PARIS (Reuters) – The chief executive of Eli Lilly and Co’s Alzheimer’s imaging unit is confident it can create a training program for its imaging drug that will satisfy concerns raised by U.S. regulators.

So are many Alzheimer’s disease experts, who are gathering in Paris this week for the Alzheimer’s Association’s international conference.

Imaging the clumps of a toxic protein called beta amyloid that accumulate in the brains of patients with Alzheimer’s is seen as a critical step toward identifying the disease in the earlier stages, before memory problems begin.

Researchers increasingly believe this is the best time to intervene with drugs that might delay or prevent the disease from progressing.

Lilly is seeking U.S. Food and Drug Administration approval to market the agent, a radioactive tracer called Amyvid, for use with positron emission tomography, or PET, scans to help doctors rule out the plaque linked with Alzheimer’s.

In January, an advisory panel to the FDA unanimously said Amyvid appears to detect brain plaques associated with the memory disease, but that more data is needed to show the scans can be properly interpreted.

“Since we got that feedback, we’re working with the FDA to figure out what is required,” said Dr. Daniel Skovronsky, president and CEO of Avid Radiopharmaceuticals, a wholly owned unit of Lilly.

“We’re quite confident that we will be successful,” Skovronsky said in a telephone interview ahead of the conference, which runs July 16-21.

IS TEST TOO COMPLICATED?

He said data from the company’s clinical trials was convincing, but the FDA said the test was too complicated for clinical use and may lead to inconsistent readings.

So the company is trying to focus its training on answering a simple question: “Is there amyloid in the brain? Yes or no?” Skovronsky said.

He said the FDA will not require additional clinical trials involving patients.

“I expect ultimately it will win approval,” said Dr. Michael Weiner, who is leading the Alzheimer’s Disease Neuroimaging Initiative, a federal study that uses imaging and other tests to track the progress of Alzheimer’s over time.

“I think most people see this as a temporary problem,” said Weiner, who also directs the Center for Imaging of Neurodegenerative Disease at the Veterans Affairs Medical Center in San Francisco.

If approved, the test will tell doctors whether amyloid is gathering in the brain. If there is none, it would tell doctors to look for other causes of mental decline, such as depression or medications.

“I’ve talked to some scientists who feel these scans can help them in assessing their patients,” Weiner said, adding: “Once there are treatments, these tests are going to be much more important.”

Avid’s compound is already being widely used by various drug companies in clinical trials, and Lilly’s $800 million acquisition of Avid last November raised concerns among Lilly’s rivals.

“One of the early questions on everyone’s mind was, ‘Are you going to continue to collaborate with us even though we are developing a drug that might compete with a Lilly drug?’”

“The answer right from the outset was yes,” Skovronsky said. “We are committed to this open collaboration model.”

Avid has been ahead in the race for such imaging agents that are estimated to have a potential global market anywhere from $1 billion to $5 billion.

General Electric Co and Bayer AG are also developing rival products, but Avid’s delay at the FDA may have cost the company some of its lead.

“When you are first, you are developing a path that others will follow. That is the benefit but also the cost of being in the lead,” Skovronsky said.

(Editing by Eric Beech)

NEW YORK (Reuters Health) – Drivers who choose to fight a speeding ticket in court, rather than pay a fine by mail, are more likely to be involved in a car crash later on, a new study of Maryland drivers shows.

The researchers don’t think appearing in traffic court actually causes people to crash their cars. Instead, they say drivers who chose this approach tended to have high-risk characteristics in the first place. And in general, those who fought their speeding tickets in court had longer histories of violations and crashes.

But in seeming contrast, the researchers also noticed that the traffic court group was less likely to be cited for speeding after their initial violation.

That finding struck Ray Peck, founder of the consulting firm R.C. Peck & Associates and an expert in crash risk, as very unusual.

“You tend to find the two correlated,” Peck, who was not involved in study, told Reuters Health.

The researchers, based at the University of Maryland and the National Transportation Safety Board, kept track of nearly 30,000 Maryland drivers who had been ticketed for speeding.

Thirteen thousand drivers decided not to argue. Instead, they just paid a fine by mail. The rest opted for traffic court, where drivers met with judges who determined their penalty.

Nearly a quarter of those who went to court were found not guilty, had their case dismissed, or were not prosecuted for speeding. Another half were placed on probation and paid a fine. And nearly a quarter of those in court received the toughest verdict: a fine plus a demerit point on their driver’s license — which can be serious because too many points and drivers lose their licenses.

Overall, those who went to court were 25 percent more likely to get in a car crash in the three years following their speeding ticket than those who paid a fine by mail, the research team reported in the Annals of Epidemiology.

Eleven out of every 100 people in the traffic court group were later in a crash, compared to eight of every 100 who paid a fine by mail.

“I think this relationship doesn’t mean that traffic court caused a higher crash risk among these drivers,” said Jingyi Li, the lead author of the study who is now a researcher at drugmaker AstraZeneca.

Rather, drivers who chose traffic court had a higher crash risk to begin with, Li said. They were more likely to be younger and have a poor driving history.

The incentive to appear in court, especially among repeat offenders, is that drivers can appeal for leniency. “They can explain to a judge what happened and the judge may lower their fines and put them on probation before judgment,” Li told Reuters Health. “I think that’s why traffic court provides an avenue for some high risk drivers to get away with it.”

But that doesn’t explain why those who chose traffic court were less likely to be cited for speeding afterwards.

They were eight percent less likely to get a speeding ticket in the three years following their initial ticket than the people who paid their fine by mail. Thirty-nine out of every 100 drivers who paid by mail received a speeding ticket later on, while 36 of every 100 drivers who went to traffic court were later caught speeding.

Speeding tickets “may not be a perfect measure of change in behavior,” Li said, because so many people speed and never get caught.

Peck added that the study did not examine other potential influences on drivers’ risks for subsequent speeding tickets and crashes, such as how much time they spent on the road, if the Department of Motor Vehicles took any action after they were penalized, and whether drivers were involved in traffic school.

Li said that for a punishment to be effective, it must be swift and certain, something that traffic court doesn’t provide. Court dates can be postponed and punishments are flexible.

Speed cameras might pose a bigger threat to speeders, because the evidence is more clear, Li offered. He added that traffic court is still a valuable method of enforcement and it provides a fair way for each person’s case to be heard.

Peck pointed out that the study did not include a control group — one in which people received no punishment at all — which means that it’s possible traffic court is still better in terms of preventing crashes “than if you do nothing at all.”

SOURCE: bit.ly/oEyyGd Annals of Epidemiology, online June 20, 2011.

BOSTON (Reuters) – Boston pediatrician David Ludwig, the center of a media firestorm this week, wants to set the record straight on his view that a state should intervene in the most extreme cases of child obesity.

Ludwig and co-author Lindsey Murtagh at the Harvard School of Public Health triggered a backlash with an opinion piece in a leading U.S. medical journal about what could be done about highly overweight youngsters.

They argued that when all other efforts failed, a state should consider putting high-risk obese kids in foster care, and said doing so may be the more ethical choice that could avert drastic measures like weight-loss surgery.

Ludwig, of Boston’s Children’s Hospital, has since responded to dozens of e-mails this week from angry and terrified parents. Other medical experts have questioned the rationale of removing a child from an otherwise functional and supportive family if they are obese.

In his first interview since the backlash began, Ludwig said the article was meant to promote a dialogue on childhood obesity, which has become a life-threatening problem for many youngsters.

“It’s absolutely understandable that if someone with an obese child heard the government could swoop in and take that child away, (they would) be frightened and outraged,” Ludwig told Reuters. “I want to emphasize that foster care should only be the last resort when all other options have failed.”

In his replies to parents, Ludwig has provided copies of his opinion piece, published this week in the Journal of the American Medical Association, that says there is a role for the state when it comes to helping obese children, but removing them from a home is very rarely the solution.

“It’s just been heartbreaking to see how the story has been wildly exaggerated by some of the media, causing a great deal of pain and suffering for people,” Ludwig said.

With at least 20 million overweight and obese children in the United States and some 2 million of those kids at the very highest risk, childhood obesity may be the “most important threat that exists to this generation of children,” he said.

But placing a youngster in foster care “should absolutely not be an option” for most of the highest risk cases.

And that is what Ludwig and Murtagh wrote in the piece, he said. To prove his point and calm the fury that has erupted, JAMA is making the full text of the piece available free to the public for a week at: here

Ludwig explained that state intervention could include financial support to families, social services, access to safe recreation areas and even parenting courses to help manage a child’s uncontrolled eating habits.

In 99 percent of the most serious cases, removing a child from a home is not an option. Ludwig said that in over 15 years of treating some 10,000 patients battling obesity he only knows of one case where the child was taken from parents.

“The ultimate answer to the obesity epidemic is not to blame parents, it’s to create a more healthful and supportive society,” Ludwig said.

“But until we get there, what do we do about that 14-year-old, 400-pound (182 kg) child who’s not facing increased risk of illness 20 years from now, but who’s facing life-threatening complications today?” he said.

(Reporting by Lauren Keiper; Editing by Michele Gershberg and Ros Krasny)

NEW YORK (Reuters) – Most Americans want smoking banned in all public places but only 19 percent believe that cigarette smoking should be illegal in the United States, a Gallup poll published on Friday said.

The Princeton, New Jersey-based pollster found in its July 7-10 telephone survey that for the first time since it initially asked the question in 2001, a majority of Americans, 59 percent, support a public ban on smoking.

Ten years ago, 39 percent were in favor, a percentage that was about the same when Gallup did a similar poll on the subject in 2007, according to the survey published on the website www.gallup.com.

The 19 percent of respondents who want a law against smoking is close to the 14 percent who told Gallup in 1990 they wanted smoking to be illegal.

“A majority of Americans now support the concept of a full smoking ban in all public places, marking a significant change from four years ago, when Gallup last measured this attitude,” the pollster said.

“Relatively few Americans support the idea of making all smoking illegal across the country, perhaps partly in recognition of the practical difficulties involved in enforcing such a ban.”

Anti-smoking sentiment has risen in the United States in recent years.

New York, the country’s most populous city of 8 million, bans smoking cigarettes in almost all public places, including outdoor plazas and beaches. The District of Columbia and 27 states have passed smoke-free laws.

Gallup said its July poll also questioned Americans about their cigarette smoking habits.

“Twenty-two percent of adult Americans reported having smoked cigarettes within the last week, a percentage that is essentially unchanged over the last five years,” Gallup said.

The results of the poll are based on a random sample of 1,016 people aged 18 and older living in all 50 U.S. states and the District of Columbia. Gallup said the maximum margin of sampling error is plus or minus 4 percentage points.

(Reporting by Grant McCool; Editing by Eric Beech)

HOUSTON (Reuters) – The crew of NASA’s final space shuttle mission restocked the International Space Station with tons of supplies on Wednesday after waking to the music of Elton John.

In media interviews, Atlantis’ crew reflected on the end of the 30-year shuttle program and the series of “lasts” that will end when the spacecraft returns to Earth for a planned landing on July 21.

“I think that after we get back down to the ground, after landing, that it’s going to hit us really hard,” said mission specialist Sandra Magnus. “I think we’re all going to have a really hard time leaving the shuttle.”

The shuttles are being retired to make way for a new generation of spacecraft that President Barack Obama says will put U.S. astronauts on an asteroid and then on to Mars.

Until then, the $100 billion space station will be NASA’s foothold for manned spaceflight. U.S. astronauts will be ferried to the station and back aboard vintage Russian Soyuz capsules, at a cost of about $50 million per crewmember.

The shuttle fleet’s crowning achievement was building the recently completed space station, a project of 16 nations that orbits 230 miles above the Earth.

“When it’s all done we have the space station to show for it,” Atlantis Commander Chris Ferguson said in a media interview. “It’s been a great program.”

Hoping to make full use of the station, NASA on Wednesday selected a Florida-backed nonprofit called the Center for the Advancement of Science in Space, or CASIS, to manage U.S. sections of the laboratory not being used by the space agency.

Atlantis’ crew now faces the uninspiring but essential task of unpacking 9,403 pounds (4,265 kg) of spare equipment, supplies and food from an Italian-made cargo carrier hauled to the station in the shuttle’s cargo bay.

“This is the great thing about spaceflight,” said station flight engineer Mike Fossum, who completed a spacewalk on Tuesday to pack up a failed cooling pump for the return trip back to Earth.

“One day you are doing the most outrageous thing humans have ever done — spacewalking. The next day, you are fixing toilets and packing boxes.”

Earlier, Atlantis’ crew woke to Elton John’s “Rocket Man,” a song about the loneliness and isolation that both celebrities and astronauts face.

“We wish you much success on your mission,” Elton John said in a message. “A huge thank you to all the men and women at NASA who worked on the shuttle for the last three decades.”

The crew’s days have recently started with “Viva la Vida” by Coldplay, “Mr. Blue Sky” by Electric Light Orchestra and “Tubthumping” by Chumbawamba.

(Additional reporting by Irene Klotz; editing by Todd Eastham)

HOUSTON (Reuters) – A U.S. astronaut on the final shuttle mission said on Friday China’s first space station will be a welcome addition to the orbital brotherhood.

“China being in space I think is a great thing. The more nations that get into space, the better cooperation we’ll have with each,” Atlantis astronaut Rex Walheim said during an in-flight interview with Reuters.

“Space is one of the biggest international brotherhoods we have.”

The first module of China’s planned Tiangong-I space station arrived at its Gobi Desert launch site on June 29, the Xinhua news agency reported. It is scheduled to fly later this year on a Long March rocket and is to be visited by Chinese astronauts — known as taikonauts — next year.

The United States is preparing to regroup its human spaceflight program. It is retiring its three-ship shuttle fleet upon Atlantis’ return on July 21 in order to free up funds to develop new vehicles that can travel beyond the space station, where the shuttles cannot go.

Walheim and his three shuttle crewmates are halfway through a planned 13-day mission, the final flight in the 30-year-old shuttle program. They are delivering more than 5 tons of cargo to the International Space Station, a $100 billion project of 16 nations that orbits 240 miles above Earth.

The food, clothes, equipment and supplies aboard Atlantis are intended to tide over the station until NASA’s newly hired cargo delivery companies, Space Exploration Technologies, or SpaceX, and Orbital Sciences Corp, are ready to begin resupply missions next year.

“There’s been extensive planning to get the station in this posture for the next decade,” said Atlantis’ pilot Doug Hurley, who plans to stay with NASA and hopes to land an assignment to join a future station crew.

Russia, Europe and Japan also operate freighters. Crew ferry flights will be handled exclusively by Russia, at a cost of more than $50 million per person, until U.S. commercial firms develop that capability as well.

SHUTTLE NOSTALGIA

“It’s going to be sad to retire the shuttle,” said Atlantis commander Chris Ferguson. “That said, it’s had a very long and storied career. It’s done tremendous things.”

The shuttle’s legacy includes launching and servicing the Hubble Space Telescope, dispatching planetary probes and Earth-orbiting satellites and building the space station, which is as big as five-bedroom house.

“If it weren’t for the space shuttle, the station wouldn’t be here and it certainly wouldn’t be as large as it is,” Ferguson said.

“Here we are a crew of different countries. We all work together. We solve problems together. We laugh together. We eat together. It is the best example of international cooperation that I know of,” Walheim said.

Back at Mission Control in Houston, NASA was trouble-shooting a problem with one of the shuttle’s main computers, which shut down Thursday night.

NASA flies five computers on the shuttle so the loss of one will not affect the mission, officials said. The problem is believed to be unrelated to another computer glitch earlier in the mission.

Atlantis is due back at the Kennedy Space Center in Florida on Thursday.

(Editing by Jane Sutton and Bill Trott)

HELSINKI/STOCKHOLM (Reuters) – Mobile phone maker Sony Ericsson forecast an upturn in the second half, as it posted a first quarterly loss since 2009 due to a parts shortage stemming from the March 11 earthquake and tsunami in Japan.

Chief Executive Bert Nordberg said on Friday most of the hit was felt in the early part of the quarter, and that this would be negligible in the third quarter.

“There might be some minor spillover. In our planning this is behind us,” he told Reuters.

Sony Ericsson, owned 50-50 by Sweden’s Ericsson and Japanese group Sony, made a pretax loss of 42 million euros ($59.5 million).

It had recorded five consecutive quarters of profit since its last loss in the final three months of 2009.

The 42 million loss was at the low end of analysts’ estimates, which ranged from a 68 million loss to a 77 million profit.

Sony Ericsson sold 7.6 million phones in the second quarter, compared with forecasts for 8-11 million, as earthquake-related supply chain constraints cut sales of mostly expensive models by 1.5 million phones, or some 400 million euros.

“Volumes were lower than even we thought, and we were below consensus,” said Hakan Wranne, analyst at Swedbank Markets.

“The product portfolio looks pretty good ahead of the second half, and if they manage to increase volume by a couple of million units they should be making profits for the rest of the year — not large profits, but a bit above zero where we thought they would be,” Wranne said.

Sony Ericsson’s forecast for a better second half was based on new smartphone models and an easing supply chain shortage.

Nordberg said it was still his ambition to report better results for 2011. To do that, second-half operating profit would have to grow 73 percent to 176 million euros.

Nordberg said demand for smartphones, whose prices have started to fall to below 200 euros, remained healthy and was hitting the sale of mid-range mobile phones, a market he said he was “nearly willing to call … collapsing.”

Many analysts have forecast a slowdown in the smartphone market, but Nordberg said: “We still see very, very strong demand in the smartphone market.”

The venture continued to bleed cash due to component constraints, and borrowed 165 million euros to balance its finances. Cash flow from operating activities was 577 million euros negative in the first half.

“It’s quite a lot, but the explanation is understandable as it was quite an extraordinary quarter,” said Hannu Rauhala, analyst at Pohjola Bank. “However, this cannot last for long.”

Continuing cash outflows raise the possibility its parents might need to inject cash: the latest 165 million euros was raised externally.

CHANGING DIRECTION

The firm, formed in 2001, has been losing out to leaner rivals at the cheaper end. Its share of handset sales has dropped below 3 percent from more than 9 percent at its height, and it is now ranked ninth globally.

Sony Ericsson has slashed costs, including cutting around 4,000 jobs, and refocused on higher-margin smartphones that link to social networking sites such as Facebook.

Its smartphone sales grew from the previous quarter, and the share of smartphones in its sales rose to more than 70 percent from 40 percent at the end of 2010.

“Smartphone volume was reassuring but Sony Ericsson still faces a considerable task in rebuilding and sustaining profit margins,” CCS Insight analyst Geoff Blaber said.

“Sony Ericsson is not alone in finding the smartphone transition a challenging one.”

Motorola Mobility has shifted its focus to smartphones, while Sony Ericsson’s bigger rivals Nokia and LG Electronics could report second-quarter losses after being slow to move into high-end handsets.

“In many ways Sony Ericsson is going through the transition Motorola went through last year, but without the kind of support Verizon gave Motorola in the U.S.,” said Gartner analyst Caolina Milanesi.

Ericsson shares were down 1 percent at 89 crowns by 1030 GMT.

(Additional reporting by Patrick Lannin and Mia Shanley in Stockholm, Editing by David Holmes, Dan Lalor and David Hulmes)

A lot of us are not aware that one might overcome hemorrhoids without need of medical operations or other variations of harsh hemorrhoid treatment programs. A lot of us are not aware that one might overcome hemorrhoids once and for good at all. In truth, our bodies can normally overcome hemorrhoids once and for good with just a bit of care. If you are ready to enhancing your daily routine to regularly do the things required to accomplish a healthy and fit body, you could overcome many diseasesfor life, plus hemorrhoids.

You can have surgical procedures to treat hemorrhoids but that can not make certain that the hemorrhoids will not return. The way you might make that happen is by altering your diet regime, by doing exercises and be patient when going number two. Your diet regime should include a large amount of fiber and liquids. These elements are found in fresh fruits and veggies. Be sure to exercise for the reason that that will build up your cardiovascular system which is responsible for the blood flow. When defecating be patient. Try not to exert pressure.

In conclusion , there is no hemorrhoid treatment which will overcome hemorrhoids once and for good. The good news is, if you give consideration to the choice to enhance your diet and lifestyle to integrate good health you should be able to overcome and once and for good block hemorrhoids from returning. In reality, the hemorroid is ordinarily still there if on the other hand you are taking care of your body, it realistically should never affect you.

Thrombosis is in short, the growth of a blood clot within an artery or a vein. If left unattended it most likely will block essential oxygen . This can potentially cause dead cells. Thrombosed hemorrhoids are simply put abnormal veins within the anus or on the anus which are swollen from blood clots. This clotting could cause the abnormal veins to swell up to produce a bulb. If the vein bursts then a bleeding hemorrhoid results.

If you sense pain and/or itching around your anus you most likely have got hemorrhoids. If you discover bluish bulbs around your anus they are without doubt thrombosed. The bluish hue comes from hardened blood clots constricting the blood flow and are constricting the oxygen. Sometimes they feel hard to the touch because of the clotting of blood. You can’t always feel or see thrombosed hemorrhoids. Sometimes hemorrhoids are ‘internal’, so they are inside the rectal canal.

Though thrombosed hemorrhoids aren’t commonly hazardous, in case you have them it truly is to your best benefit to obtain them healed speedily . Thrombosed hemorrhoids can easily develop into bleeding hemorrhoids which may then get infected. External infections, which may perhaps result from external hemorrhoids are comparatively simple to clear up once they’ve been noticed. Internal hemorrhoids on the other hand can progress into infections within your rectum which might be threatening. They not just are problematic to detect, they may be also problematic to clear up. If internal infections aren’t healed they are able to ultimately progress into blood poisoning which can kill you.

There are lots of unique types of hemorrhoid treatment which will operate effectively on thrombosed hemorrhoids. You could decide on an operation or any number of diverse all natural or holistic alternatives. The most important thing you must do to clear up hemorrhoids would be to pay attention to your food intake. Consuming dinners that include nutritional foods for example fruits and green veggies goes a long way toward clearing up your hemorrhoids. Plus it’ll help prevent hemorrhoids from developing in the long-term. Other than watching your food intake drinking clean water and physical exercise will assist quite a bit. To minimize the itching, pain, inflammation and usual discomfort you ought to be able to get numerous distinctive types of balms and gels. Witch hazel is well known for its potential to get rid of pain and itching. Make certain you keep your rear-end clean and use topical antiseptics on it fairly often.Immersing your rear-end in a sitz bath can not merely keep your rear-end clean it can assist quite a lot with soothing the inflamed location.

Supposing that you think you might are afflicted with hemorrhoids you are doubtlessly attempting to learn about what your prospective hemorrhoid treatment solutions are. As you might have already guessed, existing are a variety of hemorrhoid treatment possible choices . If you are afflicted with hemorrhoids which aren’t especially harmful you can quite likely get them cared for with one of the diverse hemorrhoid treatment homemade remedies. But bear in mind, if you are afflicted with harmful hemorrhoids, that means, thrombosed hemorrhoids and/or hemorrhoids that have started to bleed you should probably opt for surgical removal as a hemorrhoid treatment option.

Not all hemorrhoid treatment surgical removal possible choices are identical. In truth several of them are terribly painfull.What is more they usually take quite a long time to heal. Thank goodness, a number of the better possible choices ordinarily are not as painful, but yet they’re every bit as useful as a treatment to eliminate hemorrhoids. If you happen to be thinking of surgical removal as a hemorrhoid home remedy then you are doubtlessly attempting to learn about what variations of surgical removal are available to you. This material was designed to provide you an understanding of the individual variations of surgical removal that can be had to eliminate hemorrhoids.

Among the list of several forms of hemorrhoid surgical removal attainable, Rubber Band Ligation is one of the most recognized. With this method of surgical removal a rubber band roughly 1/25in . is forced snugly directly over the bottom of the hemorrhoid. The swollen arteries that make up hemorrhoid eventually shrivel up and fall off as the blood flow to them is cut-off. It generally takes close to 1 week give or take for the hemorrhoid to go away.

You may opt for laser surgical removal. Laser surgical treatment calls for making use of a lazer light to zap the hemorrhoid off. The surgical procedure needs a really short length of time therefore you can go home on the same day. it’s an out-patient hemorrhoid treatment. Laser surgical removal does not have the typical possible risks pertaining to surgical removal , and in particular bleeding mainly because the lazer gun cauterizes the area.

Aanother variety of surgery treatment that could be used to treat hemorrhoids is termed as a Stapled Hemorroidectomy. For this particular variety of surgical treatment the medical doctor uses a particular variety of stapler which literally staples the hemorrhoid. In particular this strategy is intended to help halt the bleeding.

Hemorrhoidal Artery Ligation Operation also known as HAL is a more sophisticated variety of hemorrhoid treatment bascially consisting of surgical removal. This procedure is becoming popular operation doesn’t bring about excessive pain. Basically the procedure entails identifying all the arteries that will supply the hemorroid with blood. Whenever the arteries are confirmed they are stitched to cut-off the blood flow to the hemorrhoid. Because of that the hemorrhoid shrivels up and drops off leaving merely a scar..