Archive for the ‘Hormone Clinic’ Category

Someone cut you off on the highway and you had to swerve andnarrowly avoided a collision.

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While out for a morning run, an angry dog jumps out onto your path and starts growling and barking at you.

In the second before you turned on the lights in your empty house,your coat rack looked like it was a person standing right next to you.

All three of these scenarios can trigger your bodys naturalfight or flight response, which is driven from your sympathetic nervous system.This response is your bodys reaction to danger and was designed to help yousurvive stressful and life-threating situations.

The fight or flight response, or stress response, is triggered by a release of hormones either prompting us to stay and fight or run away and flee, explains psychologist Carolyn Fisher, PhD. During the response, all bodily systems are working to keep us alive in what weve perceived as a dangerous situation.

Without you even telling it what to do, your body is assessing whats going on around you and determining your options on how you most likely could survive the event.

Heres what can happen during the stress response:

During the fight or flight response your body is trying to prioritize, so anything it doesnt need for immediate survival is placed on the back burner. This means that digestion, reproductive and growth hormone production and tissue repair are all temporarily halted. Instead, your body is using all its energy on the most crucial priorities and functions.

The stress response can be triggered in a single instant, but how quickly you calm down and return to your natural state is going to vary from person to person (and it will depend on what caused it). Typically it takes 20 to 30 minutes for your body to return to normal and to calm down.

Our fight or flight response was designed to help usthrough catastrophic circumstances, says Dr. Fisher. If you think about itfrom an evolution standpoint, it makes sense because we used to have a lot morelife-threatening emergencies.

Back in the caveman days, danger was all around us andthreats were constant. We didnt know where our next meal was coming from, wehad to brave the weather and we had to fight predators all around us. Arustling bush could be a lion or something else trying to kill you.

And so our ancestors developed the stress response to helpus survive.

Fortunately in todays word, real danger is few and farbetween, but that doesnt mean weve lost our ability to trigger the fight orflight response. It might happen while youre on an airplane thats experiencingturbulence or when someone jumps out at you from a dark room. And itll morethan likely be triggered if youre in a car accident, being robbed orexperiencing something else traumatic.

Where it gets tricky is when your body starts triggering thefight or flight response during non-threating situations like giving a bigpresentation, trying to make a deadline at work or merely thinking about a phobia, such as spiders or heights. Thesesituations arent truly dangerous, but theyve triggered our stress responseand our body is reacting to it as if it was.

In evolution, the stress response was designed to help us survive, but thats not always how it plays out in todays world, says Dr. Fisher. Our fight or flight response can now be activated from psychological or mental stress. For example, some individuals can activate it just thinking about work tomorrow.

Living in a prolonged state of high alert and stress (when there isnt any real reason for it) can be detrimental to your physical and mental health.

Your autonomic nervous system is a delicate balancing actbetween your sympathetic nervous system and your parasympathetic nervoussystem. Both networks involuntarily react to the environment around you.

Your sympathetic nervous system is responsible for how your body reacts to danger and is responsible for the fight or flight response. While your parasympathetic nervous system is responsible for maintaining homeostasis, which is your bodys built-in stability monitor. Think of it like a generator making sure everything from your body temperature to your water intake is functioning smoothly. Your parasympathetic nervous system makes sure things are balanced. It works to relax you and helps conserve and restore energy.

You need both systems to run properly.

Think of your sympathetic nervous system and yourparasympathetic nervous system like your cars gas and breaks, explains Dr.Fisher. You need to use both effectively for your car to run properly.

You need your sympathetic nervous system to keep you alive when true danger is detected and you need your parasympathetic nervous system to restore and relax you so that your body can run business as usual.

So if you find that your body is constantly reacting to every day stress with the fight or flight response it should be a warning sign that your sympathetic and parasympathetic systems arent working together in harmony.

Often times stressors that arent life threating dont havea clear on or off switch, says Dr. Fisher. Thats where we see some of thedetrimental effects of prolonged stress because its not going away. Its achronic stress to our immune system.

Work, bills, kids, your marriage, finances and health are some of the biggest non-life threatening stressors. How you interpret these things can affect your bodys reaction and can contribute to anxiety disorders.

Some people are having the fight or flight response whenthey go to work or see that their kid didnt clean up their room, says Dr.Fisher. It can vary from person to person in terms of the situations that cantrigger the stress response, but were finding that certain conditions orhealth states can be associated with this imbalance.

Some people who get in a car accident are too afraid to drive again or cant drive past the spot where the accident was because of fear and anxiety. It becomes a generalized fear response to a situation that isnt particularly dangerous anymore. This can also happen with work or strained relationships. The next thing you know, your fight or flight response is falsely activated, putting you in a state of chronic stress.

Dr. Fisher says stress management is critical to overallhealth. Its important to think big picture when you feel yourself starting toget worked up over something that you know is not a true threat or danger.

The fight or flight response is an important reaction that we all have and need, but its meant for true stress and danger. Everyone is going to have it in varying degrees for different reasons, but learning to slow down, be aware and conceptualize whats actually happening can help you regain control.

You need to get in touch with your individual physical,emotional and behavioral signs of stress, says Dr. Fisher. Maybe a migrainemeans youve had prolonged stress going on, so you need to tune into your bodyand whats going on before it gets to a crisis point.

If youre at the point where stress is impacting your quality of life talk to your doctor. Therapy, medication and stress management techniques can help you return to a more balanced state. Its not a quick fix and youll have to work on it daily, but you should be proactive about stress.

The fight or flight response has a clear purpose and function, but it shouldnt be activated over every day, non-threatening stressors like traffic, emails or bills. And if it is, the goal is to feel skilled at having an awareness when the response is activated, and to be able to bring yourself back to baseline.

Link:
What Happens to Your Body During the Fight or Flight Response? - Health Essentials from Cleveland Clinic

ONE of Britains youngest transgender children has started transitioning - after realising she was born in the wrong body aged just three.

Ash Lammin, 12, was born Ashton, but insisted that she was a girl as soon as she could speak at home in Ramsgate, Kent.

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Her mum Terri Lammin, 43, said that watching her daughter grow up confused and upset by her body was "heartbreaking".

She said: "Although she was born male, from the moment she could speak Ash insisted she was a girl.

"By age five, she was asking 'when is someone going to chop my winky off?' - and questioning why she had it at all."

Ash says that it has been difficult growing up as a trans girl, but says she feels that she is firmly on the right path.

She said: "The journey is long and it's still going, but I feel like the sense of victory is there through it all.

"I do feel accepted sometimes, but other times not.

"Not everyone is going to understand and people have to have their own opinions and I understand that. Some people might not like the idea of trans.

"I hope I inspire others but I just hope that love and acceptance comes through everything."

Now, aged almost 13, she is embarking on a lengthy journey to transition her gender from male to female at an NHS-run clinic - and is one of the youngest in the country to do so.

Ash - who changed her name by deed poll to Ashley when she was eight - will start by taking hormone blockers to halt the onset of puberty.

I do feel accepted sometimes, but other times not.

She has researched the process incessantly - and eventually wants a womb transplant so that she can be a mother when she's older.

Terri added: "I never thought it was a phase, Ash was just Ash.

"When she was three she said to me, 'I'm a boy because you gave me a boy's name - it's your fault.'

"I remember feeling horrible, because she blamed me. I personally thought maybe this was what an extremely camp gay man is like as a child."I'd never come across it before and I just went along with it. I just thought 'if he's happy, well that's the main thing.'"

But Terri, who has seven other children, said that life became much harder when Ash started at primary school.

She said: "I sent her to school in a boy's uniform. I felt awful, she didn't want to wear it and I was making her.

"The school were great. The headmaster at the time said 'if you think it's going to make life easier then bring Ash in a girl's uniform', so I did.

"I was in a right state. I thought 'everybody is going to think I'm weird' - but Ash loved it, she found it easy.

"Before, when I was taking her into school, she was biting me and kicking me, she didn't want to go in.

Although she was born male, from the moment she could speak Ash insisted she was a girl

"As soon as she put the girl's uniform on, she wanted to go every day."

Despite the school's willingness to help and the kindness of Ash's classmates, Terri says that other parents were very difficult - leaving her out of social events and complaining that Ash was using the girls' toilets.

She added: "When Ash was Ashton, she was invited to all the kids' parties, even though she used to turn up in a princess dress.

"The parents didn't mind then. But as soon as I let her be Ashley all the time, for a whole year she didn't get invited to one party.

"The kids were fine; it's not the children, kids play with anybody. It's not until an adult comes in and says you shouldn't do that then it changes."

When Ash turned 11 and went to secondary school, she became a target for bullies who would throw things at her on the bus and shout tranny at her.

Her mum was forced Terri to take her out of the school after just one term.

She is now being home-schooled, and Terri is calling for better education within schools to teach children about transgender people.

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One of Britains youngest transgender kids, 12, transitions after realising she was in wrong body aged 3 - The Sun

Over the past decade there has been a huge rise in the number of young people seeking treatment for gender dysphoria a condition in which one experiences a mismatch between ones biological sex and ones gender identity. In fact, since 2008/9, there has been a 5,337 per cent increase in referrals of teen girls, and a 1,460 per cent increase in referrals of teen boys, to the Tavistock Clinic, the UKs leading treatment centre for gender dysphoria.

Many of these young people are reported to be already suffering from serious mental health issues, and sometimes a history of self-harm. So they certainly require care. What they dont require is a potential diagnosis of gender dysphoria. The consequences can be severe. As one doctor puts it, it can mean that vulnerable teens are given puberty-blocking hormones in a context of profound scientific ignorance. These hormone-blockers suppress the release of testosterone in boys and oestrogen in girls. And they are often followed by cross-sex hormone therapy.

Many who have undergone such treatment report side-effects of physical pain, depression and suicidal thoughts. Indeed, a study produced by the Tavistock Clinic, in July this year, showed that after a year on puberty-blocking hormones, patients reported a rise in suicidal and self-harming thoughts. But these findings were brushed aside. The Tavistock Clinic now offers powerful hormones to children aged 11.

Staff at the Tavistock Clinic have understandably become worried. Five clinicians have resigned, voicing concerns that children were being rushed into hormone therapy, and that trans lobby groups had pressured doctors to medicate healthy children. Experimental treatment is being done not only on children, explained one of the ex-clinicians, but very vulnerable children, who have experienced mental-health difficulties, abuse, family trauma, but sometimes those [other factors] just get whitewashed.

Trans activists claim that puberty-blocking hormones buy time for young people to find out who they really are. They claim that the high level of self-harm and attempted suicide among trans teens is due to discrimination, transphobia and delays in hormone treatment.

But it is the diagnosis and treatment itself that is the real problem. Certainly the UK health authorities warn of the rare, potential side-effects of hormone blockers, such as blood clots or cardiovascular problems. They should also warn of the serious mental-health risks of taking these drugs.

Take the widely used puberty-blocker Lupron (also known as Leuprorelin in the UK). Having been used as a cancer drug for years, it is now used for girls who wish to transition to boys. It can have devastating side-effects, including extreme mood swings, depression and suicidal thoughts. Not to mention the crushing muscle pain and nausea.

So harmful has Lupron proved that in the US the drugs manufacturer has faced lawsuits and a petition to congress to limit its use.

Another puberty-blocker is Histrelin, which is sold as Supprelin and used to treat precocious puberty. It is left to the manufacturer to explain that, Post-marketing reports with this class of drugs include symptoms of emotional lability, such as crying, irritability, impatience, anger, and aggression. [Also] depression, including rare reports of suicidal ideation and attempt

Then theres Finastaride, a feminising hormone. The UK government warns that it risks causing major depression and suicidal thoughts.

On and on the list goes. Goserelin. Progesterone. Triptorelin. Testosterone. All can have serious impacts on mental health.

And who are the guinea pigs in this experiment? Children, many of whom have suffered from pre-existing mental-health issues, like bi-polar disorder and schizophrenia, before developing gender dysphoria.

Moreover, many are teenage girls, a generational cohort suffering from unprecedented levels of self-harm, linked to anxieties over body image and sexual pressure.

So how many self-harming trans teens could actually be depressed girls with body disorders? The answer is quite a lot. Hence many are de-transitioning back to their original bodies, and reporting that they were lied to. One well-known activist puts the plight of such girls in stark terms: Im a real live 22-year-old woman with a scarred chest and a broken voice and a five-oclock shadow because I couldnt face the idea of growing up to be a woman.

There are thousands of tragic stories like this. Yet de-transitioners are bullied by trans activists, ignored by the media, and abandoned by the NHS.

Its all too easy for troubled kids to be sucked into the trans world. They see the story of the beautiful trans model finding his or her self in his or her new body. They know that being a victim of gender dysphoria means special treatment. And they can then be sucked into a darker online world. Those who escaped talk of trans chatrooms where young people are manipulated, encouraged to take puberty-blockers and cross-sex hormones, and where suicide is discussed as an alternative to transition. One de-transitioning teenager says, the nasty stuff is so easy to find and so hard to wriggle free of.

Overuse of the internet has already been clinically linked to self-harm and suicide. But here we have trans websites actively encouraging self-harm and suicide.Teens open and exposed to such sites should not be on hormones that can cause extreme mood swings, depression or suicidal thoughts.

But far from resisting the trans lobby, the UK government has been busy following its advice. So from next year, new guidlines will tell schools to teach transgender relationships in class. And if you teach all children that they could be in the wrong body, a good number will believe it. Such an approach will cause many to go on to hormone treatment, and, with it, a life of pain and mental anguish.

And what of young gay students? Almost every long-term study shows that most who grow out of transgender feelings turn out to be gay. But as trans ideology spreads, many gay young people are now seeing transition as a way out. One doctor has even described the situation as conversion therapy for gay children.

On the other side, trans advocates assert that no one changes their mind. But the science underpinning such statements is shaky. One often-cited study follows 55 post-transition teens on their road to happiness. Yet it barely mentions the 141 participants who dropped out, or the one who died after post-surgery complications. Worse still, other studies that show that high suicide rates continue after transition are now ignored.

It seems that a vast trans marketing and lobbying campaign has changed our culture and intimidated our institutions. Young people with all kinds of mental-health issues are being told they are in the wrong body and that transition is the dream cure. Many believe it and cry out for treatment. So teenagers already at fatal risk of depression, self-harm and suicide are given huge doses of toxic hormones that can cause uncontrollable swings of emotion, anxiety and depression. The dream of being in a new and beautiful body fades. It is replaced by an agonising reality. And so many continue to self-harm. And some take their own lives.

This fate now awaits thousands more children. They should instead be left alone or given proper medical care. It might just save them.

Simon Marcus is a writer, political consultant and former government adviser.

Picture by: Getty

Read the original:
Transitioning: a threat to our children - Spiked

A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed on Tuesday in Belgrade, Serbia, by an international team of surgeons.

The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable, and to enable him to father children, said Dr. Dicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure.

The operation was only the third known transplant of this type. The first two were performed 40 years ago in St. Louis, also for identical twins, each pair with a brother lacking testicles.

The absence of testicles is an exceedingly rare condition, but doctors say that the surgery may have broader applications for transgender people, accident victims, wounded soldiers and cancer patients. But the procedure raises questions about the ethics of transplants that are not lifesaving, and about the possibility of recipients someday fathering children with sperm from donors who may not even be related to them.

The surgery was performed at the University Childrens Clinic in Tirsova, a section of Belgrade. The Serbian brothers are doing well, doctors said. By Friday, the recipient already had normal testosterone levels.

Hes good, he looks good, his brother looks good, Dr. Ko said in a telephone interview on Friday. The donor, who already has children, should remain as fertile as he was before, despite giving up a testicle.

Dr. Ko said the brothers, who have been sharing a hospital room, were expected to go home this weekend. They preferred not to be identified or interviewed, the doctors said.

Because the patients are identical twins with the same genetic makeup, there is no concern that the recipients body will reject the transplant, so he does not have to take the immune-suppressing drugs that most transplant patients need.

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Surgeons operated on the brothers simultaneously, in adjoining rooms. The procedure was challenging because it required sewing together two arteries and two veins that were less than 2 millimeters wide.

Once you remove the testicle from the donor, the clock starts ticking very fast, said Dr. Branko Bojovic, an expert in microsurgery at Harvard Medical School and part of the team in Belgrade.

Within two to four hours, you have to have it re-perfused and working again, Dr. Bojovic said. Without a blood supply, a testicle is viable for only four to six hours.

It can take 30 to 60 minutes to make each of the four blood-vessel connections. But the team managed to complete them all in less than two hours, he said.

The team did not connect a structure called the vas deferens, which carries sperm out of the testicles. The surgeons could not find the tissue in the recipient needed for the connection, which means that for now, he cannot father children in the usual way.

Another operation to make the connection may be possible. Otherwise, if the recipient wants children, he might undergo a procedure to extract sperm from the testicle for in vitro fertilization. Or his twin brothers sperm could be used.

Dr. Ko and Dr. Bojovic were both part of the surgical team that performed the first penis transplant in the United States, in 2016, on a man whose penis had been removed because of cancer.

Dr. Miroslav Djordjevic, who led the team in Belgrade, specializes in urologic reconstruction and sex reassignment surgery at Mount Sinai Hospital in New York and at the University of Belgrade. He said the brothers approached him after learning that he had performed a successful uterus transplant between twins sisters, which enabled the recipient to give birth.

Dr. Bojovic said that after the penis transplant, the surgical team received inquiries from people undergoing female-to-male sex reassignment who wondered if they might receive transplants instead of the usual surgery, which creates a penis from the patients own tissue.

But a transplant from any donor other than an identical twin would require immune-suppressing drugs to prevent rejection. The drugs have side effects that lead some experts to argue that the bar for such transplants must be very high.

Its becoming more of a popular topic for these patients, Dr. Bojovic said. They say, If immunosuppression is getting safer, I dont want to use a big piece of tissue from my forearm or thigh or back for something that looks like phallus but isnt.

He added that in patients having male-to-female reassignment surgery, the penis and testicles that were surgically removed are discarded, but in theory could be used for transplants.

The lead surgeon, Dr. Djordjevic, said that he had developed a surgical plan for transplanting a penis onto a body that is anatomically female, and that he hoped to begin performing that surgery within the next year or so.

We have to do this as soon as possible, to stop putting healthy organs in the garbage, he said.

But he would not transplant testicles as part of transgender surgery, he said. Doing so would open up the thorny possibility that the recipient could have children produced by the donors sperm. If the idea were extended to deceased organ donors, special permission would be required from them before death, or from their families.

Then the offspring is technically whose child? asked Dr. Ko, who is also chief medical officer at St. Elizabeths Hospital in Boston. It raises much debate in the literature of medical ethics.

Last year, when surgeons at Johns Hopkins Hospital transplanted a penis, scrotum and other tissue to a young soldier who had been maimed in combat, they deliberately left out the testicles. The idea that he might father children who were genetically someone elses was considered unacceptable.

The first report of a testicle transplant, by Dr. Sherman J. Silber, a fertility specialist in St. Louis, was published in a medical journal in 1978. In that case, the twin brothers were 30 when they consulted Dr. Silber.

The brother without testicles had not reached puberty until he was given testosterone at age 18, which caused a growth spurt that left him four inches taller than his brother. He needed regular testosterone injections to maintain his masculine characteristics, but the hormone levels fluctuated and sometimes caused mood swings.

He spent five years searching for a doctor who could perform a testicle transplant before he found Dr. Silber, after reading a New York Times article about his work published in 1975.

Dr. Silber said that he had performed more than 2,000 kidney transplants in rats, which required microsurgical techniques to sew together minute blood vessels the same size as those in human testicles.

So doing a testicle transplant was not a big deal, he recalled in an interview on Thursday. It was like just another kidney transplant in a rat. He said the operation took two hours.

Dr. Silber said that the donor was gay and the recipient straight, and that the brothers told him they wondered if the transplanted testicle might somehow alter the recipients sexual orientation. There is no scientific reason for such an effect, and none occurred.

The transplant was a success, and the recipient eventually had five children, Dr. Silber said. A year or so later, he performed the surgery again for another pair of identical twin brothers, though he did not write up their case in a journal.

Regarding the operation in Belgrade, Dr. Silber said, I imagine these surgeons must be pretty good, because most people wouldnt dare to try this.

Read this article:
Surgeons Transplant a Testicle From One Brother to His Twin - The New York Times

Even when you love what you do, work-related stress can pile up, affecting your physical and mental health. For many people, it's a fact of life.

Each year, a majority of Americans report experiencing heavy work stress, according to theAmerican Psychological Association's annual Stress in America survey.

The most common stressors are low salaries, too much work, little room to grow or to be challenged, and lack of autonomy and support. While you can't completely eliminate stress from your life, when it becomes chronic you are putting your health in jeopardy.

When you experience a stressor, your body releases adrenaline, causing your heart rate to spike and your blood pressure to rise,according to theMayo Clinic. Cortisol, a hormone that increases blood sugar and limits functions that are not considered essential in a crisis, also increases.

This fight-or-flight drive is a natural mechanism designed to protect you from aggressors. But problems arise when you are constantly in a state of crisis.

"The long-term activation of the stress-response system and the overexposure to cortisol and other stress hormones that follows can disrupt almost all of your body's processes," according to the Mayo Clinic.

Chronic stress can lead to anxiety, high blood pressure and a weakened immune system. It can put you at higher risk for depression, obesity and heart disease. Stress also affects the quality and quantity of sleep, which in turns contributes to difficulties focusing at work.

When stress feels out of control, people sometimes turn to unhealthy coping strategies like overloading on junk food, binge drinking, smoking or taking drugs.

So short of leaving your job, how can you better manage stress and stay healthy? Here are some tips from theAmerican Psychological Association, National Sleep Foundation, Mayo Clinicand Harvard Health:

Keep track of daily stressors and how you react to them.

Then adopt new, healthier coping strategies like adding more exercise into your weekly routine, carving out more time for hobbies or spending time with loved ones.

Make sure you are getting enough sleep by having a set bedtime and by creating rituals to prepare your mind and body for sleep. That includes avoiding electronics for at least an hour before bedtime.

Set clear boundaries for your work and home life. If you are constantly bringing work home with you, you will never completely relax and de-stress.

Practice meditation and deep breathing exercises every day to build up your resilience against stress.

Work on your problem-solving skills so you stay solution-focused instead of getting mired in negative thoughts.

Finally, don't be afraid to ask for help. Talk to your supervisor about stress management resources at work, as well as ways he or she can support you better. Family and friends also can be good sounding boards.

If you continue to feel overwhelmed, a psychologist can help you create healthy coping mechanisms. You can find resources here.

Read more from the original source:
Most Americans find their jobs stressful here's how to survive at work - PhillyVoice.com

A 36-year-old man born without testicles received one transplanted from his identical twin brother in a six-hour operation performed in Belgrade, Serbia, by an international team of surgeons.

The surgery was intended to give the recipient more stable levels of the male hormone testosterone than injections could provide, to make his genitals more natural and more comfortable, and to enable him to father children, said DrDicken Ko, a transplant surgeon and urology professor at Tufts University School of Medicine in Boston, who flew to Belgrade to help with the procedure.

The operation was only the third known transplant of this type. The first two were performed 40 years ago in StLouis, also for identical twins, each pair with a brother lacking testicles.

Sharing the full story, not just the headlines

The absence of testicles is an exceedingly rare condition, but doctors said that the surgery may have broader applications for transgender people, accident victims, wounded soldiers and cancer patients. But the procedure raises questions about the ethics of transplants that are not lifesaving and about the possibility of recipients someday fathering children with sperm from donors who may not even be related to them.

The surgery was performed at the University Childrens Clinic in Tirsova, a section of Belgrade. The Serbian brothers are doing well, doctors said. By Friday, the recipient already had normal testosterone levels.

A vaping-related lung disease has claimed the lives of 11 people in the US in recent weeks. The US Centre for Disease Control and Prevention has more than 100 officials investigating the cause of the mystery illness, and has warned citizens against smoking e-cigarette products until more is known, particularly if modified or bought off the street

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Researchers in the US claim to have overcome one of the major hurdles to cultivating human follicles from stem cells. The new system allows cells to grow in a structured tuft and emerge from the skin

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A study in the journal Scientific Reports suggests that a dose of nature of just two hours a week is associated with better health and psychological wellbeing

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Exposure to air from traffic-clogged streets could leave women with fewer years to have children, a study has found. Italian researchers found women living in the most polluted areas were three times more likely to show signs they were running low on eggs than those who lived in cleaner surroundings, potentially triggering an earlier menopause

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Junk food adverts on TV and online could be banned before 9pm as part of Government plans to fight the "epidemic" of childhood obesity.Plans for the new watershed have been put out for public consultation in a bid to combat the growing crisis, the Department of Health and Social Care (DHSC) said

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On migrating from Africa around 70,000 years ago, humans bumped into the neanderthals of Eurasia. While humans were weak to the diseases of the new lands, breeding with the resident neanderthals made for a better equipped immune system

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The breath biopsy device is designed to detect cancer hallmarks in molecules exhaled by patients

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By their 10th birthdy, children have on average already eaten more sugar than the recommended amount for an 18 year old. The average 10 year old consumes the equivalent to 13 sugar cubes a day, 8 more than is recommended

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While there is not enough evidence of harm to recommend UK-wide limits on screen use, the Royal College of Paediatrics and Child Health have advised that children should avoid screens for an hour before bed time to avoid disrupting their sleep

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A study published in the New England Journal of Medicine has found that many elderly people are taking daily aspirin to little or no avail

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A study by the University of Minnesota's Masonic Cancer Centre has found that the carcinogenic chemicals formaldehyde, acrolein, and methylglyoxal are present in the saliva of E-cigarette users

Reuters

There has been a 41% increase in children with type 2 diabetes since 2014, the National Paediatric Diabetes Audit has found. Obesity is a leading cause

Reuters

The majority of antidepressants are ineffective and may be unsafe, for children and teenager with major depression, experts have warned. In what is the most comprehensive comparison of 14 commonly prescribed antidepressant drugs to date, researchers found that only one brand was more effective at relieving symptoms of depression than a placebo. Another popular drug, venlafaxine, was shown increase the risk users engaging in suicidal thoughts and attempts at suicide

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Researchers at the Baptist Health South Florida Clinic in Miami focused on seven areas of controllable heart health and found these minority groups were particularly likely to be smokers and to have poorly controlled blood sugar

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A major pressure group has issued a fresh warning about perilously high amounts of sugar in breakfast cereals, specifically those designed for children, and has said that levels have barely been cut at all in the last two and a half decades

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New guidance by the National Institute for Health and Care Excellence (NICE), the body which determines what treatment the NHS should fund, said lax road repairs and car-dominated streets were contributing to the obesity epidemic by preventing members of the public from keeping active

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A new class of treatments for women going through the menopause is able to reduce numbers of debilitating hot flushes by as much as three quarters in a matter of days, a trial has found.The drug used in the trial belongs to a group known as NKB antagonists (blockers), which were developed as a treatment for schizophrenia but have been sitting on a shelf unused, according to Professor Waljit Dhillo, a professor of endocrinology and metabolism

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Research from Oxford University found that more than one million extra people suffering from mental health problems would benefit from being prescribed drugs and criticised ideological reasons doctors use to avoid doing so.

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The family of a teenager who died from flu has urged people not to delay going to A&E if they are worried about their symptoms. Melissa Whiteley, an 18-year-old engineering student from Hanford in Stoke-on-Trent, fell ill at Christmas and died in hospital a month later.

Just Giving

The Government has pledged to review tens of thousands of cases where women have been given harmful vaginal mesh implants.

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The NHS will be asked to go further to prevent the deaths of patients in its care as part of a zero suicide ambition being launched today

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Human trials have begun with a new cancer therapy that can prime the immune system to eradicate tumours. The treatment, that works similarly to a vaccine, is a combination of two existing drugs, of which tiny amounts are injected into the solid bulk of a tumour.

Nephron

Mothers living within a kilometre of a fracking site were 25 per cent more likely to have a child born at low birth weight, which increase their chances of asthma, ADHD and other issues

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Thousands of cervical cancer screening results are under review after failings at a laboratory meant some women were incorrectly given the all-clear. A number of women have already been told to contact their doctors following the identification of procedural issues in the service provided by Pathology First Laboratory.

Rex

Most breast cancer patients do not die from their initial tumour, but from secondary malignant growths (metastases), where cancer cells are able to enter the blood and survive to invade new sites. Asparagine, a molecule named after asparagus where it was first identified in high quantities, has now been shown to be an essential ingredient for tumour cells to gain these migratory properties.

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A record number of nursing and midwifery positions are currently being advertised by the NHS, with more than 34,000 positions currently vacant, according to the latest data. Demand for nurses was 19 per cent higher between July and September 2017 than the same period two years ago.

REX

CBD has a broadly opposite effect to delta-9-tetrahydrocannabinol (THC), the main active component in cannabis and the substance that causes paranoia and anxiety.

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Mr Bransons company sued the NHS last year after it lost out on an 82m contract to provide childrens health services across Surrey, citing concerns over serious flaws in the way the contract was awarded

PA

The numbers of people accepted to study nursing in England fell 3 per cent in 2017, while the numbers accepted in Wales and Scotland, where the bursaries were kept, increased 8.4 per cent and 8 per cent respectively

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The paper found that there were 45,000 more deaths in the first four years of Tory-led efficiencies than would have been expected if funding had stayed at pre-election levels.On this trajectory that could rise to nearly 200,000 excess deaths by the end of 2020, even with the extra funding that has been earmarked for public sector services this year.

Reuters

Hours of commuting may be mind-numbingly dull, but new research shows that it might also be having an adverse effect on both your health and performance at work. Longer commutes also appear to have a significant impact on mental wellbeing, with those commuting longer 33 per cent more likely to suffer from depression

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It is not possible to be overweight and healthy, a major new study has concluded. The study of 3.5 million Britons found that even metabolically healthy obese people are still at a higher risk of heart disease or a stroke than those with a normal weight range

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When you feel particularly exhausted, it can definitely feel like you are also lacking in brain capacity. Now, a new study has suggested this could be because chronic sleep deprivation can actually cause the brain to eat itself

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David Lloyd Gyms have launched a new health and fitness class which is essentially a bunch of people taking a nap for 45 minutes. The fitness group was spurred to launch the napercise class after research revealed 86 per cent of parents said they were fatigued. The class is therefore predominantly aimed at parents but you actually do not have to have children to take part

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Tobacco and alcohol companies could win more easily in court cases such as the recent battle over plain cigarette packaging if the EU Charter of Fundamental Rights is abandoned, a barrister and public health professor have said

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A major new study into the side effects of the cholesterol-lowering medicine suggests common symptoms such as muscle pain and weakness are not caused by the drugs themselves

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New research has found that babies born to fathers under the age of 25 or over 51 are at higher risk of developing autism and other social disorders. The study, conducted by the Seaver Autism Center for Research and Treatment at Mount Sinai, found that these children are actually more advanced than their peers as infants, but then fall behind by the time they hit their teenage years

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Commuters who swap their car or bus pass for a bike could cut their risk of developing heart disease and cancer by almost half, new research suggests but campaigners have warned there is still an urgent need to improve road conditions for cyclists.Cycling to work is linked to a lower risk of developing cancer by 45 per cent and cardiovascular disease by 46 per cent, according to a study of a quarter of a million people.Walking to work also brought health benefits, the University of Glasgow researchers found, but not to the same degree as cycling.

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Scientists conducted the research on 71 car crash victims as they were waiting for treatment at one hospitals accident and emergency department. They asked half of the patients to briefly recall the incident and then play the classic computer game, the others were given a written activity to complete. The researchers, from Karolinska Institute in Sweden and the University of Oxford, found that the patients who had played Tetris reported fewer intrusive memories, commonly known as flashbacks, in the week that followed

Rex

Vaping has been given an emphatic thumbs up by health experts after the first long-term study of its effects in ex-smokers.After six months, people who switched from real to e-cigarettes had far fewer toxins and cancer-causing substances in their bodies than continual smokers, scientists found

Matt Cardy/Getty Images

Millions of people are putting themselves at risk by cooking their rice incorrectly, scientists have warned.Recent experiments show a common method of cooking rice simply boiling it in a pan until the water has steamed out can expose those who eat it to traces of the poison arsenic, which contaminates rice while it is growing as a result of industrial toxins and pesticides

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An injectable contraceptive gel that acts as a reversible vasectomy is a step closer to being offered to men following successful trials on monkeys.Vasalgel is injected into the vas deferens, the small duct between the testicles and the urethra. It has so far been found to prevent 100 per cent of conceptions

Vasalgel

Women who work at night or do irregular shifts may experience a decline in fertility, a new study has found.Shift and night workers had fewer eggs capable of developing into healthy embryos than those who work regular daytime hours, according to researchers at Harvard University

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The Japanese government has announced measures to limit the amount of overtime employees can do in an attempt to stop people literally working themselves to death.A fifth of Japans workforce are at risk of death by overwork, known as karoshi, as they work more than 80 hours of overtime each month, according to a government survey.

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It is well known that high blood pressure is a risk factor for dementia, so the results of a new study from the University of California, Irvine, are quite surprising. The researchers found that people who developed high blood pressure between the ages of 80-89 are less likely to develop Alzheimers disease (the most common form of dementia) over the next three years than people of the same age with normal blood pressure.

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A vaping-related lung disease has claimed the lives of 11 people in the US in recent weeks. The US Centre for Disease Control and Prevention has more than 100 officials investigating the cause of the mystery illness, and has warned citizens against smoking e-cigarette products until more is known, particularly if modified or bought off the street

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Researchers in the US claim to have overcome one of the major hurdles to cultivating human follicles from stem cells. The new system allows cells to grow in a structured tuft and emerge from the skin

Sanford Burnham Preybs

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Surgeons transplant testicle from one identical twin to the other - The Independent

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, Dec. 9 - 8-4 - Appt needed

Canton - WIC Nutrition Education - Tuesday, Dec. 10 - 8-4 - Appt needed

Astoria - Clinic, WIC Nutrition Educ. - Wednesday, Dec. 11 - 9-3 - Appt needed

Canton - Clinic - Thursday, Dec. 12 - 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).

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.

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).

Canton - Clinic - Monday, Dec. 9 - 8-12 - Appt needed

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:

Canton - Screening - Monday, Dec. 9 - 8-4 - Walk in/Room 108

Cuba - Screening - Monday, Dec. 9 - 8-12 - Walk in

Astoria - Screening - Wednesday, Dec. 11 - 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).

Canton - Clinic - Monday, Dec. 9 - 8-12 - Appt needed

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).

Link:
Health Department announces services for the week of Dec 9 - Canton Daily Ledger

One of the most commonly searched questions about breastfeeding is, What medicines can you take? Since everything you consume makes its way into your babys milk supply, its a valid concern. Sure, we know to pump and dump after a couple glasses of wine, but what about medications?

There are myriad benefits to breastfeeding your baby. Nursing reduces a woman and her babys risk of getting breast cancer, and the antibodies in human milk protect against infection and build the immune system. While there are many benefits, its also important that breastfeeding moms take care of their own health. Sometimes, that means taking medication. Certified Lactation Education Counselor and Certified Childbirth Educator AAHCC Liza Janda breaks down whats OK and whats off limits.

What to do before taking any medications

The most important thing a lactation educator consultant can do is educate the mother on being an active participant in her health care decisions, Janda says. Most medications are suitable to take while breastfeeding. Many mothers are told they need to stop breastfeeding to take a medication or do a test or a procedure. In most cases, this is unnecessary.

Janda recommends asking yourself and your physician important questions before taking any medications:

Are there alternatives to treatment that dont involve medication?

Is there an alternative medication that may be safer?

Do the benefits of taking the medication outweigh the risks to my baby?

In the clear

With all medications during breastfeeding, there is a risk that trace amounts will end up in your milk supply. In most cases, however, the amount is very small and will not harm your child.

Ibuprofen is generally safe for nursing women to take. A 1984 study found that moms who took 400mg of ibuprofen every six hours passed on less than 1mg to their supply, an amount that will not negatively affect your baby, but nursing women should not take more than the daily maximum dose. Of course, consult your doctor before taking.

In the way of painkillers, acetaminophen and naproxen are also OK for breastfeeding mothers. However, naproxen (Aleve, Midol, Flanax) should be used for the short-term only.

According to Planned Parenthood, it is safe to use hormonal methods of birth control while breastfeeding. These include the shot, implant, Skyla and Mirena IUDs, and some kinds of birth control pills (known as the minipill). However, methods that include the hormone estrogen (pills, patch, or ring) should be avoided for the first three weeks after giving birth. After three weeks, these hormonal methods are fair game once again.

If you have symptoms of a cold, thats where medication while breastfeeding gets tricky.

Cold medicine can affect milk supply, Janda says. If the goal of the cold remedy is to dry up a stuffy nose, it will probably also lower her milk supply.

Most decongestants like Sudafed and Zyrtec D contain pseudoephedrine, which can lower milk supply. Use medications with this ingredient with caution. For a full list on what medications are safe to take while breastfeeding, check out this guide from the Mayo Clinic.

Not so safe

Contraindicated is a medical term that means a procedure or medication is unadvisable. While breastfeeding, contraindicated drugs include anticancer drugs, lithium, oral retinoids, iodine, amiodarone, gold salts, marijuana and other recreational drugs.

If youre interested in researching a particular medication, theres ToxNet. ToxNets LactMed feature is a resource and database featuring 31 antibiotics, their safety, and the amount that shows up in breast milk. You can also search SSRIs and other meds.

Drinking, smoking, and using CBD while breastfeeding

Breastfeeding mothers can drink alcohol, but it takes 2-3 hours to metabolize one 5-ounce glass of wine, 1-2 ounces of hard liquor, and one 8-ounce of beer, Janda explains. Do not breastfeed for 2-3 hours after that one serving. If she drinks more than one serving, it will take 4-6 hours to metabolize.

Smoking nicotine is recognized as off-limits for nursing mothers, as nicotine in the milk supply can cause fussiness, diarrhea, vomiting, rapid heard beat and restlessness in infants, according to Janda.

As for CBD, the jurys still out. Theres not enough research or regulation to decide about CBD, Janda says. So, just avoid it to be safe.

If you're interested in submitting a Letter to the Editor, click here.

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Breaking down the meds you can take while breastfeeding - The Daily Collegian Online

Image: Drugs for a clinical trial

The ICRs researchers showed that a new immunotherapy could greatly extend the lives of people with advanced head and neck cancer, with some living for over three years.

They evaluated the drug pembrolizumab in a trial of nearly 500 patients with very advanced disease that had already spread and become resistant to chemotherapy.

Treatment options for these patients are extremely limited, and they are normally expected to survive for less than six months.

Overall, patients who received pembrolizumab experienced significant benefits with 37 per cent surviving for a year or more, compared with only 26.5 per cent of those on standard care, consisting of chemotherapy or the targeted agent cetuximab.

Some 36 patients saw their cancer partially or completely disappear, and some were still cancer-free three years after first receiving pembrolizumab.

Study leader Professor Kevin Harrington, Professor of Biological Cancer Therapies at The ICR and Consultant at The Royal Marsden, said:

I would like to see pembrolizumab approved for use in the clinic, so that people with metastatic head and neck cancer can be offered the chance of a longer life and improved quality of life.

The trial, published in The Lancet, was funded byMerck & Co., Inc.

Read this article:
Scientific achievements of 2019 - The - The Institute of Cancer Research

Image:Breast cancer cells stained for DNA (red), NFkB (green), and a reactive oxygen species probe (blue). Credit: Julia Sero / the ICR, 2011

A new test could pick out women with advanced breast cancerwho are likely to benefit from an exciting new targeted therapy for more than a year.

Analysing levels of a molecule called cyclin E1 in tumour biopsies could be used to guide breast cancer treatment helping delay chemotherapy for some women and ensuring others are closely monitored for any signs of progression.

Researchers found that testing for cyclin E1 could predict the chances of a year or more of successful treatment with a drug called palbociclib a drug hailed by doctors as the biggest advance in breast cancer treatment for 20 years.

Palbociclib targets weaknesses in cancer cells specifically, and so has far fewer side-effects than conventional chemotherapy allowing women to live well with their cancer.

It comes as NICE last week recommendedthe use of palbociclib on the NHS through the Cancer Drugs Fund, for women with advanced oestrogen receptor-positive breast cancer who have received hormone therapy.

Hormone therapy works against around 70 per cent of breast cancers and is one of the most common first treatments for people with advanced breast cancer so the new approval could significantly increase the number of women who can benefit from palbociclib on the NHS.

The study by the team at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust, showed that women with low levels of cyclin E1 in their tumours responded to palbociclib given in combination with hormone treatment for nearly twice as long as women with high levels.

The tests development is described in a study in the Journal of Clinical Oncology with funding by palbociclibs manufacturer, Pfizer.

Following her initial breast cancer diagnosis and successful treatment in 2012, Christine was shocked to discover that her cancer had spread to her brain in 2018. Thanks to palbociclib, Christine is now living well with cancer, including a new-found passion for cycling.

Read Christine's story

The study found that the combination of palbociclib and hormone treatment had some benefit for women irrespective of their test results, delaying the need for chemotherapy for at least three months, even in the shortest responders.

But the researchers suggest that women with higher levels of cyclin E1 in their tumours should be monitored especially closely, since they can be expected to stop responding much more quickly than others.

Researchers in the Breast Cancer Now Toby Robins Research Centreat The Institute of Cancer Research (ICR) looked at tumour samples from two different trials involving palbociclib 302 patients from PALOMA-3, a trial which assessed the drug in combination with hormone therapy for advanced cancer, and the POP trial which looked at palbociclib used on its own before surgery in 61 patients with breast cancers that hadnt yet spread.

In the PALOMA-3 trial, women with low levels of cyclin E1 responded to combination treatment for an average of 14.1 months before their tumour started growing again, compared with only 7.6 months in women with high levels, and 4 months among those who received a placebo plus hormone therapy.

In the POP trial, palbociclib treatment stopped the tumour growing in 80 per cent of women if low levels of cyclin E1 were present, whereas palbociclib only stopped the tumour growing in 36 per cent of women it high levels of cyclin E1 were present.

Strategies to overcome cancers lethal ability to survive and resist treatment are a major focus by researchers at the ICR, who are poised to outsmart cancer with the worlds first anti-evolution Darwinian drug discovery programme.

To facilitate this, the research institution is constructing a 75 million state of the art building the Centre for Cancer Drug Discovery. It will house a series of pioneering projects to deliver long-term control and effective cures, just as comparable approaches have achieved with HIV.

Palbociclib targets two proteins called CDK4 and CDK6 that are involved in a series of checks that control when a cell can replicate its DNA. By blocking these two proteins from doing their jobs, cancer cells cant multiply.

Cyclin E1 is also involved in the checkpoints that dictate when a cell can multiply, and the researchers hypothesise that high levels of cyclin E1 allow cells to bypass other checks and keep multiplying, uncontrolled.

Previous studies hadnt been able to identify a marker which indicated how successful palbociclib would be, or to spot resistance arising, so the team widened the search and analysed the activity of 2,534 different cancer-related genes.

Cyclin E1 appeared to be the most significant predictive indicator of how a patient will respond to palbociclib, and they identified possible others including associated protein CDK2.

Interestingly, the effect of cyclin E1 on treatment response was stronger in biopsies from metastatic tumours than primary tumour biopsies taken at diagnosis.

The difference highlights the importance of taking biopsies of recurrent breast cancer to guide treatment as tumours evolve to become drug resistant.

Although the researchers show cyclin E1 is an indicator of response to palbociclib in two different treatment settings, it will still need to be validated as a test to guide treatment in clinical trials designed specifically to assess its success.

Professor Nicholas Turner, Professor of Molecular Oncology at The Institute of Cancer Research, London, and Consultant Medical Oncologist at The Royal Marsden NHS Foundation Trust, said:

Palbociclib is a targeted drug that allows women to live a normal life for longer but when their cancer evolves and develops resistance, they can stop responding to the treatment.

Weve developed a way of identifying which women with advanced breast cancer stand to benefit for more than a year from the targeted treatment palbociclib, and which are likely to stop responding much more quickly.

Nearly all the women on the PALOMA-3 trial benefited from the drug for at least a few months, delaying the need for chemotherapy. But some women will progress more quickly, and may require additional monitoring so we can switch treatments as soon as the drug stops working.

We validated our findings using data from a second trial, but we will need to assess our test further to see how effectively it can guide treatment before it could start to be used routinely in patients.

Christine OConnell, 46, from south-west London, was diagnosed with secondary breast cancer in February 2018. She said:

I have seen first-hand the difference a targeted treatment can make. Im on the 19th cycle of palbociclib and my cancer is currently stable. I take my pill every morning, and I get on with my life. I still cycle 3-4 times a week, which I could never have done had I been on conventional therapy.

Palbociclib allows me to live a good life with cancer and I want all cancer patients to have this hope and optimism for the future.

Professor Paul Workman, Chief Executive of The Institute of Cancer Research, London, said:

At the ICR, we believe precision cancer medicine should be driven by a test for every treatment ensuring that only patients who are likely to benefit from a drug are treated with it, and that patients who are likely to quickly relapse are closely monitored for signs of resistance.

Our researchers have developed a test which could ensure the exciting new drug palbociclib is used more effectively in the clinic, and that where necessary women can be moved promptly from it onto alternative treatments.

This kind of targeted, test-driven approach can reduce costs for the NHS, improve quality of life for patients and spare some people treatment that will not benefit them or which has stopped working.

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New test predicts chance of living more than a year on targeted breast cancer treatment - The Institute of Cancer Research

For years, anti-choice advocates have promoted the unfounded idea that medication abortions can be reversed halfway through the procedure. If a patient changes their mind after taking the first abortifacient drugmifepristonethey can forego the second, misoprostol, and instead take several doses of progesterone to continue the pregnancy, according to the theory.

This claim hasnt just been promoted through anti-abortion activism and crisis pregnancy centers, but legislated, too: Currently, six statesArkansas, Idaho, Kentucky, South Dakota, Utah, and Virginiahave laws requiring providers to inform patients that they can request this abortion reversal treatment should they have misgivings about their decision to terminate, a phenomenon that is exceedingly rare.

While doctors have long contended that abortion reversal is nothing more than a myth intended to stigmatize the procedure, up until recently the treatment remained virtually untested. Now, new evidence shows that attempting abortion reversal can result in severe blood loss that could be life-threatening.

The findings are the result of the first-ever randomized, controlled clinical study on abortion reversal, conducted by researchers at the University of California, Davis, and published in the journal Obstetrics & Gynecology.

Originally, researchers set out to enroll 40 women in the study, who were already scheduled to have in-clinic abortions and consented to delaying the procedure for two weeks to test the abortion reversal method. These women would take a dose of mifepristone and then follow it up with either a placebo or progesterone. But researchers halted the study prematurely, after just 12 participants had been enrolled, when three women experienced vaginal hemorrhaging, or excessive bleeding, and needed to be taken to the ER via ambulance; one woman needed a blood transfusion. Two of them had received the placebo, and the other had received doses of progesterone. (On its own, mifepristone only stops the embryo from developing, while misoprostol is necessary to initiate uterine contractions to expel the pregnancy.)

Mitchell Creinin, the studys lead researcher a professor in the Obstetrics and Gynecology department at UC Davis, said that though his paper doesnt definitively debunk abortion reversal as ineffective, it shows that there are serious risks associated with not following through with the two-drug medication abortion regimen once its begun.

We dont have any evidence that disproves the possibility that abortion reversal exists, Creinin said. But I do have evidence that not completing the regimen as its designed is dangerous. The study concludes by recommending that states stop passing laws that require providers to discuss abortion reversal with patients: For now, the treatment remains experimental and "and should be offered only in institutional review boardapproved human clinical trials to ensure proper oversight."

Laws should not mandate counseling or provision of any treatment when we do not fully understand treatment efficacy (including best route of administration, dose, and duration) and safety, the paper reads.

A self-described "pro-life" doctor, George Delgado, originated the idea of abortion reversal in 2012, when he claimed hed discovered a method for chemically reversing the effects of mifepristone. The drug blocks the hormone progesterone, which is necessary for continuing a pregnancy. In a co-authored report at the time, Delgado said he had helped six pregnant women who had initiated a medication abortion carry their pregnancies to term by giving them injections of progesterone in the 24 hours after they took the mifepristone pills.

Ever since, anti-choice advocates have used Delgados claims to suggest that science supports the idea that abortions can be reversed. But Creinin and other experts say Delgados findings are based on bad science: Delgado didnt use a placebo as a control, nor did he randomize the study. What he produced was merely a series of case reports, Creinin said, which fail to prove a cause-and-effect relationship between post-mifepristone progesterone injections and continuing a pregnancy. (Delgado told VICE News in April that he plans on conducting another study that will include 900 women, though he still will not give any of the women a placebo as a control.)

There was zero evidence that such a thing as abortion reversal worked, Creinin said, but because Delgados claims had resulted in multiple state laws, he felt he had a duty to put them to the test.

The lack of evidence hasnt stopped people from passing these laws, so we wanted to take the question seriously, in a rigorous, controlled trial with Institutional Review Board approval, he continued. Patients deserve the truth.

Reproductive health advocates say the requirement that abortion providers in some states must inform patients of a reversal protocol that isn't supported by evidence is just one way anti-choice legislating infringes on the doctor-patient relationship. Five states mandate that providers tell patients that there is a link between abortion and breast cancer, a claim that has been widely discredited, and eight of the 23 states that require providers to inform patients of possible psychological responses to having an abortion emphasize negative outcomes, like depression and anxiety, which studies have shown are not caused by abortion.

[Abortion reversal] goes beyond laws that force providers to give information about unproven or disproven claims, like that abortion causes depression or breast cancer, said Daniel Grossman, the director of Advancing New Standards in Reproductive Health (ANSIRH), a program at the University of California, San Francisco. Laws requiring doctors to inform their patients of abortion reversal encourage patients to essentially participate in an unmonitored experiment. This latest study suggests there are actual safety concerns surrounding that.

Creinin said its important to emphasize that the dangers associated with attempting to reverse a medication abortion don't diminish the overwhelming safety and effectiveness of medication abortion itself, which has decades of research to back it up. In 2017, almost 40 percentor nearly 2 in 5abortions were done with pills.

The key is that medication abortion requires both medications, he said, which has been the official recommendation of organizations like the World Health Organization, the Food and Drug Administration, and the American College of Obstetricians and Gynecologists, for decades.

Medication abortion, performed through a combination of mifepristone and misoprostol, has provided a safe, effective option for induced abortion that has benefitted millions of women, said Chris Zahn, the vice president of practice activities at ACOG, which publishes the journal in which the study appears. Even with its limitations, [Creinins] study raises safety concerns about not completing the evidence-based regimen. Mifepristone is not intended to be used without follow-up misoprostol treatment.

Still, its unlikely that Creinins finding will change the minds of abortion opponents, who are likely to continue citing Delgados ongoing research, despite its flawed methodology. Several more states (including Georgia, Kansas, North Carolina, Ohio, and Wisconsin) have abortion reversal bills working their way through the legislature, and similar federal legislationcalled the Second Chance at Life Actwas introduced in the House in April.

But while Creinins study isnt definitive, since it had to conclude early, hes come to the end of his research. The first step of any series of studies is to establish safety, he saidif this had been, say, a clinical trial for a new birth control pill, the negative outcomes the participants experienced would preclude the possibility of continuing to research it.

You study something when theres a reason to study it, and we have no evidence that suggests abortion reversal is real, while we do have evidence that its potentially dangerous, Creinin said. So if I were developing a drug I would say, I have to stop.

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The First Study on 'Abortion Reversal' Landed Three Women in the ER - Free

Tamara Loyer proudly wears a bright red lanyard around her neck, from which dangles keys to the modest office where she oversees a unique Downtown Eastside drop-in program for trans women that she designed this year.

Shes come a long way in the past decade: from a despondent homeless woman trapped inside a body with male genitalia to someone who has undergone gender-confirming surgery and now has a home, goes to school and is employed.

Ive not been in an office setting since the mid-1980s, laughs Loyer during an interview at Atira Womens Resource Society, where she started the Beyond the Street drop-in for trans women in September.

Now 57, Loyer believes her internal war with her gender was at the root of her 30-year spiral into drug addiction, sex work and homelessness, and that the surgery she had in April 2014 gave her the confidence to start putting her life back together again.

After surgery, I thought I dont want to have to think about (gender) the way I did before. I can be part of the world. I can go and do things now without being self-conscious, she reflected. I walk around here and I dont have to be afraid that whats in my head and what people see arent the same.

She is happy with her outward appearance, but is inwardly still haunted by gender dysphoria a crippling unhappiness with ones biological gender.

After surgery, we all like to think that it will never bother me again. It still does. I think about it every day, she said.

Her dark thoughts are often triggered by still-lingering male gender traits, such as facial hair and a low voice. That bothers me still to this day. Im not as critical, as I was, at what I see in the mirror, (but) it doesnt go away 100 per cent.

Tamara Loyer in the Atira office.

The Vancouver Sun documented Loyers story in 2014: the challenges of applying for the surgery and organizing the logistics when you have a vulnerable lifestyle, no fixed address, a panhandlers income, and no family supports. At the time, B.C. funded sex-reassignment surgeries, but the only place in Canada that performed them was a private Montreal hospital, where Loyer was flown by a charity airline.

I had nobody with me and it was terrifying, she said. It was daunting. There is so much red tape to go through.

The number of B.C. patients that must endure that flight to Montreal is expected to decrease in the coming years. A new gender surgery clinic opened in Vancouver General Hospital in late September, where the Health Ministry anticipates full-scale gender-affirming surgeries will be performed, likely next year.

Two surgeons with specialized skills have been hired to work at the clinic, and since September have done repairs and revisions to previous surgeries, and performed parts of so-called lower surgeries but not yet the entire procedure, the Health Ministry said in a statement.

Until this year, patients in every province had to travel to Montreal for lower surgeries which include vaginoplasty for trans women and phalloplasty for trans men. In June, Ontario started to offer these complex surgeries at Womens College Hospital in Toronto, and B.C. plans to be the next province to do so.

The trans community has advocated over a number of years for improved access to care, including access to complex lower surgeries within B.C., Health Minister Adrian Dix said in November 2018, when he first indicated the services offered here would expand.

For those seeking lower surgery, people were required to travel to Montreal or to the U.S., resulting in additional medical risks associated with travelling long distance after surgery and in receiving followup care if there were complications.

Trans woman Morgane Oger, right, greets Health Minister Adrian Dix in November 2018 following his announcement that transgender people will soon have access to publicly funded gender-affirming lower surgeries.

The number of British Columbians travelling to Montreal has been on the rise, with about 100 patients annually in recent years. That number is expected to stay roughly the same in 2020, while the B.C. program fully ramps up, the Health Ministry said.

An estimated one per cent of the population identifies as trans, which includes a wide range of people for whom their gender is different from their assigned sex at birth. In B.C., the Health Ministry says, about 46,000 people identify as trans or gender diverse, but only a few will pursue medical or surgical services.

Offering the service closer to home will make it simpler to access and to allow friends to visit during recovery. That may encourage more trans people to consider surgery, especially those from marginalized communities like the Downtown Eastside, Loyer said.

And, she argued, it will benefit society in the long run to help more people feel in sync with their own bodies.

You are going to get a person who is going to be more productive. Somebody who might want to go to school, get a job. Somebody who might want to join their family again, she said.You dont have to live in despair, overwhelmed with what is described as an illness. You can be functional.

Trans people face discrimination and harassment, which often leads to poor mental health and a greater risk for suicide, says the Calgary-based Centre for Suicide Prevention.

Loyer speaks softly when she remembers trans friends who committed suicide, got killed, ran away, were never seen again, overdosed or became mental patients. She hopes these tragedies will be less frequent among her peers with the new local access to medical help.

Another set of surgeries many trans people pursue breast augmentation or chest construction were, until recently, offered in only Vancouver and Victoria. Now B.C. has 16 surgeons who do this work, and these procedures have been extended to Abbotsford, Burnaby, Port Moody, New Westminster, Kamloops, Kelowna and Prince George.

The demand for these upper surgeries in B.C. has quadrupled in just three years, with 49 performed in 2015-16 and 254 in 2018-19. The Health Ministry anticipates 300 breast or chest surgeries will be completed by the end of this fiscal year, in March 2020.

And B.C. has a waiting list for this procedure with more than 200 names.

In 2015, the Provincial Health Services Authority launched Trans Care B.C., which offers details about health care and support for trans people or their families. Its service directory lists dozens of drop-ins and information groups across the province, including in communities outside Metro Vancouver such as Prince Rupert, Fort St John and Cranbrook.

So much as changed since Loyer first arrived in Vancouver in 1984, at age 23, leaving behind a turbulent childhood on a Quebec military base. She came here to seek acceptance. She assumed the name Tamara, found work as a computer programmer and continued to pursue post-secondary education.

But she faced discrimination, numbed her pain with drugs, and eventually worked the streets to earn income. In 1989 she began inquiring about a sex-change operation, but had no stability to pursue surgery.

She was homeless, sick and dejected in 2011 when an outreach worker took her to the first place she felt at home: a shelter for woman, run by Atira. Despite the obvious challenges of sharing communal bathrooms with the female tenants of the modest shelter, Loyer began to heal and, through a new network of support, was able to get her surgery in March 2014.

The Healthy Ministry paid $20,000 for the procedure and $2,000 for her post-surgery care in Montreal. Doctors removed her male organs and created a vagina.

The Vancouver Suns first feature on Loyer was published one month after the operation, when she was still healing and had modest ambitions to live a more stable life.

Tamara Loyer panhandles on Cordova street in Vancouver in 2014.

Today, she says that it took her about six months to physically heal from the invasive surgery while she lived in Atira-supported housing in the heart of the Downtown Eastside. There were infections that required cleaning, extreme tenderness, and a daily routine of using dilators to ensure her new vagina wouldnt close up.

And there are post-operation steps that will be necessary indefinitely. Attached to her stomach is a patch that supplies very large doses of estrogen, a female hormone that her body considers a foreign substance and tries to reject.

But, overall, she is elated with the outcome of the surgery. I wake up in the morning and Im happy that I dont have to encounter a body that is what I had. That was one of the most horrible things in the shower and the washroom and getting dressed. And that is gone.

Loyer does not wear makeup, jewelry or fancy clothes, but rather prefers basic, gender-neutral garb.

I am happy with what I look like, she said. Its not the outside thats the problem. Its the inside that is giving me the problems.

In early 2019, Loyer was upgrading her high school credits at the South Hill Adult Education Centre in south Vancouver, but she was also still panhandling, which she found increasingly demeaning, to supplement her disability pension.

I didnt want to be there. I wanted to be in school.

Loyer appeared isolated, recalled Janice Abbott, the executive director of Atira, so she suggested Loyer open a drop-in for trans women. Atira offered space to hold the meetings, a small budget for food and communication, and the encouragement for Loyer to independently create a program that was needed in the Downtown Eastside.

The trans community is complex, its not homogeneous in any shape or form. So I think that more opportunities for safe space in ways that trans women identify their own communities, I think that there needs to be more (of) that, said Abbott, adding that Loyers drop-in is a low-key environment where people can make friends and share challenges.

I think everyone in the Downtown Eastside needs an informal place, where you dont have to come in and fill out a form that says I need social services. Its a place to get a snack and have a cup of coffee and hang out for a couple of hours. And I think thats part of what makes it beautiful.

Janice Abbott, CEO of the Atira Womens Resource Society, looks over a room in a supported-housing building in the Downtown Eastside.

Loyers program, Beyond the Street, is among the first peer-led drop-ins for trans women in Vancouver. It has been holding two-hour sessions every Sunday afternoon since September.

It focuses on offering people help in three main areas: housing questions, such as dealing with transphobia while looking for an apartment or getting evicted; legal matters, such as how to change your name or marriage breakup help; and counselling issues, such as being trapped in a lifestyle that isnt true to your identity. The program also offers fun activities like Thanksgiving dinner and movies.

Sometimes trans women get stalled. Something happens and you stop. You cant get anywhere, whether its housing or medical. The idea is to keep them going, said Loyer.

The three-month-old drop-in has 12 regular attendees, but Loyer also helps women in other communities by phone or email.

She hopes the program can offer marginalized trans woman better options than they often faced in the past: You end up on the street corner, or you end up in the alleys, or you break down and cry, or you suicide.

We try to keep people from saying, Oh well, this is what I get. Which is easy to think when you dont have anybody saying anything different, Loyer said.

Among Atiras many social housing buildings, which accommodate more than 1,500 women and children every year in the Lower Mainland, up to 20 per cent of the adult female tenants identify as trans, depending on the building type and location, Abbott said.

Many trans women also use Atiras SisterSpace, which is described as the first women-only overdose prevention site in Canada. Evaluation reports on Atiras website quote trans women who say the safe space offers empathetic workers and an escape from transphobia.

Trans issues have increasingly been in the news. In a high-profile court case, a local father who opposes his transgender childs pursuit of testosterone therapy fought lower-court decisions all the way to the B.C. Court of Appeal.

And the provincial government recently introduced SOGI, or sexual orientation and gender identity learning resources for elementary and high schools, which created controversy.

For Loyer, trans issues are not new. Theyve been bottled up inside of her for five decades. She hopes, though, that more attention will lead to increased acceptance.

Since her surgery in 2014, she said, her health has improved drastically. The hepatitis C she contracted in 1989 from intravenous drug use is now not detectable in her blood. She is drug-free and quit her 30-year smoking habit. She can walk without a cane, which she had used since her leg was broken in a nasty 2011 assault. Her sight has improved after a hole in her cornea, likely from a beating, was repaired. And she now weighs 165 pounds, up from the 109 she weighed when she arrived on Atiras doorstep nearly nine years ago.

She no longer lives in supported housing, and has moved to a mixed-income Atira building where many of her neighbours have jobs and go to school. While B.C. Housing subsidizes her rent, Loyer must pay for utilities, internet, and other living expenses.

Perhaps she is most excited about the high school science and math courses she is taking to boost her marks so she can one day apply to the University of British Columbia for a combined degree in astronomy and physics. A downtown investment firm, who read about Loyer in 2014 in The Vancouver Sun, has told her it will pay for her tuition if she gets accepted to UBC.

But with that excitement also comes the fear of failure.

I need to find a place to apply myself. But the science part I was really nervous about. I didnt want to think that I could do something and find out that I made a total mess of it and lose confidence, she said.

Loyer will need confidence to complete her academic goals. She has displayed confidence already, though, in the pursuit of her gender goals. And she has a favourite saying that has, in the past, given her courage and determination: Its a song title from the movie The Rocky Horror Picture Show, which she saw in Toronto in 1978 after she ran away from home, at age 16, so she could start living as a woman.

Dont Dream it. Be it.

lculbert@postmedia.com

Twitter: @loriculbert

See the article here:
Finding her way: Five years after gender-reassignment surgery Tamara Loyer helps other trans women - Vancouver Sun

There are more than a million people who have Type 1 diabetes, and they're expected to live at least 10 years less than Americans without it.

In fact, there are only 90 diabetics who have lived more than 70 years.

But one man crushed that goal 15 years ago and is telling others how they can do it too.

Eighty-five-year-old Don Ray can't remember a life without diabetes.

As a child, Don could not go to gym class. He couldn't play sports. He couldn't even play hide and seek.

"Because if you were to hide, and they can't find you and you have an insulin reaction or a hypoglycemia, you might really be in trouble because they will never find you," Don explains.

He was told he wouldn't live past his 30s. But eventually he got tired of hearing, "You can't, you can't, you can't."

"I would go to gym class when I started school in kindergarten and first grade, and I'd sit in the chair in gym class and I'd watch these kids, and I knew I could do this, cause I just knew I could do this," Don says.

Don and his dad started playing catch, and that turned into 20 years of playing football and 30 years of baseball.

And he did it because "he followed the rules," according to Betul Hatipoglu, MD, at the Cleveland Clinic.

What rules? First make sure your blood sugar is in check: between 80 and 130 milligrams. If it's too low, eat some carbs, but don't forget to check while working out.

"If they are going to exercise for an hour, they have to check it in 30 minutes again to make sure they are still in the safe zone," Hatipoglu says.

But don't take too much insulin before your meal or before your workout.

"So if you are going to exercise after lunch, for lunch you take less insulin so it is safer for you," Hatipoglu says.

And if you're working out after dinner, be careful as well. You don't want any overnight complications.

"If you take care of the disease, the disease will take care of you, and you can if you take care of yourself," Hatipoglu explains.

Nowadays, there are nearly 140,000 people diagnosed with diabetes each year in the U.S. alone. But in 30 years, an expected five million Americans will be diagnosed with Type 1 diabetes.

DIABETES TYPE 1: DON SHATTERS EXPECTATIONS! REPORT #2699

BACKGROUND: Glucose is a critical source of energy for your brain, muscles, and tissues. When you eat, your body breaks down carbohydrates into glucose and this triggers the pancreas to release a hormone called insulin. Insulin acts as a "key" that allows glucose to enter the cells from the blood. Your body can't function or perform properly if it doesn't produce enough insulin to effectively manage glucose. This is what produces the symptoms of diabetes. Uncontrolled diabetes can lead to serious complications by damaging blood vessels and organs. It also increases the risk of heart disease, stroke, kidney disease, nerve damage, and eye disease. Nutrition and exercise help manage diabetes, but it's also important to track blood glucose levels. Treatment may include taking insulin or other medications. (Source: https://www.healthline.com/health/diabetes/facts-statistics-infographic#1)

COPING WITH TYPE 1 DIABETES: People who have had type 1 diabetes for a long time may develop what's called "diabetes burnout." This can happen when you start to feel burdened by the disease. A good support system is essential to coping with type 1 diabetes. Spending time with friends and family or talking with someone you trust are ways to manage diabetes distress, which can include stress and anxiety. Taking good care of yourself can reduce diabetes stress and help you cope with the condition. Making sure to eat well, exercise, and learn how to monitor blood sugar levels are important. Getting enough sleep each night and taking time to relax and enjoy life are also very important. There are resources available to help you manage type 1 diabetes such as apps designed to count carbs, watch blood sugar levels, and track progress with diet and exercise. The more you know about your condition, the better prepared you'll be at taking care of yourself. Your doctor can also recommend books about type 1 diabetes. (Source: https://www.healthline.com/health/type-1-diabetes/living-with-type-1/how-you-can-cope#4)

NEW DISCOVERY FOR DIABETES: Matthias Hebrok, PhD, director of the UCSF diabetes center, and Gopika Nair, PhD, have discovered how to transform human stem cells into healthy, insulin producing beta cells. "We can now generate insulin-producing cells that look and act a lot like the pancreatic beta cells you and I have in our bodies. This is a critical step towards our goal of creating cells that could be transplanted into patients with diabetes," said Dr. Hebrok. For the longest time, scientists could only produce cells at an immature stage that were unable to respond to blood sugar levels and secrete insulin properly. The team discovered that mimicking the "islet" formation of cells in the pancreas helped the cells mature. These cells were then transplanted into mice and found that they were fully functional, producing insulin and responding to changes in blood sugar levels. Dr. Hebrok's team is already in collaboration with various colleagues to make these cells transplantable into patients. (Source: https://blog.cirm.ca.gov/2019/02/05/breakthrough-for-type-1-diabetes-scientist-discovers-how-to-grow-insulin-producing-cells/)

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85-year-old man with Type 1 diabetes shatters expectations - WNDU-TV

This press release was orginally distributed by SBWire

Millcreek, UT -- (SBWIRE) -- 12/06/2019 -- Aviva Woman was founded with the goal of ensuring that women get to enjoy life to its fullest by giving them access to professionals focused on assisting them in taking charge of their feminine health. The medical spa and hormone replacement clinic is run by seasoned specialists and women who have had to go through similar issues that they are treating. As such, Aviva Woman provides all its clients with more than medical solutions but an environment where they will receive passionate care.

Talking about their for-women-by-women programs, the company's spokesperson commented, "When it comes to feminine health, there are lots of issues that women will not easily discuss with men, including their doctors and husbands. It is for this reason why we offer special sessions where you get to have a one on one discussion with one of our experienced female care providers. These unique programs are run in a quiet and comfortable setting that will enable you to relax and freely open up about your concerns without any worries."

There are several symptoms that point towards low hormones, and these include extreme fatigue, anxiety, mood swings, decreased sex drive, memory loss, and hot flashes. Aviva Woman offers a proven solution to correcting the hormonal imbalances through its Bio-identical hormone therapy in Utah. This therapy primarily involves the administration of hormone pellets in different doses after verification of the patient's condition through blood work. Aviva Woman offers free initial phone consultations for all individuals who require this therapy to provide them with adequate information before they can take any further steps.

Speaking about how women can gain the radiance of their youth again, the company's spokesperson said, "As the facility that offers the best Botox in Salt Lake City, we are confident of providing you with tailored treatment to address your concerns. We offer a variety of packages, including anti-wrinkle or Dysport, lip injections, and custom fillers. All these are provided to ensure that you get to retain the vitality of your youth and look radiant at all times. Most importantly, you will love our anti-aging approach to Botox treatment, which is centered on attaining longer-lasting results."

The inviting sanctuary-like environment and assurance of finding passionate professionals ready to attend to all needs is the winning edge for Aviva Woman. Individuals searching for a Salt Lake City med spa, have no better choice than settling for the facility that is popular for their top-class services. Aviva Woman has further adopted cutting-edge treatment techniques that have proven to be efficient with the wisdom of age. As a result, women and men have in the facility the peace of mind that comes with finding a partner that has a deep understanding of their requirements.

About Aviva WomanAviva Woman strives to empower modern women in Salt Lake City and beyond by providing them with a platform where they can freely discuss their feminine health concerns and receive medical treatment from seasoned professionals.

Contact DetailsAviva Woman999 E Murray Holladay Rd, Suite 204Millcreek, UT 84117, United StatesTelephone Number: 801-500-0919Fax: (801) 508-2661Website:https://avivawoman.com/

For more information on this press release visit: http://www.sbwire.com/press-releases/aviva-woman-is-providing-bio-identical-hormone-therapy-and-botox-treatment-in-salt-lake-city-1267379.htm

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Aviva Woman Is Providing Bio-Identical Hormone Therapy and Botox Treatment in Salt Lake City - Press Release - Digital Journal

The transgender pride flag.

A Russian court has sentenced a 53-year-old trans woman to three years in prison, on bogus distribution of pornography depicting minors charges for sharing nude anime drawings on social media.

The case began in the summer of 2018, when Michelle was informed she was under criminal investigation for posts of hentai sexually charged drawings featuring naked characters from Japanese cartoons in 2013 and 2014.

Prior to the trial, which took place in November, the investigators ordered an expert evaluation of the images from the Center for Socio-Cultural Expertise, an organization known to provide damning conclusions in politically motivated criminal cases, including the case of Pussy Riot, the child pornography case against human rights defender Yury Dmitriev, and dozens of extremism cases against Russias Jehovas Witnesses. Their evaluation of the drawings concluded that they included characters younger than 14 years of age. Authorities took Michelle into custody from the courtroom, immediately after the judge handed down the verdict. She remains in a solitary cell in jail pending an appeals hearing in her case.

Michelle, a survivor of bladder cancer who worked as an epidemiologist at a local clinic before she was fired because of the criminal case, has been on hormone therapy for transitioning for about two years. But she is legally recognized as male. She will therefore be forced to serve her sentence in a mens penal colony. Such a blatant disregard for her gender identity leaves Michelle extremely vulnerable to abuse by both male detainees and guards.

Moreover, Maria Chaschilova, a lawyer at the Moscow LGBT Community Center, who was in contact with Michelle before her trial, says Michelle does not have access to hormone therapy in prison and will not have it in penal colony. The World Professional Association for Transgender Health warns that for trans people in detention the consequences of abrupt withdrawal of hormones include a high likelihood of negative outcomes such as surgical self-treatment by autocastration, depressed mood, dysphoria, and/or suicidality.

Michelle is appealing her conviction and sentence, but so long as this case persists Michelles rights to health, identity, expression, liberty, and even to life hang in the balance.

Read the original here:
Russian Trans Woman Sentenced to Three Years in Men's Prison on Bogus Pornography Charges - Human Rights Watch

A Nov. 26 letter cites failed entrapment videos by the so-called Center for Medical Progress group of anti-abortion activists (not to be confused with a research program of the same name at the conservative Manhattan Institute for Policy Research) to perpetuate long-debunked myths about Planned Parenthood and abortion.

The record needs to be set straight once again concerning these fake journalists and their deliberately deceptive videos.

CMP founder David Daleiden and other group members were recently found civilly liable in federal court of several conspiracy charges and other federal and state violations. Meanwhile, every one of 13 states that have investigated Planned Parenthood in the matter has fully cleared that organization of any wrongdoing.

The letter implies that federal funds to Planned Parenthood are used for abortion. In fact, public tax dollars to Planned Parenthood pay for much-needed medical services such as STD testing and treatment, birth control, well-woman exams, cancer screening and prevention, hormone therapy, infertility services, and general health care for people who otherwise couldnt afford such services.

Moreover, the Hyde Amendment bars all use of federal funds to pay for abortion, except to save the life of the woman or where pregnancy arises from incest or rape.

The grotesque stories spread in this hateful letter are backed by zero credible sources. Meanwhile, there are numerous confirmed threats of violence against clinic patients and staff tied to this kind of disinformation, including the 2017 attempted bombing of Womens Health Practice in Champaign.

JENNY LOKSHIN

Champaign

Originally posted here:
Letter to the Editor | Critics' charges are totally false - Champaign/Urbana News-Gazette

In terms of fitness and bodybuilding, protein is undoubtedly the much-appraised hero for all fitness and health enthusiasts. And it is for good reason as protein definitely one of the main contributing factors towards a fit and healthy body.

The two main types of protein powders commonly used by people are whey protein and casein, out of which whey protein is the most sought after one. According to Mordor Intelligence, the global whey protein industry as a whole generated a revenue of $6.1 billion in just the last year.

This surge in demand and popularity of whey protein can be attributed to an increased awareness of the benefits of protein powders in general and also to the availability of more varieties of protein products in the market.

However, of late the pace at which the industry is booming has slowed down. In fact, growth literally took a detour in the last couple of years when some of the protein products were alleged to be loaded with harmful chemicals and sweeteners. Put together with other hypoallergenic reactions specific to individuals such as lactose intolerance, consumers are found to have started looking for other alternatives to whey protein.

Now the focus is on plant-based protein sources, which are slowly gaining popularity according to a report published by 1010 data.

While the whole world is increasingly looking for effective plant-based and vegan protein powders like Sunwarrior Canada, which is also completely gluten-free and sold by a Canadian online retailer called Yes Wellness, here are some more reasons why it is best to switch from dairy to plant-based protein.

For starters, plant-based protein powders are rich in antioxidants and other essential vitamins. This further depends on the composition of the powder, which again is increasingly diverse. From brown rice to hemp to peas, there is a wide variety of plant-based protein sources for powders and better yet, most of them are created as a blend of all these powerhouses. Suffice it to say, a single jar of plant-based protein powder will get you an array of essential nutrients derived from all of these sources, along with sufficient fiber and of course protein.

It is like packing a punch to go with their daily cardio and workout routines for fitness enthusiasts.

Another reason why you need to switch to plant from dairy is because of the glaring digestion issues reported by many people all over the world.

Generally, plant-based powders are easier for the digestive system to process and break down. And this is not only for people who are lactose intolerant. For everyone in general, dairy products are definitely a lot more complex to handle than plant-based products and for the same reason, a lot of them are reported to have experienced some form of uneasiness and discomfort from consuming dairy, even if they didnt have a history of lactose intolerance.

This kind of discomfort can be mainly caused by the presence of a high level of sugar and also because of the protein derived from whey. In the long run, a regular supply of complex dairy-based protein can prove to be harmful to the digestive system, kidneys and the entire health of a person in general.

Thirdly, dairy-based protein powders are often highly acidic in nature. This is largely due to the presence of sulfur-based amino acids. This can become a serious risk when combined with diets that are rich in supplementary acidic substances and compounds. On regular consumption, an aggravated acidic environment may be created within the body, which can lead to problems like calcium loss and in turn osteoporosis, weakening of bones and increased risk of kidney malfunctions.

Plant-based proteins, on the other hand, are alkaline in nature as such and hence contribute towards a more alkaline effect within the body. This is in addition to the many nutrients and antioxidants it provides for bodily functions.

Needless to say, plant-based products are always preferred worldwide these days because of their less environmental implications. At a time when Mother Nature is crying for help, there is an increased need to switch to more natural and clean products, free from chemicals.

Last but not least, plant-based proteins are rich in fiber content as well. This ensures smoother digestion, bowel movements and better absorption of essential nutrients.

Evidently, plant-based proteins act as a catalyst for fitness enthusiasts to reach their goals effectively by providing a natural and reliable means of daily protein consumption.

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PCOD Treatment Through Cupping Therapy - The Hear UP

captionEighty percent of miscarriages happen in the first trimester.sourceGetty

Miscarriages are common, and nobody is immune. An estimated 10% to 20% of pregnancies end in miscarriage. But, some experts think that the percentage is probably even higher since some miscarriages occur before someone even knows theyre pregnant.

You can have a miscarriage as soon as you become pregnant, says UCLA OB-GYN Leena S. Nathan, MD. Sometimes we see people who have a miscarriage very early on. We usually call that a chemical pregnancy because the pregnancy hormone hCG goes up, but we never actually see anything in the uterus.

While there is no foolproof way to prevent miscarriage, there are some lifestyle changes you can make before and during pregnancy to lower your risk.

Heres what you can do before getting pregnant to reduce your risk of miscarrying:

Heres what you can do during pregnancy to reduce your risk of miscarrying:

Its most common to miscarry in the first trimester, which is up to 13 weeks, says Nathan. In fact, about 80% of miscarriages happen within the first trimester. After this, your chance of miscarrying drops.

However, you can miscarry as late as 20 weeks. Beyond that, if the pregnancy isnt successful its no longer called a miscarriage, its a stillbirth.

There are plenty of reasons a miscarriage can happen, and unfortunately, some types of miscarriages simply cant be prevented.

Most times [the cause is] something genetic, which is unpreventable, meaning there is something wrong with the chromosomes and either the egg or the sperm that came together, Nathan says.

Other causes could be related to the mothers health. For instance, if the mother has a blood clotting issue, if the mother carries any sort of genetic mutations, health and lifestyle issues can cause miscarriages as well as smoking, diabetes, and obesity.

Then, theres always the possibility that you do everything right and still miscarry.

When I see a patient whos had a miscarriage, I reassure them that its nothing they did or didnt do because theres a lot of guilt that comes with having a miscarriage, but most of the time, its unpreventable, says Nathan.

Read this article:
You cannot prevent a miscarriage but there are steps you can take to reduce your risk - Business Insider

DESPERATELY taping her eye open, Allana Prosser was determined she would prove doctors wrong and see out of her right eye again.

The teen's eye had clamped shut after a devastating operation to remove a deadly brain tumour - months after it was misdiagnosed by medics as a cheese allergy.

9

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But Allana, from Warwickshire, wasn't going to let her ordeal set her back - and has since taught herself to see out of her right eye again.

Now in recovery, Allana is sharing her story to raise awareness and give hope to those in a similar situation.

She said: "I count myself as one of the lucky ones. I survived and have been given the chance to live my life."

Allanas nightmare ordeal begun in 2009, aged 11, when she started having headaches while she was at primary school.

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She said: "I had them every day and took two paracetamol every four hours like clockwork to even touch the pain and I also felt sick every morning."

Allana's symptoms continued to worsen until she was barely struggling to stay awake at school or go out with her friends.

"All I wanted to do was sleep," she said.

"From the moment I walked into the house from school, I just flaked out - eventually, I lost all my friends as I was so tired I didnt want to go out.

"I also had very blurry eyesight and couldnt see the whiteboard at school, but I went to the optician for an eye test and it was fine."

While other teenagers were having fun with their friends, Allanas life was put on hold - making her feel completely "isolated".

From 13 onwards, she begun waking up in the middle of the night feeling sick, only to collapse at the bottom of her mum and step-dad's bed.

She said: "They called 999 several times and I was taken to hospital and put on a drip.

"Despite my constant headaches and sickness, no one ever suggested I should have a brain scan."

Despite my constant headaches and sickness, no one ever suggested I should have a brain scan

Things continued to deteriorate and by14, Allana hadnt started her periods and also had delayed growth.

She said: "I was at least a head-and-half shorter than my classmates and didnt get my periods like the other girls.

"We went to the GP who just said to come back the following year or when I was over 18.

"Like most teenagers I wanted to fit in, but I felt different."

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Allana also developed a raging thirst" - which meant she was drinking up to ten litres of water a day.

Doctors once again dismissed her symptoms, and told Allana's mum she was just "thirsty".

Allana kept going back and forth to the GPs who repeatedly turned her away - even though she also had balance problems and, every few months, episodes of vomiting and blacking out.

In fact, one doctor even claimed her concerning symptoms were down to a cheese allergy.

"He asked me to keep a food and drink diary for two weeks," Allana said.

"When I went back, he flicked through the first few pages and read that I ate cheese sandwiches for lunch at school and loved pizza and lasagne.

"He said my headaches were triggered by a cheese allergy and suggested I stopped eating it.

"But I didnt stop because I knew there was something far more seriously wrong with me - you know your own body.

"My parents were worried sick but no one was listening to us."

Despite her struggles, Allana passed all her GCSEs in 2014 and got an apprenticeship at a wedding shop.

But at 16, her confidence was shattered when she became incontinent.

"It was so embarrassing," she said.

"I had to give up my apprenticeship and was soon scared to go out in public at all.

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"Other people my age were going out partying and there I was at 16, scared to wear white clothes and rocking a Tena lady not a great look!"

She was put on incontinence medication and when she developed a twitch in her right eye, doctors told her it was a side effect.

Allana was finally diagnosed in May 2015 when she went to the optician again about her headaches and twitchy eye.

She said: "I went to Specsavers and the optician said there was pressure behind my eyes.

"She sent me to the emergency eye clinic at my local hospital, but they said they couldnt see anything.

"As we walked out, my mum broke down and I was really embarrassed but her meltdown saved my life.

"When a doctor saw what state she was in and asked her what was wrong, he arranged a CT scan."

Other people my age were going out partying and there I was at 16, scared to wear white clothes and rocking a Tena lady not a great look

Doctors said they could see something on Allanas brain and that she needed a more detailed MRI scan.

"I was so nervous and Mum came in with me," she said.

"As I Iooked at the screen, it went from body scan to head scan and I saw my mums face change.

"What is it? What can you see? I asked

"She was trying to smile but she had tears in her eyes."

Then a doctor broke the news that Allana had an orange-sized brain tumour formed from embryonic tissue, which she had been born with.

9

The tumour was on her pituitary gland and pushing against the optic nerve on her right eye, which explained her delayed periods, growth, uncontrollable thirst and headaches.

Allana said: "Doctors told me that I was a week away from death due to a build-up of fluid on my brain.

"But I didnt show any reaction - I felt frozen.

"I sat there in silence while my mum was an emotional wreck.

"By that point, I felt so ill, part of me was just relieved they finally knew what it was."

The next morning, Allana was forced to have a life-saving five-hour operation at Coventry University Hospital to drain fluid on her brain.

A week later, she underwent a 10-hour craniotomy and surgeons removed most of the tumour.

Biopsy tests confirmed it was a slow-growing, low-grade craniopharnigioma, formed from embryonic tissue.

"It felt weird that Id probably been born with it and that Id walking around for years with this thing inside in my head which nearly killed me," she said.

9

Allana, who has dubbed her tumour Gemima as shes a Gemini, was in intensive care for a week and hospital another four weeks.

She recovered well from the surgery but was told her right eye would never open again.

Desperate not to wear an eye patch, she started taping her eye open.

Allana said: "There was no way I wanted to wear an eye patch."

"Every day for a couple of months, I put masking tape over my eye for a few hours to stimulate the eye muscles.

"God knows how I came up with the idea, but it worked."

Doctors told me that I was a week away from death due to a build-up of fluid on my brain. But I didnt show any reaction - I felt frozen

In February 2016, Allana went to Jacksonville, Florida for three months to have proton beam therapy to shrink what was left of the tumour.

A few months after her treatment, Allana was referred to a fertility clinic as it was feared she may not be able to conceive.

"At 16, it felt surreal to talk about freezing my eggs," she said.

"After tests, though, I was told that I should be able to become pregnant so didnt have them frozen."

9

But last year she had devastating news at a check-up - where she was told her fertility had been affected after all as the tumour had stopped her brain from sending hormone signals to the rest of her body.

She said: "It was a shock which Im still struggling to process.

"Its a conversation Ill have to have with a partner one day if we decide we want a family.

"But hopefully well have treatment options."

Now, Allana has scans every six months and her tumour has remained stable.

How to spot brain tumour symptoms in young people

The most typical symptoms of brain tumours in children and young people include:

At 4ft 11ins, she still suffers long- term effects including diabetes insipidus and osteoporosis.

However, she has continued to remain positive and begunstudying counselling at the University of Coventry so she can eventually work with children.

She is also a Young Ambassador for The Brain Tumour Charity and is backing the HeadSmart campaign, which raises awareness of children and teenagers brain tumour symptoms to reduce diagnosis time.

Allana said: "It helps hugely talking to other people who understand.

9

"And I want to share my story to help others if one person gets an earlier diagnosis and one life is saved, its worth it.

"It means so much to me to support other young people who are struggling with the impact of their brain tumours."

Thanks to Allana, about 20 GP surgeries across Warwickshire are stocked with HeadSmart symptom cards.

Allana has vowed to make the most of her life.

"I am still living with Gemima but I feel truly blessed with love and support," she said.

And I'm determined to make the most of every minute because I'll never forget that I am one of the lucky ones."

Sarah Lindsell, The Brain Tumour Charitys chief executive, said: "We are so grateful to Allana for sharing her story to help us raise awareness about brain tumour symptoms and how crucial early diagnosis is.

"And we are inspired by how she is turning her horrendous experience into a positive by backing our HeadSmart campaign.

SICK LEAVE My fear of vomiting made me too scared to leave the house & left me in hospital

CHILLING DIAGNOSIS Dad, 49, who went to GP with runny nose diagnosed with terminal cancer

SEXUAL HEALING I lost 10st because being fat meant I could only do one sex position

GAME ON Playing Xbox helped me lose 10st after getting so big I could barely walk

COLD TRUTH Needing to pee more when its cold can be sign of deadly condition, docs warn

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I had to tape my eye open after op to remove brain tumour which docs dismissed as cheese allergy - The Sun

From the HumanCharger which shines light into your ear to give you energy to deprivation tanks and screaming sessions, weird wellness trends have become commonplace in 2019. But even so, when wellness influencerMetaphysical Meagan shared a picture of herself on her back, legs akimbo, sunning her perineum (AKA butthole), people, understandably, took notice.

And nowDiplo has got in on the action. Yesterday, the DJposted a picture of himself on a cliff overlooking the sea, ankles in hand, ass to the sun. Accompanying this enduring image is the caption presenting my peace offering to climate change. Diplos famous friends had some things to say about his pose. Chrissy Teigen had a rare moment of speechlessness, writing been thinking about a comment for a long time, while basketball player Liz Cambage commented, I feel like this isnt your first time in this position.Megan Thee Stallion summed up all our feelings, meanwhile, with her comment: dude.

Discussion around butthole tanning first started last month when Metaphysical Meagan, who, according to her Instagram bio is also a healer, teacher, Tantrika, and Embodied Mermaid, first posted the image of herself alongside a caption explaining why she has recently begun to include sunning her bum and yoni in her daily rising routine. 30 seconds of sunlight on your butthole is the equivalent of a full day of sunlight with your clothes on! she writes, before going on to say she has noticed better sleep, better connection to her Sexual energy & control of my Life Force and so much creativity flowing through my life!! since implementing the practice.

Meagans post was then shared on Twitter with the caption, "People out here butt-chugging sunlight," and it (obviously) went viral. In response to peoples many questions about what she was doing, Meagan then posted a second time expanding on the origins and benefits of the practice. Perineum sunning is an ancient Taoist practice that originated in the Far East, she writes. In Taoism, the perineum or Hui Yin is called the Gate of Life and Death. This is a gateway where energy enters & exits the body.

While there are many who swear by the practice including Shailene Woodley who told Into the Gloss Another thing I like to do is give my vagina a little vitamin D If youre feeling depleted, go in the sun for an hour and see how much energy you get, Western doctors remain unconvinced. There is absolutely no proven scientific evidence to suggest any health benefit to sunning your perineum or bottom, Dr Stephanie Ooi from MyHealthcare Clinic in London told Insider. This is a classic example of social media medical misinformation which in some cases can be damaging or dangerous.

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Diplo joins the weird new wellness craze of butthole tanning - Dazed

In the US, more than 15 million Americans will spend a few seconds every day locating and swallowing a birth control pill. If the tableta cordial of contraceptive hormones that trick the body into thinking its pregnantis swallowed during the same three-hour window each day, the method is pretty close to ironclad. But get off-schedule or miss a day, and the pills 99 percent pregnancy prevention rate starts to dip. And most people inevitably falter. In the US, nine out of every 100 people using oral birth control become pregnant in any given year.

IUDs and other forms of contraception are more reliable. But so many people still use the pill because its cheap, easy, and often available over the counter, rather than requiring a trip to a doctor to have some hormone-emitting device implanted under your skin or inserted into your uterus. For a long time, researchers have been trying to merge the benefits of botha longer-lasting supply of hormones that are as simple to take as swallowing. But the stomach has proven a worthy nemesis.

A dark, slimy accordion of an organ, it continuously contracts and grinds a corrosive slurry of gastric juices, sending waves of whatever youve swallowed crashing over a tiny fissure called the pylorus that leads into the deeper recesses of the gut. If youre on any sort of oral medicationfor high cholesterol or HIV or to maintain your reproductive independencethis angry acid sea is the reason you have to take a pill every single day. Drugs just dont last long in such a hostile environment.

Unless, that is, you embed them in a flexible silicon ninja star that folds up neatly into pill form.

Thats the solution a team led by scientists at Brigham and Womens Hospital and MIT came up with about five years ago. Back then they were building slow-release pills designed to deliver treatments for malaria, tuberculosis, and HIV. But in a scientific first, theyve now demonstrated that the same invention can also deliver a steady drip of contraceptive hormones in the body of a pig for up to 29 days.

From an engineering aspect, the key novelty is the ability to deliver a drug for a month after a single ingestion event, says Giovanni Traverso, a gastroenterologist and biomedical engineer at Brigham and Womens and MIT, who co-authored the new study, published today in Science Translational Medicine. The proof-of-concept experiments were conducted late last year. Since then, the long-lasting contraceptive has begun to be commercially developed by a Boston-area company called Lyndra Therapeutics, which Traverso cofounded with MIT bioengineer Robert Langer in 2015. In July, the startup received $13 million from the Gates Foundation to advance the monthly pill to human trials, with a focus on bringing it to low- and middle-income countries.

To picture how this works, Traverso suggests imagining a six-armed starfish that has folded itself up into a cylinder. Except each arm is made of a body-friendly silicone polymer bonded with levonorgestrelthe hormone used in IUDs like Mirena. The arms are cut with little repeating windows that allow the drug to gradually detach itself from the surrounding polymer matrix. They connect to each other via an elastic core, and when the whole thing is folded up, it fits inside a standard-size capsule. Once swallowed, the capsule dissolves, allowing the arms to spring back into rigid starfish shape.

This is key, because once popped back open, those arms span wider than two centimetersthe diameter of the human pylorus, the gateway to the intestines. Trapped inside the stomach, the silicone starfish slowly seeps the medication through its small pores, allowing the hormone to pass through the gut and into the bloodstream to do its work.

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A Once-a-Month Birth Control Pill Is ComingHere's How It Works - WIRED

Supplementary material for this article is available at http://advances.sciencemag.org/cgi/content/full/5/12/eaax5208/DC1

Fig. S1. Clinical trial SLN mapping case in a patient with head and neck melanoma using cRGDY-Cy5.5-PEG-C dots (NCT02106598).

Fig. S2. Development of 700- and 800-nm emitting NIR fluorescent C dots.

Fig. S3. Morphology and purity characterization of MSH-PEG-Cy5.5-C dots and cRGDY-PEG-CW800-C dots.

Fig. S4. The relationship between probe concentration and signal intensity of different probes.

Fig. S5. The bleed-through of MSH-PEG-Cy5.5-C dot probes to the 800-nm channel under the excitation of a 700-nm laser (particle concentration range, 0 to 125 nM).

Fig. S6. The bleed-through of cRGDY-PEG-CW800-C dot probes to the 700-nm channel under the excitation of a 800-nm laser (concentration range, 0 to 250 nM).

Fig. S7. The bleed-through of cocktail C dots (MSH-PEG-Cy5.5-C dot probes and cRGDY-PEG-CW800-C dot) probes to the 700- or 800-nm channels under the combined excitation of 700- and 800-nm lasers (concentration range, 0 to 250 nM).

Fig. S8. Summary of MIP PET images of all seven spontaneous melanoma miniswines (the related MIP short videos are also provided as movies S1 to S7).

Fig. S9. The marking of the expected SLN locations.

Fig. S10. A representative example of multiplexing optical data analysis using the software (Architector Image Viewer, version 1.9.0) from Quest Spectrum.

Fig. S11. Whole-body PET/CT imaging of pig #1.

Fig. S12. Whole-body PET/CT imaging and histological analysis of pig #2.

Fig. S13. Whole-body PET/CT imaging and histological analysis of pig #3.

Fig. S14. Whole-body PET/CT imaging and histological analysis of pig #4.

Fig. S15. Whole-body PET/CT imaging and histological analysis of pig #6.

Fig. S16. Whole-body PET/CT imaging and histological analysis of pig #7.

Fig. S17. IVIS imaging to identify nanoparticles at the tumor site.

Fig. S18. Average body weight of all male mice from the microdose toxicology study.

Fig. S19. Average body weight of all female mice from the microdose toxicology study.

Table S1. Optimization of 800-nm emitted NIR fluorescent C dots.

Table S2. In vivo signal intensity and bleed-through percentage of cocktail C dots excited with a 700-nm laser.

Table S3. Summary of the injection information of all seven spontaneous melanoma miniswines.

Table S4. Summary of PET SUV numbers of all nodes from seven spontaneous melanoma miniswines (~0.5-mm tumor burden was highlighted in green; NA means tumor burden diameter was not available).

Table S5. Microdose toxicology study animal group.

Table S6. Mortality and morbidity summary table of the microdose toxicology study.

Table S7. Hematology parameters in the microdose toxicology study.

Table S8. Clinical chemistry parameters in the microdose toxicology study.

Table S9. Tissues examined microscopically in the microdose toxicology study.

Table S10. Hematology parameters, group 5, male, tumor, vehicle control (saline), day 2.

Table S11. Hematology parameters, group 6, female, tumor, vehicle control (saline), day 2.

Table S12. Hematology parameters, group 7, male, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S13. Hematology parameters, group 8, female, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S14. Hematology parameters, group 9, male, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S15. Hematology parameters, group 10, female, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S16. Hematology parameters, group 11, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S17. Hematology parameters, group 12, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S18. Hematology parameters, group 13, male, no tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S19. Hematology parameters, group 14, female, no tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S20. Hematology parameters, group 15, male, tumor, vehicle control (saline), day 14.

Table S21. Hematology parameters, group 16, female, tumor, vehicle control (saline), day 14.

Table S22. Hematology parameters, group 17, male, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S23. Hematology parameters, group 18, female, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S24. Hematology parameters, group 19, male, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 14.

Table S25. Hematology parameters, group 20, female, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 14.

Table S26. Hematology parameters, group 21, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S27. Hematology parameters, group 22, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S28. Hematology parameters, group 23, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S29. Hematology parameters, group 24, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S30. Hematology parameters, group 5, male, tumor, vehicle control (saline), day 2.

Table S31. Hematology parameters, group 6, female, tumor, vehicle control (saline), day 2.

Table S32. Hematology parameters, group 7, male, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S33. Hematology parameters, group 8, female, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S34. Hematology parameters, group 9, male, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S35. Hematology parameters, group 10, female, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S36. Hematology parameters, group 11, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S37. Hematology parameters, group 12, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 2.

Table S38. Hematology parameters, group 13, male, no tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S39. Hematology parameters, group 14, female, no tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 2.

Table S40. Hematology parameters, group 15, male, tumor, vehicle control (saline), day 14.

Table S41. Hematology parameters, group 16, female, tumor, vehicle control (saline), day 14.

Table S42. Hematology parameters, group 17, male, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S43. Hematology parameters, group 18, female, tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S44. Hematology parameters, group 19, male, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 14.

Table S45. Hematology parameters, group 20, female, tumor, test article cRGDY-PEG-cw800-C dots at 1.2 nmol, day 14.

Table S46. Hematology parameters, group 21, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S47. Hematology parameters, group 22, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S48. Hematology parameters, group 23, male, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Table S49. Hematology parameters, group 24, female, no tumor, test article MSH-PEG-Cy5.5-C dots at 1.2 nmol, day 14.

Movie S1. MIP video of pig #1.

Movie S2. MIP video of pig #2.

Movie S3. MIP video of pig #3.

Movie S4. MIP video of pig #4.

Movie S5. MIP video of pig #5.

Movie S6. MIP video of pig #6.

Movie S7. MIP video of pig #7.

Movie S8. Image-guided multiplexing, pig #5.

Movie S9. Image-guided multiplexing, pig #3.

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Molecular phenotyping and image-guided surgical treatment of melanoma using spectrally distinct ultrasmall core-shell silica nanoparticles - Science...

Headline after headline has been writtenabout legislators efforts to help Minnesotans suffering because they cannotafford their insulin medication. Yet no tangible compromise has been reached ona medical issue that affects so many Minnesotans.

Many suffering from diabetes simply cannotwait for a more affordable option. Some people have literally died whilewaiting for economic relief that would allow them to purchase a drug that costsas much as $300 for a 10-day supply.

The 30-day deadline has gone and passed,an exasperated Nicole Smith-Holt said. At this point, it feels like itis all PR just making it look like they care. They need to do this to savelives, she stressed.

State Representative Micheal Howardagreed. He has been working to get a law passed that would make insulinavailable to those who either have an emergency or just cannot afford theinsulin they need to survive. We need to show more urgency; there really is noreason why we shouldnt be able to come together and get something done, hesaid.

This is a bill I have been working on formore than a year. Its been like working at the kitchen table trying to figureout how do we create a safety net so that nobody loses their life because theycannot afford their drugs? explained Howard. I understand the frustration foradvocates who have been pushing for this for more than a year. The crisis isright in front of us; the solution is right in front of us. We need all sidesto show that sense of urgency, the legislator said, alluding to what some havecalled foot-dragging and grandstanding on the part of Republicans.

Everybody knows a family member that isaffected, he added.

Medical experts have described diabetes asa disease that occurs when a persons blood glucose, also referred to as bloodsugar, is too high. And having too much glucose in ones blood can cause healthproblems.

Blood glucose is our main source of energyand comes from the food we eat. Insulin, a hormone made by the pancreas, helpsglucose from food get into your cells to be used for energy. Sometimes our bodydoesnt make enoughor anyinsulin or doesnt use insulin well. Glucose then staysin our blood and doesnt reach our cells.

Diabetes leads to heart disease, visionloss, kidney disease, a stroke or even amputation.

According to the American DiabetesAssociation, diabetes is a major health problem in the U.S. The fallout fromthe disease puts a tremendous strain on the health care industry. Studies haveshown that nearly one-third of the total U.S. population is affected by someform of diabetes, either Type 1, Type 2 or prediabetic.

And the risk of diabetes is higher inAfrican American adults. Latest studies showed that about 4.9 million or 18.7%of all African Americans 20 years of age and older have diagnosed orundiagnosed diabetes, compared to 7.1% of non-Hispanic White Americans. Therisk of diabetes is 77% higher among African Americans than non-Hispanic WhiteAmericans.

Holt has expressed disappointment thatafter all of the talk, no compromise has been reached. She said with theexception of a few, there has been little communication with those affected,especially with the families that have been pushing for something to be done.They cant write the bill without us, she said.

Holt has credited Governor Tim Walz withbeing a great ally but said that something needs to be done soon. There havebeen two deaths this year involving young people who simply could not affordtheir insulin.

Holts son Alec Holt died in 2017 when heattempted to ration his insulin because it was no longer affordable on hissalary. He had been on his mothers health insurance plan until he turned 26.His mother said that he searched for an insurance plan that was affordable onhis restaurant salary. But the best option was one that required a $7,000deductible, so he eventually chose to pay for his medical expensesout-of-pocket while he continued to search for a plan that was affordable.

Alec only survived another month. He wentfrom paying two to three hundred for his insulin to a thousand dollars, whichwas out of reach on his salary. His effort to stretch his meds cost him hislife.

According to Health Care Cost Institute, patients with Type 1 diabetes spent an average of $5,705 in 2016, nearly double what they paid in 2015.

Dr. Victor Montori, an endocrinologist atthe Mayo Clinic in Rochester, accused the health care system of corrupting itsmission for the sake of profits. The consequences are human lives,he said. Its a cruelty we can no longer accept.

The Alec Smith Emergency Insulin Actpassed by the Minnesota House of Representatives last spring was designed tocreate a statewide insulin assistance program to help Minnesotans who struggleto afford the insulin they desperately need. The bill would be funded throughan Insulin Manufacturer Fee, that would be collected from the threelargest insulin manufacturers, Eli Lilly, French company Sanofi and the Danishfirm Novo Nordisk, that control more than 90% of the market.

Since the House passed its version of anemergency bill, two young Minnesota men have died. A 28-year-old whose familyrequested that he remain anonymous died as a result of rationing his insulinsupply. Jesimya Scherer-Radcliff, 21, who had Type 1 diabetes, died in July.His parents said he was on their health insurance, but he still could notafford the insulin he needed to survive. He reportedly had been rationing his insulinsupply. One of his relatives testified at a legislative hearing on the cost ofinsulin that, Jesy didnt die from insulin rationing, he died from theprohibitive cost of insulin.

The pharmaceutical companies absolutelyneed to be a big participant in this because they caused this problem,explainedHoward. They should have a role in solving it. There are onlythree insulin producers that control the entire market and they have ratchetedthe price up.

According to Rep. Howard, both billsrequire contributions from the insulin manufacturers. The House bill includes amanufacturers fee, while the Senate bill requires companies to provide freeinsulin. The other difference between the bills is the Senate bill allows forlong-term assistance, but leaves out the emergency option plan the Houseprefers as a safety net.

What we do produce is going to be a newbill that will take elements of the House proposal and the Senate proposal,which will create a safety net and provide longer-term situations.

The global insulin market is dominated bythree companies: Eli Lilly, the French company Sanofi and the Danish firm NovoNordisk. All three have raised list prices to similar levels. According to IBMWatson Health data, documented that Sanofis popular insulin brand Lantus was$35 a vial when it was introduced in 2001; its now $270. Novo NordisksNovolog was priced at $40 in 2001, and as of July 2018, it was priced at $289.

Rep. Howard said he holds out hope thatsomething that can be done before the next session in February. It does nothave to be either or it should be yes and. We should try to address theemergency issue first to prevent more loss of life but also look at solutionsfor long term affordability. There is a way to marry the two and accomplishboth goals, a compromise that leaves the door open for public funding as well,he said.

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A matter of life and death: insulin emergency/affordability bill... - MSR News Online

In a contemporary marketplace learn about revealed via Truth.MR, the present and long term possibilities of the Hormone Substitute Treatment Marketplace are totally analyzed. Additional, the document contains an in-depth research of the quite a lot of components which are prone to keep an eye on the expansion trajectory of the Hormone Substitute Treatment Marketplace within the upcoming years.

As well as, a qualitative and quantitative evaluate of the quite a lot of marketplace segments is enclosed within the document and correctly represented within the type of tables, graphs, and figures.

The document signifies that the Hormone Substitute Treatment Marketplace is anticipated to sign in a CAGR expansion of ~XX% over the forecast length and succeed in a worth of ~US$XX. The document elaborates at the micro and macro-economic components which are projected to persuade the expansion of the Hormone Substitute Treatment Marketplace within the upcoming years 2018 to 2028.

Request 100 Web page Pattern File Now at https://www.factmr.co/connectus/sample?flag=S&rep_id=2224

Crucial Findings of the File

Necessary questions referring to the Hormone Substitute Treatment Marketplace catered to within the document:

Discuss To Analysis Analyst For Detailed Insights athttps://www.factmr.co/connectus/sample?flag=AE&rep_id=2224

Aggressive Panorama

The document on hormone alternative treatment marketplace gives intelligence on key individuals within the hormone alternative treatment marketplace. The important thing firms concerned within the components of hormone alternative treatment merchandise are totally assessed and profiled within the document. More than a few sides of pageant together with SWOT research, product portfolio research, drug tendencies and inventions, methods and key financials are coated. Key firms profiled within the document come with Novartis AG, Novo Nordisk A/S, Teva Prescription drugs, Mylan N.V and Pfizer Inc.

Primary firms within the hormone replacement therapy market are targeting increasing their present product portfolio. New hormone alternative treatment formulations being the core center of attention, firms are sporting out trials and acquire FDA approvals. As an example, Novartis AGs analysis and building division delivered 6 crucial FDA step forward treatment designations and 16 submissions in 2017. In Would possibly 2017, Novartis AG introduced U.S. FDAs popularity of its hormone alternative treatment pills for hormone receptor sure and metastatic breast most cancers remedy in postmenopausal ladies.

In February 2018, Novo Nordisk A/S concluded major section of REAL 1 the pivotal section three trial along side somapacitan, a long-acting expansion hormone to regard adults with expansion hormone deficiency.

Teva Prescription drugs Industries Ltd. presented Vagifem in 2017 for the remedy of atrophic vaginitis. In January 2018, the corporate introduced Estrace cream to regard reasonable and serious signs of vaginal and vulgar atrophy going on because of menopause. Likewise, Mylan N.V expanded its US portfolio within the ladiess healthcare vary with U.S. FDA popularity of Estradiol Vaginal Cream to regard vaginal atrophy.

Non-public fairness companies are fascinated about obtaining rising individuals which are excited by drug supply methods within the hormone alternative treatment area. As an example, Riverside Corporate has got DoseLogix in a bid to offer leading edge dosing dispensers for making sure correct dosing drugs of hormone alternative treatment and different prerequisites.

Click on to understand extra on competitive scenario within the hormone alternative treatment marketplace to know key methods of marketplace individuals

Definition

Hormone alternative treatment, additionally known as menopausal hormone treatment, is used to regard quite a lot of signs associated with menopause amongst ladies. Hormone alternative treatment replaces hormones which are low in stage as ladies close to menopause. There are quite a lot of kinds of hormone alternative treatment akin to estrogen hormone alternative treatment, thyroid hormone alternative treatment and expansion hormone alternative treatment.

Concerning the File

The document on hormone alternative treatment marketplace supplies incisive insights on all sides influencing expansion in call for for hormone alternative treatment international. The document supplies a radical research on call for of hormone alternative treatment throughout key areas within the globe along side gross sales of quite a lot of hormone alternative treatment merchandise.

Key drivers, demanding situations, tendencies and alternatives shaping the expansion of the hormone alternative treatment marketplace also are coated within the hormone alternative treatment marketplace document. The hormone alternative treatment marketplace document supplies historic knowledge evaluate on use of hormone alternative treatment, present hormone alternative treatment situation and long term call for of hormone alternative treatment. The forecast projections equipped duvet a timeline of 10 years (2018-2028).

Marketplace Construction

The hormone alternative treatment marketplace is segmented intimately to hide each attitude of the hormone alternative treatment area. The hormone alternative treatment marketplace has been segmented at the foundation of product sort, via dosage shape, via indication, via distribution channel and via area.

More than a few hormone alternative treatment merchandise akin to estrogen hormone alternative treatment, thyroid hormone alternative treatment and expansion hormone alternative treatment is roofed. Via dosage shape, hormone alternative treatment marketplace is segmented into pills, patches, injections, implants and lotions. Via indications, hormone alternative treatment marketplace is categorised into menopause, osteoporosis, thyroid and expansion hormone deficiency. Via distribution channel, its segmented via clinic pharmacies, clinics, retail pharmacies and on-line pharmacies.

The hormone alternative treatment marketplace is classified throughout key areas akin to North The united states, Latin The united states, Europe, Asia Pacific with the exception of Japan (APEJ), Center East and Africa (MEA) and Japan.

Further Questions Spoke back

Except key findings discussed above, the hormone alternative treatment marketplace document additionally solutions further questions akin to:

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Hormone Substitute Treatment Marketplace International Research and Forecast File 2018 to 2028 - Markets Gazette

This is a guest contribution for The Economists Open Future initiative, which aims to foster a global conversation on the challenges of the 21st century. More Open Future articles are at Economist.com/openfuture

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The day I knew I should quit my job answering phones at the transgender health-care clinic in California was the day a caller (lets use the name Betty) threatened her in-home caretaker with a knife during the call. As the caretaker begged our clinics nurse to track down Bettys doctor and tell him that Betty was having a psychotic episode, Betty stood between her and the apartments front door with a kitchen knife. Betty had poorly controlled paranoid schizophrenia, and often called the clinic agitated, alternately whispering and screaming about government agents stalking her. Betty was also a trans woman whom most people regarded as male, the sex of her birth.

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The clinic followed the informed-consent protocol: its mission was to provide transgender patients who otherwise lacked access to health care with injections, skin patches and pills of feminising or masculinising hormones without having to pass through a series of requirements and assessmentsknown as gatekeepingthat restricted access in the past.

In medicine broadly, informed-consent refers to the ethical requirement that a clinician administering a treatment communicate to the patient the anticipated risks and benefits, as well as reasonable alternatives to the treatment. Yet for transition medicine in America, informed-consent programmes do not require clinical documentation, beyond patient reports, of the patients gender dysphoria over time (ie, a feeling of mismatch between ones biological sex and gender identity) and readiness for medical interventions.

Gatekeeping horror stories are notorious in the transgender community. In the past it was not unusual for a trans person to be told by doctors and psychologists they would not be referred for hormones because they were not visually appealing as their preferred gender, werent interested in dating the opposite gender, or had unresolved mental-health problems (some of which are predictable responses to experiencing transphobia, such as anxiety and depression).

It was not unusual for a trans person to be told they would not be referred for hormones because they were not visually appealing

Pioneering LGBT health centres across America developed informed-consent protocols for hormone treatment in a well-intentioned effort to imbue the experience of pursuing hormone treatment with dignity for patients. But as informed-consent protocols have become the norm rather than the exception, we may be shunting transgender people in America into a parallel medical systemone in which patients bargain away careful assessment and education for greater autonomy and shortened timelines to access medical treatments.

At my clinic, we were informed-consent true-believers. We didnt badger you with questions; as long as you were 18, even if you had no way to pay the clinics fees, you would get your hormones. You had to sign forms stating that you understood that although hormone-replacement therapy (HRT) benefits many trans people suffering from gender dysphoria, the health risks are largely unknown. Starting hormones could have negative consequences for your mental well-being, social functioning and even the intensity of your gender dysphoria (many people find that their distress about a body part like their breasts will only increase when the effects of testosterone appear, such as facial hair).

Also, people were informed that they were waiving the mental-health screening recommended by the World Professional Association for Transgender Health. Its standard of care recommends that patients seeking HRT be screened for schizotypal disorders, autism-spectrum disorders, personality disorders, dissociative disorders, post-traumatic stress disorders and more.

In the case of Betty, I felt that the clinic where I worked wasnt sufficiently concerned whether her mental disorder created delusions that often controlled her life, or meant she was so cognitively disabled that transition predictably left her more isolated and chronically stressed than before she started HRT. The medical staffs attitude towards Betty and many of the other patients who were receiving hormones while managing (or failing to manage) severe mental illness was a profound lack of interest about whether one affected the other.

We were informed-consent true-believers. We didnt badger you with questions; as long as you were 18, you would get your hormones.

In fact, most of us worked there because we rejected the idea that a strongly felt internal sense of gender could be a symptom of mental illness. That shared, ideological foundation meant it was verboten for the staff to consider whether the HRT might be exacerbating Bettys schizophrenic symptoms or making it harder for her to build the basic social relationships that provide the support and positive feedback that is so necessary for mental health. If the HRT did not actually assist Betty in presenting as a woman or improve her functioningand it seemed to be doing neitherwe considered affirming her identity more important than those conventional measures of the treatments effectiveness.

The most radical and liberatory action we could take was to affirm Bettys identity. If we were the one and only place she visited in her day where she was referred to using her chosen pronouns, we considered it paramount we gave her that experience. This commitment to affirming identity through correct pronouns and easy HRT was our reason for being. But strangely, by fulfilling our commitment to affirming felt identity, we seemed to be off the hook for questioning whether we were doing all we could to avoid harming her.

I quit the clinic in 2014, and in 2016 I spoke to the lawyer of a patient suing that same clinic. This patient also pursued HRT while experiencing intense delusional symptomsit was 2012 and he thought the world was ending. The clinic, affirming as ever, recommended and provided the referral letters for him to have an orchiectomy, a removal of his testicles, which he underwent. When his delusional symptoms eventually abated he detransitioned, coming to an uneasy peace being, and presenting as, male.

I know him because we are both detransitioned people. I was also convinced that I was a trans personas a result of misunderstanding a persistent sense that my body felt unreal, a common dissociative symptom following traumaand received HRT at this same clinic, taking testosterone for nine months. For the past five years Ive been a part of a growing community of detransitioned people who are speaking out about questionable norms and practices in transgender medicine.

The clinic, affirming as ever, provided the referral letters for him to have an orchiectomy, a removal of his testicles

When I first detransitioned, my community consisted of online groups of fewer than 100 women. Five years later the detransition discussion-forum on the popular site Reddit has just hit 7,000 people of both sexes. I know detransitioned people who later discovered they had autism-spectrum disorders, detransitioned people who came to recognise that they were experiencing traumatic dissociation, even detransitioned people who had such severe dissociation that they had multiple alters (ie, multiple identities) while being treated with hormones and surgeries.

Our stories, if taken seriously, could help improve the state of transgender health careparticularly at informed-consent clinics, which are becoming the norm at American colleges, LGBT health centres and recently many Planned Parenthoods. Instead we are ignored, compared to ex-gay Christians or treated as political footballs. (I was particularly disheartened when Ryan Anderson, a fellow at the Heritage Foundation, a conservative think-tank, used my and other detransitioners stories in his book that was critical of LGBT and feminist issues, When Harry Became Sally.)

That is because the burgeoning orthodoxy on the left is that detransition is so rare that only transphobes care about it. If you draw attention to the stories of transition gone wrong, the thinking goes, there will be less public support for transition and for transgender people themselves. For academic researchers and journalists, telling our stories is a fast track to being labelled a transphobe. This has profound consequences for what we know about the medical paths that leads to detransition.

In fact, we have no idea how prevalent detransition is in America. The most widely used estimate, that 2.2% of people who transition later detransition, comes from a study in a completely different place (Sweden) and time (1960-2010), when gatekeeping was much stricter. Moreover, that study defined a detransitioner as someone who had changed their name and gender legally (an arduous process in Sweden at the time) and then had the motivation and money to go through the name change process in reverse, a standard so strict that I wouldnt be counted, and nor would 90% of the detransitioners I know.

If you draw attention to the stories of transition gone wrong, the thinking goes, there will be less public support for transgender people

This passionate but misguided argumentthat detransition is extremely rare, thus any research into it is harmful and motivated by transphobiahas led to outright censorship. In 2017 Bath Spa University in Britain shot down a research proposal that sought simply to collect stories from detransitioners. The same year the Philadelphia Trans Health Conference, a major annual gathering of the transgender health community, abruptly cancelled two previously approved panels that I had helped organise on detransition and alternative methods of managing gender dysphoria, because of the level of heated conversation and controversy. These were just two out of nearly 200 sessions.

As a result, the subject of detransitioners health-care experiences remains virtually untouched by academic researchers. This shows in the clumsy approaches of those few researchers willing to engage the subject. For example, a poster presented this summer at the European Professional Association of Transgender Health conference purported to show a very low rate of detransition and regret (0.47%) at an NHS clinic in London. The poster bounced all over social media, cited as proof that detransition is indeed exceptionally rare.

But that estimate was generated by combing through case files for patients who returned to the clinic to inform staff of their detransition or regret. The thing is, though, detransitioners almost never do this. This is widely known within the communitywhy would you go back to a clinic or to a doctor who, in your view, helped you hurt yourself?

Apart from the few who sue their doctors and therapists, detransitioners tend simply to disappear from a clinics view, despite often having urgent needs for continued medical treatment and therapy. I have heard of only three detransitioners who went back to talk to the clinicians who had assisted them in transitioning. (The experience of one who did just that convinced me that I probably never will.) Nor do they tend to go to other clinics for follow-on care: they simply become invisible.

The majority of the studies supporting the conclusion that medical transition yields positive outcomesand there are manyfollowed patients in highly structured clinical programmes that provided comprehensive assessments. But when I searched last February for programmes that met that careful standard in America, I wasnt able to find one. No one knows whether informed-consent protocols will yield the same success rate, but the stories Ive heard during the past five years make me profoundly sceptical.

In a comprehensive examination of peer-reviewed articles on medical-transition between 1991 and 2017 by researchers art Cornell University, called What We Know, there have been no studies tracking a cohort of patients at an informed-consent clinic over time to investigate the outcomes that their protocol produces. Moreover, there have been no studies on what percentage of clinics in America follow the standard of care recommended by the World Professional Association for Transgender Health versus their own informed-consent protocols.

From the point of view of clinics, they would respond to the criticisms by noting that informed-consent clinics often serve a poor and transient population, which presents challenges to following up with patients. Another difficulty is that transgender medicine is a relatively new field serving a small minority of the population, necessarily limiting funding and opportunities for research. As to whether informed-consent policies have the effect of leading people to medical interventions too soon, they would argue that the people who end up feeling ill-served by the high level of patient autonomy will always be a small minority.

Yet this does not obviate the need for better practices. I dont want informed-consent clinics shuttered. I want them to do the tasks normally associated with medical care. This includes giving patients access to differential diagnosis (distinguishing between conditions that share similar symptoms) and follow-up research so that providers can improve the care they offer.

There is a responsible path between making transgender people jump through hoops and allowing people experiencing psychosis to have their testicles removed

For example, ensuring that low-cost psychology referrals are offered to all patients seeking informed-consent care could increase voluntary participation in comprehensive evaluations. Ensuring that staff are trained to identify patients showing signs of certain severe disorders, and to provide psychological evaluations when appropriate, could help prevent outcomes like Bettys.

Even ensuring that all clinics have counselling referrals on hand would be a step in the right direction. Although I received a prescription for hormones by my second visit, many patients sat on the waiting list for counselling from the same clinics social workers for more than five months and when I requested an outside referral, I was told to google the phone number of a local counselling internship site.

There is a responsible middle path between making transgender people jump through hoops to access needed medical care and allowing people experiencing psychosis and delusions to have their testicles removed. Until gender care providers accept their ethical responsibility to find that path, the American medical system continues to serve this community of people poorlybut this time, this neglect is designed and perpetrated by allies under the banner of transgender rights.

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Carey Callahan is a family therapist and board member of the Gender Care Consumer Advocacy Network, a non-profit group that advocates for the rights and welfare of consumers of gender care services.

Go here to read the rest:
Gender identity is hard but jumping to medical solutions is worse - The Economist