Archive for the ‘Hormone Clinic’ Category

Its important to remember that what we find important in medicine is not necessarily what our patients find important, Dr. Wilkinson said. Often, doctors focus only on the efficacy of a particular method, rather than how acceptable it is to a particular patient. When she talks to adolescents, I ask them, does it matter to you to have your period every month, she said, and whether your partner can see the method or is aware that youre on birth control.

For some adolescents, it may be important that they can stop the method whenever they want. And the conversation has to include a discussion of what would happen if a method were not to be used, or were to fail, and about the importance of being able to discuss all these issues with your partner.

Pediatricians need to be comfortable having these conversations, Dr. Wilkinson said. Data shows young people are transitioning into their sexual lives during the time we are taking care of them, she said. The dialogue should include conversations about when they are ready for that transition, and how that reflects their personal values.

Even in medicine, some may have assumed that contraception would not be a priority during a pandemic, she said, but that is not necessarily true. And the topic is even more important this fall, with a whole cohort of young people either going back to universities under extraordinary conditions, or else not going back to their universities, where they might be accustomed to getting health care.

Updated Sept. 22, 2020

The latest on how schools are reopening amid the pandemic.

As some college students do go back to campus, Dr. Lindberg said, colleges and universities response and guidance around safe behaviors around Covid ignored the fact that young people are sexual beings.

Instead, what we see are guidelines that say, no guests allowed in your room, she said. Kids are going to break that rule, and then were going to be mad at them. Guidance should emphasize careful decision making, she said, both with respect to sex and with respect to Covid, and guidelines should be cast in terms of risk reduction and consent. It cant be all or nothing, because that model fails, she said.

The themes repeat themselves again and again, Dr. Lindberg said. You need to have empowered them and given them the skills how they make decisions, how they choose their actions wisely. She pointed to the New York Department of Health guidelines for sexual behavior, which start with the advice that you are your own safest sexual partner, but move beyond that to address the specific risks of different kinds of behavior.

Read more here:
For Young Peoples Sexual Health, the Pandemic Changes the Game - The New York Times

Updated results from the phase 3 ALTERNATIVE study showed that dual HER2 blockade plus aromatase inhibition (AI) in post-menopausal women with HER2-positive, hormone receptor (HR)positive metastatic breast cancer outperformed single HER2 blockade.

The new results, printed in theJournal of Clinical Oncology,1 include numerical corrections that affected secondary analyses but did not affect the major conclusions of the study; nonetheless, the original ALTERNATIVE study, which was published in 2017, was retracted.

Typically, according to the investigators led by Stephen R. D. Johnston, PhD, of the Royal Marsden NHS Foundation Trust, in England, patients with HER2-positive cancers are given chemotherapy regardless of their HR status. Johnston and colleagues noted that targeted agents such as trastuzumab (Herceptin), lapatinib (Tykerb), pertuzumab (Perjeta), and trastuzumab-emtansine (T-DM1; Kadcyla) have significantly improved outcomes. However, the investigators said not all patients need or can tolerate chemotherapy. In such cases, anti-HER2 therapies paired with endocrine therapy can be a good option. Earlier research has suggested HER2-blockade with endocrine therapy (ET) in the first-line setting can improve outcomes over ET alone. In the ALTERNATIVE study, Johnston and colleagues set out to evaluate the use of a dual HER2-blockade, using a combination of trastuzumab and lapatinib.

Dual targeting of HER2-positive tumors with [trastuzumab] and [lapatinib] is benecial because of differing mechanisms of action and because of the well-characterized synergistic interaction between them in HER2 [breast cancer] models, the investigators wrote. In the clinic, dual anti-HER2 blockade has been shown to improve outcomes in both the neoadjuvant and the metastatic setting compared with single HER2 blockade.

The investigators enrolled a group of 355 patients with HER2-positive/HR-positive metastatic breast cancer who were not expected to undergo chemotherapy and who had previously received treatment with ET and had progressed on or after a trastuzumab and chemotherapybased neoadjuvant/adjuvant regimen and/or in the first-line setting. The enrollees were randomly split into 3 groups: one group received lapatinib plus trastuzumab plus AI (n = 120), one group received trastuzumab plus AI (n = 117), and the final group received lapatinib plus AI (n = 118). Investigators chose whether patients received steroidal or nonsteroidal AI.

The primary end point was to evaluate progression-free survival (PFS) with lapatinib plus trastuzumab and AI versus trastuzumab plus AI.

The data showed that lapatinib plus trastuzumab and AI had a median PFS of 11 months (HR, 0.62; 95% CI, 0.45-0.88; P = .0063) versus 5.6 months on the trastuzumab-plus-AI. Overall response rate (ORR), clinical benefit rate, and overall survival were also superior in the lapatinib plus trastuzumab and AI group.

Comparing lapatinib plus AI to trastuzumab plus AI resulted in a median PFS of 8.3 months versus 5.6 months, respectively (HR, 0.85; 95% CI, 0.62-1.17; P = .3159).

The rates of any-grade adverse events (AEs) were 92% with the triplet regimen, 74% with trastuzumab and AI, and 92% with lapatinib and AI. Most AEs were grade 1 or 2, and the most common were diarrhea, rash, nausea, and paronychia. Rates of serious AEs were similar across the 3 groups, though the group with lapatinib plus trastuzumab and AI had the lowest number of AEs leading to discontinuation.

Johnston and colleagues wrote that although it is too early to report survival data, early indications suggest the dual blockade is similarly superior.

The investigators noted that their results contrast with the lack of benefit shown in the adjuvant setting in the ALTTO2trial, and the minimal benefit shown in the APHINITY3 trial.

This discrepancy may be the result, at least in part, of the excellent outcome with adjuvant single HER2 blockade with [trastuzumab], making the demonstration of additional benefit with dual blockade challenging, they wrote. Dual HER2 blockade may benefit only a small subject of high-risk patients.

In conclusion, the authors said the results of this trial show a clinically meaningful and robust benefit with lapatinib plus trastuzumab and AI in patients previously treated with trastuzumab and ET, as well as a relatively good tolerability. Thus, they said, the data suggest patients with HER2-positive/HR-positive metastatic breast cancer who are not candidates for chemotherapy should be considered for this regimen.

This combination can potentially offer an effective and well-tolerated chemotherapy-sparing alternative treatment regimen for patients for whom chemotherapy is not intended, Johnston et al concluded.

References:

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Updated ALTERNATIVE Results Favor Dual HER2 Blockade in HER2+/HR+ Metastatic Breast Cancer - Targeted Oncology

Both abortion advocates and opponents have used the COVID-19 crisis to further their policy goals.

The gendered dimensions of the political response to the COVID-19 crisis are manifesting clearly in efforts to close abortion clinics, as well as in campaigns led by doctors, lawyers, and reproductive rights advocates to expand access to telemedicine abortion during the pandemic and beyond.

Anti-abortion politicians in states across the country have used the COVID-19 pandemic to attempt to restrict abortion, arguing that abortion is not essential health care and that banning the procedure will conserve personal protective equipment for COVID-19 cases. In March and April of 2020, 12 states tried to restrict abortion, including Alaska, Iowa, Louisiana, Mississippi, and West Virginia, among others. Legislators in Kentucky passed a bill to allow the states Attorney General to block abortion access during COVID-19, but the Kentucky governor vetoed the bill.

Advocates for abortion rights have condemned these actions and sued to keep clinics open. The National Abortion Federation, a professional association of abortion providers, issued a statement declaring that abortion care is an essential health service and that denying or deferring abortion care places an immediate burden on patients, their families, and the health system, and can have profound and lasting consequences. The Center for Reproductive Rights, the American Civil Liberties Union, and clinics in states with abortion bans have brought legal challenges to protect abortion access during the pandemic.

In response, courts have blocked the bans in Alabama, Ohio, Oklahoma, and Tennessee. In Louisiana, the state lifted the ban after clinics sued. Texas finally lifted its ban on April 22 after multiple court decisions see-sawed back and forth for weeks, forcing pregnant people to travel hundreds of miles to other states to obtain abortion care.

But restrictions prevailed in some states. The U.S. Court of Appeals for the Eighth Circuit upheld an abortion ban in Arkansas, although the Arkansas Department of Health later issued a directive permitting providers to resume elective procedures. Banssome of which were lifted or have since expiredhave not been challenged in Alaska, Indiana, and Mississippi, whereas a clinic in West Virginia challenged a ban in the state, which the Governor later lifted.

In addition to filing lawsuits challenging the bans, abortion advocates are calling for greater access to telemedicine abortion to provide safe, accessible, socially distant abortion health care.

Telemedicine abortion combines medication abortionwhich uses pills to end a pregnancyand telemedicinewhich allows providers to supervise the use of abortion pills through videoconferencing or telephone consultations. Approved by the U.S. Food and Drug Administration (FDA) for use during the first 10 weeks of pregnancy, medication abortion uses two types of pills: mifepristone, which interrupts the flow of the hormone progesterone that sustains the pregnancy, and misoprostol, which causes contractions. Misoprostol alone, or in combination with mifepristone, is an extremely safe way to end a pregnancy in the first 12 weeks of gestation. According to the Guttmacher Institute, medication abortion accounted for approximately 40 percent of all recorded abortions and 60 percent of abortions performed up to 10 weeks gestation in 2017. The actual rate is likely higher because of the growing number of people who are self-managing their abortions using medication purchased on the internet or obtained in other ways.

The growth in the use of medication abortion has dovetailed with expansion of telehealth to provide new opportunities for pregnant people to access abortion in a safe and private way. As abortion restrictions have increased over the last several years and harassment of people entering health clinics persistseven during the COVID-19 crisispregnant people are increasingly turning to medication abortion and telehealth to increase their safety and privacy when obtaining abortion care. Reproductive health advocacy organizations, such as Aid Access, Plan C, and the Self-managed Abortion; Safe and Supported Project, provide pregnant people with information and support on how to use abortion pills safely, especially with the recent proliferation of abortion bans in conservative states.

Nevertheless, numerous legal and regulatory barriers limit the reach of telehealth abortion. Many states prohibit patient access to the abortion pill through telemedicine, despite the pills proven safety and efficacy. Eighteen states currently require the prescribing clinician to be physically present when prescribing the abortion pill. Thirty-two states require the clinician prescribing the abortion pill to be a physician.

Another significant barrier to telemedicine abortion is that FDA restricts the distribution of mifepristone. When FDA initially approved the drug in 2000, the agency blocked easy access to the pill using its Risk Evaluation and Mitigation Strategies (REMS) due to pressure from anti-abortion forces. REMS is a drug safety program that allows FDA to restrict the circulation of certain medications with serious safety concerns to help ensure that the benefits of the medication outweigh its risks. Under the REMS program, mifepristone must be dispensed in person at a clinic, medical office, or hospital under the supervision of a health care provider registered with the drug manufacturer.

In light of COVID-19 and the need for social distancing, advocates are challenging FDAs REMS restriction on the abortion pill. On March 30, California Attorney General Xavier Becerra sent a strongly-worded letter to the U.S. Department of Health and Human Services and FDA, urging the Trump Administration to waive or use its discretion on enforcement of its REMS designation.

Forcing women to unnecessarily seek in-person reproductive health care during this public health crisis is foolish and irresponsible, Attorney General Becerra stated at a press conference. That is why we are calling on the Trump Administration to remove red tape that makes it more difficult for women to access the medication abortion prescription drug.

On the same day, New York Attorney General Letitia James spoke out in favor of removing the FDA restriction on mifepristone. Control over ones reproductive freedom should not be limited to those able to leave their homes as we battle the coronavirus, Attorney General James said. She highlighted that a coalition of state attorneys general is calling on the federal government to make mifepristone more easily accessible so that no woman is forced to risk her health while exercising her constitutional right to an abortion.

Reproductive health groups are also pressuring the government to remove the REMS restriction on the abortion pill. The National Womens Health Network, for example, created a petition and social media campaign with the slogan, Get the pill where you take the pillat home!

In addition to lobbying FDA, medical providers and advocates are filing lawsuits to remove the REMS restriction on mifepristone. On May 27, the American College of Obstetricians and Gynecologists (ACOG) filed a lawsuit challenging the FDA restriction. Joined by the Council of University Chairs of Obstetrics and Gynecology, the New York Academy of Family Physicians, and SisterSong, ACOG is asking a federal district court to order FDA to lift the REMS restriction on mifepristone during the COVID-19 crisis.

In July, Judge Theodore Chuang of the U.S. District Court for the District of Maryland issued a decision temporarily suspending enforcement of FDAs restriction on the abortion pill, ruling the FDA requirement of in-person visits during the pandemic imposes a substantial obstacle to abortion health care that is likely unconstitutional. Judge Chuangs order allowed patients to receive mifepristone from their doctors through the mail. The Trump Administration asked the district court, and then the U.S. Court of Appeals for the Fourth Circuit, to reinstate the in-person requirements while FDA appeals the decision, but both courts rejected the Administrations request. The Administration has now taken its request to the U.S. Supreme Court.

Some reproductive health advocacy organizations have also promoted self-managed abortion, a process by which people order abortion pills online and use them independently of any direct medical supervision. Plan C maintains an updated list of safe websites from which to order abortion pills and also has information about how to self-manage abortion safely using the pills. Although self-managing abortion involves some legal risks, for many people it might be safer than traveling long distances to access abortion health care or risking further delay in securing an abortion.

Research shows that self-managed abortion has increased during the coronavirus, especially in conservative states that have enacted restrictions on abortion. The legal advocacy organization If/When/How has a new campaign and an online petition pushing for the decriminalization of self-managed abortion, which the organization argues is critical during the coronavirus epidemic. In a campaign fact sheet on self-managing abortion during the COVID-19 crisis, If/When/How argues that during times of heightened societal fear, overzealous police, prosecutors, and anti-abortion politicians may more than usualrely on a racist, classist criminal legal system to punish people for their pregnancy outcomes. The group also expresses concern that international postal delivery and transit across international borders could be slowed, interrupted, or suspended as countries around the world enact safety measures, affecting the distribution of abortion medication.

Another way to increase abortion access during the pandemic, as well as afterwards, is to expand a research exception to the REMS restriction. Since 2016, the womens reproductive health care organization Gynuity has operated a research study on telemedicine abortion, TelAbortion, which allows clinicians participating in the study to provide medication abortion care by videoconference and mail without an in-person visit. The study is currently running in Washington, D.C. and 13 states, including Hawaii, Washington, and Oregon, among others. This study has shown that telemedicine abortion is safe and effective. Advocates are working to expand the TelAbortion program to more states.

Both advocates for and opponents of abortion have used the COVID-19 crisis as an opportunity to advance their political agendas. Although anti-abortion politicians have tried to ban abortion as a non-essential medical procedure, womens health advocates have pressed for increased access to the abortion pill and telemedicine abortion.

These abortion policies have gendered impacts. Restrictions on abortion impose on female, transgender, and nonbinary people unwanted pregnancies and medical risks, especially during a pandemic, while removing these restrictions frees pregnant people from the burdens, costs, and risks of unwanted pregnancy and parenthood during dire economic times.

Carrie N. Bakeris a professor in the Program for the Study of Women and Gender at Smith College.

Go here to see the original:
Abortion Regulation in the Age of COVID-19 - The Regulatory Review

San Diego State University is reeling from a calamitous outbreak of COVID-19, with 882 students testing positive or probable. Is the same thing about to happen at UC San Diego?

The answer will begin to emerge this weekend as 7,500 undergraduates start to move into meticulously cleaned dorms on the sprawling La Jolla campus for the start of the fall quarter.

UCSD has been running drills that simulate mass infections, but even that may not have fully prepared the university for what it is about to face as it begins its 60th year.

College students nationwide have been shrugging off the pandemic, leading to tens of thousands of COVID-19 infections and billions of dollars in costs.

The trouble spots include SDSU, which is providing mostly online classes to about 35,000 students this fall, most of whom wont be on campus due to the pandemic.

But the university wanted to offer a semblance of normalcy to some of its youngest students. So it put 2,600 of them in dorms with the proviso that everyone wear masks and socially distance.

SDSU didnt pressure students to comply, or require that everyone get tested for COVID-19.

Many students ended up ignoring the rules. Over two weekends in August, the Union-Tribune watched hundreds of them roaming without masks, especially in the party-hearty section of the College Area neighborhood.

Signs provide warnings and information about COVID-19 on the campus of San Diego State University on Monday, Sept. 14, 2020. The university had to pause in-person instruction in an attempt to prevent the spread of the novel coronavirus.

(Sam Hodgson/The San Diego Union-Tribune)

At a bash on Pontiac Street, about 35 students had to squeeze past each other just to get around. Not far away, other mask-less students lingered outside the Paseo Place housing complex, two blocks from the student health center.

Within two weeks, the coronavirus was spreading rapidly. Dorm students were placed in quarantine. The small number of in-person classes were shifted online. The campus enlisted administrators to help patrol the streets for students shirking the rules. And SDSU last week finally began requiring on-campus dorm students to be tested for the coronavirus.

The university knew over the summer that students were having parties in the College Area, and that they could spread the virus, but they did not do enough to make sure things wouldnt get out of hand, said Scott Kelley, a microbiologist at SDSU who studies how aerosols spread indoor.

We can spend $8 million on a basketball coach, $30 million on Mission Valley, but we cant do things to make sure students wear masks and get tested. It doesnt make any sense. (Kelleys bio).

To date, at least 882 SDSU students have tested positive or probably for the coronavirus, a number that could contribute to another round of state-ordered restrictions on where people can go and what they can do in San Diego County.

SDSUs neighbors in the College Area are especially worried about being infected by students. County health officials say students have already spread the virus to at least seven people outside the SDSU community.

Less than 20 miles away, UCSD has been game planning what it should do when 38,000 students begin the fall quarter on Sept. 28 with a slate of mostly online classes.

About 11,000 undergraduate and graduate students will live in campus housing.

Jayden Pearson receives a coronavirus test before checking into her dorm at UCSD on Saturday.

(Sandy Huffaker)

The university will try to prevent an outbreak by conducting regular mandatory testing, monitoring waste water for the virus, and getting people to use a cellphone app that tells them if theyve had contact with infected people.

UCSD also will have student ambassadors moving about, helping coax students into wearing masks and staying 6 feet apart.

As much as anything, defeating COVID-19 on campus involves getting rambunctious, hormone-charged teenagers to keep their distance and cover their faces.

The stakes are high.

If we cant open the school in a way they can stay here, weve got to either close the school or lock them down in dorm rooms, said Dr. Robert T. Chip Schooley, a professor of medicine who is helping guide UCSDs Return to Learn program.

Nobody wants to spend the next four years with what they hoped would be their college lives in their grandmothers attic with an iPad, looking at lectures on Zoom.

He added: Weve got a virus that only induces short-term immunity. People are already getting reinfected who were infected back in February.

At the moment , UCSD likes its odds for success.

The campus predicts that few of the 7,500 undergraduates moving into dorms will test positive for the virus. And those who do will be quickly isolated.

Maybe it will be 30, maybe it will be 20, maybe it will be 40, said Dr. Angela Scioscia, interim executive director of Student Health and Wellbeing at UCSD. I dont expect 100 (infections). That would be a bit of a surprise.

Theres concern that the campus, which has had 264 people test positive for the virus since March, is suffering from hubris. And much of that concern comes from within UCSD, which rarely airs its problems publicly.

More than 600 UCSD students, faculty, staff and alumni recently issued an open letter that asks the university to drop plans to repopulate its dorms and offer some in-person classes key parts of Return to Learn.

The universitys refusal to acknowledge fears about Return to Learn, as well as the release of recent data on the universitys budget and finances, suggests that the university is being run as a business rather than as a community and that financial incentives are being prioritized at the expense of community well-being, the open letter says.

The signatories included history professor Cathy Gere.

The idea that we can dictate student behavior and roll out technical solutions has been shown again and again to be demonstrably untrue, Gere told the Union-Tribune.

The full scope of the problem facing college campuses and their surrounding communities isnt known.

But a New York Times survey of more than 1,600 colleges and universities says that at least 88,000 students, faculty and staff have tested positive since the pandemic began, and that at least 60 have died.

The survey, last updated on Sept. 10, says SDSU has the highest number of infections of any college in California. UCSD, which has a medical school, two hospitals and a healthcare network, ranked third.

A series of jolting images has crystallized how indifferent many students are to the pandemic.

Several virus-positive students at Miami University in Ohio were filmed hosting a large party for classmates. At Indiana University, dozens of students were videotaped jammed together, mingling mask-less on party boats. And University of Wisconsin students were photographed moving out of a dorm due to an outbreak.

The images and the trouble at SDSU have not led UCSD to back away from Return to Learn. It also didnt deter Point Loma Nazarene University, which just added added 526 dorms students, and the University of San Diego, which is adding 519 this weekend.

Sage Greve, from Switzerland, prepares to make her bed in her dorm room at the University of San Diego on Friday, Sept. 18, 2020.

(Sandy Huffaker)

All three schools say young students often fare better academically when they live on or near campus. Students also have been pushing schools to open the dorms so that they can better experience college life.

UCSD also is flexing its muscles as one of the nations 10 largest research schools.

On average, the campus pulls in about $4 million a day in new research money, the majority of which goes to health and medicine. UCSD is helping run two major COVID-19 vaccine trials and is working on numerous therapeutic drugs to fight the virus.

The university also found ways to more quickly and cheaply test people for COVID-19, an advance its about to exploit. UCSD will test new undergraduate dorm students when they arrive and again 12 to 16 days later to make sure they catch those with the virus. It added the second test after noticing it was an effective strategy at other schools. Testing will continue, at intervals, through the fall.

Additionally, UCSD is making the most of a time advantage; its classes begin about a month later than most schools, so it has more time to tweak Return to Learn.

The university is putting together a system to continually check waste water for the presence of the virus, which can show up in fecal matter, highlighting the location of infections.

During a recent drill, UCSD unexpectedly found the virus in the Revelle College area at the south end of campus. The school quickly tested about 700 people and found two people who were the source of the reading. They were placed in isolation.

This totally transforms our ability to respond to an outbreak, sad Rob Knight, an acclaimed biologist UCSD hired five years ago for his expertise in studying microbes.

Everyone poops, right? This allows us to find populations (of people) who are infectious that are otherwise inaccessbile. The waste water signal shows up as much as a week before people start having symptoms and showing up in the clinic. So it gives us an excellent warning system, especially to test asymptomatic students.

UCSD hopes to have the system fully operational in October.

The university also got permission from the state last week to test out Apple and Google exposure notification technology, which uses Bluetooth technology in cellphones to inform students and staff when they have come into contact with someone who is infected.

If I get COVID-19, Im going to tell my family right away. But I may not remember or even know everybody that Ive encountered in the last two weeks, said Dr. Christopher Longhurst, the chief information officer and associate chief medical officer at UC San Diego Health.

Thats where this application can help notify the people whose names and phone numbers I dont have. Its designed to help the community, making it safer for everyone.

Its unclear whether the app will play a significant role in slowing the spread of COVID-19, despite the optimism of school officials. Users must choose to use the program, and some may take a pass because theyre concerned about preserving their privacy.

Apple, Google, the university and the state have said often that the cellphone technology does not collect identifying information, including location data.

Grayson Henard, from Fresno, unpacks his belongings at the Tower dormitory at UCSD on Saturday.

(Sandy Huffaker)

UCSDs strategy is deep, complex, and costly. But these kind of plans wont work without student buy-in, as the University of Illinois at Urbana-Champaign learned over the past couple of weeks.

Illinois has upwards of 40,000 students, all of whom were tested twice a week for the coronavirus. Many of them werent following anti-COVID-19 rules. By the time Labor Day rolled around, the school was reporting more than 1,000 infections.

The simple lesson: kids will be kids.

Despite reputation to the contrary, I dont think UCSD and SDSU students are very different, Longhurst said. Technology wont change that but can help limit the size of outbreaks.

The pressure is rising to get things right, which was evident Saturday at UCSD as the first undergraduates began moving into dorms.

They underwent drive-through testing at an isolated spot on campus. Then they reported for precisely scheduled move-in appointments that heavily emphasized social distancing. No one had to jockey for a parking spot.

Kim Peterson of Fountain Valley liked what she saw Saturday as she and her husband Gene pulled to the curb outside The Village residence hall to drop off their twin daughters, Grace and Ellie.

Weve been following the COVID situation very closely and feel really confident about UCSDs Return to Learn program, Kim Peterson said. Theyve been wonderful about educating parents and students about whats expected of students this fall.

Grace stood nearby, holding a pillow that shed brought from home.

UCSD is doing really good testing, she said. Im really excited to be here.

Staff writers Paul Sisson, Lyndsay Winkley and Jonathan Wosen contributed to this report.

Read more from the original source:
UC San Diego trying to avoid the coronavirus chaos that has upended SDSU - The San Diego Union-Tribune

Endometriosis Therapies Industry 2020 Global Market research report studies the latest Endometriosis Therapies industry aspects market size, share, trends, Opportunities and Strategies To Boost Growth, business overview, revenue, demand, marketplace expanding, technological innovations, recent development, and Endometriosis Therapies industry scenario during the forecast period (2020-2025).

Download Premium Sample of the Report: https://industrystatsreport.com/Request/Sample?ResearchPostId=12189&RequestType=Sample

Endometriosis Therapies Market unveils a succinct analysis of the market size, regional spectrum and revenue forecast about the Endometriosis Therapies market. Furthermore, the report points out major challenges and latest growth plans embraced by key manufacturers that constitute the competitive spectrum of this business domain.

Therapies used totreat endometriosisinclude: Hormonal contraceptives. Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup ofendometrialtissue each month.In this report, 2018 has been considered as the base year and 2019 to 2025 as the forecast period to estimate the market size for Endometriosis Therapies.

This report studies the global market size of Endometriosis Therapies, especially focuses on the key regions like United States, European Union, China, and other regions (Japan, Korea, India and Southeast Asia).

This study presents the Endometriosis Therapies production, revenue, market share and growth rate for each key company, and also covers the breakdown data (production, consumption, revenue and market share) by regions, type and applications. history breakdown data from 2014 to 2019, and forecast to 2025.

In this study, the years considered to estimate the market size of Endometriosis Therapies are as follows:

History Year: 2014-2018 Base Year: 2018 Estimated Year: 2019 Forecast Year 2019 to 2025

For top companies in United States, European Union and China, this report investigates and analyzes the production, value, price, market share and growth rate for the top manufacturers, key data from 2014 to 2019.

In global market, the following companies are covered:

AbbVie Eli Lilly AstraZeneca Bayer Astellas Pharma Meditrina Pharmaceuticals Pfizer Neurocrine Biosciences Takeda Pharmaceutical

Market Segment by Product Type

Hormonal Contraceptives Gonadotropin-releasing Hormone (Gn-RH) Agonists Progestin Therapy Aromatase Inhibitors

Market Segment by Application

Hospital Clinic Other

Key Regions split in this report: breakdown data for each region.

United States China European Union Rest of World (Japan, Korea, India and Southeast Asia)

Endometriosis Therapies market report consists of the worlds crucial region market share, size (volume), trends including the product profit, price, value, production, capacity, capability utilization, supply, and demand. Besides, market growth rate, size, and forecasts at the global level have been provided. The geographic areas covered in this report:North America (United States, Canada and Mexico), Europe (Germany, France, UK, Russia and Italy), Asia-Pacific (China, Japan, Korea, India and Southeast Asia), South America (Brazil, Argentina, Colombia etc.), Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa).

This research study involved the extensive usage of both primary and secondary data sources. The research process involved the study of various factors affecting the industry, including the government policy, market environment, competitive landscape, historical data, present trends in the market, technological innovation, upcoming technologies and the technical progress in related industry, and market risks, opportunities, market barriers and challenges. Top-down and bottom-up approaches are used to validate the global market size market and estimate the market size for manufacturers, regions segments, product segments and applications (end users). All possible factors that influence the markets included in this research study have been accounted for, viewed in extensive detail, verified through primary research, and analyzed to get the final quantitative and qualitative data. The market size for top-level markets and sub-segments is normalized, and the effect of inflation, economic downturns, and regulatory & policy changes or other factors are not accounted for in the market forecast. This data is combined and added with detailed inputs and analysis from BrandEssenceResearch and presented in this report.

After complete market engineering with calculations for market statistics; market size estimations; market forecasting; market breakdown; and data triangulation, extensive primary research was conducted to gather information and verify and validate the critical numbers arrived at. In the complete market engineering process, both top-down and bottom-up approaches were extensively used, along with several data triangulation methods, to perform market estimation and market forecasting for the overall market segments and sub segments listed in this report. Extensive qualitative and further quantitative analysis is also done from all the numbers arrived at in the complete market engineering process to list key information throughout the report.

The study objectives are:

To analyze and research the Endometriosis Therapies status and future forecast in United States, European Union and China, involving sales, value (revenue), growth rate (CAGR), market share, historical and forecast. To present the key Endometriosis Therapies manufacturers, presenting the sales, revenue, market share, and recent development for key players. To split the breakdown data by regions, type, companies and applications To analyze the global and key regions market potential and advantage, opportunity and challenge, restraints and risks. To identify significant trends, drivers, influence factors in global and regions To analyze competitive developments such as expansions, agreements, new product launches, and acquisitions in the market

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1 Market Overview1.1 Product Definition and Market Characteristics1.2 Global Endometriosis Therapies Market Size1.3 Market Segmentation1.4 Global Macroeconomic Analysis1.5 SWOT Analysis

3 Associated Industry Assessment3.1 Supply Chain Analysis3.2 Industry Active Participants3.2.1 Suppliers of Raw Materials3.2.2 Key Distributors/Retailers3.3 Alternative Analysis3.4 The Impact of Covid-19 From the Perspective of Industry Chain

4 Market Competitive Landscape4.1 Industry Leading Players4.2 Industry News4.2.1 Key Product Launch News4.2.2 Expansion Plans

5 Analysis of Leading Companies5.1 Company 15.1.1 Company 1 Company Profile5.1.2 Company 1 Business Overview5.1.3 Company 1 Endometriosis Therapies Sales, Revenue, Average Selling Price and Gross Margin (2015-2020)5.1.4 Company 1 Endometriosis Therapies Products Introduction

5.2 Company 25.2.1 Company 2 Company Profile5.2.2 Company 2 Business Overview5.2.3 Company 2 Endometriosis Therapies Sales, Revenue, Average Selling Price and Gross Margin (2015-2020)5.2.4 Company 2 Endometriosis Therapies Products Introduction

5.3 Company 35.3.1 Company 3 Company Profile5.3.2 Company 3 Business Overview5.3.3 Company 3 Endometriosis Therapies Sales, Revenue, Average Selling Price and Gross Margin (2015-2020)5.3.4 Company 3 Endometriosis Therapies Products Introduction

5.4 Company 45.4.1 Company 4 Company Profile5.4.2 Company 4 Business Overview5.4.3 Company 4 Endometriosis Therapies Sales, Revenue, Average Selling Price and Gross Margin (2015-2020)5.4.4 Company 4 Endometriosis Therapies Products Introduction

6 Market Analysis and Forecast, By Product Types6.1 Global Endometriosis Therapies Sales, Revenue and Market Share by Types (2015-2020)6.2 Global Endometriosis Therapies Market Forecast by Types (2020-2026)6.3 Global Endometriosis Therapies Sales, Price and Growth Rate by Types (2015-2020)6.4 Global Endometriosis Therapies Market Revenue and Sales Forecast, by Types (2020-2026)

7 Market Analysis and Forecast, By Applications7.1 Global Endometriosis Therapies Sales, Revenue and Market Share by Applications (2015-2020)7.2 Global Endometriosis Therapies Market Forecast by Applications (2020-2026)7.3 Global Revenue, Sales and Growth Rate by Applications (2015-2020)7.4 Global Endometriosis Therapies Market Revenue and Sales Forecast, by Applications (2020-2026)

8 Market Analysis and Forecast, By Regions8.1 Global Endometriosis Therapies Sales by Regions (2015-2020)8.2 Global Endometriosis Therapies Market Revenue by Regions (2015-2020)8.3 Global Endometriosis Therapies Market Forecast by Regions (2020-2026)Continued.

Read More: https://industrystatsreport.com/Lifesciences-and-Healthcare/Dynamic-Growth-On-Endometriosis-Therapies-Market-Size-and-Share/Summary

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Endometriosis Therapies Market Size to Expand Significantly by the End of 2025 - The Daily Chronicle

Philadelphia --Gavin Perrin has his work cut out for him this semester. The Susquehanna University sophomore is taking a hefty 22 credits in a demanding accounting program. But as he planned to head back to campus this month, the pandemic permitting, Perrin was thinking about the fun stuff: seeing all the friends he made last year, moving in with his new roommates, playing sports.

It's a far cry from Perrin's high school days.

"I was that type of kid in high school who would rather be anywhere else," Perrin said.

It's not that his high school was a bad place. The difference is him: "I feel like a new man."

Between his junior year of high school and his freshman year of college, Perrin lost more than 200 pounds. At 5-foot-10, the 19-year-old from Turbotville, Northumberland County, is down to 230 pounds. He says he feels healthier, more confident.

Gavin Perrin is photographed at his Turbotsville, Pennsylvania home Sept. 3, 2020. He has lost a substantial amount weight through bariatric surgery.(Photo: TOM GRALISH, TNS)

Perrin accomplished that through a lot of hard work that included diet change and exercise. But it probably wouldn't have happened so quickly without another strategy that's used to help only a small number of the estimated 4.5 million American children and teenagers with severe obesity: bariatric surgery. That's despite growing research that it is an effective, safe way to deal with a health problem that has reached epidemic proportions. Obesity increases the risk of hypertension, liver disease, diabetes, sleep apnea, and many other health problems, even among teens.

The American Academy of Pediatrics in December came out in support of bariatric surgery as an "evidence-based effective treatment of severe obesity" and said greater access to the surgery for pediatric patients ages 13 and older "is urgently needed." There is no authoritative count of how many of these surgeries are performed each year on teenagers, but estimates range from 450 to about 1,600. Most experts agree it's less than 1% of the youngsters who might benefit.

"It's definitely underutilized," said Elizabeth Parks Prout, medical director of Children's Hospital of Philadelphia's Adolescent Bariatric Surgery Program, a joint effort with the Hospital of the University of Pennsylvania. "We're not treating everyone who needs treatment, unfortunately."

'A tool for change'

Most teens who undergo bariatric surgery, like Perrin, have the gastric sleeve procedure, in which 70% to 80% of the stomach is permanently removed. Not only is the size of the stomach greatly reduced, but, especially significant, the surgery also affects hormonal balance, including the production of ghrelin, often referred to as the hunger hormone.

Surgery along with lifestyle changes result in a 20% to 30% average weight loss for adolescent patients, Prout said. Lifestyle changes alone aren't effective for long-term obesity treatment, many experts say.

A growing body of research shows there are few post-bariatric surgery complications, though many programs recommend nutritional supplements in response to concerns about postsurgery deficiencies.

Money, not safety, is one reason few teens get this surgery. It's not unusual for insurers to turn down adolescents for the surgery, according to the AAP, especially children from low-income families and children of color who may be stymied by complex, and at times costly, insurance appeals, or inconsistent coverage policies. These families may also lack access to a bariatric surgery program near them.

Some parents and patients fear going under the knife for something they might think could be handled without surgery. In addition, doctors involved in bariatric programs say other physicians often hesitate to refer younger patients, in part due to misunderstanding about the surgery.

"It's a surgery to help you to be able to be effective in the changes in your diet and exercise," Prout said. "The surgery is not a cure. The surgery is a tool for change."

Ann Rogers, director of the Penn State Surgical Weight Loss Program, said she thinks the stigma of obesity can extend to its treatment.

"Obesity isn't a choice. It's not a lifestyle people want to embrace," Rogers said. "It's a chronic and recurring medical condition, just like cancer. So if we have medical therapies that are designed to treat medical problems, we should use them."

'What am I waiting for?'

Lyndsey Gibb, 17, said she's always been "a bigger kid," at least since she was a toddler. "It was something that continued to get out of control as I grew when I hit the teenage years. That's especially when it got bad," she said.

The Dillsburg, York County, teenager tried various diet and exercise programs and went to multiple nutritionists, but nothing ever kept the weight off. Then a couple of years ago, her father had bariatric surgery. As her dad shed weight, she noticed other changes in him. He was more confident, less self-conscious about what he wore, less restricted in the things he would do. She decided she wanted that for herself.

Gibb had her surgery last December at Hershey Medical Center with Rogers. Since then, she's lost 115 pounds and intends to shed another 60. Her BMI went from almost 53 to 36. (Severely obese is considered to start at a BMI of 35 to 40.)

"I definitely feel a lot better, more so confidence-wise than health-wise," Gibb said. "Health-wise, I feel like I can do more, but just being more comfortable with what I look like and what I can wear makes me feel a lot better."

Gibb said she is excited that she can now wear stylish brands like Simply Southern that she always liked, but didn't come in her old size. She gave up riding horses because of her weight. She thinks that could be an option again. Just walking is more enjoyable.

She's beginning her senior year at Northern York High School. COVID-19 permitting, she's looking forward to the prom. Growing up in a rural area, Future Farmers of America is an important activity for her. It involves speaking in front of large groups of people.

"It will help if I feel better about how I look," she said. "I'll be more confident in what I'm doing, and hopefully I can even be better at what I'm doing because of it."

To those who would say she was too young to have this kind of surgery, she has a ready answer.

"What am I waiting for in my life? I've dealt with this for how many years now? My dad got it when he was 40-something years old. It's either I live with how I am and continue to go up and down, or give this a shot and be able to improve my quality of life sooner."

Gavin Perrin is photographed at his Turbotsville, Pennsylvania home Sept. 3, 2020. He has lost a substantial amount weight through bariatric surgery.(Photo: TOM GRALISH, TNS)

A new start

Perrin started his battle with weight at a young age, too. From ages 4 to 15, he participated in a medical weight-loss clinic program where he was given nutrition counseling. Finally, he was told there was nothing more they could do for him. By the time he got to the CHOP bariatric program, his BMI was 65.

"I had high blood pressure. I was borderline diabetic. Even walking around, my feet would burn up. I'd get tired really quick. I did try to play sports, but I couldn't last," Perrin said. "My size definitely bothered me. I could tell from a young age there were these differences, and I wasn't the same as everybody else."

Eating in public places made him feel self-conscious. "Even if they're not looking at you, you felt as if all eyes were on you."

In elementary and middle school, he had temper problems. He thinks his weight had something to do with it.

In high school, he found himself not wanting to go most of the time. He didn't ask anyone to the prom, and no one asked him.

He was a sophomore when he entered CHOP's program. He spent about a year in the presurgery program, which included education and lifestyle changes like a high-protein diet, vitamins, and medication. He had his doubts, given his past experiences. But for the first time, the pounds started coming off _ and staying off. He also was no longer prediabetic, and his blood pressure returned to normal.

"I thought, 'These are people I can trust.'"

By the time he arrived for freshman year at Susquehanna University, Perrin was very different from the kid who underwent weight-loss surgery.

"No one knew me. I could kind of reinvent myself," Perrin said.

After taking charge of his body and his health, "I felt like I could really talk to anybody. I didn't have trouble going out and meeting new people."

The high schooler who preferred to stay in his room became a college student who set goals of meeting as many people as he could. He was a regular at the campus gym. He joined the rugby team and played pickup basketball.

Last month, classes at Susquehanna started online, and Sept. 20 is his back-to-campus day. His roommates will be waiting. He's got a new job as an academic coach for freshman business students. Perrin's ready for whatever the future might bring.

"As long as coronavirus doesn't get in the way," he said, "I think these next couple years are going to be the best time of my life."

___

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For teens with severe obesity, bariatric surgery works, but is rarely used. Experts say that needs to change - The Detroit News

KENILWORTH, N.J.--(BUSINESS WIRE)--Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced five-year survival results from the pivotal Phase 3 KEYNOTE-024 trial, which demonstrated a sustained, long-term survival benefit and durable responses with KEYTRUDA, Mercks anti-PD-1 therapy, versus chemotherapy as first-line treatment in patients with metastatic non-small cell lung cancer (NSCLC) whose tumors express PD-L1 (tumor proportion score [TPS] 50%) with no EGFR or ALK genomic tumor aberrations. At five years, the overall survival (OS) rate was twice as high for patients who received KEYTRUDA (31.9%; n=154) versus chemotherapy (16.3%; n=151). KEYTRUDA also reduced the risk of death by 38% (HR=0.62 [95% CI, 0.48-0.81) versus chemotherapy, with a median OS of 26.3 versus 13.4 months. Results from KEYNOTE-024 represent the longest follow-up and first-ever five-year survival data for an immunotherapy in a randomized Phase 3 study for the first-line treatment of NSCLC.

Before 2014, the five-year survival rate for patients in the U.S. with advanced non-small cell lung cancer was only 5%. Data presented today from KEYNOTE-024 showed that 31.9% of patients treated with KEYTRUDA were alive at five years, said Martin Reck, M.D., Ph.D., Lung Clinic Grosshansdorf, German Center of Lung Research. Survival outcomes in these patients with metastatic lung cancer did not seem possible to many oncologists, including myself, several years ago. The long-term survival benefit achieved with KEYTRUDA as a single agent in this study is a great example of the progress we have made in lung cancer to provide patients with more time without disease progression and a chance at a longer life.

KEYTRUDA has become foundational in the treatment of metastatic lung cancer based on the sustained, long-term survival benefit demonstrated in our clinical trials. These new, first-of-their-kind five-year survival results from KEYNOTE-024 add to our understanding of the important role that KEYTRUDA now has in the treatment of lung cancer, said Dr. Roy Baynes, senior vice president and head of global clinical development, chief medical officer, Merck Research Laboratories. It is particularly noteworthy that at five years, 81.4% of patients who completed two years of treatment with KEYTRUDA were alive and nearly half of these patients remained treatment-free, representing an encouraging new precedent in the first-line metastatic non-small cell lung cancer setting. We are grateful to the many patients and health care providers in this trial and our other trials for their essential role in these studies and in advancing cancer care.

These late-breaking data were presented as a proffered paper at the European Society for Medical Oncology (ESMO) Virtual Congress 2020 on Monday, Sept. 21 (Abstract #LBA51). As announced, data spanning more than 15 types of cancer will be presented from Mercks broad oncology portfolio and investigational pipeline at the congress. A compendium of presentations and posters of Merck-led studies is available here. Follow Merck on Twitter via @Merck and keep up to date with ESMO news and updates by using the hashtag #ESMO20.

Five-Year Overall Survival Data From KEYNOTE-024 (Abstract #LBA51)

New data from KEYNOTE-024 (ClinicalTrials.gov, NCT02142738) demonstrated a sustained, long-term survival benefit with KEYTRUDA versus chemotherapy after 59.9 months of median follow-up (range, 55.1 to 68.4). The pivotal Phase 3, randomized, open-label trial evaluated KEYTRUDA monotherapy versus standard of care platinum-based chemotherapy as first-line treatment in patients with metastatic NSCLC whose tumors express high levels of PD-L1 (TPS 50%) with no EGFR or ALK genomic tumor aberrations.

KEYTRUDA reduced the risk of death by 38% (HR=0.62 [95% CI, 0.48-0.81]) versus chemotherapy alone, with a median OS of 26.3 versus 13.4 months. The five-year OS rate was 31.9% for patients who received KEYTRUDA versus 16.3% for those who received chemotherapy. The OS benefit was observed, despite a 66% (n=99/150) effective crossover rate from chemotherapy to subsequent anti-PD-1/PD-L1 therapy. KEYTRUDA also reduced the risk of disease progression or death by half (HR=0.50 [95% CI, 0.39-0.65]) versus chemotherapy as assessed by investigators, with a median progression-free survival of 7.7 versus 5.5 months. The objective response rate (ORR) was 46.1% for KEYTRUDA versus 31.1% for chemotherapy. The median duration of response was 29.1 months (range, 2.2 to 60.8+) for KEYTRUDA versus 6.3 months (range, 3.1 to 52.4) for chemotherapy.

Of the patients who completed two years of treatment with KEYTRUDA (n=39/154), 81.4% were alive at five years and nearly half (46%) remained treatment-free. These data suggest that patients who completed two years of treatment with KEYTRUDA experienced a long-term OS benefit. The ORR was 82% for patients who completed two years of treatment with KEYTRUDA. Additionally, 12 patients received a second course of therapy.

No new safety signals for KEYTRUDA were identified with long-term follow-up. Among all patients who were treated, 31.2% of those who received KEYTRUDA and 53.3% of those who received chemotherapy experienced Grade 3-5 treatment-related adverse events (TRAEs). Among patients who completed two years of treatment with KEYTRUDA, Grade 3-5 TRAEs occurred in 15.4%.

About Lung Cancer

Lung cancer, which forms in the tissues of the lungs, usually within cells lining the air passages, is the leading cause of cancer death worldwide. Each year, more people die of lung cancer than die of colon and breast cancers combined. The two main types of lung cancer are non-small cell and small cell. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for about 85% of all cases. Small cell lung cancer (SCLC) accounts for about 10 to 15% of all lung cancers. Before 2014, the five-year survival rate for patients diagnosed in the U.S. with NSCLC and SCLC was estimated to be 5% and 6%, respectively.

About KEYTRUDA (pembrolizumab) Injection, 100 mg

KEYTRUDA is an anti-PD-1 therapy that works by increasing the ability of the bodys immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

Merck has the industrys largest immuno-oncology clinical research program. There are currently more than 1,200 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

Selected KEYTRUDA (pembrolizumab) Indications

Melanoma

KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.

KEYTRUDA is indicated for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.

Non-Small Cell Lung Cancer

KEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic tumor aberrations.

KEYTRUDA, in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, is indicated for the first-line treatment of patients with metastatic squamous NSCLC.

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with NSCLC expressing PD-L1 [tumor proportion score (TPS) 1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is stage III where patients are not candidates for surgical resection or definitive chemoradiation, or metastatic.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS 1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving KEYTRUDA.

Small Cell Lung Cancer

KEYTRUDA is indicated for the treatment of patients with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy and at least 1 other prior line of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

Head and Neck Squamous Cell Cancer

KEYTRUDA, in combination with platinum and fluorouracil (FU), is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [combined positive score (CPS) 1] as determined by an FDA-approved test.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) with disease progression on or after platinum-containing chemotherapy.

Classical Hodgkin Lymphoma

KEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory classical Hodgkin lymphoma (cHL), or who have relapsed after 3 or more prior lines of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Primary Mediastinal Large B-Cell Lymphoma

KEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or who have relapsed after 2 or more prior lines of therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. KEYTRUDA is not recommended for treatment of patients with PMBCL who require urgent cytoreductive therapy.

Urothelial Carcinoma

KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who are not eligible for cisplatin-containing chemotherapy and whose tumors express PD-L1 [combined positive score (CPS) 10], as determined by an FDA-approved test, or in patients who are not eligible for any platinum-containing chemotherapy regardless of PD-L1 status. This indication is approved under accelerated approval based on tumor response rate and duration of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC) who have disease progression during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant treatment with platinum-containing chemotherapy.

KEYTRUDA is indicated for the treatment of patients with Bacillus Calmette-Guerin (BCG)-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ (CIS) with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.

Microsatellite Instability-High or Mismatch Repair Deficient Cancer

KEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR)

This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with MSI-H central nervous system cancers have not been established.

Microsatellite Instability-High or Mismatch Repair Deficient Colorectal Cancer

KEYTRUDA is indicated for the first-line treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC).

Gastric Cancer

KEYTRUDA is indicated for the treatment of patients with recurrent locally advanced or metastatic gastric or gastroesophageal junction (GEJ) adenocarcinoma whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test, with disease progression on or after two or more prior lines of therapy including fluoropyrimidine- and platinum-containing chemotherapy and if appropriate, HER2/neu-targeted therapy. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Esophageal Cancer

KEYTRUDA is indicated for the treatment of patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus whose tumors express PD-L1 (CPS 10) as determined by an FDA-approved test, with disease progression after one or more prior lines of systemic therapy.

Cervical Cancer

KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Hepatocellular Carcinoma

KEYTRUDA is indicated for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Merkel Cell Carcinoma

KEYTRUDA is indicated for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma (MCC). This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Renal Cell Carcinoma

KEYTRUDA, in combination with axitinib, is indicated for the first-line treatment of patients with advanced renal cell carcinoma (RCC).

Tumor Mutational Burden-High

KEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) [10 mutations/megabase (mut/Mb)] solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with TMB-H central nervous system cancers have not been established.

Cutaneous Squamous Cell Carcinoma

KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) that is not curable by surgery or radiation.

Selected Important Safety Information for KEYTRUDA (pembrolizumab)

Immune-Mediated Pneumonitis

KEYTRUDA can cause immune-mediated pneumonitis, including fatal cases. Pneumonitis occurred in 3.4% (94/2799) of patients with various cancers receiving KEYTRUDA, including Grade 1 (0.8%), 2 (1.3%), 3 (0.9%), 4 (0.3%), and 5 (0.1%). Pneumonitis occurred in 8.2% (65/790) of NSCLC patients receiving KEYTRUDA as a single agent, including Grades 3-4 in 3.2% of patients, and occurred more frequently in patients with a history of prior thoracic radiation (17%) compared to those without (7.7%). Pneumonitis occurred in 6% (18/300) of HNSCC patients receiving KEYTRUDA as a single agent, including Grades 3-5 in 1.6% of patients, and occurred in 5.4% (15/276) of patients receiving KEYTRUDA in combination with platinum and FU as first-line therapy for advanced disease, including Grades 3-5 in 1.5% of patients.

Monitor patients for signs and symptoms of pneumonitis. Evaluate suspected pneumonitis with radiographic imaging. Administer corticosteroids for Grade 2 or greater pneumonitis. Withhold KEYTRUDA for Grade 2; permanently discontinue KEYTRUDA for Grade 3 or 4 or recurrent Grade 2 pneumonitis.

Immune-Mediated Colitis

KEYTRUDA can cause immune-mediated colitis. Colitis occurred in 1.7% (48/2799) of patients receiving KEYTRUDA, including Grade 2 (0.4%), 3 (1.1%), and 4 (<0.1%). Monitor patients for signs and symptoms of colitis. Administer corticosteroids for Grade 2 or greater colitis. Withhold KEYTRUDA for Grade 2 or 3; permanently discontinue KEYTRUDA for Grade 4 colitis.

Immune-Mediated Hepatitis (KEYTRUDA) and Hepatotoxicity (KEYTRUDA in Combination With Axitinib)

Immune-Mediated Hepatitis

KEYTRUDA can cause immune-mediated hepatitis. Hepatitis occurred in 0.7% (19/2799) of patients receiving KEYTRUDA, including Grade 2 (0.1%), 3 (0.4%), and 4 (<0.1%). Monitor patients for changes in liver function. Administer corticosteroids for Grade 2 or greater hepatitis and, based on severity of liver enzyme elevations, withhold or discontinue KEYTRUDA.

Hepatotoxicity in Combination With Axitinib

KEYTRUDA in combination with axitinib can cause hepatic toxicity with higher than expected frequencies of Grades 3 and 4 ALT and AST elevations compared to KEYTRUDA alone. With the combination of KEYTRUDA and axitinib, Grades 3 and 4 increased ALT (20%) and increased AST (13%) were seen. Monitor liver enzymes before initiation of and periodically throughout treatment. Consider more frequent monitoring of liver enzymes as compared to when the drugs are administered as single agents. For elevated liver enzymes, interrupt KEYTRUDA and axitinib, and consider administering corticosteroids as needed.

Immune-Mediated Endocrinopathies

KEYTRUDA can cause adrenal insufficiency (primary and secondary), hypophysitis, thyroid disorders, and type 1 diabetes mellitus. Adrenal insufficiency occurred in 0.8% (22/2799) of patients, including Grade 2 (0.3%), 3 (0.3%), and 4 (<0.1%). Hypophysitis occurred in 0.6% (17/2799) of patients, including Grade 2 (0.2%), 3 (0.3%), and 4 (<0.1%). Hypothyroidism occurred in 8.5% (237/2799) of patients, including Grade 2 (6.2%) and 3 (0.1%). The incidence of new or worsening hypothyroidism was higher in 1185 patients with HNSCC (16%) receiving KEYTRUDA, as a single agent or in combination with platinum and FU, including Grade 3 (0.3%) hypothyroidism. Hyperthyroidism occurred in 3.4% (96/2799) of patients, including Grade 2 (0.8%) and 3 (0.1%), and thyroiditis occurred in 0.6% (16/2799) of patients, including Grade 2 (0.3%). Type 1 diabetes mellitus, including diabetic ketoacidosis, occurred in 0.2% (6/2799) of patients.

Monitor patients for signs and symptoms of adrenal insufficiency, hypophysitis (including hypopituitarism), thyroid function (prior to and periodically during treatment), and hyperglycemia. For adrenal insufficiency or hypophysitis, administer corticosteroids and hormone replacement as clinically indicated. Withhold KEYTRUDA for Grade 2 adrenal insufficiency or hypophysitis and withhold or discontinue KEYTRUDA for Grade 3 or Grade 4 adrenal insufficiency or hypophysitis. Administer hormone replacement for hypothyroidism and manage hyperthyroidism with thionamides and beta-blockers as appropriate. Withhold or discontinue KEYTRUDA for Grade 3 or 4 hyperthyroidism. Administer insulin for type 1 diabetes, and withhold KEYTRUDA and administer antihyperglycemics in patients with severe hyperglycemia.

Immune-Mediated Nephritis and Renal Dysfunction

KEYTRUDA can cause immune-mediated nephritis. Nephritis occurred in 0.3% (9/2799) of patients receiving KEYTRUDA, including Grade 2 (0.1%), 3 (0.1%), and 4 (<0.1%) nephritis. Nephritis occurred in 1.7% (7/405) of patients receiving KEYTRUDA in combination with pemetrexed and platinum chemotherapy. Monitor patients for changes in renal function. Administer corticosteroids for Grade 2 or greater nephritis. Withhold KEYTRUDA for Grade 2; permanently discontinue for Grade 3 or 4 nephritis.

Immune-Mediated Skin Reactions

Immune-mediated rashes, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) (some cases with fatal outcome), exfoliative dermatitis, and bullous pemphigoid, can occur. Monitor patients for suspected severe skin reactions and based on the severity of the adverse reaction, withhold or permanently discontinue KEYTRUDA and administer corticosteroids. For signs or symptoms of SJS or TEN, withhold KEYTRUDA and refer the patient for specialized care for assessment and treatment. If SJS or TEN is confirmed, permanently discontinue KEYTRUDA.

Other Immune-Mediated Adverse Reactions

Immune-mediated adverse reactions, which may be severe or fatal, can occur in any organ system or tissue in patients receiving KEYTRUDA and may also occur after discontinuation of treatment. For suspected immune-mediated adverse reactions, ensure adequate evaluation to confirm etiology or exclude other causes. Based on the severity of the adverse reaction, withhold KEYTRUDA and administer corticosteroids. Upon improvement to Grade 1 or less, initiate corticosteroid taper and continue to taper over at least 1 month. Based on limited data from clinical studies in patients whose immune-related adverse reactions could not be controlled with corticosteroid use, administration of other systemic immunosuppressants can be considered. Resume KEYTRUDA when the adverse reaction remains at Grade 1 or less following corticosteroid taper. Permanently discontinue KEYTRUDA for any Grade 3 immune-mediated adverse reaction that recurs and for any life-threatening immune-mediated adverse reaction.

The following clinically significant immune-mediated adverse reactions occurred in less than 1% (unless otherwise indicated) of 2799 patients: arthritis (1.5%), uveitis, myositis, Guillain-Barr syndrome, myasthenia gravis, vasculitis, pancreatitis, hemolytic anemia, sarcoidosis, and encephalitis. In addition, myelitis and myocarditis were reported in other clinical trials, including classical Hodgkin lymphoma, and postmarketing use.

Treatment with KEYTRUDA may increase the risk of rejection in solid organ transplant recipients. Consider the benefit of treatment vs the risk of possible organ rejection in these patients.

Infusion-Related Reactions

KEYTRUDA can cause severe or life-threatening infusion-related reactions, including hypersensitivity and anaphylaxis, which have been reported in 0.2% (6/2799) of patients. Monitor patients for signs and symptoms of infusion-related reactions. For Grade 3 or 4 reactions, stop infusion and permanently discontinue KEYTRUDA.

Complications of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT)

Immune-mediated complications, including fatal events, occurred in patients who underwent allogeneic HSCT after treatment with KEYTRUDA. Of 23 patients with cHL who proceeded to allogeneic HSCT after KEYTRUDA, 6 (26%) developed graft-versus-host disease (GVHD) (1 fatal case) and 2 (9%) developed severe hepatic veno-occlusive disease (VOD) after reduced-intensity conditioning (1 fatal case). Cases of fatal hyperacute GVHD after allogeneic HSCT have also been reported in patients with lymphoma who received a PD-1 receptorblocking antibody before transplantation. Follow patients closely for early evidence of transplant-related complications such as hyperacute graft-versus-host disease (GVHD), Grade 3 to 4 acute GVHD, steroid-requiring febrile syndrome, hepatic veno-occlusive disease (VOD), and other immune-mediated adverse reactions.

In patients with a history of allogeneic HSCT, acute GVHD (including fatal GVHD) has been reported after treatment with KEYTRUDA. Patients who experienced GVHD after their transplant procedure may be at increased risk for GVHD after KEYTRUDA. Consider the benefit of KEYTRUDA vs the risk of GVHD in these patients.

Increased Mortality in Patients With Multiple Myeloma

In trials in patients with multiple myeloma, the addition of KEYTRUDA to a thalidomide analogue plus dexamethasone resulted in increased mortality. Treatment of these patients with a PD-1 or PD-L1 blocking antibody in this combination is not recommended outside of controlled trials.

Embryofetal Toxicity

Based on its mechanism of action, KEYTRUDA can cause fetal harm when administered to a pregnant woman. Advise women of this potential risk. In females of reproductive potential, verify pregnancy status prior to initiating KEYTRUDA and advise them to use effective contraception during treatment and for 4 months after the last dose.

Adverse Reactions

In KEYNOTE-006, KEYTRUDA was discontinued due to adverse reactions in 9% of 555 patients with advanced melanoma; adverse reactions leading to permanent discontinuation in more than one patient were colitis (1.4%), autoimmune hepatitis (0.7%), allergic reaction (0.4%), polyneuropathy (0.4%), and cardiac failure (0.4%). The most common adverse reactions (20%) with KEYTRUDA were fatigue (28%), diarrhea (26%), rash (24%), and nausea (21%).

In KEYNOTE-002, KEYTRUDA was permanently discontinued due to adverse reactions in 12% of 357 patients with advanced melanoma; the most common (1%) were general physical health deterioration (1%), asthenia (1%), dyspnea (1%), pneumonitis (1%), and generalized edema (1%). The most common adverse reactions were fatigue (43%), pruritus (28%), rash (24%), constipation (22%), nausea (22%), diarrhea (20%), and decreased appetite (20%).

In KEYNOTE-054, KEYTRUDA was permanently discontinued due to adverse reactions in 14% of 509 patients; the most common (1%) were pneumonitis (1.4%), colitis (1.2%), and diarrhea (1%). Serious adverse reactions occurred in 25% of patients receiving KEYTRUDA. The most common adverse reaction (20%) with KEYTRUDA was diarrhea (28%).

In KEYNOTE-189, when KEYTRUDA was administered with pemetrexed and platinum chemotherapy in metastatic nonsquamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 20% of 405 patients. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonitis (3%) and acute kidney injury (2%). The most common adverse reactions (20%) with KEYTRUDA were nausea (56%), fatigue (56%), constipation (35%), diarrhea (31%), decreased appetite (28%), rash (25%), vomiting (24%), cough (21%), dyspnea (21%), and pyrexia (20%).

In KEYNOTE-407, when KEYTRUDA was administered with carboplatin and either paclitaxel or paclitaxel protein-bound in metastatic squamous NSCLC, KEYTRUDA was discontinued due to adverse reactions in 15% of 101 patients. The most frequent serious adverse reactions reported in at least 2% of patients were febrile neutropenia, pneumonia, and urinary tract infection. Adverse reactions observed in KEYNOTE-407 were similar to those observed in KEYNOTE-189 with the exception that increased incidences of alopecia (47% vs 36%) and peripheral neuropathy (31% vs 25%) were observed in the KEYTRUDA and chemotherapy arm compared to the placebo and chemotherapy arm in KEYNOTE-407.

In KEYNOTE-042, KEYTRUDA was discontinued due to adverse reactions in 19% of 636 patients with advanced NSCLC; the most common were pneumonitis (3%), death due to unknown cause (1.6%), and pneumonia (1.4%). The most frequent serious adverse reactions reported in at least 2% of patients were pneumonia (7%), pneumonitis (3.9%), pulmonary embolism (2.4%), and pleural effusion (2.2%). The most common adverse reaction (20%) was fatigue (25%).

In KEYNOTE-010, KEYTRUDA monotherapy was discontinued due to adverse reactions in 8% of 682 patients with metastatic NSCLC; the most common was pneumonitis (1.8%). The most common adverse reactions (20%) were decreased appetite (25%), fatigue (25%), dyspnea (23%), and nausea (20%).

Adverse reactions occurring in patients with SCLC were similar to those occurring in patients with other solid tumors who received KEYTRUDA as a single agent.

In KEYNOTE-048, KEYTRUDA monotherapy was discontinued due to adverse events in 12% of 300 patients with HNSCC; the most common adverse reactions leading to permanent discontinuation were sepsis (1.7%) and pneumonia (1.3%). The most common adverse reactions (20%) were fatigue (33%), constipation (20%), and rash (20%).

In KEYNOTE-048, when KEYTRUDA was administered in combination with platinum (cisplatin or carboplatin) and FU chemotherapy, KEYTRUDA was discontinued due to adverse reactions in 16% of 276 patients with HNSCC. The most common adverse reactions resulting in permanent discontinuation of KEYTRUDA were pneumonia (2.5%), pneumonitis (1.8%), and septic shock (1.4%). The most common adverse reactions (20%) were nausea (51%), fatigue (49%), constipation (37%), vomiting (32%), mucosal inflammation (31%), diarrhea (29%), decreased appetite (29%), stomatitis (26%), and cough (22%).

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First-Line Treatment With Merck's KEYTRUDA (pembrolizumab) Doubled Five-Year Survival Rate (31.9%) Versus Chemotherapy (16.3%) in Certain Patients...

The global Adenomyosis Treatment Market is expected to reach at xx % in the forecast period, stated by a recent study of Contrive Datum Insights. It offers a complete overview of the global market along with the market influencing factors. Furthermore, it offers a detailed description of the global market with respect to the dynamics of the market such as internal and external driving forces, restraining factors, risks, challenges, threats, and opportunities. Analysts of this research report are predicting the financial attributes such as investment, pricing structures along with profit margin. This research document has been prepared by using advanced research methodologies like primary and secondary research.

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For product type segment, this report listed main product type of Adenomyosis Treatment market in global. Anti-inflammatory drugs, Hormone medications, Other

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Geographically, the global market has fragmented across several regions. The major regions include North America, Latin America, Asia-Pacific, Africa, the Middle East, and Europe. It also offers a comparative study of the global market to understand the difference in performance among global competitors. Also, it represents how those competitors competing against each others to drive the businesses rapidly. This publication includes market segmentation such as applications, end-users, and geography. Researchers present informative data in a clear and professional manner. The historical growth rate, as well as forecasted rate, is also mentioned in the report.

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-Qualitative and quantitative analysis of the market based on segmentation involving both economic as well as non-economic factors

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Indicates the region and segment that is expected to witness the fastest growth as well as to dominate the market

-Analysis by geography highlighting the consumption of the product/service in the region as well as indicating the factors that are affecting the market within each region

-Competitive landscape which incorporates the market ranking of the major players, along with new service/product launches, partnerships, business expansions and acquisitions in the past five years of companies profiled

-Extensive company profiles comprising of company overview, company insights, product benchmarking and SWOT analysis for the major market players

-The current as well as the future market outlook of the industry with respect to recent developments (which involve growth opportunities and drivers as well as challenges and restraints of both emerging as well as developed regions

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-Market dynamics scenario, along with growth opportunities of the market in the years to come

Advanced Technologies, Trends, In-Depth Analysis, Regional Demand, Growth Strategy, Company Profiled Players

The major key questions addressed through this innovative research report:

Table of Content (TOC):

Chapter 1 Introduction and Overview

Chapter 2 Industry Cost Structure and Economic Impact

Chapter 3 Rising Trends and New Technologies with Major key players

Chapter 4 Global Adenomyosis Treatment Market Analysis, Trends, Growth Factor

Chapter 5 Adenomyosis Treatment Market Application and Business with Potential Analysis

Chapter 6 Global Adenomyosis Treatment Market Segment, Type, Application

Chapter 7 Global Adenomyosis Treatment Market Analysis (by Application, Type, End-User)

Chapter 8 Major Key Vendors Analysis of Adenomyosis Treatment Market

Chapter 9 Development Trend of Analysis

Chapter 10 Conclusion

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Adenomyosis Treatment Market to Witness a Pronounce Growth During (2020-2027) | Bayer AG, Ferring BV, Johnson & Johnson, Novartis - Verdant News

So, at long last the children are gone back to school. Long may it last! I think nearly every parent in the country swore that everything was going to change when the kids went back to school. Back to healthy eating, getting in the 5km walk a day and drinking gallons of water, all in the hope of losing the covid stone.In reality it may have been a case of, peace at last so time to break out the choccie biscuits. Before you know it, you wake up and its Tuesday and you cant start a diet on a Tuesday.So, you may overindulge over the next few days with the mindset of starting again next Monday, and this pattern goes on week after week. Does this sound all too familiar? As a busy mum of five, I totally get this and Im here to help you with my tips and ideas to keep you reach your goals for a happy and healthy you.

1. START WITH A PLANOne of the best things you can do for yourself is to get into the habit of planning your family meals. This will save you time and money. Planning meals in advance ensures you use up the ingredients you have before buying more. Get the whole family involved by allowing everyone pick a meal. There is a meal planner in my 28-day rescue plan, download it free from my website and get writing!

2. WRITE A LISTWrite a shopping list for the ingredients you need to put your meal plan into action. This will save you time wandering around the shop wondering what to buy and save you money as you will be less likely to put unwanted items in your trolley. And of course, none of us want to be hanging around the supermarket longer than we need to.

3. PLAN FOR LEFTOVERSPlan for leftovers to be used the next day as lunch. For example leftover chili is delicious the next day when heated in a wholemeal pitta bread or wrap with grated cheese, avocado and salad. Leftover roast chicken is so versatile and can be used in salads or wraps. My personal favorite is to make an egg fried rice with it.

4. PREPARE FOOD IN BATCHESIf your family are great at coming up with the meal plan ideas but not so great at helping to prep or cook it, then lighten your load by prepping once to eat multiple times.Chop and wash a variety of veg all at once, then place them in an airtight container in the fridge to use as snacks. Carrots, celery, peppers all make great snacks to dip in hummus or cream cheese.Double your recipe ingredients and store them in the fridge or freezer and you will have a meal ready to be cooked when you want it. This works great for curries. Just pop your chicken and veg that has been marinating in the lovely spices into a pot with a tin of coconut milk, simmer for 20 minutes and you have a tasty meal on the table that the whole family will love. Check out my curry recipe on my website http://www.thenutricoach.ie

5. ENSURE YOU ARE GETTING A WIDE RANGE OF NUTRIENTSIts important to remember there is no specific food or supplement that will help you lose weight or boost your immune system, contrary to what you see on social media. However, a healthy balanced diet thats low in sugar and processed food and high in nutrients that support the immune system such as, vitamin C (berries, tomatoes, peppers, citrus fruit) vitamin A (sweet potato, spinach) vitamin D (oily fish, mushrooms) zinc (meat, shellfish, dairy) is the best thing you can do for your immune system and your waistline.

6. EAT REGULARLYAs tempting as it may be to restrict your calorie intake, skipping meals is never a good idea. Going long periods without eating causes your blood sugar to drop, which leads to fatigue and cravings for sugary snacks and stimulants. Aim for three main meals a day and include a maximum of two nutritious snacks, such as a piece of fruit with four or five nuts, vegetable crudits with hummus or sliced apple dipped in nut butter or try out my no bake energy balls!

7. EAT A SOURCE OF PROTEIN WITH EVERY MEAL OR SNACKWhen you eat carbohydrates alone, they quickly get digested and converted into sugar which is then absorbed into your blood stream causing a spike in blood sugar. However including a source of protein with your meal or snack slows down digestion. This leads to a slower absorption of carbohydrates, therefore a lower rise in blood sugar, so less of the fat storing hormone insulin is needed, and protein will help you feel full for longer resulting in less snacking.

8. STAY HYDRATEDDrinking water has many benefits, including boosting your metabolism and suppressing your appetite. When you dont drink enough water, your body receives mixed signals from the hypothalamus, which is the part of the brain that regulates appetite and thirst. A lot of the time when we think we are hungry, we are actually dehydrated. Aim to drink two litres of water a day. This can be achieved by starting your day with hot water and lemon, adding lemon slices, cucumber and mint leaves to a jug of water and sipping throughout the day and having some herbal teas.

9. FOLLOW THE HEALTHY PLATE GUIDEThe healthy plate guide is an easy way to make sure you are having a well-balanced meal, just fill half your plate with vegetables, a quarter of your plate protein/healthy fats e.g. chicken, meat, fish, eggs, lentils, and a quarter of your plate low GL carbohydrates e.g. sweet potato, brown pasta or rice, quinoa.Are you struggling to get back to healthy eating and getting your weight back to what it was pre-covid? Why not schedule in an appointment with The Nutri Coach! There is no time like the present. My clinic open and I am taking bookings for new and existing clients, so just pop me a message if you would like to schedule an appointment. Contact details below.

Debbie Devane from The Nutri Coach is a qualified Nutritional Therapist and health & lifestyle coach, Debbie runs her clinic from the Glenard Clinic in Mountmellick and also offers one to one and group online consultations. Debbie is also Nutritionist to the Offaly GAA senior footballers.For more information or to make an appointment email Debbie atinfo@thenutricoach.iePh: 086-1720055Facebook: The Nutri Coach @debbiedevanethenutricoachInstagram: the_nutricoachFor more information or to download your copy of Debbie's 28 day rescue plan go to http://www.thenutricoach.ie

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A new routine to lose the Covid stone - Leitrim Observer

Brian Bradley, Special to San Angelo Standard-Times Published 1:21 p.m. CT Sept. 9, 2020

Normal testosterone levels in men are important for a variety of important functions. The older a man gets, it is typical for this hormone to decrease.(Photo: Zerbor / Getty Images)

SAN ANGELO Normal testosterone levels in men are important for a variety of important functions. The older a man gets, it is typical for this hormone to decrease.

Symptoms of low or absent testosterone include:

To help men combat low testosterone levels, doctors can prescribe hormone replacement therapy to regulate levels appropriate to each individual. The Shannon Urology Clinic is now offering a new replacement option in the form of hormone pellet therapy.

Hormone pellet therapy is a convenient way to steadily dose testosterone for hormone replacement in adult males. The slow-release hormones are designed to last 3 to 4 months and aid in certain conditions causing low or absent testosterone in the body. The consistencies in these hormones help promote a more active lifestyle with less of the hassle of other methods.

Testopel testosterone pellets are inserted just under the skin of the hip or other fatty area during a 10 minute in-office procedure. Each pellet is 10mm in size and dosed based off the recommendation of your doctor. The pellets are FDA-approved and covered by most insurance providers. All Shannon Urology Providers are able to offer this as a service to their patients.

Brian Bradley(Photo: Shannon Medical Center / Contributed)

In the past, the Shannon Urology Clinic has offered other methods of hormone replacement, such as shots and gels. While these methods may have worked for some individuals, they do not provide as much convenience as pellet therapy. Gels often transfer onto clothing or other people, and shots typically require administration either every 2 to 4 weeks for short-acting injections or every 10 weeks for long-acting injections. Pellets release a more consistent dose over a longer period of time without the risk of transference. This provides both convenience of regular dosage of hormones and fewer trips to the doctors office.

If you feel like you might be experiencing symptoms of low or absent testosterone, visit with your doctor about potential treatment options. For more information about testosterone replacement therapy, or to schedule an appointment, call the Shannon Clinic Urology Department at 325-481-2231.

Dr. Brian Bradley is part of the Shannon Clinic Urology team. He earned his medical degree from the University of Texas Medical Branch inGalveston and did his residency at the University of Florida.If you appreciate locally driven journalism, consider a digital subscription to GoSanAngelo.com. Follow us on Facebook, Twitter and Instagram for news updates. Submit news tips to News@GoSanAngelo.com.

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Shannon Medical Center offers new option for hormone replacement therapy - Standard-Times

So, flowing and holding poses in a heated room isnt your thing.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

Fair enough.

But dont give up on yoga quite yet. Did you know that theres a style of yoga that just involves relaxing on a mat, blanket or even your bed?

Interested now? Well keep going.

And the best part about this style of yoga is that a 45-minute session could leave you feeling like you indulged in a peaceful three-hour nap.

If youre ready for an easy, pose-free way to slow down and recover from the stressors in your life, read on to discover how yoga nidra could be the answer.

Yoga nidra involves slowing down and chilling out. So does meditation. While some people tend to lump them together, they really are two different practices.

Yoga nidra is like meditation, but yet its not, says yoga therapist and yoga program manager, Judi Bar. There are overlaps, but there also are key differences. With yoga nidra, you are lying down and the goal is to move into a deep state of conscious awareness sleep, which is a deeper state of relaxation with awareness. This state involves moving from consciousness while awake to dreaming and then to not-dreaming while remaining awake going past the unconscious to the conscious. Bar says that this practice is guided like some meditation practices, but its very structured.

With meditation, youre sitting and in a waking state of consciousness while focusing the mind and allowing thoughts to come and go. Meditation makes it possible for us to get to the theta state the state we go through to get to the delta state, which is the place of the deepest sleep cycle. The delta state is a deep healing state. Thats where were trying to get through yoga nidra. In this state, the body and mind rest and the consciousness is awake.

Bar says that yoga nidra works with the autonomic nervous system. The autonomic nervous system regulates processes of the body that take place without a conscious effort (heartbeat, breathing, digestion and blood flow). This system also includes the sympathetic and parasympathetic nervous systems.

Meditation helps us calm the sympathetic nervous system; mainly, our fight-or-flight response, explains Bar.We do a meditation practice to basically calm the sympathetic, or fight-or-flight and activate the parasympathetic more. Theres such a benefit when those are balanced overall for immunity, digestion and stress management. But in this deeper relaxation, the pineal gland is activated and that releases the hormone melatonin.

Melatonin is a powerful antioxidant. It can also help manage immune function, blood pressure, cortisol levels and induce restful sleep.

A recent study showed that while meditation and yoga nidra were both effective in reducing anxiety and stress, yoga nidra seemed to be more effective in reducing anxiety. The study also suggested that yoga nidra can be a useful tool in reducing both cognitive and physiological symptoms of anxiety.

Some yoga studios offer yoga nidra, but you can also do it at home with the help of YouTube or a meditation app. You dont need fancy equipment either. You can lie flat on your back on a yoga mat or a blanket with a bolster or pillow supporting your lower back, spine and your head. You can even put a blanket or pillow under your knees.

Bar says there are 10 stages of a yoga nidra practice. These steps are outlined by Richard Miller in his 10 Stages of Yoga Nidra.

While yoga nidra might seem much easier than traditional yoga, Bar says you still have to practice, especially if youre not used to meditation or quieting your mind. She recommends practicing away from distractions and in a darker room. You can use a sleep mask to block out light if you need to. Bar also recommends covering up with a blanket since the body tends to cool down when its at rest.

If lying on the floor for a while wouldnt be comfortable for you, you can practice yoga nidra in a recliner or even in bed. And you dont have to start with a long session. Start with 15 or 20 minutes and work your way up. You also dont have to do yoga nidra in the middle of the day. A nighttime practice can help you sleep tight through most of the night.

And like with most things, dont give up if you struggle with your first session. Quieting your mind and not doing anything is much harder than you think. So give yoga nidra a few tries. Youll get the hang of it in no time especially when your mind and body need time to rest and recover.

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What Is Yoga Nidra? - Health Essentials from Cleveland Clinic

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He had that hair.

Curly and blond, it floated around his head like a cloud and set him apart from his swarthier, shaggier classmates. He had the bluest eyes. He was tall. He was confident, and when she saw him across the room at her little brothers Halloween carnival in 1975 she knew that he was the one she wanted as her boyfriend.

They were both 14, and she was right. From seventh grade at Taft Junior High to 11th grade at Valley High, Francisca Contreras and Jubal Bobb were together.

Then, as it does, life took them on different paths to different cities, different loves, different worlds in which their relationship was a distant memory.

................................................................

But it was a sweet one.

Jubal Bobb and Francisca Contreras were junior high sweethearts but only rekindled their romance this spring, 45 years after they met.

We were each others first everything, said Contreras, now 59. We were each others first love.

Now, in spite of the years and miles and the improbability between them they just may be each others last love.

Contreras calls it love in the time of COVID-19, a rekindling of a romance that blossomed anew 45 year after it began through an unexpected courtship hampered but not deterred by closures and travel restrictions.

It is, she said, love with the one who has known her past yesterday.

Hes the closest thing to being home again, she said.

Which is an interesting feeling for two people who have been married since June 17 but still maintain their separate domiciles hers in Palm Springs, California, his in Breckenridge, Colorado.

By air, thats a distance of 702 miles. By COVID-19 restrictions, it feels like many more.

When we talk, Contreras, who manages a bio-identical hormone clinic in Palm Springs, is in Breckenridge for the long Labor Day weekend. Bobb is off on his route for UPS.

Here, restrictions are more relaxed than in California. Restaurants are open to 50% capacity, Main Street and hiking trails are accessible to those who wear masks.

Earlier this year, there were no movies or places open for dinner, drinks or coffee.

We couldnt go on regular dates, but in a way we didnt have to because we already knew each other so well, Contreras said.

Jubal Bobb and Francisca Contreras dated from seventh grade until 11th grade. In 1977, they went to the Homecoming dance at Valley High School. (Courtesy of Francisca Contreras)

It reminded them of their younger days when money was tight.

He used to forego lunch because he saved his lunch money for gas to pick me up, she said. We never had real dates.

In high school, sports kept Bobb too busy for jobs. Contreras had several. She was ambitious, a straight A student with a focus on earning a college scholarship.

Thats why we broke up, she said. I wanted to be serious about academics, and he wanted to be a boy.

Contreras earned a presidential scholarship to the University of New Mexico after graduation in 1979. Bobb became a mechanic.

Both eventually married other people, had children, divorced, married again. Contreras moved to the West Coast; Bobb moved to the Western Slope.

They and their spouses attended Valley High Schools 10-year reunion, where Bobb won the Most Lost Hair award, his cloud of curl now coiffed in a less lofty style.

They saw each other again at the 20-year reunion but didnt converse much.

The 40-year reunion was held in the summer of 2019, and for Contreras it was a reminder of how much had changed in her life. Both her parents had died within months of each other. Her children were grown. She had been divorced for four years and flailing in a dating pool that had grown increasingly shallow.

In her head, she heard her mothers voice saying, Go to him, hes waiting. But she had no idea who he was.

From across the room at the reunion she saw Bobb. They raised their glasses in a silent toast.

They didnt speak. He left with his wife of 27 years.

And I was thinking, how I wish I could meet someone who knows me past yesterday, she said. But you realize you just go on in life.

Several weeks after the reunion, Bobb called her late one night. His wife had left him, leaving her farewell on a sticky note.

He was broken, and in need of a friend who had been down that divorce path, she said.

She never imagined then that the path would lead them back to each other.

For eight months, they talked and texted and Facetimed as old friends. It wasnt until April that they admitted that maybe they were more than old friends.

I could hear my mothers voice again, she said. And I realized he was someone who knew me past yesterday. We connected on every level. Being someones first everything is an undeniable connection.

For now, their paths connect through airports and long car drives. Both plan to retire in three years and settle down together, although Contreras said she is hopeful she can move her business to be closer to Bobb sooner.

If COVID-19 restrictions allow, they plan to meet up in Albuquerque Sept. 19 to share their joy with family and friends in that place where it all began for them home.

Bobs hair is gray and thinner now. But from across the room, he still stands out to her and she still knows he is who she wants.

UpFront is a front-page news and opinion column. Reach Joline at 730-2793, jkrueger@abqjournal.com, Facebook or @jolinegkg on Twitter.

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First loves overcome years to be together at last - Albuquerque Journal

While most patients with metastatic hormone-sensitive prostate cancer (mHSPC) will initially respond to androgen deprivation therapy (ADT) plus abiraterone acetate with prednisone (AA/P), the majority will develop castration-resistant disease. The ability to track early prostate-specific antigen (PSA) changes may alert clinicians to those more likely to progress and initiate subsequent therapies earlier before clinical or radiographic progression develops.

Historically with ADT alone or docetaxel-based chemotherapy, a non-detectable PSA at 7 months was considered a predictor of overall survival.1-2 However, there has not been a standard time frame established for patients treated with adrenal biosynthesis inhibitors.3-4 Our results showed a significant association between the degree of PSA decline at 3 months and serologic progression in mHSPC patients treated with ADT plus AA/P. Moreover, a PSA reduction < 98% from baseline and PSA > 3.0 ng/mL at 3 months were associated with a significantly shorter castration-resistant prostate cancer (CRPC)-free survival.

These findings support evaluating response to ADT plus AA/P for mHSPC as early as 3 months after initiation of therapy. Since castration-resistant disease is associated with high morbidity and mortality, it is important to identify patients with aggressive disease early to help maintain quality of life and prevent increased exposures to the healthcare system.

Written by: Iris Y Sheng, Jaleh Fallah, Ruby Gupta, Hong Li, Kimberly Allman, Allison Martin, Pedro Barata, Moshe C Ornstein, Timothy D Gilligan, Brian I Rini, Jorge A Garcia

Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA., Department of Hematology and Medical Oncology, Bellmunt Hospital, Troy, MI, USA., Department of Internal Medicine, Section of Hematology Oncology, Tulane University Medical School, New Orleans, LA, USA., Department of Internal Medicine, Section of Hematology Oncology, Vanderbilit University, Nashville, TN, USA., Department of Hematology Oncology, University Hospital Cleveland Medical Center, Cleveland, OH, USA.

References:

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Identifying Prostate Surface Antigen Patterns of Change in Patients with Metastatic Hormone Sensitive Prostate Cancer Treated with Abiraterone and...

The Duchess of Sussex while pregnant at the the Fashion Awards 2018

Tristan Fewings / BFC / Getty Images

The treatments to indulge in...

Its pure countryside splendour at Thyme, a Cotswolds retreat with acres of herbs, pretty flowers and rolling meadows, home to a blissful spa with an outdoor freshwater swimming pool. The Aurelia skincare line is used in the spa treatments, which take place in a light and airy room with the late summer breeze flooding in through open windows, along with the sounds of birds chirping. The full body pregnancy massage is light yet deeply relaxing. Oils with a reviving citrus base are massaged into ones skin, followed by a foot, scalp and neck massage. The treatment is finished with rose quartz (prized for its depuffing qualities) gently rubbed across the face, for lymphatic drainage. Expect to pad back to the achingly chic antique-filled bedrooms, swathed in a dressing gown, feeling perfectly serene.The Peaceful Pregnancy Massage - 70 for 75 minutes - at the Thyme treatment rooms. Bedrooms at Thyme start at 250 per night. Nr, Lechlade GL7 3NX / 01367 850174 / thyme.co.uk

In Belgravia at the Renee Lapino Clinic, state-of-the-art pregnancy pampering is the order of the day. As part of the antenatal offering, clients can climb into a high-tech pair of galoshes, wired up to the mains (reminiscent of The Wrong Trousers in Wallace and Gromit), and lie back on the bed while the trousers gently pulse and massage the legs to rid them of water retention and heaviness, for 30 soothing minutes, as an equally high-tech facial takes place. Iris, the therapist, first scrubs your face with a cranberry-based enzyme gel for exfoliation, then steams your pores before a gentle manual extraction of blackheads. Useful, since a surge of pregnancy hormones can throw the skins equilibrium off balance, leading to congestion and breakouts. Then heat-activating gel is slathered on the face, followed by radio and LED frequency (only offered from the second trimester onwards) to stimulate collagen production. Finally, theres a lymphatic Chinese Gua Sha massage to rid the face of unwelcome pregnancy puffiness and improve circulation.New Mummy Pregnancy Facial - 195. Length 1 hour. Body balancer, applied simultaneously, is an extra 65. Renee Lapino at Neville Hair & Beauty, 5 Pont St, London SW1X 9EJ / 020 7235 3654 / nevillehairandbeauty.net

The spa at the Corinthia in Westminster looks just like a Bond villains lair: an underground bunker with lashings of black marble and roaring fireplaces, ice fountains, sleep pods accessed through secret doors and even an amphitheatre sauna. On arrival water is served on a silver salver and a high-tech facial recognition machine takes your temperature, for Coronavirus compliance. Once in the clear, the Espa Blissful Maternity massage begins with a hot towel hand cleanse, then rosehip exfoliator is gently scrubbed into ones back, followed by an indulgent rosehip massage oil kneaded across the back, chest and belly. (Rosehips are packed with vitamin C, E and B, and contain a substance to help combat stretch marks and inflammation). Mercifully, tired cramp-afflicted pregnant legs are soothed, too, before the treatment finishes with a neck rub and a nourishing hair mask being massaged into the scalp. It is the ultimate in cosseted, luxury relaxation.Espa life at the Corinthia: Espa Blissful Maternity - duration 90 mins - 240. The Corinthia Hotel, Whitehall Pl, Westminster, London SW1A 2BD / 020 7321 3050 / espalifeatcorinthia.com

Set in the basement of East Londons hottest hotel is the Neds Cowshed spa, a stylish beauty haven. Low-lit treatment rooms have a calming, earthy palette of beige and browns, while a high-tech massage bed has every conceivable adjustment for comfort - perfect for supporting weary pregnant bodies. The maternity Full Body Care treatment starts with a foot soak and scrub. Then, sitting upright on a stool and leaning into the cushion laden bed, therapist Pavlina kneads your back with the Cowshed range, especially designed for pregnancy (lotions without essential oils, some of which the NHS recommends women avoid as they can cross the placenta). For the next stage, moving onto the bed theres a massage with Mother Stretchmark Balm, containing seabuckthorn to help prevent stretchmarks, followed by a vigorous dry body brushing across the legs, belly and chest, to exfoliate and aid the bodys circulation, rejuvenating tired skin. Leave feeling buffed and renewed. Full Body Care: 90min - 200. Cowshed at The Ned: 27 Poultry, London EC2R 8AJ / 020 3828 2000 / thened.com

A holistic approach to facials is on offer at the smart Marylebone clinic Avicenna. Its founder Sana Khan offers in-depth skin consultations for clients, which involves computer imaging to detect sun damage, pigmentation and skin texture, highlighting deficiencies in the dermis and leading to a plan of action. For the maternity facial, the focus is on balancing out hormone spikes in the skin that you find in pregnant women (an overload of testosterone is thought to lead to more breakouts, for example). Sana avoids harsh acids and rather than adhere to a template facial, she adapts the treatment to what the client most needs. For dry skin, she starts with a double cleanse and applies a moisture surge of hyaluronic acid serum (which has a function of retaining water). The next stage is extraction with a needle to clear skin congested with blackheads and impurities, before applying a hyaluronic mask. After the hours session skin looks plump and dewy. Avicenna Wellbeing Pregnancy Facial - 180. Duration 1 hour. 30 b, Nottingham Pl, Marylebone, London W1U 5NP / 020 7935 3057 / avicennawellbeing.com

The products to try...

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Pregnancy beauty treatments mum-to-be luxury spas and products - Tatler

In a season when we would usually be out cheering on our local sports teams, we are spending more time at home and repeating a new mantra: Wash your hands, practice social distancing, wear a mask.

But what if you could play offense instead of defense to fend off colds and viruses? What if adjusting your daily habits could build your immunity to help your body fend off illness, not only this year but every year?

Thats not only possible, says Katie Moksnes Bowman, its something she encourages her patients to do every day.

Stress is the number one way we increase inflammation in the body, says Moksnes Bowman, a licensed acupuncturist and Doctor of Acupuncture and Chinese Medicine (DACM) for Northwestern Health Sciences University. She says inflammation can affect digestion, sleep patterns, pain, and your bodys immunity.

The key to improving your immunity is to reduce inflammation in your body.

The amount of stress that has been created from the pandemic is causing issues for people physically and emotionally, she says. In Chinese medicine, your digestion matters, sleep matters, your immune system matters.

When I am in practice with a patient, we talk about sleep, bowels, diet and movement at every single treatment. I really want to work with them where theyre at.

She sees patients ranging from professional athletes to seniors with mobility issues and everyone in between, so there is no one-size-fits-all approach to treatment.

In Chinese medicine, we really view the body as a whole, she says. For example, if a patient has shoulder pain, Moksnes Bowman proceeds knowing the shoulder does not work independently from the rest of the body.

"The amount of stress that has been created from the pandemic is causing issues for people physically and emotionally. In Chinese medicine, your digestion matters, sleep matters, your immune system matters." Kate Moksnes Bowman, Northwestern Health Sciences University

If you are not digesting your foods properly, if youre not getting a good nights sleep, she says, I can do a ton of work on your shoulder, but its not going to repair well.

To help patients improve their health and build their immunity, she suggests small changes in diet and exercise, such as drinking enough water, reducing caffeine and sugar consumption, adding anti-inflammatory foods to their diet, and getting more movement every day.

I am not going to overhaul your whole diet, she says. If you do not want to stop eating pizza, I cannot make you stop eating pizza. But she might suggest that you try goat cheese on your pizza or sample a cauliflower crust.

I see myself as a reminder person, she says. I have patients come in and I say, How did your diet go this week? Did you eat something green? That means a plant, you know, not a green Jolly Rancher.

That question always gets a laugh, but the point is that little changes can make a difference in reducing inflammation and improving immunity.

When we are talking about diet and exercise, both of those things reduce inflammation and so does sleeping. Sleeping is a time to repair your body, Moksnes Bowman says. Asked what tops her list as the most important step, she says: Its not a hierarchy for me. Its more of a circle than a list, because all of those things are going to influence the next thing.

Small adjustments in diet and exercise are something patients do on their own between clinic visits, where Moksnes Bowman and other practitioners offer a range of therapies, from acupuncture and massage to cupping, Gua Sha, herbal medicine and even recipes to help improve your immunity.

If you have a lot of stress and are getting the common cold five times a winter, I would suggest you consider herbal medicine, she says. She advises against buying supplements in the grocery aisle. Seek a health professional who is specialized before taking Vitamin D, C or Elderberry syrup. They are all really good things, but theyre not always the right thing for everybody. Its always important to make sure you are taking the right amount.

Creating good sleep habits and a good sleeping environment are important, too. If you are on your phone or watching TV at night, the blue light from the device stimulates a part of the brain that doesn't allow you to fall asleep as well, she says.

Improved diet and exercise, combined with acupuncture or other types of Chinese medicine, can reduce inflammation over time by increasing blood flow and releasing endorphins, which Moksnes Bowman describes as that calm, happy hormone. That is our own bodys way of reducing pain in the body.

And that calm, happy hormone can lead to a good nights sleep, as described in a text from one of Moksnes Bowmans patients, who said: I cant believe how much my sleep improved by getting acupuncture.

The results arent anecdotal, she says. Sleep-tracking devices demonstrate that acupuncture can improve sleep; they record how well and deeply you are sleeping and if you are waking frequently during the night.

And while youre getting those extra ZZZs, your body is resting and fortifying its immunity.

One of the side effects of social distancing and working from home has been an increase in loneliness. Moksnes Bowman says that after a brief shutdown of the NWHSU Bloomington Clinic several months ago, she noticed two things when the clinic reopened: Patients who had missed appointments were in pain, and they were lonely.

People wanted to talk for so long, she says. I made my treatments a bit longer so patients could just talk, because people were feeling lonely.

She and other practitioners frequently refer patients to therapists, Tai Chi or Pilates instructors or others when they see an opportunity to help the patient move, relax or sort things out. Taking a deep breath and getting some release is also good for building a sense of well-being.

Think of amping up your immune system as the ultimate DIY project. Add some green to your diet, make sure you drink enough water, cut out some caffeine and get enough sleep for starters, and then add some acupuncture or massage. Together those steps can help fortify your immunity.

And keep in mind that this year, none of that replaces the need to frequently wash your hands, socially distance wherever possible and wear a mask when its not.

___________________________________________________________________________

Located in Bloomington,Northwestern Health Sciences Universityis a pioneer in integrative natural health care education, offering degree programs in chiropractic, acupuncture, Chinese medicine, massage therapy, medical assisting, medical laboratory programs, post-bac/pre-health, radiation therapy, and B.S. completion. At press time, itsBloomington clinicis open to the public and services include chiropractic care, Chinese medicine, massage therapy, naturopathic medicine, Bloomington Clinic offers integrative, natural care for the entire family in one location.

Each monththe Bloomington Clinic providers host a Provider Talks webinar that discusses topics from foot health to the ABZzzzs of Sleep to Promoting Health through the Seasons. Learn more about the webinar serieshere.

Telemedicine is a convenient way to care for yourself during these unprecedented times. Appointment times vary depending on the service. Providers are part ofNorthwestern Health Sciences University, a non-profit industry leader in integrative and natural healthcare education that provides access to the latest evidence and state-of-the-art technology so you get the natural solutions you truly need.

See more content fromNorthwestern Health Sciences University.

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Immune-Boosting Strategies to Stay Ahead of the Cold - Mpls.St.Paul Magazine

WHOI marine chemist Ken Buesseler (right), one of the authors of the study, deploys a sediment trap used to study the biological carbon pump during a 2018 expedition in the Gulf of Alaska.

Alyson Santoro, University of California Santa Barbara

The ocean plays an invaluable role in capturing carbon dioxide (CO2) from the atmosphere, taking in somewhere between five to 12 gigatons (billion tons) annually. Due to limited research, scientists aren't sure exactly how much carbon is captured and storedor sequesteredby the ocean each year or how increasing CO2 emissions will affect this process in the future.

A new paper published in the journalScience of the Total Environment from the Woods Hole Oceanographic Institution (WHOI) puts an economic value on the benefit of research to improve knowledge of the biological carbon pump and reduce the uncertainty of ocean carbon sequestration estimates.

Using a climate economy model that factors in the social costs of carbon and reflects future damages expected as a consequence of a changing climate, lead author Di Jin of WHOI's Marine Policy Center places the value of studying ocean carbon sequestration at $500 billion.

"The paper lays out the connections between the benefit of scientific research and decision making," says Jin. "By investing in science, you can narrow the range of uncertainty and improve a social cost-benefit assessment."

Better understanding of the ocean's carbon sequestration capacity will lead to more accurate climate models, providing policymakers with the information they need to establish emissions targets and make plans for a changing climate, Jin adds.

With co-authors Porter Hoagland and Ken Buesseler, Jin builds a case for a 20-year scientific research program to measure and model the ocean's biological carbon pump, the process by which atmospheric carbon dioxide is transported to the deep ocean through the marine food web.

The biological carbon pump is fueled by tiny plant-like organisms floating on the ocean surface called phytoplankton, which consume carbon dioxide in the process of photosynthesis. When the phytoplankton die or are eaten by larger organisms, the carbon-rich fragments and fecal matter sink deeper into the ocean, where they are eaten by other creatures or buried in seafloor sediments, which helps decrease atmospheric carbon dioxide and thus reduces global climate change.

Rising carbon dioxide levels in the atmosphere, a result of human activity such as burning fossil fuels, warms the planet by trapping heat from the sun and also dissolves into seawater, lowering the pH of the ocean, a phenomenon known as ocean acidification. A warmer, more acidic ocean could weaken the carbon pump, causing atmospheric temperatures to riseor it could get stronger, with the opposite effect.

"When we try to predict what the world is going to look like, there's great uncertainty," says Buesseler, a WHOI marine chemist. "Not only do we not know how big this pump is, we don't know whether it will remove more or less carbon dioxide in the future. We need to make progress to better understand where we're headed, because the climate affects all of humanity."

Buesseler added that efforts like WHOI's Ocean Twilight Zone initiative and NASA's EXport Processes in the global Ocean from RemoTe Sensing (EXPORTS) program are making important strides in understanding the ocean's role in the global carbon cycle, but this research needs to be vastly scaled up in order to develop predictive models such as those used by the Intergovernmental Panel on Climate Change (IPCC). Current IPCC models do not account for change in the ocean's ability to take up carbon, which Buesseler said affects their accuracy.

Though the paper's assessment doesn't account for the cost of a global research program, Buesseler said that investment would be a small fraction of the $500 billion expected benefit. The authors warn that this savings could also be viewed as a cost to society if the research does not lead to policy decisions that mitigate the effects of climate change.

"Just like a weather forecast that helps you decide whether or not to bring an umbrella, you use your knowledge and experience to make a decision based on science," Jin says. "If you hear it's going to rain and you don't listen, you will get wet."

- This press release was originally published on theWHOI website

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What's the Value of Studying the Ocean's Biological Carbon Pump? - Lab Manager Magazine

Add plenty of fiber-rich vegetables to your diet to help you stay full for longer.

Image Credit: agrobacter/iStock/GettyImages

There's no shortage of strategies and tips out there to help you lose weight. But what if you want to avoid putting on weight in the first place?

Forty-two percent of U.S. adults today are affected by obesity, which is defined as having a body mass index (BMI) of 30 or more, according to data from the Centers for Disease Control and Prevention (CDC). That percentage has gone up since 2000 and it's predicted to increase even more, per a December 2019 analysis from the New England Journal of Medicine (NEJM).

The factors behind our growing obesity rates are complex, to say the least. But there are plenty of proven ways to keep your weight in check. Here's what you can do starting right now to reduce your risk for obesity.

Why Obesity Prevention Is So Important

It's no secret that having too much body fat can be bad for your health. But when you consider the laundry list of conditions for which obesity increases your risk, the importance of being at a healthy weight really hits home. According to the CDC, people with obesity are more likely to experience:

You'll greatly improve your health by losing weight, of course. But you're better off avoiding gaining too much weight in the first place. Once you are living with obesity, it becomes harder to get back to a healthy weight, per a September 2015 study in the American Journal of Public Health.

"If you're seriously overweight, your body naturally seeks a larger number of calories in order to maintain that weight. And that larger amount of food is what your brain says you need, so you eat more. It's really a vicious circle," explains Scott A. Cunneen, MD, director of metabolic and bariatric surgery at Cedars-Sinai Medical Center in Los Angeles, and author of Weighty Issues: Getting the Skinny on Weight-Loss Surgery.

That's not to say it's impossible to get to a healthier size far from it. While you can always work to lose weight, "health professionals are realizing that prevention is better than cure when it comes to managing your weight," says weight-management expert Naveen Gupta, MD.

The 10 Best Ways to Prevent Obesity

If prevention is the best medicine for obesity, what exactly should you be doing to keep your weight in check? Science shows it all comes down to forming healthy lifestyle habits and sticking with them.

There's a genetic component to obesity, and you may be more prone to gaining weight easily if your family members have obesity, per the CDC. But genes aren't everything environmental changes are also a key factor, Dr. Gupta says. You can always take measures to keep your weight in a healthy place.

Here are 10 evidence-based steps to help prevent weight gain.

1. Pay Attention to Portions

Watch your portion size, even if you're eating something healthy, since excess calories will be stored as fat.

Image Credit: Westend61/Westend61/GettyImages

If you keep just one thing in mind about weight gain, it should be this: When you eat more calories than your body needs for energy, the extra gets stored as fat.

"Portion control is one of the most important things for maintaining your weight," says Keri Gans, RDN, CDN, author of The Small Change Diet.

That's true even for healthy foods. Whether it's pepperoni pizza or brown rice with tofu and veggies, eating more than you need will ultimately cause your weight to go up. Paying attention to how you feel as you're eating and stopping when you're satisfied is one way to avoid taking in too much food, per the CDC.

Also: Get familiar with what recommended portion sizes actually look like. Very often, they're smaller than you think.

Another strategy is to fill more of your plate with fruits and vegetables so you get what feels like a generous portion for fewer calories. "Instead of a huge bowl of pasta, for instance, cut the portion of pasta in half and add lots of veggies to bulk up the dish," Gans says.

2. Have More Fruits, Vegetables and High-Fiber Foods

Simply eating a fiber-rich diet around 30 grams per day may be enough to help you manage your weight, per February 2015 research in the Annals of Internal Medicine.

"High-fiber foods take longer to digest and may help to stabilize blood sugars, resulting in increased satiety levels," Gans explains. And the more satisfied you feel after eating, the less likely you'll be to scrounge for a snack later on.

Whole grains, beans and even nuts and seeds can all be good sources of fiber. But when it comes to weight, fiber-rich produce like berries, apples, pears and non-starchy vegetables are an especially weight-friendly choice, per analysis published in September 2015 in PLOS Medicine. Not only do they serve up plenty of roughage, they're also very low in calories.

3. Cut Back on Sugar, Refined Flour and Processed Snacks

The more junky snacks you eat, the more likely you are to have obesity, per an October 2016 study published in the American Clinical Journal of Nutrition.

Not only are things like cookies, crackers, chips and baked goods high in empty calories, but the fact that they're low in fiber and high in refined carbs means they'll spike your blood sugar and leave you hungry again shortly after eating, per Harvard Health Publishing.

That's not to say you can never have a brownie or a cupcake again. But it's worth learning to enjoy them in a healthier way.

"Instead of removing chocolate from your diet altogether, try having one square right after a meal, which can potentially stop a craving before it gets out of control," Gans says.

4. Stop Drinking Soda (Yes, Even Diet Soda)

Opt for beverages without any sweeteners, such as sugar-free iced tea or plain old H2O, in place of soda.

Image Credit: pilipphoto/iStock/GettyImages

Drinking a single sweetened beverage like soda, juice or sweetened tea each day could result in a weight gain of up to five pounds in a year, according to the Harvard T.H. Chan School of Public Health. That's because sweetened drinks are high in sugary calories but don't actually fill you up so you don't compensate for those calories by eating less.

Soda is "a well-known enemy of weight-control success," Dr. Cunneen says.

And while diet soda is calorie-free, it may not be a better choice when it comes to managing your weight, according to March 2015 findings published in the Journal of the American Geriatrics Society.

"The artificial sweeteners found in diet soda may trick the body into reacting as if it were real sugar, so that the inclination is generated to eat other sugar-laden food," Dr. Cunneen explains.

5. Slash Your Screen Time

The more TV and screen time you log each day, the more likely you are to be overweight. Sitting in front of a screen prompts your body to store fat instead of burning it for energy, Dr. Gupta explains. It might make you more likely to eat more snacks, too.

Simply cutting back on screen use has been shown to help people lower their BMIs, per a December 2009 study in the Archives of Internal Medicine.

There's a good chance that doing so will encourage you to naturally move more: Without the TV on, you might find yourself going for a walk or finally clearing out that closet. And the more you move, the more fat your body will burn, Dr. Gupta says.

Along with regular workouts, look for simple ways to move more throughout the day.

Image Credit: eternalcreative/iStock/GettyImages

Speaking of curbing screen time, it's worth finding ways to incorporate more activity into your day overall. Aim to get at least 150 minutes of moderate exercise per week, which breaks down to around 30 minutes per day, per the CDC.

But that's really just a bare minimum. "Studies indicate that activity needs to increase to one hour a day to lose any significant weight," Dr. Cunneen says. "The more you move, the better you'll do," he says.

That's not to say you need to log hours and hours at the gym every day. Take up a hobby that you love that gets your heart pumping like hiking, playing tennis or riding your bike. And think about ways to incorporate more movement into everyday activities, like walking to do errands instead of driving or meeting a friend for a stroll instead of grabbing lunch together.

7. Make Most of Your Food at Home

Restaurants tend to add more fat, salt and sugar to their food and offer much bigger portions than you'd serve yourself at home, resulting in higher-calorie meals.

"Cooking at home gives you more control over the amount of food you're served," Gans says. In fact, those who eat home-cooked meals five times a week or more are 28 percent less likely to be overweight compared to those who eat at home less than three times a week, according to August 2017 research in the International Journal of Behavioral Nutrition and Physical Activity.

No need to avoid dining out altogether. But it's worth saving restaurant meals for special occasions and adopting strategies to help you avoid overeating.

"Get into the habit of ordering a side of vegetables with your meal, then eating only half your entre and taking the other half home," Gans suggests.

8. Get Your Stress Under Control

You might not realize it, but your mood can have a major influence on what and how much you eat.

"When we're stressed we're more likely to grab something on the go with no regard to how healthy it is," Dr. Gupta says. "We're also more likely to overeat or overindulge." Over time, that can add up to excess pounds.

Taking steps to manage your stress can help. Adults with obesity who participated in an eight-week stress management plan including things like deep breathing and guided imagery lost significantly more weight compared to those who didn't, per a December 2018 study in the Journal of Molecular Biochemistry. Plus, they also experienced less depression and anxiety.

Make a grocery list that includes everything you'd need to make a week's worth of meals.

Image Credit: SDI Productions/E+/GettyImages

Mapping out every item on your menu every single day is unrealistic. But making food choices on the fly ups the chances that you'll opt for something quick or convenient (hello, takeout!), which might not always be the best option for your weight.

"The more you're prepared, the less likely you are to make unhealthy choices," Gans says.

Before going shopping for the week, try outlining your breakfasts, lunches, dinners and snacks and making a grocery list based on what you need to make complete meals. "For example, don't just buy a piece of chicken. Also buy the veggie you'd have it with and a carbohydrate like a sweet potato," Gans says.

Keeping your pantry and freezer stocked with wholesome staples can give you easy, healthy options for those times when you haven't had a chance to plan. For instance, you can make a quick dinner with a box of whole-wheat pasta, a can of chickpeas and a bag of frozen veggies in about the same amount of time it would take for a pizza delivery order to arrive.

If you're not logging the recommended seven to nine hours of shut-eye per night, start.

"A healthy sleep pattern is essential in maintaining a healthier weight and overall good health," Dr. Cunneen says. On the flip side, adults who regularly snooze for less than seven hours a night have higher body mass indexes and are more likely to develop obesity, per an October 2018 review in BMJ Open Sport and Exercise Medicine.

"When you sleep less and spend more hours awake, the hunger hormone ghrelin increases and the satiety hormone leptin decreases," Dr. Cunneen explains. That means it takes more food to make you satisfied. And chances are you won't be munching on salad to fill your belly.

When you're sleep deprived, you're more likely to gravitate toward comforting high-carb, high-calorie fare like cookies or mac and cheese, according to the Mayo Clinic.

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Obesity Prevention: The 10 Best Ways to Help Prevent Obesity - LIVESTRONG.COM

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Global Peptide Hormones Market Will Hit Big Revenues In Future with Sales and Revenue Analysis Report and Forecast to (2020-2027) - Bulletin Line

September 01, 2020

When Christina Sarcevic Verdgeline, of Forty Fort, picks up her camera, the result could be a closeup of stunning dark pink foxgloves, a brilliant yellow sunflower or maybe a picture of an insect doing what an insects gotta do. More about that later.

If she picks up a pencil, she might draw a detailed sketch of a young woman in a high-collared Croatian dress. Or of a solitary cross on top of a mountain overlooking the village of Medjugorje in Bosnia-Herzegovina.

With a repertoire that ranges from pointillism to architectural renderings, the multi-talented Verdgeline, 60, has sold a miniature acrylic painting called Starry Lake, reminiscent of Vincent Van Goghs Starry Night, that was on display at Mainstreet Galleries in Kingston, and collected a third-place prize from the Wyoming Valley Art League for a snowy watercolor called Winter Tracks.

While one of her next projects might be a sketch of the historic Denison House, located not far from her home, Verdgeline admitted that in recent months she hasnt had an abundance of time for painting or sketching. Not with working full time at a bank in Scranton and, quite frankly, feeling the pull of a garden and yard that called out to her like a blank canvas.

This is the first full summer she and her husband, Paul, have spent at their new home in Forty Fort after moving from Plains Township, and Verdgeline has taken great joy in planting daisies and lilies, zinnias and black-eyed Susans, coreopsis and cone flowers.

Beautifying the yard is an art, too, she said.

Art is something you see with your eyes, but it speaks to your heart, said Verdgeline, whose heart seems to dance with joy whenever she notices a bumblebee visiting a zinnia, a butterfly hovering near the butterfly bush that survived the move, or a goldfinch attracted to the sunflowers.

Yay! I had my first monarch butterfly sighting in our backyard, she gleefully reported in July.

Of course, nature isnt always pretty.

Some people might think its kind of creepy she said of the photograph she shot of a praying mantis devouring a bumblebee, an image that was exhibited at Wilkes-Barres Fine Arts Fiesta and also accepted into an international National Geographic photo contest. But thats nature. Its the circle of life.

Verdgeline said she hadnt noticed the praying mantis at first, when she started shooting photos of asters. Then a bee came along and ate a little from one flower. Then suddenly the mantis was there and just grabbed the bee.

Fascinated, the artist said, I thought about it and realized this is a moment in both these creatures lives that will never happen again.

While Verdgeline has created hundreds of pieces of art (which she sells as prints, stationery, apparel and more, through christina-verdgeline.pixels.com) her favorite is a miniature painting, which was exhibited at Luzerne County Community Colleges Schulman Gallery in 2015, called Cranes in Croatia.

Her inspiration for the painting of the birds, in their nest on top of a chimney, was a photo her niece, attorney Adriana Vukmanic, shot on a trip to Croatia, in an area not far from where Verdgelines father grew up.

The artists parents, Joseph and Helen Sarcevic, fled the former Yugoslavia on foot in the late 1950s, making their way across the border into Slovenia first and then into Italy.

My parents were in their 20s at the time, Verdgeline said, recounting the family story about the way Joseph and Helen crossed the first border by mingling with a group of students who were heading into the woods for a picnic and didnt return with them.

The Sarcevics had arranged to meet and travel with another couple, but the other couple never showed up at the meeting spot. Verdgelines parents crossed the second border at night, hoping and praying the border guards would not notice them under the light of the full moon.

They were praying like crazy, Verdgeline said her mother told her. Even today, I get chills just thinking about it.

Years later, Verdgeline would have several opportunities to visit her parents homeland with them, and to visit relatives.

In 1983 her mother wanted to take a side trip to the village of Medjugorje in Bosnia-Herzegovina, where several teen-agers and a younger boy claimed to see apparitions of the Blessed Mother.

The artist was 23 at the time and wasnt especially eager to go there, Verdgeline recalls. My sister and I were, like, oh, Mom

But they accompanied their mother and were able to spend time in the same room with the visionaries.

I felt the highest high I ever felt in my life, the artist recalled. I felt as if I was part of everything, at one with everything and everybody.

Verdgelines mother eventually led pilgrimages from America to Medjugorje through an organization called Mir Peace and Verdgeline found inspiration there for yet another style of artwork, including Christmas cards, Easter cards and greeting cards featuring messages from Medjugorje.

The artists sister Darlene Milas of Clarks Summit has led the groups most recent pilgrimages to Medjugorje, but not this year becaue of the global pandemic.

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The day after I was diagnosed with breast cancer, I walked into the garden center of the nearest home improvement store. My mission: Bring home the prettiest rose on the lot.

My garden is my sanctuary and plant stores are my happy place verdant showrooms overgrown with aspirational beauty. Under normal circumstances, I can spend hours wandering blithely, smelling flowers, indulging daydreams.

That day was different. I wandered up and down the aisles in a daze, an uneasy feeling burrowing under the breast that betrayed me, an ugly squatter setting up residence in my chest.

Then I saw her the Miranda Lambert rose. This was no ordinary rose. Impossibly large and pink with petals spilling forth from the center, this was a fairy princess petticoat of a flower, a Southern belle on the way to her Sweet 16, a rose that exuded sassy femininity like its namesake country crooner.

For a moment, as I imagined her blossoming in my front garden, the fear and worry dissipated. I felt at peace.

This is not a story about that rose. If youre waiting for the glorious rose bush at the end, spoiler alert: It still hasnt happened. But it is a story about the magic of plants and every time Miranda blesses me with a bloom, something magical happens inside me.

Lets be clear: I never thought I was going to die. My diagnosis was ductal carcinoma in situ (DCIS). I was classified stage 0. It was non-invasive. This wasnt hard cancer. I had done that seven years earlier when my 2-year-old daughter was diagnosed with an aggressive form of acute lymphoblastic leukemia that required a grueling two-year course of chemotherapy, most of which was in-patient.

Did you know theres a tunnel between the Specially for Children clinic building in the Mueller development and Dell Childrens Hospital? We used to check in at the Childrens Blood and Cancer Center on the top floor of the complex early in the morning, then walk through the basement tunnel to the hospital to admit for surgery (a spinal drip of chemo), usually followed by treatment stays that lasted three to 10 days. We did this over 20 times. One day we walked with a woman who had lost a daughter to bone cancer and now had a son battling leukemia. She told me she didnt like being in the basement because she had to go down there to collect her daughters remains.

I know the way cancer ravages peoples lives, and what I was facing was certainly not that.

In truth, I was lucky. I had put off getting my first mammogram for a couple of years and only forced myself to do it when my company changed ownership, triggering a change in my health insurance. While the cancer was unable to spread beyond the milk duct where it was discovered, the cells were dividing rapidly so fast you could see it happening under a microscope, one doctor told me.

It was April, that brief season when Texas is blissfully temperate and exploding with natural beauty. Id taken to working out my emotional issues in my garden a few years earlier, after my husband and I completed a remodel of the East Austin home we had owned for a decade. Piece by piece I reclaimed the front yard from strangling Bermuda grass and weeds. In the winter I laid down slabs of cardboard and brown paper bags, then covered them with mulch, and now I had the final section, one of my only sunny patches, ready to plant. Thats where I put my girl, Miranda.

My treatment plan was not difficult. There would be surgery, a lumpectomy and reduction my plastic surgeon called it a "lift" and my girlfriends and I decided to go with that because it sounded like something fancy ladies do after brunch followed by 21 rounds of radiation and no chemotherapy.

Physically, I knew I could handle it. I had delivered two babies, one by emergency C-section. But something strange was happening with my mental state. So much of my job is forward-facing and suddenly I didnt want to be seen. I wanted to disappear, to hide in the shadows.

A few weeks before the surgery, I hosted a Facebook live session in the Statesman studio with Black Pumas, a band I love that was about to be famous. Theyre the nicest guys in the world and it was an easy interview, but I felt stupid and awkward. Afterward, the producer said I seemed nervous.

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The only thing that put me at ease was working in my garden, which I did at a fevered pace, knowing that I might not be able to dig in the ground after the surgery. My mom bought me a golden thryallis, which I made a centerpiece of the bed at the front of my yard, and my uncle sent me two dwarf fruit trees, a goji berry and the adorably named Little Miss Figgy. In one of my few sunny corners at the edge of my yard I planted the most symbolic addition, an esperanza, a shrubby perennial with beautiful clusters of yellow trumpet flowers and a name synonymous with hope.

Cancer changes the way you think about your body, breast cancer maybe doubly so. As women were constantly judged by our appearance and this society is obsessed with breasts. Id been busty since I was 11. My adolescence was defined by fending off unwanted touch and fighting to be known for my mind, not my body. In my 20s, surrounded by a badass group of sex-positive hip-hop chicas, I learned that it was possible, powerful even, to be known for both.

"I dont want to lose my titties," I told my husband, tears welling in my eyes.

"I dont want to lose you," he said.

And he held me tight.

Again, I was lucky. When the post-op lab results arrived, my margins were clear. No further surgery was required. I was part of a Facebook group for women my age and younger facing breast cancer, and I was in awe of the strength and dignity of these women some with tiny babies, some factoring the children they might one day have into difficult treatment decisions, some facing unfathomable challenges with incredible grace.

Still, I felt like a shell of myself. Who was this person who had been sliced apart and Frankensteined back together? For four long weeks, I had a daily date with a gamma ray machine and no promise of superpowers. My confidence was shaken. At work, I was faking it, fumbling my way through.

But the esperanza began producing cheery yellow flowers, alongside the fiery blooms of the huge pride of Barbados at the front of my yard that was gifted to my family years earlier when my daughter fell ill.

A pair of massive pecan trees blanket my yard in almost full canopy shade, and for several years I had obsessively searched the garden sections of discount stores like Ross and Marshalls for interesting, affordable containers to place around their bases. Now, unable to dig in the ground, I doubled down on these efforts, painstakingly arranging pots in colorful collections that made me smile.

A few months out, when the pain from the surgery subsided enough for me to work with my arms, I bought a set of drill bits that cut through porcelain. Soon I was combing the kitchen sections of thrift stores, in search of interesting mugs and bowls that could be repurposed as whimsical planters.

No stranger to rooting plants in water, I began diving deeper into the art of propagation. I bought rooting hormone and began taking cuttings of everything around me and sticking them in small pots filled with dirt that lined my front steps. It was my private laboratory. Sometimes the stalks withered and died immediately, but sometimes they flopped over, looking sad but still green for a week or so, then miraculously pulled themselves up as new little plants.

Obviously, a true botanist could explain the scientific process behind how this happens, but I didnt care about any of that. To me, this was pure magic and the fact that I was secretly becoming an amateur plant wizard was rebuilding my morale. If I could dig in the dirt and create life and beauty with my bare hands, who knew what else was possible?

In October, as the oppressive grip of summer loosened, I realized I was starting to feel like myself again. For the first time in my life, I decided to plant annuals. I had never understood why people would waste time putting something in the ground that they knew would die a couple of months later, but that winter, as pansies and snapdragons adorned my garden with dazzling bursts of color, I got it. Ephemeral beauty is magical, too.

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Since the country shut down in March, Ive been relishing the comfort of my garden. Spring was spectacular and even in the dead of summer, the thryallis is blanketed with tiny yellow flowers and the esperanza and pride of Barbados are blooming brightly. After dark, heady perfume from night-blooming jasmine drifts up to my balcony, adding an air of enchantment to my outdoor lounge.

Desperate to add to my container collection, I went foraging in a neighbors backyard and found a few rusty tin buckets. I drilled holes in them and filled them with flowers. Ive doubled down on my propagation lab and now angel wing begonias with deep green and burgundy leaves and sprays of delicate pink flowers are scattered around my garden alongside heat-hardy kalanchoes.

This year, I moved Miranda to my backyard, where she doesnt have to compete as much for the small patch of dappled sun I can offer her. And like she has for each of the last two years, she provided me with just a handful of beautiful, decadent roses. Do I wish shed bloom abundantly? Of course. But Ill take what I get. Every time I see one of those extravagant flowers my heart sings.

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Grounded: A story about breast cancer and the magic of plants - austin360

Infertility is a global issue with one in five couples worldwide struggling to conceive. In Ireland that figure is thought to be one in four. When infertility occurs it can be a very painful experience for women or couples that really want a child.

Globally, couples are waiting longer to start a family, which has meant a steady rise in infertility rates. According to experts, every year, the number of people accessing assisted reproductive treatments increases by 5- 10 per cent. In addition to heterosexual couples, there are same-sex couples and single women who need fertility services to create their families.

In 30 per cent of couples the cause is attributed to male factor infertility, 30 per cent are female factors, 30 per cent will have a combination of male and female factors and in 10 per cent of cases no cause will be found, which is called unexplained infertility.

Dr Bart Kuczera, of Beacon Care Fertility, says roughly 2 per cent of women in the 20-44 age bracket will be infertile if they never use contraception, or have never delivered a baby. Of those who have had one child and wish to have another, the figure for secondary infertility will be about 10 per cent for the same age group.

The scale of the problem is significant, Dr John Waterstone, of Waterstone Clinic in Cork, says. In the Western world, women are steadily waiting later in life to become mothers. According to Eurostat figures, 52 per cent of first-time mothers in Ireland are between 30 and 39. Alongside Italians, Irish women are the oldest mothers in Europe, he says.

This trend looks set to continue, and we know that age will limit womens ability to conceive. The rates may be complicated further by a drop in male fertility as studies are showing that sperm counts are falling in men in Western countries, he adds.

The older a woman is, the more her egg quantity decreases, while the chance of miscarriage unfortunately increases, group head of nursing at Sims IVF and Rotunda Deirdre Gorman says.

Those suffering from PCOS (polycystic ovarian syndrome) and endometriosis can also play a huge part in female infertility. Male factor infertility is also a major factor. Lifestyle choices such as smoking and drinking can affect sperm quality too.

For those that are experiencing problems conceiving, the rule of thumb is: under the age of 35 and trying to conceive for a year or more, get tested. Those over 35 and trying for six months with no luck should see a doctor. The good news is there are now lots of options available to help women get pregnant.

In heterosexual relationships there is timed sexual intercourse and artificial insemination that can be beneficial for younger women.

We have IVF or ICSI, which is a more sophisticated version of IVF. One single sperm is selected to fertilise the egg. If egg or sperm quality is the issue then we have donor programmes available. PGS is another procedure, whereby after the embryos have been created they can be tested for any abnormalities. This is especially useful for those experiencing recurrent miscarriage, Gorman says.

If you are a single woman, we have a robust sperm donor programme, artificial insemination or IVF would be options too. Same-sex female couples will need sperm donors but we also have a fantastic programme called Shared Motherhood Reciprocal Donation, she adds.

This is where the eggs of one partner are used in an IVF cycle to create embryos that are then transferred into the other partner, with the effect that one partner is the birth mother and the other partner is the genetic mother.

Meanwhile, periodic sexual and fertility health checks for both men and women will let them know where they stand in terms of fertility and can help them plan for the future.

During a fertility check , we use blood tests to explore various hormone levels, one of which is the anti-mullerian hormone (AMH) level. Along with your menstrual history and a transvaginal ultrasound, we count the number of antral follicles in the ovaries and explore the general health of your uterus and pelvis. These explorations help us to build a picture of your overall fertility health and give an insight into your ovarian reserve. At the end of the check, youll know if you have more or fewer eggs than average for someone of your age, and have our recommendations. You can then use the results to inform your decision making, Dr Waterstone says.

After a fertility test, women might consider preserving their fertility through egg freezing, or pursuing fertility treatment with a partner or donor. IVF remains the most common treatment plan for women who cannot conceive, with 80 per cent in Sims IVF and Rotunda undergoing the treatment.

However, simple procedures are tried first the philosophy at Waterstone Clinic is to minimise intervention while maximising patients chances of creating a family. They often use ovulation induction (OII) treatment or intrauterine insemination (IUI) treatment first.

So what happens during IVF? A woman produces many immature eggs each month. One or two mature eggs become dominant and the rest are then discarded. In fertility treatment, we use drugs to stimulate those immature eggs and help them mature. The woman will have to undergo a series of injections and undergo ultrasound scans to see how the eggs are developing. This usually takes 10-14 days. After this, she will undergo an egg collection. Her eggs will then be fertilised in the lab by her partners or donors sperm. The embryos are then usually grown out to five days. Either they will be frozen or transferred after those five days, Gorman says.

There is also the option of freezing embryos when exploring IVF. This means it is possible to have one round of IVF treatment and create an entire family from that one cycle over the course of a few years.

Sims IVF and Rotunda'smost recent clinical pregnancy rates sees 48.7 per cent under 35, 49.8 per cent between 35 and 37, 41.8 per cent between 38 and 39 and 30.6 per cent for women 40 getting pregnant and a foetal heartbeat is found at a scan between 8-12 weeks gestation.

At Waterstone Clinic, for women aged between 38 and 39 they have a live birth rate of 30 per cent (meaning a baby born full term) while women aged between 40 and 42 can expect a live birth rate of 22 per cent.

While each cycle of IVF is expensive, ranging anywhere from 4,500 to 8,500 with an average cost of about 6,000 there is also a physical and psychological cost too.

Physically it is well managed, but psychologically the toll is much higher. For patients who have had two failed cycles, this can be similar to a loss in your family. This is a degree of stress that often involves counselling and its one of the reasons why they have a link with professional counsellors if they are struggling and this is a part of the patients management, Dr Kuczera says.

Fertility doesnt last forever, and at some point infertility is natural every couple will be infertile eventually, so the sooner you start diagnostics the better the outcome, he adds.

Continued here:
Fertility treatments on the rise as couples waiting longer to start families - The Irish Times

During pregnancy, there are several ingredients in skincare and beauty products that are not recommended for use. Since some ingredients are chemical-based and doctors advise that their use be discontinued during pregnancy. Other components that might seem natural, such as pure essential oils, should also be used with extreme caution due to the fact that there is not enough research to support their safety. Furthermore, beauty skin treatments like skin peels and Botox should definitely be put on hold during pregnancy. While the ingredients are not safe, there are also slight risks of your body going into a minor state of shock due to the pain of the procedure (similar to why women are not meant to get tattoos during pregnancy). While the risks might be low, it's better to take no chances with an unborn baby's health!

While it might seem daunting to uncover which products are the safest to use during pregnancy, BabyGaga has consulted industry experts to get the scoop on which ingredients should be completely avoided during your pregnancy. It's always recommended that you do a bit of a spring clean in your beauty and cosmetics collection once you are expecting since many products won't keep until after the baby is born. Consider it a great opportunity to get closer to nature, and to eliminate some of the harsher ingredients in your day to day products.

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The biggest rule of thumb in pregnancy skincare is to avoid all products with retinol as an ingredient. Retinol is derived from Vitamin A and has been clinically proven to have adverse effects on babies in utero. While not all women will have complications from using products with retinol, it's strongly suggested to avoid it entirely until after the baby is born. There are so many alternative products in the skincare world these days that have natural ingredients, and experts agree you should stick to these!

Dr. Yelena Deshko ND is a naturopathic doctor who runs the Timeless Health Clinic of Integrative Medicine in Toronto, Ontario. As an expert in skincare procedures, she has years of experience using various skincare products on her clients. Dr. Deshko spoke to BabyGaga about the risks of using retinol during pregnancy:

The number one ingredient that pregnant women need to avoid in their skincare is retinol. Retinol is a derivative of Vitamin A and has been shown in scientific studies to have a teratogenic (negative) effect on the developing fetus. In addition to this, it is generally prudent to switch to mainly natural and organic skincare products. Skin is our largest organ and many chemicals found in commercial products are easily absorbed through the skin. The effect of many of these ingredients has generally not been evaluated to be safe for the developing baby and they may present certain risks.

While retinol is one of the most harmful ingredients in skincare products for pregnant women, there are several other ingredients and components you will want to skip. BabyGaga spoke withDr. Kemunto Mokaya (Dr. Kemmy MD), who is a board-certified dermatologist, author, and speaker who hails from Knoxville, TN. As a skincare expert, she was able to give us a more comprehensive list of what ingredients pregnant women should watch out for in makeup and skincare. Dr. Mokaya advised against using,

Retinoids: The first product that comes to my mind is retinoids. They are vitamin A derivatives that are popular skincare products because they help control acne, they help even out the skins pigmentation and are anti-aging products that stimulate collagen growth (thereby reducing fine lines and wrinkles). They are not recommended in pregnancy because they are associated with birth defects. Oral retinoids are actually pregnancy category X (meaning that studies in humans and animals have shown them to actually cause harm to fetuses, including fetal abnormalities). Topical retinoids are pregnancy category C.

Hydroquinone: It is tempting to use hydroquinone a skin lightener during pregnancy to treat melasma and other pigmentary defects of pregnancy. However, its use in pregnancy should be avoided, especially because studies have shown that as much as 45% of hydroquinone is absorbed into the skin after topical application. The FDA lists hydroquinone under pregnancy category C and its use should be avoided until after the baby is born.

Botulimum toxin (e.g. Botox or Dysport): *Use of botulinum toxin to paralyze muscles around wrinkles, thereby making the wrinkles less visible, is one of the most popular non-invasive cosmetic procedures performed. It is not recommended or FDA-approved for pregnant or lactating mothers.

Benzoyl peroxide & Salicylic acid:Benzoyl peroxide and salicylic acid are medications commonly used to treat acne. Pregnancy can cause hormonal acne, and while it is tempting to use them to control the condition, they are classified by the FDA as pregnancy category C. They should therefore be avoided in pregnancy.

Formaldehyde: Formaldehyde is a carcinogen that has also been linked to fertility problems and miscarriages. It is found in some hair products (e.g. hair straighteners), nail polishes and eye-lash glue. Formaldehyde should be avoided in pregnancy.

Essential Oils: Should be used with caution in pregnancy. They are not regulated by the FDA and therefore do not have to follow strict labeling standards. It is difficult to assess the quality, concentration, or purity of different essential oils due to the loose regulations. Unless the source of essential oils is a verified and trusted one, it is best to simply avoid them in pregnancy. For example, tea tree oil when absorbed in high quantities can affect hormones and trigger premature contractions.

Phthalates:Some studies have found a link between phthalate exposure and abnormal development of fetuses. Personal care products containing phthalates should be avoided in pregnancy.

Dihydroxyacetone: Many spray self-tanners contain the chemical dihydroxyacetone. It is commonly listed on product labels as DHA. If it is accidentally inhaled during its application, it is unsafe for the mother and the baby.

Toluene: Many nail-polishes contain toluene, which is a suspected carcinogen. It should be avoided during pregnancy due to the potential risk to the fetus.

Chemical sunscreens: Ingredients in chemical sunscreens include: Avobenzone, homosalate, octisalate, octocrylene, oxybenzone, oxtinoxate, menthyl anthranilate and oxtocrylene. Some of these ingredients are thought to be hormone disrupters. They can interfere with the babys nervous system development.

Thioglycolic acid:Found in chemical hair removers; can also be labeled acetyl mercaptan, mercaptoacetate, mercaptoacetic acid and thiovanic acid.

If you have struggled with problem skin prior to becoming pregnant, or you are experiencing pregnancy-related skin issues, you might want to make an appointment with a dermatologist to see what the root of the problem is. A specialist can determine what is causing the issue, and recommend skincare products that are safe to use throughout pregnancy.

Furthermore, dermatologists can offer treatments or facials that do not use harsh chemicals or products and can help you relax and feel pampered!

If you are experiencing eczema or skin rashes, you can even speak to your GP or OBGYN. Many of these conditions are really common during pregnancy and can be treated with safe for use creams. In the absolute worst-case scenario, the condition will likely only last during pregnancy, and should clear up as soon as the baby arrives. While this isn't always the best news for women who haven't dealt with skin problems until pregnancy, it is generally due to hormone changes and will not last forever.

Though you might have to ditch some of your cosmetics and skincare treatments during pregnancy, it doesn't mean that your skin has to suffer. In many cases, switching to more natural ingredients can be very soothing for your skin. There are many DIY face masks that you can create with items from your fridge. For a soothing face mask, you can add plain yogurt, oatmeal, and honey. If you need more hydration, blend an avocado, an egg, and a teaspoon of honey. Some of the most basic items can be used in your skincare routine, like using coconut oil as a moisturizer, for example.

With a multitude of vegan, organic, and natural cosmetic lines on the market today, you should have no problems finding some new makeup items to get you through pregnancy without issues. It's also a great time to skip makeup altogether, and give your skin a breather! While it might take a little time to adjust to bare-faced, you might notice that after skipping makeup for awhile (or reducing the amount that you wear) your skin will actually look and feel more healthy.

Skin health is super important during pregnancy since your skin absorbs everything that you put on it. You will want to be extra vigilant during these months to make sure that you are not lathering yourself up with toxic and harmful ingredients.

If you are an essential oil enthusiast and you chose to continue using them, exercise caution and dilute them with a carrier oil to make sure you aren't putting a highly concentrated oil directly on your skin. Make sure that the source of your oils is reputable, and do a little bit of a background check to find out which oils are potentially dangerous for pregnant women and fetuses.

Getting a good amount of sleep and drinking enough water can help keep skin issues at bay, so make sure that you are monitoring this during your pregnancy! Dehydrated skin is more prone to breakouts and rashes, so make sure your skin is drinking enough!

NEXT:How To Treat Postpartum Dry Skin

SOURCES: Timeless Health Clinic, Dr. Kemmy, MD, Women's Health Magazine

This Is When Chelsea Houska Will Give Birth

Ariane Signer has been writing her thoughts, fears and dreams in journals since the early 90's. A personal development and self-help junkie, she has been working as a creative freelance writer since 2016. A native Canadian, she has found her home in small town Switzerland, where she lives with her husband and two young sons. She published her first book, Things That Shine: Poems, in 2019.

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Skincare Ingredients To Avoid During Pregnancy | BabyGaga - BabyGaga

Dr. Kayla Luhrs is Petersburg Medical Centers fifth full-time doctor. (Photo courtesy of Kayla Luhrs)

Petersburg Medical Center has hired a fifth doctor, which administration hopes will improve access to care. As KFSKs Angela Denning reports, Dr. Kayla Luhrs hails from Southeast Alaska.

Dr. Kayla Luhrs grew up in Ketchikan and she also lived in Juneau before moving to Petersburg. She says shes liking the new town so far.

I have a dog and were loving the trails, the quick access to the trails and the beach, she said. And the people have been so kind, I cant even count how many meals Ive had dropped off on my doorstep and I would say thats my very favorite way to be shown appreciation so yeah, Ive felt really good in my transition here.

Historically, PMC has employed four doctors and a physicians assistant or a nurse practitioner. CEO Phil Hofstetter says the last nurse practitioner left at the start of COVID so PMC decided to hire another doctor to help with pandemic response. At first Luhrs was hired as an independent contractor and then she became a permanent full-time position.

Hofstetter says the pandemic wasnt the only reason PMC was looking for another doctor.

It was sort of dual effect of opportunity and also need, he said.

Besides addressing additional COVID details, Hofstetter says they had a long standing need to help patients access care more easily. They have wanted to improve waiting times for appointments at the clinic.

If you look at a scheduling book and you look how far ahead does it take to have an appointment, they were pretty far down the road for some physicians, Hofstetter said. You can come in and do walk-in but scheduled, follow-up appointments were sometimes quite a ways out and that tells me that theres a higher demand in the community.

Luhrs says as a doctor, she likes to develop relationships with her patients to find out what their health goals are. She also appreciates the variety of work that PMC provides.

I get to be in the ER and take care of patients when they have acute needs but then I also get the follow up of seeing them in clinic, she said. I think this is kind of a unique situation where as a general physician you do get to follow patients in the hospital, in the ER, in the clinic, and I really like that.

Luhrs has an interest in sports medicine and she likes to use food as medicine through a holistic approach to helping patients. One specialty that she has background in and hopes to pursue in Petersburg once the pandemic situation changes are group visits. Its where patients see the doctor together about a common issue. The patients typically spend 90 minutes with her in the group, which is longer than a normal one-person clinical visit.

It can be a really efficient and an effective way to share information. And we also have studies showing that when we meet together in groups then we can have better outcomes than meeting one on one, Luhrs said. I think we learn so much from each other. Other people maybe think to ask question that is a question for you but you didnt even think to ask it.

Seeing the doctor in a group setting wont work for everything. But Luhrs says it can help with healing and wellness for some things. Specifically, she has a group on the topic of womens health where patients get a better understanding of the cyclical nature of hormone changes. Shes done groups on diabetes and pregnancy loss and support.

Shes also had success with groups on Irritable Bowel Syndrome. She says patients have benefited from getting a better understanding of how digestion works for them.

I think that can be kind of a frustrating diagnosis for people and so meeting together and just getting more information in depth about how your digestive system works and the timing of these things and the way we break down different foods and nutrients and the downstream effects of that, Luhrs said.

Hofstetter says that the new hire will help PMC move towards a more patient-centered focus, which includes more case management and outreach to patients.

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PMC's new doctor hopes to bring group visits to patient care - KFSK

Global Recombinant Protein Drug Report offers market size, share, overview, segmentation by types, application, countries, key manufactures, cost analysis, industrial chain, sourcing strategy, downstream buyers, marketing strategy analysis, distributors/traders, factors affecting market, forecast and other important information for key insight.

The business intelligence summary of Recombinant Protein Drug market is a compilation of the key trends leading the business growth related to the competitive terrain and geographical landscape. Additionally, the study covers the restraints that upset the market growth and throws light on the opportunities and drivers that are anticipated to foster business expansion in existing and untapped markets. Moreover, the report encompasses the impact of the COVID-19 pandemic, to impart a better understanding of this industry vertical to all the investors.

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Key highlights from COVID-19 impact analysis:

Other highlights from the Recombinant Protein Drug market report:

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A gist of the regional landscape:

Table of Contents:

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Growth Factors of Recombinant Protein Drug Market with Emerging Trends and Revenue Estimation By 2025 - AlgosOnline

September 05, 2020

According to the U.S. Department of Labors website, Sept. 2, 2019 is the 125th anniversary of Labor Day being celebrated as a national holiday.

The DOL website offers a brief history: The first Labor Day holiday was celebrated on Tuesday, Sept. 5, 1882, in New York City, in accordance with the plans of the Central Labor Union. The Central Labor Union held its second Labor Day holiday just a year later, on Sept. 5, 1883. By 1894, 23 states had adopted the holiday, and on June 28, 1894, President Grover Cleveland signed a law making the first Monday in September of each year a national holiday.

Presently, workforce has become one of the leading drivers for location choices. In an article from the Wharton University of Pennsylvania The Headquarters Checklist: How Do Companies Pick A Location, Wharton management professor Peter Cappelli, Director of the Schools Center for Human Resources states: For most businesses, the issue of location choice now is driven by labor: Will we be able to attract the white-collar skills we need? For unskilled or semi-skilled jobs, will we be able to get it at a price we want to pay? No business goes to the Silicon Valley or New York City because it is cheap; they go because of the labor supply. Christopher Thornberg, founding partner of Los Angeles economics research firm Beacon Economics, further strengthens this thought, It boils down to access to clients, access to labor force, access to suppliers these all play a role in these decisions.

Just as it was important to start the celebration of the workforce in 1882, the importance of the available workforce in site selection has made it even more vital and worthy of continued celebration.

The Maysville-Mason County Area Chamber of Commerce believes that Workforce is the heart of everything we do. It begins with our Mission Statement: To enhance economic growth, promote development and provide leadership of the business community in the Maysville-Mason County Area. That may still sound rather general, but thats the beauty of it the Chamber can move in almost any area where our membership has a need. To simplify it, we can break it down to three words, Enhance, Promote and Lead. But my favorite way to describe the Chamber is that we are a Connector. We can connect one person to another, or someone to the information or product that they need.

It has been a pleasure to provide the leadership for the process of becoming certified as a Kentucky Work Ready Community. We had the opportunity to prove that Mason County has the quality workforce employers are looking for. Our workforce has graduated from high school, has some college experience to a two-year or higher degree, and has attained Career Readiness Certificates. The Chamber, in conjunction with the Mason County School System, has developed the Work Ethic Seal Program to reward Mason County Juniors and Seniors for exhibiting the habits employers look for in an employee. One of the best outcomes of the program has been connecting all the stakeholders needed for the process: Economic Development, Business and Industry, Elected Officials, Education, Workforce Development and those who work with the Veteran, Disabled, Ex-offender, and Medicaid Populations. It takes all of us working together!

Always looking to the future, we partner with (enhance) and actively serve on committees for the Kentucky Career Center, Business Services Team and Maysville Community and Technical College. We produce (promote) a Relocation Guide to use when talking with new businesses or to help a new resident navigate settling in the area. We also produce the Maysville/Mason County map to help us all find our way around. We were a founding sponsor of the Maysville Young Professionals Network and continue to support them as they provide a connection to our new, younger residents. We regularly provide Professional Development opportunities (lead) such as our Exceeding Customer Expectations seminar on Sept. 26 and our Annual Leadership Conference. The Chamber helped to start the Leadership Horizons program which has continued for 20 years. We are proud to be a part of the steering committee to make Maysville the First Green Dot City and have had a couple of opportunities to represent Maysville at the State level.

Everything we do supports our workforce. It doesnt matter if the business is along the river or on top of the hill, or if they have one employee or 600, our goal is to connect them to the resources that are needed.

On this 126th Labor Day, lets all take a moment to thank each other for the great job everyone does. Truly, Big things are happening in Maysville and we have our workforce to thank for it.

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Painting the town red - Ledger Independent