Archive for the ‘Hormone Physician’ Category

Sen. Mitt Romney, R-Utah, returns to the chamber from a short break as House impeachment managers present their second day of arguments in the Senate trial of former President Donald Trump, at the Capitol in Washington, Thursday, Feb. 11, 2021. (AP Photo/J. Scott Applewhite)

By Christine B. Helfrich | The Public Forum

| Feb. 13, 2021, 1:00 p.m.

I am sad to see Sen. Mitt Romney joining Sen. Rand Paul in objecting to transgender youth participating in school sports. Romney said, They shouldnt be competing with people who are physiologically in an entirely different category, and I think boys should be competing with boys and girls should be competing with (girls) on the athletic field.

My niece is 62 and athletically gifted. I am 55 and am blessed with double vision. We are physiologically in an entirely different category. My nieces large public school volleyball team took a state championship. My tiny private schools team did not.

Should students be subjected to humiliating physical exams to determine their fitness to participate in team sports?

Sixteen states already allow student trans athletes to compete according to their gender identification in current school records and daily-life activities. The world has not come to an end.

Just because a physician or midwife pronounces a gender at birth, based on a view of external genitalia, doesnt mean that the baby will neatly conform to that designation.

There are many variations in sexual characteristics that include internal genitals, external genitals, gonads, chromosomes, gene expression, hormone levels, and brain structure.

In fact 1.7% of the population meets the definition of intersex, which is about as common as having red hair.

Sen. Romney please get your medical information from someone who doesnt present himself as a board certified ophthalmologist despite his self-created board being out of business since 2011.

Christine B. Helfrich, Millcreek

Visit link:
Letter: Sad to see Romney objecting to transgender youth participating in sports - Salt Lake Tribune

Misfolded proteins (orange) in the endoplasmic reticulum may play a role in Wolfram syndromes many symptoms.

By Mitch LeslieFeb. 11, 2021 , 2:00 PM

Maureen Marshall-Doss says the first sign that her vision was deteriorating came when she misidentified the color of a dress. At a backyard get-together about 20 years ago, the Indianapolis resident pointed out an attractive yellow dress another woman was wearing. You see that as yellow? Shes wearing a pink dress, Marshall-Doss recalls her husband responding.

Today, Marshall-Doss is virtually blind. With help from custom made eyeglasses that magnify objects 500 times, I can see shapes, she says. But she can no longer drive and had to quit the job she loved as a school librarian. Along with her dimming vision, she has type 1 diabetes and has lost her sense of taste and smell.

Marshall-Doss is one of 15,000 to 30,000 people around the world with Wolfram syndrome, a genetic disease. For decades, the condition remained enigmatic, untreatable, and fatal. But in the past few years, insights into its mechanism have begun to pay off, leading to the first clinical trials of drugs that might slow the illness and sparking hopes that gene therapy and the CRISPR DNA-editing tool might rectify the underlying genetic flaws. Here is a rare disease that the basic science is telling us how to treat, says physiologist Barbara Ehrlich of the Yale School of Medicine.

The research could also aid more than the relatively few patients with Wolfram syndrome. Driving the diseases many symptoms is a malfunction of the endoplasmic reticulum (ER), the multichambered organelle that serves as a finishing school for many cellular proteins. Known as ER stress, the same problem helps propel far more common illnesses, including type 2 diabetes, amyotrophic lateral sclerosis (ALS), Parkinsons disease, and Alzheimers disease. Wolfram syndrome is the prototype of an endoplasmic reticulum disorder, says medical geneticist Fumihiko Fumi Urano of Washington University School of Medicine in St. Louis. Because Wolfram syndrome is simpler, says Scott Oakes, a cell biologist and pathologist at the University of Chicago, researchers think it could illuminate the mechanisms of other ER-disrupting diseases, which affect hundreds of millions of people worldwide.

In the late 1930s,four children with diabetes were going blind, and doctors were stumped. Like many other people in the United States struggling through the Great Depression, the siblings ate a paltry diet, subsisting on potatoes, bread, oatmeal, and a little milk. But after examining three of the children, Donald Wolfram, a physician at the Mayo Clinic in Rochester, Minnesota, and an ophthalmologist colleague ruled out malnutrition as the cause of their puzzling condition. Lead poisoning and syphilisthough common enoughwerent to blame, either. When Wolfram and his partner wrote up the cases in 1938, they concluded that the symptoms could be manifestations of an hereditary or acquired cerebral lesion.

The physicians were right that the syndrome eventually named for Wolfram is hereditary. Recessive mutations in the gene for a protein called wolframin are responsible for most cases, with glitches in a second gene causing most of the rest. However, the pair was wrong to think the defect lies only in the brain. Instead, the symptoms stem from widespread cell death. Its definitely a disease that affects the whole body, Marshall-Doss says.

The first sign of the illness, appearing when patients are children, is usually diabetes mellitus, or faulty sugar metabolism, sparked by the demise of insulin-secreting beta cells in the pancreas. Most patients also develop the unrelated condition diabetes insipidus, in which the pituitary gland doesnt dole out enough of a hormone that helps control the bodys fluid balance, causing the kidneys to produce huge amounts of urine.

Mutations in the gene for wolframin disrupt the endoplasmic reticulum and lead to cell death throughout the body, causing a range of symptoms.

V. Altounian/Science

Ellie White, 19, of Centennial, Colorado, who was diagnosed with Wolfram syndrome 12 years ago, says she hasnt had a full night of sleep since she was 3 years old. She gets up again and again to use the bathroom and monitor her blood sugar.

Yet she and other patients say that as disruptive as those problems are, they are not the diseases most dismaying consequence. The biggest symptom of Wolfram syndrome that affects me the most is my vision, White says. Because neurons in the optic nerve perish, patients usually go blind within 10 years of their first visual symptoms.

Other neurons die as well. As the disease progresses, brain cells expire, and walking, breathing, and swallowing become difficult. Most people with Wolfram syndrome die before age 40, often because they can no longer breathe. At 57, Marshall-Doss is one of the oldest patients; one of her mutated genes may yield a partly functional version of wolframin, triggering a milder form of the disease, Urano says.

Two advanceshave made it possible to begin to tackle those symptoms. The first was Uranos discovery nearly 20 years ago that linked Wolfram syndrome to ER stress. The ER is where about one-third of a cells newly made proteins fold into the correct shapes and undergo fine-tuning. Cells can develop ER stress whenever they are under duress, such as when they dont have enough oxygen or when misfolded proteins begin to pile up inside the organelle.

In test tube experiments, Urano and his colleagues were measuring the activity of genes to pinpoint which ones help alleviate ER stress. One gene that popped up encodes wolframin, which scientists had shown in 1998 was mutated in patients with Wolfram syndrome. Following up on that finding, Urano and his team determined that wolframin takes part in whats known as the unfolded protein response, which is a mechanism for coping with ER stress in which cells take steps including dialing back protein production.

Scientists think wolframin plays a key role in the unfolded protein response, though they havent nailed down exactly how. When wolframin is impaired, cells become vulnerable to ER stress. And if they cant relieve that stress, they often self-destruct, which could explain why so many neurons and beta cells die in the disease.

Defective wolframin may harm cells in other ways. The ER tends the cells supply of calcium, continually releasing and absorbing the ion to control the amount in the cytoplasm. Changes in calcium levels promote certain cellular activities, including the contraction of heart muscle cells and the release of neurotransmitters by neurons. And wolframin affects calcium regulation.

Beta cells genetically engineered to lack functional wolframin brim with calcium, Ehrlich and colleagues reported in July 2020 in theProceedings of the National Academy of Sciences. When exposed to lots of sugar, the altered cells release less insulin and are more likely to die than healthy beta cells, the team found. The cells share that vulnerability with beta cells from patients with Wolfram syndrome. We think that excess calcium is leading to excess cell death, Ehrlich says.

ER malfunctions could hamstring other organelles as well. The ER donates calcium to the mitochondria, the cells power plants, helping them generate energy. In 2018, a team led by molecular biologist Ccile Delettre and molecular and cellular biologist Benjamin Delprat, both of the French biomedical research agency INSERM, discovered that in cells from patients with Wolfram syndrome, mitochondria receive less calcium from the ER and produce less energy. Those underpowered mitochondria could spur the death of optic nerve cells, the researchers speculate.

Fumihiko Urano holds dantrolene, a muscle relaxant drug he helped test as a treatment for Wolfram syndrome.

The link between ER stress and Wolfram syndrome has been crucial for identifying potential treatments because otherwise we would have nothing to target, Urano says. But a second development was also key, he says: the advocacy and support of patient organizations, such as the Snow Foundation and the Ellie White Foundation, headed by its namesakes mother. The foundations have stepped up with money for lab research and clinical trials when other sources, including government agencies, didnt come through.

Scientists, patients, and their advocates say Urano also deserves much of the credit. Besides treating patients, he heads the international registry of cases and has taken the lead in organizing clinical trials, screening compounds for possible use as treatments, and devising potential therapies. Fumi is clearly the driving force, says Stephanie Snow Gebel, co-founder of the Snow Foundation, who about 10 years ago helped persuade him to forgo a plum job as department chair at a Japanese university and take over the Wolfram program at Washington University.

Patients could soonstart to reap the benefits. In 2016, Urano and colleagues started the worlds first clinical trial for the disease: a phase 1/2 study of dantrolene, an approved muscle relaxant. The molecule was a top performer when they screened 73 potential treatments for their ability to save cells with terminal ER stress. Dantrolene didnt improve vision in the 22 participants, including White, the scientists reported in an October 2020 preprint. But in some patients, beta cells appeared to be working better and releasing more insulin. The drug is safe, but Urano says it will need to be chemically tweaked to target its effects before future trials are warranted.

Researchers are pursuing other possible treatments targeting ER stress or calcium levels. In 2018, U.K. scientists launched a trial that will include 70 patients to evaluate sodium valproate, a therapy for bipolar disorder and epilepsy that, in the lab, prevents cells with faulty wolframin from dying. Last year, another compound that emerged from Uranos screens, the diabetes drug liraglutide, entered a clinical trial. Also last year, an experimental drug developed by Amylyx Pharmaceuticals for Alzheimers disease and ALS received orphan drug designation from the U.S. Food and Drug Administration for Wolfram syndrome because it curbs ER stress. That designation offers tax breaks and other incentives, and it will get trials started sooner, Urano says.

Ehrlich and her team have a candidate of their own that they have begun to test in rodents: the drug ibudilast, which is approved in Japan to treat asthma. The researchers found it reduces calcium levels in beta cells lacking wolframin and boosts their survival and insulin output. New screening projects may reveal still more candidates.

But Urano knows that even if a treatment receives approval, it would be only a Band-Aid for Wolfram syndrome. Hoping to develop a genetic cure, he and colleagues are introducing replacement genes into cells from patients and from mice engineered to replicate the disease. The researchers are endowing the cells with healthy copies of the gene for wolframin or the gene for a protein that reduces ER stress to determine whether they restore cellular function and reduce cell death. At INSERM, Delettre and colleagues are also evaluating whether directing a working gene into optic nerve cells can curtail vision loss in mice with faulty wolframin. The scientists are still gathering data, but early results suggest the treatment can halt the deterioration.

Urano and his collaborators have also turned to the genome editor CRISPR, deploying it to correct the gene defect in patients stem cells and then growing them into beta cells. When the researchers transplanted the revamped cells into mice with diabetes, the animals blood sugar returned to healthy levels, the team reported in April 2020 inScience Translational Medicine.

Stem cell biologist Catherine Verfaillie of KU Leuven is collaborating on the CRISPR research. But she notes that because the faulty wolframin gene affects so many tissues, researchers will have to figure out how to deliver the CRISPR components to most cells in large organs such as the brain and livera prospect she calls pretty daunting. Urano agrees, predicting that CRISPR-based Wolfram therapies might take 10 to 20 years to develop. The alternative approach, gene therapy, could reach clinical trials more quickly, in 3 to 10 years, he says, because researchers have more experience with gene therapy and have created several treatments that have already been approved for other illnesses.

Because it stems from a single genetic glitch, Wolfram syndrome could also help scientists tease out the role of the ER in more complex diseases, including neurological conditions, type 2 diabetes, and cancer. The ER also falters in those diseases, causing cells to die, but the mechanism is harder to discern because they stem from myriad genetic and environmental factors. In Alzheimers disease, for instance, neurons develop ER stress as misfolded proteins accumulate inside and outside the cells.

Besides deepening researchers understanding of other conditions, the research on Wolfram syndrome might even deliver candidate treatments. Everyone would be very excited if we can make advances in targeting ER stress in Wolfram syndrome, Oakes says. It would open up the whole field to doing this in other degenerative diseases.

More:
The race to treat a rare, fatal syndrome may help others with common disorders like diabetes - Science Magazine

Buckingham:For starters, I want to emphasize the importance of preventing your skin from aging in general, starting when youre young. When you go outside in the sun, wear protective hats, sunglasses, clothing, and sunscreen.

Your overall health impacts skin health too, so I recommend eating a healthy diet and exercising and not gaining excess weight.

People ask me what the most important components of skincare are, and I think its helpful to view those priorities in the same way we use the food pyramid to eat the right amount of certain foods for a healthy diet.

On that base layer of the pyramid is sunscreen, thats the most important thing. Put that on after using a good facial cleanser to wash away the dirt and oil on your face.

The middle box is a vitamin A derivative such as retinol or Retin-A. We have research that shows if you use these products consistently, you can increase your collagen production and your elastin as well as increasing the epidermal turnover. This can keep the skin looking healthy and less dull. The little box at the top of the pyramid is topical antioxidants like vitamin C, peptides, and pigment-reducing agents.

Once you have that good skincare foundation, there are interventions we can do to reverse the effects of aging.

These include neuromodulators, such as Botox, which can temporarily cause the muscle to not contract as robustly as it should, which reduces the appearance of wrinkles.

Microneedling uses a pen-shaped or roller device with fine needles that penetrate the dermal level and create very tiny punctures in the skin. It heals within a day and promotes the growth of new collagen and elastin. Radiofrequency microneedling uses an actual plastic plate that has needles embedded in it that are stamped or inserted into the skin. While the needles are in the face, it emits radio frequency heat energy, which amplifies the effect of microneedling.

There are several laser treatment options depending on the amount of intervention needed. By using concentrated light in different wavelengths, these treatments can rejuvenate skin by increasing the production of collagen and elastin.

Chemical peels can range from very light peels that cause just a small amount of flaking to more intense peels that can require up to 10 days of recovery and continuous application of healing ointment.

See the article here:
Ask a Castle Connolly Top Doctor: How Aging and Gravity Affect Your Skin - Everyday Health

According to cardiologist the prevalence of heart disease has transcended most diseases worldwide to be the leading cause of death. With 17 million people perishing from cardiovascular diseases worldwide, every year, the need to visit a heart doctor is rapidly expanding.

Heart doctors or cardiologists specialize in treating cardiovascular diseases by first observing the heart from multiple levels. An extensive examination is done to determine the root cause of the problem and find ways to heal the patient. Heart doctors also educate their patients on how to best take care of their hearts through lifestyle and diet choices and preventive medicine.

Cardiologists or heart physicians go through medical school before focusing on the heart specialty. With four years of medical school below their belt, they should have an additional three years of medical training specific to cardiology. This training seeks to prepare them for their fellowship, which requires another three years. Overall, a typical cardiologist has the minimum practice of around ten years before they start working professionally. Some have longer due to research degrees or additional fellowships.

Additional skills and interests of heart doctors include the willingness to motivate the patient and make critical judgments about management often after a complex decision making process. Being able to communicate efficiently and effectively with patients and staff is also important. Heart doctors should be confident and always be willing to learn more about the heart and vascular system.

There are telltale symptoms of heart problems that individuals should look out for and aim to seek medical attention as soon as possible:

When experiencing trouble breathing, it is best to see a cardiologist for assessment. Breathing should come naturally, and shortness of breath is a reason for concern.

Low blood flow to the brain can cause loss of consciousness or dizziness and light-headedness. It is important to ensure this is not caused by the heart, ie a heart arrhythmia. A visit to the heart doctor will examine the reasons why the heart isnt pumping blood to the brain.

An unstable sensation, dizziness can indicate the lack of adequate blood flow to the brain, potentially indicating a heart problem.

The occurrence of irregular heartbeats such as palpitations or a racing or erratic heartbeat might indicate heart disorders, warranting the heart physicians visit all the most crucial. Heart flutters also indicate the need for immediate treatment.

This can be due to various reasons, one of which might be angina or heart attack, caused by lack of enough oxygen reaching the heart. It is best to see your physician immediately to correct the diagnosis before the chest pains escalate to something much worse. The pain can sometimes spread to the arm, back, or jaw. Patients can also sometimes experience sweating and shortness of breath alongside the pain.

When visiting the heart physician, the patient will first answer several questions to determine the condition of their heart. These questions range from drug and family history to lifestyle habits, and their list of symptoms.

Next, the physician will conduct a series of tests to try and identify the cardiovascular conditions that the patient might have. These tests include:

An electrocardiogram tests the electrical activity of the heartbeat. This test examines the reason for chestpains, dizziness, and irregular heartbeats. This procedure involves attaching electrodes on your chest, arms and legs, and attaching them to the EKG machine, which records the hearts activity and records the information on a graph. This procedure is painless and takes around ten to fifteen minutes.

This test seeks to understand how the heart performs at a time when it requires the most blood flow, stress. The patient is attached to an EKG machine while on a treadmill. The heart physician monitors the ECG or echocardiogram to determine whether enough oxygen through proper blood flow is directed towards the heart.

The patient lies on a bed and a technician or heart specialist uses an ultrasound machine to look at the structure and function of the heart, and its valves. The test takes 20-30 minutes and no X-rays are used.

This procedure involves introducing a catheter to the blood vessel until it reaches the heart to diagnose heart problems. The catheter is injected with a dye, which exposes irregularities or blockages of the heart arteries.

After these tests, the heart physician will diagnose the results and advise on a suitable treatment plan. Depending on the heart condition, the heart physician will prescribe medications and advice on preventive and lifestyle changes. More severe complications will require heart surgery, depending on the situation.

It is paramount to maintain healthy lifestyle practices that will help prevent a visit to the cardiologist. Such practices include:

Read more:
All You Need to Know About a Heart Doctor Before Your Visit - Chiang Rai Times

Melatonin is a hormone your body naturally produces to induce sleep. It can also be purchased as an over-the-counter oral supplement to help ease insomnia or reset your body clock after traveling to a different time zone.

Melatonin is generally safe and effective in low doses, but you can overdose which can cause adverse side effects. Here is what you need to know about the side effects of melatonin and how to determine how much to take.

Low doses of melatonin cause relatively few side effects, but it is possible to take too much, says Nicole Avena, PhD, an assistant professor of neuroscience at Mount Sinai School of Medicine in New York City.

Melatonin supplements are not regulated by the US Food and Drug Administration (FDA) and therefore have no standardized dose. The typical dosage found in stores ranges from about one to five mg but can be found in doses as high as 10 mg.

Overdosing on melatonin can lead to side effects, including:

It's hard to say exactly how much melatonin is too much since there is no standardized dose, but it's best to start with the lowest dose possible and work up from there, says Alex Dimitriu, MD, founder of Menlo Park Psychiatry and Sleep Medicine in Menlo Park, California.

There is no known lethal dose of melatonin and no reports of death from taking too much melatonin, Dimitriu says, but taking too much can disrupt your natural circadian rhythm and internal body clock, causing you to actually have more trouble falling asleep.

What the research says: Some studies have shown that cancer patients can benefit from large doses of melatonin ranging from 20mg to 1,000mg, but these doses are generally not recommended for those with no underlying medical conditions.

The effects of taking large doses of melatonin don't appear to be lethal, Dimitriu says, but more research is needed to determine the long-term health implications of melatonin use and the effects of doses larger than 30mg.

The right dose of melatonin for you is the lowest possible dose that can help you sleep with minimal side effects, Dimitriu says. This can vary by individual.

General advice: For most people, a melatonin dose of 0.5 to 5 mg can effectively help them fall asleep. If you find this dose isn't effective, you can increase it from there under the guidance of your doctor.

Melatonin should only be used occasionally unless you have otherwise been instructed by a physician, Avena says. Melatonin is considered safe in low doses for short-term use, but there is little data available on its long-term effects and more research is needed to determine overall safety.

If you find you are relying on melatonin in order to fall asleep every night, Avena recommends lowering your dosage slowly. You may experience a few nights of less than great sleep as your body adjusts.

Relaxation techniques like meditation or breathing exercises can help you fall asleep without the help of a melatonin supplement.

"It is more important to have healthy sleep habits and a regular sleep schedule, exercise, and minimal stress, than to rely on any supplement, including melatonin for sleep," Dimitru says.

Melatonin is not addictive, but taking it every night can cause you to rely on it as part of your bedtime routine.

"People can become psychologically or biologically dependent on any supplement or medication they take, especially with sleep. People start associating substances and behaviors as part of the bedtime routine," Dimitriu says. "The bedtime routine may suffer if some of the parts are missing, whether it be a favorite blanket, bed, or supplement like melatonin."

It is impossible to become physically dependent on melatonin like you could with other substances, like alcohol, Avena says, but you can come to rely on it as a sleep association.

If you find you are needing to take melatonin every night to sleep, you may have another health condition, like anxiety or a sleep disorder that is affecting your ability to sleep, Dimitriu says.

"With melatonin, it is important to maintain healthy habits besides just using a supplement," Dimitriu says, "Our bodies and minds, if healthy and not anxious should be able to sleep naturally."

In small doses, melatonin supplements are a safe and effective way to help you fall asleep, but more research is needed to determine the long-term effects of taking melatonin regularly.

There is no known lethal dosage of melatonin, but taking more than 10 mg can cause side effects, like daytime drowsiness and headaches.

If you are relying on melatonin to sleep, talk with your doctor about ways to improve your sleep hygiene.

More:
Yes, you can overdose on melatonin here's how to find your proper dosage - Insider

Happy national "Satisfied With Being Single Day"!

I love that this falls right before Valentine's Day. It's a great way to embrace the solo life. It's also a great day to print out a picture of your ex. I know it sounds counter productive, but it's actually going to benefit you this weekend.

The benefit? Free wings. What's better than that? Hooters does this hilarious thing every year where they want to help you get over your ex, and in return they'll also give you some free food.

So I went to go check if the Hooters in Rockford is one of the participating locations, and it led me to a virtual survey about my ex. So of course I took it. Here's what the survey looked like -

So after I chose some of the hilarious options, they lead me here.

Then they made me pick a picture, and I wasn't really trying to shred an ex. So I picked a picture of the 97ZOK logo (oops).

Well, here we go.

I'M SORRY 97ZOK! I didn't mean it!

After all that virtual shredding, I was finally prompted to enter my information for a coupon to the Rockford location. So if you have an ex you're ready to get over, and you're also a wing lover, then this is the perfect way to celebrate Valentine's Day.

Also, I still recommend printing out a picture to ACTUALLY shred. Sounds like a great way to get over someone.

H/T DELISH

See the article here:
Hooters Will Give You Free Wings For Shredding a Pic of Your Ex - q985online.com

Though a peanut allergy is generally considered a pediatric issue, many people don't develop one until after turning 18 years old.

More than 800,000 of the 4.6 million U.S. adults who have peanut allergies didn't develop them until after reaching adulthood, according to a new study. That equates to 17% a larger percentage than previously believed.

The reasons behind late-onset peanut allergies are not completely understood, but the Northwestern University researchers who conducted the study suggest environmental factors and hormone fluctuations may play a role.

Other experts said a delayed or extended period of sensitization to peanuts could also be to blame or even a cross-reaction to some other allergens such as pollen. Research is ongoing to improve diagnosis, management and treatment of peanut allergies.

"Given the high prevalence of peanut allergy among U.S. adults, additional therapies are needed to help address this growing burden of disease,"Dr. Ruchi Gupta, director of the Center for Food Allergy and Asthma Research at Northwestern University,toldUPI.

The study's findings, published inThe Journal of Allergy and Clinical Immunology, stem from a survey of more than 40,000 adults.

Though 2.9% of respondents reported having peanut allergies, researchers found only 1.8% actually had convincing peanut allergies.Gupta said it is important for adults who think they have developed peanut allergies to be diagnosed by a physician instead of just avoiding peanuts.

Their doctors can teach them how best to avoid exposure and prescribe epinephrine, an emergency treatment for anaphylaxis, a severe allergic reaction.

Gupta also toldCNNthat more adults than children have peanut allergies. Only 15 to 20% of children with a peanut allergy will outgrow it by adulthood.

People who said they developed peanut allergies in adulthood were less likely to have been diagnosed by a physician compared to adults whose allergies emerged during childhood, researchers found.

They also were more likely to report multiple food allergies.They were less likely to have an epinephrine prescription 44% compared to 56%.

A food allergy develops when the immune system mistakenly labels the food as a threat and launches an attack against it, Harvard Health experts say.

For people with peanut allergies, even a small amount of peanuts can cause a serious, possibly life-threatening reaction. Symptoms usually start minutes after exposure, according to the Mayo Clinic.

The most common symptoms include skin reactions such as hives or redness, an itching or tingling in the mouth or throat, nausea or vomiting, tightening of the throat and wheezing.

Any severe reaction requires treatment with an epinephrine autoinjector and an emergency department visit. Anaphylaxis symptoms include trouble breathing, a sharp drop in blood pressure, a rapid pulse, dizziness and loss of consciousness.

Peanut allergies are a leading cause of fatal and near-fatal anaphylaxis. People who suspect they may have peanut allergies should get evaluated by their physicians as soon as possible.

The U.S. Food and Drug Administration has not approved any therapies for adults with peanut allergies, An oral immunotherapy has been approved for patients 4 to 17 years of age to help desensitize them to peanuts.

See more here:
More than 4.6 million US adults have peanut allergies, Northwestern University study finds - PhillyVoice.com

February 8, 2021

Theres a good reason medical checkups typically include a quick but gentle pat-down of your neck area by health care providers. Among other conditions, theyre looking for a goiter, an enlarged thyroid gland that may spell health problems but can also be harmless.

Goiters affect about 16 percent of people worldwide, ranging from just under 5 percent in the United States to 28.3 percent in Africa, according to the National Institutes of Health. But the most common cause of goiters globallya lack of the nutrient iodineisnt a significant issue in the U.S., where iodized salt is routinely used.

In our country, many goiters are idiopathic, meaning we dont know the reason why they occur, says Alexander Shifrin, M.D., an endocrine surgeon at Jersey Shore University Medical Center.

Still, various risk factors can make it more likely that youll develop a goiter. These include:

Located at the base of the neck, the thyroid produces hormones that regulate a variety of crucial bodily functions, ranging from helping us keep warm and use energy to fueling proper function of organs and muscles. The development of a goiter doesnt mean the gland isnt working. But this enlargement, which can happen slowly or quickly, may also signal the thyroid is making too much or too little hormone.

What signs of a goiter should you watch for? Dr. Shifrin says size matters. Watch for an enlargement of the thyroid, he says, including swelling at the base of your neck. Every enlarged gland should be checked for cancer.

According to the American Thyroid Association, you should also watch for these signs:

Most goiters arent cancerous, Dr. Shifrin says, but you should still have it checked by your primary physician or an endocrine specialist. Blood tests alone cant usually determine if thyroid cancer is present. Ninety percent of thyroid cancers are detected by palpating the gland and a thyroid ultrasound, Dr. Shifrin says.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.

Follow this link:
Causes and Signs of an Enlarged Thyroid - Health Topics, Men's Health, Women's Health - Hackensack Meridian Health

Study Design: Cohort study design with retrospective and prospective components.

Methods: Women were eligible to participate in accordance with the CMS Quality Rating System technical specification for breast cancer screening. Eligible women with no documented screening for a mammogram from January 1, 2016, through November 7, 2017, were invited to participate in a campaign that included outreach about screening mammography as a no-cost covered benefit, education about screening mammography to detect asymptomatic disease, and a gift card to a local grocery merchant if the member obtained screening mammography by December 31, 2017.

Results: During December 2017, 20.8% (27/130) of eligible women obtained a screening mammogram compared with 7.8% (5/64) of eligible women during the nonintervention reference period of December 2016. Mammography screening increased by 170% during the study period in comparison with the reference period of a year earlier (prevalence ratio [PR], 2.7; 95% CI, 1.1-6.6; P=.02).

Conclusions: A one-time, time-limited cue-to-action pilot project consisting of outreach, education, and incentive increased uptake of screening mammography by women enrolled in a community health insurance plan providing health insurance coverage as part of the Affordable Care Act. This increase is statistically significant in the intervention period compared with the reference period (PR, 2.7; 95% CI, 1.1-6.6; P=.02). Despite a small sample size, the magnitude of the effect for this pilot study is encouraging and warrants future studies in a larger population.

Am J Manag Care. 2021;27(2):In Press

_____

Takeaway Points

Managed care organizations (MCOs) can help members achieve positive health outcomes through the consistent use and application of quality improvement activities. We demonstrated that an MCO can effectively target members to improve uptake of a preventive service through a series of cues to actions. MCOs should consider the findings from this pilot project as evidence that outreach, education, and incentives play a role in member decision-making with regard to using preventive services. This research also demonstrates that MCOs can effectively encourage members to use free, covered benefits available to them as part of the Affordable Care Act.

_____

Breast cancer is the most common cancer among women in the United States.1 The National Cancer Institute estimated that the number of new breast cancer cases and the number of deaths from breast cancer among women would approach 268,600 and 41,760, respectively, in 2019.2 However, despite these numbers, the population-adjusted mortality rate for breast cancer decreased by 36% from 1989 through 2012.3 This reduction is due to a variety of factors, including improved chemotherapeutic treatments, reduced hormone replacement use among women, and the continued use of screening mammography to identify breast cancer among asymptomatic women.3 Case-control studies show a reduction in breast cancerrelated mortality ranging from 36% to 70% for women who obtain screening mammography.4

In the United States,5 as in many countries around the world,6-8 national health officials have developed evidence-based guidelines to promote screening mammography among asymptomatic women. Guidelines from the US Preventive Services Task Force (USPSTF) indicate that women of average risk aged 50 through 74 years will receive the most benefit from regular biennial screening.5 With the introduction of the Patient Protection and Affordable Care Act (ACA), screening mammography became a covered, no-cost, preventive service.9

METHODS

Study Setting

Sendero Health Plans is a community-based health insurance plan serving an 8-county area of central Texas that offers health insurance on the ACA federal marketplace. In 2017, as part of its ongoing quality improvement focus, Sendero sought to increase uptake of screening mammography for members enrolled in its ACA line of business based on the USPSTF recommendation for mammography screening.10

Theoretical Basis

We used both the health belief model and the transtheoretical model as a basis for this pilot project. The health belief model includes a variety of theoretical constructs, such as perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and cues to action, to guide health promotion activities.11 The health belief model has been used to predict health behaviors for a variety of clinical issues, including screening for asymptomatic disease12 and helping to improve breast cancer screening rates among asymptomatic women.13-15 In this pilot project, we used cues to action to provide an overt action (ie, outreach and education) as a stimulus to asymptomatic women aged 52 to 74 years to undertake a known preventive intervention to identify breast cancer. In addition, a financial incentive, which is rooted in the transtheoretical model, was used to encourage women who may otherwise be ambivalent to undertake this health-seeking behavior to undergo screening mammography.16

Study Design

We conducted a pilot project using a cohort study design to determine if cues to action involving outreach about screening mammography as a no-cost benefit, education about screening mammography to detect asymptomatic disease, and a financial incentive using a gift card to a local grocery merchant would encourage women to obtain a screening mammogram. We focused on a time-limited, 6-week pilot project from November 17, 2017, through December 31, 2017. Women were identified and eligible to participate in this study based on the following inclusion and exclusion criteria (Figure 1).

Women had to be eligible to receive a screening mammogram based on the CMS Quality Rating System technical specification for breast cancer.17 Using this technical specification, we identified 277 women aged 52 to 74 years who were continuously enrolled in the Sendero IdealCare plan for the period October 1, 2015, to December 31, 2017.

We adjusted this group to include only 2 full years of data for analysis, removing 10 women who were eligible in the period from October 1, 2015, through December 31, 2015. This resulted in 267 women eligible for screening mammography in calendar years 2016 and 2017.

We identified all women in the 2016 and 2017 time period who had not received a screening mammogram by November 7, 2017, based on submission of a medical claim for Current Procedural Terminology code 77067 or Healthcare Common Procedure Coding System code G0202. One hundred women were identified. These women are defined as the population eligible for this study.

Women were not randomized or otherwise allocated to an intervention or nonintervention group, as it was deemed unethical to restrict individuals from receiving a secondary prevention examination with known positive health benefits.

Study Intervention

This study consisted of 3 interventions, all of which were targeted at women aged 52 to 74 years. The interventions were (1) outreach to inform women that screening mammography is a benefit available to them at no additional out-of-pocket cost as part of their Sendero health insurance; (2) educational information about the exam (adapted from material produced by the CDC), the benefits of screening mammography, and how to prepare for and what to expect on the day of the exam11; and (3) an incentive of a $50 gift card to a local grocery merchant to women who completed the screening mammography exam by December 31, 2017.

Materials were mailed to eligible women on November 17, 2017, just prior to the US Thanksgiving holiday period. Follow-up text messages were sent 12 days later on November 29, 2017. Follow-up phone calls were initiated between December 4 and December 21, 2017, some 17 days after the initial mailing, to assist women with scheduling a mammogram appointment or to answer questions about screening mammography. All written materials, texts, and phone calls were provided in English and Spanish.

A member of the research team (N.T.) who is bilingual in English and Spanish made follow-up phone calls to women eligible for the campaign. A script was developed, and the research team member was trained on how to use the script, how to address comments or questions not in the script, and how to provide scheduling assistance if requested. Calls were recorded for quality assurance purposes but were not monitored or reviewed at a later date. After identity verification, the member was asked if she:

Statistical Analyses

Data were obtained from medical claim submissions and included the date on which screening mammography occurred, the county and zip code of the individuals residence, and the individuals age in years. Data on income and federal poverty levels by county were obtained from the US Census; such data are not reported to Sendero by federal officials and, therefore, we do not have the ability to provide member-level data analysis on this information.18 Similarly, data on race and ethnicity are not provided to Sendero by federal officials.

Descriptive statistics included age and proportion of women eligible to participate in the health promotion campaign and were based on full-year data in 2016 and 2017, respectively. Chi-square goodness of fit tests were used to test the hypothesis that there is no difference by month when women choose to obtain a screening mammogram. A separate 2 test was conducted for each calendar year, as well as for the 2-year period of the study. A prevalence ratio (PR), the 95% CI, and a P value were calculated to compare the prevalence of women screened in the intervention period (December 2017) with the reference period of a year earlier (December 2016).

RESULTS

One hundred women were eligible to participate in the outreach, education, and incentive campaign. These 100 women were represented by 46 zip codes. Twenty-five zip codes were located in Travis County, 9 in Williamson County, 6 in Bastrop County, 3 in Hays County, 2 in Caldwell County, and 1 in Fayette County. Among these 46 zip codes, the median household income ranged from $38,100 to $136,138 and the percentage of people living at or below the federal poverty level ranged from 2.1% to 30.6%.18

Twenty-seven of the 100 individuals eligible for this intervention obtained a screening mammogram during the assessment month of December 2017. By comparison, 5 women obtained a screening mammogram during the reference period of December 2016. Women who received the intervention were 170% more likely to be screened in December 2017 compared with December 2016 (PR, 2.7; 95% CI, 1.1-6.6; P=.02).

During 2016 and 2017, 194 women obtained a screening mammogram (Table 1). The number of women who obtained a screening mammogram varied by month during 2016 (211=14; P=.23), during 2017 (211=42.62; P<.001), and across the 24-month reporting period of January 1, 2016, through December 31, 2017 (223=88.80; P<.001) (Table 2 and Figure 2). The difference was not significant in 2016, but it was statistically significant during 2017 and during the overall 2-year observation period. In both 2016 and 2017 the number of monthly screening mammograms varied: 2016 (range, 1-9) and 2017 (range, 4-27).

Follow-up texts were transmitted to 94 women based on contact preferences; 54 of the text messages were confirmed as having been received. Follow-up phone calls were initiated to 85 members based on contact preferences, with 145 attempted calls resulting in a conversation with 40 members. Of the 40 women contacted by phone, 15 had not scheduled a mammogram by the time of the call. Eight women (53.3%) accepted the offer of assistance to schedule an exam, 6 (40.0%) did not accept scheduling assistance, and 1 (6.7%) reported she had, unbeknownst to us, scheduled her mammogram prior to the call.

DISCUSSION

Two cues to action and 1 incentive component were used to encourage uptake of screening mammography among women aged 52 to 74 years. To our knowledge, no other health insurance plan in Texas has conducted a similar pilot project to increase uptake of a USPSTF preventive service as part of the ACA package of benefits.

Outreach and Education

The outreach and education cues to action informed women that screening mammography was a covered benefit of their health insurance policy, how screening mammography can identify breast cancer in its earliest stages when it is usually more effective to treat, and what screening mammography entails. Reminders tied to a specific date have been shown to improve uptake of screening mammography,19 which in our case were focused on a specific intervention time frame. Educational material has been shown to be a useful tool to encourage women to obtain screening mammography.20,21

The Incentive Component

The incentive component provided women with a $50 gift card to a local grocery merchant if they obtained their screening mammography between November 17, 2017, and December 31, 2017. The incentive was designed to encourage a healthy behavior among women for a known preventive service. However, the notion of a financial incentive sometimes prompts disquiet among those who believe that paying a person to obtain a known health benefit is somehow wrong or immoral, whereas others question the medium- or long-term viability of such an activity. We provide our insight into these notions from the health insurance company perspective.

First, we do not believe there is any reason to suggest or imply that providing a financial incentive to obtain a preventive service is somehow wrong; in fact, this notion strikes us as both paternalistic and judgmental. Financial incentives are a part of contemporary life and are used to guide people into making decisions. In health care, the goal is to encourage individuals to make healthy choices; therefore, it seems appropriate to provide incentives to encourage healthy behavior and thus maximize utility.22-24 As a form of trade, this is a voluntary action that, if implemented, benefits both parties.22 In this case, a woman obtains a preventive health service with demonstrated evidence of success and the health insurance company fulfills its obligations to promote the health and well-being of its members. If the woman chooses not to participate in the incentive program, which 73 did not for this campaign, then this is her right as would be expected of any type of voluntary transaction.

Second, with regard to the medium- and long-term viability, several items need to be considered. One is to identify the expected outcome of the financial incentive. The idea is not, as some might suggest, to pay a person to obtain a preventive service; rather, the idea is to use the incentive to introduce and support ongoing positive behavioral change. Further research on the impact of financial incentives and behavioral change within a community-based health insurance plan is needed.

Third, there may be a concern about the overall financial benefit of screening and early detection. Routine screening, simply put, is designed to identify disease in its earliest stage before it has had an opportunity to metastasize. Treating breast cancer in situ is more successful and less costly than treating metastatic cancer.25 For example, breast cancer in situ is reported to have mean per-patient costs of $48,477 and $71,909 at 0 to 6 months and 0 to 24 months post diagnosis, respectively. On the other hand, breast cancer that has spread beyond the breast tissue and may have entered the lymph node is reported to have mean per-patient costs of $84,481 and $159,442 at 0 to 6 months and 0 to 24 months post diagnosis, respectively.26 In our cue-to-action project, the maximum total expenditure for the financial incentive would have been $5000 if all women had participated in the pilot project. Had 1 case of breast cancer in situ been identified rather than waiting until regional lymph node involvement had occurred, the amount of money expended due to early treatment vs late-stage treatment would have more than offset the cost of the entire incentive program.

Women Who Choose Not to Be Screened

Women who choose not to be screened represent a small but important part of the overall population eligible for screening mammography. Of the 267 women eligible for screening, 73 (27.3%) in the 2-year period from January 1, 2016, to December 31, 2017, did not obtain screening mammography as part of their Sendero health insurance benefit. The research team member who made follow-up calls to members to encourage participation in this pilot project collected information about why women chose not to participate. Although this was not a primary outcome for this pilot study, we present here some of the qualitative findings from the conversations that took place with the 40 members who were contacted. (Each statement is from a specific person, with additional comment, if any, by the authors in brackets.)

This feedback indicates that primary care physicians play an important role in helping women make an informed decision about whether to obtain screening mammography. Further research on the impact of the role of the primary care physician and behavioral change to support secondary prevention campaigns is warranted.

Limitations

Several limitations have been identified with this study. The first limitation is the timing of the campaign and its potential impact on mammography screening uptake. The 6-week intervention time period included 3 major holidays, which may have limited participation and may have impacted service availability; however, based on discussions with our preferred mammography provider during the planning process, they did not indicate a lack of availability during the 6-week time period. Second, some campaign-eligible women may have already scheduled a mammogram before receiving campaign material in the mail. Third, although the campaign included 3 cues to action, we did not seek to, nor were we able to, ascribe variance to any particular cue to action. Fourth and finally, we are blinded to some data that could be useful in the analysis of these findings. Such data include income and race/ethnicity data, as this information is not provided by the federal Marketplace to health plans.

CONCLUSIONS

A one-time, time-limited cue-to-action pilot project consisting of outreach, education, and incentive increased uptake of screening mammography by women enrolled in a community health insurance plan providing health insurance coverage as part of the ACA. This increase is statistically significant in the intervention period compared with the reference period (PR, 2.7; 95% CI, 1.1-6.6; P=.02). Despite a small sample size, the magnitude of the effect for this pilot study is encouraging and warrants future studies in a larger population.

Acknowledgments

The authors would like to acknowledge the assistance and advice of current and former Sendero staff members and contractors Dr Avishek Kumar, Bryan Palma, Linda Burton, Tammy Liu, Norma Lozano, Rodolfo Ybarra, and Priscilla Gonzales in the development of this project. The authors would also like to thank Travis County taxpayers for their continued support of Sendero Health Plans.

Author Affiliations: The Litaker Group, LLC (JRL), Austin, TX; Sendero Health Plans (NT, WD), Austin, TX; University of Texas at Austin (RT), Austin, TX.

Source of Funding: Funding for this project was provided in the form of staff and contractor time by Sendero Health Plans.

Author Disclosures: Drs Litaker and Taylor are independent paid research consultants to Sendero Health Plans and received payment for their involvement in the preparation of this manuscript. The remaining authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (JRL, NT, WD, RT); acquisition of data (JRL, NT, WD, RT); analysis and interpretation of data (JRL, NT, RT); drafting of the manuscript (JRL, RT); critical revision of the manuscript for important intellectual content (JRL, RT); statistical analysis (JRL, NT, RT); provision of patients or study materials (NT); obtaining funding (WD); administrative, technical, or logistic support (JRL, NT, RT); and supervision (JRL).

Address Correspondence to: John R. Litaker, PhD, MSc, MMedSc, The Litaker Group, LLC, PO Box 160505, Austin, TX 78716. Email: john.litaker@litakergroup.com.

REFERENCES

1. Cronin KA, Lake AJ, Scott S, et al. Annual Report to the Nation on the Status of Cancer, part I: national cancer statistics.Cancer. 2018;124(13):2785-2800. doi:10.1002/cncr.31551

2. Cancer stat facts: female breast cancer. National Cancer Institute. Accessed March 22, 2020. https://seer.cancer.gov/statfacts/html/breast.html

3. DeSantis CE, Fedewa SA, Goding Sauer A, Kramer JL, Smith RA, Jemal A. Breast cancer statistics, 2015: convergence of incidence rates between black and white women. CA Cancer J Clin. 2016;66(1):31-42. doi:10.3322/caac.21320

4. Puliti D, Zappa M. Breast cancer screening: are we seeing the benefit? BMC Med. 2012;10:106. doi:10.1186/1741-7015-10-106

5. Clinical summary: breast cancer: screening. US Preventive Services Task Force. January 11, 2016. Accessed August 1, 2017. https://www.uspreventiveservicestaskforce.org/Page/Document/ClinicalSummaryFinal/breast-cancer-screening1

6. Breast Screen Australia: policy. Australian Government Department of Health. Updated June 5, 2020. Accessed July 1, 2020. http://www.cancerscreening.gov.au/internet/screening/publishing.nsf/Content/policy

7. Overview: breast cancer screening. National Health Service. Updated March 27, 2018. Accessed August 1, 2018.https://www.nhs.uk/conditions/breast-cancer-screening/

8. Tonelli M, Gorber SC, Joffres M, et al; Canadian Task Force on Preventive Health Care. Recommendations on screening for breast cancer in average-risk women aged 40-74 years. CMAJ. 2011;183(17):1991-2001. doi:10.1503/cmaj.110334

9. Coverage of Preventive Health Services, 42 USC 300gg13 (2010).

10. What is a mammogram? CDC. Updated September 14, 2020. Accessed October 1, 2020. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm

11. Zheng Y, Mancino J, Burke LE, Glanz K. Current theoretical bases for nutrition intervention and their uses.In: Coulston AM, Boushey CJ, Ferruzzi MG, Delahanty LM, eds. Nutrition in the Prevention and Treatment of Disease. Elsevier; 2001:83-93. doi:10.1016/b978-012193155-1/50008-8

12. Urich A. The Health Belief Model. Pennsylvania State University Open Resource Publishing. Accessed March 10, 2020. https://psu.pb.unizin.org/kines082/chapter/the-health-belief-model/

13. Sohl SJ, Moyer A. Tailored interventions to promote mammography screening: a meta-analytic review.Prev Med. 2007;45(4):252-261. doi:10.1016/j.ypmed.2007.06.009

14. Yarbrough SS, Braden CJ. Utility of health belief model as a guide for explaining or predicting breast cancer screening behaviours.J Adv Nurs. 2001;33(5):677-688. doi:10.1046/j.1365-2648.2001.01699.x

15. Deavenport A, Modeste N, Marshak HH, Neish C. Closing the gap in mammogram screening: an experimental intervention among low-income Hispanic women in community health clinics.Health Educ Behav. 2011;38(5):452-461. doi:10.1177/1090198110375037

16. Slater JS, Parks MJ, Malone ME, Henly GA, Nelson CL. Coupling financial incentives with direct mail in population-based practice.Health Educ Behav. 2016;44(1):165-174. doi:10.1177/1090198116646714

17. 2018 Quality Rating System measure technical specifications. CMS. September 2017. Accessed October 1, 2017. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityInitiativesGenInfo/Downloads/Revised_QRS-2018-Measure-Tech-Specs_20170929_508.pdf

18. American FactFinder Community Facts. US Census Bureau. Accessed March 20, 2020. https://factfinder.census.gov/faces/nav/jsf/pages/community_facts.xhtml

19. Buist DSM, Gao H, Anderson ML, et al. Breast cancer screening outreach effectiveness: mammogram-specific reminders vs. comprehensive preventive services birthday letters.Prev Med. 2017;102:49-58. doi:10.1016/j.ypmed.2017.06.028

20. Michielutte R, Sharp PC, Foley KL, et al. Intervention to increase screening mammography among women 65 and older.Health Educ Res. 2004;20(2):149-162. doi:10.1093/her/cyg108

21. Boling W, Laufman L, Lynch GR, Weinberg AD. Increasing mammography screening through inpatient education.J Cancer Educ. 2005;20(4):247-250. doi:10.1207/s15430154jce2004_14

22. Grant RW. The ethics of incentives: historical origins and contemporary understandings.Econ Philos. 2002;18(1):111-139. doi:10.1017/s0266267102001104

23. Tambor M, Pavlova M, Golinowska S, Arsenijevic J, Groot W. Financial incentives for a healthy life style and disease prevention among older people: a systematic literature review.BMC Health Serv Res. 2016;16(suppl 5):426. doi:10.1186/s12913-016-1517-0

24. Vlaev I, King D, Darzi A, Dolan P. Changing health behaviors using financial incentives: a review from behavioral economics.BMC Public Health. 2019;19(1):1059. doi:10.1186/s12889-019-7407-8

25. Kakushadze Z, Raghubanshi R, Yu W. Estimating cost savings from early cancer diagnosis.Data (Basel). 2017;2(3):30. doi:10.3390/data2030030

26. Blumen H, Fitch K, Polkus V. Comparison of treatment costs for breast cancer, by tumor stage and type of service.Am Health Drug Benefits. 2016;9(1):23-32.

Go here to read the rest:
A Cue-to-Action Pilot Project to Increase Screening Mammography - AJMC.com Managed Markets Network

Its a mans world is an iconic, soulful ballad co-written by the late James Brown and recorded in February 1966 at Bob Gallos Talent Masters studio in New York City. And it is a song that celebrates the virtues of being a man while simultaneously acknowledging the many virtues of women. Something to note about this iconic, soulful ballad that reached No. 1 on the Billboard R&B chart and No. 8 on the Billboard Hot 100 more than 50 years ago is how it called attention to the many differences between men and women. Along with emotional and psychological differences, men and women are also remarkably different from a physiological standpoint. To understand to what extent, it helps to know a little more about the endocrine system in both genders.

What Science Has Revealed About the Male and Female Endocrine System

For those not as well-versed in human physiology, the male and female body houses an endocrine system. And this system is comprised of a network of hormone-secreting glands that allow the body to function optimally. In both genders, the primary hormones that make up the endocrine system include the pineal, pituitary, hypothalamus, thyroid, parathyroid, adrenal, and thymus glands. The pancreas is also one of the many glands that make up the endocrine system in both men and women. One key difference between the male and female endocrine system has to do with the reproductive glands.

Male and female bodies alike have reproductive glands that make conception possible. In men, this would be the testes. And in women, it would be the ovaries. The testes are responsible for secreting testosterone. The ovaries, on the other hand, secrete estrogen. When these glands secrete adequate amounts of their respective hormones, they play a vital role in contributing to homeostasis and enabling men and women to realize the joys of parenthood. However, if these hormone levels fall too low, it can lead to fertility issues and other physical health problems in men and women alike. For example, women with low estrogen levels, which correlates with estrone and estradiol levels below 17 and 15 nanograms per deciliter (ng/dL), respectively, will usually experience the following:

Much like women, men with low testosterone levels, typically below 280 ng/dL, will see their fair share of ill-effects, some of which include the following:

One of the biggest misconceptions when it comes to the endocrine system is that its ability to secrete estrogen applies only to women. And this couldnt be any further from the truth. While the ovaries and adrenal glands secrete estrogen in women, the testes and adrenal glands secrete estrogen in men. Of course, the amount of this hormone secreted in men is much lower. When estrogen levels are too high, delineated by estradiol and estrone levels greater than 40 and 50 picograms per milliliter (pg/mL), respectively, men are more likely to suffer from prostate enlargement.

Common Causes of Prostate Cancer

Along with an enlarged prostate resulting from high estrogen levels, men who also have low testosterone levels are more likely to develop prostate cancer, say researchers with the National Institutes of Health. The sentiment is further echoed by the Centers for Disease Control and Prevention (CDC), which notes that prostate cancer is the most common cancer in men, especially among those age 40 and over. Further, a study published by Science Daily revealed that men with high testosterone and high human growth hormone (HGH) levels are also at risk of developing prostate cancer. And it does not end there as prostate cancer can also stem from inherited gene mutations, acquired gene mutations, and poor dietary habits. Men who have the misfortune of developing prostate cancer will often experience the following symptoms:

How Is Prostate Cancer Diagnosed?

While symptoms detailed in this article generally correlate with prostate cancer, the only way for men to know for sure if they have developed the disease is to schedule an appointment with a urologist or oncologist. Two of the screening tests that these practitioners will use to determine if an individual has prostate cancer include a digital rectal exam (DRE) and a prostate-specific antigen (PSA) test. Some practitioners will arrange an ultrasound, magnetic resonance imaging (MRI), and may even order a biopsy if they observe prostate abnormalities that might be cancerous. If prostate cancer is confirmed, some practitioners may advise undergoing a prostatectomy.

What Is a Prostatectomy?

In short, a prostatectomy, otherwise known as prostate surgery, is a procedure that involves the partial or complete surgical removal of the prostate. This type of surgical procedure is a go-to for men with cancer affecting the prostate, which has not metastasized to other parts of the body, or an enlarged prostate. According to the American Cancer Society, the following are the different types of prostatectomy surgery that a physician might recommend to men diagnosed with either of these two health problems:

Consequences of Undergoing a Prostatectomy

As with any surgery, there are risks associated with undergoing a prostatectomy of any kind. Some of the ones frequently reported by men who have gone through with such a procedure include the following:

Ways to Ensure a Safe and Quick Recovery Following Prostatectomy Surgery

Indeed, numerous side effects can stem from undergoing prostatectomy surgery. However, according to most urologists, men who do the following are much less likely to encounter them:

Close medical supervision One of the best ways to ensure a safe and speedy recovery following prostatectomy surgery is to immediately contact your physician if youre experiencing excessive pain or bleeding post-surgery. After all, neglecting these issues can pave the way for infections and other complications that could significantly slow down the healing process.

Positive attitude Having a positive attitude aids in speeding up recovery and minimizing complications after a surgical procedure, say most naturopathic physicians. And prostatectomy surgery is no exception as a positive attitude can tamp down feelings of stress that would otherwise weaken the immune system and, in turn, slow down healing.

Avoiding accidents Another way to minimize complications while speeding up healing following prostatectomy surgery is by avoiding trauma to the urethra or bladder. For this reason, physicians often advise against engaging in strenuous activities, such as biking, running, or even having sex, while the body is still healing.

Prevention of Prostate Cancer: Testosterone and Human Growth Hormone Therapy

According to a study published by cancer.net, over 190,000 men will likely be diagnosed with prostate cancer by the end of 2020. But this doesnt mean that such a grim reality is unavoidable. There are things that men can do to lower their chances of developing the disease. For example, addressing hormone imbalance problems as soon as possible can significantly reduce the likelihood of developing prostate cancer. And this generally means taking medication to help boost low testosterone (find more about results of depo-testosterone in reviews of patients) or human growth hormone levels. Similarly, taking medication to lower high estrogen levels can help in this regard as well.

Natural Ways to Boost Immunity That Also Protects Against Prostate Cancer

Many of the same things that strengthen the immune system, which, in turn, lowers the risk of infection, can also protect against prostate cancer. Generally speaking, this comes down to healthy lifestyle habits, such as exercising regularly, consuming a healthy, well-balanced diet, and keeping stress to a minimum. Quitting smoking and minimizing alcohol consumption can further lower the risk of developing prostate cancer.

Bottom Line

All in all, men and women are more the same than they are different in that both have a higher chance of encountering life-altering diseases as they get older. Fortunately, breakthroughs in science and modern medicine, coupled with positive lifestyle choices, can go a long way toward keeping many age-related diseases, including prostate cancer in men and breast cancer in women, at bay.

See the original post here:
Prostatectomy: Safe and Quick Ways to Recover - Voice Online - The Voice Online

In recent years there have been many scientific advancements targeting the problems men face in the bedroom. Use of male enhancement pills increased 312% from 1998 to 2002 leading to massive amounts of money being poured into research.

The high demand and competition leads to new formulas addressing more specific problems such as arousal, erection intensity, and length of climax. In this article we go over what ingredients to look for, what sex pills work, and what the best male enhancement pills are by type.

Top Male Enhancement Pills by Category

1. Best ED pill subscription service - Hims ED Pills2. Best for boosting sex drive - VigRX Plus3. Best for increasing orgasm intensity - Semenax4. Best for increasing testosterone - Testogen5. A unique twist on male enhancement - SemEnhance6. Best natural supplement for stiffer erections - Max Performer 7. Best for longer erections - Male Extra 8. Best herbal supplement - Viasil 9. Best value-for-money - Huge.com10. Best premature ejaculation remedy - ProSolution Plus11. Best maximum strength formulation - ExtenZe

1. Hims ED Pills Most Powerful Male Enhancement Pill

Hims Inc. is a telemedicine company founded in 2017. Hims employs doctors that review a subscriber's personal health information. These doctors then prescribe ED medications that subscribers purchase through the Hims website.

When needed, Hims doctors can prescribe up to 100 mg of Viagra or 200 mg of Stendra. Aside from ED medication, Hims also offers medication for premature climax issues. A subscriber can access Sertraline for early ejaculation, which is available in pills of 25 mg, 50 mg, or 100 mg.

Hims ED pills are generic versions but theyve gone through the same stringent regulatory approval process as their brand-name counterparts. If you're looking for potent ED medication at an affordable price, Hims ED pills might be a good alternative.

2. VigRX Plus Best for Boosting Libido and Sex Drive

If you want to try an ED medication but are wary of possible side effects, you might want to give VigRX Plus a try. VigRX Plus uses natural ingredients that are not as concentrated as over the counter options.

Although there are no reported side effects because of its natural formulation, it is still best to read the complete list of ingredients to ensure that there won't be any allergic reactions.

VigRX Plus offers a 67-day money-back guarantee for subscribers who are not completely satisfied with its products.

3. Semenax - Best Sex Pill for More Intense Orgasms

Semenax also has Epimedium Sagittatum, Butea Superba, and L-Lysine. The combination of these ingredients can help boost libido and testosterone levels. On top of increased sexual performance, they can also help users who suffer from low sperm count and poor sperm motility.

Semenax gives customers a 67-day return period if they are not happy with the product. Semenax also has a 24/7 dedicated support line to assist customers with their questions or concerns.

4. Testogen - Best Male Enhancement for Increasing Testosterone

The herbal extracts in this medication can provide improved strength and stamina if you like working out. Combined with a healthy diet, Testogen can help the user maximize muscle mass growth.

Testogen also has Magnesium, Vitamin D3, and Vitamin B6 to improve mood and aid in better sleep. The medication also enhances desire so users can have a healthier sex life.

5. SemEnhance - Most Unique Male Enhancement

SemEnhance contains natural ingredients that neutralize molecules responsible for the sour, chemically, or salty pheromones released in sweat and throughout the body. The formula that SemEnhance uses include pineapple, Vitamin C, Bee pollen, and kiwi.

SemEnhance is from the same company that produces Semenax, a herbal supplement that increases semen volume. This somewhat assures customers that SemEnhance has undergone the same rigorous testing process as Semenax. Like Semenax, customers have a 67-day money-back guarantee if they try the product and are unhappy with its effects.

6. Max Performer - Best Natural Male Enhancement for Powerful Erections

Max Performer contains 1,000 mg of Horny Goat's Weed, which bolsters testosterone levels and increases blood circulation. It also has 1,000 mg of Maca that helps restore hormone levels and improve sperm count and motility.A key ingredient of Max Performer is Korean Red Ginseng, which can help; ease anxiety, increase desire and improve endurance.

Other natural ingredients in Max Performer include Cordyceps, Bioperine, selenium, and zinc. These ingredients can help boost self-esteem and improve sexual stamina, leading to a more satisfying performance.

7. Male Extra - Best Natural Male Enhancement for Longer Erections

If you want to have longer erections, you might want to give Male Extra a try. This natural male enhancement supplement might help increase size and hardness because of the full erection. It can also improve the sustainability of erections by increasing blood flow to the penis.Male Extra uses a potent mix of natural ingredients to help users improve the quality of their erections. It contains ellagic acid, L-Arginine HCL, niacin, MSM, and L-Methionine. Male Extra also has zinc that can help increase testosterone production and improve libido.Male Extra also has an infusion of cordyceps extract that acts as a natural aphrodisiac to increase sexual drive and function.

8. Viasil - Best Herbal Male Enhancement Supplement

Viasil has Horny Goat Weed and Ginkgo Biloba that can help increase blood flow to the penis. This can lead to bigger and harder erections.

Viasil also has Panax Ginseng Root that helps reduce stress. The high levels of ginsenosides in ginseng can help improve sexual performance.

One edge that Viasil has over other ED medication is the generous guarantee that it provides. Customers have a 100-day money-back guarantee when they purchase Viasil.

9. Huge.com Best Cheap Male Enhancement Pill

Huge.com only uses approved erectile dysfunction medication, including Tadalafil and Sildenafil. This medication helps improve blood supply to the male reproductive organs to enhance sexual performance.

Huge.com offers secretive specialized consultation to subscribers. These consultations help Huge.com's doctors formulate a plan that will help address your needs to combat ED and improve your sex life.

If you have your doubts about Huge.com's effectiveness, you can try their plan for one month since your first month will only cost you $1.

10. ProSolution Plus - Best Pill for Premature Ejaculation

ProSolution Plus contains Tribulus Terrestris. This traditional Chinese herb is a known aphrodisiac. It also contains Withania somnifera that helps increase nitric oxide.

With an increased nitric oxide, the blood flow to the penis increases, allowing for a larger erection.

ProSolution Plus also has asparagus adscendens that provide natural relief to stress. Additionally, the mucuna pruriens in ProSolution Plus helps increase erection frequency and sexual activity.

To top it off, this medication also has asteracantha longifilia that helps increase attraction to female sexual partners.

11. ExtenZe Natural Penis Enlargement Pill

ExtenZe contains Yohimbe. This is an herbal supplement commonly used in West African medicine as a treatment for male infertility. It blocks alpha-2 adrenergic receptors, which usually prevents erections. Yohimbe also helps produce nitric oxide to help improve blood flow to the male reproductive organs.

ExtenZe also uses a scientific formulation containing 26 pharmaceutical-grade compounds. These compounds can help a user boost vitality and energy to increase pleasure and performance.

Which Is Safest?We've mentioned VigRX as the safest pill on the list, and for good reasons. Compared to other male sex pills that contain fillers, VigRX has only essential ingredients that can improve a man's sexual health.

As an herbal pill, VigRX also prides itself on general health benefits among men. Users reported that the herbal pill could improve blood flow over a few weeks of intake.

We've listed VigRX's essential ingredients to help you understand how it works:

Do Male Enhancement Pills Make You Bigger?

However, many male enhancement supplements can increase the usable size of the penis by improving one's blood flow. A product like BlueChew can increase the erection's firmness so much that you get somewhat bigger.

An enzyme called Protein Phosphodiesterase Type 5 (PDE5) promotes erectile dysfunction. With this enzyme, the blood can't move through the penile arteries, which causes the dysfunction. Effective supplements suppress the PDE5's activity that blocks dilation of the arteries. This then results in a larger penis size because of a firmer erection.

How To Maximize the Effects of Male Enhancement Pills and Increase Sex Drive NaturallyManage Weight

For many years, we've known that physical conditions that go along with obesity can also affect one's sex drive. According to a study, around 30% of obese individuals indicated problems with sexual desire, drive, or performance in general.

Losing weight and getting in shape can stimulate sex hormones. It can make you look better, improve your confidence, and fortify your stamina during sex. For best results, you can focus your workouts on your pelvic area to get the blood flowing there.

Reduce StressWhen you're in a stressful situation, your body naturally prepares to fight or run away. This concept is called the "fight or flight response."

If you're constantly stressed, your hormone levels disrupt, and your arteries narrow. This results in blood flow restriction, which can cause erectile dysfunction.

You can perform some stress management techniques, including meditation, breathing exercises, or talking to a therapist.

A physical touch from your partner can also help alleviate stress. Cuddles, kisses, and hugs from a special someone can go a long way.

Refrain From Alcohol and Smoking

Meanwhile, too much alcohol disables your autonomic nervous system's natural sexual response. This then prevents you from getting or staying aroused. Loss of erection is also a common alcohol-related problem.You can smoke and drink, but always in moderation.

Healthy DietSome studies indicate that food high in Zinc and Vitamin B can fuel testosterone levels.

While there is no solid clinical data linking libido with food, a healthy diet can affect your overall energy and mood. Having high energy levels and a good mood can then positively impact your sexual drive.

Of course, you won't be able to notice the positive effects of a healthy diet on your libido right off the bat. However, it can help you stay fit, increasing your sexual stamina for the long haul.

Check Testosterone Levels

Testosterone is the most significant male sex hormone. Having low testosterone levels results in low sexual drive and erectile dysfunction.

You can always see a doctor for a testosterone test. Expect that you may need to make some lifestyle changes to increase your testosterone levels. You may also undergo supplementation and testosterone therapy.

Communication With a Partner About Any Worries in BedroomCommunication can be a potent aphrodisiac if you're confident enough to discuss your problems with your partner. Intimacy is more than what happens during sex. It's also what happens before and after.

If your partner is aware of your problems, disappointment may be unlikely to happen. You can discuss possible solutions together and be ultimately in sync in bed. You will be surprised at the spark communication can ignite in your sex life.

Frequently Asked Questions About Sex Pills for Guys (FAQs) What products can be used with sex pills?

Bathmate penis enhancement may be great to use along with sex pills. Bathmate is entirely safe to use and can deliver remarkable results in a short period.

Can you use creams for erectile dysfunction?

Currently, the U.S. Food and Drug Administration (FDA) has not approved medicated creams to treat erectile dysfunction.

What are the common side effects of erectile dysfunction medications?The usual side effects of ED drugs include headache, nasal congestion, upset stomach, diarrhea, and dizziness. Note that not all people experience this. Consulting a doctor before taking ED drugs is essential.

Best Sex Pills for Men: Key Takeaway

If you think taking one of our recommended sex pills can help you, consult your physician first. Above all, no two people are alike. What works for others may not work for you.

Read more from the original source:
11 Best Male Enhancement Pills and Products in 2021: Review of the Top-Rated Sex Pills for Men - Cleveland Scene

By Liora Engel-Smith, North Carolina Health News

Alyssa McCord would rather not see a doctor at all. The upstate New York native who now lives in Jacksonville with her husband and daughter attributes some of her reluctance to upbringing. Her parents only went to the doctor when absolutely necessary, she said.

The other part of that reluctance, says the 38 year old, is how providers react to her weight.

McCord, who wears size 20 pants, is used to providers making demeaning comments about her body. Often, theyd blame her weight for every ailment from heavy periods to colds to numbness and tingling in her hands.

In September, McCord had an experience that surprised even her. Shed gone to a family doctor to discuss consistently heavy periods and constant exhaustion. The doctor said her stomach was cramping because she is fat. If she lost weight, he told her, the pain would go away.

The doctor did not order any of the customary tests, such as abdominal ultrasound or blood tests to confirm his assertion. He looked at her and made up his mind, McCord said.

McCord would later learn from another provider that an enlarged uterus caused the cramps and heavy bleeding. Blood loss from the heavy periods made her anemic, accounting for her fatigue.

Nearly every person in a bigger body has their own story of weight-based bias at the doctors office. It could be anything: a too-small blood pressure cuff or medical gown, a wince from a triage nurse during a weigh-in, a negative comment from a physician, or as in McCords case, blaming every symptom on weight.

Its impossible to know exactly how pervasive weight bias is in the health care system, especially because it involves provider attitudes, but its safe to say that fat discrimination is rather common, said Ya-Ke Grace Wu, assistant professor at the UNC Chapel Hills school of nursing.

Current estimates are that 19 to 24 percent of obese adults experience some form of discrimination because of their weight, from bullying at home or work to fat discrimination in clinical settings. The rates of weight bias are even higher in women and people with higher body mass index scores.

Wu, who studies weight discrimination, said the maltreatment can also be nonverbal, from flimsy chairs that cannot accommodate larger bodies in the clinic waiting rooms to weighing them in hallways, rather than in a room that offers some privacy from passers-by.

No matter how the bias is delivered, the message is clear to any person in a big body: Weight isnt just a number, its a moral failing and a cause for shame.

These negative attitudes from providers have far-reaching health implications, Wu said. Some fat people may avoid the doctor altogether, delaying diagnosis of conditions such as diabetes, high blood pressure, or more serious conditions, such as cancer. Sense of shame about body size can also lead to a host of mental illnesses, from depression to anxiety to suicidal thoughts. Its even correlated with weight gain and binge eating disorder, a condition that involves cycles of compulsive and restrictive eating.

The fat is bad lense kind of corrupts everything, said Lindo Bacon, author, researcher and a member of the Health at Every Size movement, a grassroots effort to eliminate weight stigma in all areas of society. And at this point, it just seems like its basic good health care or so it seems to the doctors, that everybodys supposed to get thinner.

Weight stigma isnt just about hurt feelings, it is also linked to higher mortality rates, in part because discrimination often leads to unhealthy behaviors, such as exercise avoidance, overeating and substance use. The stress of weight stigma is associated with metabolic changes that can make people sicker, including higher levels of the stress hormone cortisol and inflammation markers.

Evidence of harm is so robust that last spring, a panel of experts from universities and health care systems all over the globe published a call to end weight stigma in all areas of life in the prestigious journal Nature Medicine.

Weight bias and stigma can result in discrimination, and undermine human rights, social rights, and the health of afflicted individuals, the authors wrote.

As obesity rates in adults continue to rise, the public health consequences of fat discrimination could be significant. In North Carolina, for example, adult obesity rates more than doubled between 1990 and 2019.

While the scientific community has established that weight alone is not a predictor for health, societal understanding of obesity continues to lag. Many people, including health care providers, believe that diet and exercise are the only ways to manage obesity, despite evidence to the contrary.

Public health experts have known for years that obesity is a multifactorial condition, affected not only by behaviors but by the social determinants of health, including income, access to healthy food and neighborhoods that may discourage walking, to name a few. The focus on diet and exercise alone assumes that obesity is always within a persons control, said Bacon, the Health at Every Size advocate.

From a global perspective, we know that its the social determinants of health that play a much larger role [in obesity], Bacon said. So even our messages of bringing it down to individual behavior, are ignoring the really big issues in health, which is about inequity.

Rashelle Hamilton was used to providers taking her seriously. Hamilton, who had always been trim, had gained 30 pounds after the birth of her youngest daughter, Violet. She thought her birth control implant may be at fault.

Hamilton, who weighed 218 pounds late last year after the birth, was surprised to find that her new weight affected the quality of care she received.

Before they would mostly believe me when I said I had a problem, the Cary resident said. They believed me and listened to my symptoms and then went off of my symptoms.

But at an annual physical last December her first in a larger body the doctor looked at her and determined that she had Type 2 diabetes without a blood test or a review of diabetes symptoms, Hamilton said. The physician immediately prescribed Hamilton an $800-a week diabetes injection and then ordered tests to confirm what she thought was the correct diagnosis.

Hamilton didnt have diabetes, the blood tests later showed. The experience left her with a sense that she cannot trust medical providers. At the recommendation of a friend, Hamilton found a different doctor to go to. But the December physical cost her time, money and aggravation.

Wu, the UNC researcher, said that many overweight and obese people take the same route, moving from doctor to doctor until they find someone who would listen. But that approach can still cause damage, because of delayed diagnoses.

Some diseases have a golden window for treatment, Wu said. And so if you delay the treatment, you may delay the whole improvement [trajectory] of the disease.

The economic impact of repeated appointments for the same complaint is unknown, Wu said, but with rising health care costs and the lack of provider availability in rural areas, patients may not have the money or ability to find a provider who would listen.

If you walk into Aimee Festes clinic in Asheville, odds are, the word weight wont come up unless you say it. Feste, a body-positive nurse midwife with the Asheville-based Mountain Area Health Education Center, says she first learned about the weight discrimination from her patients.

People can be healthy in a larger body size, she said. I say to my own patients who are worried about their weight I could cut off your arm and you would lose 10 pounds and you can be a whole heck of a lot less healthy.

Feste says very few conditions, such as water retention during eclampsia, require in-office weight measurement. Instead, Feste focuses on the patients life as a whole, even when patients have chronic diseases, such as diabetes, that would traditionally trigger a discussion about weight.

She might talk to diabetic patients about their stress levels, their sleep, their ability to get medication and access food that nourishes them. That approach may take more conversation, Feste added, but its far kinder and respectful to patients who are already ashamed about their bodies.

Wu agrees with that approach. A provider is in a position of power, she said, and their job is to build trust with patients.

We dont have to push patients to talk about weight, we should just focus on whatever health issue they come in [with] for that days appointment, Wu added. If the patient wants to talk about weight, then we can talk about it, but I always suggest that the patient lead that conversation.

Feste said that rather than bringing up weight to patients with larger bodies, providers should educate themselves on approaching all patients, regardless of size, kindly and without judgment.

The more we shine light on it, the more its talked about, the more its going to be an open conversation, she said.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons license. North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org

Read more here:
From NC Health News: Fat bias at the doctor's office takes a serious toll - Mountain Xpress

Love can feel pretty wonderful when all goes well, that is.

If your romance follows a rockier path, you might notice your inner compass needle swinging more toward abject misery than euphoric joy.

Maybe you havent yet found the courage to confess your love, or you have summoned the strength to share your feelings, only to face rejection.

Perhaps youve fallen for a person you know you cant be with, like your boss or a friends partner, or someone you just know will never return your feelings.

An unexpected and unwanted breakup can also give rise to emotional turmoil and physical distress.

Any of these situations can leave you feeling somewhat unwell in mind and body. For example:

Sound familiar? Heres a possible diagnosis: Lovesickness.

Below, youll find more details on exactly what it means to be lovesick and what you can do to recover.

People use the term lovesick in different ways.

You might hear it used to describe the range of feelings that accompany the early stages of being in love, such as:

These effects of love usually go by another name, though well get into that in more detail below.

Lovesickness generally refers to the more unpleasant aspects of love.

This ailment involves all those unwanted feelings you might experience when your passion doesnt play out as planned, without the enjoyable effects of a mutual attachment.

Its natural to feel sad and disappointed when you like someone who doesnt feel the same way. The pain and frustration of heartbreak or unrequited love affects everyone differently, but the sting often lessens within a few weeks or months.

Not everyone coping with rejection will become lovesick, but you can often recognize the condition by its more intense symptoms.

The effects of lovesickness might stick around until they begin to affect your day-to-day life, and these symptoms can have a very real impact on your health and wellness.

Some people also use the term lovesickness to refer to a phenomenon known as limerence.

Psychologist and professor Dorothy Tennov pioneered the research on this condition, introducing the term in her book Love and Limerence: The Experience of Being in Love.

Tennov defines limerence as an involuntary fixation on another person. This fixation can feel a lot like love, but it has more of an obsessive component.

In a state of limerence, you desperately long for the other person to return your feelings and feel terrified theyll reject you. Your mood often depends on how they treat you.

If they smile or speak to you, you might feel on top of the world. If they ignore you or seem indifferent, you might feel distressed or physically pained.

Other key symptoms of limerence include:

Lovesickness is nothing new. This malady dates back to some of the earliest writings, in fact, though it sometimes went by different names.

Youll find descriptions of the condition in ancient medical texts and classical literature, from Greek philosophy to Shakespeare to Jane Austen.

Research traces the concept of lovesickness to Hippocrates, who believed that lovesickness, like other illnesses, resulted from an excess or imbalance of certain bodily humors.

Galen, another notable ancient physician, was one of the first to diagnose lovesickness and other conditions where physical symptoms resulted from emotional causes.

From culture to culture and era to era, the general symptoms of lovesickness remain much the same.

If youre lovesick, youll probably notice some of the following signs:

You might also notice mood changes brought on by thoughts of the person you love.

Your emotions might range from a general sense of longing to frustration, anger, nervousness, and anxiety, and sometimes even hopelessness and despair.

Languishing over lost love can leave you feeling pretty rotten, to the point where you might begin to wonder whether youre coming down with some type of flu.

Running a fever, which can sometimes happen with lovesickness, might only reinforce your concerns.

Love cant give you the flu. But the hormone fluctuations associated with love and heartbreak particularly the stress hormone cortisol can prompt physical symptoms that affect your long-term health.

Lovesickness can also make you sick indirectly. A lack of sleep, good nutrition, or adequate hydration can absolutely worsen your health.

Whats more, changes in mood, such as irritability or a general sense of melancholy, can begin to affect your relationships with others or your performance at work and school.

Difficulties in these areas of life can eventually increase stress and affect your health, especially if your thoughts of love get in the way of regular self-care.

Serious cases of lovesickness can get intense. You might have trouble talking about anything besides the person you love and the relationship you want to develop.

Lovesickness can make it hard to concentrate and distract you from your responsibilities. You might forget important appointments, chores, errands, or plans with friends.

Its also common to feel anxious about the outcome of your love.

Lovesickness can also involve difficulty getting over someone after they reject you.

Whether thats an ex-partner who ended your relationship or someone you fell for who didnt return your love, trouble moving on from the heartbreak could prompt feelings of melancholy or depression. Some people even have thoughts of suicide.

For those in the throes of limerence, persistent intrusive thoughts can fuel anxiety and rumination.

Some people attempt to resolve these thoughts with avoidance strategies or compulsive behaviors. These might seem to offer some temporary relief, but they generally wont help long term.

Lovestruck and lovesick arent entirely unrelated concepts, but they do refer to separate states.

Falling in love prompts your brain to ramp up production of certain hormones, including dopamine, oxytocin, and norepinephrine.

So youll probably experience some level of surging emotions and temporary changes in mood and behavior as a natural consequence of falling head over heels.

When this happens, people might say youre lovestruck or struck by Cupids arrow. (Cher and Nicolas Cage offer another name for this state of mind: Moonstruck.)

Lovesickness, on the other hand, tends to follow heartbreak, rejection, or unrequited love, so it carries more of a negative connotation. It might also involve mental health symptoms, including anxiety and depression.

Not everyone who falls in love will experience lovesickness, even after rejection, but some degree of lovestruck-ness is pretty universal everyone has hormones, after all.

The early stages of a relationship usually involve some degree of infatuation. For example:

This fixation can show up in physical ways, too.

You might notice signs of arousal as soon as you see them or, lets be honest, whenever you think about them or remember your last encounter. When together, you might find it impossible to keep your hands off each other (or make it out of bed).

All of these things usually feel pretty good, and most people enjoy being in the honeymoon phase.

This stage can last anywhere from a few weeks to several months, but it usually passes once the relationship stabilizes and things become a little less rosy and a little more realistic.

If you think lovesickness sounds pretty awful, you might wonder whether pursuing love is really worth it.

Finding real, sustainable love can take time and effort, but romance isnt all rejection and misery.

Each time you develop a crush or more intense liking for someone and follow up on those feelings by confessing your love, youre making an attempt to find the romantic connection you desire.

You may not find this love without running the risk of potential rejection. For many people, the eventual outcome of lasting love is worth the risk of potential rejection or lovesickness.

Even if your crush doesnt pan out, it may not necessarily feel bad. People who love the butterflies, energy boost, and euphoria that accompany their crushes might feel pretty fantastic in the thick of a crush.

Crushes can also teach you more about what you want (and dont want) in a romantic partner. They can also lead to new friends.

Sometimes, the romance flops, but you find yourself connecting with your ex-crush in a completely platonic but still rewarding way.

In spite of lovesickness lengthy history, experts have yet to discover any real cure. Absent a vaccine or other quick fix, youre left in the healing hands of time itself.

Lovesickness generally does ease eventually, much like the common cold. Heres what you can do in the meantime to get some relief.

Turn your feelings into something tangible by getting in touch with your creative side.

Art, journaling, poetry or short-story writing, and making music are all great ways to experience and express difficult emotions.

Cheery, energizing music might lift your spirits, but if youd rather treat your senses to a favorite heartbreak playlist, go for it. Research suggests listening to sad music could also have a positive impact on your mood.

Giving yourself time to heal involves creating some space. In other words, youll want to avoid texting, calling, and checking up on them in person or on social media.

Its also wise to wait on friendship until youre feeling better.

You might not feel much like eating but try to plan balanced meals and snacks to help maintain good health.

Going to bed at the same time every night can make it easier to get the sleep you need.

Meditation and sunshine are other simple, low-cost methods to help boost a low mood.

Exercise, favorite hobbies, and time with friends can all help distract you from feelings of lovesickness and help improve your outlook.

A good book or favorite movie can also help you cope when you want to stay in and process your emotions alone.

We wont lie. Heartbreak can take weeks, even months, to heal. This length of time varies from person to person, so theres really no way to predict how long lovesickness will last.

If unwanted physical or emotional symptoms linger for more than a week or two, professional support can help.

Therapists are trained to help people navigate all the messy aspects of love, so your therapist wont laugh at you or tell you its all in your head.

They will:

If you experience obsessive or intrusive thoughts, compulsions, or thoughts of suicide along with lovesickness, its best to seek support right away.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 1-800-273-8255.

During a crisis, people who are hard of hearing should call 1-800-799-4889.

Click here for more links and local resources.

If youre feeling a little lovesick lately, take heart. It wont last forever.

To heal more quickly, treat yourself to some rest and relaxation, draw emotional support from friends, and remember to take care of your basic needs.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, shes committed to helping decrease stigma around mental health issues.

Excerpt from:
11 FAQs About Lovesickness: Signs, What to Do, More - Healthline

HOUSTON, Texas, Feb. 05, 2021 (GLOBE NEWSWIRE) -- via NewMediaWire -- China Infrastructure Construction Corp. (OTC: CHNC) https://www.chnc-hdh.com/ -- CHNC has finally reconstructed itself; it seems as if it was only yesterday when on December 19, 2019 Pharmacology University concluded its merger with CHNC. As established during negotiations, Pharmacology University also appropriated responsibility for the management of the company and though we planned for difficulties, we did not budget for calamitous. Since then, we started to peel the onion and the more we did, the more it stunk. Particularly, because CHNC had a $1,844,500 debt, a Shell Risk designation meaning the company had no or minimal assets and operations, no employees to speak of, and during the calendar year of 2019 the company only reported revenues of $259,737, as well as a great sum of operating complications. It was time to get to work; we were on the edge of a rock bottom point of no return, unless we were determined to accept and endure a complete paradigm shift.

Consequently, we went to our little partners (employees, though, we do not use the word employees at our firm) and charted a completely new course for 2020, and that we did. We pledged 40-to-50-hour weeks and for directors 50 to 60, divided responsibilities, rolled up our sleeves and implemented a rigid plan that had a mixture of integrity, emotional intelligence, mission, flexibility, a maniacal focus on customer service and our products, but most importantly a vision of our companys future. After tremendous chest pounding, litigation, negotiations, and unwavering commitment to our core values, on June 16, 2020 we finally, completely eliminated our debt, says Henry Levinski, CHNC Treasurer.

More to the point, we created revenues that generated an increase in sales/revenues from the previous year of 285% for the calendar year of 2020; furthermore, with proper reporting and increased revenues we were able to obtain the removal of our Shell Risk in September of the same year. Congruently, despite 2020 being a year that distributed evil to the world in a way that has never been written, we managed to increase our personnel 175%. Consequently, 2021 has brought strong winds and has rewarded our firm, our industrial partners, our directors and our shareholders with the normality and stability that they so richly deserve, says Elizabeth Hernandez, COO of CHNC.

For the same reason, I would like to extend a warm salute to our 2020 HEROES, the ones who did not tire or despair in our darkest hour but on the contrary pushed forward and made this possible.

I am referring of course to our doctors, clinical technicians, chemists, biologists, professors, social media managers, concept and graphic designers, accountants, attorneys, software engineers, video editing experts, translators, and all other industrial partners that collaborated on our projects. We continue to grow our educational project more each day and continue to search for new horizons where we can break down barriers and vanquish outdated stigmas. Curiously, the most amazing aspect of our 2020 trials and tribulations was the fact that our young bloods, our young samurais by way of leadership and empowerment surpassed our expectations, saved our company, found purpose, understood our vision and in an amazing form transported and elevated us into a firm that now enjoys their very own fabricated core values of passion, transparency, integrity and diversity.

As a result, we are proud to have a variety of products such as Canna Law Magazine, a digital biweekly publication that educates users about the most relevant legal changes in the cannabis industry worldwide. We understand the importance of staying informed and how the cannabis industry affects millions around the globe. That is why we offer our magazine in five different languages: English, Spanish, Portuguese, Italian and Arabic. We have had such a positive feedback that we are currently present in an astonishing 55 countries such as Algeria, Argentina, Australia, Austria, Bahrain, Bolivia, Bonaire, Brazil, Canada, Chile, Colombia, Costa Rica, Czech Republic, Dominican Republic, Denmark, Ecuador, Egypt, El Salvador, Estonia, France, Germany, Greece, Guatemala, Honduras, Iraq, Ireland, Israel, Italy, Jordan, Lebanon, Libya, Mexico, Mauritania, Morocco, New Zealand, Nicaragua, Palestinian Territories, Panama, Paraguay, Peru, Portugal, Puerto Rico, Qatar, Spain, Syria, Sudan, Sweden, Switzerland, Tunisia, United Arab Emirates, United Kingdom (UK), United States, Uruguay, Venezuela, and Yemen, says Anne Graham, CHNC Corporate Legal Counsel.

With Canna Law https://cannalawmagazine.com/, we plan to continue our expansion with a main goal in mind: to inform our subscribers of the legal realities that the industry entails and to provide them with a useful tool that will help them navigate its complexities.

We are also aware that change is not one-dimensional, but rather a combination of different areas, and as an army we have chosen to take-on different battlefronts. Therefore, as well we are pleased to also introduce Canna Med Magazine https://cannamedmagazine.com/, a monthly digital publication created by health professionals for health professionals. Education is the key to change, and we want to ensure that every hardworking doctor, nurse, scientist and caregiver understands the existing research and ongoing studies about the benefits of medical cannabis. With our blogs, news pieces and editions we have designed a portal of current, relevant information, scientific data and more. We also understand that as a global community we need to be able to communicate with as many countries as possible to continue to expand. That is why Canna Med is available in English, Spanish, Italian, Arabic and Portuguese and coming soon Mandarin and Hindi as we continue to grow.

Moreover, in a world that surprised us with a pandemic we quickly grasped the importance of adapting our existing products. With Pharmacology University https://www.pharmacologyuniversityonline.com/, our company with over 12 years of experience in educational systems, we developed a new software so that we could continue our education online, offering more courses every month, in different languages, so that a home could also be a classroom. With our new technology in place, we have been able to develop new courses, continue our certified university alliances, provide consultancy services, expand our reach and evolve our platform.

Of course, the monitoring of financial aspects is a priority, and this evolution in our software has allowed us to grow Precision Research Institute https://www.pri.center/, our Houston-based Research Unit. We have been able to continue with our clinical trials, transforming the life of our patients, says Elizabeth Hernandez, COO of CHNC.

Currently, we conduct clinical studies in knee osteoarthritis, Streptococcus vaccine, respiratory Syncytial virus vaccine, Asthma, Chlamydia, Gonorrhea and of course COVID-19. We offer our services in the Houston area primarily and with projects expanding into Puerto Rico but with COVID-19 therapies we have extended our efforts across the United States to assist people in their time of need. With some of the most reputable sponsors in the pharmaceutical industry, such as Abbvie, Intercept Pharmaceuticals, Shionogi, Iterum Therapeutics, Allergan amongst many others.

In our search to tackle existing health problems, we are now most proud to announce the creation of our new baby: ALPHA Fertility & Sleep Center https://www.alphasleepcenter.com/ under the Medical Direction of Dr. Kiran Nair, DO and Dr. Ralph Gallo, MD as the designated Sleep Board Certified Physician. With this center, CHNC seeks to help the high statistics of people suffering from sleep-related disorders, including fertility problems in men and women. According to a national study, almost a third of the people in the United States, an estimated 50 to 70 million people, suffer from chronic sleep and wakefulness disorders. Patients may receive different types of services, including Fertility Consultations, Overnight in-lab sleep study, Overnight CPAP titration, Split night sleep study, Oxygen titration, MSLT (Multiple Sleep Latency Test), MWT (Maintenance of Wakefulness Test), Adapt SV PAP, Compliance Follow up (DME), Sleep Specialist Evaluation, Referring Services and Fertility Education and wellness programs. CBD will also be studied, as it induces the feelings of tranquility and sleepiness, making it ideal for sleep disorders and insomnia. Preliminary research showed that the use of cannabidiol molecules enhances sleep during the REM stage, balancing hormone production, which leads to the significant reduction of the feeling of sleepiness during the daytime. Moreover, preliminary studies in humans have indicated that treatment with cannabinoids may decrease post-traumatic stress disorder symptoms, including nightmares. It brings your rest to a deeper level improving the quality of your sleep, says Peggy Mitchell, Director of Alpha Fertility and Sleep Center.

To the investors who have patiently awaited the awakening of CHNC, we thank you and send you our desire to continue developing projects that impact our society and that help us grow organically and see it reflected in the return of our investments. We are confident that our new CHNC will intelligently respond to the challenges expected by 2021, with the same dedication that we responded to the past debt and the global COVID-19 crisis.

Thank you for the support, in allowing us to bring you a stronger CHNC. We flirted with the brink of failure, but we pushed through and prevailed. We have found our balance to succeed, we will continue to improve what we already know, adjust to what we find difficult and embrace the unknown, for it is here where opportunity is found.

Safe Harbor Statement

The information posted in this release may contain forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. You can identify these statements by use of the words "may," "will," "should," "plans," "explores," "expects," "anticipates," "continue," "estimate," "projects," "intends," and similar phrases. Forward-looking statements involve risks and uncertainties that could cause actual results to differ from those projected or anticipated. These risks and uncertainties include, but are not limited to, general economic and business conditions, effects of geopolitical conditions, competition, changes in technology and methods of marketing, and various other factors beyond the company's control.

For more information contact us at:

info@pharmacologyuniversity.com

817/528-2475 for English

214/733-0868 for Spanish

Or view us here: https://www.youtube.com/watch?v=p7bGr16NxWw

The rest is here:
CHNC Saga, Metamorphosis, and Transformation Other OTC:CHNC - GlobeNewswire

Eat This, Not That!

You're reading a ton of information about coronavirus (more specifically, COVID-19) and what to do while we're in an active pandemic. Some of what you've heard is spot-on; some of it's utterly bogus; some of it changes every day; most of it's scaring the pants off you. That's why we've consulted the experts to compile this comprehensive list of the most important, science-backed coronavirus tips you can do to stay healthy. Read on, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus. 1 Don't Travel Stay with just the people you're sheltering with. "The tragedy that could happen is one of your family members, from coming together in a family gathering, could wind up hospitalized and severely ill and could die. We don't want to see that happen," said Dr. Henry Walke, a COVID-19 incident manager at the CDC. "This year we're asking people to be as safe as possible." 2 Don't Think You're Immune Now isn't the time to be complacent. If you're young, you can still develop COVID-19 and serious complicationsMillenials are being hospitalizedand spread coronavirus to people who are more vulnerable, like the elderly and immunocompromised, even if you're symptom free. 3 Don't Ignore These Simple Fundamentals Everyone from Dr. Anthony Fauci, the nation's top infectious disease doctor, to Alex Azar, President Trump's apointed United States Secretary of Health and Human Services, agree that the following fundamentals, if followed, can keep us safer until we're all vaccinated:Universal wearing of masksMaintaining physical distanceAvoiding congregate settings or crowdsDoing more outdoors, as opposed to indoorsWashing hands frequently 4 Don't Drink Bleach or Disinfectant After President Trump mentioned "disinfectant" as a possible cure, calls to poison control doubled and companies like Lysol had to send notices telling people they should not ingest their products. Don't ever ingest bleach or disinfectant! It is literally poisonous and can least to gastric distress at best, death at worst. 5 Don't Think a Lamp or Bright Light Will Cure COVID-19 President Trump once mused that "the heat and the light" might kill the coronavirus. "Not as a treatment," answered Deborah Birx, a top adviser. Same goes for the sun. It would be "irresponsible for us to say that we feel that the summer is just going to totally kill the virus," says Bill Bryan, an undersecretary of science and technology at the Department of Homeland Security. 6 Don't Think Social Distancing Will be Over Tomorrow "Social distancing will be with us to really ensure that we protect one another as we move through these phases," Birx told NBC's Meet the Press. That includes even after the first folks start taking the vaccine, which is set to be distributed to those most in need come December. 7 Don't Hoard Food There's no need to panic-buy food. Officials from around the U.S. and world have said there is no shortage in the food supply, and grocery stores will be restocked. 8 Obviously: Don't Forget to Wash Your Hands This is the most important protection against COVID-19. Wash your hands after being out in public, after you use the bathroom, after coughing or sneezing, and before preparing or consuming foodbasically, as often as is practical. 9 Don't Touch Your Face Germs are most often introduced into our body when we touch our eyes, nose or mouth, experts say. 10 Don't Wash Your Hands for Less Than 20 Seconds Anything less would be uncivilizedand will leave germs on your hands, experts say. Do it for 20 seconds or more, or as long as it takes to sing "Happy Birthday"or the theme from Full House or the Imperial March from Star Wars. Whatever it takes to get you through. 11 Always Wash Your Hands With Soap Studies show that during handwashing, soap creates a chemical reaction that removes germs from your hands more efficiently than water alone. Don't use too little or too muchtoo much soap can prevent thorough rinsing of germs from your handsand rinse and dry completely. 12 Don't Sneeze or Cough Openly Cough or sneeze into the crook of your elbowsome call it "The Batman Sneeze"or into a disposable tissue. 13 Don't Touch Door Handles (If You Can Help It) Researchers have found that coronavirus can live for two to three days on hard surfaces like door handles. That's why it's especially important to wash your hands regularly, and push doors with your arm or elbow when possible. 14 Adhere to Social Distancing Recommendations Social distancing guidelines come from a place of knowledgethey've prevented other novel viruses (like the flu of 1918) from exacting an even greater toll. 15 Don't Attend Large Gatherings The White House still recommends that gatherings be limited to 10 people or fewer. 16 Be Wary of Entering Restaurants and Bars Many localities have closed bars and restaurants to everything but carryout and delivery. Even if your city has opened these places, enter with caution, as the virus can still spread. 17 Don't Shake Hands Not to encourage antisocial behavior, but now's a good time to substitute a handshake for a wave or an elbow bump. 18 Don't Forget to Wash Your Hands After Handling Food Packages and Food Deliveries You don't need to spray your groceries or food deliveries with disinfectant, but be sure to take the food out of the packaging right when you get home (in a special area for this purpose), discard it, and then wash your hands for 20 seconds before eating. 19 Don't Forget Your Face Mask According to the CDC: "In light of new data about how COVID-19 spreads, along with evidence of widespread COVID-19 illness in communities across the country, CDC recommends that people wear a cloth face covering to cover their nose and mouth in the community setting. This is to protect people around you if you are infected but do not have symptoms."You can make your own at home out of cloth.They go on: "A cloth face covering should be worn whenever people are in a community setting, especially in situations where you may be near people. These settings include grocery stores and pharmacies. These face coverings are not a substitute for social distancing. Cloth face coverings are especially important to wear in public in areas of widespread COVID-19 illness." 20 Don't Cross-Contaminate Via Your Mask "Once you wear a mask once, it's contaminated by whatever. If you take the mask off and sit it on another surface, that surface is now contaminated," says Geoffrey Mount Varner, MD, MPH, FACEP, a Maryland-based emergency medicine physician.The Rx: "It's best to use one-use masks and once they are taken off, dispose of them," says Mount Varner. "If you use a cloth or hand-made mask, it needs to be washed and sanitized between wears." 21 Don't Touch the Mask With Dirty Hands "If you contaminate your mask even from the outside, you can get easily infected," says physician Dimitar Marinov, MD, Ph.D."Taking off your face mask and then reapplying it with contaminated hands can move the bacteria or virus directly into the breathable area," says Jared Heathman, MD, a Texas-based psychiatrist.The Rx: Make sure your hands are clean before adjusting the mask. It's best to avoid touching your face in general. 22 Don't Wear the Same Mask All Day "A mask should be changed or disinfected as often as every 2 hours, otherwise viral particles can accumulate on it and you are more likely to breathe them in," says Marinov. 23 Make Sure You're Fully Covered "I see many people wearing their masks below the nose," says Marinov. "While it will still protect others if you are coughing or sneezing, it will not protect you from COVID-19 if someone else nearby is infected and coughs."The Rx: Once the mask is fitted properly on the nose, it should be extended so that it fits right under your chin, says Angela Abernathy, a New York City-based dentist. "This is to ensure maximum coverage." Adds Heathman: "The purpose is to breathe through the mask, not around the mask." 24 Don't Put It on Too Late Without the mask, you're susceptible to inhaling the particles in the air. "You must put it on ahead of entering an area of risk," says Rafael Lugo, a general surgeon and owner/CEO at Lugo Surgical Group in The Woodlands, Texas. 25 Don't Trust the Mask Too Much You may think "the mask is 100 percent reliable," says Lugo. Not so. "It is meant to decrease the risk. Ultimately, social distancing is king.""A surgical mask is not designed to provide a barrier between your respiratory system and all viruses and bacteria," says Leann Poston, MD, a physician with Invigor Medical in New York City. "Social distancing helps protect you from viral particles sneezed and coughed into the air by people who may not know that they are sick yet." 26 Don't Spray Your Mask With Chemicals "Applying any chemical like Lysol to the mask that makes it wet is bad," says Lugo. "You can spray it to sanitize lightly, and then put it in a bag. Do not saturate it." 27 Don't Get Your Mask Wet "Once the mask becomes wet, it becomes less effective and needs to be changed to a dry one," says Abernathy. Avoid touching the mask with your tongue. "Touching the mask with your tongue makes it wet and more porous," advises Lugo. "You want the mask to stay dry." 28 Don't Wear It Wrong "Masks have a front (that is usually colored, textured or has the brand name) and a back (that is usually white and more cotton-like)," says Abernathy. "The back side should be touching your face. It is designed this way so that particles are properly filtered." 29 Don't Think All Masks Are the Same Different masks have different uses. "An N95 mask filters out 95% of bacteria and viruses if they are correctly fitted to your face," says Poston. This is what healthcare workers are using to better protect themselves when caring for sick patients. "A surgical mask is designed to contain your droplets to help protect those around you." 30 Don't Go to an ER Unless You're Seriously Ill If you have COVID-19 symptoms, it's best to call your healthcare provider for advice. Don't go to an ER unless you're having trouble breathing; you might infect others there. 31 Don't Drink Too Much Alcohol It's a scary time, but overindulging in alcohol isn't the answer. Drinking too much can raise blood pressure and reduce immunity, two factors that could make you more susceptible to COVID-19 and complications. 32 Don't Sleep Less Sleep is a time when our immune system recharges, and a lack of quality sleep has been associated with other serious diseases. Aim for seven to nine hours a night. 33 Don't Let Anxiety Take Over If you're feeling anxious, turn off the news and social media. Breathe deeply for a few minutes. Practice techniques that reduce anxiety and stress, including mindfulness, meditation and exercise. 34 You're Using Sanitizer Wrong "Another mistake is that people don't completely saturate their hands with hand sanitizer," says Stephen Loyd, MD, chief medical director at JourneyPure. They might only be covering the palms or the backs of their hands."The Rx: "It's important to put it between your fingers, as well as under the nails, to distribute the sanitizer evenly," says Loyd. "You want to apply hand sanitizer in the same way you would if you are washing your hands with soap." 35 You're Overusing It "Hand sanitizers kill not only bad bacteria, but also communal good bacteria, which can be irritating to the skin," says Dr. Rhonda Kalasho, a double board-certified dentist in Los Angeles. The Rx: "Hand sanitizer is much more drying for the hands than soap and water, so it's easy to get dry skin from over-using hand sanitizer," says Loyd. "People should moisturize their hands immediately after use, preferably with a cream." 36 You're Using A Less Concentrated One "Hand sanitizer should have at least 60 percent alcohol," says Inna Husain, MD, an otolaryngologist in Chicago. "The higher the concentration of alcohol, the more effective it will be." 37 You're Keeping It Near Children "People need to keep hand sanitizer, especially nicely scented ones, out of the reach of young children," says Heather Finlay-Morreale, MD, a pediatrician in Sterling, Massachusetts. "Young children can drink them and get poisoned." 38 You're Not Letting It Dry "One common mistake people make when using hand sanitizer is that they fail to rub it in all the way," says Loyd. "It's important to continue to rub it into your skin until it dries." The Rx: "Give hand sanitizer time to take effect," says Husain. "I have seen people squirt a small amount, then immediately touch their face. Give it at least a minute to dry." 39 You're Contaminating Yourself Again "The sanitizer pump has been touched lots of times by people with unclean hands," says general practitioner Dr. Giuseppe Aragona. "It can harbor similar levels of germs to door handles, cash and ATM keypads."The Rx: Pump with the side of your hand or fist, and don't touch any part of the bottle after you've applied hand sanitizer. 40 You're Making Hand Sanitizer Yourself Because of panic buying, your local store might have run out of hand sanitizer. You may be tempted to create your own. Experts advise against it; it's easy to mistakenly create a mixture that's not strong enough to kill germs. "I've seen people try and make sunscreen before, and the worst-case scenario was people being sunburned," says Aragona. "With COVID-19, the worst-case scenario is death and infecting dozens of other people." 41 You're Not Using Enough Because of the hand sanitizer shortage, you may be tempted to use a smaller amount of sanitizer than usual to make it last longer. But that may not kill germs as expected. A common mistake is "not applying the right amount, and not applying to both hands," says Magdalena Cadet, MD, a rheumatologist based in New York City. "Don't forget under fingernails and the back of the hand, as well as the entire palm." 42 Don't Use Hand Sanitizer That's Less Than 60% Alcohol Experts say 60% and above is necessary to kill germs. 43 Don't Forget to Check in With Others "Social distancing only applies to physical space, not all human connections," said doctors from Johns Hopkins on March 17. "If you know someone who can't go outside, like an older person, call them regularly." 44 Don't Stop Exercising Even though gyms may be closed in your area, daily exercise is key to staying healthy. Luckily, working out at home is easier than ever, thanks to apps and sites like Beachbody, Openfit, Aaptiv and Fitbod. Several gym chains have online workouts too. 45 Don't Eat Poorly Stress eating could turn COVID-19 into the new version of the Freshman 15. Don't let it; that will only compromise your overall health. 46 Don't Share Bogus Information We all want our friends, loved ones and community to stay informed about COVID-19, but make sure any information you share comes from major news sources, hospitals and health organizations like the CDC and WHO. 47 Don't Totally Avoid Nature Going outside during social distancing is "more than okay. It's a good idea," the Johns Hopkins doctors said. "Just keep your distance from others. Walking, hiking and biking are good. Contact sports are a no-no. Exercise is physically and mentally important, especially in stressful times." 48 Self-Quarantine If You Suspect You've Been Exposed This is key to slowing the spread of the virus, experts say. Follow your healthcare provider's instructions. 49 Self-Isolate If You Suspect You've Been Infected If you're ill with COVID-19, it's important to occupy a separate bedroom from other members of your family if you can, and avoid sharing towels, bedding, glasses, plates and silverware until you're recovered. 50 Don't Touch Shopping Carts without wiping them down with an antibacterial wipe, or washing your hands as soon as you get home, that is. 51 Don't Touch Elevator Buttons If you can help it, press these germ magnets with a knuckle or the side of your hand; it'll lower the chances you'll transfer 52 Don't Stock Up on Simple Carbs When you're buying groceries, go for complex carbs, not white bread and flour, baked goods and processed foods. 53 Disinfect Your Cell Phone Even in normal times, they can carry seven times more germs than the average toilet seat. Wipe them down with disinfectant daily. 54 Don't Feel Helpless to Help Others These are unforeseen circumstances, but staying at home doesn't mean you're powerless to help others. Michigan Health has a great list of things you can do, from donating to food and diaper banks to helping the homebound. 55 Don't Forget to Wash Your Hand Towels Experts recommend washing your kitchen hand towels after two days of use, in hot water, with a bit of bleach or a product with activated oxygen bleach. 56 Don't Panic! Be prepared, be vigilant, be informed. But don't be panicked. We will get through this together, even if we have to temporarily remain apart. 57 Don't Skip a Vitamin D Supplement Among other benefits, Vitamin D boosts the immune system. "If you are deficient in vitamin D, that does have an impact on your susceptibility to infection. So I would not mind recommending, and I do it myself taking vitamin D supplements," says Dr. Anthony Fauci, the nation's top infectious disease expert. 58 Don't Skip the Flu Shot If you haven't gotten one, it's not too late. It won't protect against COVID-19, but it will help protect you against the seasonal flu, which can have similar symptoms. 59 Don't Let Your Blood Pressure Rise If you're on medication or a lifestyle-change regimen for high blood pressure, don't discontinue them. High blood pressure has been associated with worse outcomes for people who contract COVID-19. 60 Don't Skip the Veggies As always, try to eat as many fruits and vegetables as possiblethey contain vitamins, minerals and compounds that can boost your immune system. 61 Don't Handle Cash (If You Can Help It) Initial reports indicated that cash might help spread coronavirus. No harm in paying with plastic whenever possible. 62 Don't Touch a Public Screen Or Keypad (Without Washing Your Hands) The checkout screens at grocery stores and keypads at banks and ATMs were notoriously germy even before the coronavirus outbreak. Bring a pen with you and use the non-writing end to press keys and give your signature. 63 Don't Go to Religious Services Right now is the time to avoid crowds in general. Attend services online, or in a virtual group hangout. 64 Don't Take Chloroquine Phosphate An Arizona man died, and his wife became seriously ill, after the couple ingested chloroquine phosphate, an additive used to clean fish tanks. President Trump had touted the antimalarial drug chloroquine as a potential coronavirus cure. 65 Don't Use a Community Pen Bring your own writing utensil with you anywhere you might need to use oneto the bank, doctor's office or other essential places. 66 Don't Blame Others Viruses don't belong to one country or discriminate about who they infect. Blaming one country or group of people for COVID-19 isn't emotionally healthy or constructive. 67 Consider Every Health Procedure Carefully Ask your healthcare provider if any of your upcoming procedures are urgent or can be rescheduled. 68 Don't Take a Cruise Cruises have proven to be an effective vector for transmitting a number of viruses, including coronavirus. If you have one booked, now's a good time to reschedule or choose another diversion. 69 Don't Take Children to Closed Playgrounds Many parks and playgrounds remain closed for a reasonplayground equipment is rarely (if ever) disinfected. 70 Don't Go Out When You're Sick If you feel ill, stay home. 71 Disinfect "High-Touch" Surfaces Take a minute to wipe down other frequently touched surfaces such as computer keyboards, remote controls and light switches. 72 Don't Close-Talk There will be time for establishing intimacy later. If you run into a friend on the street, try to stay three feet apart for the time being. 73 And Sorry About This One: Don't Visit the Grandparents (or Your Grandkids) In Person Older people are more susceptible to complications from COVID-19. Move any visits to FaceTime for the time being. 74 If You're Thinking Negatively, Flip the Script Although times can be scary, try to engage in self-talk that's positive and constructive. "We'll get through this" and "I'm doing the best I can" are two good examples. They may sound corny but they really work. 75 Don't Forget to Make Time For Yourself Your plate may be full of remote work and caring for a partner, children and other family members. But it's important to allot regular time for yourself, whether it's exercise, meditation, indulging in a favorite TV show, reading a book or taking a long bath. 76 Don't OD on News Using TV news as background noise, or constantly checking news sites, may not be helpful and can lead to anxiety. Pick a reputable news site, and check in briefly once or twice a day. 77 Your ChecklistCheck in With it! Create a checklist of things you'd like to get done, and hold yourself to it each day. 78 Don't Slack on Your Routine Get up and go to bed at a regular time. Wake up, shower, get dressed as if you were going to work or heading out. Eat welland regularlyand exercise. Start work at the same time each day, and have an end of daydon't just keep working all night. 79 Try Not to Work From the Bed Create a work-from-home space for yourself; your own desk, if a whole room isn't available. It'll help you maintain a routine and stay focused. 80 BreaksYou Need 'Em When you're working from home, don't let it expand to fill your entire day. Give yourself a lunch hour and at least two 15-minute breaks. 81 Set Boundariesand Stick to Them If you're working from home with a spouse and/or children around, establish clear guidelines about when you'll be available and when you must concentrate on work. 82 Don't Fade Away From Your Co-Workers If you work on a team, check in with your boss and/or co-workers at an established time. It'll help you keep focused and targeted and will be good for your mental health. 83 It's OK: Give Yourself a "Worry Window" The executive director of UNICEF recently shared this tip on social media: As things worry you throughout the day, write them down, and put the list aside. Then give yourself a few minutes a day to look over the list and worry. Then put those things out of your mind. It's an effective strategy for reducing free-floating anxiety. 84 Don't Take Life for GrantedKeep a Gratitude Journal This time-tested therapy for anxiety and depression can be especially helpful now: Each day, write down three things you're grateful for that day. They can be as basic as the roof over your head or the food you have to eat. 85 Remember You Can't Predict the Future Predictions about the economic repercussions of COVID-19 can be alarming. But remember that none of us has a crystal ball; we don't know how things are going to turn out. They could be much better than predicted. 86 Be Careful About Talking With Kids "Don't put your adult's brain into a child's brain," advises Dr. Joyce Mikal-Flynn, who works with trauma survivors. Be a calming presence, and if a child asks you a question, "answer that question and just that questiondon't go overboard. Then ask, 'Is there something else you want to ask me?'" Make it clear that asking questions is always OK, and if you don't know the answer, you can look it up together. 87 Don't Follow the Rumor Mill Don't concentrate on speculation or rumorsand unfortunately, a lot of news reports right now are one, the other or both. Focus on facts about COVID-19, how it spreads, how serious it is, and where we are by reading the latest updates on the CDC and WHO websites. 88 Talk About Anything But Coronavirus When you call or video-chat with friends and family, be open and share your worries about the current situation. But don't let that be your entire conversation. Talk about something great on TV, a book you're reading, a meal you've cooked or pop-culture nonsenseanything to get your mind off coronavirus for a minute. 89 Reschedule That Date Unfortunately, now is the time to give the dating apps a rest for a little while. 90 Don't Ignore Cleaning Product Labels As you disinfect your home, be aware of the ingredients of and warnings on the products you buy, and follow any listed instructions. 91 Don't Spray Lysol on Yourself You might be tempted to spray yourself down after a trip outside. "Do not do this. There is no fine line it is a bad idea," cleaning expert Jolie Kerr told Vox. Disinfectants like Lysol can be harmful if inhaled, and their ingredients can cause skin irritation or burns. Wash your hands thoroughly instead; it's your best protection. 92 Don't Mix Products Cleaning products with ammonia should never be mixed with bleach, and vinegar should never be mixed with products containing hydrogen peroxide, says Kerr. The combinations can create gases that are harmful to the eyes, nose and respiratory system. 93 Don't Spray Down Your Mail It's not necessary to disinfect your mail or cardboard packages before you open them. Just wash your hands thoroughly after touching them, and dispose of them outside your home if possible.RELATED: COVID Symptoms Usually Appear in This Order, Study Finds 94 Know the Facts About COVID-19 and Children Children are not at higher risk for coronavirus, the CDC says. But they can still become ill or transmit the virus to more vulnerable people. 95 Don't Scare Your Kids; Teach Them The CDC recommends teaching kids to do the things you're doing to reduce spread of the virus: Wash your hands frequently and thoroughly, stay home if you're sick, clean and disinfect high-touch surfaces daily, and launder items according to manufacturer's instructions, in the warmest possible water. 96 Don't Give Children Under 2 Face Masks This is not necessary, the CDC says. 97 Limit Children's Social Interactions The CDC recommends that playdates and group outings should be minimized for the time being, as well as any visits with older adults like grandparents. 98 One More Thing About the Little Ones: Assure Them They'll Be Safe The most important thing to tell children about COVID-19 is that you'll do everything possible to keep them safe, says Karen Swartz, MD, a psychiatrist with Johns Hopkins Medicine. Their anxiety levels may be high because of news and social media, and this reassurance can go a long way. 99 Encourage Young People to Reschedule Trips Older children should reschedule non-essential travel to crowded areas, the CDC says. 100 Stress May Be Quarantined With You, But He is Not Your Friend Stress increases the level of cortisol in the body, a hormone that can inhibit the immune system. RELATED: Unhealthiest Habits on the Planet, According to Doctors 101 Avoid Screens Before Bed This is an especially important time to practice good sleep hygiene to ensure you get quality rest. To avoid insomnia, avoid looking at laptops, tablets and cellphones for a few hours before turning in. 102 Don't Let Yourself Get Overwhelmed Feeling overwhelmed can lead to stress and panic, which taxes your immune system. If you feel like things are getting to be too much to handle, give yourself a time-out. Do some relaxation exercises or a pleasurable activity that you enjoy. 103 Don't Forget to Drink That Water Drinking water isn't a miracle cure for COVID-19, but it has plenty of benefits, from moistening mucous membranes to improving metabolism. Aim to drink five to seven cups of water a day. 104 If You've Read This Far, Take a Moment and Breathe Deeply If you're feeling anxious, take a moment to concentrate on your breath. Breathe in for a count of four, then slowly release the breath for another count of four. Repeat until you feel yourself begin to relax. It's simple but one of the most effective anti-anxiety exercises around. 105 Don't Check the News Before Bed For a few hours before bed, read a book, meditate, listen to musicanything but check the news. It'll be there in the morning. 106 Let Yourself Laugh More Laughter reduces stress, eases tension, improves circulationand studies show it can also reduce inflammation and bolster your immune system. 107 Avoid Non-Essential Flights The CDC currently advises against non-essential plane travel for older adults. It's a good idea for everyone. 108 Take Advantage of Telehealth See if you can schedule telemedicine sessions for any doctor's appointments you can't miss. In fact, many doctors nor prefer this, given the contagiousness of COVID-19.RELATED: Everything Dr. Fauci Has Said About Coronavirus 109 Who is Your Emergency Contact? If you don't have a designated person to reach out to in an emergency, now's a good time to establish one. That contact can apprise caregivers of any essential information and contact other family members in the event you need care or are hospitalized. 110 Do Not Hold a Blowdryer Up To Your Nose (Please) A Florida politician claimed that blowing a hairdryer up your nose can cure coronavirus. Shockingly, this is not true. Be skeptical about any folk remedies circulating online. Follow the advice of your healthcare provider and reputable health organizations. 111 Pick a Time of Day to Address Relationship Conflict Stressed about sharing space with a partner all day and getting on their nerves? Swartz recommends picking a specific time of day to discuss any areas of conflict briefly, then concentrating on avoiding arguments for the rest of the day. 112 If You Live Alone, Make a Network If you're flying solo, take this time to connect with other people who live alone. Swartz suggests using a program like FaceTime or Zoom to hold group chats, start a virtual book club or movie discussion group. 113 Don't Catastrophize Sometimes we have to force our minds away from negative thoughts, like changing the channel, says Swartz. For example: Instead of thinking "this is a disaster and things will never be the same again," think, "This is a challenging time, but we'll get through it." 114 Keep a File of Positive Thoughts Think of some things that make you happyit could be a great memory, an event, a family member, a comedian or cute cat videos. Whatever those are, keep them at top of mind. When you feel yourself getting stressed or anxious, replace those negative thoughts with positive ones. 115 Don't Sleep Too Much Getting enough sleep is important for maintaining your health. But don't overcorrect and hibernate in bed; that can lead to depression. 116 Do Things You Enjoy To reduce stress and anxiety, take this time to reconnect with things you enjoy doing but might have let fall by the waysidewhether it's reading, crafting, writing, listening to music, looking at art online or working on things around the house. 117 Don't Take Antibiotics Without Guidance They only cure bacterial infections. COVID-19 is caused by a virus, and antibiotics won't clear it. Only take antibiotics on the advice of your healthcare provider. 118 Don't Take Colloidal Silver Don't believe online rumors that colloidal silver is effective against coronavirus. In fact, on March 9, the FDA warned seven companies to stop selling silver products they claimed cure the coronavirus. RELATED: The Unhealthiest Supplements You Shouldn't Take 119 Don't Count on a Hot Water Cure A widely circulated internet rumor claims that drinking hot water will kill the coronavirus. This is not true. The disease affects the respiratory system, not the digestive tract. Do, however, get plenty of fluids, when you're healthy and anytime you're sick. 120 Don't Take Megadoses of Vitamins No vitamin or supplement has been proven to combat COVID-19. And taking high doses of various vitamins can have side effects that range from minor (stomach irritation) to serious (toxicity). Instead, eat a nutritious, well-balanced diet with plenty of fruits and vegetables to bolster your immune system. 121 Don't Drink or Inhale Iodine One online rumor maintains that drinking or inhaling liquid iodine can be a COVID-19 remedy. This is not true. What's more, the practice can be seriously harmful. 122 Remember That "This Too Shall Pass" Because it will. This is a chapter in history, not the rest of your future. 123 One Final Thought If each and every one of us follow this simple checklist, we can get through this pandemic with fewer infections and fewer deaths. Universal wearing of masksMaintaining physical distanceAvoiding congregate settings or crowdsDoing more outdoors, as opposed to indoorsWashing hands frequentlyPlease forward it to someone you care about, so they can do the same. And to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

Here is the original post:
Fred VanVleet: Raptors need to adjust to game officiating - Yahoo Canada Shine On

This study aims to explore the prevalence of decreased frontal lobe function and its associated factors in women with surgical menopause.This study is a retrospective analysis of a cross-sectional study conducted between October 2013 and July 2014. Data from 164 women with surgical menopause were analyzed. The Montreal Cognitive Assessment Thai version (MoCA-T) test was administered by a psychologist. The MoCA frontal lobe function score was derived from visuospatial/executive, abstraction, attention, and verbal fluency tests. Multivariable logistic regression was used to assess data associated with decreased frontal lobe function.The mean age of participants was 56.36.9years, and the mean time since menopause was 11.37.4years. The prevalence of decreased frontal lobe function score was 73.8%, with an average score of 6.211.84. The independent factor associated with a lower MoCA frontal lobe function score was duration of education greater than 6years.Our study adds information about decreased frontal lobe function in almost three-quarters of women with surgical menopause. Duration of education greater than 6years was a protective factor. Menopause hormone therapy usage did not seem to increase the detrimental effect on frontal lobe function when initiated in young women with surgical menopause.

PubMed

Read more:
Effect of surgical menopause and frontal lobe cognitive function. - Physician's Weekly

By Karen Dandurant| news@seacoastonline.com

FDA approves generic EpiPen

The FDA has approved the first official generic version of the EpiPen, a life-saving device for people with severe allergies.

Wochit

PORTSMOUTH -- Most people have heard of an EpiPen, and know, at least marginally, that they are used to help quickly counteract symptoms of severe allergic reactions that can quickly result in anaphylactic shock, which is life threatening and can be fatal.

There are many reasons for EpiPen use. Allergic reactions can come from bee stings, from food or medication allergies and even environmental allergies.

But health care experts say parents are often hesitant to use the device on their children, sometimes delaying until it is too late to stop the dangerous cascade of allergic reactions.

Eric Jaeger, a paramedic, and the EMS educator at Exeter Hospital said he sees hesitation and reluctance to use EpiPen all the time.

Portsmouth health officer: Stay vigilant before COVID variants hit

Parents sent home with an EpiPen are cautious, said Jaeger. There was a death several years ago of a college student who didnt use the EpiPen in time. It prompted me to realize there is still a significant issue, where people are not sure when to use it, or who wait longer than they should. Often people wait for a severe reaction and by that time, within 5-10 minutes, the cascade of symptoms has started, and a person can die.

EpiPens are a type of epinephrine auto-injector. They work by automatically injecting a dose of the hormone epinephrine (also called adrenaline) into a person's body.

Dr. Anupriya Grover, is a primary care physician at Appledore Family Practice in Portsmouth and is the Associate program director at the family medical residency program at Portsmouth Regional Hospital, in association with Tufts School of Medicine.

EpiPens are basically adrenaline and it is used to counteract symptoms that can constrict the airway, said Grover. That is an adverse event. The throat can swell; blood pressure can be lowered, and it can be a very serious condition. Bees and peanuts are commonly known allergies. Adults and children can be allergic to many medications, Tylenol, antibiotics, or opioids. There are airborne allergies that can be severe.

Grover said an EpiPen should be used in any situation where there is an allergy exposure resulting in difficulty breathing or tightening in the chest.

I have come into a home and as a paramedic, the signs of anaphylaxis are clearly there, said Jaeger. The parent is standing there holding an EpiPen. Once the dam has broken, an EpiPen might not pull the child back from the brink. Using it, even if unsure, makes so much more sense.

Read more: COVID precautions appear to reduce seasonal flu; doctors still urge vaccinations

I tell my patients if you are feeling like maybe you should use the pen, use it, said Dr. Nicholas Armellino, an emergency department physician at Exeter Hospital. The only time an EpiPen will not work, is if you do not use it. A lot of people are hesitant for whatever reason but my thought is if you do not feel well, use it. There are no detrimental effects for doing so, no contraindications.

Using an EpiPen is simple but Grover said taking the time to practice, using a fake EpiPen is a good idea.

I teach patients the swing and push method, said Grover. You hold your hands straight out and push into your thigh. The needle is so fine it will go through clothing. Then you hold for 10 seconds. People can practice this with a writing pen. The twin packs often come with their own practice pen.

No one would ever advocate using a medication past its expiration date, except with the use of an EpiPen in an extreme medical emergency.

MoreGuest View: NH must address prescription drug affordability now

Parents should inspect the device, said Grover. There should be no floating particles in it, and the liquid should not be cloudy. However, if you only have access to an expired pen; it is still preferable to not using it at all. Some residual benefits will still be there.

Armellino said the medication might not be fully active if past the expiration date. But he said the chance there is some active medication is definitely worth it in an emergency.

Ashley Child, PharmD at Wentworth-Douglass Hospital, said she tries to answer questions when parents come in to get an EpiPen for their child.

I agree there is some hesitation to use them, said Child. I tell them the rule of thumb is when in doubt, use it. EpiPens are not considered a dangerous medication when used properly. You cant buy it at a store, so if a family has one, it is a needed device, given by prescription. I think there is a small stigma attached to it. Some parents feel if they use it someone will judge them for it, will judge if they needed to. Thats not enough reason not to use it for your child when you feel it is needed. Most allergists will tell you the same thing, thatit's better to use than not to use. And in the case of anaphylaxis, the sooner you use it, the better. Delaying care can be harmful.

Child said using expired medication is never a decision to make without talking to your doctor.

However, studies have shown that after an EpiPen has been expired for six months, it still contains about 60% of its active ingredients, said Child. So, the benefit outweighs the risk.

Grover said EpiPens should be stored at room temperature, and never stored in a car where temperatures can fluctuate.

Cost may be a factor in peoples reluctance to use devices unnecessarily. A twin pack of EpiPens averages about $350, very pricey if a person has no insurance and has to pay out-of-pocket.

They are expensive, said Armellino. Its not actually the medicine that is expensive. Its the delivery system itself. I think there should be some entrepreneurial type who can create a less expensive way to deliver this medicine.

Jaeger said EMTs used to carry EpiPens, but the cost is prohibitive so many are now not being routinely equipped with them.

Child said all pharmacists should explain the pen and its use.

If you have questions ask, said Child. The more education you get, the better and more confident you will feel about using an EpiPen.

More:
EpiPen advice: Doctors say when in doubt, use it to nip allergic reactions in the bud - Seacoastonline.com

In the world of diabetes research, there are superstar names you just know.

For example, Banting and Best, who discovered insulin. Elliot Joslin, who pioneered modern treatment and care. Kamen, Tamborlane, and others who led technology development.

And then there are the names that may not be as familiar: researchers who spent years in labs studying and testing, who broke down barriers to reveal a better understanding of diabetes and, yes, better outcomes.

Dr. Jesse Roth of the Feinstein Institutes for Medical Research in Manhasset, New York, is one of those quiet heroes.

After 5 decades of lab work that have changed the diabetes treatment landscape, he was recently named one of the Giants in Medicine by the renowned Journal of Clinical Investigation.

His work hastened the discovery of insulin receptors and their molecular interactions within the body. New research by Dr. Roth and his colleagues around hormone-like molecules released within the intestine show promise for preventing pathological inflammation that is closely associated with diabetes and other illnesses, writes the Feinstein Institutes in an earlier press statement.

His lifetime contributions to understanding diabetes continues to lay the groundwork for future advancements.

Turns out none of this may have been the case were it not for a lost job opportunity, a war in Vietnam, and Roths then-bosses going overseas for a bit.

I felt like there was a divine finger pointing me in the right direction, Roth said of his career, still ongoing 50-plus years later.

As a freshly minted graduate from his medical residency program, Roth was at a loss for where to land next. After a well-known prestigious institute turned him down (they werent hiring at the time), a seasoned physician became a mentor and guided him along.

He took me for a drink in a fancy hotel in St. Louis, Roth told DiabetesMine. Id never had such a fancy drink before.

While the drink was sublime, it was the advice that resonated.

He looked me in the eye and said, The guy you want to work with is Rosalyn Yalow. She was at a small but avant-garde place in the Bronx (the Bronx Veterans Administration). Ends up, it was the perfect place for me.

There, Roth had a chance to hone his skills in research and in partnering on studies, he said, especially when the big guns there traveled to Europe on an extended trip.

That time to explore and expand helped him grow as a researcher, he said. And it was noticed.

When they came back, they saw us and me as future stars, he said.

Indeed, Yalow later won a Nobel Prize for her work with Dr. Solomon Berson proving that type 2 diabetes is caused by the bodys inefficient use of insulin, rather than a complete lack of insulin as was previously thought.

When the Vietnam War began, Roth, not wanting to be drafted, asked his boss for help. That boss landed him a job at the National Institutes of Health (NIH). He basically called the NIH and said, Ive got this kid for you! Roth remembered.

And that is where his diabetes-world-changing discoveries took root.

My boss there said to me, These are exciting times. Instead of doing what you were doing before, think of what the most exciting thing you could do would be, he said.

Roth settled on a question to answer: How does a cell know that insulin is there?

At that time, nearly 50 years ago, it was thought that insulin receptors were found in muscles and fat, and nowhere else in the body, Roth said. It was also thought that insulin worked pretty much on its own.

A younger Dr. Jesse Roth

What Roth and his team discovered was groundbreaking in every way: First, insulin receptors exist not just in pockets of muscle and fat, but throughout the entire body (even in the brain).

Second and this opened the door to researchers digging even deeper into the cause and effect of diabetes insulin itself does nothing, Roth said. Its the receptor that drives what the diabetes does.

It was definitely an aha moment, he said. It took us several years to convince people why this was important, which meant we had to stick to it and go several years with no applause. People were not ready for it. They yawned at us.

But Roth and his NIH team knew theyd revealed crucial and useful information.

And they were right. Their discovery led to not just understanding how insulin and receptors work in tandem in a body, but also that insulin works differently in different people.

This finding led to the now common understanding that there arent just one or even two types of diabetes: There are many, and each requires its own research, understanding, and treatment.

It used to be seen as one or two diseases, Roth said. Now, it turns out diabetes is a portfolio of diseases.

That discovery, along with more research looking at how receptors act in each type of diabetes, he said, led to better treatments, since physicians could now look at each type of disease with a unique set of eyes.

Roth said that is what jazzes up a researcher such as himself.

The lab is driven by whats going on in the clinic, he said. Any time there is an improvement clinically, were extremely excited as well as motivated.

For people with diabetes of any type, this knowledge led to more discoveries and, better yet, more precise treatments.

Being able to zero in on things like helping urine flush glucose is one example, Roth said, referring to SGLT2 drugs that leverage that pathway. This treatment has proven highly beneficial to people with type 2 diabetes, and is now sometimes introduced into treatment for those with type 1 as well.

Roths discovery of different forms of diabetes also helped practitioners explore things like exercise, stress, growth, and other factors that can come into play with insulin and receptors.

This has allowed people with diabetes and their medical teams to strive for better management and understand more when things go wonky.

While this may seem simple to anyone newer to diabetes, its important to remember that before this discovery, most people with type 1 diabetes took one injection a day and made few other changes in their dosing or daily activities around diabetes. This led to very imprecise diabetes management.

Today, all that has changed, thanks in large part to the work of Roth and his team.

Roths work over the years helped land him in some challenging and exciting roles.

He served as assistant surgeon general to the U.S. Public Health Service from 1985 to 1991 and as a fellow of the American College of Physicians, and has held leadership positions at the NIH and Johns Hopkins before joining Northwell Health and the Feinstein Institutes in 2000.

Today, Roth is still working hard and has more questions to answer in the lab.

Among them, he said, is further exploring the information he learned early on about the brain.

One area Im excited by is knowing we have insulin receptors all over the brain, he said.

We couldnt figure out what to do there, but there are groups working on this now in Munich and Cologne (Germany), and in the United States. Its exciting to think what could come of that, he said.

Roth would also like to see more investigation into insulin and the nervous system. We started it years ago but could not get people excited about it Now, its getting worked on.

Roth also has another dream that he believes can be reality: I am very optimistic that we can cure type 1 and type 2 diabetes, he said.

Theres no timeline attached to that, but not for lack of effort, he said.

The body is just much more complicated than we think, Roth said.

One more goal has less to do with the lab than the rest of the world, but its one Roth is passionate about: combating racial disparities in treatment.

There is a marked unevenness in care in the United States, Roth said. We dont see this in other places where healthcare is more accessible. We need to change that.

See the original post:
Meet One of the World's Most Influential Diabetes Scientists - Healthline

This article was written by Mila McManus, M.D. and it can be found on her blog at The Woodlands Institue. Dr. McManus is the A4M member of the month, as a functional medicine specialist, she practices preventive and personalized patient care and believes in a proactive approach to healthcare.

Bio-identical hormones are hormones that are near identical to the hormones our bodies produce. This is in contrast to conventional hormone replacement therapy (a.k.a HRT) which uses synthetic hormone-like drugs, such as birth control pills and other synthetic hormones used to treat menopausal symptoms in women. One might wonder why doctors would prescribe synthetic hormones when real hormones are available. The answer involves understanding patent laws. Nobody can patent things that already occur naturally, so you cant patent a palm tree, and drug companies cant patent the structure of a real hormone. Since drug companies are in the business of making money, they want to be able to protect their property with patents, so they created synthetic hormones which they could patent. These are, unfortunately, the only hormones we learn to prescribe in medical school.

Some causes of hormone imbalance include stress, sleep deprivation, vitamin deficiencies, poor dietary habits, toxins, and side effects of various medications. The list of symptoms of hormonal imbalance is long. Some symptoms include fatigue, insomnia, depressed moods, decreased mental sharpness, anxiety, PMS, post-partum depression, decreased sex drive, unexplained weight gain and inability to lose weight, low motivation, headaches, hot flashes, night sweats, and irregular menstruation.

Benefits of balancing and optimizing hormones with bio-identical hormones include improvement or resolution of the above symptoms, improvement in bone density, preservation of brain function, reduced risk for heart disease, and increased overall sense of wellbeing, to name a few. Risks are minute compared to typical HRT with synthetic hormone-like drugs. For instance, there is virtually no risk of blood clots with bio-identical progesterone, whereas synthetic progestins are well-known to heighten the risk. Its also noteworthy to say that the Womens Health Initiative Study that revealed an increase in the incidence of breast cancer was based solely on the use of synthetic hormones. Moreover, keep in mind that cancer is the result of a perfect storm of events, and hormones are a tiny piece of that puzzle. Other factors that are linked to cancer that people tend to ignore are stress, sleep deprivation, poor dietary habits, vitamin and other nutrient deficiencies, and toxins.

A wonderful thing about bio-identical hormones is the ability to have them compounded into specific doses. For instance, one person may need 5mg twice daily of progesterone, while another may need 37.5mg twice daily. We can order various doses in various forms, such as creams, pills, lozenges, injections, and pellets. Doses are fine-tuned based on the resolution of symptoms and other factors. This is not possible with most commercially-available options.

As has happened in the past, the FDA is again gearing up to issue a ban on compounded bioidentical hormone replacement therapy under the disguise of insufficient evidence of safety and effectiveness, when it is just one of the ways the FDA and the government bolster drug monopolies and undermine natural health options. Interestingly, it is the FDA-approved synthetic hormones that are known for common side effects including headaches, breast tenderness, mood swings, fluid retention, weight gain, and loss of libido. They are also associated with an increased incidence of breast cancer, heart disease, stroke, and blood clots to the lungs. And there are numerous and severe side effects of synthetic hormones listed in the Physicians Desk Reference.

As a functional medicine physician, I would be very saddened to see compounded bioidentical hormones banned. So please take 60 seconds to join the fight! Click this LINK to sign the petition.

On a final note, while not optimal or easily customized to patients individual needs, if bio-identical hormones are banned in the future, there will be some alternatives! There are a few bio-identical hormones that are commercially available, made possible by the drug companies patenting a delivery mechanism, for instance, such as a patch.

Link:
Why Bioidentical Hormone Therapy? - Anti Aging News

Breathing hasnt always gotten the respect it deserves. Weve always known that it keeps us alive, in an automatic and largely unthought of way, but now, we are living in a time when breath has never felt more sacredbecoming eerily significant as a respiratory virus ravages the globe. But almost concurrent with the spread of COVID, the practice of breathwork has gained momentum and entered the realm of pop culture.

The Goop Lab with Gwyneth Paltrow debuted on Netflix in late January 2020, a few weeks before the world shut down. In a popular episode highlighting Dutch extreme athlete Wim Hofs soft belly breathing and cold-resistance training for physical and psychological healing, we watched from the comfort of our couches as Goop employees plunged into a freezing-cold lake. By the time Justin Bieber called him a G on The Ellen DeGeneres Show in December 2020, and reported DM-ing with him on Instagram (as one of his 1.6 million followers), the self-proclaimed crazy Dutch man was practically a household name. Breathwork had gone mainstream, practiced by influencers and spiritual seekers alike.

Getty Images

But breathwork is hardly new. A particular reverence for the breath as a conduit of life force energy goes back thousands of years in spiritual traditions and Eastern practices; breathing through the physical postures is a critical component of yoga, while counting your breaths is the backbone of certain meditative traditions. Most breathing practices come from ancient yoga traditions and are based on pranayama, which means the regulation of the breath through certain techniques and exercises, says Jay Bradley, founder of BreatheOnIt and Chakra Balms, who teaches a three-part, circular breath technique.

The draw of the practice largely comes down to the transformational potential a practice has on the mental state. Regular practitioners claim mental improvements such as overcoming depression, managing addiction, and/or having a more compassionate self-view. But even in our modern world, the spiritual component cannot be ignored. The depth of practice, experience of the practitioner, and the trust and willingness of the person are what can elevate a simple technique to a whole other level of sacred, even in a less typical-seeming, spiritual context, explains Erin Telford, a breathwork instructor who teaches a form of the practice created by David Elliott.

For the skeptics: Medicine also confirms claims of its physical benefits. There are so many studies that show deep breathing is one easy, accessible practice that can help to balance the mind and body, and reduce the stress response, says Mark Hyman, M.D., a 13-time New York Times best-selling author and the head of strategy and innovation at the Cleveland Clinic Center for Functional Medicine. Breathwork has been shown to increase parasympathetic activity, heart rate variability, physiological flexibility, [and] is one of the greatest tools I have in my medical toolbox to help individuals manage stress, [which] has become an epidemic in our society.

Read on for everything you need to know about starting and maintaining a breathwork practice.

What is a breathwork practice?

As Shel Pink, founder of SPARITUAL and a proponent of breathwork in Slow Beauty, puts it, Breathwork can be the meditation, or breathwork can be the focus or the intention of the meditation. Put differently, Breathwork is an active meditation technique that uses breath to purge the body and nervous system of emotional debris, says ALTYR practitioner Rony Ghoraishy, a yoga and holotropic breathwork teacher. [It facilitates a] disconnection from the mind and thoughts, and a connection to the heart.

The relaxing effects of a class can be immediate, but profound cumulative effects come from turning your sessions into regular occurrences. If someone is looking to speed up their emotional healing, doing a breathing technique [for 20 to 28 minutes] every day for one to two weeks is a wonderful kick-start, advises Bradley. For maintenance, to stay centered and balanced, one to two times per week is recommended.

If you dont have a ton of time though, Erika Polsinelli, a Kundalini breathwork teacher and the founder of Evolve by Erika, explains that every little bit counts. Ideally, a 20- to 30-minute practice in the morning would be wonderful. However, even just spending three minutes each morning consciously breathing can help change the projection of your entire day. She recommends practicing in the mornings, because the brains relaxed; a sleepy state can help you achieve a meditative headspace more quickly and with fewer distractions.

This content is imported from Instagram. You may be able to find the same content in another format, or you may be able to find more information, at their web site.

How exactly does breathwork, work?

Of the hundreds of schools of breathwork, and within them, various breath types (i.e., circular, boxed, ujjayi, breath of fire) and techniques (i.e., nostril breathing, opposite nostril breathing, mouth breathing, breath holding), the healing mechanism remains the same: the mind-body connection. In 1975, Harvard physician Herbert Benson coined the term relaxation response, the body's innate stress-countering mechanism courtesy of the parasympathetic nervous system. His research showed that you could use relaxation techniques (i.e., meditation) to quell the physiological fight-or-flight response, or stress response.

Research has shown over and over again that learning to relax is one of the most important keys to long-term health and vitality, Hyman says. That doesnt mean sipping a glass of chardonnay while watching TV or practicing retail therapy. You have to learn how to deeply relax and stimulate your vagus nerve. He explains that the vagus nerve connects to all the bodys immune cells, stem cells, organs, and tissues, and that it has the ability to turn off your stress response and activate your relaxation response, making it incredibly healing to the nervous system. Your stress response gets turned on automatically day after day. However, very few of us know how to calm this system down, [and] this is a serious health concern, because stress is very bad for your brain. Breathwork is one of the most powerful tools we have to activate the vagus nerve and improve the brain and mind-body connection.

What does a breathwork session feel like?

During a class, your breathwork teacher first guides you through the specific breathing technique in which they are trained. Once you begin breathing, they might play inspirational music, have you incorporate aromatherapy or crystal therapy into your session, and finish with a guided meditation or even Reiki healing. Breathwork can be practiced just as effectively remotely, and even alone, but the presence of an instructor is suggested to guide you through the sometimes physically and emotionally intense experience.

Ghoraishy teaches a form of holotropic breathwork consisting of a two-part inhale and one-part exhale through the mouth. In a session with her, she also pulls an Inner Compass Meditation Card to help you set an intention for the practice. Everyone remembers their first breathwork session, she says. For me, it was the emotional release, the freedom, and liberation from my thoughts, and the flooding of gratitude that brought me back to the practice again and again. She felt drastically better after each session, and found it to be so healing that she decided to get certified in order to teach the self-help tool to others. I have seen breathwork serve as an emotional release for people struggling with stress, anxiety, PTSD, and depression. Some of the most profound shifts I have seen are an overall increased mind-body connection and emotional purging, says Ghoraishy.

Speaking from experience, it can feel like your hands are vibrating. You may experience temperature changes, lightheadedness, tingling, or tetanywhere your hands temporarily spasm into a clawlike position. (The first time I experienced it, during a session with Ghoraishy, I couldnt wait to tell her. It took a few minutes before I could type or text again.)

Emotional release is also common, as unconscious emotions that have been stored in the body bubble their way up to consciousness. Subconscious thoughts, memories, insights, emotional realizations, and even creative inspiration can arise; lines of this article spontaneously came to mind in the middle of a session with Bradley. It happened after painful, lingering, psychosomatic pressure in my throat (what metaphysically minded folks would call an energy block in the throat chakra, the energy center associated with self-expression and speaking your truth) dissipatedmuch to my reliefafter 30 minutes of breathing with a kyanite crystal on my blanket, essential oil-infused ChakraBalms, and Bradley as my guide.

Many also report losing a sense of time. Once your body enters a state of deep relaxation, timelessness takes over; it reminds me of the state between wakefulness and sleep that is induced by acupuncture, a modality that always leaves me clueless as to how much time has passed or whether I have fallen asleep. After 20 to 30 minutes of breathwork, you emerge from the depths of your inner mind and shift your focus back to the environment. You feel clarity, lightness, and energized, having sent oxygen through the blood to the bodys vital organs. This, of course, is all connected to the bodys parasympathetic nervous system activity. But the experience of the relaxation response is like a miniature vacation from the stress of lifeand in this case, your breath is the only vehicle needed.

This content is imported from Instagram. You may be able to find the same content in another format, or you may be able to find more information, at their web site.

At the core, breathwork is a stress-reduction technique that brings physical relaxation and peace of mind. Naturopathic doctor Nadia Musavvir explains, Shallow breathing (or not breathing) sends the message to the brain that you are under threat. You can interrupt this by simply taking a pause to breathe. The longer you exhale, the more the lungs can expand and send a signal to the brain that you are not in any imminent danger.

Breathwork also brings physical changes to the chemistry of the body, reducing the stress hormones like cortisol and releasing the pleasant cuddle hormone oxytocin. Alterations to your perspective, when less influenced by stress, provide you with the ability to reframe your world view more positively, while making other thought processeslike stress-exacerbating ruminationless prevalent. Breathwork has helped me break old patterns and recurring thoughts, breathwork facilitator Nadia Josse, who also works in the luxury fashion industry, tells us. I made peace with some childhood traumas that were impacting my daily life. (As Dr. Hyman points out, trauma is kept in both the mind and body, which is why, he says, mind-body healing modalities can bring around long-term healing.)

Of her journey to breathwork, Josse says, I found breathwork first a few years ago. I dont think I was prepared to have such an intense experience at that time. After exploring breathing techniques during yoga, and even the Wim Hof Method, she resonated with the technique taught through Lara Elliott, and then Erin Telford. Every time I would go back to the breath, I would have an intense experience, sometimes even a breakthrough, says Josse. You feel the effects during the session but also afterbehaviors change, you start seeing the world differently without the lenses of your conditioning and traumas. Of course, this is all if you desire to do the work and change for the better.

Users also report a better relationship to themselves; a healthier, more harmonious, compassionate experience within their minds as they tune in and observe their inner processes. The biggest impact that breathwork has had on my life is that it has magnified my sense of self-love and self-acceptance, says Bradley. I was always my worst critic and had a pretty judgmental view of myself. I now treat myself with gentleness, kindness, and support. Bradley describes a past of suffering from depression and how, over time, his practice allowed him to separate from his depression experientially, becoming more of an observer. [Now], I watch my pain with less attachment, helping me to remain calm, balanced, and centered, even in the midst of high-stress situations, he says.

This ability to access mindful equanimity can help to promote emotional stability and create inner peace. Many people are still struggling with feeling safe and at home in their bodies and with their emotions, explains Telford. This practice allows you to learn how to be with yourself and the many ebbs and flows of the human experience. It connects you to the part of you that already knows, the part of you that holds embodied truths and wisdoms.

This content is imported from Instagram. You may be able to find the same content in another format, or you may be able to find more information, at their web site.

As research verifies what we already know about the adverse mental health consequences of 2020, the isolation of our socially distant lifestyles makes individualized, self-directed practices like breathwork uniquely suited for our new normal. The ability to induce the bodys sense of calm imparts a sense of self-mastery that can help to restore the locus of controlsomething that we need during times of uncertainty. The flexibility of breathwork lies in how it can be practiced alone or remotely; even if you choose to have a session with a teacher, you can easily complete it over Zoom. And like anything that goes mainstream, the presence of breathwork in pop culture makes it feel relatable and relevant.

A growing need for meaningful relief has been met by the booming wellness industry. Camrin Agin, who founded ALTYR to make wellness practices accessible, considered the intricacies of the market when it came to selecting her offerings and found that breathwork warranted a place in her menu of services. Whats interesting about wellness is that it can be a very active, conscious endeavor just as much as it can be a passive, unconscious one, Agrin says. Meditation, breathwork, and readings all fall into the former category, while Reiki, sound baths, and yoga nidra fall into the latter. Sometimes its important to take charge of our own bodies, while other times, its important to have another audit them for us.

The varied experiences afforded by breathwork can be seen as the public embracing the grounding return to the present moment, where we can face and cope with heightened stress (which often takes us to the future or to revisit the past) as we move forward into an uncertain future. To me, the popularity of breathwork in the mainstream means that we have reached a new level of readiness in the collective to face our shadows, to learn to trust our bodies and our intuition again, and to heal more deeply, Telford says.

For many, the heart of the matter is the need to feel okay againand breathwork is proving itself a popular and effective means for trying to do so. The quality of our breath is what connects us to our lives, says Pink. When my breathing is deeper, I feel more connected in the present, calmer, and life feels more meaningful and purposeful.

This content is created and maintained by a third party, and imported onto this page to help users provide their email addresses. You may be able to find more information about this and similar content at piano.io

Go here to read the rest:
Breathwork Has Gone Mainstream During the COVID Era - HarpersBAZAAR.com

If you find yourself managing busy family life, social life, and career, its common to feel tired and achy sometimes. But do ever wonder if youre achiness and fatigue maybe something more? Are they symptoms of a stressful life, or could they be tied to an underlying condition like an autoimmune disease?

Dr.Redd, a Chiropractic Physician with a Masters in Human Nutrition from RedRiver Health and Wellness is addressing why many people with low thyroid and auto-immunityissues still have their symptoms after being on medication and seeing many specialists. Symptoms of autoimmune disease may be severe in some people and mild in others, but there is a way to get help as one lifelong athlete found.

Nicole, an avid fitness fan and now a recovered patient of RedRiver Health, explained how she feels after seeing Dr.Redd. RedRiver works to make patient satisfaction a top priority and every chiropractic physician and administrative team member works hard to ensure that each patient receives attention and individualized care.

Suffering from chronic symptoms that affect your ability to live your life can be frustrating. Many people visit multiple doctors and specialists and still cant find good answers about what is causing symptoms. People often brush symptoms off as just being the result of a busy and active lifestyle, or the result of stress from kids, work, and life in general. But when they start to get in the way of your ability to live your life its time to figure out exactly whats causing these symptomsa proper diagnosis is critical to find the right treatment.

RedRiver start with extensive testing that delves deeper than most lab panels, then add testing for everything from food sensitivity or intolerance to parasites, hormone imbalances, and adrenal function. They work to understand exactly what is happening inside your body so we can effectively eliminate the issues you are experiencing today while avoiding future flare-ups or a return of symptoms.

RedRiver Health and Wellness has offices in Springville, St. George, Logan, and South Jordan.

For more information, visitRedRiver Health or call (866) 36-RIVER for a free consultation or download a free guide on their website.

This story contains sponsored content.

Read more from the original source:
Lifelong athlete recovers from a hidden health condition that plagued her for years - ABC 4

USADA announced today that Abu Azaitar, of Rabat, Morocco, has accepted a seven-month sanction for a violation of the UFCAnti-Doping Policy.

Azaitar, 34, tested positive for tamoxifen and/or tamoxifen metabolite 3-hydroxy-4-methoxy-tamoxifen as the result of urine samples collected on August 25, 2020, September 4, 2020, September 9, 2020 and September 17, 2020. Tamoxifen is a Specified Substance in the class of Hormone and Metabolic Modulators and is prohibited at all times under the UFC Anti-Doping Policy and UFC Prohibited List.

After being notified of his positive test, Azaitar provided evidence (including medical records), that he was prescribed tamoxifen by a physician to treat symptoms. Tamoxifen is a selective estrogen receptor modulator used therapeutically to treat certain types of cancer in females and also prescribed off-label for males with various other conditions. Although the substance was taken at the direction of a physician, Azaitar lacked a valid Therapeutic Use Exemption (TUE) and his subsequent application for a retroactive TUE was denied due to lack of sufficient medical justification. Under the applicable rules, Azaitar was eligible for a reduction to the period of ineligibility based on the specific circumstances of his case and for his Full and Complete Cooperation.

Azaitars seven-month period of ineligibility began on August 25, 2020, the date his first positive sample was collected.

Read Full Statement

View post:
Statement on Abu Azaitar | UFC - The Official Website of the Ultimate Fighting Championship

Hi, everyone. I'm Dr Kenny Lin. I am a family physician at Georgetown University Medical Center, and I blog at Common Sense Family Doctor.

Kenneth W. Lin, MD, MPH

2020 was a very tough year for primary care clinicians, even when we weren't regularly treating patients with COVID-19. Last spring, the number of preventive services provided at community health centers well-child visits, Pap smears, A1c tests for patients with diabetes, and screening mammograms fell by one half to two thirds compared with the previous year and had not returned to their usual levels by the end of the summer. Although in some cases telehealth can replace in-person visits, a retrospective analysis posted online ahead of print by the American Academy of Family Physicians' Robert Graham Center suggested that two thirds of typical primary care visits require at least one in-person service, such as an immunization or blood draw.

Pandemic-related declines in well-child visits and adult physical examinations not only had negative financial effects on primary care practices, but also raised fears that delayed cancer diagnoses would lead to thousands of preventable deaths in children (O'Neill A and colleagues; Ding Y and colleagues) and in adults (Sharpless NE; Maringe C and colleagues). As a result, even though daily death and hospitalization rates from COVID-19 are exceeding the peaks from last spring and summer, hospitals and medical practices have been strongly encouraging patients not to defer routine care.

Medical offices are generally safer for patients now than they were during the first few months of the pandemic, when infectious disease protocols were not well established, and in many places surgical masks and other PPE were in short supply. But we do patients a disservice by pretending that primary care can or should return to "business as usual." Preventive services, by definition, are offered to persons without symptoms of the diseases we are trying to prevent, and false-positive test results can lead to harmful diagnostic cascades. For example, one study found that nearly 1 in 5 seniors who underwent a Medicare annual wellness visit in 2014 received at least one nonrecommended test (eg, electrocardiography, urinalysis, thyroid-stimulating hormone), and many of these "low value" tests led to further tests that required additional in-person encounters.

Even for recommended screenings, overall benefits may only exceed harms by a small margin (Ropeik D; Carr T). Compared with management of acute symptoms or chronic conditions, cancer screening does not help most patients; the best evidence indicates that one needs to screen approximately 1000 patients to avoid one death from breast, colorectal, or prostate cancer.

Last summer, current and former members of the Canadian Task Force on Preventive Health Care argued that the increased infection risk associated with an in-person healthcare visit during the pandemic should cause us to consider extending recommended screening intervals and permanently abandon the evidence-free tradition of performing annual or periodic physical examinations on adults without a specific indication. I wholeheartedly agree!

The development of effective coronavirus vaccines has raised hopes that disruptions to primary care will only persist until enough people have been immunized to make it safe to fill up our waiting rooms again. That prediction may turn out to be true, but it would be a shame to miss this once-in-a-lifetime opportunity to reassess the value of routine medical services.

Sorenson and colleagues have suggested that health professional organizations develop "do not restart" lists for their members on pandemic-deferred services that are wasteful or likely to do more harm than good; the American Board of Internal Medicine's Choosing Wisely campaign is a good place to begin. I propose that family medicine's "do not restart" list include not only outdated tests but office processes, too, including the aforementioned waiting room. As is routine in many restaurants and hair salons, patients could wait outside or in their vehicles and receive a text message when it's time for them to be seen, limiting exposure to other potentially ill persons and allowing the practice to use the no-longer-needed waiting space for another purpose.

Kenny Lin, MD, MPH, teaches family medicine, preventive medicine, and health policy at Georgetown University School of Medicine. He is deputy editor of the journalAmerican Family Physician.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

See the article here:
Ditch the Waiting Room (and Other Post-COVID Ideas) - Medscape

Every year, the month of January is celebrated as Thyroid Awareness Month to raise awareness regarding the various health problems related to the thyroid gland. The thyroid is a small, butterfly-shaped gland located at the base of the neck and plays a major role in the metabolism, growth, and development of the human body. It also helps in regulating several body functions by releasing hormones into the bloodstream.

If the thyroid gland doesnt function properly, you may develop several diseases, including hyperthyroidism, hypothyroidism, Hashimotos disease, Graves disease, goiter, and thyroid cancer.

Thyroid awareness month seeks to raise awareness regarding these diseases, their causes, symptoms, treatment, and prevention.

Symptoms of Hypothyroidism

Symptoms of Hyperthyroidism

Stand in front of a mirror, tilt back your head, and take a sip of water

Observe the area below Adams apple for signs of bulging

Repeat the process a few times and note down the observations

If you see excessive bulging, nodules, or enlarged glands, contact your physician immediately

The only way to be sure, however, is to perform a blood test that measures your thyroid hormone levels. Usually, a physician would recommend a TSH (Thyroid Stimulating Hormone) test. Depending on the amount of hormone present in your system, the physician can then zero in on the type of thyroid disorder that you may be suffering from and prescribe appropriate treatment accordingly.

It is much more difficult to diagnose thyroid-related disorders in senior citizens because many of the symptoms associated with a malfunctioning thyroid gland overlap with the symptoms of aging. Symptoms like loss of memory, weight gain, and constipation are a few examples.

January is thyroid awareness month: All you need to know about thyroid disorders

Read more| Tax benefits for investing in national pension system: Here's all you need to know

Read more from the original source:
January is thyroid awareness month: All you need to know about thyroid disorders - India Today

Since February is American Heart Health month, what better time to raise awareness of heart disease and stroke, especially among women. Did you know that heart disease is the No. 1 cause of death for women in the United States? More women than men die of heart disease, but many women are unaware of the danger theyre in.

Heart disease is a term that covers several types of diseases of the heart, blood, arteries, and veins. Having heart disease can often result in heart failure, heart attack, stroke, or peripheral artery disease. The risks for developing heart disease range from age, gender, family history, diet, blood pressure, level of cholesterol, diabetes, obesity, and stress.

It doesnt take much to improve your heart health for both men and women. In fact, heart disease is about 80 percent preventable when you make the right choices. Ready to make over your heart? Lets get started.

There are a couple of things that always need to be stressed. First, avoid cigarette smoking and secondhand smoke. The reasons are clear: Smoking contributes to the buildup of fatty substances in the arteries, increases blood pressure, and lowers good (HDL) cholesterol. Plus, a double whammy for the heart, smokers also tend to have more difficulty exercising.

You dont have to quit alone. Smoking cessation classes are offered at Bingham Memorial Hospital. For more information, please call (208) 785-3820.

Physical activity is so powerful. If you can do nothing else, move every day. People who are active are better at controlling their weight, keeping blood pressure low, and managing cholesterol levels.

You dont need to huff and puff to reap the benefits a daily 30-minute brisk walk (or three 10-minute walks) is a good start.

A healthy diet is essential to a healthy heart. Start by avoiding processed foods and loading up on fruits and vegetables. Having a colorful plate leads to heart-healthy choices. Favor vegetables over fruit preferably.

One of the keys to a healthier ticker is managing stress.

Stressful situations can start a number of chain reactions. Your body releases adrenaline, a hormone that temporarily causes your breathing and heart rate to speed up, and if youre under constant stress, this can keep happening on and off.

While researchers are still trying to understand the exact link, they do know that stress raises blood pressure levels. And for some people, it might invite unhealthy coping mechanisms, like smoking or alcohol.

So what can you do to chill out? Its easy. Youll feel better with just 20 minutes of daily laughter, meditation, yoga, or even just deep breathing.

When we dont get enough sleep, we see increases in the stress hormone cortisol and blood pressure levels. Constantly elevated cortisol and blood pressure damages the lining of the blood vessels of the heart. Try to aim for seven to eight hours of shuteye each night.

6. See Your Doctor Once a Year

High blood pressure and elevated blood sugar and cholesterol levels raise your risk of heart disease. But you wont know whether your numbers are high without seeing your family medicine provider or a cardiologist.

To promote good heart health, be sure to take care of yourself and visit your primary care physician at least once a year. Have a discussion with your primary care doctor to see where you are. If your levels are out of range, your doctor may prescribe medications that can help control these risk factors.

About Bingham Healthcare Cardiology

Bingham Healthcares cardiologists are certified to diagnose and treat disorders of the circulatory system and the cardiovascular system the heart, arteries and veins. Using the latest and state-of-the art technology, they provide initial diagnostic services, including basic cardiology evaluations, consultations, stress tests, heart pathology, and arrhythmia detection.

With complete cardiology coverage throughout Eastern Idaho, the following cardiologists are always welcoming new patients.

Call to schedule a consultation in Blackfoot: (208) 785-3897.

Call to schedule a consultation in Idaho Falls: (208) 524-9404.

Call to schedule a consultation in Pocatello: (208) 239-8027.

Dont wait until its too late to treat cardiovascular disease. Youll be glad you did.

Read the original:
Give your heart a makeover - Post Register