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If you are looking for motivation to kick-start your daily exercise routine here it is:

At just 9 years old Winter Vinecki swam 1.5k (a little less than a mile), biked 40k (roughly 25 miles) and ran 10k (about 6.2 miles) in less than 4 hours. And she didn't do it because she loves to exercise; rather the Michigan native competed in the inaugural Athletes for a Cure Triathlon at the Disney World Resort near Orlando, Florida last week for one reason---her dad.

Winter's father is fighting for his life. Michael Vinecki was diagnosed with a very aggressive form of prostate cancer earlier this year. When doctors couldn't say how long Michael had to live, Winter sprung into action. In the six weeks between her dad's diagnosis and a 12-hour Father's Day surgery at the Mayo Clinic, Winter dedicated herself to training for the triathlon in an effort to raise money for cancer research and honor her beloved father.

She's 9-years-old, people.

Winter went into the triathlon with a goal of raising $10,000 specifically for prostate cancer research and to make people aware of the importance of early detection. In addition, the spry preteen says she wanted to pay tribute to her dad by fighting to stay on the course as hard as he has to stay alive. In the end Winter exceeded her original goal by helping raise more than $100,000. She was able to do so by getting (for the first time ever) the entire field of competitors at the Athletes for a Cure Triathlon to compete as a single team: Team Winter. According to race organizers, every participant registered as a fundraiser symbolically "gave" their fundraising total to Team Winter.

As for how well Winter performed on the course, after being given a ten-minute head start in front of the nearly 1,000 competing athletes she was able to cross the finish line in a time of 03:59:04 hours, beating 62 of her fellow competitors. Winter's mother, Dawn Vinecki, who is also a triathlete, was at her side for the entire race providing encouragement. In addition, several other world-famous triathletes also stuck by Winter during the grueling event. Simon Lessing, former World Champion triathlete was at her side for the swim and running segments, and former World and Ironman Champion Karen Smyers ran with Winter in the final leg of the competition.

Unfortunately, Winter's dad (who is also a triathlete... I guess it must run in the family) was able to travel to Orlando to watch his family compete. He is currently back at the Mayo Clinic recovering from more surgery and undergoing more treatment. Still, Winter says she thought of her dad the entire time she was out on the course and was determined to finish (despite being physically exhausted) to show her dad how much she is inspired by his fight to stay alive.

After reading that what's an hour on the treadmill, right?

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His 1,350 doses arrived by the end of August, a far cry from previous years when supplies arrived late or not at all. Some 143 million to 146 million doses are expected before the season is done, and all five manufacturers have been shipping since early August.

"This is really quite a technical achievement that [manufacturers] are rising to this challenge and are on a faster timeline than in previous years," said Bruce Innis, MD, vice president for clinical research and development at GlaxoSmithKline.

Medical societies and public health agencies have long been working to stabilize the supply chain. The American Medical Association and the Centers for Disease Control and Prevention, for example, have organized the National Influenza Vaccine Summit, which meets annually and holds conference calls regularly during flu season. The AMA also advocates that physicians serving high-risk populations receive influenza vaccine in a timely and equitable manner.

Improvements in the supply chain are due to these efforts as well as a combination of business changes and scientific advancements that have made the vaccine's journey more efficient.

On the business side, more companies are in the game, making a repeat of the 2004-05 season less likely. At that time, one company, Chiron Corp., had sterility problems in its manufacturing facility, and 46 million to 48 million doses -- nearly half of the total expected supply -- were lost. This left Sanofi Pasteur, then Aventis Pasteur, which initially planned to deliver 52 million doses, as the sole manufacturer of injectable vaccine. Production ramped up, and the company delivered about 58 million doses. MedImmune Inc. created 3 million doses of the intranasal version.

This season, five companies are involved. Sanofi Pasteur expects to ship 50 million doses, and CSL Limited is supplying 6 million. Novartis, which purchased Chiron in 2006, will manufacture 40 million shots, and GSK plans to provide 35 million to 38 million. MedImmune will make 12 million doses of the intranasal version.

Science also is speeding the process. Manufacturers increasingly are using reverse genetics to hasten production of seed viruses. They also are working to develop cell culture production, which is expected to increase capacity and make supplies more predictable. Cell culture would be particularly useful to deal with a pandemic in which the virus also affects birds, since chickens produce the eggs required to make the vaccine.

"The key thing is that it takes chickens out of the mix," said Matthew Stober, global head of technical operations for Novartis.

In the research world, investigators also are looking at vaccine formulations that would not need to be changed annually.

Data on a phase I study of a vaccine for all influenza A viruses will be presented at an October joint meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy and the Infectious Diseases Society of America, to be held in Washington, D.C. The findings suggest this vaccine creates a good immune response and is well tolerated.

"[This] has the potential to be a safe, highly effective and much-needed option to prevent seasonal and pandemic influenza," said Christine Turley, MD, the study's primary investigator and director of clinical trials and research at the Sealy Center for Vaccine Development at the University of Texas Medical Branch in Galveston.

This formula does not rely on cell- or egg-based production processes. Instead, vaccine antigens are produced more quickly by combining toll-like receptor-mediated immune enhancers and recombinant bacteria.

With an eye toward elevating awareness of these potentially serious medical conditions, acting Surgeon General Steven K. Galson, MD, MPH, issued a "Call to Action to Prevent Deep Vein Thrombosis and Pulmonary Embolism." He introduced the publication Sept. 15 at the second annual meeting of the Venous Disease Coalition in Washington, D.C.

"DVT and PE are often referred to as 'silent' conditions -- they can occur suddenly and without symptoms. In nearly half of the cases, there are no apparent symptoms," he said. Although gains have been made in understanding how these dangerous clots develop and how to prevent, diagnose and treat them, that knowledge is not always applied systematically, he added.

The conditions generally keep a low profile, but they hit the headlines when they strike young, seemingly healthy individuals. NBC journalist David Bloom died in 2003 at age 39 of DVT and PE while covering the Iraq war, where he spent hours crouched in the close confines of a tank. His widow, Melanie, who attended the surgeon general's meeting, has since worked to spread the word about the dangers of DVT.

The two conditions may contribute to as many as 100,000 deaths each year, Dr. Galson said. That number is expected to rise as the population ages because patients older than 50 are at increased risk.

"It is clear that we are dealing with a major health problem," noted Elizabeth Nabel, MD, director of the National Heart Lung and Blood Institute, who spoke at the event.

The call also is intended to spell out certain warning signs to the primary care physician, who is often the first to detect a clot, Dr. Nabel said. Initial symptoms can be subtle.

Mistaken identity

Patients may have swelling or pain in an arm or leg, skin redness or a warm spot on a leg. Physicians first might consider diagnoses of skin infections or muscle strains instead of DVT. In the case of shortness of breath caused by a pulmonary embolism, the patient may be thought simply to be out of shape, Dr. Nabel said.

Le Keisha Ruffin, 32, described several fruitless trips to emergency departments when pain in her side and chest from an undiagnosed PE became so sharp "it felt like someone was literally stabbing me over and over again in the same spot." She was told the pain was from the birth of her daughter by cesarean section.

The proper diagnosis was made weeks later after a hot bath at home resulted in massive swelling in her right leg and she was rushed back to the emergency department. A physician told Ruffin that the DVT in her leg had caused one of the largest blood clots the physician had ever seen. Plus, part of the clot had broken off and caused a PE. She was told she might not have lived through the night had she not received help.

To prevent such occurrences and speed recognition of these conditions, the Agency for Healthcare Research and Quality published a 12-page patient guide and a 60-page physician guide on preventing and treating dangerous blood clots, said AHRQ Director Carolyn Clancy, MD. "We know how to prevent many of these dangerous blood clots, and these guides will help patients and clinicians put that knowledge to work to improve care."

The clinician guide, "Preventing Hospital-Acquired Venous Thromboembolism: A Guide for Effective Quality Improvement," is intended to help hospitals and clinicians implement successful processes to prevent dangerous blood clots, Dr. Clancy said. It identifies such clots as the "most common, preventable cause of hospital deaths."

The document also points to additional triggers for DVT that include taking hormones, having a bad bump or bruise, having had a stroke, being obese, or taking a trip of more than an hour in a car, airplane, bus or train. Certain inherited blood disorders also can make clots more likely.

NHLBI also is funding new research on the two conditions. Studies are under way on treatment for damaged veins and valves following DVT and on improving the health and well-being of elderly patients at risk for dangerous blood clots.

The institute also is launching the first multicenter, randomized clinical trial of genotype-guided dosing of warfarin, the most common blood-thinning treatment for those with diagnosed clots. The study will examine whether the use of clinical plus genetic data during warfarin initiation can lead to better and safer treatment.

Meanwhile, the AMA and other groups have developed the brochure "Personalized health care report 2008: Warfarin and genetic testing." It is designed for physicians and other health care providers who commonly prescribe warfarin but who may not have had exposure to pharmacogenomics and genetic testing. It outlines the effects of variations in the genes CYP2C9 and VKORC1 on warfarin metabolism and response, and summarizes the genetic testing available to determine whether a patient carries such gene variations.

Did you gain the "Freshman Fifteen" during your first year at college? Was it easier shedding the pounds then than it is now? This week a famous pro basketball player revealed that he has never struggled more to lose weight than right now... and he's playing in the big leagues. His fitness story was just one of the many topics that were covered in this week's blog. If you missed any of them this is your chance to get caught up.

September 22nd---Avoiding Classic College Weight Gain. A well-known West Coast university is pulling out all the stops to help students stay fit and trim during their stay on campus. See which school is getting high marks for its efforts to help future leaders stay healthy.

September 23rd---Jump for Joy... and Stronger Bones. Who knew simple jumping could help build stronger bones? Find out why researchers are encouraging children (especially girls) to jump, skip and hop more.

September 24th---Pro Basketball Player Speaks Out About His Fitness Challenges. Find out which NBA player is coming clean, telling the world about his struggles to maintain his weight and physicality. His course of action may surprise you.

September 25th---How Effective are those Fancy Exercise Machines? Those ads hawking the latest and greatest (or so the companies claim) fitness equipment can be annoying at times. But how many of us have paused long enough to look and wonder just how well the machines worked in real life? Several fitness experts recently put the red hot Skorcher to the test. Find out what they had to say in this blog.

September 26th---How Effective are those Fancy Exercise Machines? Part 2. The RealRyder is one of the hottest new fitness machines on the market. But is it really worth $2,400? Find out in this blog.

September 27th---Popular New Exercise Equipment. Slanted Risers are all the rage at gyms across America. There may not be a simpler design out there, yet it has caught the attention of fitness buffs from coast-to-coast. Find out what fitness experts are saying about this new piece of equipment and another new trend-Yoga Fusion classes.

Have you ever seen a new product and asked yourself: "Now, why didn't I think of that?"

I mutter that question each and every time I run on the treadmills at my local gym and peer into the step aerobic classroom. The gym recently acquired a few dozen of those new Slanted Risers. The angled plastic riser fits under a traditional step, like those used in step aerobics classes, to allow you to step up or lie back on a slant.

The ad on TV claims: "Not only will the Slanted Riser add a new dimension to your cardio workout by transforming your flat Step into an angled platform, but paired with standard risers, the Slanted Riser will also turn your Step into an incline/decline bench ... From aerobic training to strength conditioning, SPRI's patented Slanted Riser will bring unlimited versatility to your workout."

The ingenious product will set you back $59.95. (Now you see why I kick myself about not coming up with the idea first.)

The risers are by no means revolutionary. I think anyone who has worked out on those plastic steps before at some point considered the idea, but someone else simply got working on it first. The risers act as an upgrade to a traditional flat step and help tremendously when you are doing sets of forward lunges as it offers a more comfortable angle. It also allows you to complete other exercises you wouldn't be able to on a flat step, such as incline and decline chest presses.

Another new and extremely popular offering at my gym is the Fall Yoga Fusion class. It basically pairs yoga with other cardio exercises such as aerobics, dance, cycling, even boxing.

According to the flyer, the classes are designed for people who have a limited time to work out. The Yoga Fusion classes allow you to get in cardio, sculpting and relaxation all at once-in less than 90 minutes.

It sounds great; however, when researching the new trend I discovered that not everyone is embracing the idea. Some fitness experts say the new classes give yoga a bad name. One fitness expert claimed the classes "taint" yoga's image by giving people a false sense of what yoga is and how it is practiced. Basically, her argument is that the classes have made the practice of yoga to be more of a weight loss, fitness workout, when yoga is really designed for meditation, calming and quieting the mind and body.

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How Effective are those Fancy Exercise Machines?

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