundation, said the new drug looked promising but further trials were needed to establish its potential.

He said: ‘It’s the first oral warfarin alternative that’s been through a phase 3 clinical trial without showing severe toxicity.

‘There are more oral agents in the pipeline and this type of therapy might lead to a rise in the numbers being treated.

‘The health economists are going to have to see if the lives saved and the hassle saved are worth the extra costs’ he added.

Dr Keith Muir, medical advisor for The Stroke Association said ‘Warfarin is a highly effective treatment when indicated for stroke prevention, but it is underused, often because of safety concerns or the need for regular blood tests to monitor its effects.

‘The RE-LY trial indicates that dabigatran may offer a useful alternative to warfarin for stroke prevention in some circumstances, but the trial highlights both pros and cons that mean its place isn’t yet clear.

‘The trial only involved people who could equally well have taken warfarin, and anyone currently taking warfarin should continue it unless advised by their doctor.’

NORWALK – Press Release

August 31, 2009  —  Norwalk Hospital’s “wellness in the community series,” sponsored by the medical staff, enters its 31st year and attracts residents from throughout the area who are interested in learning about health, wellness, new technology and medical advancements, a news release stated.

This year’s series kicks off with a program on “Heartburn: Don’t Ignore It!” on Tuesday, Sept. 22, at 7 p.m. in the Richard S. Perkin Auditorium of the hospital, according to Norwalk Hospital spokeswoman Maura Romaine.

Norwalk Hospital gastroenterolgists William Hale, MD, FACG, of New Canaan, chief of gastroenterology and hepatology at Norwalk Hospital, and Seth A. Gross, MD, from Westchester County, chief of advanced endoscopy, will be the featured speakers.

Digestive disorders, such as frequent heartburn or acid indigestion, are very common. Both doctors, experts in this field, will discuss the causes, symptoms, risks and treatments of these conditions. Following their presentation, they will allow time to answer questions from the audience.

About the speakers

Dr. Hale, recently named a “Top Doctor” in Connecticut Magazine’s 2009 listing, is board certified in gastroenterology and internal medicine. He is also director of the hospital’s Gastroenterology Fellowship Program and is trained in advanced endoscopy procedures. He completed his Fellowship training at Boston University Medical Center after his residency and internship at Boston Medical Center. He received his M.D. degree from the University of Wisconsin Medical School.

Dr. Hale developed Norwalk Hospital’s Biliary Endoscopy program, which treats patients with complex gallstone disease and cancers of the bile duct and pancreas. He has been a longtime faculty member in the Yale affiliated Gastroenterology Fellowship Program at Norwalk Hospital and has participated in numerous clinical research studies. His areas of expertise include colon cancer screening, hereditary cancer syndromes, pancreas disease, management of acid reflux, Hepatitis B, C and fatty liver disease.

Under the leadership of Dr. Hale, Norwalk Hospital has developed a comprehensive heartburn program that offers patients advanced treatments and education options. Norwalk Hospital has also gained attention for being the first and only hospital in the State of Connecticut to offer cryotherapy — a breakthrough preventive treatment for esophageal cancer.

The other featured speaker, Dr. Gross, completed his fellowship training in gastroenterology and hepatology at the Mayo Clinic. He specializes in the treatment of gastrointestinal malignancies and has advanced training in endoscopic ultrasound (EUS), which combines endoscopy with ultrasound to obtain images of the digestive tract and surrounding tissues and organs.

EUS is useful in the staging of cancers of the esophagus, rectum, stomach, lung and pancreas as well as detecting bile duct stones. It is also utilized for evaluating chronic pancreatitis, cysts of the pancreas, incontinence and “submucosal” tumors, which are lesions within the intestinal wall.

Dr. Gross is highly skilled in endoscopic treatments of Barrett’s esophagus and early esophageal cancer. Barrett’s esophagus is a condition in which the esophagus, which carries food and saliva from the mouth to the stomach, is changed by the stomach acid (often caused by gastoesophageal reflux disease or GERD) replacing the lining of the esophagus with a type of tissue similar to that normally found in the intestine.

While Barrett’s esophagus may not cause symptoms, a small percentage of people with this condition may develop a relatively rare but potentially fatal type of cancer of the esophagus called esophageal adenocarcinoma.

Dr. Gross has experience and expertise in treating Barrett’s esophagus with cryotherapy and radiofrequency ablation (Barrx). Cryotherapy, which uses liquid nitrogen in medical treatments, has been used effectively since the 1950’s to treat certain types of cancers and precancerous conditions. Cryotherapy is a recent breakthrough in the field of gastroenterology to treat conditions of the esophagus, such as Barrett’s esophagus, high and low grade dysplasia and esophageal cancer.

“It has been shown in clinical research that by using liquid nitrogen, cryotherapy freezes diseased tissue in the esophagus destroying the cells, which are replaced with healthy cells,” Dr. Gross said.

A similar technique is used with radiofrequency ablation allowing for a targeted superficial burn to destroy these cells resulting in regrowth of a healthy lining in the esophagus.

He is also proficient in balloon assisted enteroscopy, which allows for complete evaluation of the small intestine. Balloon enteroscopy allows for both diagnostic and therapeutic intervention and can spare patients the need for surgery. The most common indication for the procedure is for unexplained gastrointestinal bleeding.

Prior to his fellowship training, Dr. Gross completed his internship and residency in internal medicine at North Shore University Hospital, New York University School of Medicine. He also served as a hospitalist at North Shore University Hospital- NYU.

Upcoming topics in the Medicine series

Oct. 27: “All About Breast Health” by Kathleen LaVorgna, MD, surgeon

Jan. 26, 2010: “What is Emergency Angioplasty?” by Charles Augenbraun, MD, FACC, cardiologist, Cardiology Associates of Fairfield County and David Lomnitz, MD, FACC, cardiologist, Cardiology Associates of Fairfield County

Feb. 23, 2010: “Learn about Advanced Robotic Surgery” by Jonathan Bernie, MD, urologist, Urology Associates of Norwalk, John M. Garofalo, MD, obstetrician/gynecologist, and Adam Ofer, MD, obstetrician/gynecologist, Avery Center for Obstetrics and Gynecology

March 23, 2010: “Arthritis of the Elbow, Wrist, Hip and Knee” by Michael Marks, MD, MBA, orthopaedic surgeon, Coastal Orthopaedics and Michael G. Soojian, MD, orthopaedic surgeon, Coastal Orthopaedics

April 27, 2010: “What You Should Know about Sleep Apnea” by Christopher Manfredi, DO, pulmonologist and critical care specialist, Norwalk Hospital Sleep Disorders Center

May 25, 2010: “Prevention and Treatment of Chronic Wounds” by Sandra Wainwright, MD, Wound Care and Hyperbaric Medicine Center and Paul J. Gagne, MD, FACS, vascular surgeon, Southern Connecticut Vascular Center

For more information on Medicine 2010, call the Norwalk Hospital Community Relations Department at (203)852-2250  –  Prospective attendees with disabilities should call in advance so that their special needs can be met.

Physical activity lowers risk for a wide range of diseases., August 31, 2009  —  In the 19th century, most work involved physical activity; in the 20th century, exercise became a leisure pursuit; today, it’s an urgent medical necessity.

Exercise: It’s cheap, readily available, and the single most effective step nonsmokers can take to avoid chronic and potentially fatal diseases. If it were being hawked on late-night television, you’d think the phone lines would be tied up for hours.

But regular physical activity remains a hard sell. Despite mounting evidence that it lowers the risk for obesity, heart disease, diabetes, depression, and many forms of cancer, the average citizen is increasingly sedentary. Still, the U.S. Department of Health and Human Services (HHS) isn’t giving up on us.

In 2007, the agency convened an expert committee to evaluate a decade of scientific evidence on the benefits of physical activity. Committee member Dr. I-Min Lee, who also serves on the Harvard Women’s Health Watch advisory board, said she and her colleagues found an “impressive range of health benefits coming from being physically active.” They submitted their findings, and in the fall of 2008, the U.S. government issued a detailed exercise prescription for the nation.


The “2008 Physical Activity Guidelines for Americans” ( are more extensive than those of most other health organizations, and more extensive than earlier HHS recommendations. While assuring us that a couple of hours a week of moderate activity provides important health benefits, the guidelines also stress that more is indeed more — finding added benefit from exercising longer and doing so with greater intensity. As Dr. Lee puts it, “Any physical activity one can do is good, but more is better.”

The guidelines are also more inclusive. They apply not just to the standard adult audience but to almost everyone age 6 and over — children, adolescents, pregnant women, seniors, and people with chronic diseases and disabilities. This time around, no one gets off the hook. Adults, whether 18 or 81, are urged to get no less than 150 minutes (two and a half hours) of moderate activity or 75 minutes (one hour and 15 minutes) of vigorous activity — or some combination of the two — each week. Sessions should last at least 10 minutes and be spread evenly through the week.

Adults are advised to fit in two weekly sessions of strength training, as well. The authors urge even people with medical conditions to meet these standards, though they acknowledge this may require a gradual buildup.


The HHS exercise guidelines emphasize that people with chronic medical conditions and disabilities should get just as much exercise as other adults, if they can. This prescription may be daunting, especially for those with disabilities that sap energy or hamper mobility, like depression, multiple sclerosis, and arthritis. But regular exercise can actually improve mood and energy level, increase muscle and bone strength, and reduce the pain associated with many health problems. So even if a health condition makes it difficult to meet the guidelines, you should participate in any activity as best you can and avoid inactivity.

The HHS guidelines advise patients with disabilities or chronic conditions to speak with their health care providers about appropriate kinds and levels of exercise.

The National Institutes of Health and other organizations like the American Heart Association and the National Multiple Sclerosis Society provide specific, condition-based exercise information. For example, the National Osteoporosis Foundation suggests low-impact exercises that build bone and minimize the risk of fracture during workouts. If you’re not sure where to go, just type “exercise” and the name of a condition into an Internet search engine. The most reliable Web sites are those ending in “.gov,” “.org,” or “.edu.”

The American College of Sports Medicine Web site also has detailed advice for people with certain chronic health conditions. It provides topical paperback guides (“Action Plans”) that discuss particular challenges associated with menopause, allergies, arthritis, diabetes, osteoporosis, high cholesterol, and high blood pressure.

The site also offers “Your Prescription for Health” — concise tip sheets on issues related to physical activity, including Alzheimer’s disease, blood clots during exercise, anxiety and depression, heart conditions, cancer, low back pain, and visual impairment. To order or download these materials, go to

Children and adolescents should be getting even more than adults: at least an hour a day (420 minutes per week), including both aerobic activity and exercise that builds muscle and bone.

The guidelines also distinguish between different levels of physical activity. For example, for most middle-aged adults, moderate-intensity aerobic exercise is comparable to walking three to five miles an hour; vigorous exercise is anything higher. Or, on a zero-to-10 scale, with zero as the amount of activity involved in sitting, and 10 as the effort of running at top speed, moderate exercise begins at five and vigorous exercise at seven.

Perhaps the simplest way to distinguish moderate from vigorous exercise is by trying to speak as you work out: if you can talk while working out but have a hard time singing, you’re exercising moderately; if you find it difficult even to talk, that’s vigorous.

Strength training should involve all the major muscle groups of the legs, hips, back, chest, stomach, shoulders, and arms. You should repeat each exercise for each muscle group eight to 12 times. Many aerobic activities also provide strength training: for example, race-walking strengthens legs and hips; rowing builds muscles in the arms, legs, chest, and shoulders.


Go beyond the basics if you can, say the guidelines. Once you’re routinely logging the recommended levels of aerobic activity, start to add a few minutes a day. (Ramping up slowly reduces the likelihood of injury.) The HHS committee found that you can get even greater health benefits and more effective weight control when you reach twice the recommended weekly amount — that is, 300 minutes of moderate activity, 150 minutes of vigorous activity, or a combination of the two. More than that may be even better.


Anyone who’s followed a regular exercise regimen knows that the hardest part is getting started. Often, it takes a wake-up call, whether that’s a heart attack or just the inability to zip your favorite skirt or pants. If you need a nudge but don’t want to wait for an unwelcome event, the President’s Council on Physical Fitness and Sports (PCPFS) has a tool that might help — the Adult Fitness Test.

Originally convened during the Eisenhower administration, the PCPFS celebrated its 50th birthday in 2006 by producing an instrument that adults can use to determine how fit they are in terms of aerobic capacity, muscle strength, and flexibility.

All you have to do is walk a mile, do a few sit-ups and push-ups, and perform a single stretching exercise, and you can find out where you fall on the nation’s fitness spectrum. If you’re unpleasantly surprised, the PCPFS offers some pointers for improving your score. The test can be downloaded at

The American College of Sports Medicine (ACSM) has developed two interactive questionnaires to help provide you with a realistic basis for establishing a routine. The first, a health assessment form, helps you gauge the factors that might pose risks or limit your ability to exercise. You can print out the results and share them with your clinician.

The second questionnaire helps identify attitudes or habits that could undermine your resolve and generates personalized advice for overcoming them. Because research confirms that people with well-designed programs and goals are more likely to succeed, the ACSM also offers printable, customizable planning forms including a cost/benefit analyzer, an exercise time scheduler, a goal-setter, and a form you sign pledging to make exercise a ritual. All are available at

“Tips to Help You Get Active, from the National Institute of Diabetes and Digestive and Kidney Diseases” is a 24-page guide that could be subtitled “No More Excuses.” It offers helpful suggestions for overcoming just about every barrier to exercise you can think of — psychological, physical, or environmental. The guide is available at


If you find that sticking to a regimen is at least as challenging as starting one, several free offerings from health organizations may help you stay on board:

“Be Active Your Way” is a quick reference for ways to incorporate the 2008 HHS activity recommendations into your life. The advice isn’t new, but it’s presented in an accessible and easy-to-follow way. You can order or download this booklet from the HHS guidelines Web site:

“Keys to Exercise,” a video series produced by the ACSM and the American Heart Association, presents exercises that help improve strength, flexibility, and endurance. To reinforce the message that you don’t have to go anywhere special to stay fit, many of these exercises are performed at home and require no special equipment. The videos can be viewed on your home computer; just go to

“Exercise: A Guide from the National Institute on Aging” (NIA), dedicated to people over 65, emphasizes that our bodies don’t transcend the need for exercise when we become eligible for Medicare. The 82-page guide does recognize and explain the changes that come with age, and it provides appropriate exercise programs, including suggestions for people with joint replacements, people who find it difficult to perform exercises on the floor, and people taking beta blockers (which can slow heart rate). It can be printed out or ordered from the NIA Web site,

The ACSM has developed Current Comments, a series of two-page primers on a range of specific exercise topics. Titles include “Exercise and the common cold,” “Exercise and age-related weight gain,” “Exercise while traveling,” and “Strength, power, and the baby boomer.” These and many more are available under “Helpful Resources” at


For healthy women, pregnancy is no longer a license to take it easy. The HHS concurs with the 2002 guidelines issued by the American College of Obstetricians and Gynecologists, which indicate that during pregnancy and the postpartum period, women with uncomplicated pregnancies should try to get 30 minutes of moderate exercise on most if not all days.

Contact sports and activities like gymnastics and downhill skiing are off-limits, but a pregnant woman can continue swimming, walking, bicycling, and doing yoga. And those with uncomplicated pregnancies who were exercising vigorously before becoming pregnant can probably keep doing so but should consult their clinicians.

Keeping active reduces the risk of developing gestational diabetes and high blood pressure while helping to counter such pregnancy-related discomforts as pain, aching legs, constipation, and sleep disturbances. Physical activity also builds strength and stamina that can ease delivery and hasten postpartum recovery. Finally, an established exercise routine lowers the risk of postpartum depression and aids in shedding extra pounds. For more information, see “Have a Fit Pregnancy” at


Simplicity is the key to establishing and maintaining a lifelong exercise program. If your routine requires little more than comfortable shoes and clothing, you’re less likely to abandon it because of weather, travel, or changing schedules. Pick a time of day that works for you. Find a friend to do it with you.

With a little creativity — and perhaps some help from the sources listed above — you should be able to put together a combination of aerobic, strength-building, and flexibility exercises that enhance your health, improve your well-being, and keep you at it for the long haul. – Harvard Women’s Health Watch


Seti Institute, August 31, 2009, by Laurance R. Doyle  —  Millions of years ago a group of wasps “decided to” become vegetarians and so today we have the bee. Some of their cousins “decided to” quit flying and so became the ants, but that is another story. Although only about 20% of bees are social, honey bees are very social indeed. It has been stated by several biologists that, if it were not for the honey bee pollinating plants, humans would only last 3 or 4 years as our food supply would disappear.

The female honey bees are the workers of the hive. First, they learn to babysit, then they learn the construction trade (specializing, of course, in hexagonal wax structures), and eventually take on the daunting task of navigating in the outside world. Honey bees have been known to travel to find honey over 10 kilometers away from their hives – the equivalent of a human flying from San Francisco to Denver to get some pollen. It takes about 6 bees life work, and thousands of miles flown, to make one teaspoon of honey.

Bees are the only other species, to date, that have been shown to communicate with symbolic language-that is, they can “talk” about details of something that is not present. (We note that psychologists dispute the use of the terms “symbolic” being applied to any non-human communication systems, but bee scientists regularly apply this term to describe bee language.) And what do bees “talk” about? Mostly astronomy – in particular about the Sun; where it is as compared to where the flowers are. And how do they “talk”? Mostly they dance!

We know of three languages that bees use; it has been postulated that they have several more. The easiest is the Round Dance. Basically when a bee finds a nectar source nearby she comes back to the hive and dances around in a circle giving out samples; (for humans this works well at ice cream stores). The Round Dance tells the other bees to go out and sniff around for the source – it is very close.

Another dance is known as the DVAV Dance – basically a kind of bee belly dance. This dialect is reserved for internal hive politics-who is to be the next queen? Is it a good day to swarm?  And so on.

But the most studied language of the bees is the Waggle Dance. When a bee finds a nectar source farther away, she comes into the hive and gets some of the other ladies to gather around. Although it is dark, they can feel how she dances and also taste a bit of the quality of nectar she has brought back. She then starts this special dance over the combs. If more than one bee is dancing, eventually, which source to go to first will be decided democratically; it is “discussed” until the vote is unanimous. 

In the waggle dance “up” is always the direction to the Sun. The bees have little muscles in their necks that can tell which direction is vertical in the dark. The angle from the Sun to the nectar source is then the angle at which the scout bee dances from the vertical, indicating the angle at which the others must navigate.

But how far away is the flower? As the scout bee (sometimes called the “recruiter bee”) dances, the number of waggles she does in the correct angular direction before turning around to begin again is how far the honey source is in bee units. Different types of honeybees have slightly different units of measurement. Finally, the time she takes doing the dance indicates how much of a head wind can be expected. This tells the other bees how much fuel (honey) to tank up on to make their trip there and back.

Many remarkable experiments have been done with bees over the past hundred years-how they use polarized light to see the Sun on a cloudy day, how they can understand the landscape as a map and so don’t need to follow the same route back to the hive that they took going out, how they know where the Sun is even after it sets and so can forage during a full Moon, and many more.

But I was particularly intrigued by a serendipitous experiment I read about recently that occurred when some university scientists were training bees to go farther and farther away for nectar so they could determine the precision of their navigational directions to each other. They placed some nectar close to the hive and then moved it out 25% farther every day until, after a while, the nectar source was quite far away. This required quite precise directions from the scout bees to the others in order to allow them to find a spot this far away-in other words, the angle of the waggle dance had to be smaller the farther the distance.

They were doing this experiment, which had been going on for many days, when the professor got a call from his graduate student. The student’s car had broken down so he had been unable to re-place the nectar source the extra 25% farther that morning. The professor said he would do it, then, that afternoon.

When the professor arrived at the nectar source there were no bees present. But when he arrived at the place where the nectar should have been for that day (but had not been moved there yet), there were all the bees waiting for him! Not only had the bees gotten the math correct (25% farther), but the implication is that they had demonstrated the imagination to be able to picture the future by picturing the nectar-not where it was-but where it was going to be! The professor wrote that he would never have done such an experiment on purpose since he never would have thought that the bees could have been so intelligent!

Besides basically doing all the work to bring us fruits, vegetables, and other pollination-requiring plants – plus honey and beeswax – bees remind us not to underestimate the expression of intelligence from any of our fellow (or, in this case, our lady) species.  So to bee or not to bee is not the question. We have to bee, and we should be grateful to have such reliable, symbiotic friends to share our planet with.

So what does all this have to do with SETI (the Search for ExtraTerrestrial Intelligence)? Well the three main requirements for producing extraterrestrial communications are a communication system, advanced tool use, and astronomy. Bees demonstrate non-human skills in all three. And the more we can learn from them (and other species) the more prepared we should be for a truly alien signal if and when it is received from extraterrestrials that have not grown up on the same planet nor shared the same star with us for millions of years. 

(For further details about this serendipitous experiment, see: Gould, J.L. and Gould, C.G., The Honey Bee, Scientific American Library Series.)