Archive for the ‘Hormone Clinic’ Category

Federal Health Minister Greg Hunt has announced that Kyleena a long-acting, low-hormone, reversible form of contraceptive will be added to the Pharmaceutical Benefits Scheme. This will allow general patients to pay just $41 (or $6.60 for concession card holders) for up to five years of birth control.

WATCH:Abbie Chatfield reveals she had an abortion before going on The Bachelor

Kyleena is the first IUD of its kind in 15 years to be subsidised under the PBS. The move is expected to save women up to $160 a year, totalling $93 million collectively for Australian consumers.

We know from the Choice Project research that long-acting reversible contraceptives (LARCs) are highly reliable, desirable methods of "fit & forget" contraceptives and countries that have high rates of LARC use have lower unplanned pregnancy and abortion rates, Dr Karen Osborne, Clinical Director of Clinic 66 tells Womens Health.

RELATED:How To Use Your Birth Control To Prevent PMS

Getty

We want to get as many women to use the more effective LARC methods rather than the higher risk and more inconvenient contraceptive pill.We need to make allLARCS as affordable for women as possible so that they have a better range of choice.

In comparison to a global benchmark of 15 per cent, around 12.5 per cent of Aussies rely on long-acting reversible contraceptives. As well as Kyleena, other popular choices include the Mirena and ParaGard, a non-hormonal copper IUD.

The benefits of using these forms of birth control include:

RELATED:Exactly How Each Form Of Birth Control Affects Your Period

Link:
The Kyleena IUD Is Set To Be Subsidised By The Government - Women's Health

SEATTLE Samira Ummat, MD of Longevity Medical Clinic says there is evidence that androgens (or hormones) like testosterone are breast protective in women.

"Unfortunately, all women after mid-thirties, become deficient in many important hormones. In recent studies, its true, there is an 86% reduction in breast cancer cases when high-risk women were on androgen therapy. "

How does a woman know if she is at high risk for Breast Cancer?

According to Dr. Ummat, women who are at high risk for Breast Cancer often have above-average menopausal symptoms with lots of side effects. Some women breeze through menopause and other women get hammered with mood swings, hot flashes, low libido, and bone loss. The more problems you have, the higher the risk, and the more problems you can get. Plus, some women have genetic predisposition, make poor lifestyle choices, like smoking, living a sedentary lifestyle, lack of exercise, becoming obese, too much alcohol, poor diet, too much radiation, late menopause, and delayed childbearing. The danger of being overweight is the fat tissue, like visceral fat, is a hormone factory, but it can create too much of the wrong hormones.

To know risk and whether you are getting the right treatments Longevity Medical Clinic, starts with measuring first, if you dont measure, you dont know.''

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Androgen therapy looks promising for high-risk breast cancer patients - KING5.com

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Daniel Walters photo

Ken Peters, pastor of the Church at Planned Parenthood.

But to local anti-abortion Pastor Ken Peters, Planned Parenthood also represents another setting: the "gates of hell." And it's the job of a Christian church, he argues, to prevail against the gates of hell.

In October 2018, inspired by a sermon from anti-abortion protest movement leader Rusty Thomas,Peters launched "the Church at Planned Parenthood," conducting worship, prayer and fiery anti-abortion preaching on the public lawn directly outside of the Planned Parenthood clinic on Indiana Avenue on Wednesday evenings. Peters didn't consider it a protest. He considered it church.

But Planned Parenthood considered it something else: harassment. The clinic reported that theamplified sermons and condemnations from the Church at Planned Parenthoodwould leak through their clinic walls, and that, according to their attorney, "patients and caregivers cannot hear each other speak even when sitting right across from each other."

Over the last year and a half, tensions between the church, Planned Parenthood and pro-choice counter-protesters have continued to ratchet up. Teams of armed police officers have attended some City Council meetings, responding to unspecified social media threats. And this Monday, the conflict will come to a head when the City Council will likely pass Councilwoman Lori Kinnear's resolution intended to strengthen the city's noise ordinance in response to the concerns.

But last Friday,Mayor Nadine Woodward took her own action: Her staff sent out an email to both Peters and Karl Eastlund, CEO of the Planned Parenthood of Greater Washington and North Idaho, with a message: Let's all sit down and talk.

"Mayor Woodward asked if we could arrange a meeting to discuss the current concerns about noise, assembly, ordinances, etc," the email reads."We are hopeful to have a small group that represents the voices of interested parties.This includes each of you, the Police Chief, Councilmember Kinnear, Council President Beggs, the Mayor and the City Administrator."

City spokesman Brian Coddington says the proposal to bring everyone together was Mayor Woodward's idea. The mayor, he says, was concerned about the sheer number of police officers and supervisors who were needed to keep the peace and handle existing noise ordinance complaints during services. According to an email from the Spokane Police Department to Councilman Michael Cathcart, the law enforcement response to the Jan. 29 Church at Planned Parenthood service required one police captain, one lieutenant, two sergeants, one detective and eight police officers, costing the taxpayer more than $5,450 in police overtime in a single night.

Woodward, Coddington says, was "looking for a chance to be an intermediary for the situation and seeing if there's another solution that doesnt involve a commitment of city resources." Local government might be one fo the last places we can get around everyone in the same table with common goals: Lets keep everyone safe, and protect everyones rights, City Administrator Wes Crago says. I think the mayor, to her credit, said, 'Lets reach out to both sides and lets set up a dialogue.'

"Mr. Peters continues to incite his followers with violent rhetoric and has vowed to continue to disrupt our health care services," Eastlund wrote in an email. "You would be better off meeting with him and police separately to discuss how enforcement will impact him and his followers."

Daniel Walters photo

Ken Peters greets Rep. Matt Shea at a December meeting of the Church at Planned Parenthood.

THE KEN PETERS MEETING

He says the mayor wasn't trying to take one side or the other, only looking for ways that everyone could accomplish what she wanted to accomplish.

"I think shes wanting to work this out so where it doesnt escalate," Peters says. "I think shes doing exactly what a mayor should do, trying to resolve problems at a table and bring all the parties together."

City Council President Breean Beggs says there was "no grand resolution" or possible third-way compromise floated at the meeting that would result in delaying or canceling Monday night's vote. Instead, he sees the possibility of addressing the conflict after the ordinance passes.

"The closer we can get to Planned Parenthood the better," Peters says.

"You cant stop sin with sin. You stop sin with holiness," Peters says. "Gods weaponry are prayer and worship and preaching. Its never any kind of sin or violence. ... We wouldnt harm a flea."

"For us, its our constitutional rights of freedom of worship and freedom of speech and freedom to peaceably assemble without a dark cloud held over our head," Peters says. "Thats what we want and thats what were fighting for."

The draft version of Kinnear's ordinance goes beyond the state standard barring "noise that unreasonably disturbs the peace within" a health facility. Instead, it bans intentionally making any noise outside a health care facility that is intended to cause or actually causes "interference with the safe and effective delivery of health services within the building" after a law enforcement officer has told them to cease. Not only that, but it allows individuals to sue violators directly in civil court.

"Im hoping that well find a resolution with all parties involved, so we dont have to go to court and use lawyers and all that stuff," Peters says.

"The First Amendment does not demand that patients at a medical facility undertake Herculean efforts to escape the cacophony of political protests," wrote Chief Justice William Renquist, a Reagan appointee.

"He didnt go run and hide, he kept praying," Peters says. "Theres law that is higher than mans law Gods law. The kingdom of heaven has laws that are higher than the United States of America."

In other words, even if the law passes, don't expect the Church at Planned Parenthood to go away quietly.

"Were going to show up until Jesus Christ comes to take us home or until abortion is abolished in America," Peters says.

Daniel Walters photo

Planned Parenthood has repeatedly asked counter-protesters like these to quit it. In recent months, the numbers of counter-protesters have dwindled as a result.

Paul Dillon, vice president of public affairs, says that Planned Parenthood met with city officials on Thursday. Woodward, he says, left the meeting early on, but other officials like Police Chief Craig Meidl and City Administrator Wes Crago stayed to listen.

"The meeting really started with us explaining how this has been escalating and the fears around that," Dillon says. "It seemed like at the end of the day they understood that and also had concerns."

Dillon sent the Inlander a slew of screenshots of comments from Peters on social media to bolster the argument that Peters is looking to interfere with the clinic, not just to sing worship songs and pray outside.

"The Planned Parenthood Staff fled the building in fear when we showed up and started our church service," Peters wrote on Facebook in October 2018.

To him, there's a distinction: Yelling at a woman that she's a "baby murderer" is harassment, but softly pleading with her not to kill her baby is advocacy.

Confrontations between anti-abortion activists and counter-protesters can become particularly disruptive, Dillon says.

"This guy just drove his car right up to the egress and just looked like he was going to ram [an anti-abortion activist] but stops his car, and just laid on the horn for 15-minutes," Dillon says. "That is really scary."

Dillon says that Planned Parenthood has repeatedly been explicit with counter-protesters: They're not helping.

Because ultimately, Planned Parenthood's complaint is about both the enforcement of the law and the alleged violators of it.

Planned Parenthood supporters were particularly horrified this month when a records request revealed a cop on a body camera assessing the comparative aesthetic merits of the women on each side of the abortion divide.

Daniel Walters photo

Nadine Woodward at her campaign kickoff breakfast last year.

Last year, when Woodward was introduced for her mayoral campaign kickoff breakfast, she was praised for her work with a variety of nonprofits, including Life Services' crisis pregnancy center, an anti-abortion group that aims to both help pregnant women and discourage them from having abortions, sometimes through controversial tactics. Pressed on her position on the issue by the Inlander last year, she said she was in favor of women having "choices," emphasizing the "S."

And at a Spokesman-Review hosted candidate forum last year, Woodward was asked by Planned Parenthood's Dillon what she would do to enforce existing noise ordinances at health care facilities like Planned Parenthood. She replied in generalities.

"Noise ordinances should be enforced everywhere. In neighborhoods, on business districts, I would say they should be enforced everywhere," Woodward said. "I would say everywhere, doesn't matter where it is."

But now, that she's mayor, the question has gone from theoretical to very real:To start with, she has to decide if she'll veto Kinnear's ordinance or sign it. On Thursday afternoon, Coddington said Woodward hadn't committed to either course yet, saying the language of the resolution could still be changed.

"There still needs to be legal review of the language to make sure its practical and implementable," Coddington says. Coddington says the mayor's primarily driven by the burden the conflict has put on the Police Department, and the interests of the surrounding neighborhood. Coddington says the mayor is still looking to broker an agreement between the two groups.

There is a hope that, at some point, we could get to a point where there is a mutually accepted solution, Coddington says. That typically happens better when you can have both parties at the table at the same time.

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Mayor Woodward to controversial anti-abortion church and Planned Parenthood: Let's sit down and talk - Pacific Northwest Inlander

You are infantilising women! I heard my mother yell one day when I was a teenager. Alarmed, I went into the kitchen to find her slamming the phone receiver down.

Have you seen this? she said, holding up a roll of paper towels printed with colourful images of teddy bears and blocks.

Mom, I said. Did you just call the Bounty paper-towel company to complain about these teddy bears?

Yes, she said, eyes flashing. They should be ashamed.

In retrospect, I think that my then middle-aged mother dealing with a grouchy teenage daughter, dying parents, marriage problems and an acting career ending because she was no longer young might have been finding a way to express her feelings without bothering anyone except a supervisor at that paper-towel company.

Twenty-five years later, struggling with a career that felt over, facing various physical problems and trying to get my child into a good school, I found myself paying a lot of attention to my sons pet turtle.

Jenny looks bored, I said, gazing into the tank. When was the last time Jenny had some fun?

Shes a turtle, my husband said. Turtles dont have hobbies.

Maybe they want more! I snapped.

And that was the moment I realised that Jenny the turtle had become my very own paper-towel teddy bear.

Menopause, defined as a full year with no period, hits women on average around the age of 51. But the years before that cessation called perimenopause can be more emotionally and physically fraught than we anticipate. We change a lot during these years. And, as we may remember from puberty, transitions can be awkward. Our bodies and our moods frequently betray us, but one of the worst parts of perimenopause and menopause is that no one talks about them.

Sometimes my own perimenopausal moods are more rage than anxiety. I woke up the other day and noticed that my husband had placed a couple of champagne corks on top of a picture frame. It made me want to start breaking things. What is this, a goddamned student house? In this state, I noticed things I had missed before: bags spilling out of cupboards, stacks of receipts and change on a table, my sons stuff everywhere. Its like living in Hoarders! I ranted. If Id had a pack of matches I could have burned the place down.

When I open the book How to Face the Change of Life with Confidence, published in 1955, I see a question from a woman, 37, who has wild mood swings before she gets her period. The expert male gynaecologist author tells her: Man reaches physical maturity at 25, and emotional maturity at 35. Unfortunately, you seem to have missed the boat somewhere along the line, and you are still in your childish stage of emotional reactions.

Decades of that sort of condescension have kept women from asking certain questions twice.

Almost every woman I know of my age is feeling confused and in a state of transition even as most of us are at the top of our game in our careers, financially stable and pretty comfortable with being parents, said Yvette, 43, a Californian who is the COO of a video game company. I spend a lot of time with other friends of my age. We talk about the fact that we are widening and softening where we dont want to and dont know if it makes us shallow or not feminists to do something about it; the fear that we dont know how to monitor our childrens screen time; the fact that we dont really like or need sex very often; our worry that we are losing time to try our dream job.

Experts in gynaecology maintain that hormone replacement therapy (HRT) remains the most effective scientifically proven treatment for the symptoms of menopause. And yet, fearing the increased risk of cancer, stroke and blood clots that weve long heard comes with a hormone therapy regimen, weve gone rogue. That, perhaps, is why Gwyneth Paltrows online community Goop can get away with selling us expensive jade eggs to stick up our yonis.

Gynaecologists I spoke to said they werent surprised that women were casting around for exotic fixes to their perimenopausal woes. Jacqueline Thielen, who works at the Womens Health Clinic at the Mayo Clinic in Minnesota, said she sees many women in their 40s and 50s who tell her theyre scared of hormone therapy, but made miserable by symptoms and being swamped with responsibilities.

This makes them vulnerable, Dr Thielen said, to controversial things like subcutaneous hormone pellet therapy, inappropriate ovary removal, or pricey vaginal rejuvenation, which can cost a fortune and may involve shooting lasers into your vagina one more thing I guarantee you our mothers did not have on their to-do lists.

For some women, its not a big deal. For others, it can be crushing. In a survey by the American Association of Retired Persons, 84% of participating women said that menopausal symptoms interfered with their lives.

You know, said JoAnn Pinkerton, executive director of the North American Menopause Society (Nams), we tell people who are grieving not to make major changes for a year. I dont think anybodys ever said: Dont make a major decision when youre perimenopausal.

Good idea, I think. We can just take it easy until perimenopause ends. How long is that, anyway? I asked.

Anywhere from a few months to 10 to 13 years.

Oh my goodness, I said.

On average, they call it four years, she said. But she added that menopause is actually a lot easier than the perimenopausal transition which is unpredictable. Its based on ovarian fluctuations. You might have six months of severe hot flashes, skipping periods and then your cycles come back for three to five years before it happens again.

Women need to recognise that its a time of vulnerability, and there are some things that they can do to help.

Dr Pinkerton gave me an example: A woman came into my office and said, I hate my husband. I hate my marriage. I need to get out of this. The husband had called me earlier and said, Ive noticed that my wife is really having exaggerated responses to things around the time of her periods.

We ended up getting her into counselling as well as on to oral contraceptives. The contraceptives calmed the hormones down and then doing some counselling let her start to see some of the stressors that were hidden.

I saw her recently, Dr Pinkerton continued, and she said her marriage could not be better. She recognised that the perimenopausal hormonal fluctuations were making the problems seem incapable of being solved. I guess what I would just say is if youre in perimenopause, recognise that hormonal fluctuations may make the problems at work or at home seem larger.

Women also benefit exponentially from sleeping more, Dr Pinkerton added. Its often the first thing to go, but its absolutely one of the things that can help you navigate this time. Then, stress reduction.

But heres what I want to know: why are Generation X women arriving in their 40s knowing something is going to happen, but without a clear idea of exactly what that is?

One answer is: denial. We have had incentives for a long time to pretend we are the same as men in every way. For decades, women have had to argue that they could still work and function through those messy period, pregnancy and menopause-related symptoms, and as a result weve minimised them, both to others and to ourselves. So as not to call attention to ourselves as women, we pretend its not happening. Boomer women arguably started this, entering the work world in shoulder-pad armour. It makes sense that they felt they had to hide the inconvenient fact of their womanhood, particularly in middle age.

After taking our children to see the latest Star Wars, a friend and I sat at her dining table while the kids ran around. Its just too hard, she said. This has ruined my life! Two years without sleeping through the night! Two years with hot flashes! Two years with no energy.

Id had no idea. I asked why she hadnt told me before.

I hate talking about menopause, she said. Its like saying youve closed up shop as a sexual being. Its embarrassing.

Aside from the embarrassment, we are getting less help than we should from our doctors. A 2013 Johns Hopkins survey found that only one in five American obstetrics and gynaecology residents had received formal training in menopause medicine. Thats 20% of gynaecologists. Forget about general practitioners.

As it turns out, the reason Gen X women have grown up believing that hormone replacement therapy again, one of the only proven treatments for menopausal symptoms is dangerous is something that happened in the medical community in 2002.

Its like saying that youve closed up shop as a sexual being

In 1993, as the menopause was becoming a hot topic, the Womens Health Initiative (WHI), a national, long-term study on the possible benefits of hormone treatment for postmenopausal women, was launched in the US. But, in July 2002, the premature termination of the oestrogen-progesterone part of the study was announced. The reason given was an apparent rise in the risk of coronary heart disease, stroke, blood clots and breast cancer.

There was a hitch in this: WHI had been looking at what the hormones did in women aged 50 to 79. The aim was to figure out if this type of hormone treatment could help protect these women from heart disease and other illnesses. It was not about short-term hormone therapy for treatment of symptoms in women in their 40s and 50s. But many midlife women heard only cancer and went off HRT immediately.

Dr Wulf Utian, founder of the Nams, wrote an editorial calling the manner in which the study was ended poorly planned, abrupt and inhumane. In 2017, Professor Robert D Langer, one of the original WHI investigators, said that errors in the 2002 report led to a lot of unnecessary suffering for women.

However, this has done little to calm the fears of hormone therapy among women, and even doctors. 9 July 2002 was the day the music died for menopausal women, said Dr Mary Jane Minkin of Yale, one of the nations leading experts on gynaecological health. One of the things that was very bad about it was that no one was given advance notice this report was coming out. There was also a journalistic cock-up. A WHI investigator gave the story to the Detroit Free Press on the grounds that it was an embargoed study due to appear the following week in the Journal of the American Medical Association. The Detroit Free Press broke the embargo.

Thats how Good Morning America got the story. Everybody went insane, she continued. In that week, every American woman went to her cabinet and took out her hormone prescription and flushed it down the toilet. Which, of course, was ridiculous, because the WHI Part One was the only study that was stopped at that point. That was the oestrogen plus progesterone. The oestrogen-only went on for another two years. It eventually showed a decreased risk of breast cancer, not an increased risk of breast cancer.

People of Generation X tend to be demanding, and theyre having all these things happen to them. Why? asked Dr Minkin. Whats going on? Theyre being told: Just ignore it; its going to get better, or You can take an SSRI [antidepressant], which will help your hot flashes though, yeah, its going to make you love sex less and get fat. Your options are not too fabulous, but they dont know how to handle hormonal therapy, because they think its going to give you breast cancer. The other part of the problem is that you have such authoritative spokespeople as Dr Kim Kardashian, Dr Suzanne Somers, Dr Oprah Winfrey, Dr Gwyneth Paltrow

Dr Minkin does not believe women should grin and bear it. Here is some of her advice for us: get daily exercise, especially weight-bearing exercise; a good diet; plenty of sleep. For hot flashes, she advises layering clothes and keeping a dry set of nightclothes next to the bed so you can change quickly if you wake up in the night. She recommends keeping the bedroom cool and getting your partner an electric blanket if he or she complains.

Other non-pill things can make life easier, too, like absorbent period-proof underwear and period tracker apps. She advises many women to consider oestrogen and progesterone hormone therapy (or just oestrogen, if youve had a hysterectomy), in the form of pills, patches, gels, or sprays, though its important to do so only under the direction of a doctor, because there are risks.

Low doses of an SSRI or SNRI antidepressant can combat hot flashes, as can gabapentin (Neurontin). For heavy or irregular periods, Dr Minkin says you can take a birth control pill or get a progesterone IUD called Mirena. When it comes to herbs and supplements like evening primrose oil or bee pollen, theres no proven benefit, though some women say that those things make them feel better.

Sifting through all the advice is hard, especially because it can seem to change with every new headline. In her history of hormones, Aroused, Randi Hutter Epstein writes: Those of us old enough to be in menopause cant help but wonder if the experts are going to change their minds again.

In her 2019 memoir, Deep Creek, Pam Houston gives a younger woman this advice: Im just saying, I guess, theres another version, after this version, to look forward to. Because of wisdom or hormones or just enough years going by. If you live long enough you quit chasing the things that hurt you; you eventually learn to hear the sound of your own voice.

Perimenopause may last months or years; it may be more or less drastic; but one day it will be over. On the other side, well be different perhaps more focused on whats most important to us and almost certainly calmer. Psychotherapist Amy Jordan Jones told me: This is the time of life when we learn we dont have to be pleasing; the work now is just to become more ourselves.

This is an extract from Why We Cant Sleep: Womens New Midlife Crisis by Ada Calhoun, published by Grove Press UK on 5 March. Order it for 12.59 at guardianbookshop.com

Originally posted here:
Surviving perimenopause: I was overwhelmed and full of rage. Why was I so badly prepared? - The Guardian

The Fulton County Health Department has scheduled the following health clinics and services.

CANTON The Fulton County Health Department has scheduled the following health clinics and services. Please call the number listed with each service for an appointment or more information.

Maternal child health: Health screenings, WIC nutrition education and supplemental food coupons for women, infants and children. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria clinic appointments call 329-2922.

Canton - Clinic - Monday, March 2 - 8-4 - Appt needed

Canton - WIC Nutrition Education - Tuesday, March 3 - 8-4 - Appt needed

Canton - Clinic/Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Clinic/Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Astoria - Clinic, WIC Nutrition Educ. - Wednesday, March 4 - 9-3 - Appt needed

Canton - Clinic - Thursday, March 5 - 8-4 - Appt needed

Adult Health Immunizations: Various vaccines are available. There is a fee for immunization administration. Medicaid cards are accepted. To make an appointment or for more information call 647-1134 (ext. 254).

Canton - Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Other times available by special arrangement at Canton, Cuba and Astoria.

Blood Lead Screening: Blood lead screenings are available for children ages one to six years. A fee is based on income. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria appointments call 329-2922.

Canton - Clinic - Wednesday, March 4 - 8-4 - Appt needed

Family Planning: Confidential family planning services are available by appointment at the Canton office for families and males of child-bearing age. Services provided include physical exams, pap smears, sexually transmitted disease testing, contraceptive methods, pregnancy testing, education and counseling. Services are available to individuals of all income levels. Fees are based on a sliding fee scale with services provided at no charge to many clients. Medicaid and many insurances are accepted. After hours appointments are available. To make an appointment or for more information call the 647-1134 (ext. 244). *Program funding includes a grant from the US DHHS Title X.

Pregnancy testing: Confidential urine pregnancy testing is available at the Canton and Astoria offices. This service is available to females of all income levels. A nominal fee is charged. No appointment is needed. A first morning urine specimen should be collected for optimal testing and brought to the health department. Services are provided on a walk-in basis on the following days each week:

Canton: Every Wednesday & Thursday, 8-3:30 (for more information call 647-1134 ext. 244)

Astoria: Every Wednesday, 9-2:30 (for more information call 329-2922)

Womens Health: A womens clinic for pap tests, clinical breast examinations and vaginal examinations is available by appointment. There is a nominal fee for this service. Medicaid cards are accepted. Financial assistance is available for a mammogram. Cardiovascular screenings may be available to age and income eligible women. To make an appointment or for more information call 647-1134 (ext. 244).

Mammograms: Age and income eligible women may receive mammograms at no charge. Speakers are available to provide information to clubs and organizations. For more information or to apply for financial assistance, call 647-1134 (ext. 254).

Mens Health: Prostate specific antigen (PSA) blood tests are available for men for a fee. To make an appointment or for more information call 647-1134 (ext. 224).

Sexually Transmitted Disease (STD) Clinic: Confidential STD and HIV testing services are available by appointment to males and females at the Canton office. Services include physical exams to identify STDs, a variety of STD testing, HIV testing, education, counseling, medications and condoms. There is a nominal fee for services. Services are available to individuals of all income levels. Medicaid cards are accepted. To make an appointment or for more information call 746-1134 (ext. 224).

HIV Testing and Counseling: Confidential HIV testing and counseling services are available by appointment through the sexually transmitted disease (STD) clinic at the Canton office. To make an appointment or for more information call 647-1134 (ext. 224).

Tuberculosis (TB) Testing: TB skin tests are available at no charge by appointment. To make an appointment or for more information call 647-1134 (ext. 254).

Blood Pressure Screenings: The Fulton County Health Department provides blood pressure screenings at no charge on a walk-in basis during the following times:

Astoria - Screening - Wednesday, March 4 - 9-12 - Walk in

Health Watch Wellness Program: The Health Watch Program provides low cost lab services. Through this program adults can obtain venous blood draws for a variety of blood tests. Blood tests offered without a doctors order Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), Lipid Panel, Prostate Specific Antigen (PSA) test, Hepatitis C test, and Thyroid Stimulating Hormone (TSH). A wide variety of blood tests are also available with a doctors order. There is a charge at the time of service. To make an appointment or for more information call 647-1134 (ext. 254).

Dental Services: The Dental Center offers a variety of basic dental services to children and adults. An appointment is needed. Medicaid and Kid Care cards are accepted. To make an appointment or for more information call 647-1134 (ext. 292).

View original post here:
Health Department announces services for the week of March 2 - Canton Daily Ledger

February 2020

Are you looking for a health care provider who offers innovative alternatives and a customized approach to your health issues? Indiana Regenerative Medicine Institute (IRMI) believes in offering specialized alternatives to health care. Its medical team, headed by Doctor of Chiropractic Preston Peachee, utilizes the latest developments in regenerative medicine, hormone replacement and pain management.

Dr. Peachee is a native of Jasper, Indiana. He graduatedfrom Logan College of Chiropractic and has been in practice since 2003. Hisareas of specialty include patients with chronic and severe back, neck andjoint pain as well as other complex neurological conditions.

Dr. Peachee has earned a reputation as an innovative thinkeras well as a compassionate practitioner who brings his wide expertise andexperience to the Greater Indianapolis area. His ability to help those in needof regenerative medicine, neuropathy pain relief, low testosterone or otherphysical ailments, such as back pain or fibromyalgia, makes him not only uniquebut highly sought-after.

A key member of the IRMI team is Leann Emery, FNP. Emery isa family nurse practitioner with more than 20 years of experience in hormonereplacement and alternative pain management. Emery provides optimal patientcare through personal consultations and assessments to identify her patientsspecific health needs. She was rated in the top 10% of providers in the U.S.with patient satisfaction.

Regenerative medicine is making huge leaps in our understanding of the human body, and it is offering real, possible treatments that would have seemed like science fiction a few short years ago, according to IRMI. Most patients we see have tried other more traditional treatments and have either not gotten any better or have gotten even worse. Unfortunately, a lot of people we see depend on multiple medications per day to try and function but still are not happy with how they feel or how they live their lives. It is unfortunately the nature of deteriorating and degenerative joints, they will get worse with time, and generally the pain increases as well.

Depending on the injury, Dr. Peachee will often combinelaser therapy with the regenerative medicine protocols to improve the outcomesand try and speed the recovery process.

We offer mesenchymal stem cell therapy, Dr. Peachee said. With the combination of laser therapy, mesenchymal stem cell therapy is incredibly effective for rotator cuff problems and treating knee pain. Eighty percent of our stem patients are dealing with knee pain or Osteoarthritis. Osteoarthritis-or O.A. of the knee- is a huge problem for a lot of people, and we get great results from these therapies. Most people can even avoidknee surgery.

Dr. Peachee recently introduced hormone treatments for low testosterone. Family Nurse Practitioner Leann Emery has been doing [hormone] treatments for 20 years, and that area of medicine became a natural fit for IRMI.

I have several patients who were seeking this type ofcaremany who are police officers and firefighterswho couldnt find thetherapy and individualized care and attention that they needed.

Dr. Peachee explained that low T treatments help patients with unique and even complicated cases of Erectile Dysfunction (E.D.). Most people seek us out for treatment because they are tired, worn out, stressed out and just simply lack the energy they used to have.

We are able to fill a niche with patients who hadcomplicated cases that were not responding well with their primary careproviders or other places, Dr. Peachee shared. We have a patient who hasstruggled for a long time with fertility issues but has done very well [withtreatments], and we just got good news that he and his wife are expecting aftertrying for a really long time. So, he is really enthused about that.

The typical candidates for low T treatments, according toDr. Peachee, are men who feel worn out, are lethargic and have lost theirzest for life.

Our patients dont have the same pep that they had 10 or20 years ago, Dr. Peachee stated. They struggle getting up in the morning andmight be struggling in the afternoon after having six cups of coffee or threeRed Bulls just to get through the day. We have a lot of people that want to getback into the gym and get the maximum benefit of their workouts. We can helpthem improve their overall health and energy so that they can enjoyrecreational activities like working out or practice with the Little Leaguewith their kids. Many times we hear from spouses, friends and family how muchbetter they feel and that they seem happier and get more out of life again.

It goes without saying that proper hormonal balance canimprove a patients personal relationships as well and improve the overallmental health of a patient by reducing stress, anxiety and depression oftencaused by symptoms related to low testosterone levels.

We focus on injectable [low T] treatments because we canmodify the dosage and give more frequent doses to keep our patients at a levelthats going to give them the maximum benefit and improvement for theirconditions, Dr. Peachee explained.

With the modern changes in medicine over the last 20 and 50years, were helping people to live a lot longer and adding 20 to 30 years totheir lives, but we have not given them an improved quality of life as theyage. By working with their hormones and getting them in balance, their qualityof life becomes way better, and were seeing a positive improvement for manypeople with these treatments.

Patients suffering from severe disc injuries, such a bulgingor herniated disc or discs, or who suffer from degenerative disc disease mayhave undergone treatment from chiropractors or have seen physical therapistsbefore coming to Indiana Regenerative Medicine Institute.

Our typical patient who comes in for this type of treatmenthas seen other therapists or chiropractors but hasnt found lasting relief,Dr. Peachee said. Many of our patients want to get off the rollercoaster ofopioids and pain medications. They are looking for a solution without narcoticsand risk of addiction or other possible negative side effects of narcoticsand/or surgery. We are generally able to alleviate the pain in 90% of patientsand are able to keep them from having surgery or from taking addictivemedications.

Laser therapy allows Dr. Peachee to work on the damaged tissue so that it can heal, and the method reduces inflammation and swelling in a way that traditional treatments cannot.

Its an innovative new therapy within the last decade thatallows us to do some amazing things, Dr. Peachee stated. We perform ourprocedures in our office and have several different devices for the specificneeds and issues of our patients. For instance, we have a unique device forpeople with knee pain that can help the majority of our patients walk betterand live more pain-free. We get a phenomenal outcome with this procedure.

One of the other major differentiators that sets IndianaRegenerative Medicine Institute apart from other offices and clinics is thatthey are advocates for their patients, especially when it comes to dealing withtheir patients insurance providers.

A lot of our low T patients are able to get their insurancecarriers to cover the services so that it doesnt cost them as much out ofpocket for the care they seek, Dr. Peachee said. Weve partnered with abilling company that has helped us to be able to navigate the craziness of ourmodern insurance companies, and by doing so, were able to keep the cost downfor a lot of patients. Not every insurance plan will cover this type of care,but a lot of them will. When its possible and ethical, we do whatever we canto benefit our patients to help keep the cost low. I have spent a lot of freetime writing letters on behalf of our patients. We go above and beyond with ourservice and care of our patients.

The Indiana Regenerative Medicine Institute team will make housecalls or come to a patients place of work when the situation calls for thatlevel of care.

We will go and draw blood for blood work, bring medications and even do exams in some situations, Dr. Peachee said. As I mentioned before, we see a lot of police officers and firemen all over the statefrom Mishawaka to South Bend and all over Indiana. We go once a month to see these patients at their departments and stations so that we see them all in one day versus making 10 to 15 guys drive hours to come in to see us. Its a service we can offer because we are a small clinic and we are focused on that one-on-one patient attention and relationship building. We have great relationships with our patients, and thats something that we work very hard at.

Building trust and transparency is crucial to the success ofhis practice, Dr. Peachee emphasized. The trust that we build with ourpatients is crucial to not only the success of the practice but to thepatients outcomes. And not just with hormone therapy but also with ournonsurgical spinal decompression patients. These are patients with significant discinjuries, and we need them to tell us everything we need to know so we can givemore accurate and complete care for a better outcome.

I would say to anybody if you have any doubts or reservations to take some of the burden and some of the anxiety out of the equation and schedule an initial consultationabsolutely free of charge, Dr. Peachee encouraged.

Dont put off living your best life any longer. Visit Indiana Regenerative Medicine Institutes website at indianaregen.com or call (317) 653-4503 for more information about its services and specialized treatments and schedule your free consultationtoday!

Writer:

Janelle Morrison

Photography:

Laura Arick and submitted

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Indiana Regenerative Medicine Institute Offers Innovative Approaches in Regenerative Medicine, Hormone Replacement and Pain Management - Zionsville...

WEST PALM BEACH, Florida Women who have no history of a full-term pregnancy show an earlier onset of progressive multiple sclerosis (MS) compared with those who have had pregnancies, and the apparent onset-delaying effect appears to increase with the number of pregnancies, new research suggests.

The results add to speculation on the effects of pregnancy in MS.

"Our results suggest that a higher number of full-term pregnancies than average is associated with later onset of progressive MS, while having no full-term pregnancies is associated with significantly younger age at progressive MS onset," first author Burcu Zeydan, MD, an assistant professor of radiology in the Center for MS and Autoimmune Neurology at the Mayo Clinic in Rochester, Minnesota, told Medscape Medical News.

The study was presented here at the 5th annual Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2020.

The findings, which also link early menopause with faster disease progression, offer important insights into the broader effects of pregnancy on MS, commented ACTRIMS president Jeffrey A. Cohen, MD, who is the director of Experimental Therapeutics at the Mellen Center for MS Treatment and Research, Cleveland Clinic, Ohio.

"We know pregnancy affects the short term disease activity relapses tend to quiet down during pregnancy but what has been somewhat conflicting is whether it affects the long-term prognosis or is just a temporary effect," he told Medscape Medical News.

"So that is the main interest in this study, and it does indicate that pregnancy affects the long-term prognosis and provides some insight into the mechanism by which it might do that."

While being female is in fact considered the most important risk factor for MS susceptibility, pregnancy has been suggested to have a protective role in disease progression. However, more research is needed on the nature of the effect and its mechanisms.

For this study, Zeydan and colleagues evaluated data on 202 patients (134 women, 68 men) with MS who were part of a Mayo Clinic survey.

They found that women who had no full-term pregnancies (n = 32), had an earlier onset of progressive MS (mean age 41.4 12.6 years) compared with women giving birth to one or more children (n = 95; 47.1 9.7 years; P = .012).

In addition, the mean age of progressive MS onset increased with a dose-effect trend according to the number of full pregnancies (no children, 41.4 12.6 years; 1-3 children: 46.4 9.2 years; 4 or more children: 52.6 12.9 years; P = .002).

A look at a subgroup of patients with secondary progressive MS also showed an earlier mean age of onset among women who had no full pregnancies(n = 19; 41.5 9.2 years) compared with women who had one or more full pregnancies (n = 57; 47.3 10.6 years; P = .049).

The later disease onset associated with pregnancy was also seen in relapsing-remitting MS: Mean age of onset was earlier women with no pregnancies (27.5 7.0 years) compared with those with one or more children (33.0 9.4 years;P = .021).

The mean duration of time from relapsing-remitting MS to secondary progressive MS was also shorter among women with premature or early menopause (n = 26; 12.9 9.0 years) compared with those who had menopause at a normal age (n = 39; 17.8 10.3 years).

The pattern was similar for women experiencing the onset of secondary progressive MS after menopause, with a shorter progression among those with early menopause (P = .012).

The trends of later onset with more pregnancies was also observed with the mean age of onset of secondary progressive MS (no full pregnancies: onset at 41.5 9.2 years; 1-3 pregnancies: onset 46.2 9.9 years; 4 or more pregnancies: onset 52.6 12.9 years; P = .010).

And likewise, the later mean age of onset of relapsing-remitting MS was seen with additional pregnancies (no full pregnancies: 27.5 7.0 years; 1-3 pregnancies: 32.4 9.3 years; 4 or more pregnancies: 35.8 9.8 years;P = .012).

"The dose effect was clearly a surprise (having no full-term pregnancies vs 1-3 vs 4 or more)," Zeydan said.

"In addition to the significant difference between having no vs 1 or more full-term pregnancies, the clear dose-effect consolidates our results related to the association between the number of pregnancies and age at progressive MS onset."

The study also showed that women with premature or early menopause had a shorter duration of progression from relapsing-remitting MS to secondary progressive MS (n = 26; 12.9 9.0 years) compared with women who experienced menopause at a normal age (n = 39; 17.8 10.3 years).

The patterns in early menopause are consistent with previous observations regarding menopause and MS progression, Cohen said.

"When women go through menopause, estradiol and pregnancy-related factors further decline and we know this coincides temporally with the development of progressive MS in women," he noted.

Compared with men, women with premature or early menopause furthermore had a longer duration from relapsing-remitting MS to secondary progressive MS (P = .008), and women with secondary progressive MS also had also had an earlier age of relapsing-remitting MS onset than men (P = .018).

The mechanisms of pregnancy could include a complex interaction between estrogen and factors such as astrocyte and microglia function, Zeydan explained.

"Estrogen, through various mechanisms of eliminating toxicity of highly activated neurons including preventing pro-inflammatory molecule release, supporting mitochondria function thereby eliminating energy failure, and promoting remyelination helps neuronal plasticity and delays neurodegeneration, which is closely related to the progressive phase of MS," she said.

"One could easily make the probable association, while yet to be proven, that our findings may relate to these mechanisms," Zeydan said.

The logical question of whether hormone replacement or some type of therapy that could mimic the effects of pregnancy could also benefit in delaying MS onset remain to be seen, Zeydan said.

"While we believe that is possible, particularly for delaying the onset of progressive phase, definitive evidence is lacking at this time," Zeydan said. "However, our study ultimately may lead to such a trial."

In the meantime, the findings provide additional insights that may be beneficial in sharing with patients regarding pregnancy, she said.

"As the contemporary problem in MS care is to delay or prevent progressive MS onset, our findings may suggest that how we counsel women with MS who are planning to get pregnant, or contemplating surgically induced menopause, or how we consider hormone therapies during perimenopause, may impact the course of their disease."

Zeydan cautions, however, that "our findings do not confirm causality beyond an association."

"More studies are needed in this important issue in a disease that affects women three times more than men," she stressed.

Zeydan has disclosed no relevant financial relationships. Cohen reports personal compensation for consulting for Adamas, Convelo, MedDay, Mylan, and Population Council; and serving as an editor of Multiple Sclerosis Journal.

Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2020: Abstract P135. Presented February 27, 2020.

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In the predawn darkness, you can see an eerie red glow shining from the windows of the Hudson, Wisconsin, home of Thaddeus Owen and his fiance, Heidi Sime.

The couple are awake, having slept in their Faraday cage a canopy over their bed that blocks electromagnetic fields like the Wi-Fi signals or radiation from cellphone towers, which they believe are harmful.

Their primal sleeping environment also has special pads under the bed that are supposed to mimic the effect of sleeping on the ground under the influence of the Earths magnetic field, thus combating Magnetic Field Deficiency Syndrome.

Their house is bathed in red light because they think white incandescent, LED and fluorescent lighting robs them of sleep-regulating melatonin hormones. They wear special sunglasses indoors for the same reason, blocking the blue light from computers, cellphones or televisions when its dark outside.

Their morning routine includes yoga in a shielded, infrared sauna designed to create an EMF-free ancestral space, and putting tiny spoonfuls of bitter white powders under their tongues. These are nootropics, so-called smart drugs, which are supposed to improve focus, mood or memory.

When day breaks, they go out in their yard and face the rising sun Thaddeus in shorts and no shirt, Heidi in a sports bra and yoga pants doing Qigong in the snow and 25-degree air.

Getting early-morning sunlight, they believe, will correctly set the circadian rhythm of their bodies. Exposing their skin to the freezing temperatures, they hope, will help release human growth hormone, stimulate their immune system and trigger the body to burn fat to heat itself.

Forget Blue Zones. This is what your morning looks like if youre biohacking your way to an optimal you.

DIY HUMAN ENGINEERING

Biohacking is a DIY biology movement that started in Silicon Valley by people who want to boost productivity and human performance and engineer away aging and ordinary life spans. Think of it as high-tech tinkering, but instead of trying to create a better phone, biohackers are trying to upgrade to a faster, smarter, longer lasting, enhanced version of themselves.

Owen, 44, describes it as a journey of self-experimentation, using practices that are not talked about by mainstream media and your family doctor. His aim is to combine the latest technology and science with ancient knowledge to modify his environment, inside and out.

My entire goal is to basically age in reverse, he said.

Owen, who is from New York, studied chemical engineering in college. He worked for Procter & Gamble, helping to create beauty care products, and for pharmaceutical firms, developing manufacturing processes.

Now he works from home, managing worldwide product regulations in the sustainability department for office furniture company Herman Miller. But he moonlights as a biohacking guru.

He started a Twin Cities biohacking Meetup group that organizes weekly cold-water immersions at Cedar Lake in Minneapolis. Hes given a TEDx talk urging audience members to wear blue-light-blocking glasses indoors at night.

He founded the website primalhacker.com and he and the 45-year-old Sime (who also goes by the name Tomorrow) run a website called thaddeustomorrow.com, where they market biohacking products like red light panels, a baby blanket that blocks EMF radiation and a $5,499 Faraday cage sauna thats the same type used by Twitter founder Jack Dorsey.

Owen said he relies on tons of research to support avoiding blue light at night and the healing properties of the early morning sun.

WHATS THE DEAL WITH BLUE LIGHT?

The Harvard Health Letter, for example, said that blue light from devices, LED and compact fluorescent bulbs can throw off the bodys circadian rhythm, affect sleep and might contribute to cancer, diabetes, heart disease and obesity. Some studies have shown that exposing people to cold temperatures burns calories and repeated cold-water immersions might stimulate the immune system.

And those infrared saunas? They dont appear to be harmful and maybe they do some good, according to Dr. Brent Bauer, an internal medicine expert at the Mayo Clinic.

But being healthy really doesnt need to be that complicated, according to Dr. Michael Joyner, a human performance specialist at the Mayo Clinic.

All these things sound great, Joyner said of the biohacks. Theres a ring of what I call bioplausibility to them.

But Joyner said its often hard to find evidence that biohacking practices actually work and that most Americans would be healthier if they just followed basic advice: go for a walk, dont smoke, dont drink too much and dont eat too much.

But Owens goal is not to be merely healthy.

I want my biology to be shifted to that supernormal range, where Im optimally healthy, he said.

When he started biohacking about 12 years ago, Owens goal was to improve his sleep. As a competitive athlete, he was fit, but he had problems with anxiety and insomnia.

So he started wearing special glasses to block blue light. His co-workers used to think he was odd. Now Owens company is asking him for advice on what kind of lighting should be used in work settings to keep employees healthy. And his sleep and anxiety problems have gone away.

I went from being the weird guy to being consulted, he said.

We all sort of watch what he does, said Gabe Wing, director of sustainability at Herman Miller and Owens boss. Wing said Owen has influenced some co-workers to try blue-light-blocking tools.

When Owen first got into it, he didnt know of any other biohackers in the Twin Cities. Now there are more than 500 people in the Biohackers Twin Cities Meetup group.

Although many biohacks seem odd now, Owen is convinced that some of them will become common practices.

This whole blue light thing, its not going away, he said. More research comes out every day and its becoming more mainstream.

Owen and Sime have five of their children, ages 8 to 17, living with them. The kids wear blue-light-blocking glasses when they watch TV, but theyre OK with it, the couple said.

I think cellphone radiation is going to be the new lead, asbestos and smoking, said Owen, who turns his Wi-Fi off at night, keeps his cellphone in a special Faraday pouch when he sleeps and sometimes wears radiation-proof underwear.

(The National Institute of Environmental Health Sciences says scientific evidence has not conclusively linked cellphone use with any adverse human health problems, although scientists admit more research is needed.)

Owen eats what he describes as a local, seasonal diet: local vegetables, fruits, nuts and honey during the growing season. Thats followed by a high-fat, low-carb ketogenic diet in late fall and early winter. Then an all-carnivore diet in late winter, including animals hes raised at a friends farm.

Owen doesnt have a particular longevity goal, unlike biohacker and Bulletproof Coffee founder Dave Asprey, who has said he wants to live to at least 180.

Owen just wants to be healthy and independent for as long as he lives.

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Can red lights, sleep cages and ice baths really extend life spans? - yoursun.com

Annual Health Fair to be held March 5 from 8 a.m. to 6 p.m. in the Pond Student Union Ballroom

POCATELLO Continuing a 30-year tradition, the Idaho State University Health Fair will provide education and activities designed to help anyone with the goal of improving their health and quality of life. Among the highlights for 2020 are live food demonstrations, educational health and wellness information booths staffed by ISU students and staff, and free or reduced-cost health screenings.

The 2020 ISU Health Fair will take place from 8 a.m. to 6 p.m. March 5 at the ISU Pond Student Union and will showcase Kasiska Division of Health Sciences (KDHS) clinics. KDHS faculty and students will offerfree health screening services, including blood pressure screenings, point-of-service diabetes screening tests (blood glucose [sugar] and A1c), foot exams, dental screenings, hearing screenings and medication reviews.

Services available at the KDHS Clinics health-screening event are as follows:

After visiting the screening stations, attendees can talk with a health action plan team that includes ISU dietetic faculty and students to answer nutrition and lifestyle questions. ISU clinic personnel, KDHS faculty and students, and Health West ISU care coordinators can review screening results and provide recommendations for follow-up appointments.

As always, the 2020 ISU Health Fair will offer learning centers, educational booths, and displays from ISU programs and community businesses.

Food demonstrations will be offered throughout the day by ISU nutrition and dietetic students:

9 a.m.: Smoothies

10:30 a.m.: Energy bites

Noon: Heart-healthy and diabetes-friendly lunch sampler

1:30 p.m.: Easy salsa with tortilla chips

3 p.m.: Veggies with hummus or Greek yogurt dip

As in previous years, discounted laboratory services will also be available throughout the month of February and at the Health Fair, this year offered by Portneuf Medical Center. Blood screenings at the ISU Health Fair are always offered at reduced rates. Attendees can have all of the following tests performed:

Other blood screening tests are available. Individuals interested in having screening tests done can either have their blood drawn during the month of February at Portneuf Medical Center or the day of ISU Health Fair. Participants do not need to be fasting to have their blood drawn. Blood draws are available all day from 8 a.m. -to 6 p.m. during the ISU Health Fair.

Pre-Health Fair blood draws are available Feb. 1 through March 4 at the Portneuf Medical Center Laboratory Services, Monday through Friday from 7 a.m. to 6 p.m. and Saturday and Sunday from 7 a.m. to 1 p.m.

Results for blood work drawn at Portneuf Medical Center Laboratory Services by March 1 will be available for pick-up and review at the ISU Health Fair and can be reviewed by a KDHS faculty or Health West Health Action Plan team member.

Post-Health Fair blood draws are available March 6 through March 15 at the Portneuf Medical Center Laboratory Services, Monday through Friday from 7 a.m. to 6 p.m. and Saturday and Sunday from 7 a.m. to 1 p.m.

Event parking is free in the Pond Student Union parking lot during the time of the ISU Health Fair. Additionally, a free shuttle service will be available from the Holt Arena to the Pond Student Union to allow for additional parking. The last shuttle leaves the Pond Student Union at 5:40 p.m.

For more information, visitISU Health Fair.

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Health screenings, individualized health plans, education, food and demonstrations to highlight 2020 Idaho State University Health Fair - Idaho State...

I can do a lot of things: I can finish any quote from Brooklyn Nine-Nine, I can spend four hours in a TJ Maxx and be endlessly entertained, and I can recite all of Hasan Minhajs Homecoming King from memory.

What I cant do is sleep.

More specifically, I cant fall asleep.

Most of the sleep problems that college students have and by extension, me can be traced back to a delayed circadian rhythm.

A circadian rhythm is our body's internal clock. Its what causes us to feel sleepy and energized at roughly the same times every day, regulating our levels of alertness with the time of day. A delayed rhythm is when your internal clock shifts ahead a couple of hours.

Dr. Vishesh Kapur, UWs director of sleep medicine, says this shift results in increased alertness late at night and a subsequent inability to fall asleep.

According to the Mayo Clinic, adults require between seven and nine hours of sleep per night. Most college students fall short of this requirement and end up building a sleep debt.

Sleep debt is exactly what it sounds like: sleep deprivation compounds on a nightly basis, resulting in longer-term sleep problems.

A student who only gets five to six hours of sleep per night is already around 10 hours in debt by the end of the week. To make up for this, we tend to sleep in on weekends, but even those extra couple of hours arent enough to make up for the week.

While hitting this target sleep goal isnt always easy, there are things you can do to help yourself get close.

For one, a consistent sleep schedule is key.

A nightly routine is a good way to maintain consistency. Whether it's watching an episode (or eight) of whatever it is that youre binging or relaxing with a face mask, doing it every day before sleeping will help you build a positive association between your routine and sleep.

Next, disengage. Turn off your phone, turn off your brain. Stop checking those emails; theyll be there in the morning.

This process of disconnecting lets your brain relax and avoid things that cause anxiety, which can impede sleep.

There is another part of sleep hygiene that is using the bed just for sleep, Kapur said.

This comes down to your brains psychological association with your bed. Studying or reading in bed creates a link in your brain between wakefulness and the bed.

If you spend more time in bed than you need, you spend more time awake in bed, Kapur said. And so, the association gets worse.

Instead of being tired when you get into bed, your brain might use that as a cue to wake up.

Alcohol right before bed can suppress some stages of sleep like REM sleep, which is required for memory consolidation. Alcohol also causes you to wake up in the middle of the night as it metabolizes.

While alcohol does not directly cause sleep apnea, research has shown that habitual drinkers are at a higher risk for developing the disorder.

So, what actually causes you to fall asleep?

Melatonin is the hormone that regulates your circadian rhythm. It is produced in response to darkness and helps maintain your sleep cycle. Melatonin supplements are available over-the-counter and can help with sleep disorders or even recovering after jet lag.

As the worlds leading sleep struggler, Ive grappled with the idea of taking melatonin for quite some time.

A lot of people use melatonin as a sleep aid, independent of changing the timing of their sleep, Kapur said. The danger there is that people end up on [a] high dose.

Instead of relying on melatonin to fall asleep, Kapur recommends taking it in low doses a couple of hours before you intend on falling asleep to help shift a delayed circadian rhythm and move you to an earlier bedtime.

It should be noted that depression, anxiety, and other mood disorders can often cause insomnia. Those conditions should be primarily addressed before adding treatment for insomnia itself.

Overall, most healthy sleep habits involve cutting things out as opposed to actively adopting new habits. Even so, sleeping is hard.

In an insane world, trying to turn your brain off and relaxing isnt as simple as putting your phone away, but its a step.

Reach Science Editor Ash Shah at wellness@dailyuw.com. Twitter: @itsashshah

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A crash course: The do's and don'ts of dozing - Dailyuw

Image: Pancreatic adenocarcinoma (left) vs. normal ductal epithelium (right). Credit:Ed Uthman,CC BY 2.0

By the time a pancreatic tumour begins to cause symptoms, it is usually pretty advanced, since many of the tumours are silent.

Dr Anguraj Sadanandam, a team leader in the Division of Molecular Pathologyat The Institute of Cancer Research, works on two types of pancreatic tumours: neuroendocrine tumours and adenocarcinomas.

Neuroendocrine tumours are exceptionally rare, making up just one to three per cent of all pancreatic cancers.

There are two types of pancreatic neuroendocrine tumour functional and non-functional. Functional tumours are tumours which produce hormones, which means theyre more likely to produce noticeable symptoms.

The majority of pancreatic neuroendocrine tumours, however, are non-functional, meaning they dont produce any hormones. These tumours grow silently, and without hormone production, they usually dont produce symptoms until they have advanced to a large size.

At this point, the tumours are usually inoperable, and treatment options are limited to palliative care.

In fact, pancreatic tumours are often diagnosed only when they have spread to other organs, and begin to cause symptoms there. Some 60% of patients diagnosed with non-functional pancreatic cancer have metastases at diagnosis half of these in the liver.

Diversity causes difficulty in clinical practice so says Dr Anguraj Sadanandam.

He recently published a reviewon the molecular biology of pancreatic neuroendocrine tumours.

There is a clear unmet need when it comes to pancreatic neuroendocrine cancer we know that patients diagnosed with pancreatic tumours are not seeing the same improvements in treatment that we see for other cancer types.

Our researchers are dedicated to tackling cancers that continue to have very poor survival rates such as pancreatic cancer.

Find out more

Pancreatic neuroendocrine tumours are divided into grades by the World Health Organisation based on features of the cells that are common when we look down the microscope.

When cells divide, they make a complete copy of all of their chromosomes.

Under ordinary circumstances, a cell keeps all of its genetic material wound up and compact inside of the nucleus the control centre of the cell. In order to divide, the cell unwinds all of its chromosomes and unzips them to make copies.

By using special staining, scientists are able to assess how many cells have visible chromosomes. Visible chromosomes give a good indication that the cell is in the middle of dividing.

If lots of cells show signs of being in the middle of dividing, scientists can get an indication of how fast the tumour is growing and how aggressive it is. More cells making copies means more growth and a highly aggressive tumour.

Combining this information about cell division with other visible changes to cells results in pancreatic tumours being divided into three grades.

Grade 1 tumours have the best prognosis patients have a median overall survival of 12 years with this type of tumour.

Median overall survival refers to the length of time from either the date of diagnosis or the start of treatment for a disease that half of patients in a group are still alive.

Grade 3 tumours have the worst prognosis, with a median overall survival of just 10 months.

Roy Bowdery was diagnosed with pancreatic cancer in April 2014 following a prolonged period of pain in his stomach and back.

His pancreatic cancer was an adenocarcinoma these cancers have different biology from neuroendocrine tumours, but survival compared to other more common cancers is also relatively poor.

Although one-year survival rates for pancreatic cancers have been improving in recent years, there hasnt been much of an improvement in five and 10-year survival rates since the 1970s.

Despite repeated trips to his local GP, it took several weeks before Roy was sent for a CT scan as part of a local bowel cancer screening programme, and it was only then that doctors discovered the tumour on his pancreas.

Fortunately, Roy qualified for the Whipple procedure a 10-hour surgery to remove thelower half of the stomach, duodenum, gall bladder, bile duct and the head of the pancreas.

This was followed up with six months of chemotherapy.

Roy now lives cancer-free, but goes for check ups every six months. He knows he's one of the lucky few. One in four people die within the first month of diagnosis and only 1 per cent of patients survive 10 years.

"Pancreatic cancer is a really brutal type of cancer," Roy explains. "It's the most fatal of all common cancers. I've just gone over the five year mark, and now my aim is to get into the one per cent."

Since his diagnosis, Roy has been actively campaigning to change the journey for others in the future.

"The figures haven't improved in my five years, and they haven't even improved in the last 40 years. There needs to be more research, and there needs to be a quick, easy diagnostic test to catch the cancer early, so more people get a chance at surgery and get a chance to survive.

We are now poised to outsmart cancer with the worlds first anti-evolution 'Darwinian' drug discovery programme, in which we will focus on understanding, anticipating and overcoming cancer evolution, and preventing drug resistance.

Find out more

Although the World Health Organisations grading of tumours is useful in that they give some indication of prognosis, there are substantial differences in tumours within the same grade, and this makes personalised treatment for these tumours hugely challenging.

Dr Sadanandam published a major paper five years ago which divided pancreatic neuroendocrine tumours into molecular subtypes.

The study recreated pancreatic cancer in mice, and together with data from human cancers the researchers were able to classify the tumours in three different ways.

Untangling the complexities of the cancer and categorising the tumours can help when it comes to making decisions about treatment - the aim is always to personalise treatment as much as possible for the specific tumour and the specific patient in front of you.

In other types of cancer, recent research has drastically improved our ability to give a precision diagnosis to each patient, which not only improves the accuracy of the information we can give to a patient about how their cancer is likely to progress, but also allows clinicians to pick the best possible treatments.

For example, recent research from the ICRshowed that testing men for faults in DNA repair genes in their tumours could identify those most likely to respond to a new type of search-and-destroy treatment.

The treatment seeks out a particular molecule called PSMA (prostate-specific membrane antigen) on the surface of prostate cancer cells and uses a radioactive particle to kill the cells.

This type of approach - finding something unique to a particular cancer type, identifying it and targeting treatments against it is the next big challenge when it comes to pancreatic cancer.

Dr Sadanandam explains:

There is a clear unmet clinical need for novel prognostic and predictive biomarkers to complement the World Health Organisations grading system.

We need more detailed information with which we can categorise tumours to guide us in determining overall survival rates and to support individualised treatment decisions for patients.

In order to bring pancreatic cancers to a level playing field with other cancers, research focusing on comparisons is key.

By examining the similarities pancreatic cancers have to other types of cancer, scientists can begin to unravel the specific cell changes that make the tumours so aggressive and difficult to pin down.

In order to bring pancreatic cancers to a level playing field other cancers, research focusing on comparisons is key. Thats an approach Dr Sadanandam is taking in an ongoing study which is comparing the similarities pancreatic and other cancers have to colon cancers.

By classifying and reclassifying cancers into different subtypes, the problem becomes easier to tackle like categorising your belongings before tackling a big spring clean.

Other ICR researchers are taking the same approach Professor Chris Lord, Deputy Head of the Division of Breast Cancer Researchat the ICR works with PrecisionPanc, a research platform which has collaborators from across the cancer research spectrum.

They are translating basic scientific discoveries into the clinic by looking at the genetics of pancreatic cancers, and developing biomarkers which help doctors understand the roadmap of a patients cancer. They are also working hard to develop new treatments to tackle the tumours.

There is a long way to go before the playing field is leveled, but further research will pave the way for smarter, kinder treatments.

Excerpt from:
Squaring up to silent tumours: the research burden of pancreatic cancer - The Institute of Cancer Research

Frank Lawlis possesses a deep Texas drawl, one that makes the now-iconic intonation of Dr. Phil McGraw his decades-long friend and business associate seem almost city-slicker by comparison. His down-home voice, along with the bolo ties, pale eyes and unkempt white hair, are a comfort to the clients who travel to his private practice from all over the country in the hope that he can help mend minds even those minds that other doctors cannot.

The Lawlis Peavey PsychoNeuroPlasticity Center, in suburban Lewisville north of Dallas, primarily caters, by his estimate, to troubled adolescents as well as people decades older "who've never been able to launch themselves," he says. A battery of tests, including brain mapping, is administered in an attempt to pinpoint the problem during a two-day visit. Only a diagnosis is provided in exchange for the $9,295 fee, not treatment.

The Lewisville center is where Lawlis screens select Dr. Phil guests as well as many clients who've found their way through the door because they watch the CBS-syndicated daytime show. It's also where, in between rooms devoted to a hyperbaric chamber and a sensory deprivation compartment, Lawlis takes his seat in a remote studio for his regular Dr. Phil segments.

Lawlis, 79, holds an influential position as chief content adviser to McGraw. Drawing more than 3 million viewers each weekday, Dr. Phil has been the No. 1 syndicated talk show by a healthy margin, ahead of competitors like Ellen and Live With Kelly and Ryan, since Oprah Winfrey left broadcast TV in 2011. McGraw, who has branded himself as an authoritative voice on the nation's public health issues, made an estimated $95 million in 2019, according to Forbes, and received a star on the Walk of Fame on Feb. 21.

Without the platform of Dr. Phil, Lawlis, who espouses ideas and treatments considered controversial and even dangerous by the mainstream medical community, might be a figure on the margins of public health. But his ability to directly impact the show's guests, and inform its massive audience, makes him a figure of consequence.

Dr. Phil viewers recognize Lawlis from his frequent appearances as a designated expert on the show, during which McGraw treats Lawlis with notable respect, often introducing him as one the foremost authors or experts on whatever subject he's conferring on. (Lawlis was McGraw's Ph.D. adviser decades ago.) Beamed in from Texas and donning a white coat, Lawlis weighs in on everything from opioid dependency to autism. In a 2017 segment focused on Chase, a 19-year-old man who claimed his life had spiraled out of control after a marijuana-induced panic attack, McGraw said he was sending him to the Lewisville clinic to get a "scan of your brain." Lawlis, who ventured that "we also might have a feature of PTSD" to explore, explained that techniques "that work very quickly" would be utilized that "will help resolve him back to where he was before." Hearing the news back in Los Angeles on the Paramount lot, Chase and his family dissolved into hugs and tears as the crowd applauded.

While the talking-head segments are Lawlis' most visible contribution to the show, more important is his behind-the-scenes input, acting as the guru's guru. In coordination with producers, Lawlis vets would-be guests with psychological problems, consults with McGraw on how to advise them during their segments (despite his famed honorific, McGraw holds no license to practice medicine), examines the thorniest cases at his Texas clinic and helps coordinate treatment at favored rehab facilities. "There's probably not a show that goes on the air that doesn't have Dr. Lawlis' feedback," explains Dr. Barbara Peavey, Lawlis' private practice partner. Lawlis also has weighed in on McGraw's congressional testimony the TV host has been invited to Capitol Hill to speak about mental health and advised on his best-selling books.

Lawlis derives multiple income streams from his work with Dr. Phil as an adviser to the show, as a proprietor of the clinic where additional services are performed on selected guests, and as a consultant to the rehab facility where many are later treated. (Guests themselves are not paid to appear on Dr. Phil.)

Even apart from his work with McGraw, Lawlis boasts an eclectic rsum. His sojourns have included heading a prayer healing foundation in Santa Fe for cancer patients, running a Silicon Valley institute dedicated to the study of transpersonal psychology mystical experiences, spiritual crises, altered states of consciousness and consulting on a mental wellness program pertaining to employee overwork in Japan for a division of Toyota. For the past two decades, he's worked part-time, designing exams as the testing director for the American branch of the international high-IQ society Mensa. (He's never applied to become a member: "I don't think it makes ethical sense that I take the test that I already know about.") There he sees the effect of Big Pharma a perceived nemesis through much of his work observing that the organization has been grappling with doping among applicants: "Adderall is a big one."

Lawlis sees himself as an anti-establishment maverick. He fondly recalls the Dallas Police raiding a pain group he once ran at an area hospital circa 1980, during which as an experiment in pain relief he passed around a peace pipe whose tobacco included willow bark and sage. The authorities wanted to arrest him on a marijuana charge. "But three of the participants were actually cops, so it was dropped," he says. "The [hospital] administration said never to do it again."

In another incident at a medical facility in Fort Worth, Texas, he constructed a saltwater floatation tank for patient use that soon leaked into the cardiac intensive care unit below. "It turned out to be one of the best things that ever happened," Lawlis remembers. "I walked in, expecting to be fired, and the chief of staff said, 'Frank, don't make anything! If you want something made, we'll do it for you!' He did and it was beautiful." Lawlis shrugs, amused. "I'm always looking over my shoulder, afraid of going to prison."

Lawlis, who's from a small West Texas town, contends his lifelong contrarianism was set in motion by a pair of character-establishing childhood experiences. By his account, he was "born dead," or at least his folks told him so growing up: Because of birthing complications involving pain medication, he'd been oxygen deprived and brain damaged. "This notion existed in my family from that point on even when I got my Ph.D.," he says. "I had tremendous problems in school. Now it could be explained in other ways, like ADHD."

The other defining feature shadowing his youth was his mother's chronic ill health, largely gastric and arthritic in scope, which required more than two dozen operations. "As a kid, I lost faith in Western medicine," Lawlis says. "I had the insight that many of my mother's problems were psychological. My father [a pharmacist turned pharmaceutical sales representative] wanted me to be a doctor. But seeing the failure for her in terms of pills and surgery, I wanted to be somebody who could help through behavior."

Lawlis, inspired in part by The Eleventh Hour, a 1960s NBC medical drama about psychiatry, compares his chosen vocation to a secular ministry and has taught at several schools, including the University of North Texas, where he met McGraw. His future boss stood out to Lawlis from his pupil's first day in his doctoral-level class in advanced personality. "There were about 12 people in there, and all of them were writing notes down like crazy except him," Lawlis says. "He was looking at me like he already knew it. We would have conversations, and he did know it. I made a decision that he was either the dumbest guy or the smartest guy I've ever dealt with."

The pair grew close, bonding over their mutual pasts as college football players and their hobbyists' joy in piloting small planes. In the decades that followed, before national prominence on Dr. Phil, they teamed on business ventures, including a never-launched set of seminars for physicians.

Later, when McGraw had set up his litigation services firm Courtroom Sciences, which inspired the CBS drama Bull, his mentor was regularly contracted out as an expert witness in personal injury cases. "I would testify as to what money [the plaintiff] would've made as opposed to how much money he's capable of now," Lawlis says.

Since Dr. Phil's 2002 debut, McGraw has faced criticism over his credibility. He's taken it all in stride. During a segment on the Late Show With David Letterman the following year, he pulled out a list of epithets (including "half-baked quack") the host had called him and good-naturedly read them on-air. In 2017, medical news outlet STAT and The Boston Globe published an investigation into the alleged exploitation of Dr. Phil guests with addiction problems, asserting some had been allowed easy access to alcohol and drugs in immediate advance of showtime. Martin Greenberg, a psychologist who serves as Dr. Phil's director of professional affairs, denied the claims. Previously, McGraw found himself fighting a yearslong class-action lawsuit involving the psychotherapist customers of a service called the LearnDrPhil Network. The litigation claimed the service had, in exchange for their participation in the program, dangled referrals from the large pool of Dr. Phil viewers. Lawlis was part of the endeavor and named as a defendant in the case, which was settled in 2009. Lawlis says now of the service, "That's gone away."

McGraw's engagement with celebrity mental health issues also has drawn criticism. Britney Spears' parents said he violated their trust after he publicly spoke about a private visit with the troubled pop singer in 2008. Eight years later, a heavily promoted November sweeps episode of Dr. Phil focused on a disoriented Shelley Duvall. Mia Farrow and Ron Perlman called it exploitative. Lawlis stands by the program. "You can't script what a person says, and sometimes the guests are their worst enemies. We don't exploit a person's problems," he says. "I always think we can do better, but I think we do a better job than anybody else has ever done with the types of things we deal with."

***

About 20 Dr. Phil guests cycle through the PsychoNeuroPlasticity Center each season. Its website notes it helps clients with ADHD, autism, mood disorders, OCD, PTSD and other challenges. "I can tell you that for the majority [of visitors]," Peavey explains, "it's 'I've heard about you through Dr. Phil.' "

Peavey, who was once Lawlis' student and now handles the administrative end of their partnership, says multiple show guests have confided that they initially contacted Dr. Phil with the specific intent to secure an expenses-covered visit to the Texas clinic. (Insurers may also cover a portion of the price tag.)

The customized screening includes a variety of diagnostic tests, among them the use of a medical instrument designed by Lawlis and his son, an electrical engineer, called the Bio-Acoustical Utilization Device, or BAUD. It emits calibrated sounds in each ear think of drumming rhythms with the intended benefit of influencing brain function. In 2006, the FDA granted Lawlis permission to use and sell the BAUD "for relaxation training and muscle reeducation and prescription use." Lawlis, meanwhile, characterizes the BAUD as a panacea for a variety of health problems. "A person comes in with PTSD and you give him the BAUD and after 30 minutes it goes away," he claims.

In 2014, the Texas State Board of Examiners of Psychologists disciplined Lawlis and Peavey for the same offense: Allowing one of their staffers, who was not licensed, to provide psychological services under their watch for more than a year. More recently, according to the agency's records, Peavey was reprimanded for having signed an employee application to practice psychology in the state "that contained inaccurate and false information." Peavey is prohibited until August from "providing any supervision of psychological services provided by another person."

Lawlis was unwilling to substantively address his history with the Texas State Board. Peavey didn't clarify either.

In addition to his partnership stake at the Texas clinic, Lawlis is a salaried consultant at Los Angeles-based Creative Care, an inpatient rehabilitation center that specializes in dual diagnosis cases (the overlap of substance abuse and mental illness) and is one of fewer than two dozen "Dr. Phil Preferred" facilities in the country, meaning it's received his on-air seal of approval and is listed on the show's website resource page. Show guests often receive treatment there, their cost covered by the program. In return, Dr. Phil publicizes Creative Care on-air, an arrangement that drives nearly a third of its admissions, according to the rehab. The facility treats 300 people each year. Between two and four Dr. Phil guests, who have often already visited Lawlis' Texas assessment center, are in treatment at Creative Care during the show's season at any given time.

Creative Care has operated for three decades in Malibu, pioneering the region's so-called Rehab Riviera alongside Promises. Its facility on a 40-acre property just up the road from Broad Beach was wiped out by the Woolsey Fire in November 2018, so the center has temporarily resettled to a series of adjacent houses in Woodland Hills, where it can treat up to 24 clients. Lawlis visits for several days each month and works daily by email and phone.

Around the time of the fire, Dr. Farrah Khaleghi, the 30-year-old, recently credentialed psychologist daughter of Creative Care's husband-and-wife co-founders, was appointed its clinical director. "Dr. Lawlis calls me 'the phoenix,' " she explains during a visit to the facility in October. "I wanted to fine-tune all of our program elements. We survived. Let's use this opportunity for a rebirth." Though her parents have had an affiliation with Lawlis and Dr. Phil for more than 15 years, Khaleghi has leaned into Lawlis' methods to put her own stamp on the program a majority of the facility's clients now utilize some component of Lawlis' "Neuroplasticity Transformation Program," which includes use of a sensory deprivation chamber designed to his specifications.

The chamber is a heated waterbed in which clients, cloaked in darkness, speak to their therapist or listen to music. Close to half of those in treatment at Creative Care also make use of the BAUD: "It's an extra layer of support," says Khaleghi. "For our population that's so acute, with really serious mental health and addiction issues, the more tools the better."

By Khaleghi's account, her staff's use of Lawlis' techniques as a complement to the overall treatment regimen has been helpful in convincing clients not to self-discharge during their first month in residence, a common challenge for inpatient rehabs. "Sometimes people that really struggle with nervous system agitation itchy people that are always kind of fidgety neuroplasticity is a way to regulate them, to settle them down so they're not acting out as much and leaving," she says. "The first three or four weeks are super-vulnerable and this is soothing."

Khaleghi notes that the clients often find Lawlis' methods appealing because they're a departure from prescription treatment. "It's not invasive, it's not 'artificial,' it's really present-focused and organic," she says.

Creative Care has its own troubles, past and present. In 2012, the California Senate Office of Oversight and Outcomes produced a report, "Rogue Rehabs," about how the state "failed to police drug and alcohol homes, with deadly results." Creative Care was a key case study. The report noted that the facility had "offered medical care, contrary to state law, for 10 years."

In December, after THR's visit, California's Department of Health Care Services suspended its license following two client deaths. According to the Los Angeles County coroner's office, on Feb. 16, 2019, a 54-year-old woman died by suicide on-site, and on July 4, a 26-year-old man died of a fentanyl overdose. (A representative for Dr. Phil says that neither was a show guest.) "We have no comment," Khaleghi wrote by email when asked about these developments.

Lawlis and McGraw have recently cut ties with Creative Care, and the rehab has scrubbed its website of Dr. Phil material at the TV host's request. "Phil doesn't want anybody to think that he sent anybody to a program that has had its license suspended," Lawlis explains.

McGraw who declined to participate in this story wouldn't say why the facility had long persisted as a preferred provider of care despite its public record. He also wouldn't elaborate on Dr. Phil's vetting process for the treatment facilities it directs its guests and viewers toward.

A CBS spokesperson for the program did, however, provide a statement. "The platform provides the opportunity for guests to connect with and avail themselves to a variety of health care providers, including individual therapy, outpatient and inpatient facilities," it reads. "In doing so, guests meet with the resource representatives and decide for themselves if they choose to participate or not. By forming working relationships with hundreds of quality professionals and facilities, it is expected that these independent resources comply with the laws and regulations of their governing licensing or regulatory agencies. Upon being notified of alleged activity that raises significant regulatory concerns regarding any of these resources, the working relationship is terminated until the matter has been resolved within the rules and guidelines governing state agency or board."

***

Lawlis is strikingly confidentabout the BAUD, comparing his breakthroughs to Charles Goodyear's discovery of vulcanized rubber. By his account, 86 patients were treated by 19 therapists in a study he conducted, and "all were significantly improved, with most having no more symptoms in three sessions or less," he wrote in his 2015 book Psychoneuroplasticity Protocols for Addictions. (He's published more than a dozen books on various subjects.)

Yet despite such an impressive suggested outcome, other researchers have since ignored the device. This is because, Lawlis acknowledges, his own study was never accepted for publication. "Credibility is an issue," he says.

Lawlis who has been published in peer-reviewed outlets like Spine and the Journal of Psychosomatic Research blames conflict-of-interest policies for his inability to gain scientific traction for the BAUD. "I can't get it through a review committee," he says. "They say, 'I'm sorry, you have a self-interest in this. That's a problem.' "

Dr. Stephen Barrett, a psychiatrist and peer-review panelist for several top medical journals, has been skeptical of the BAUD for years, listing it as a questionable medical instrument on his anti-fraud watchdog website, Device Watch. "Conflict of interest isn't a legitimate reason not to be published," he says. "If the study is appropriate, journals simply disclose the conflict. The more likely reason he hasn't been published is that his research hasn't been adequate."

Lawlis contends the BAUD is useful for addressing not just PTSD but drug addiction, ADHD, depression, anxiety, phobia and pain. Barrett believes this transgresses the FDA's allowance, observing in particular that use for depression could be dangerous. "If the device is not effective, and you represent that it treats depression, you may be dealing with people who have the potential for suicide," he says.

Lawlis and Peavey have other views that counter prevailing accepted science. They question childhood immunization scheduling standards that have been established by the federal Centers for Disease Control and Prevention. "My theory is that if the child is still dealing with the mother's immune system," ventures Lawlis, "maybe in some instances the vaccines confuse the whole immune system. But if you wait a little longer, where you have more of a balanced person that can incorporate it, that might be the solution." The pair also express unease about what they perceive as the pernicious effects of mercury in vaccines, principally the MMR inoculation (scientific consensus has determined it's safe), believing such shots may be responsible for some of the problems their clients face.

Lawlis' belief that mercury may, as he put it in his 2010 book, The Autism Answer, induce "a cascade of poor auto-immune reactions which produce autistic behaviors," has led him to advocate for an unproven application of chelation therapy, a detoxification process in which heavy metals and minerals are removed from the body. The FDA has approved chelation therapy for heavy metal toxicity, such as lead poisoning, but warns against unapproved use for autism disorders.

Dr. Kelly Johnson-Arbor, a toxicology expert and co-head of the National Capital Poison Center in Washington, D.C., is alarmed. "Putting aside that the idea that vaccines cause autism has been widely discredited, this treatment approach is both unreliable and may even have negative effects," she says, noting that chelation also can have the deleterious consequence of extracting nutrients, from electrolytes to potassium. "There is no medical basis for it."

While Peavey speaks of chelation as an active component of the Texas practice, Lawlis claims "we have not used it for the last three or four years at all."

Lawlis ventures other arguable contentions as well. In 2008's Retraining the Brain (which McGraw blurbed, touting "groundbreaking techniques that can dramatically improve our lives"), he connects exposure to TV and video games after the age of 7 to ADD diagnosis. "The dust that comes from the heat shields and sound-proofing in the back of color television sets has been shown to have very negative effects on hormone levels and disruption of cognitive abilities," he writes. When asked about the evidence, he responds: "Well, let me just say this. I'm not at liberty to reveal the sources. But it has to do with some people I know in Washington that have been studying these waveforms, especially that come from cellphones and other sources."

***

At a Tex-Mex restaurant north of Dallas, Lawlis sweepingly dismisses the legitimacy of double-blind studies, the placebo-controlled, randomized trials that are a cornerstone of medical research. He argues that humans are too complex to provide a true control group. Regardless, "I read through the journals and they're not making any headway," anyway. "If you read the [studies'] titles, it's amazing how stupid the findings are: 'Children From Conflictual Families Don't Do Well.' " He goes on, "We haven't learned a goddamn thing from that particular approach."

Lawlis' wife, Dr. Susan Franks, a neuropsychologist on the faculty at the Texas College of Osteopathic Medicine in Fort Worth, contextualizes his view. "Where he gets frustrated is, because the double-blind trial puts everything in a box, how do you start moving out of the box?" she says. "How does science advance? He's just so outside the box. He's bringing in concepts and integrating everything and coming up with creative approaches."

As a contrast, Franks points to herself and other academic subspecialists. They're "very focused on the science and the numbers, and we're not the most creative people." She adds, "the data can't show everything."

Dr. Nina Shapiro, an extensively published UCLA surgeon and author of Hype: A Doctor's Guide to Medical Myths, Exaggerated Claims and Bad Advice, takes issue with the couple's outlook. "It's predatory on people who are desperate, on people who are seeking some sort of 'alternative,' " she says. "If you're someone with charisma and a following, it's enticing to a captive audience. But it's sad."

Lawlis' latest book, Healing Rhythms to Reset Wellness, will be published in April. He wrote it last year following "an a-ha moment when I was studying string theory and, at the same time, I was reading about Egypt's ancient medicine." The treatise, which underscores his break from the strictures of hard science "double-blind research," he writes, "doesn't take into account how human healing happens" contends that treating illness is about balancing circadian rhythms. "The reason we get sick," Lawlis says, "is that we get out of tune with our rhythms."

McGraw penned the book's foreword. "He offers works of magnitude, not frivolity, not pop psychology, not trends," he writes of his mentor, going on to extol their half-century relationship. "In everything he does, Dr. Lawlis' impact has been profound."

Email Gary Baum at gary.baum@thr.com.

This story first appeared in the Feb. 26 issue of The Hollywood Reporter magazine. Click here to subscribe.

Excerpt from:
The Controversial Therapist Shaping Dr. Phil - Hollywood Reporter

Image source: The Motley Fool.

Viking Therapeutics Inc(NASDAQ:VKTX)Q42019 Earnings CallFeb 26, 2020, 4:30 p.m. ET

Operator

Good day, and welcome to the Viking Therapeutics Fourth Quarter 2019 and Year-End Conference Call. [Operator Instructions]

I would now like to turn the conference over to Stephanie Diaz, Investor Relations. Please go ahead.

Stephanie C. Diaz -- President and Chief Executive Officer

Hello, and thank you all for participating in today's call. Joining me today is Brian Lian, Viking's President and CEO; and Greg Zante, Senior Vice President of Finance.

Before we begin, I'd like to caution that comments made during this conference call today, February 26, 2020, will contain forward-looking statements within the meaning of the Securities Act of 1933 concerning the current beliefs of the Company, which involves a number of assumptions, risks and uncertainties. Actual results could differ from these statements, and the Company undertakes no obligation to revise or update any statement made today. I encourage you to review all of the Company's filings with the Securities and Exchange Commission concerning these and other matters.

I'll now turn the call over to Brian Lian for his initial comments. Brian?

Brian Lian -- President and Chief Executive Officer

Thanks, Stephanie, and thanks to everyone listening on the webcast or by phone. Today we'll provide an overview of our fourth quarter and year-end 2019 financial results as well as an update on recent progress and developments related to our pipeline programs and operations. 2019 was a year of tremendous progress at Viking, building on the momentum that follows the successful outcomes of our completed clinical studies.

With respect to our lead program VK2809, our novel thyroid receptor beta agonist, we completed the important work required to support a Phase 2b study in patients with biopsy-confirmed NASH. And we are pleased to announce in November, the initiation of this important study. With respect to VK0214, our second thyroid receptor beta agonist, our efforts during 2019 focused on continuing the IND enabling work required to commence clinical studies of this molecule and we expect to file an IND for this program in the first half of this year.

I will provide additional detail on our development activities in a few minutes. But first, we'd like to review our fourth quarter and year end financial results. For that, I'll turn the call over to Greg Zante, Viking's Senior Vice President of Finance. Greg?

Greg Zante -- Senior Vice President of Finance.

Thanks, Brian. In conjunction with my comments, I'd like to recommend that participants refer to Viking's Form 10-K filing with the Securities and Exchange Commission, which we filed after the market close today for additional detail.

I'll first go over our financial results for the fourth quarter ended December 31, 2019. Our research and development expenses for the three-months ended December 31, 2019 were $6.5 million compared to $5.1 million for the same period in 2018. The increase was primarily due to increased expenses related to clinical studies with the initiation of the Phase 2b VOYAGE study during the quarter and manufacturing for our drug candidates, partially offset by decreased expenses related to our pre-clinical studies and services provided by third-party consultants. Our general and administrative expenses for the three months ended December 31, 2019 were $2.4 million compared to $1.9 million for the same period in 2018. The increase was primarily due to increased expenses related to stock-based compensation and professional fees.

For the three months ended December 31, 2019, Viking reported a net loss of $7.5 million, or $0.10 per share, compared to a net loss of $5.2 million, or $0.07 per share, in the corresponding period in 2018. The increase in net loss and net loss per share for the three months ended December 31, 2019 was primarily due to increased research and development and general and administrative expenses noted previously, as well as decreased interest income due to the decline in interest rates throughout 2019 as compared to prevailing interest rates during the fourth quarter of 2018.

Research and development expenses for the 12-months ended December 31, 2019 were $23.6 million compared to $19 million for the same period in 2018. The increase was primarily due to increased expenses related to manufacturing for our drug candidates, clinical studies, services provided by third-party consultants and salaries and benefits, partially offset by decreased expenses related to pre-clinical studies.

General and administrative expenses for the 12-months ended December 31, 2019 were $9.1 million compared to $7.1 million for the same period in 2018. The increase was primarily due to increased expenses related to stock-based compensation, services provided by third-party consultants, corporate insurance, legal and patent expenses and professional fees.

For the 12-months ended December 31, 2019, Viking reported a net loss of $25.8 million, or $0.36 per share compared to a net loss of $22.1 million, or $0.38 per share in the corresponding period in 2018. The increase in net loss for the 12-months ended December 31, 2019 was primarily due to increased research and development and general and administrative expenses as noted previously, partially offset by increased interest income as well as the elimination of expenses related to the change in fair value of the debt conversion feature liability due to the repayment of the Ligand, noted May 2018. The decrease in net loss per share for the 12-months ended December 31, 2019 was primarily driven by the additional weighted average shares outstanding at December 31, 2019 versus those outstanding at December 31, 2018, given the public equity financings that occurred during 2018.

Turning to the balance sheet. At December 31, 2019, Viking held cash, cash equivalents and short-term investments totaling $275.6 million and had 72,413,602 shares of common stock outstanding.

This concludes my financial review and I'll now turn the call back over to Brian.

Brian Lian -- President and Chief Executive Officer

Thanks, Greg. I'll now provide an update on recent progress and activity with our lead program VK2809. As a reminder, VK2809 is an orally available small molecule agonist of the thyroid hormone receptor that possesses selectivity for liver tissue as well as the beta receptor subtype suggesting promising therapeutic potential in a range of metabolic disorders including NASH. In September, 2018, we announced positive results from a 12-week Phase 2 trial of VK2809 in patients with hypercholesterolemia and non-alcoholic fatty liver disease. As we previously discussed, this trial successfully achieved both its primary and secondary endpoints, demonstrating potent reductions in liver fat content as well as improvements in plasma lipid measures. As a brief reminder patients receiving VK2809 experienced median relative reduction in liver fat ranging from 54% to approximately 60%, compared with approximately 9% for placebo.

The proportion of patients experiencing at least a 30% relative reduction in liver fat range from 77% to 100% with the overall average of 88%, compared with 17% for placebo patients. In addition, 70% of patients receiving VK2809 experienced at least a 50% relative reduction in liver fat content compared to baseline. VK2809 also produced significant reductions in plasma lipids, including LDL-cholesterol, triglycerides and atherogenic proteins such as apolipoprotein B and lipoprotein (a). This lipid lowering profile is a novel feature of thyroid receptor beta activation, and is a particular interest in the setting of NASH as it may suggest long-term cardiovascular benefit.

In addition to the impressive efficacy observed, VK2809 has also demonstrated an encouraging safety and tolerability profile. In the Phase 2 study, no serious adverse events were reported among patients receiving VK2809 or placebo and the overall numbers of adverse events were relatively evenly distributed across treatment arms. We believe VK2809's potent liver specific effects combined with the safety, tolerability and potential cardiovascular benefits, that is a part from competitive programs targeting NASH. And we are very pleased to advance this compound into a Phase 2b study in patients with biopsy-confirmed NASH. In preparation for this study, in 2019, we completed several additional clinical and pre-clinical evaluations of VK2809 to enable us to file a new IND with the FDA's Division of Gastroenterology and Inborn Errors Products. As a reminder, a new IND required because the prior IND was directed toward hyperlipidemia and was active in the division of metabolic and endocrine products. However, the GI division is where most NASH IND applications are reviewed.

In preparation for the NASH IND, during 2019, we completed several new studies in addition to the 12-week Phase 2 study I described a moment ago. These included a Phase 1 study to evaluate the safety, tolerability and pharmacokinetics of VK2809 when co-administered with atorvastatin. The results of this study confirmed previously reported data, demonstrating no meaningful interaction between VK2809 and with atorvastatin. We also conducted the Phase 1 study to evaluate the safety, tolerability and pharmacokinetics of VK2809 dosed in an every other day regimen. These data confirmed previously reported results, demonstrating that VK2809 possesses a predictable and consistent PK profile.

We also conducted a Phase 1 study to evaluate the safety, tolerability pharmacokinetics and pharmacodynamics of VK2809 under various dosing regimens. These data demonstrated that alternative dosing regimens may also produced improvements in measures of plasma lipids. And finally, we completed toxicity studies of 26 and 52 weeks in duration to support chronic dosing in humans. The results of this and prior work formed the basis of the new IND that was filed with the GI division. Following the IND filing in November, we announced the initiation of a Phase 2b study of VK2809 in patients with NASH. We've named this study as the VOYAGE study and we're excited to have it under way.

The VOYAGE study is a randomized, double-blind, placebo-controlled, multicenter trial designed to efficacy, safety and tolerability of VK2809 in patients with biopsy-confirmed NASH and fibrosis. The study will target enrollment of approximately 340 patients across five treatment arms, including 1 milligram daily; 2.5 milligrams daily; 5 milligrams every other day; 10 milligram every other day; and placebo. The target population includes patients with F2 and F3 fibrosis as well as up to 25% with F1 fibrosis. F1 patients must also possess additional risk factors to be eligible for enrollment. The primary endpoint of the study will evaluate the relative change in liver fat content, as assessed by magnetic resonance imaging, proton density fat fraction from baseline to week 12 in subjects treated with VK2809, as compared to placebo. Secondary objectives include evaluation of histologic changes assessed by hepatic biopsy after 52 weeks of dosing. We are currently dosing patients at clinical sites in the U.S. and expect to open additional sites outside the U.S. later this year.

In addition to commencing the VOYAGE study, in the fourth quarter, we submitted an abstract describing additional data from the prior 12 -week Phase 2 study of VK2809 for presentation at the annual meeting of the European Association for the Study of the Liver, or EASL. We were recently informed that this abstract has been selected for an oral presentation on April 17. We look forward to sharing these additional data at that time. Given the positive results from the previous Phase 2 trial and the supplemental data generated in multiple studies during 2019, we continue to believe that VK2809 demonstrates a compelling efficacy and safety profile with the potential to provide benefit to the millions of patients worldwide suffering from NASH. We look forward to sharing additional updates on VK2809 and the voyage study as the trial progresses.

I'll now provide an update on our VK0214 program. VK0214 is being evaluated as a potential treatment for X-linked adrenoleukodystrophy, or X-ALD. X-ALD is a devastating disease for which there is no approved treatment. The disease is caused by a defect in a peroxisomal transporter called ABCD1. This defect can result in an accumulation of very long-chain fatty acids in plasma and tissue and it is these elevated very long-chain fatty acid levels that are believed to contribute to the severe cerebral and motor neuron toxicities that are characteristic of the disease. The thyroid beta receptor is an important potential target for therapeutic intervention in X-ALD because it is believed to play a role in very long-chain fatty acid metabolism.

Like VK2809, VK0214 is an orally available small molecule bioreceptor agonist that possesses selectivity for the beta receptor subtype. To-date, results from in vitro and in vivo studies have demonstrated that administration of VK0214 results in a significant increase in the expression of the compensatory transporter, which is believed to result in a reduction of very long-chain fatty acids in both plasma and tissue. Given these promising results we believe VK0214 may provide benefit to patients with X-ALD and we are eager to move this program into the clinic. We are currently conducting IND enabling work for VK0214 and we expect to file the IND in the first half of this year, followed by initiation of a proof-of-concept study in humans.

With our two lead programs advancing in clinical development, we continue to carefully manage our balance sheet. As Greg reported earlier, we ended 2019 with approximately $275 million in cash and equivalents. We believe these resources provide ample runway to reach multiple clinical inflection points with both VK2809 and VK0214.

In closing, I'd like to reiterate that the important work completed in 2019 was critical to pave the way for realizing the potential of both VK2809 and VK0214. For VK2809, the compelling data generated in both 2018 and 2019 validate our belief that it is one of the most promising candidates in development today for the treatment of NASH. And we are excited to be advancing it through the clinic. We look forward to continue the enrollment in our Phase 2b VOYAGE study. With respect to VK0214, we continue working toward completion of the IND enabling studies that will allow us to initiate a proof-of-concept study in humans. It is our goal to file this IND during the first half of the year. Finally, our balance sheet remains strong, providing the resources to execute through multiple value-creating events.

This concludes our prepared comments for today. Thanks again for joining us. And I'd now like to open the call for questions. Operator.

Operator

Thank you. We will now begin the question-and-answer session. [Operator Instructions] Our first question today will come from Joon Lee of SunTrust. Please go ahead.

Joon Lee -- SunTrust -- Analyst

Hi. Thanks for taking my questions, and congrats on getting the podium presentation for 2809 at EASL. In addition to the additional data from the Phase 2 novel study, will you also be sharing additional pre-clinical tox data as well? And can you tell us where you are in submitting the full tox data to cover the entire 12 months? Is that imminent or has it already been submitted? And I have one more follow-up. Thank you.

Brian Lian -- President and Chief Executive Officer

Hey, Joon. Yes, thanks for the questions. No, as part of the presentation at EASL, we won't be disclosing any of the the toxicity studies that were completed in animals. The submission of the full 12 month dataset is imminent and yes, it's very near term, I'd say, all the reports are completed there are just -- undergoing final QC proofing.

Joon Lee -- SunTrust -- Analyst

Great. And can you tell us a little bit about the design of the X-ALD proof-of-concept study? What that would look like and what you would hope to learn from that initial study? Thank you.

Brian Lian -- President and Chief Executive Officer

Yes, no, great question. So the -- it's sort of a two-tiered clinical study, the first portion will target healthy volunteers in this is called the stacked design where you begin single ascending dose study in healthy volunteers and during that you begin dosing multiple saying dose study also in healthy volunteers in during that, then you begin enrolling patients with X-ALD. We would target a 28-day treatment window and look at very long-chain fatty acid changes after 28 days. And with those data then, if they are encouraging, we would then speak with the FDA about what the next steps might look like. But that would be the proof-of-concept.

Joon Lee -- SunTrust -- Analyst

And when do we hope to get the top line? If at all, on the initial study?

Brian Lian -- President and Chief Executive Officer

Yes, I would say, the most likely window for that is probably going to be first half of '21. I mean it's not impossible that it would be available later this year, but I would say first half of '21 is a safe bet.

Joon Lee -- SunTrust -- Analyst

Great. Thank you very much.

Brian Lian -- President and Chief Executive Officer

Okay, thanks.

Operator

Our next question will come from Steve Seedhouse of Raymond James. Please go ahead.

Steve Seedhouse -- Raymond James -- Analyst

Hi, good afternoon. My question is on one theme that's come up in the NASH deals in a couple recent Phase 2 studies and also at some of the recent meetings. And that is, I was hoping you could clarify generally what the biopsy reading protocol is for the Phase 2b study for example, how are biopsy is blinded or scrambled to the reading pathologist? How many pathologist are there? And are you going to be rereading baseline biopsies at the end of the study? Or does the screening biopsy kind of serve as the time zero comparator? Thanks.

Brian Lian -- President and Chief Executive Officer

Yes. Thanks, Steve. It's a great and complex question. I don't have the answer for all of the parts of it. We are using one pathologist, that person will be reviewing the baseline and end of treatment biopsy. We will not be reshuffling and reassessing the baseline at a later date. And I think that's about all I know on the logistics of the biopsy read procedure, but we're not going to send it out multiple people or reshuffle and do that sort of thing.

Steve Seedhouse -- Raymond James -- Analyst

Okay. Those details are already helpful actually, given the variant service between studies. So thank you for that. The other thing I just wanted to ask in terms of the enrollment for the Phase 2b study. Are you willing to say, kind of what inning you're in there or roughly how long you think it will take you to fully enroll the study?

Brian Lian -- President and Chief Executive Officer

Yes, I think it's early to say, it's the early innings via one way to answer that. But that's -- we're still in the in the ramp-up process opening sites and we are -- I think moving along according to schedule there. We will be adding 12 to 15 sites outside the U.S. and those are expected to come online in the second quarter. And it's a little early to give guidance on completion of enrollment. I certainly expect it to be in 2020 but tightening from there, I don't -- it's hard to do right now.

Steve Seedhouse -- Raymond James -- Analyst

Okay. I appreciate it. Thanks for taking the questions. I look forward to see any additional data at EASL.

Brian Lian -- President and Chief Executive Officer

Thanks, Steve.

Operator

Our next question will come from Derek Archila of Stifel. Please go ahead.

Bill Grau -- Stifel -- Analyst

Hi. Bill, on for Derek. Congrats on the progress in 2019. So first from us, can you just speak to, sort of what other biomarkers you're evaluating in the study? And then what -- which of those biomarkers you'll read out at the same time as the MRI-PDFF?

Brian Lian -- President and Chief Executive Officer

Yes. So we're looking at the health panel, we're looking at Proceed 3, we're looking at TIMP 1 and several others, I don't have that full list in front of me. And I'm not sure yet, it will read out all of that with the 12-week data, sometimes those take a little longer to -- different labs are doing those evaluations that might take a little bit longer to receive, but we'll play it by a year there. But there is a whole panel of other biomarkers, we're looking at.

Bill Grau -- Stifel -- Analyst

Great. And then can you brief -- just really briefly describe the differences between 0214 and 2809?

Brian Lian -- President and Chief Executive Officer

Yes. Yes, different structures. So, 0214 has a slightly different substitution pattern on one of the aromatic rings and as a result, it has a slightly better beta selectivity and the PD profile was just a little bit different. We always look at those guys in parallel in all of our animal studies and on some metrics, it's superior on other metrics 2809 is superior. So I think they're both tremendously effective in the in vivo models for NASH. But when you look at the X-ALD profile, VK0214 seems to be effective in X-ALD and VK2809 is not very effective there. So that was a key difference in the actual in vivo data.

Bill Grau -- Stifel -- Analyst

Does that have to do with the liver sensitivity of 2809?

Brian Lian -- President and Chief Executive Officer

Maybe. I don't know, it was a surprise to us to see that the delta there since they are similar in virtually every other assay. But it could, it could have that, I mean that could play a role there.

Bill Grau -- Stifel -- Analyst

Great. Thanks a lot.

Brian Lian -- President and Chief Executive Officer

Thanks for the questions.

Operator

Our next question will come from Scott Henry of Roth Capital. Please go ahead.

Scott Henry -- Roth Capital -- Analyst

Thank you, and good afternoon. Just a couple of questions. First, on the modeling for 2020. How should we think about R&D spend throughout the year? Should we ramp it steadily? And then as far as magnitude, perhaps relative to 2019, are we thinking double of 2019 spending? Just trying to get a sense on R&D for the year.

Brian Lian -- President and Chief Executive Officer

Yes, it's a good question. Thanks, Scott. It's going to be certainly higher than in 2019. And I would say overall, the spend will be about 50% higher, skewed a little bit. Well, it's going to be a gradual ramp. So 4Q is going to be higher than 1Q and 1Q is going to be higher than 4Q ''19. But when you think about overall R&D and overall opex, it's about 50%. Right now, we think it's going to be about 50% higher. Greg, do you have anything?

Greg Zante -- Senior Vice President of Finance.

Yes. No, that's right on target, I think yes.

Scott Henry -- Roth Capital -- Analyst

Okay, great. Thank you for that color. And just one question on the trial. I realize it's not new, but we haven't had a chance to talk about it. When you look at the five doses, I was a little surprised not to see a 5 milligram daily since it was relatively robust dose in the earlier trial. Any thoughts on deciding which ones to go with? And why always 5 milligrams every other day versus daily?

Brian Lian -- President and Chief Executive Officer

Yes. We definitely -- it's a great question. So we definitely wanted to have some overlap with the Phase 2a study for comparative purposes. We thought that going with the higher sort of a pulsatile dose might be advantageous. I mean, I think you could argue, 5 mg [Phonetic] study would be advantageous based on the data. But we chose to go 10 mg just to have that -- be the overlap dose and then step down from there. We went to 5 mg every other day because we know that, when we look the last three doses in the Phase 2a, they all pretty much stacked on top of each other. As far as efficacy. So we were -- we felt right on the far right hand side of the dose response curve. So we think that coming down as we are. We should still see efficacy and we have that overlap with the very effective 10 mg every other day from the Phase 2a study.

Scott Henry -- Roth Capital -- Analyst

Okay, great. Thank you for the additional color. And thank you for taking the question.

Brian Lian -- President and Chief Executive Officer

Read more:
Viking Therapeutics Inc (VKTX) Q4 2019 Earnings Call Transcript - Motley Fool

SOUTH SAN FRANCISCO, Calif., Feb. 27, 2020 (GLOBE NEWSWIRE) -- CytomX Therapeutics, Inc. (Nasdaq: CTMX), a clinical-stage oncology-focused biopharmaceutical company pioneering a novel class of investigational antibody therapeutics based on its Probody therapeutic technology platform, today reported full-year 2019 financial results.

As ofDecember 31, 2019, CytomX had cash, cash equivalents and short-term investments of$296.1 million.

During 2019, CytomX made substantial progress in advancing our clinical stage pipeline of innovative Probody therapeutics from Phase 1 platform proof of concept into Phase 2 clinical studies. We took major steps forward with our proprietary programs and in our partnerships and set the stage for significant updates throughout 2020, said Sean McCarthy, D.Phil., president, chief executive officer and chairman ofCytomX Therapeutics. We also strengthened our product development capabilities with the recruitment of deeply experienced leadership, positioning ourselves to maximize the potential of our lead, wholly-owned assets, CX-072 and CX-2009, and of our entire portfolio. My colleagues and I look forward to continued pipeline momentum throughout the coming year as we maintain our focus on the discovery, development and ultimate commercialization of potentially transformative cancer treatments.

Business Highlights and Recent Developments

Initiation of Combination Phase 2 Study of CX-072, An Anti-PD-L1 Probody Therapeutic

Initiation of Phase 2 Study of CX-2009, An Anti-CD166 Probody Drug Conjugate

Initiation of Part 2a of Ongoing Study by Bristol-Myers Squibb of BMS-986249, An Anti-CTLA-4 Probody Therapeutic

Ongoing Dose Escalation Phase 1 Study of CX-2029, An Anti-CD71 Probody Drug Conjugate, within AbbVie Alliance

Phase 1 Study Initiation by Bristol Myers Squibb of BMS-986288, An Anti-CTLA-4 Probody Therapeutic

ImmunoGen Collaboration

Probody T-Cell Bispecific Program

Clinical Development Team Appointments

Anticipated 2020 Milestones

PROCLAIM-CX-072 (Anti-PD-L1)

PROCLAIM-CX-2009 (Anti-CD166)

PROCLAIM-CX-2029 (Anti-CD71)

Full Year 2019 Financial Results

Cash, cash equivalents and short-term investments totaled $296.1 million as of December 31, 2019, compared to $436.1 million as of December 31, 2018.

Revenue was $57.5 million for the year ended December 31, 2019, compared to $59.5 million for the year ended December 31, 2018. The net decrease in revenue of $2.0 million for 2019 compared to 2018 was primarily due to a decrease in revenue of $13.1 million from AbbVie under the CD71 Co-Development and Licensing Agreement with AbbVie Unlimited Company (AbbVie), as well as decreases in revenue under our agreements with Amgen, Pfizer and ImmunoGen, partially offset by an increase in revenue from Bristol-Myers Squibb due to the accelerated recognition of revenue related to the cessation of research on certain targets under our agreement with Bristol-Myers Squibb in the first quarter of 2019.

Research and development expenses increased by $27.8 million during the year ended December 31, 2019 compared to the corresponding period in 2018. The increase was largely attributed to an increase in personnel-related expenses; expenses relating to the acquisition of technical know-how during the first quarter of 2019; license fees paid to the University of California, Santa Barbara (UCSB) in connection with an amendment to our license agreement with UCSB in the second quarter of 2019; and an upfront license fee paid to ImmunoGen in the fourth quarter of 2019 for the EpCAM program.

General and administrative expenses increased by $3.3 million during the year ended December 31, 2019 compared to the corresponding period in 2018. The increase was primarily due to an increase in personnel-related expenses due to an increase in headcount.

Teleconference Scheduled Today at 5:00 p.m. ETConference Call/Webcast InformationCytomX management will host a conference call today at 5:00 p.m. ET. Interested parties may access the live audio webcast of the teleconference through the Investor & News section of CytomX's website at http://ir.cytomx.com or by dialing 1-877-809-6037 (U.S. and Canada) or 1-615-247-0221 (International) and using the passcode 1686972. An archive of the webcast will be available on the CytomX website from February 27, 2020, until March 6, 2020.

About CytomX Therapeutics

CytomX is a clinical-stage, oncology-focused biopharmaceutical company with a vision of transforming lives with safer, more effective therapies. We are developing a novel class of investigational antibody therapeutics, based on our Probody technology platform, for the treatment of cancer. As leaders in the field, our innovative technology is designed to turn previously undruggable targets into druggable targets and to enable more effective combination therapies. CytomX and its partners, comprised of leading biotechnology and pharmaceutical companies, have developed a robust pipeline of potential best-in-class immunotherapies against clinically validated targets and potential first-in-class therapeutics against novel, difficult to drug targets. Five novel drug-candidates utilizing our Probody technology are in the clinic, with three in Phase 2 studies and two in Phase 1 studies. These clinical programs include cancer immunotherapies against validated targets such as a PD-L1-targeting Probody therapeutic wholly owned by CytomX (CX-072) and the CTLA-4-targeting Probody therapeutics partnered with Bristol-Myers Squibb (BMS-986249 and BMS-986288). The CytomX clinical stage pipeline also includes first-in-class Probody drug conjugates against previously undruggable targets, including a CD166-targeting Probody drug conjugate wholly owned by CytomX (CX-2009) and a CD71-targeting Probody drug conjugate partnered with AbbVie (CX-2029). CD166 and CD71 are among cancer targets that are considered to be inaccessible to conventional antibody drug conjugates due to their presence on many healthy tissues. In addition to its wholly owned programs, CytomX has strategic collaborations with AbbVie, Amgen and BMS. For additional information about CytomX Therapeutics, visit http://www.cytomx.com and follow us on LinkedIn and Twitter.

CytomX Therapeutics Forward-Looking Statements

This press release includes forward-looking statements. Such forward-looking statements involve known and unknown risks, uncertainties and other important factors that are difficult to predict, may be beyond our control, and may cause the actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied in such statements. In particular, clinical progress is based on preliminary data from ongoing clinical trials and anticipated future disclosures of data are based on assumptions of clinical trial enrollment in our clinical trials and the clinical trials of our collaborative partners. Accordingly, you should not rely on any of these forward-looking statements, including those relating to the potential benefits, safety and efficacy of CytomXs or any of its collaborative partners product candidates, administered separately or in combination, the potential benefits or applications of CytomXs Probody platform technology, CytomXs ability to develop and advance product candidates into and successfully complete clinical trials, including the ongoing clinical trials of CX-072 and CX-2009, and the timing of any future clinical trials to be initiated by CytomX or its collaborative partners. Risks and uncertainties that contribute to the uncertain nature of the forward-looking statements include: the unproven nature of CytomXs novel Probody Platform technology; five product candidates under its Probody platform are in the initial stages of clinical development and its other product candidates are currently in preclinical development, and the process by which preclinical and clinical development could potentially lead to an approved product is long and subject to significant risks and uncertainties, including the risk that enrollment in clinical trials may take longer than expected; the possibility that the results of early clinical trials may not be predictive of future results; the possibility that CytomXs clinical trials will not be successful; the possibility that current pre-clinical research may not result in additional product candidates; CytomXs dependence on the success of CX-072, CX-2009, CX-2029 and BMS 986249; CytomXs reliance on third parties for the manufacture of the companys product candidates; and possible regulatory developments in the United States and foreign countries. Additional applicable risks and uncertainties include those relating to our preclinical research and development, clinical development, and other risks identified under the heading "Risk Factors" included in CytomXs Annual Report on Form 10-K filed with the SEC on February 27, 2020. The forward-looking statements contained in this press release are based on information currently available to CytomX and speak only as of the date on which they are made. CytomX does not undertake and specifically disclaims any obligation to update any forward-looking statements, whether as a result of any new information, future events, changed circumstances or otherwise.

PROBODY is a registered trademark of CytomX Therapeutics.Yervoy and Opdivo are registered trademarks of Bristol-Myers Squibb.

CYTOMX THERAPEUTICS, INC.STATEMENTS OF OPERATIONS AND COMPREHENSIVE LOSS(in thousands, except share and per share data)

CYTOMX THERAPEUTICS, INC.BALANCE SHEETS(in thousands, except share and per share data)

Investor and Media Contact: Christopher Keenan VP, Investor Relations and Corporate Communicationsckeenan@cytomx.com650-383-0823

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CytomX Therapeutics Announces Full-Year 2019 Financial Results and Provides Business Update - GlobeNewswire

February 28, 2020 (LifeSiteNews) These numbers are just staggering: According to Swedens Board of Health and Welfare, there has been a 1,500% spike in diagnoses of gender dysphoriagirls believing they are boysamong teen girls between the ages of 13 and 17. According to the Guardian, this rise in numbers is a reflection of a shift in public opinion on transgenderism that has made many people more open to permitting young people to pursue gender reassignment surgery.

Critics say this spike has been enormously exacerbated by the fact that in 2018, under pressure from LGBT activists, Swedens government put forward a law that would eliminate the necessity for parental consent, reduce the minimum age for sex change surgeries from age 18 to age 15, and in some instances permit children even younger to transition. In response, some medical professionalsincluding one prestigious psychiatristwarned that so-called gender reassignment surgery on children was, in essence, an experiment with unknown consequences.

Sweden is not the only country witnessing a sudden spike in children and teensmostly girlsidentifying as the opposite sex. The United Kingdom has seen a 4,000% rise in children wanting to change their sex in ten years, from 97 in 2008 to 2,510 in 2017-2018. The same phenomenon is occurring in Canada, the United States, and Australia. Some experts have already pointed out that transgenderism is functioning as a social contagion, but LGBT activists are insisting that there has always been thousands upon thousands of children born into the wrong bodies that must become lifelong medical patients and undergo endless hormone treatments and surgeries.

There has been at least some pushback in the Swedish media, with one TV documentary highlighting a man who regretting transitioning and focusing on Karolinska University hospital in Stockholm, which has been criticized for hastily transitioning minors, and has even performed double mastectomies on girls as young as 14. Additionally, the Guardian noted, tragic stories began to surface.

At the same time,Filtermagazine profiled the case of Jennifer Ring, a 32-year-old trans woman who hanged herself four years after her surgery. An expert on psychosis who was shown her medical journal by her father, Avi Ring, was quoted as saying that she had shown clear signs of psychosis at the time she first sought treatment for gender dysphoria. Indeed, the first clinic she approached refused to treat her, citing signs of schizotypal symptoms and lack of a history of gender dysphoria. But the team at Karolinska went ahead. "Karolinska don't stop anyone; virtually 100% get sex reassignment," says Ring.

In response to the backlash, the Swedish government has delayed legislation lowering the minimum age for sex change surgery and instead asked the Board of Health and Welfare to re-examine the data in light of recent criticisms. The Boards report is scheduled for release on March 21, and in the meantime, the Swedish Agency for Health Technology Assessment was directed by the government to examine why so many teenage girls were suffering from gender dysphoria. Of the teen girls who reported gender dysphoria, 15.2% reported autism, 28.9% reported depression, 19.4% had ADHD, and 32.4% had some form of anxiety disorder.

To the Guardians credit, they noted that critics are now louder and more numerous, citing the experience of several de-transitioners and the opinions of a number of experts urging caution. For several years now, countries have rushed headlong into this sweeping social experiment at the behest of the LGBT movement, ignoring calls for pause, demonizing as transphobic anyone who attempted to criticize sex changes or hormone therapy for minors, and declaring that feminists and gay activists who also had concerns were also bigots. There is some indication that the scale of this experiment and the increasing number of voices offering an alternativeand often tragicexperience with the transgender movement is now forcing people to pause and consider the implications of what we are doing.

For the sake of thousands of teenage girls and boys who have been swept up in this social phenomenon, I certainly hope so.

Jonathons new podcast,The Van Maren Show, isdedicated to telling the stories of the pro-life and pro-family movement. In his latest episode, he interviews Bjorn Korf, an activist trying to fight kidnapping by governmentsocial services in Norway.The nightmarish stories he shares are heartbreaking, but can't be ignored.

You can subscribehereand listen to the episode below:

Original post:
Cases of teen girls who believe theyre boys skyrockets in Sweden - Lifesite

The Fulton County Health Department has scheduled the following health clinics and services.

CANTON The Fulton County Health Department has scheduled the following health clinics and services. Please call the number listed with each service for an appointment or more information.

Maternal child health: Health screenings, WIC nutrition education and supplemental food coupons for women, infants and children. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria clinic appointments call 329-2922.

Canton - Clinic - Monday, March 2 - 8-4 - Appt needed

Canton - WIC Nutrition Education - Tuesday, March 3 - 8-4 - Appt needed

Canton - Clinic/Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Clinic/Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Astoria - Clinic, WIC Nutrition Educ. - Wednesday, March 4 - 9-3 - Appt needed

Canton - Clinic - Thursday, March 5 - 8-4 - Appt needed

Adult Health Immunizations: Various vaccines are available. There is a fee for immunization administration. Medicaid cards are accepted. To make an appointment or for more information call 647-1134 (ext. 254).

Canton - Immunizations - Tuesday, March 3 - 4-7 - Appt needed

Canton - Immunizations - Wednesday, March 4 - 8-4 - Appt needed

Other times available by special arrangement at Canton, Cuba and Astoria.

Blood Lead Screening: Blood lead screenings are available for children ages one to six years. A fee is based on income. To make an appointment or for more information call 647-1134 (ext. 254). For Astoria appointments call 329-2922.

Canton - Clinic - Wednesday, March 4 - 8-4 - Appt needed

Family Planning: Confidential family planning services are available by appointment at the Canton office for families and males of child-bearing age. Services provided include physical exams, pap smears, sexually transmitted disease testing, contraceptive methods, pregnancy testing, education and counseling. Services are available to individuals of all income levels. Fees are based on a sliding fee scale with services provided at no charge to many clients. Medicaid and many insurances are accepted. After hours appointments are available. To make an appointment or for more information call the 647-1134 (ext. 244). *Program funding includes a grant from the US DHHS Title X.

Pregnancy testing: Confidential urine pregnancy testing is available at the Canton and Astoria offices. This service is available to females of all income levels. A nominal fee is charged. No appointment is needed. A first morning urine specimen should be collected for optimal testing and brought to the health department. Services are provided on a walk-in basis on the following days each week:

Canton: Every Wednesday & Thursday, 8-3:30 (for more information call 647-1134 ext. 244)

Astoria: Every Wednesday, 9-2:30 (for more information call 329-2922)

Womens Health: A womens clinic for pap tests, clinical breast examinations and vaginal examinations is available by appointment. There is a nominal fee for this service. Medicaid cards are accepted. Financial assistance is available for a mammogram. Cardiovascular screenings may be available to age and income eligible women. To make an appointment or for more information call 647-1134 (ext. 244).

Mammograms: Age and income eligible women may receive mammograms at no charge. Speakers are available to provide information to clubs and organizations. For more information or to apply for financial assistance, call 647-1134 (ext. 254).

Mens Health: Prostate specific antigen (PSA) blood tests are available for men for a fee. To make an appointment or for more information call 647-1134 (ext. 224).

Sexually Transmitted Disease (STD) Clinic: Confidential STD and HIV testing services are available by appointment to males and females at the Canton office. Services include physical exams to identify STDs, a variety of STD testing, HIV testing, education, counseling, medications and condoms. There is a nominal fee for services. Services are available to individuals of all income levels. Medicaid cards are accepted. To make an appointment or for more information call 746-1134 (ext. 224).

HIV Testing and Counseling: Confidential HIV testing and counseling services are available by appointment through the sexually transmitted disease (STD) clinic at the Canton office. To make an appointment or for more information call 647-1134 (ext. 224).

Tuberculosis (TB) Testing: TB skin tests are available at no charge by appointment. To make an appointment or for more information call 647-1134 (ext. 254).

Blood Pressure Screenings: The Fulton County Health Department provides blood pressure screenings at no charge on a walk-in basis during the following times:

Astoria - Screening - Wednesday, March 4 - 9-12 - Walk in

Health Watch Wellness Program: The Health Watch Program provides low cost lab services. Through this program adults can obtain venous blood draws for a variety of blood tests. Blood tests offered without a doctors order Comprehensive Metabolic Panel (CMP), Complete Blood Count (CBC), Lipid Panel, Prostate Specific Antigen (PSA) test, Hepatitis C test, and Thyroid Stimulating Hormone (TSH). A wide variety of blood tests are also available with a doctors order. There is a charge at the time of service. To make an appointment or for more information call 647-1134 (ext. 254).

Dental Services: The Dental Center offers a variety of basic dental services to children and adults. An appointment is needed. Medicaid and Kid Care cards are accepted. To make an appointment or for more information call 647-1134 (ext. 292).

See the article here:
Health Department announces services for the week of March 2 - Newton Press Mentor

When the transition to menopause starts, women can be plagued by uncomfortable symptoms such as hot flashes, night sweats, sleep problems, mood swings, weight gain, and vaginal dryness. The pharmacological approach to controlling menopausal symptoms (which occur when levels of estrogen, progesterone, andtestosteronedrop off in midlife) is hormone therapy (HT), medications with female hormones that replace the ones the body no longer produces. Lifestyle changes such as diet, exercise, layered clothing, smoking cessation, and vaginal moisturizers and lubricants have also been shown to be effective in coping with symptoms related to menopause.

RELATED: What to Eat and Avoid on a Plant-Based Diet, and a 14-Day Sample Menu

Many studies have looked at the positive effects of the Mediterranean diet (a diet rich in fruit, vegetables, whole grains, nuts and healthy fats) on these symptoms, especially hot flashes and weight gain. An Iranian study published in the journal of theNorth American Menopause Society (NAMS), Menopause, on February 19, 2020, looked at subgroups of fruits and vegetables to find which provide the biggest benefits. The study recruited 393 post-menopausal women between ages 40 and 76 years. Possible participants were excluded if they were overweight, smoked, had a medical history of cancer, diabetes, stroke, multiple sclerosis, dementia,hyper- or hypothyroidism, or had undergone hormone therapy in the previous six months.

Overall, participants who self-reported a higher intake of fruits and vegetables combined, total vegetables, or total fruits had more energy and physical activity compared with individuals who reported a lower intake. A previous study, published in June 2018 in Maturitas, looked at vegans, who do not eat animal products, and found that they report less bothersome vasomotor and physical menopausal symptoms than omnivores.

These results are consistent with other studies. The mechanism by which it works is not entirely clear, but we are assuming it is related to the antioxidant effects of the vitamin C, beta-carotene, and lycopene contained in the fruits and vegetables, said Neal Barnard, MD, author of Your Body in Balance.

RELATED: Coping With Hot Flashes and Other Menopausal Symptoms: What 9 Celebrities Said

The researchers also looked at specific subgroups of fruits and vegetables, including cruciferous vegetables, green leafy vegetables, dark yellow vegetables, berries, and citrus fruits.

In the results, the researchers found that in the vegetable groups, higher consumption of leafy greens and cruciferous vegetables led to a significant reduction in overall menopausal symptoms and specifically in physical symptoms.

Dr. Barnard, who is also the president of thePhysicians Committeefor Responsible Medicine, says, This study also fits a longer-term observation from years ago in Japan, when the diet was much lower in animal products and higher in rice and vegetables, and women rarely complained of menopausal symptoms. When the diet become more Westernized with more meat and dairy, menopausal symptoms were much more frequently reported.

RELATED: Vegetarian Diet Linked to Lowered Risk of Urinary Tract Infection

A higher intake of fruits across the board was found to have a slight impact on the psychological front, with high consumption respondents reporting somewhat less moodiness. Citrus fruits (oranges, limes, lemons, citrons, grapefruit, kumquats, ugli fruit) were also reported to help reduce overall menopause symptoms.

Acidic tomatoes and citrus fruits are known to act as bladder irritants. One concerning result from the study was that higher intakes of fruits and vegetable combined, total vegetables, green leafy vegetables, dark yellow vegetables, and citrus fruits were associated with higher urogenital issues, such as urinary tract infections (UTIs). However, further investigation is warranted to confirm the findings, wrote the researchers in the published papers.

RELATED: Home Remedies for Urinary Tract Infection (UTI) Symptoms

The researchers caution that the nature of Iranian society and characteristics of diet and food preparation there may limit the ability to generalize results to women worldwide. For example, frying as a method for vegetable preparation in Iran is very popular. Therefore, confirming the findings of the present study in different sociocultural and dietary behavior contexts will better illuminate the relationship between fruit and vegetable consumption and menopausal symptoms, wrote the researchers.

RELATED: Fitness After 40:Midlife Exercise Needs

This small cross-sectional study provides some preliminary evidence regarding the influence of fruit and vegetable intake on menopause symptoms. There is ample evidence that a healthy diet rich in fruits and vegetables has a beneficial effect on health in a myriad of ways, but additional study is needed to determine whether various menopause symptoms may be affected by dietary choices, said Stephanie Faubion, MD, the medical director of NAMS, and the Penny and Bill George Director at the Mayo Clinic Center for Womens Health in Rochester, Minnesota, in a news release about the study.

Barnard adds, This was not a randomized trial this was self-reported food intake, which makes it more likely that there was a [confounding factor]. However, the study does seem to be rigorously done. It suggests that the next step is to conduct a randomized trial in which people would be given a certain amount of food or asked to consume a certain diet, and [which would include] the presence of a control group.

See the article here:
Foods That Help Ease Menopausal Symptoms - Everyday Health

DEAR DEIDRE:I WANT a third baby but my husband has said hes not keen.

I fear it will all turn out badly with me to blame.

1

My contraceptive implant was due to be removed last week.

Ive decided I want to give my body a rest from hormone contraception.

Were both 35 and I explained to my husband wed have to use condoms instead.

Hes now refusing to wear one and says well use the withdrawal method.

If I end up pregnant, I fear he will blame it on me. I want having another baby to be a joint decision.

Get in touch with Deidre today

Got a problem?

Send an email to problems@deardeidre.org. Every problem gets a personal reply, usually within 24 hours weekdays.

You can also send a private message on the DearDeidreOfficial Facebook page.

Follow me on Twitter @deardeidre.

DEIDRE SAYS:Good for you. Its hugely important that a child is wanted by both parents.

Dont let him duck the responsibility of making a decision through laziness.

If he doesnt want to wear condoms, talk to your doctor or family planning clinic about other methods of non-hormonal contraception, such as female condoms, IUDs and diaphragms. See nhs.uk/contraception.

View original post here:
I want another baby but fear my husband will blame me if I end up pregnant - The Sun

This transcript has been edited for clarity.

I'm Dr Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine and NewYork-Presbyterian.

Hormone replacement therapy (HRT) for Alzheimer's prevention is a loaded topic, around which there are a lot of differing opinions out there. Over the past 5 years, I can tell you that my own comfort level with discussing this topic has definitely evolved exponentially.

Five years ago, I wouldn't have even wanted to talk about a topic like this because the data were all over the place. At that time, I may have been able to state one thing: HRT during the perimenopause transition may have some protective effect on the brain. I couldn't say whether it's protective against dementia, Alzheimer's, or cognitive declinejust that taking HRT for 5-7 years during the menopause transition was okay. But I'd add, "I don't know. I'm just a brain doctor. You should probably go see an ob/gyn."

Today, things are a little bit different. Now when I see a woman with a family history of Alzheimer's disease at our program who wants to try to do anything to reduce her risk for dementia, I spend at least 10-15 minutes in the first hour-and-a-half visit just talking about HRT.

We talk about what her symptoms are. Is she having hot flashes? If so, I explain that hot flashes are not necessarily just an endocrine-related thing; it's really a neurologic manifestation of a hormonal shift in the brain.

I take a pretty comprehensive history of the perimenopausal changes. When was the very first time she started having any symptom whatsoever? Is it night sweats? Is it mood changes? Is it something else?

I also don't ask just about brain symptoms but about other symptoms that maybe neurologists don't focus on too much: Is there vaginal dryness? Is there pain during intercourse? These are really important things to understand, because it helps me fine-tune my understanding of the underlying issues. I can hone in on whether there is a local problem of too little estrogen in the reproductive organs or whether it is just neurologic complaints.

When it comes to HRT, I don't think we know exactly what the right treatment is. However, my general feeling, based on the evidence, being cautious, and wanting to do no harm, is that less is more. For example, is it really necessary to take a pill of estrogen when a very small dose of a cream or even a patch may give a smoother, more continuous delivery over time, which may in fact replicate the body's natural process anyway? Based on my own gut instinct and reviewing the best available evidence on my own and in conversation with many ob/gyns and reproductive endocrinologists, a patch may be sufficient.

Does a person just need estrogen or perhaps progesterone as well? This requires taking a clinical history. Even though we're an Alzheimer's prevention clinic, we now look at hormones, estradiol, progesterone, and all sorts of different things. We obtain these baseline results and follow them over time, just as we track other objective measures. In addition to body composition (eg, fat levels or muscle mass), cognitive function, cholesterol levels, and metabolism, hormones are now one of the important puzzle pieces we consider.

Another aspect of this that we're really just starting to look at is brain function. For example, what if a woman in the perimenopause transition has glucose hypometabolism, meaning reduced glucose activity in specific brain regions that are worrisome for the earliest phases of Alzheimer's disease, even before they exhibit symptoms? Is that someone who I may want to pay more attention to from a hormone replacement perspective? If someone has normal brain metabolism versus impaired brain glucose metabolism, maybe that can give us a clue as to whether they need HRT, and if so, which specific type of treatment.

Although the jury is still out about some of these seminal questions, there has been a big difference in my response to hormone replacement as a potential protective intervention for Alzheimer's prevention.

Now, I understand these idiosyncrasies. I understand that, in the future, whether it's 2 or 10 years away, patients will get an examination, blood test, and perhaps a brain scan, followed by a conversation with their physician to really understand the specific aspects of hormone deficiency that may need to be replaced or balanced in an effort to protect brain function over time.

Also in a few years, when someone goes on HRT, aside from just getting a bone scan and perhaps responding to a questionnaire, they may also get a brain scan. By better understanding this, perhaps we can tell whether whatever variation or specific regimen of HRT the person was put on needs to be changed because cognitive function actually declined.

I truly believe that the perimenopause transition is an exceptional window of opportunity in our fight against Alzheimer's disease. Two out of every three brains affected by Alzheimer's disease is a woman's brain. Five to 10 years ago, I had no idea why. It's not just because women live longer; it's because hormone transition affects brain pathology, brain metabolism, and the person's risk for Alzheimer's disease.

Another key consideration is weighing the risks versus the benefits of HRT so we can get everyone on the same page. For example, if someone has a familial risk for breast cancer, or if the woman has actually had a stroke, a blood clot, or currently smokes, these are all things that increase the potential risks of using HRT. Also, what if a person is using progesterone and she has her uterus? Maybe she will be increasing her risk for uterine cancer. These are really important aspects to consider.

But overall, I would say the gestalt about HRT and its specific impact on women's Alzheimer's risk is that it's an individual decision. One must balance the risks versus benefits, take into account the evolving evidence, and really consider the type, dose, method of delivery, and duration of the HRT. For example, in our practice, 5-7 years of HRT sounds reasonable, but does 10, 12, 15 years, or more? I'm not sure that we really know enough to have a one-size-fits-all approach to this.

In the next several years, I expect much new data to come from our research and from others'. I think, following that, we will have the recipe, algorithm, or at least a general set of recommendations for HRT to reduce Alzheimer's risk.

Thanks so much for listening.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Originally posted here:
Why a Brain Doctor Asks About Hormone Replacement Therapy - Medscape

TPG Specialty (TSLX) came out with quarterly earnings of $0.51 per share, beating the Zacks Consensus Estimate of $0.47 per share. This compares to earnings of $0.67 per share a year ago. These figures are adjusted for non-recurring items.

This quarterly report represents an earnings surprise of 8.51%. A quarter ago, it was expected that this business development company would post earnings of $0.48 per share when it actually produced earnings of $0.55, delivering a surprise of 14.58%.

Over the last four quarters, the company has surpassed consensus EPS estimates three times.

TPG, which belongs to the Zacks Financial - Mortgage & Related Services industry, posted revenues of $66.50 million for the quarter ended December 2019, surpassing the Zacks Consensus Estimate by 3.62%. This compares to year-ago revenues of $74.74 million. The company has topped consensus revenue estimates three times over the last four quarters.

The sustainability of the stock's immediate price movement based on the recently-released numbers and future earnings expectations will mostly depend on management's commentary on the earnings call.

TPG shares have added about 5.7% since the beginning of the year versus the S&P 500's gain of 4.3%.

What's Next for TPG?

While TPG has outperformed the market so far this year, the question that comes to investors' minds is: what's next for the stock?

There are no easy answers to this key question, but one reliable measure that can help investors address this is the company's earnings outlook. Not only does this include current consensus earnings expectations for the coming quarter(s), but also how these expectations have changed lately.

Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions. Investors can track such revisions by themselves or rely on a tried-and-tested rating tool like the Zacks Rank, which has an impressive track record of harnessing the power of earnings estimate revisions.

Ahead of this earnings release, the estimate revisions trend for TPG was favorable. While the magnitude and direction of estimate revisions could change following the company's just-released earnings report, the current status translates into a Zacks Rank #2 (Buy) for the stock. So, the shares are expected to outperform the market in the near future. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here.

It will be interesting to see how estimates for the coming quarters and current fiscal year change in the days ahead. The current consensus EPS estimate is $0.49 on $64.50 million in revenues for the coming quarter and $1.96 on $267.42 million in revenues for the current fiscal year.

Investors should be mindful of the fact that the outlook for the industry can have a material impact on the performance of the stock as well. In terms of the Zacks Industry Rank, Financial - Mortgage & Related Services is currently in the top 8% of the 250 plus Zacks industries. Our research shows that the top 50% of the Zacks-ranked industries outperform the bottom 50% by a factor of more than 2 to 1.

To read this article on Zacks.com click here.

Zacks Investment Research

The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.

Read more here:
TPG Specialty (TSLX) Q4 Earnings and Revenues Top Estimates - Nasdaq

America's Car-Mart (CRMT) came out with quarterly earnings of $1.83 per share, beating the Zacks Consensus Estimate of $1.78 per share. This compares to earnings of $1.55 per share a year ago. These figures are adjusted for non-recurring items.

This quarterly report represents an earnings surprise of 2.81%. A quarter ago, it was expected that this auto retailer would post earnings of $1.85 per share when it actually produced earnings of $2, delivering a surprise of 8.11%.

Over the last four quarters, the company has surpassed consensus EPS estimates four times.

America's Car-Mart, which belongs to the Zacks Automotive - Retail and Whole Sales industry, posted revenues of $186.73 million for the quarter ended January 2020, surpassing the Zacks Consensus Estimate by 5.51%. This compares to year-ago revenues of $161.05 million. The company has topped consensus revenue estimates two times over the last four quarters.

The sustainability of the stock's immediate price movement based on the recently-released numbers and future earnings expectations will mostly depend on management's commentary on the earnings call.

America's Car-Mart shares have added about 10.9% since the beginning of the year versus the S&P 500's gain of 4.3%.

What's Next for America's Car-Mart?

While America's Car-Mart has outperformed the market so far this year, the question that comes to investors' minds is: what's next for the stock?

There are no easy answers to this key question, but one reliable measure that can help investors address this is the company's earnings outlook. Not only does this include current consensus earnings expectations for the coming quarter(s), but also how these expectations have changed lately.

Empirical research shows a strong correlation between near-term stock movements and trends in earnings estimate revisions. Investors can track such revisions by themselves or rely on a tried-and-tested rating tool like the Zacks Rank, which has an impressive track record of harnessing the power of earnings estimate revisions.

Ahead of this earnings release, the estimate revisions trend for America's Car-Mart was favorable. While the magnitude and direction of estimate revisions could change following the company's just-released earnings report, the current status translates into a Zacks Rank #2 (Buy) for the stock. So, the shares are expected to outperform the market in the near future. You can see the complete list of today's Zacks #1 Rank (Strong Buy) stocks here.

It will be interesting to see how estimates for the coming quarters and current fiscal year change in the days ahead. The current consensus EPS estimate is $2.13 on $189.46 million in revenues for the coming quarter and $8.12 on $728.64 million in revenues for the current fiscal year.

Investors should be mindful of the fact that the outlook for the industry can have a material impact on the performance of the stock as well. In terms of the Zacks Industry Rank, Automotive - Retail and Whole Sales is currently in the top 21% of the 250 plus Zacks industries. Our research shows that the top 50% of the Zacks-ranked industries outperform the bottom 50% by a factor of more than 2 to 1.

To read this article on Zacks.com click here.

The views and opinions expressed herein are the views and opinions of the author and do not necessarily reflect those of Nasdaq, Inc.

Read this article:
America's Car-Mart (CRMT) Beats Q3 Earnings and Revenue Estimates - Nasdaq

Human development research focused on often overlooked communities

In California, Hispanics have surpassed whites as the largest ethnic group in the state. Although it is often thought that this increase is due to immigration, it is actually caused by individuals already living in the state and building families.

Hispanics increasingly choose to raise families in the U.S., yet little research has gone into understanding their family dynamics and childhood development. Instead, research in human development has historically been focused on white Americans of European descent, resulting in a lack of representative knowledge. Leah Hibel, an associate professor of human development and family studies, is striving to bridge this racial gap in scientific research and learn more about the lives of Hispanics in the U.S.

The California Babies Project began in 2017 with the intention of learning how stress factors impact childhood development in Mexican families in the Yolo County area. The project selected families that had already been studied through the California Families Project, a childhood development study that started at UC Davis in 2006.

The children that are part of the ongoing California Babies Project are the descendants of those who participated in the 2006 California Families Project as children. Hibels study hopes to better understand the daily lives of the families through understanding the main stressors they are facing and the resilience mechanisms they rely on to combat challenges.

The main goals of the project are to understand daily life as its lived, how parents are supporting their infants development and their infants ability to regulate their physiology, emotions and sleep said Andrea C. Bhler-Wassman, a doctoral candidate in human development.

To collect data on the families and children, the study started with children at six months old and plans to follow them until they reach the age of four. A key part of data collection relies on the diaries that the families use to document the many fluctuations in daily life during two-week periods.

What is unique about this project is that we have the families filling out questionnaires each day, so we can see how life is lived each day and how each day is impactful, Hibel said.

Beyond the daily diaries, a quantifiable aspect of the study is the recording of the stress hormone cortisol. To measure cortisol, saliva is collected from both the parents and the children. This physiological measure serves as an objective view of the parents stress levels and as an indicator for the way in which the parents stress is impacting their children. Additionally, sleep patterns are recorded to understand how differing amounts of sleep impact the health of the family members.

Although the study is still primarily in the data collection phase, early analysis has already identified stress factors and resilience methods among the families. Correlations can be found between partner hostility and the amount of sleep mothers receive each night. For mothers sleeping the recommended seven to eight hours a night, less partner conflicts are observed. These are experiences to which many families in the U.S. can relate; however, a specific stressor for the families in this study is the fear of deportation.

The study has seen a significant difference in the depression symptoms for mothers who are worried about deportation compared to mothers with less concerns about deportation. Bhler-Wassman pointed out that it is not just undocumented mothers who are negatively impacted by the fear of deportation. Regardless of citizenship status, these mothers still have fears surrounding deportation from concerns about other family members to racist assumptions that they might be undocumented which may result in symptoms of depression.

In the face of these stress factors, the families have shown strong resilience through familial support. The importance of family and the support members receive from one another helps them fight the challenges they face in the U.S.

We are currently studying how social support affects the families mental health, because when families are living in these stressful environments, the main thing that buffers that stress is familial support, Bhler-Wassman said.

The researchers hope that more evidence-based research on Mexican families in the U.S. will ultimately lead to positive changes and more enjoyable lives for the families they study.

I really want to make this research be reflective of the needs of the community and I hope that this research will be able to help them and give back to them, Bhler-Wassman said.

To help the families, policy and social services need to be catered to their specific needs. It is important for the societal support to be inclusive of all family types. This research will help policy-makers come up with specific solutions that will be most beneficial to the families they hope to serve.

Its important to meet families where they are at and be able to provide families with prevention and intervention, Hibel said. We need to make sure those interventions are culturally appropriate and need them to be able to fit into their day to day lives.

Although there has been widespread objection to policies that are negatively impacting immigrants and their families, Jonathan Mulligan Seplveda, a staff attorney for the UC Davis Immigration Law Clinic, emphasized that such policies have been this way for years.

There does seem to be significant push back that is saying this is extremely inhumane policy, yet it seems like policy has been this way for a long time, Mulligan Seplveda said.

Hibel stressed that it is ultimately a societal limitation to not support all the diverse aspects and people of the U.S.

What is important to recognize is that our country is diverse and our communities are diverse, and that diversity is an asset, Hibel said. If we are not supporting and acknowledging aspects of our society, it holds our society back.

Written by: Alma Meckler-Pacheco science@theaggie.org

See the original post:
California Babies Project works to better understand lives of Mexican families in Yolo County - The Aggie

CLEVELAND Too bad there isnt some magic pill we could take to make the dream of sleep a reality.

One popular supplement that a lot of people take to deal with sleep issues is melatonin.

Melatonin is a hormone that our body produces naturally to help promote sleep. Most people can produce enough melatonin on their own, but there are some cases where it may be helpful to take a supplement.

The 3News Go! team reached out to Michelle Drerup, PsyD from the Cleveland Clinic's Sleep Disorders Center to find out more about melatonin. Dredrup is a sleep psychologist and behavioral sleep medicine specialist, who specializes in treating conditions like insomnia, circadian rhythm disorders, sleep apnea and more.

Sleep problems are very common. In fact, Drerup says about 10 percent of the population has symptoms of an insomnia disorder that impacts their daily functioning.

Dredrup also says theres not a lot of data out there on the efficacy of using melatonin at bedtime, but it may help you fall asleep.

RELATED: Do I have sleep apnea? Here are the symptoms to watch for

RELATED: 'Being fatigued is no different than being drunk' | Father shares story after sleepy driver fatally crashes into wife on Ohio Turnpike

Melatonin is a hormone of darkness," she says. "We call it the vampire hormone. It doesn't help with sleep maintenance or staying asleep, but more so it has some benefit for sleep onset for some people, as well as those who have delayed sleep phase disorder.

Dredrup says melatonin can also help for people dealing with jet lag.

But with so many different dosage options available, how do you know where to start?

Dredrup says, start with as small of a dose as possible.

I usually do not recommend higher than anything than 3mg. It doesn't tend to be effective at higher dosages for most people and it will just tend to make them feel groggy.

If youre considering using melatonin to help you fall asleep, its also a good idea to check with your doctor. Melatonin can interact with some medications, like blood pressure and diabetes drugs.

Link:
The vampire hormone: What you need to know about melatonin - WKYC.com

Dr. Amauri Caversan, ND, a Naturopath in Toronto, and his practice, the Dr Amauri Wellness Centre, has published a blog post about the thyroid, the diseases that affect the thyroid, and some Naturopathic approaches which may help with thyroid function. The thyroid is an essential organ in the human body, located in the neck. Its shaped like a butterfly and releases hormones that work to regulate energy levels, metabolism, muscle control, fertility, and much more.

Because the thyroid and the hormones it releases have such broad ranging effects in the body, thyroid difficulties can be a cause for serious concern, which is why its very important to maintain healthy thyroid function. Thyroid dysfunction may lead to a number of symptoms, including constipation, weight gain, unbearable fatigue, weakness, and problems with memory. The most common thyroid issues are either that the thyroid is under functioning, as in hypothyroidism, or over functioning, as in hyperthyroidism.

The thyroid produces two main hormones, known as T3 and T4, both of which are essential to the metabolic function of cells. When the thyroid is underperforming, or not creating the amount of hormones that the body needs, the bodys metabolism is compromised. This can cause a range of symptoms including fatigue, memory problems, mood swings, depression, weight gain, muscle cramps, and cholesterol elevation. The most common cause of hypothyroidism is Hashimotos thyroiditis, an autoimmune disorder in which the bodys immune system treats the thyroid like a threat. The immune system creates antibodies which prevent the thyroid from creating sufficient hormones for the body to function. Because the symptoms of hypothyroidism can be so severe, it is very important for people experiencing hypothyroidism to seek treatment to maintain their thyroid hormone levels at a healthy level.

One point discussed by the blog post is Naturopathic Medicine for thyroid function. The clinic offers a range of naturopathic treatments which may provide some benefits to thyroid health. Whether a person has hypothyroidism or the equally serious hyperthyroidism, the Dr. Amauri Wellness Centre would like them to consider a visit to a naturopath to discuss their condition.

The diagnosis of thyroid disorders is generally conducted through blood work or a thyroid ultrasound. Blood tests may include TSH, Free T4, Free T3, Reverse T3, thyroid peroxidase and anti-thyroid antibodies. TSH is the hormone produced by the pituitary gland that signals to the thyroid that it needs to produce more hormones. The level can indicate whether the body has enough thyroid hormones, too much or too little. Free T3 and Free T4 measure T3 and T4 and can be indicative of a thyroid disorder, but generally are not used on their own for diagnosis. Thyroid peroxidase and anti-thyroid antibodies are tested to determine if the thyroid disorder is caused by an autoimmune disorder.

Anyone looking for a Toronto-based Naturopath interested in learning more about Dr Amauri Caversan, ND and his naturopathic practices can visit his website or contact his office. The office offers a number of treatments that could offer some benefit in the case of thyroid disorders, including thyroid replacement therapy with natural dessicated thyroid hormones and recommendations for diet changes and supplement additions. Dr Amauri Wellness Centre may also suggest herbal formulas or IV therapy.

In addition to offering services for patients who may be dealing with thyroid disorders, Dr Amauri Caversan, ND and his clinic offer a number of other naturopathic treatments for people with a variety of issues as well as those who are just interested in their general wellness. Some of these treatments include acupuncture, cold laser treatments, naturopathic manipulation, and shockwave therapy. The Dr Amauri Wellness Centre caters a number of their services to people suffering from chronic pain, which often persists in spite of many attempts at treatment. Dr Amauri Caversan, ND does his best to understand each patients individual situation, because he understands that every situation is unique and no two people will respond in exactly the same way to exactly the same conditions.

People can visit the naturopathic clinic located at 1200 Bay Street #1102, Toronto, ON M5R 2A5, or call (416) 922-4114 for further inquiries.

###

For more information about Dr. Amauri Wellness Centre, contact the company here:

Dr. Amauri Wellness CentreDr. Amauri Caversan, ND(416) 922-4114info@dramauriwellnesscentre.comDr. Amauri Wellness Center1200 Bay Street #1102Toronto, Ontario M5R 2A5

More:
Naturopathic Clinic In Toronto Recommends These Naturopathic Approaches To Help Correct Thyroid Function - Press Release - Digital Journal

These days, you can chart cultural change through public loos.

In Los Angeles, gone are the bold-print doorsigns that say gender neutral restroom, complete with baffling stick men/women dressed in the kind of half-skirt, half-trouser ensembles that belong on a Jean Paul Gaultier runway; the interlinked Mars and Venus symbols with pompous explanatory small print welcoming everyone, regardless of gender or expression. Thanks, guys, but its a bathroom none of us are planning to stay long enough to feel the love.

Today, the signs simply read: We Dont Care. Or, my personal favourite: Whatever. Just wash your hands.

However, in the UK, when it comes to bathroom signs, there is no such levity. Were still desperately contorted about trans and gender issues and a long way from levelling out a debate that, I fear, hasnt yet reached peak insanity.

I thought wed peaked last year, when Always, the sanitary towel company, agreed to remove the Venus symbol from its wrapping after the trans lobby complained that not everyone who has periods identifies as a woman.

I thought wed peaked when the police were forced to reveal that convicted rapists were allowed to be logged as female when arrested, if that is how they choose to identify themselves. When the BBC promoted an educational short film telling nine-year-olds that there were over 100 genders, that had to be it?

Surely we peaked last January, when former policeman Harry Miller was visited by police after tweeting transphobic comments (such as: I was assigned mammal at birth, but my orientation is fish. Dont mis-species me)? Miller claimed that the Humberside Police officer who interviewed him had said hed committed no crime, but we need to check your thinking.

Which is Orwellian enough but after Miller discovered his tweet incident had been entered onto his police record, as a non-crime hate incident, he launched legal action so that a court might establish once and for all that he had not broken any law. The police probe was decreed unlawful by the High Court on Friday.

But this is no time to celebrate, thanks to the opposition Labour Party, which, in the midst of its leadership contest, is busy descending into a farcical civil war over transgender rights.

A controversial pledge card calling on the party to expel transphobic members has exposed a faultline running through the movement between and those who sign up wholeheartedly to the trans-activist insistence that transwomen are women, and seasoned Left-wing feminists, who worry about proposed reforms to make it simpler to transition legally and, thus, access all-female spaces such as changing rooms and toilets.

Out there in the Labour heartlands, these are not the issues keeping voters up at night. Its as if the party has learnt nothing from Trump or Brexit or from Jo Swinson, the headmistressy and super-woke former Liberal Democrat leader whose election campaign went up in smoke on the altar of transgender ideology.

But all of this pales in importance beside an easily missed news item tucked away in this weekends Sunday papers. One headline ran: NHS endorsing guide for transgender patients that approves puberty blockers and declares anatomy is not always a good guide to determining a childs sex.

The NHS has already tarnished itself over matters of gender. More than once, the scandal-hit Tavistock Clinic, the countrys only NHS gender identity service for children, has found itself in the eye of the storm after accusations that it was fast-tracking young people into changing gender and offering children as young as 11 hormone-blocking drugs. But at least this shockingly proactive approach has been limited to patients within the clinic until now.

A number of NHS trusts across the south west are to send out a Supporting Trans People toolkit, written by trans campaigners and branded with NHS logos, that declares that anatomy is not always a good guide to determining a childs sex. It also condones the use of puberty blockers on adolescents, drugs that are, at present, licensed in the UK only to treat children who start puberty abnormally early, not those just questioning their gender identity.

Both the Royal College of Paediatrics and Child Health and NHS England have ordered national reviews into the ethics of prescribing such treatment.

Its the inherent contradictions in PC-culture-gone-mad that I cant get past. Because if you pare down the argument for hormone blockers, its all about protecting youngsters mental health a mental health that could understandably suffer if someone felt trapped in the wrong body for years.

So what do we do? We pump them full of drugs that keep them in that state, preventing their natural sex hormones, oestrogen and testosterone, from kicking in.

Its official: weve hit new levels of gender insanity.

Read Celia Walden at telegraph.co.uk every Monday, from 7pm

Read the original here:
Weve finally hit peak insanity over trans havent we? - Telegraph.co.uk