Archive for the ‘Hormone Physician’ Category

Dear Doctor: Our dad was diagnosed with lung cancer and will be getting chemo and radiation. Im not really sure how they work, or why he has to have both. Should we get a second opinion?

Dear Reader: We use the word cancer to refer to a group of diseases in which abnormal cells within the body begin to divide uncontrollably. They are able to evade the bodys natural defenses, and, over time, they can spread throughout the body. The goal of cancer treatment is to prevent these rogue cells from dividing. This is achieved either by killing the cancer cells outright, or disrupting their DNA, and thus their ability to divide. Radiation and chemotherapy are two of the most common cancer treatments. Although each works to stop the progress of the disease, they act in different ways.

Chemotherapy is a systemic treatment. That means that the specialized drugs used in chemotherapy are administered via the bloodstream so that they can reach and act upon cells throughout the body. More than 100 different chemotherapy medications fall into five major categories. Each of these drug categories behave in a different way, but all share the same objective. That is, to disrupt the life cycle of cells within the body that divide rapidly, which includes cancer cells.

Chemotherapy drugs are quite powerful. Because they circulate to all parts of the body, they act on all of the rapidly dividing cells in the body, including those that are not cancer. This includes hair roots, which is why hair loss occurs in many cancer patients undergoing chemo. Other common side effects include nausea, vomiting, fatigue, anemia and infection.

Radiation therapy, by contrast, is a localized treatment. It targets a specific part of the body where cancer cells are found. The powerful energy delivered via X-rays, gamma rays, electron beams or protons destroys cancer cells and damages their DNA as well. This prevents the rogue cells from dividing and growing, and thus stops their spread.

Some radiation treatments involve ingesting, injecting or implanting a radioactive substance, which either locates or binds to cancer cells. Although the effect on noncancerous cells isnt as severe in radiation therapy as it is in chemotherapy, healthy cells do get damaged. This results in side effects such as skin problems at the delivery site and fatigue.

Depending on the type of cancer and how far it has spread, its not unusual for several treatments to be used together. This includes chemotherapy and radiation therapy, as well as surgery, immunotherapy, hormone therapy and targeted drug therapies.

In certain types of lung cancer, studies have found that using chemotherapy along with radiation therapy can improve survival rates. While radiation is effective at targeting solid tumors, chemotherapy can act upon cancer cells throughout the body, including those that havent yet been identified.

Lung cancer treatment is a rapidly advancing field. For that reason, its often helpful for patients to have their case and treatment plan reviewed by a physician or medical team that specializes in the disease. To avoid unexpected costs, check with your insurer for guidance on which doctors and facilities are covered by your plan.

Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.

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Ask the Doctors: Many cancers require more than one kind of treatment - Eureka Times-Standard

By William Petri, The Conversation

I am a physician and a scientist at the University of Virginia. I care for patients and conduct research to find better ways to diagnose and treat infectious diseases, including COVID-19. Here Im sharing what is known about which treatments work, and which dont, for the new coronavirus infection.

Keep in mind that this field of medicine is rapidly evolving as our understanding of the SARS-CoV-2 virus improves. So what I am writing today may change within days or weeks.

Below are the treatments that have been tried and for which we have the best knowledge.

There are three randomized controlled trials of hydroxychloroquine, all of which have failed to prove or disprove a beneficial or harmful effect on COVID-19 clinical course or clearance of virus. Given this current lack of evidence, these drugs, which normally are used to treat arthritis, should only be used within the context of a controlled clinical trial.

The drug lopinavir is an inhibitor of an enzyme called HIV protease which is involved in the production of viral particles. Protease inhibitors for HIV were revolutionary, leading to our current ability to effectively treat HIV. Lopinavir also can inhibit enzymes that perform similar functions as the HIV protease in the SARS and MERS coronaviruses. Ritonavir increases the level of lopinavir in the blood so the lopinavir/ritonavir combination was tested in a randomized controlled clinical trial for COVID-19.

Unfortunately, there was no impact on the levels of virus in the throat or duration of viral shedding, nor did patients clinical course or survival change. There therefore is no role for lopinavir/ritonavir in the treatment of COVID-19.

When a synthetic steroid hormone, called dexamethasone, was given to patients with COVID-19 the drug decreased 28-day mortality by 17 percent and hastened hospital discharge.

This work was performed in a randomized and controlled clinical trial of over 6,000 patients, and while not replicated in another study or yet peer reviewed, is certainly enough evidence to recommend its use.

Tocilizumab is an antibody, that blocks a protein, called IL-6 receptor, from binding IL-6 and triggering inflammation. Levels of IL-6 are higher in many patients with COVID-19, and the immune system in general seems to be hyper-activated in those with the most severe disease. This leads many physicians and physicians to think that inhibiting the IL-6 receptor might protect patients from severe disease.

Tocilizumab is currently FDA approved for the treatment of rheumatoid arthritis and several other collagen-vascular diseases and for cytokine storma harmful overreaction of the immune system that can be caused by certain types of cancer therapy and COVID-19.

A retrospective observational study found that COVID-19 patients treated with tocilizumab had a lower risk of mechanical ventilation and death. But we lack a randomized controlled clinical trial so there is no way to ascertain if this apparent improvement was due to tocilizumab or from the imprecise nature of retrospective studies.

Convalescent plasma, the liquid derived from blood after removing the white and red blood cells, contains antibodies from previous infections that the plasma donor had. This plasma has been used to prevent infectious diseases including pneumonia, tetanus, diphtheria, mumps and chickenpox for over a century. It is thought to benefit patients because antibodies from the plasma of survivors bind to and inactivate pathogens or their toxins of patients. Convalescent plasma has now been used in thousands of COVID-19 patients.

However, the only randomized clinical trial was small and included just 103 patients who received convalescent plasma 14 days after they became ill. There was no difference in the time to clinical improvement or mortality between those who did and did not receive treatment. The encouraging news was that there was a significant decrease in virus levels detected by PCR.

It is therefore too early to tell if this will be beneficial and controlled clinical trials are needed.

A nurse is collecting convalescent plasma from a recovered COVID-19 patient to help the healing process of other COVID-19 patients in Indonesia. Budiono,/ Sijori images/Barcroft Media via Getty Images

Remdesivir is a drug that inhibits the coronavirus enzyme that makes copies of the viral RNA genome. It acts by causing premature stoppage or termination of the copying and ultimately blocks the virus from replicating.

Remdesivir treatment, especially for patients who required supplemental oxygen before they were placed on a ventilator reduced mortality and shortened the average recovery timefrom 15 to 11 days.

There was a concern that drugs called ACE inhibitors or angiotensin receptor blockers (ARBs), which are used to treat high blood pressure and heart failure, could increase levels of the ACE2 proteins, the receptor for SARS-CoV-2, on the surface of cells in the body. This would, physicians hypothesized, allow more entry points for the virus to infect cells and would therefore boost the severity of new coronavirus infections.

However, there is no evidence that this is the case. The American Heart Association, the Heart Failure Society of America and the American College of Cardiology all recommend that patients continue to take these medications during the pandemic as they are beneficial in the treatment of high blood pressure and heart failure.

We have made amazing progress in the treatment of COVID-19. Two therapiessteroids and Remdesivirhave already been shown to help. Those who benefit from these treatments owe thanks to patients who volunteered to participate in controlled clinical trials, and the physicians and pharmaceutical companies that lead them.

William Petri is a professor of medicine at the University of Virginia

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Surveying COVID-19 Treatments From Hydroxychloroquine and Remdesivir to Steroids and Plasma - The Daily Beast

DetailsCategory: AntibodiesPublished on Monday, 06 July 2020 14:45Hits: 328

Trodelvy significantly improved progression-free survival (PFS) and overall survival (OS) in previously-treated brain metastasis negative patients with advanced mTNBC

The safety profile of Trodelvy was consistent with the FDA-approved label and no new safety signals were observed

Trodelvy is the first antibody-drug conjugate (ADC) shown to improve clinical outcomes in people with relapsed or refractory mTNBC who have received two prior therapies

sBLA submission seeking full approval planned for later this year

MORRIS PLAINS, NJ, USA I July 06, 2020 IImmunomedics, Inc. (NASDAQ: IMMU) (Immunomedics or the Company), a leading biopharmaceutical company in the area of antibody-drug conjugates, today announced that the confirmatory Phase 3 ASCENT study of Trodelvy (sacituzumab govitecan-hziy) met its primary endpoint of progression-free survival (PFS), as well as key secondary endpoints in brain metastasis negative patients with mTNBC who have previously received at least two prior therapies for metastatic disease.

The results of the global Phase 3 ASCENT study confirm our initial observations that sacituzumab govitecan has the potential to change the standard management of mTNBC. Based on these data, sacituzumab govitecan has set a new benchmark in scientific and clinical innovation for patients with mTNBC by offering a novel alternative to the common drugs currently in clinical practice. Importantly, the ASCENT topline data also validate the manageable safety profile of sacituzumab govitecan, rendering it a good partner candidate for combination with other therapies, including immunotherapy, stated the study principal investigator, Aditya Bardia, MD, MPH, Director of Precision Medicine at the Center for Breast Cancer, Mass General Cancer Center and Assistant Professor of Medicine at Harvard Medical School.

In the ASCENT study, Trodelvy demonstrated a statistically significant improvement in the primary endpoint of PFS compared to chemotherapy, with a hazard ratio of 0.41 (95% confidence interval (CI), 0.32-0.52). The median PFS for patients treated with Trodelvy was 5.6 months (95% CI, 4.3-6.3), compared to 1.7 months (95% CI, 1.5-2.6) for chemotherapy (p<0.0001). Trodelvy also met key secondary endpoints of the study, including overall survival and objective response rate. The safety profile of Trodelvy observed in the ASCENT study remained consistent with the U.S. Food and Drug Administration (FDA)-approved label, with neutropenia and diarrhea as the most common Grade 3 or 4 adverse events and no new safety signals were observed. Full results will be presented at an upcoming medical conference.

Given the poor prognosis associated with mTNBC, we are excited that Trodelvy demonstrated improved clinical outcomes for these patients, said Dr. Loretta M. Itri, Chief Medical Officer of Immunomedics. We are grateful to all the patients, their families and healthcare providers, as well as our colleagues at Immunomedics, who participated in the ASCENT study and overcame many obstacles, including the COVID-19 pandemic, to complete the collection and analyses of these important data. We look forward to presenting full results at an upcoming medical conference, as well as sharing them with the FDA in support of the full approval of Trodelvy in this difficult-to-treat cancer.

Trodelvy was recently approved by the FDA as a third-line treatment for adult patients with mTNBC under the agencys Accelerated Approval Program based on the objective response rate and duration of response observed in a single-arm, multicenter Phase 2 study. The Phase 3 confirmatory ASCENT study was designed under an FDA Special Protocol Assessment (SPA) to validate the promising safety and efficacy activity of Trodelvy that supported its accelerated approval.

It is gratifying to see the final confirmatory results of Trodelvy in a randomized study supporting the previously reported Phase 2 data that formed the basis of the accelerated approval of Trodelvy. These results provide important additional information for patients and their treating physicians to understand the definitive benefits they are deriving, commented Dr. Behzad Aghazadeh, Executive Chairman of Immunomedics. Importantly, the strong ASCENT data reinforce the promise of our unique ADC technology and embolden us to continue our work to change the treatment paradigm for patients with difficult-to-treat cancers.

Trodelvy carries a black box warning for severe neutropenia and severe diarrhea. The most common adverse reactions occurring in 25 or more percent of patients included nausea, neutropenia, diarrhea, fatigue, anemia, vomiting, alopecia, constipation, decreased appetite, rash and abdominal pain. The most common Grade 3 or 4 adverse events occurring in more than 5 percent of patients were neutropenia, white blood cell count decreased, anemia, hypophosphatemia, diarrhea, fatigue, nausea and vomiting. Two percent of patients discontinued treatment due to adverse events. There were no deaths related to treatment and no severe cases of neuropathy or interstitial lung disease.1

Conference Call

The Company will host a conference call and live audio webcast today at 8:00 a.m. Eastern Time to discuss the ASCENT data. To access the conference call, please dial (877) 303-2523 or (253) 237-1755 using the Conference ID 8872919. The conference call will be webcast via the Investors page on the Companys website at https://immunomedics.com/investors/. Approximately two hours following the live event, a webcast replay of the conference call will be available on the Companys website for approximately 30 days.

About ASCENT

The international, open-label confirmatory Phase 3 study enrolled more than 500 patients with metastatic triple-negative breast cancer who had received at least two prior therapies for metastatic disease. Patients were randomized to receive either Trodelvy or a physicians choice of chemotherapy. The primary endpoint of the study was progression-free survival. Secondary endpoints include overall survival, objective response rate, duration of response, time to onset of response, and other measures of safety and tolerability. More information about ASCENT is available at http://clinicaltrials.gov/show/NCT02574455.

About TRODELVY

Trodelvy (sacituzumab govitecan-hziy) is the lead product and the most advanced program in Immunomedics unique antibody-drug conjugate (ADC) platform. Trodelvy is an ADC that is directed against Trop-2, a cell-surface protein expressed in many solid cancers. Trodelvy binds to Trop-2 and delivers the anti-cancer drug, SN-38, to kill cancer cells. Immunomedics has an extensive development program for Trodelvy, including multiple ongoing studies in triple-negative breast cancer, metastatic urothelial cancer, hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer, and metastatic non-small cell lung cancer, either as a monotherapy or in combination with other agents. Visit https://www.trodelvy.com/ for more information.

About triple-negative breast cancer (TNBC)

TNBC is an aggressive type of breast cancer, accounting for up to 20 percent of all breast cancers. The disease is diagnosed more frequently in younger and premenopausal women and is highly prevalent in African American and Hispanic women. TNBC cells do not have estrogen or progesterone hormone receptors, or very much of the human epidermal growth factor receptor 2 hence the term triple negative. This means that medicines that target these receptors are not typically effective in TNBC. There is currently no approved standard of care for people with previously-treated mTNBC.

About Immunomedics

Immunomedics is a leader in next-generation antibody-drug conjugate (ADC) technology, committed to help transform the lives of people with hard-to-treat cancers. Our proprietary ADC platform centers on using a novel linker that does not require an enzyme to release the payload to deliver an active drug inside the tumor cell and the tumor microenvironment, thereby producing a bystander effect. Trodelvy, our lead ADC, is the first ADC the FDA has approved for the treatment of people with metastatic triple-negative breast cancer and is also the first FDA-approved anti-Trop-2 ADC. For additional information on the Company, please visit its website at https://immunomedics.com/. The information on its website does not, however, form a part of this press release.

Reference

1. TRODELVY Prescribing Information. Morris Plains, NJ: Immunomedics Inc, 2020.

SOURCE: Immunomedics

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Immunomedics Announces Positive Results from Phase 3 ASCENT Study of TRODELVY in Previously-Treated Patients with Metastatic Triple-Negative Breast...

Arts and CultureBooksThe controversy surrounding JK Rowling had continued as the writer published statements comparing hormone treatment for transgender people to conversion therapy and fellow writer Margaret Atwood has now weighed in

Tuesday, 7th July 2020, 2:41 pm

The controversy concerning the writer initially occurred after she responded to an article discussing menstruation products, taking issue with the phrase people who menstruate.

She has since gone on to release personal essays about the subject, received backlash from fans and Harry Potter stars alike.

This is everything you need to know about the situation.

On Saturday 6 June, JK Rowling quote tweeted an article with the title: Opinion: Creating a more equal post-COVID-19 world for people who menstruate.

Rowling took issue with the phrasing, tweeting: People who menstruate. Im sure there used to be a word for those people. Someone help me out. Wumben? Wimpund? Woomud?

The tweet sparked criticism, with some users taking issue with Rowling appearing to define women as people who menstruate.

In response to Rowlings tweet, some Twitter users highlighted that transgender men experience menstruation, transgender women dont, and other gender identities across the spectrum could also experience periods as well.

Why are the authors tweets being called transphobic?

Rowlings insistence that only women experience menstruation has been criticised as being transphobic by some Twitter users, who have pointed out that her comments are just not accurate when it comes to people who menstruate.

One person wrote: Trans men who havent transitioned still menstruate.

Another tweeted: I know you know this because you have been told over and over and over again, but transgender men can menstruate. Non-binary people menstuate. I, a 37 year old woman with a uterus, have not menstruated in a decade. Women are not defined by their periods.

The official Clue Twitter, an app designed to track menstrual cycles, also responded to the tweet, writing: Hi @jk_rowling, using non-gendered language is about moving beyond the idea that woman = uterus. Feminists were once mocked for wanting to change sexist language, but its now common to say firefighter instead of fireman.

It seems awkward right now to say people who menstruate but this is just like changing other biased language. Menstruation is a biological function; not a woman thing. Its unnecessary to gender body parts and doing so can restrict healthcare access for those who need it.

LGBTQ+ organisation GLAAD (Gay & Lesbian Alliance Against Defamation) responded to Rowlings comments, tweeting: JK Rowling continues to align herself with an ideaology which willfully distorts facts about gender identity and people who are trans. In 2020, there is no excuse for targeting trans people.

GLAAD followed up by recommending people check out the Percy Jackson series by author Rick Riordan.

By the way, looking for some summer reading? Percy Jacson author Rick Riordan isnt transphobic #AllKidsDeserveRepresensation, the non-profit organisation wrote.

Rowling responded to the backlash by posting a series of tweets to defend her earlier statements.

She tweeted: I know and love trans people, but erasing the concept of sex removes the ability of many to meaningfully discuss their lives. It isnt hate to speak the truth.

The idea that women like me, whove been empathetic to trans people for decades, feeling kinship because theyre vulnerable in the same way as women - ie, to male violence - hate trans people because they think sex is real and has lived consequences - is nonsense.

These additional comments were also met with subsequent backlash, with users labelling Rowling a TERF which stands for Trans Exclusionary Radical Feminist.

One person replied to her tweets, writing: As a physician, I want people to know that sex exists on a bimodal biological specturm just like gender exists on a bimodal sociological spectrum. While most identify as either female or male, there are intersex and trans individuals who identities are just as valid and real.

Another wrote: Youre a smart person. How d you not yet understand the difference between sex and gender? The only way I can possibly explain your ignorance at this point is willfulness. Its incredibly disappointing.

Someone else tried to explain how Rowling equating sex and gender was wrong, writing: Were not saying sex isnt real. Were saying its different from gender. My assigned sex at birth was male. But I identify as a woman.

TV presenter Jonathan Ross, however, came to the writer's defence, tweeting: I just ate too many brownies. Again. Oh, and also. @jk_rowling is both right and magnificent. For those accusing her of transphobia, please read what she wrote. She clearly is not.

Ross daughter, Honey, on the other hand criticised Rowling for her comments hours after her father went to her defence.

Honey took to Instagram, sharing a photoshopped picture of the cover of Harry Potter and the Order of the Phoenix which had been changed to read Harry potter and the Audacity of This B***h. Honey then also shared a tweet by a user who accused Rowling of hating trans people.

Ross then returned to Twitter later to take back his initial support for Rowling, tweeting: These who know me will concede I try to be thoughtful & not a d***.

Having talk to some people (OK, my daughters) re my earlier tweet, Ive come to accept that Im not in a position to decide what is or isnt considered transphobic.

Whats the blog post that Rowling published about?

On 10 June, the author posted a tweet that read TERF wars with a link to her website for a blog post titled: J.K. Rowling writes about her reasons for speaking out on sex and gender issues.

In the post, she revealed her experience with domestic abuse and sexual assault for the first time.

She wrote: Im mentioning these things now not in an attempt to garner sympathy, but out of solidarity with the huge numbers of women who have histories like mine, whove been slurred as bigots for having concerns around single-sex spaces.

In the 3,600 word essay, Rowling writes about her struggles with sexism and misogyny, adding that reading accounts of gender dysphoira by trans men had made her wonder if Id been born 30 years later, I too might have tried to transition.

She wrote that she believed that misogyny and sexism were reasons behind the 4,400 per cent increase in the number of girls being referred for transitioning treatment in the past decade.

The essay has prompted heated debate online, with many Twitter users creating threads to debunk some claims about trans people that Rowling made in the essay, and with stars from the Harry Potter franchises responding to Rowlings comments.

Did she compare hormone treatment to gay conversion therapy?

On 5 July, Rowling began a new Twitter thread to respond to a tweet that read: Who had money on JK Rowling pivoting to supporting those who call people who take mental health medication lazy? I take daily medication to function, this sentiment is beyond offensive, it is actively harmful to millions.

In response, Rowling wrote: Ive ignored fake tweets attributed to me and RTed widely. Ive ignored porn tweeted at children on a thread about their art. Ive ignored death and rape threats. Im not going to ignore this. 1/11.

In the thread, Rowling discussed her own mental health challenges and how she herself has taken anti-depressants in the past to help her.

She went on to write: Many, myself included, believe we are watching a new kind of conversion therapy for young gay people, who are being set on a lifelong path of medicalisation that may result in the loss of their fertility and/or full sexual function.

She wrote that transition may be the answer for some, but not for all and posted a link to an account of a woman who destransitioned after briefly living as a trans man.

According to LGBT+ organisation Stonewall, detransitioning is extremely rare according to a 2019 study which showed that of the 3,398 trans patients who spoke to the NHS Gender Identity Service between 2016 and 2017, less than one per cent expressed regrets about transitioning or had detransitioned.

Her comments comparing hormone replacement therapy to gay conversion therapy has come under fire from a number of trans activists and allies.

Transgender model and activist Munroe Bergdorf tweeted: J.K. Rowling is not a scientist. She is not a doctor. She is not an expert on gender. She is not a supporter of our community.

She is a billionaire, cisgender, heterosexual, white woman who has decided she knows what is best for us and our bodies. This is not her fight.

She added: If you want to know what is best for trans people, listen to trans people.

Nikkie de Jager, a YouTube makeup artist and transgender woman, tweeted: and to think I was such a fan of Harry Potter. youre a disgrace @jk_rowling. you have no idea how much hurt youre causing. shame on you.

Artist Juno Birch also tweeted: "JK Rowling needs to be quiet immediately she is literally harming the trans community, she apparently just posted the clinic I went to as a child and said that they are experimenting on us, when in fact the Tavistock clinic saved my life.

What did Lloyd Russell-Moyle say?

Lloyd Russell-Moyle, a Labour MP, wrote an article in Tribune magazine which stated that the Harry Potter writer disclosure of experience of domestic abuse was part of a divide and rule tactic to undermine efforts to cement rights for transgender people.

In the article, Russell-Moyle wrote: Recently, of course, we saw people like JK Rowling using her own sexual assault as justification for discriminating against a group of people who were not responsible for it.

After the article sparked backlash against the MP, Russell-Moyle took to Twitter to issue an apology for his words.

He wrote: I want to apologies unreservedly about the comments in the article that I wrote that last in Tribune regarding Trans rights in which I mention J.K Rowling. J.K Rowlings first disclosures of domestic abuse and sexual assault in her recent article on Trans issues were heartfelt and must have been hard to say.

While I may disagree with some of her analysis on trans rights, it is wrong of me to suggest that she used her own dreadful experience in anything other than good faith. I have asked Tribune to remove the line in question.

How did Stephen King get involved?

Popular supernatural writer Stephen King got involved in the online controversy after retweeting a tweet by Rowling.

The tweet read: Andrea Dworkin wrote: Men often react to womens words speaking and writing as if they were acts of violence; sometimes men react to womens words with violence. It isnt hateful for women speak about their own experiences, nor do they deserve shaming for doing so. 8/9

The tweet was part of thread that Rowling wrote in response to the statements made by Russell-Moyle.

After her tweet was retweeted by King, Rowling wrote on Twitter: Ive always revered @StephenKing, but today my love reached maybe not Annie Wilkes levels but new heights.

Fans of the writer tweeted him to clarify his stance on transgender issues.

One wrote: You should address the TERF tweet. By telling us constant readers if you believe trans women are women.

King replied succinctly, writing: Yes. Trans women are women.

After his response to a fan affirming that trans women are women, Rowling subsequently deleted her tweet which praised The Shining author.

What did Margaret Atwood say?

The writer behind The Handmaid's Tale, Margaret Atwood, showed her support for the transgender community in a series of tweets on Monday 6 July.

She wrote: Some science here: When Sex and Gender Collide. #TransGenderWomen Biology doesnt deal in sealed Either/Or compartments. Were all part of a flowing Bell curve. Respect that! Rejoice in Natures infinite variety!

In the tweet, Atwood included a link to a Scientific American article titled The New Science of Sex and Gender: Why the new science of sex & gender matters for everyone.

Responding to critics, she followed up her tweets by writing: What the piece is talking about is that sex and gender dont always go together and are not experienced by all people in the same way. That appears to be undeniable.

Atwood followed up again on Twitter, writing: Nobody has said there arent men + women. But gender and sex are two different things.

How have Harry Potter stars responded?

Various members of the Harry Potter cast have taken to Twitter and other online platforms to respond to Rowlings comments.

Daniel Radcliffe, who played the titular character of Harry Potter himself in the film adaptations of Rowling's books, wrote a statement on the Trevor Project website, a charity that provides crisis intervention and suicide prevention for LGBTQ+ youth and one that Radcliffe has been involved with for over a decade.

Radcliffe wrote: While Jo is unquestionably responsible for the course my life has taken, as someone who has been honoured to work with and continues to contribute to The Trevor Project for the last decade, and just as a human being, I feel compelled to say something at this moment.

Transgender women are women. Any statement to the contrary erases the identity and dignity of transgender people and goes against all advice given by professional health care associations who have far more expertise on this subject matter than either Jo or I.

He added: It's clear that we need to do more to support transgender and nonbinary people, not invalidate their identities, and not cause further harm.

Emma Watson, who portrayed Hermione Granger, took to Twitter to write: Trans people are who they say they are and deserve to live their lives without being constantly questioned or told they arent who they say they are. I want my trans followers to know that I and so many other people around the world see you, respect you and love you for who you are.

I donate to @Mermaids_Gender and @mamacash. If you can, perhaps youll feel inclined to do the same.

All three stars the portrayed the trio in the films have now weighed in on the controversy, with Rupert Grint, who played Ron Weasely, also releasing a statement that said: I firmly stand with the trans community. Trans women are women. Trans men are men. We should all be entitled to live with love and without judgement.

Bonnie Wright, who played Ginny Weasley, tweeted: If Harry Potter was a source of love and belonging for you, that love is infinite and there to take without judgement or question. Transwomen are women. I see and love you, Bonnie x

Evanna Lynch, who plays Luna Lovegood in the Harry Potter series, shared screenshots from the iPhone notes app on Twitter responding to Rowlings comments.

The notes started by saying: I wanted to stay out of commenting on JKRs tweets because it feels impossible to address the subject on Twitter but I am so saddened to see trans people feeling abandoned by the HP community, so here are my thoughts.

The post continues: I disagree with her opinion that cis-women are the most vulnerable minority in this situation and I think shes on the wrong side of this debate.

Eddie Redmayne, who stars at Newt Scarmander in the Fantastic Beasts and Where to Find Them series, published a statement via Variety, which said: Respect for transgender people remains a cultural imperative, and over the years I have been trying to constantly educate myself. This is an ongoing process.

As someone who has worked with both J.K Rowling and members of the trans community, I wanted to make it absolutely clear where I stand. I disagree with Jos comments.

Redmayne continued: Trans women are women, trans men are men, and non-binary identities are valid. I would never want to speak on behalf of the community but I do know that my dear transgender friends and colleagues are tired of this constant questioning of their identities, which all too often results in violence and abuse. They simply want to live their lives peacefully, and its time to let them do so.

Warner Bros. also issued a statement in light of the controversy with Rowling.

The statement read: The events in the last several weeks have firmed our resolve as a company to confront difficult societal issues. Warner Bros. position on inclusiveness is well established, and fostering a diverse and inclusive culture has never been more important to our company and to our audiences around the world, the company said in a statement.

We deeply value the work of our storytellers who give so much of themselves in sharing their creations with us all. We recognize our responsibility to foster empathy and advocate understanding of all communities and all people, particularly those we work with and those we reach through our content.

Has Rowling made statements like this in the past?

Rowling has come under criticism before for similar comments in the past.

In December 2019, she came out in support of a researcher who had lost her job after saying a person could not change their biological sex.

The researcher, Maya Forstater, had lost her job after tweeting: Why I am so surprised at is that smart people who I admire, who are absolutely pro-science in other areas, and champion human rights & womens rights are tying themselves into knots to avoid saying the truth that men cannot change into women (because that might hurt men's feelings).

Rowling took to Twitter and wrote: Dress however you please. Call yourself whatever you like. Sleep with any consenting adult wholl have you. Live your best life in peace and security. But force women out of their jobs for stating that sex is real? #IStandWithMaya #ThisIsNotADrill.

GLAAD previously issued a statement in regards to Rowling's comments.

Anthony Ramon, head of talent at GLAAD, said: J.K Rowling, whose books gave kids hope that they could work together to create a better world, has now aligned herself with an anti-science ideology that denies the basic humanity of people who are transgender.

Trans men, trans women and non-binary people are not a threat, and to imply otherwise puts trans people at risk. Now is the time for allies who know and support trans people to speak up and support their fundamental right to be treated equally and fairly.

Read more here:
JK Rowling on Twitter: why has the Harry Potter writer been accused of transphobia - and her latest tweets on conversion therapy explained - The...

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Clinical Chemistry Technology segment to dominate the Endocrine Testing Market

Commercial Laboratories Segment to be the Fastest Growing in theEndocrine Testing Market

North America to Dominate Global Endocrine Testing Market

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Endocrine Testing Market is Anticipated to Expand at a CAGR of 6.4% from 2019 to 2027 - Science Examiner

What is Norditropin, prefilled pen injection and what is it used for?

Therapeutic class: Somatropin and Somatropin Agonists

Norditropin HGH Injections

Norditropin HGH pens contain the human growth hormone analog somatropin, which is identical to the growth hormone naturally produced by the human body. Children need the growth hormone to promote their growth, but adults also need it for their general health.

In children, Norditropin is used to treat growth disorders:

In adults, Norditropin is used as a growth hormone replacement when its production has been reduced from childhood or stopped in adulthood due to a tumor, tumor treatment, or pituitary gland disease. If treated for HGH deficiency in your childhood, the persistence of this deficiency will be reassessed when growth is complete. If the growth hormone deficiency is confirmed, further treatment is necessary. Somatropin can also be prescribed to those experiencing wasting caused by HIV.

Read Also: HGH Benefits: What to Expect From Using Human Growth Hormone

Never use Norditropin prefilled pen injections:

Warnings and precautions

Talk to your doctor or pharmacist before using Norditropin:

Tell your doctor or pharmacist if you are using or have recently used any of the following medications:

Read Also: Anti-Aging: HGH Can Reduce Biological Age by One Year and a Half Study Shows

Products containing somatropin are not recommended for women of childbearing age who do not use contraception.

Norditropin has no effect on the ability to drive vehicles and operate machinery.

Always use this medicine exactly as directed by your physician. Consult your doctor or pharmacist if you are unsure.

In children, the dose depends on weight and body surface area. After childhood, the dose depends on height, weight, sex, and sensitivity to growth hormone and is adjusted until the optimal dose is reached.

When using Norditropin 5 mg/1.5 mL, prefilled pen injection solution

Inject your daily dose under the skin every evening just before bedtime.

How to use Norditropin pen?

Do not share on your Norditropin pen with other people.

If you have accidentally used more Norditropin than you needed Consult your doctor or pharmacist immediately!

If you have injected too much somatropin, talk to your doctor. Prolonged somatropin overdose may cause abnormal growth and thickening of the facial features (Acromegaly).

If you forgot to use Norditropin:

Take the next usual dose at the usual time. Do not take a double dose to make up for the lost dose.

When discontinuing Norditropin injections do not stop taking Norditropin without first consulting your doctor.

If you have further questions about the use of this medicine, ask your doctor or pharmacist for more information.

Like all medicines, this medicine may have side effects. However, these side effects do not always occur in everyone.

Adverse reactions in children and adults (frequency not known) :

If you experience any of these effects, consult a doctor as soon as possible. Stop taking Norditropin until your doctor tells you to start taking it again.

The formation of antibodies that act directly against somatropin has rarely been observed during treatment with Norditropin.

High concentrations of liver enzymes have been reported.

Leukemia and recurrent brain tumors have also been reported in patients treated with somatropin (the active ingredient of Norditropin), although there is no evidence that somatropin is the cause.

If you think you have any of these conditions, talk to your doctor.

Additional side effects in children:

Unusual (may affect up to 1 in 100 children):

Rare (may affect up to 1 in 1,000 children):

Rare cases of hip and knee pain and limping have been reported in children taking Norditropin. These symptoms may be related to a disorder of the femur (Legg-Calve-Perthes disease) or slippage of the tip of the femur in relation to the cartilage (epiphysiolysis of the femoral head) and may not be due to Norditropin.

Read Also: Do HGH Supplements Like Genf20 Plus, Growth Factor Plus, GenfX, Hypergh 14X, HGH X2 and Provacyl Work?

In children with Turner syndrome, clinical studies have observed some cases of increased growth of hands and feet in relation to height.

A clinical study in children with Turner syndrome showed that high doses of Norditropin may increase the risk of ear infections.

If any of these side effects affect you significantly, or if you notice any side effects not listed in this guide, you should talk to your doctor or pharmacist as the dose may be reduced.

Additional adverse reactions in adults

Very common (may affect more than 1 in 10 adults):

Unusual (may affect up to 1 in 100 adults):

If you experience any side effects, talk to your doctor or pharmacist. This also applies to any side effects not mentioned in this article. You can also report adverse reactions directly to the FDA.

By reporting adverse reactions, it helps to provide more information on the safety of the medicine.

Read Also: Increasing Height: Can HGH Help You Grow Taller?

Keep the medicine out of sight and out of the reach of children.

Do not use this medicine after the expiry date shown on the container.

Store unused Norditropin in a refrigerator (between 2C and 8C) away from light. Do not freeze or expose to heat.

After starting to use Norditropin store the opened pen in a refrigerator (between 2C and 8C) for up to 4 weeks or store at room temperature (not above 25C) for up to 3 weeks

Do not continue to use a Norditropin pen that has been frozen or exposed to excessive temperatures.

Do not use Norditropin Pen if the growth hormone solution inside is opaque or discolored.

Always store Norditropin without a needle.

Always keep the cap of the Norditropin Pen closed when not in use.

Always use a new needle for each injection.

Do not dispose of drugs in the sewerage system or with household waste. Ask your pharmacist to dispose of medicines that you no longer use. This will help to protect the environment.

Read Also: Growing Taller as an Adult: Is It Possible?

Norditropin is presented as a clear, colorless injectable HGH solution in a pre-filled 1.5 mL multi-dose disposable pen.

Norditropin is available in three strengths:

5 mg/1.5 mL, 10 mg/1.5 mL and 15 mg/1.5 mL (3.3 mg/mL, 6.7 mg/mL and 10 mg/mL respectively).

https://www.norditropin.com/

Read more from the original source:
Norditropin: The facts about this Prescription HGH Brand - Gilmore Health News

Our dad was diagnosed with lung cancer and will be getting chemo and radiation. Im not really sure how they work, or why he has to have both. Should we get a second opinion?

Dear Reader: We use the word cancer to refer to a group of diseases in which abnormal cells within the body begin to divide uncontrollably. They are able to evade the bodys natural defenses, and, over time, they can spread throughout the body. The goal of cancer treatment is to prevent these rogue cells from dividing. This is achieved either by killing the cancer cells outright, or disrupting their DNA, and thus their ability to divide. Radiation and chemotherapy are two of the most common cancer treatments. Although each works to stop the progress of the disease, they act in different ways.

Chemotherapy is a systemic treatment. That means that the specialized drugs used in chemotherapy are administered via the bloodstream so that they can reach and act upon cells throughout the body. More than 100 different chemotherapy medications fall into five major categories. Each of these drug categories behave in a different way, but all share the same objective. That is, to disrupt the life cycle of cells within the body that divide rapidly, which includes cancer cells.

Chemotherapy drugs are quite powerful. Because they circulate to all parts of the body, they act on all of the rapidly dividing cells in the body, including those that are not cancer. This includes hair roots, which is why hair loss occurs in many cancer patients undergoing chemo. Other common side effects include nausea, vomiting, fatigue, anemia and infection.

Radiation therapy, by contrast, is a localized treatment. It targets a specific part of the body where cancer cells are found. The powerful energy delivered via X-rays, gamma rays, electron beams or protons destroys cancer cells and damages their DNA as well. This prevents the rogue cells from dividing and growing, and thus stops their spread.

Some radiation treatments involve ingesting, injecting or implanting a radioactive substance, which either locates or binds to cancer cells. Although the effect on noncancerous cells isnt as severe in radiation therapy as it is in chemotherapy, healthy cells do get damaged. This results in side effects such as skin problems at the delivery site and fatigue.

Depending on the type of cancer and how far it has spread, its not unusual for several treatments to be used together. This includes chemotherapy and radiation therapy, as well as surgery, immunotherapy, hormone therapy and targeted drug therapies.

In certain types of lung cancer, studies have found that using chemotherapy along with radiation therapy can improve survival rates. While radiation is effective at targeting solid tumors, chemotherapy can act upon cancer cells throughout the body, including those that havent yet been identified.

Lung cancer treatment is a rapidly advancing field. For that reason, its often helpful for patients to have their case and treatment plan reviewed by a physician or medical team that specializes in the disease. To avoid unexpected costs, check with your insurer for guidance on which doctors and facilities are covered by your plan.

More:
Many cancers require more than one kind of treatment - Brunswick News

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I am a physician and a scientistat the University of Virginia. I care for patients and conduct research to find better ways to diagnose and treat infectious diseases, including COVID-19. Here Im sharing what is known about which treatments work, and which dont, for the new coronavirus infection.

Keep in mind that this field of medicine is rapidly evolving as our understanding of the SARS-CoV-2 virus improves. So what I am writing today may change within days or weeks.

Below are the treatments that have been tried and for which we have the best knowledge.

There arethree randomized controlled trialsof hydroxychloroquine, all of which have failed to prove or disprove a beneficial or harmful effect on COVID-19 clinical course or clearance of virus. Given this current lack of evidence, these drugs, which normally are used to treat arthritis, shouldonly be used within the context of a controlled clinical trial.

The drug Lopinavir is an inhibitor of an enzyme called HIV protease which is involved in the production of viral particles. Protease inhibitors for HIV were revolutionary, leading to our current ability to effectively treat HIV. Lopinavir also can inhibit enzymes that perform similar functions as the HIV protease in theSARS and MERS coronaviruses. Ritonavir increases the level of Lopinavir in the blood so the lopinavir/ritonavir combination was tested in a randomized controlled clinical trial for COVID-19.

Unfortunately, there was no impact on the levels of virus in the throat or duration of viral shedding, nor did patients clinical course or survival change. There therefore isno role for lopinavir/ritonavir in the treatment of COVID-19.

When a synthetic steroid hormone, called dexamethasone, was given to patients with COVID-19 the drug decreased28-day mortality by 17% and hastened hospital discharge.

This work was performed in arandomized and controlled clinical trialof over 6,000 patients, and while not replicated in another study or yet peer reviewed, is certainly enough evidence to recommend its use.

Tocilizumab is anantibody, that blocks a protein, called IL-6 receptor, from binding IL-6 and triggering inflammation. Levels of IL-6 are higher in many patients with COVID-19, and the immune system in general seems to be hyperactivated in those with the most severe disease. This leads many physicians and physicians to think that inhibiting the IL-6 receptor might protect patients from severe disease.

Tocilizumab is currently FDA approved for the treatment of rheumatoid arthritis and several other collagen-vascular diseases and for cytokine storm a harmful overreaction of the immune system that can be caused by certain types of cancer therapy and COVID-19.

A retrospective observational studyfound that COVID-19 patients treated with tocilizumab had a lower risk of mechanical ventilation and death. But we lack a randomized controlled clinical trial so there is no way to ascertain if this apparent improvement was due to tocilizumab or from the imprecise nature of retrospective studies.

Convalescent plasma, the liquid derived from blood after removing the white and red blood cells, contains antibodies from previous infections that the plasma donor had. This plasma has been used to prevent infectious diseases including pneumonia, tetanus, diphtheria, mumps and chickenpox for over a century. It is thought to benefit patients because antibodies from the plasma of survivors bind to and inactivate pathogens or their toxins of patients. Convalescent plasma has now been used in thousands of COVID-19 patients.

However, the only randomized clinical trial was small and included just 103 patients who received convalescent plasma 14 days after they became ill. There wasno difference in the time to clinical improvement or mortalitybetween those who did and did not receive treatment. The encouraging news was that there was a significant decrease in virus levels detected by PCR.

It is therefore too early to tell if this will be beneficial and controlled clinical trials are needed.

Remdesivir is a drug that inhibits the coronavirus enzymethat makes copies of the viral RNA genome. It acts by causing premature stoppage or termination of the copying and ultimately blocks the virus from replicating.

Remdesivir treatment, especially for patients who required supplemental oxygen before they were placed on a ventilatorreduced mortality and shortened the average recovery timefrom 15 to 11 days.

There was a concern that drugs calledACE inhibitorsor angiotensin receptor blockers (ARBs), which are used to treat high blood pressure and heart failure, could increase levels of the ACE2 proteins, the receptorfor SARS-CoV-2,on the surface of cells in the body. This would, physicians hypothesized, allow more entry points for the virus to infect cells and would therefore boost the severity of new coronavirus infections.

However, there is no evidence that this is the case. The American Heart Association, the Heart Failure Society of America and the American College of Cardiology all recommend that patients continue to take these medications during the pandemic as they arebeneficial in the treatment of high blood pressure and heart failure.

We have made amazing progress in the treatment of COVID-19. Two therapies steroids and Remdesivir have already been shown to help. Those who benefit from these treatments owe thanks to patients who volunteered to participate in controlled clinical trials, and the physicians and pharmaceutical companies that lead them.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Also read:Dexamethasone, favipiravir, plasma therapy how Indias Covid care has evolved in 5 months

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Remdesivir to HCQ: What works against Covid-19, and what doesnt - ThePrint

Courtesy of William Petri, University of Virginia

I am a physician and a scientist at the University of Virginia. I care for patients and conduct research to find better ways to diagnose and treat infectious diseases, including COVID-19. Here Im sharing what is known about which treatments work, and which dont, for the new coronavirus infection.

Keep in mind that this field of medicine is rapidly evolving as our understanding of the SARS-CoV-2 virus improves. So what I am writing today may change within days or weeks.

Below are the treatments that have been tried and for which we have the best knowledge.

There are three randomized controlled trials of hydroxychloroquine, all of which have failed to prove or disprove a beneficial or harmful effect on COVID-19 clinical course or clearance of virus. Given this current lack of evidence, these drugs, which normally are used to treat arthritis, should only be used within the context of a controlled clinical trial.

The drug Lopinavir is an inhibitor of an enzyme called HIV protease which is involved in the production of viral particles. Protease inhibitors for HIV were revolutionary, leading to our current ability to effectively treat HIV. Lopinavir also can inhibit enzymes that perform similar functions as the HIV protease in the SARS and MERS coronaviruses. Ritonavir increases the level of Lopinavir in the blood so the lopinavir/ritonavir combination was tested in a randomized controlled clinical trial for COVID-19.

Unfortunately, there was no impact on the levels of virus in the throat or duration of viral shedding, nor did patients clinical course or survival change. There therefore is no role for lopinavir/ritonavir in the treatment of COVID-19.

When a synthetic steroid hormone, called dexamethasone, was given to patients with COVID-19 the drug decreased 28-day mortality by 17% and hastened hospital discharge.

This work was performed in a randomized and controlled clinical trial of over 6,000 patients, and while not replicated in another study or yet peer reviewed, is certainly enough evidence to recommend its use.

Tocilizumab is an antibody, that blocks a protein, called IL-6 receptor, from binding IL-6 and triggering inflammation. Levels of IL-6 are higher in many patients with COVID-19, and the immune system in general seems to be hyperactivated in those with the most severe disease. This leads many physicians and physicians to think that inhibiting the IL-6 receptor might protect patients from severe disease.

Tocilizumab is currently FDA approved for the treatment of rheumatoid arthritis and several other collagen-vascular diseases and for cytokine storm a harmful overreaction of the immune system that can be caused by certain types of cancer therapy and COVID-19.

A retrospective observational study found that COVID-19 patients treated with tocilizumab had a lower risk of mechanical ventilation and death. But we lack a randomized controlled clinical trial so there is no way to ascertain if this apparent improvement was due to tocilizumab or from the imprecise nature of retrospective studies.

Convalescent plasma, the liquid derived from blood after removing the white and red blood cells, contains antibodies from previous infections that the plasma donor had. This plasma has been used to prevent infectious diseases including pneumonia, tetanus, diphtheria, mumps and chickenpox for over a century. It is thought to benefit patients because antibodies from the plasma of survivors bind to and inactivate pathogens or their toxins of patients. Convalescent plasma has now been used in thousands of COVID-19 patients.

However, the only randomized clinical trial was small and included just 103 patients who received convalescent plasma 14 days after they became ill. There was no difference in the time to clinical improvement or mortality between those who did and did not receive treatment. The encouraging news was that there was a significant decrease in virus levels detected by PCR.

It is therefore too early to tell if this will be beneficial and controlled clinical trials are needed.

Remdesivir is a drug that inhibits the coronavirus enzyme that makes copies of the viral RNA genome. It acts by causing premature stoppage or termination of the copying and ultimately blocks the virus from replicating.

Remdesivir treatment, especially for patients who required supplemental oxygen before they were placed on a ventilator reduced mortality and shortened the average recovery time from 15 to 11 days.

There was a concern that drugs called ACE inhibitors or angiotensin receptor blockers (ARBs), which are used to treat high blood pressure and heart failure, could increase levels of the ACE2 proteins, the receptor for SARS-CoV-2, on the surface of cells in the body. This would, physicians hypothesized, allow more entry points for the virus to infect cells and would therefore boost the severity of new coronavirus infections.

However, there is no evidence that this is the case. The American Heart Association, the Heart Failure Society of America and the American College of Cardiology all recommend that patients continue to take these medications during the pandemic as they are beneficial in the treatment of high blood pressure and heart failure.

We have made amazing progress in the treatment of COVID-19. Two therapies steroids and Remdesivir have already been shown to help. Those who benefit from these treatments owe thanks to patients who volunteered to participate in controlled clinical trials, and the physicians and pharmaceutical companies that lead them.

[Deep knowledge, daily. Sign up for The Conversations newsletter.]

William Petri, Professor of Medicine, University of Virginia

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here is the original post:
Which drugs and therapies are proven to work, and which ones don't, for COVID-19? - TheStreet

A research has shown that men who are bald are more likely to die when they get the COVID-19 than men who have hair.

According to researchers, most men who have died, so far, since COVID-19 started in China, were bald.

This new risk factor is given the name of "Gabrin sign" after Frank Gabrin, the first physician in the United States who succumbed to COVID-19. He was also bald.

Brown University's Professor Carlos Wambier had told The Telegraph that they think baldness is the perfect predictor for the COVID-19 severity.

The COVID-19 is caused by the virus SARS-CoV-2.

Researchers who have been looking into the link between bald men and the COVID-19 believed that androgens, the male sex hormones such as testosterone, could be boosting the virus' ability to attack the cells.

Thus, it could be possible that the treatment that suppresses these hormones like those used to treat baldness and prostate cancer could also be used to slow down the virus and allow patients more time to fight it off.

However, further study is needed because the evidence on whether the hormone treatment will have the same effect on the lungs as that in prostate cells have been conflicting.

Although there are now several clinical studies that have started looking into it as more concrete evidence would be needed before they can conclude that these hormone therapies would be effective as a treatment for COVID-19.

Another study also found that men are more likely to die from COVID-19 than women. The researchers are not sure why but they are looking at factors such as immune system differences between men and women, lifestyle differences, and smoking.

With the COVID-19 pandemic still very much around and with no vaccine or treatment yet, everyone is advised to continue following protocols such as social distancing and hand sanitation.

Go here to see the original:
Study shows that the COVID-19 could be severe in bald men - EconoTimes

Intermittent fasting is one of the top lifestyle trends this year not only because we came out of COVID-19 looking a little chubbier and tubbier, but also because it has proven results with (relatively) little effort required. Nevertheless, as with all diets (and diet fads), its important to be properly informed before embarking on a journey of changing your eating habits.

Here, Dr Priya Khorana gives us the ultimate low-down on intermittent fasting, from the perspective of someone who really knows a thing or two about this stuff. Read on, take note, and decide for yourself if youre ready to (stomach) rumble.

Intermittent fasting (IF) is not a diet. It is a timed approach to eating, and unlike a restricted fad diet, it does not specify what foods a person should eat or avoid. To put simply; IF does not change what you eat, it changes when you eat.

It may have some health benefits, including weight loss and improved insulin sensitivity, but it is not suitable for everyone and should be done with careful consideration. People with advanced diabetes or who are on medications for diabetes, people with a history of eating disorders like anorexia and bulimia, and pregnant or breastfeeding women should not attempt intermittent fasting unless under the close supervision of a physician who can monitor them.

Having said that, there are some evidence-based benefits of IF. In men, it has shown to reduce insulin resistance and lower blood sugar levels (and thereby reducing the risk of type 2 diabetes). It has also been shown to reduce oxidative damage and inflammation, thereby slowing down the effects of ageing. Lastly, the insulin levels drop human growth hormone (HGH) increases, which helps facilitate fat burning and muscle gain.

Depending on your IF approach, youre either shortening the eating window each day or engaging in 24-hour fasts one or more times a week. One of the most popular approaches is the 16:8 method, which is when you fast for an eight-hour window this is often the approach I go for. It is vital to stress that folks use an eating approach that works and is sustainable to them.

The 16:8 MethodThis is also called the Leangains Protocol and involves skipping breakfast and restricting your daily eating period to 8 hours, such as 1-9:00 pm. Then you fast for 16 hours in between.

The Eat-Stop-EatThis involves fasting for 24 hours, once or twice a week. For example, you may not eat from dinner one day until dinner the next day.

The 5:2 DietWith this method, you consume only 500-600 calories on two non-consecutive days of the week but eat normally the other 5 days.

As a doctor of nutrition, I will always recommend foods for improved health, including high-fibre, unprocessed, whole foods in all colours and varieties. A mostly plant-based Mediterranean-style diet has been linked to improved health benefits, and in this case, I will suggest this way of life even whilst fasting. Making sure you are nourishing your body as effectively prior to starting your fast will help prevent any feelings of being hangry during the fast.

It is also vital for me to suggest that if you are embarking on an IF journey, staying hydrated is key. Fasting can come with some initial side effects, such as increased hunger, low blood sugar, headache, irritability, dizziness, and fatigue so please embark with caution.

Limiting your dining window does not give you an excuse to binge eat especially on unhealthy foods because you will not see the benefits. Eating unwholesome (read: junk) food in a shortened feeding window on the IF diet may also put you at risk of deficiencies in key nutrients such as calcium, iron, protein, and fibre, all of which are essential for normal biological function.

What you need to do is consume a diet rich in fruits and vegetables, whole-grains, and sufficient lean protein and healthy fat boosting important antioxidants and nutrients which all result in an increased lifespan and reduces the risks of developing lifestyle-related chronic diseases.

What is important to emphasise is that the goal of IF is to maintain a healthy amount of calories for your body during the fast so you do not rebound eat.

For those starting out, I suggest implementing a 12-hour fasting/12-hour eating window and building up from there, eventually finding a schedule that works best for you. The most important thing is breaking your fast with fresh, unprocessed, nutrient-dense whole foods, prioritising healthy sources of protein and good fats, all while limiting junk foods that negate any benefits of IF.

For more super-nutritious advice and information, be sure to follow the fabulous Priya over onInstagramandFacebook.

Featured and hero image: Courtesy Malvestida Magazine/Unsplash

This story first appeared on Lifestyle Asia Bangkok.

Continue reading here:
What is intermittent fasting and what to actually eat while intermittent fasting - Lifestyle Asia

Our bodies keep score.

Thats what I had on my mind as I entered into my June 22 conversation about the trauma experienced by Black folks with Akua Boateng, a licensed psychotherapist. In the email exchange we had setting up the conversation, Boateng had brought up this idea of the physical ways our lived experiences manifest, and it stuck with me. It was indicative of something Ive always felt and wondered about: How has my body been affected by trauma? How does it follow me? How do I carry it? Is this why I have migraines? (Yes.) Is it the cause of other health issues I experience? (Possibly.)

I went into Conversations, a limited live series for Slate, with this in mind. Boateng had so many answers and invaluable insight. Mostly we went over curatives and how folks can take care of themselves. The trauma Black people experience is frequently discussed, but media outlets dont dedicate as much energy to covering healing and self-care. Above you can watch our chatproduced by Britt Pullie and Faith Smithand below is a transcript of the discussion.

I hope you walk away with something valuable.

Hi everyone. Im Julia Craven. Today, I have with me Dr. Akua Boateng, a licensed psychotherapist in Philadelphia, and were going to discuss trauma and were going to talk about the physiological impacts of it. Were going to start talking about how Black people in particular experience it a lot and how we can heal from it. So thank you. Im so happy that you were able to join me for the first installment of Conversations with Julia Craven, a limited series that Slate is doing. How are you today?

Akua Boateng: I am great. Thank you so much for having me. Im really excited to talk about trauma as well. Given the times that were in, I think its important to be able to talk about the need for resources that people need right now. So Im excited to talk about this.

All right. Well, lets get to it. The first thing I wanted to ask you was, give us a definition of trauma. What are the symptoms of it and how does it impact you?

Trauma is really an experience that we have that overwhelms our ability to cope. Its unique. Its out of the scope of normal. Its an experience that you go through that really impacts every part of your brain. And when youre going through an experience that you have limited resources for, limited supply for, and theres a great demand on you; your system, your brain, your body starts to try to navigate and integrate this information, and it has trouble doing that. And so, during this time the person might feel total helplessness. They may feel a total lack of resources. And during this time the brain gets frozen in either hyperawareness or paralysis. That is the devastation of trauma.

Wow. So your brain gets frozen. Tell me, what does that mean? Is that why whenever yeah, just explain to the audience what you mean by that.

Yeah. Typically what the appropriate type of coping is is when a person goes through an experience, we take it in through our five senses, right? And via our five senses, were able to smell it, were able to see it, were being able to taste it, and we can make sense of it, put files in our brains that help us to make sense of it, put it away in long-term memory and short-term memory, right? And so thats how information goes in. Its integrated into our sense of self, who we believe we are, how we see the world, our outlook.

But the challenge with trauma is when youre going through something that exhausts that coping strategy and exhausts the ability for you to integrate that information, your brain gets frozen, right? It kind of gets jammed up and it is not able to make those files. Its not able to now see the resources that you have to tap into to take care of that challenge or to make sure that you integrate it into who you sense you are, how you view the world, your relationships and all of that. And so, the devastation of trauma really is a persons inability to take in this really significant event and make sense of it.

Wow. And so, how does that apply to our world currently? Because theres so many different things going on, right? Were still in the middle of the coronavirus pandemic, we are in the middle of a, lets call it a new spark has been lit under the Black Lives Matter movement. And so, were taking all of this in and it feels constant. How does that affect us, just the onslaught of pretty bad news?

Yeah. I mean, again, were taking it a lot nowadays, right? Sometimes whats happening with a lot of people is were taking in too much information, were taking in too much media, were taking in too many new things and our brain and our body doesnt have the time to catch up, right? Were getting this kind of big log of information, not being able to process it regularly day to day, or not even having the resources to be able to process it. And so a lot of people are experiencing secondary trauma, even to the level of post-traumatic stress disorder because the symptoms that theyre having are really debilitating, right? Loss of ability to concentrate, insomnia, lack of emotional balance, you cant think clearly. I have so many people that are coming to me right now saying, Im having so many nightmares in dreams about the things that are going on in the world and I cant cope with it.

But really we were not meant to take in such high levels of information and data at one time. We get it on our phone, we get it on television, we talk to our partners and our friends about it, we get it on our watches, right? Every moment these challenges are right in front of us. Do we have a moment to just breathe? Have we had a moment to actually sit down and process this information, to journal, to have self-reflection? Oftentimes we may not have that. And so were not processing, were not filtering this information down and our systems are being exhausted.

So, how does being a Black person make that worse?

Yeah. So many different things, right? So many different things. The legacy of trauma has been within the Black community for so long, right? We have the secondary trauma thats happening. Were watching these images, were witnessing these images. It has to really go down into an arsenal of history and information that is already within us given our intergenerational trauma, right? And so, why that is specific to the Black community is because we have heard the stories of our pain growing up generation after generation after generation. That is paired with lack of resources in order to deal with some of the pain that were dealing with, feeling helpless in systems that dont support our growth in our ability to deal with these challenges. And also, being in a situation where we are constantly retraumatized, right?

You may even be able to deal with one trauma, which is hearing the experiences of your parents or your caregivers or your family members. But then you experience it too. You go out into the world and you experience profiling or you experience an incident with the cops or you experience microaggressions at work. Its a retraumatization after retraumatization after retraumatization. And again, all of that may not necessarily register as trauma to a person, but it has to be paired with the lack of resources and the ability to process the information and do something about it. That place of total helplessness is really the significance that we experience systemically, interpersonally, so many different dimensions.

Yeah. I often think about and tell people about how when I was 7 or 8 years old, that was the first time I got followed in the store. I didnt realize what was happening because I was a kid, so I didnt know what was going on. This was during the height of Americas Most Wanted. When my grandmother pulls me out of the store and tells me that someone was following me, Im just like, Oh. I was about to be on this TV show like something really bad was about to happen, and it could have but not necessarily in that sense, right?

That moment in her explaining to me that being Black meant that I had to conduct myself differently everywhere, no matter where I was, it completely changed the way I operated in public and how I operate in stores to this day. When I walk out of a grocery store or any store, I dont put my hands in my pocket. I dont rustle or move around too fast. I stay as stoic as I can and I get away from the store and then I start shifting in my bags and then I start digging for something that I just bought that I want to snack on on my way home.

Yeah. And so really whats happening to you, Julia, in that situation is that youre experiencing that hyperawareness because youve heard the stories about and the messages and narratives that the world may not be a safe place for you. You have to be aware, you have to be on guard. And what happens in those situations is that we are living in an operation and an internal mechanism of survival, right? And so, biologically and physically were experiencing a lot of stress internally in order to be ready for what could potentially be a threat or be ready for the world that is not safe to us. And so, living in and normalizing this really high stress internal environment and external environment causes wear and tear on us, right?

Many research studies talk about that its linked to inflammatory diseases, right? Were not meant to have all of this cortisol, which is a stress hormone, were not meant to have high levels of this hormone in our body for extended amounts of time. And so, when youre in this space of hypervigilance, hyperawareness, defensiveness in order to protect yourself, your body is in a mode that is only meant to be in temporarily.

Right. I mean, it does. That sounds like PTSD. We walk around just traumatized as a culture, as a people. Just to kind of go on the physiological effects of that; how else do our bodies, as you put it earlier when we were talking before we got on camera, how do our bodies keep score? Because I think about how I had this bizarre lower back pain for a year and no physician could figure out what was wrong with me. And then I started going to therapy and it went away in like a week or two.

Yes, that happens. Some people talk to me about that all the time. When were having undiagnosed physical pain, that typically manifests, especially for women, in our lower back or in our shoulders. Our muscle fibers are actually holding that pain. It is literally a physiological experience that were going through. We are holding the pain. And not only that, we have compromised immune systems because of the high levels of cortisol, the stress response thats happening. Our immune systems are inflamed and compromised as a result of that. Sometimes people even get migraines or cluster headaches. Youd get that? Yes, people have that. They get cluster headaches or migraines. Insomnia is a very big symptom that people talk about having, not being able to sleep.

We have to be able to relax to sleep. And so if were not relaxed, our body has the tendency to not want to go into that REM sleep. Of course the mental health affects our physical effects as well. So depression, having fatigue, low energy, low mood, lots of sadness, and then anxiety, right? Anxiety is the hyperawareness part of that trauma, which is hyperfixation, rehearsing things, avoiding potential threats, needing to have control over a lot of things that are in your life. Sometimes people even talk about that being associated with sometimes how Black mothers raise us to be really mindful of everything, right? Mindful of your surroundings, mindful of the people that you have contact with. All of that can be a hypervigilance thats happening within the body.

Thats every Black woman who played a role in raising me, just right there. Its each one of them. And of course as a kid, you dont see them as being anxious and you dont necessarily understand or realize that that anxiety is likely going to get passed down to you because that also describes me.

And so it goes into these familial narratives that we get, right? So its in our body, its the way that we cope, its also now the way that we live, the way that we speak, the way that we parent, our outlook on the world, even how we make sense of our future. There is a study that talked about people that experience trauma having a shortened view of their life. That I dont know if Im going to live past 25, I dont know if Im going to live past 14. And so, thats how I begin to set up my day to day as it pertains to goals, as it pertains to relationships. And so, its pretty pervasive.

And so now I want to switch gears and talk about the healing side of things. What can we do to start the healing process in our community?

Yeah. Well, the first part I think is education, right? Many people have experienced trauma. They dont realize its trauma, right? They might call it culture, they might call it just how our family is. And so, education around how this is impacting you, what trauma looks like, have you been through it is really the first step because if a person doesnt know theyre traumatized or have experienced trauma, how would they even know they need healing? And so, education I think is really, really valuable. Healing comes on two levels, right? The first level is a systemic one, I believe, as well as an interpersonal and individual healing. The systemic part of healing is really we need high level recovery, being able to regain those resources that weve lost.

If a person is traumatized and does not feel that they have resources in their environment, in their community, in their world that will help them to grow and thrive, they remain traumatized. And so we need systems that allow people to have safety, we need systems that allow people to not have to live in survival tendencies and hypervigilance. Thats why Ive been really excited about people talking about, what does it look like to decrease and eradicate oppression in our community? That is really pivotal when it comes to trauma, right? If were oppressed, again, that has to do with our outlet. So it aligns with our outlet, it aligns with what we think about the world, what our potential is, our future. And so being able to do the things that social justice allows us to do to minimize oppression, create systems that are better for us, create policy that really works in our favor to help us grow is really, really valuable.

So thats the systemic healing, I think, and recovery thats important. And then there is an interpersonal and individual healing thats important. Integration is the curative for trauma. Where things have been misaligned, integration brings them back together. Oftentimes when people are traumatized, we want to zone out, dont we? I dont want to feel the pain. There are so many people that I hear, I just need a drink. I need to zone out. Theres too much going on. I cant really think about these things. Youve heard that before.

And I think that I cant speak for all, I can only speak to my experiences and my family and the people I know. And that in many different ways sounds like everyone I know, right? In my family, its just like, Im going to detach in these various different ways. And as we know, most people dont separate themselves in a healthy way, which also kind of links back to, well not kind of, it links back to these broader systemic issues that we see in our communities, the high rates of alcoholism, the high rates of drug use, etc.

Right. If I dont have the resources, if I dont have the potential of being able to grow in an adaptive and healthy way, Im going to have to cope anyway I can cope. And so being able to have this integration looks like instead of zoning out, I really need to sit within. Mindfulness is really helpful for that, self-care practices are really important for that. Empathy is important for that, interpersonal support. All of these things are literally changing the molecules of your brain. When you have these resources that are available to you, it now rewrites the damage of trauma. And so, being able to have a change in perspective, right? Having access to new ways of thinking about your family, about having a relationship, about being in a partnership. Therapy can really be helpful in being able to change some of these things for people as well.

Anytime anybody comes to me and theyre going through something, I love to say: A, you need a therapist, and Im not saying that to be condescending or mean, but Im saying it because its helpful. Its very helpful to have someone who is trained to help you help you. But as you and I both know, that isnt necessarily accessible to everyone. And so, what are some resources? How can people access therapy if they dont have insurance or if there arent any, frankly, well, culturally trained therapists in their area?

Yeah. And that can be a problem, that can be a challenge to do that. There are so many resources out there for people to link up with a therapist. I tell people to go on BlackFemaleTherapists.com, which also they include Black male therapists at this time. Therapy for Black Girls, I think, has been a great resource for so many people. The prices that people have are typically on the website, or if you call some practitioners, they have sliding scales, they have discounted prices for people. And then there are environments that you can go into that work with individuals that are not able to pay for therapy at all. And so some behavioral health centers that might be in your community might be able to help you. If you work for a company, sometimes companies have employee assistance programs, and those programs allow you to have three to 10 sessions for free sometimes.

Many people have that within the framework of their job and they dont realize it. And so making sure that you ask your job, do I have any resources for behavioral health care, and tapping into looking for a therapist that might suit you would be important. There are two initiatives that Im a part of that are really helpful. First one is Dark Beauty Healing. Its a campaign that is seeking to do 10,000 hours of free virtual therapy for women of color. I think its very important. And so if you go onto their website, you can find and link up with a therapist for free and be able to work with one of the practitioners there. Also the Boris Henson Foundation, which is Taraji P. Hensons nonprofit, is also doing free therapy for individuals of color. And theyve expanded to those that have experienced traumatic experience for the past two months.

So why, because we were talking a little bit earlier about how a lot of this starts in childhood. And so how can parents or caretakers, teachers, whoever is working with the child, how can they talk to children about the trauma associated with being Black without burdening them?

Thats important. You want to talk to your child on the level of their understanding, right? We dont want to inject trauma where trauma has not been experienced. And so being able to, first of all, allow your children to have self-care practices that are normalized. Being able to talk about their emotions, having spaces where you literally just start to process things as theyre going through it. If a child comes to you and theyve experienced something that is at school or on the playground or something that theyre going through, you want to put that information into context, right?

And so, lets say that someone is on the playground and they say something thats racist to your child and your child comes back and talks to you about it. Having a healthy conversation around the differences that people have, having healthy conversations around what we want to do as a family and how we treat people as a family, as opposed to how other people may treat us in certain circumstances is going to be important. So having that conversation, putting it into context as it comes up, not injecting it before it comes up because sometimes it can be really traumatizing and stressful to a child if they dont have that experience yet and we now put them into that hyper awareness and hypervigilance before they really need it. So, those conversations are really valuable early on and as they come up.

Got you. So another, how do we eradicate the stigma within communities surrounding mental health services? And obviously this is not just a Black community thing as I feel its often painted to me, but how do we convince people that they should even go to therapy?

I think education is really important. There is a lot of misinformation and stigma around mental health and that is really because of history, right? Because psychology has had a schism with the Black community because of practices that have been harmful to us historically. And so, education looks like being able to have Black therapists do programs and have resources in the community to meet people, right? People talking about their experiences in therapy openly is really important. Recognizing that, Oh, I know someone that has a therapist. And oh, they actually enjoy it. It wasnt harmful to them. Oh, theres nothing wrong with them. Oh, theyre not crazy. And so, having that close contact with someone that goes to therapy can be really helpful as well as getting to know a therapist in your community that normalizes the idea of it.

And then also other practitioners like doctors, primary care physicians, suggesting that is really important. Referring people to therapists is really important, from their medical doctor. I know that a lot of people have had a change of heart when they have been in their spiritual communities and their pastor has told them that they have gone to therapy or has referred them to a therapist. And so, again, making sure that the people that have understanding and new ways of thinking of therapy and mental health are open and often speaking to people about their experiences. And then us as professionals providing education in the community can be really, really helpful.

And so how do mental health professionals meet communities where they are, especially if youre working with people who are resistant to the idea for whatever reason?

Yes. Well, again, through speaking through platforms like this, through going to community events, which I often try to do, and having moments where you speak about what you do. Sometimes even mentoring people in community and programs nonprofits, being able to be a resource to nonprofits that are doing work in the community with young people or with mothers or with families. Having that close proximity is what it is that you need to have. As well as being able to have that in the media I think is really important too. People consume a lot of media. So they see it on Insecure and they say, OK, or they see it in a program like this, or they see the stories of Black people get included in normalized therapy and mental health services, and it helps them see it.

Yeah. This reminds me, theres this great meme. Its Miguel talking to, I think, Drake. The meme basically has Miguel saying like, OK, but were still going to need a therapist though. I love that thing because its like, yeah, I dont know what youre saying, I dont know what this fictional conversation is about but whatever, thats great. Im glad you came to that realization. You still need a therapist though. Like you still have to work through things, and we constantly One of the best things my mama has ever told me is that everything is a process, and that includes healing. Youre always working at it.

That is so true. Your mom is right. It is a process. Its a journey. Its a lifelong process sometimes for people as well. And so, being able to normalize that in therapy is something that I find myself doing a lot to counteract the intergenerational narrative that therapy is not for us, right?

Or the narrative that something is wrong with you if you go to a therapist. And so, being able to have this in context and make sense of it in the process is something that really is healing to people.

Absolutely. Before we get into the questions that we got from folks who are watching, what are some self-care tips, some examples of self-care practices that people can feasibly work into their daily lives?

Great. Im glad you got to that. I think its important because in order to know when you need self-care, you have to know yourself, right? And so, self-awareness becomes the gateway to being able to have self-care practices. What you see on someone elses Instagram may not be useful for you. And so anticipate right? Knowing yourself is very important, and anticipating your needs before they come up is going to be valuable to you. There are physical self-care strategies that you can employ. Some of those physical things are really just having a safe housing experience, eating healthy, regular medical care, taking a bath, sleeping. And when I say these things, people look at me and say, what do you mean, Akua? Thats pretty typical and normal. It may not be for everyone.

You might be a mom that has an infant and sleeping is not happening right now, right? And so being able to ask for help in order to sleep is a physical self-care practice that you can implement right now. I think that everyone right now can turn off their phone for some portion of the day. Turn off your notifications, take a break from Instagram or social media and/or getting the news, being able to take a walk, asking for help, right? Or even sexual support from your partner, being able to connect with human beings, right? So thats a physical way of doing it.

Psychologically: self-reflection, therapy can help, journaling, sensory engagement. Doing things like listening to music, being in a support group is really helpful, or even going to a concert, maybe not at this time but as the pandemic lifts, right? Being able to be in experiences that are life-giving to you. Emotionally: self-affirmations. Tell yourself you love yourself today, right? Being in spaces where people care for you, laughing, watching movies, flirting. All of these things help us to decompress, to relieve stress and change some of the narratives that trauma has inputted within our experiences.

Spiritually: having a spiritual community can be important. Meditating can be important. Having time for just praying is also really important part of that. Social justice is a part of self-care. Some people dont know that. It helps us to have agency and autonomy to engage in social justice, but its important to know what is best for you and what does not trigger your own trauma and the things that have been historically challenging for you. Professionally: taking some time off, making sure that you take your lunch break, asking for help, and then personally making sure that you have goals, short term and longterm, in knowing who you are. So many ways to take care of yourself.

And thats all fantastic. Thats great. Thank you for giving us insight that is very feasible and not just something quick packaged for Instagram. So yeah, lets get into the questions that we have. John asked, do people on average have the same internal amounts of coping resources?

No. And by amount, Im not sure if he means the type. It could be a person grows up with several resources, right? We can even categorize that as privilege, right? And so each person doesnt have the same amount of resources, but access to resources that you do have, maybe agency in order to get those things, is something that we could have in common. And so again, being able to have people that support you, having finances to take care of yourself, having future orientation is going to be important if youre not in survival mode. And so, some of those things can be really different for people. Thats not to say that they may not have resources, it might look different for every person.

And so what is future orientation? What does that mean?

Being able to have a positive outlook for the future, right? I know how to make goals for myself, I can see myself in the future, I feel positive about it, but then also I feel like I can handle what comes up in the future.

Got you. And just to ask you another take on that question because they may have meant, do people have the same capacity for coping resources? Like do people have the same, I guess, capability to handle certain coping mechanisms? Just a different spin on it so that way in case thats what they meant, we can also get that information to them too.

Sure. Our capacity looks very different and its based on how we grew up, its based on if we have preexisting mental health illnesses, it looks very different based on our socioeconomic status. And so, our capacity really is impacted by our environment and its impacted by what has happened to us psychologically as well. And so, our capacity can look quite different. And so, being able to get into therapy, talking about the implications of the things that youve been through does help you to have a greater self awareness of your capacities, what it looks like. And even if your capacities are limited, there is hope for expanding them with healing, with integration and many of the things that weve talked about.

Another question that we got is, so what do normal levels of information intake, sorry, what does that look like? What is considered normal, especially now?

Right. When we talk about what normal is, its important to know that who you are matters, right? That it really depends on the person and what it means to them. So if a person has been through or is in a family where several people have been harmed or they have been shot or something has happened to their family, what might be traumatizing to them may not be traumatizing to another person, right? And so, really knowing who this person is and what meaning they make of the things that theyre taking in is going to be important. And so, I always advise people to listen to their body, listen to the symptoms that might be coming up.

If youre having trouble sleeping, if youre kind of fixating on information, if you are having feelings of hopelessness or sadness, heart palpitations, having hard time breathing after youre taking in the media that you typically do, you know its too much, right? And so, minimizing that to the degree that you feel like you can thrive, attend to tasks on your day-to-day basis and have a good level of functioning is going to be important. I tell people on average it might be helpful for them to tap into media and social media maybe once or twice a day. And so having an hour here, an hour there on a daily basis may not be too much for most people, but listening to your body is really going to be important. Several hours, probably not a good idea.

Thats now achievable. And then I think about how often Im on the internet and Im just like, Oh yeah, this is my job. And its just like, I could probably log off though. But then I dont know.

Yeah. And the thing is you can take that media, take that information and go offline to do something with it. Lets say you go online, you need to get information, you get the information, you log off and you either write down whats going on, you start typing about your thoughts and feelings about this issue. And so it doesnt necessarily mean that you have to have all this input. We have to pair it with output, and you being able to have self-reflection and have thoughts that youre generating, making sure youre still creative and not being given information on how to think about things. All of this is something thats helpful and adaptive.

Absolutely. Because after this Im going on a long walk. I hope my editor is not watching because Im really about to disappear on him for like an hour.

Yeah, its needed. Its needed, right?

Yeah, it is. But thank you so, so much for your time today. This conversation was great. I feel like it was informative and I think that our viewers will too. Thank you everyone at home for watching. Next week Ill be back to talk to somebody else. Tell us, do you have a website plug? Is there a way that people in Philadelphia can reach you?

Yes. You can reach me at my website, AkuaKBoateng.com. Thats the same on Instagram and Facebook as well as Twitter. And hopefully Ill connect with many people.

I hope so too. All right. Thanks everyone. I hope that you all have a good day and go for a walk. Get off Twitter.

Yes, please do.

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A conversation with Akua Boateng about Black trauma, and how to start healing. - Slate

Nanotechnology is poised to revolutionize the diagnosis and treatment of patients with type 1 diabetes.

According to the WHO, in 2016, an estimated 1.6 million deaths were directly caused by diabetes. It is a chronic disease that occurs when the body is unable to produce or process a hormone called insulin, which helps regulate blood sugar levels.

Of the three major types, type 1 diabetes has proven to be the most problematic in terms of providing patients with a timely diagnosis, as patients may be asymptomatic for long periods of time with a sudden onset of symptoms well into the diseases progression.

Currently, type 1 diabetes can be diagnosed at any age, but it is mostly found in children and adolescents. Once diagnosed, patients also have a high risk of diabetes-related complications, as well as other autoimmune diseases, such as hashimotos thyroiditis or celiac disease. Therefore, early diagnosis and treatment could prevent the progression of type 1 diabetes.

At present, the diagnosis of type 1 diabetes depends on the detection of blood glucose levels and islet autoantibodies, which are markers that appear when insulin producing islet cells clusters of hormone producing cells in the pancreas are damaged. But the function of the patients cells have likely already been severely damaged by the time they receive a diagnosis.

As more and more people suffer from type 1 diabetes of the 422 million people worldwide diagnosed with diabetes in 2016, roughly 5% were categorized as type 1 the importance of early diagnosis and the urgency of effective treatments becomes ever more important. However, recent medical methods for the early diagnosis of type 1 diabetes are still limited. So, its important to develop new methods for early diagnosis and treatment.

Nanomedicine is an emerging field and provides a promising and more effective alternative to diagnose type 1 diabetes, and stands to revolutionize treatment for patients. Experts in this field, Dr. Yuanzeng Min from the School of Chemistry and Material Science at the University of Science and Technology of China (USTC) and Dr. Jianping Weng, a clinician from the First Affiliated Hospital of USTC discuss the findings in a recent reviewpublished in WIREs Nanomedicine and Nanobiotechnology.

Magnetic resonance imaging (MRI) has in itself revolutionized imaging in medicine. It takes advantage of powerful magnets to make a detailed internal picture of the body and helps doctors diagnose otherwise unseen disease or injury. To improve this technique and make it more suitable to diagnosing patients with type 1 diabetes, scientists have explored using common biomarkers of the disease, such as inflammation, and enhancing physicians ability to detect them in MRI analysis using helper materials. In this sense, nanomaterials have been shown great promise in facilitating the accumulation of imaging substrates at the targeted site, thus improving the quality of MRI imaging and the accuracy of diagnosis.

An excellent example of this is the clinical use of the nanoparticle ferumoxtran-10 or ferumoxytol. In clinical studies, there was an observed increase in pancreatic accumulation of this imaging nanoparticle in inflamed islets of type 1 diabetes patients in comparison to a healthy control group. This method is non-invasive, and the imaging materials are readily metabolized by the body without harmful side effects. This technique has been ground-breaking in visualizing insulitis, an inflammatory lesion and an early stage marker of type 1 diabetes.

Type 1 diabetes is classified as an autoimmune disease in which insulin-producing cells are destroyed by the bodys own immune system, and is affected by a number of factors, such as genetics, environment and metabolism, among others. The downregulation of the overactive immune cells that kill the insulin-producing cells has been gathering more and more attention in the medical and research community.

Studies have shown that nanoparticles have the beneficial characteristics of high drug loading and are capable of being targeted to a specific location in the body, minimizing harmful side effects usually observed in these types of therapies. Scientists have used loaded nanoparticles to carry antigenic peptides or pMHC (peptide major histocompatibility complex) to suppress the bodys immune response so that the immune cells no longer attack cells. Research has also explored encapsulating cytokines or other synthesized molecules to modulate the immune system into the nanoparticles, which could be locally administered along with modulating immune cells, such as T cells or APCs (antigen presenting cells).

Significant progress in the development of sophisticated nanotechnologies has also been seen in the past 10 years for immunotherapy and islet transplantation in type 1 diabetes. Nanotechnology has played a significant role in islet transplantation by encapsulating healthy cells with biomaterials as most of the insulin-producing cells are destroyed by the patients own immune system. The biomaterials also protect the transplanted cells from immune exclusion. In addition to avoiding a deleterious host response, encapsulated islets must receive an adequate nutrient supply and positive extracellular cues in order to survive and functionin vivo.Thus, while using nanotechnology to encapsulate cells, it alsorequires as little interference as possible with the generation of new blood vessels in the encapsulation. This is usually achieved by improving the mechanical rigidity, charge distribution, morphology, and other related parameters of the nanomaterials.

While great strides have been made, limitations in the application of nanotechnology in diagnosis and treatment of type 1 diabetes remain. For example, some nanoparticles are not specifically target islets, their production process can be complicated, and the cost is high. However, their application in this area of medicine has only just begun, and we are beginning to see the benefits of this research in clinical trials.

With research in type 1 diabetes and the development of nanotechnology, these problems will hopefully one day be solved. We believe that in the next 10-20 years there will be high chance of this type of therapy used regularly in the clinical diagnosis and treatment oftype 1 diabetes patients.

Written by: Yuanzeng Min and Jianping Weng

Reference: Wen Pan, et al. Nanotechnologys application in Type 1 diabetes. WIREs Nanomedicine and Nanobiotechnology (2020). DOI: 10.1002/wnan.1645

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Earlier diagnosis and better treatment for type 1 diabetes - Advanced Science News

Depression has been shown to be prevalent during menopause, affecting as many as 70 per cent of women transitioning into menopause, say researchers.The study, published in the journal of The North American Menopause Society (NAMS), not only confirms the high prevalence of depression but also the greatest risk factors for it in postmenopausal women, as well as any relationships with anxiety and fear of death. "The findings are consistent with existing literature and emphasize the high prevalence of depressive symptoms in midlife women, particularly those with a history of depression or anxiety and chronic health conditions," said study researcher Stephanie Faubion, NAMS medical director.With the decrease in hormone production during menopause, women are more prone to a number of psychological problems, including depression, anxiety, irritability, nervousness, sadness, restlessness, memory problems, lack of confidence and concentration, and a loss of libido.

At the same time, as women age, the fear of death becomes more pronounced.

Depression and anxiety, which are the most common psychological problems that occur during the menopause transition, likely increase that fear, the researchers said.

For the current findings, the research team picked 485 postmenopausal Turkish women aged between 35 and 78 years.

The researchers sought to determine the frequency of depressive symptoms in postmenopausal women, the variables affecting it, and the levels of anxiety and fear of death.

They then evaluated the relationship between all these variables and postmenopausal depression.

They found that depression in postmenopausal women is a common and important health problem that requires further study.

In this specific study, 41 per cent of the participants were confirmed to experience some form of depression.

bu/rs/

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Going through menopause increases risk of depression in 70% women, says study - Times of India

Today the whole world is focusing only on COVID-19 pandemic. The virus is the common topic now for every discussion, either official or non-official. But most of these talks are about COVID-19 patients and the potential drugs. And hardly anybody talk about the emotional and physical challenges that doctors on COVID-19 duty are going through, or for that matter, their health. Today, India is celebrating the National Doctors Day to acknowledge the services of doctors and their huge contribution to medical advancement. The day is also observed to pay tribute to legendary physician Dr. Bidhan Chandra Roy (Dr. B C Roy), who was also the second Chief Minister of West Bengal. As we thank doctors for providing us with selfless service and health care today, lets also asked them about their health, and how are theyre managing the work and family life amidst the pandemic. Also Read - Doctors' Day 2020: Help your doctor treat you better in the era of teleconsultation

We have spoken to four doctors a cardiologist, a pulmonologist, a diabetologist and a general practitioner to get a rough idea about what doctors are doing to maintain their work-life balance and keep themselves strong and healthy amidst the pandemic. Here is what the four doctors say: Also Read - Doctors Day 2020: Expert tips for patients and physicians to get along with each other

Dr. TS Kler is the Chairman of PSRI Heart Institute in Delhi and a recipient of the prestigious Padma Bhushan Award. Prior to this, Dr. Kler has served as Head of Cardiac Sciences Department at the Fortis Flt Lt Rajan Dhall Hospital in Vasant Kunj. Lets hear from him about things he does to stay healthy and the challenges he is facing amidst the pandemic. Also Read - Doctors Day 2020: What do physicians fear and expect while treating COVID-19 patients?

Things you do to maintain work-life balance: As far as maintaining work-life balance is concerned, my formula is simple, have a positive attitude towards life and then everything becomes easier. I dont take unnecessary worries, worrying too much is a pathological reaction. If you keep worrying about things, your performance decreases, your decision-making abilities become poor. On the other hand, when your mind is free from worries, you think rationally in any given situation that may help you deal with any problem in life. Similar is my attitude with COVID-19, which a big challenge for everybody. Yes, the chances of getting exposed to the virus are much more for doctors and health care workers as compared to others, but you have to take that challenge. I have been going to the hospital throughout the lockdown period without taking a single day leave. Im a cardiologist and there are always patients who need urgent care and they cannot be left alone. There are always emergency cases. We are also offering telemedicine options for those who dont need hospitalization. In my family, there are only four us my wife and our two sons. My wife is also a doctor and she is also playing a huge role in fighting the COVID-19 pandemic. My elder son is an engineer and my younger son is also a doctor and he has been posted in the COVID ward. As there are three doctors in the family, the evening discussion is mostly on COVID nowadays. And we all understand the demands of our job as a doctor and our responsibilities towards society. In fact, I keep telling my colleagues that we dont have any excuses at all to be scared of COVID or not to go to the hospital and see patients. If our patients need us, we have to go and see them.

Things you do to keep your heart healthy: I walk at least 10 km a day. I use an app called health application that records how much I have walked daily, every month and every year. So, based on the figure shown in this app, last year I walked 3842 km, which is more than the distance from Srinagar to Kanyakumari. You can do exercise any time whichever convenient for you but I prefer the morning time. I get up at 5 am in the morning and by 5:45 am I am out in the park. Exercise to me is a passion, its my addiction. I also do yoga regularly. We organize a regular yoga programme in my home, three days a week. When it comes to diet, I eat a lot of green vegetables and fruits. I am a non-vegetarian but I keep non-veg consumption very low. Neither I smoke nor do I allow anybody in the family to smoke in my home. The rest, be happy, stay positive, and help others, this can make a lot of difference in your health too. Helping others is actually good for your overall health. Your generosity will not only bring about a change in others life but I believe that it produces some special hormone in your body which gives you a lot of satisfaction, improves your mental wellbeing and make you strong in life.

Dr. Anoop Misra is the Chairman of Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology. He is also the Chairman of National Diabetes, Obesity and Cholesterol Foundation (N-DOC), and Vice President of Diabetes Foundation (India) (DFI).

Things you do to maintain your work-life balance: I maintain a strict discipline so as to compartmentalize time for work and then personal life and do regular exercise to enable augmentation of clear thinking and generate ideas. Another thing that I do to keep a balance between my work and family life is planning my day ahead. Much of my days planning is done while listening to music or exercising outdoors. Also, I always try to think of ways to increase the efficiency of the workforce, so as to achieve daily objectives in a shorter time and save time for home. Everybody should have some me time to relax, it allows your mind and body to repair. For me relaxation time in the evening is sacrosanct; I avoid phone calls during this time.

Things you do to keep your blood sugar levels under control: There are simple things that I do keep sugar and blood pressure under control, and keep my heart ticking regularly. In short, to keep myself fit. There is no magic mantra in following these rules. And I would like all people to follow the same to avoid diabetes, hypertension or heart disease; and those who are patients, to manage the conditions effectively.

Dr. Nikhil Modi is a well-known Pulmonologist with experience of more than 13 years. Presently he is working as a Consultant in the Department of Respiratory, Critical care, and Sleep medicine at Indraprastha Apollo Hospital, New Delhi.

Things you do to maintain your work-life balance: First and foremost work comes first in any situation and so I make sure that I am available whenever my patients need me. At the same time, your family is also important and so I try to spend as much quality time as possible with them, whenever I dont have any emergency case. Also, those times spend with your family also act as a stress buster. Thats why it important to give equal importance to work and life. But in this situation, our patients need me more than my family and I am committed to my work.

Things you to keep your lungs healthy: When it comes to keeping myself fit and my lungs healthy, it starts from early morning with exercises like yoga or walking, followed by a healthy and heavy breakfast. Since doctors are quite busy these days, I dont get much time for exercise but whenever I get time, I do some sort of exercise. When youre going in a place where you have to see patients who are infected with COVID-19, you have to be strong from inside too. Frequent small meals also help provide the nutrients your body needs to keep the immune system strong. The most important thing to keep your lungs healthy is to stay away from smoking and pollution. If you can do yoga and deep breathing for at least 10 minutes daily, its the best you can do to your lungs.

Dr. Pulin Kumar Gupta is currently associated as Professor (Medicine), Ram Manohar Lohia Hospital, Delhi.

Things you do to maintain your work-life balance: These days due to the COVID-19 pandemic, theres no fixed timing for our work. I leave for the hospital at 8 and but then you dont know when our work will end. If I am able to reach home early like 7 in the evening, I always spend some time with my kids, have dinner with them, or play an indoor game. Thats how I try to maintain my work-life balance. Since I am on COVID-19 duty these days, I also take all the necessary precautions like keeping my shoes outside, changing my clothes immediately after reaching home, and taking a bath. For the safety of my family, I stay in a separate room and avoid doing certain things that I used to do before the pandemic like kissing my kids.

Things you to keep yourself healthy: A healthy diet is a must to stay healthy and its more important now. My diet includes lots of protein, like boiled eggs, paneer, and soybean. I also eat 30 gm of almond and lots of fruit. There is very little fat in my diet. I drink turmeric milk twice daily in the morning and at night to boost my immunity. I also make sure that I drink plenty of water and limit alcohol intake. In the evening I walk on my treadmill for about 45 minutes daily. In the hospital, during lunchtime I play table tennis with my colleagues. Thats how I try my best to keep myself healthy during this pandemic.

Published : July 1, 2020 10:48 am | Updated:July 1, 2020 11:12 am

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Doctors Day 2020: Four pandemic heroes share how they maintain their work-life balance and keep themselves h - TheHealthSite

Scary Mommy and Westend61/Getty

So, 2020 has really been a shit year.

It has been for nearly everyone, of course, and when the stuff stops hitting the fan, we all need to take a collective breath, pat ourselves on the back, and celebrate.

I had a busy year planned for 2020: Im a gynecologic surgeon seeing patients and trying to build a badly needed menopause clinic in a local hospital here in Seattle. Im editing a book, and consulting and providing telemedicine care for women in menopause as Chief Medical Officer at Gennev.

But then in January, I got a diagnosis of breast cancer, and suddenly I was making new plans. Somehow I had to carve out five weeks from this life to recover from a double mastectomy, then more time later for recovery from reconstruction. I managed it, barely, to have my first surgery in March.

I thought I had it pretty much under control. My patients were scheduled with other physicians, meetings were on hold, a bunch of work up-front meant I could relax and heal. In February, I went on a vacation to Mexico, where I spent a lot of time crying on beaches and into margaritas with friends. It helped. I came back ready to move forward.

And then COVID-19 hit, and it hit right here at home: epicenter, Seattle.

Suddenly the chaos and noise of my own life have expanded to a global level, and all of us in health care are scrambling to find answers, help others stay calm and safe, keep ourselves as safe as possible on the front lines, and meanwhile Im trying desperately to ignore the little voice inside thats saying, What about me?

As a physician and surgeon, I know what cancer looks like. I have an idea how it progresses and how bad treatment can be. I wanted to get on with it, have the surgery and whatever treatment so I could recover and get back to my life. But with my first surgery scheduled for mid-March, now it looked like those carefully extracted five weeks werent mine anymore.

Oh, and did I mention, suddenly my kids were home all the time? Theyre pretty much grown, so I have it easier than many, but the advanced clusterf*ck of trying to home school an attention-deficit high schooler while sympathizing with my college kid who was missing out on some pretty important stuff in her education and future career (shes a dancer) deflated any zen I managed to scrape together in a hurry.

This is a tough time for teens and young adults who rely on their social structures more than ever, and suddenly mine were stuck with a sick mom and Zoom.

Despite being a pretty practical person, I havent always approached my health practically. It wasnt until I was diagnosed as pre-diabetic at 42 that I finally started taking some things seriously. Perimenopause had added some belly fat and bumped up my bad cholesterol, so I at last started exercising regularly and taking medication, since eating better wasnt enough anymore.

However, as someone with a family history of cancers, Im a huge advocate of screening and started annual mammograms at 40.

Now thats irony, Alanis.

As with most women in their 40s, the mammograms showed that I had dense breasts, but nothing particularly concerning.

Then Gennev started working with MiraKind, an organization researching the connection between a gene defect called the KRAS variant and a greater likelihood of developing certain cancers. I got tested, and sure enough, I was a carrier. Knowing being KRAS positive could mean I was more susceptible to breast cancer, I added an MRI to my usual mammogram (remember, dense breasts).

Two days later, they called me and said, So, there are a couple of masses on your MRI. A couple of biopsies revealed invasive ductal carcinoma. More testing, more biopsies, more black and blue boobs.

Now I had a decision to make: I could get bilateral lumpectomies and sign up for a life of going in every six months and probably having to get biopsies every six months. Eventually theyd find something, and Id be right back here again. Im a doctor I knew how Id feel with these things on my chest, knowing there was cancer in them. So I decided on a bilateral mastectomy.

In the end, it was the right choice: there was more cancer that hadnt yet been detected. It was small, sure; but it wouldnt always be small.

The hospital where I would have my surgery started disallowing non-essential surgery the week before my mastectomy was planned. And surgery on anyone who was medically fragile old, ill, likely to respond poorly to anesthesia, etc. was postponed.

I wanted nothing to do with postponing the surgery. I had done everything to make taking those five weeks okay for everyone it affected patients, family, colleagues. Just the thought of redoing all that was exhausting. I had taken the time to take care of me, and dammit, I was going to take care of me!

In the end, it came down to the fact that I was young and healthy going in, so I wouldnt need an ICU bed that was needed for a COVID-19 patient. Id be out the next day. So we went ahead.

On March 19, all my breast tissue was removed.

March and April were spent alternating holding my breath and breathing sighs of relief: biopsy of sentinal nodes revealed no signs of spreading. Testing of the tumor showed it wasnt aggressive enough to require chemotherapy. Because I did what I did when I did it, the cancer was Stage 1. Ill be treated with hormone therapy; Im on Tamoxifen. They got great margins when they did the surgery, and I dont need radiation.

Ask anyone who knows me: Im pretty blunt. Im never unkind, but if a patient wants a lot of touchy-feely handholding, they should probably find another doctor. However. Telling your daughters you have breast cancer is not an occasion for blunt.

Not only was I telling them I was sick, I also knew they would watch me for signs of what was to come for them. Realistic but reassuring is a delicate dance. Fortunately, I was able to be pretty reassuring. It was Stage 1, not a particularly aggressive form, and Id be fine on the other side. But I also wanted to be honest with them about their own health and the screenings theyd need, given their family history.

I could complain about how unfair it is to have bad genetics, or how much it sucks to take care of myself and still have cancer, but I really have a shit happens approach to life, and it served me well. Yelling about how unfair it is as much as I was screaming it on the inside sometimes wasnt going to help me or my kids get through it.

COVID and being isolated together certainly didnt make it easier. This is a hard time for kids their lives are dominated by social things, the groups theyre in, who they communicate with, the things they do. Theyre missing out on things. So managing their emotions and my own is really tough; Im maybe not as patient as I would be otherwise, because Im going through some shit. I have cancer and it sucks. I dont tell them everything because it wouldnt help them. But I try to be open and honest because I know your imagination can sometimes be worse than the truth.

It could be easy to let cancer and COVID take charge and send me screaming to a safe room, but thats really not my style. I take precautions to protect myself from the coronavirus, but Im still seeing patients. I know that as a healthcare professional, Ill get it eventually. I just intend to be at full strength when it happens.

I walk every day, three to five miles with my dog. I run three days a week. Im back in physical therapy because too many hours performing surgery have caused problems with my neck. I truly think staying active has helped with my recovery.

Recovery was tough, not so much because of pain, but because COVID meant my friends and family couldnt help the way they wanted to: they couldnt come clean my house or cook meals, though many dropped meals on my doorstep, rang the bell and ran.

I have two sisters who live locally, and it was killing them not to be able to come and help. One sis is a chef and she just wanted to come and cook for me, but she couldnt come into my house. That was hard, but honestly, it was harder for them than me, since I was pretty out of it for the first two weeks after surgery.

So, yeah, 2020 is a shit year, but at least some things will get easier now. No more mammograms for me, because the reconstruction surgery scheduled for July will be done using my own abdominal tissue. From now on, a check up involves making sure the area around the reconstruction is healthy and cancer-free, including the lymph nodes and chest wall.

I know a lot about health, particularly womens health, because its my job. And I made a lot of decisions, together with my doctors, based on the knowledge I have. I wanted to share a few things that might help others have an easier time of it, COVID or no.

It might not prevent you from having health problems, but being fit can make it easier to handle the treatment and make recovery easier and faster.

Diabetes, cancer, heart disease are all in my family history. Knowing that helped me make better choices. And the KRAS test prompted me to do the MRI that revealed the cancer while it was still early-stage. Knowledge matters.

When I got that pre-diabetes diagnosis, I decided it was time to get a handle on me Ive spent my life caring for others as a doctor, wife, and mom. I was trained in residency to go until you drop. But suddenly I realized I needed to focus on my own health too. I made changes in work and home life, ate better, took meds. I wanted to feel good and I did. And when this came up, I had good endurance, strong muscles, a strong cardiovascular system, even strong legs and abs to help me get out of bed when I couldnt use my arms!

For the past few years, I had managed my sleep patterns to feel better, and through all of this, I managed to for the most part still get good sleep.

Because I made great decisions for a solid few years before this diagnosis, there was a little WTF? that I did everything right and still got this disease. But we live in a toxic world, I hadnt always made great decisions, my work has at times been really stressful, plus, I just had some bad dumb luck. Theres always been that bit of pessimism in me because my family history indicates that I have at least one cancer in my future. But, I thought, this can be dealt with, Im healthy going in, and Ill take this one day at a time.

Ive lost sensation in my chest area. I bump into things, and I dont even know it. Its weird, and Im mourning the loss of sensation there, but I knew it would happen, and I was at least somewhat prepared. Make plans. Have a wedge for your bed. Know what the drain looks like coming out of your body. Know who will help you shower and who will make you laugh when your life just has so much yuck in it. Because theres a lot of yuck; youre going to need your sense of humor. And if yours is AWOL, borrow some from a friend.

Just because I knew what was coming doesnt mean I didnt have emotions around it. I had to let myself grieve the loss of my breasts even as I was taking control of the decision to have the bilateral mastectomy. I had to stop being practical and allow myself to mourn.

Living in Seattle, I am blessed with having so many amazing medical professionals in cancer treatment. But I also wanted to work with someone I was comfortable with, someone I trusted with my body, with my future. I needed to feel they were making decisions that worked for me. Please know that youre not hurting a doctors feelings if you decide to move on from them because youre not connecting well with them. It happens all the time, and docs understand how important it is that you feel comfortable. I picked people I felt great with and felt we were making decisions for the same reasons.

Hey, I get a tummy tuck out of this get lemons, make lemonade! Im not exactly going to be voluptuous, but Im good with Bs or even really big As that look nice.

Dont rely on self-breast exams even when I knew where my biggest tumor was, I couldnt feel it. Also, some people are pushing thermograms, claiming theyre safer than mammograms, but they are NOT safer, so do your research before committing. A mammogram isnt perfect, but its a good tool and has saved lives. And you wont get breast cancer from mammograms. The radiation is minimal: you get more from walking around for two weeks in the world. Be informed about your choices before you make them.

I could have put off the reconstruction until next year, when theres a chance COVID-19 will be behind us, and things will be back to whatever normal there is on the other side. But I figured, 2020 is already a hot mess of a year, I might as well shove all the shit into this one and look forward to 2021.

So thats what Im doing. May you get all your shit behind you too. Now go schedule your next screening.

Go here to see the original:
Im A Physician Who Had Breast Cancer, And Here Are The Knowledge-Based Decisions I Made For Myself - Scary Mommy

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New York: Clinicians can examine COVID-19 patients' blood to identify those at greatest risk of severe illness and to pinpoint those most likely to need a ventilator, according to a new study.

The discovery could lead to new treatments to prevent deadly "cytokine storms" seen in severe cases of COVID-19. It also may help explain why diabetes contributes to worse outcomes in patients with the coronavirus.

The researchers from the University of Virginias (UVA) found that the levels of a particular cytokine in the blood upon diagnosis could be used to predict later outcomes.

Cytokines - proteins produced by immune cells - are responsible for severe overreactions by the immune system, known as cytokine storms, associated with COVID-19 and other serious illnesses.

"The immune response that we discovered to predict severe shortness of breath in COVID-19 is known in other pulmonary diseases to cause damage," said study researcher Bill Petri from the UVA.

"So this could lead to a novel way to prevent respiratory failure in individuals infected with the new coronavirus, by inhibiting this immune cytokine. We plan to test this in a model of COVID-19 prior to considering a clinical trial," Petri added.

For the findings, the research team identified 57 COVID-19 patients treated at UVA who ultimately required a ventilator. They then tested blood samples taken from the patients within 48 hours of diagnosis or hospital admission.

The research team compared the results with those from patients who did not wind up needing a ventilator. Cytokine storms, in which the immune system spirals out of control, are typically associated with an established group of cytokines.

But the best predictor of COVID-19 outcomes was an "underappreciated" cytokine more associated with allergies, the researchers reported. High levels of that cytokine, IL-13, were associated with worsened Covid-19 outcomes regardless of patients' gender, age or other health problems.

The researchers also identified two more cytokines associated with severe outcomes, though the duo had less ability to predict the need for a ventilator.

In addition, the researchers found that levels of two other cytokines were significantly higher in patients with elevated blood sugar. This "pro-inflammatory response," they said, may help explain why diabetes is associated with worse COVID-19 outcomes. In short, the body is primed to respond too strongly to the infection.

The researchers said the discovery could become part of a scoring system to let doctors flag at-risk COVID-19 patients for closer monitoring and personalized interventions. The finding also identifies cytokines doctors could target as a new treatment approach.

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There are countless dieting tips, tricks, recipes, and meal plans you can find in a single Google search, all promoting different ways to lose weight. But what you eatand how muchis affected by more than just your hunger, desire to control eating, or diet plan.

The first thing to understand when you want to lose a few pounds is something experts call your set-point weight: This is your body's "happy weight"it's a size that your brain and body try to maintain, and it includes the fat stores on your belly and elsewhere.

According to registered dietitian Dara Dirhan, this amount of fat becomes what the brain has determined to be the best for optimal function.

Two hunger hormones are responsible for trying to regulate your body's set point: ghrelin and leptin, says Dirhan. Ghrelin is known as the "hunger hormone" because it is secreted when the brain senses that available energy stores are running low.

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This hormone generates feelings of hunger that convince you it's time to get some food in your belly. Your digestive system converts the calories to blood sugar (glucose), which can then power muscles, organs, the brain, and other cellular functions.

Leptin is known as the "satiety hormone"it's released when your body senses that you've eaten enough; it signals the brain that energy levels have been met.

These signals have three primary functions, according to David Prologo, MD, a dual board-certified obesity-medicine physician, and interventional radiologist. They tell your body when to seek food, when to slow down and conserve energy, and when to store and preserve fuel if it senses deprivation (a leftover from the days when famines weren't uncommon)and this is all in the name of survival.

The brain isn't concerned with how you look, Dr. Prolongo says. "It is concerned with maintaining life." Your body and brain are programmed to remain stable at your set point.

How your brain changes on a diet

When you first start a new dietor you aren't consuming enough energy for your brain's needsyou can experience symptoms like weakness, hunger, depression, fatigue, and headaches, among other symptoms. The good news is that after several weeks the brain eases up on these signals, Dr. Prologo says, as your body begins to find a new set point.

Jason McKeown, MD, neurologist and CEO of Modius Health, adds that once your body reaches a new set point, you'll see a reduction in your appetite and cravings. "To maintain results, diets in the long-term can influence this set-range, making your brain adapt and be comfortable at a lower weight," Dr. McKeown says. It's also possible to drive your set point upwards, he warns.

Changing your set point is no easy task: It can take months and sometimes even years, says Dr. McKeown, which is why you should set long-term diet and weight goals. "In the long run you could reset the weight range that your brain has established which will cause your body to speed up metabolism and decrease appetite, becoming comfortable with a lower weight," Dr. McKeown says. "Whereas in the short run, you may lose a few pounds, but youll often plateau and see the weight creep back up as its not enough to influence the weight your brain and body is happy with."

Food quality makes a difference

The quality of your diet is another variable. For brain health and well-being, Dirham recommends choosing a whole foods diet as much as possible. This means staying away from foods that have been processed or refinedenergy-dense, high-calorie foodsand incorporating healthier whole foods like fresh fruits and vegetables, lean meat, poultry, fish, and whole grains, Dirhan says.

Instead of focusing on what she calls a "calorie salary," stick to a whole food diet and practice mindful eating (slowing down your eating and taking time to appreciate meals). "This will make sure the brain is happy while aiding in weight loss," she says. (Focusing on calories is just one of many things keeping you from losing weight.)

Farrah Hauke, a psychologist in Scottsdale, Arizona who specializes in weight management and weight loss, believes that people are more likely to binge when they overly restricting what they eat. When people eat foods higher in fat or sugar, the brain releases "feel-good" chemicals that make the indulgence more rewarding. "We don't see this same brain stimulation with foods such as broccoli and grilled chicken breast," Hauke says.

When you diet, you can lose out on those feel-good chemicals, which means you're less likely to get those brain-boosting rewards from dieting. Hauke recommends you find other ways to reward yourself and feel satisfied; the goal is to avoid what she calls "cognitive distortions"negative thinking patterns that contribute to the common all-or-nothing diet approach.

The experts all agree that rigid rules, unrealistic expectations about eating, and fad diets aren't the best strategies for your body and brain. Instead, focus on the quality of your diet, listening to your body's hunger cues, and adding in physical activity. This, along with these tiny changes, can help you lose weight.

Gallery: 101 Ultimate Weight Loss Tips for Summer 2020 (Best Life)

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This Is What Happens to Your Brain on a Diet - MSN Money

A 19-month-old boy with a medical history of 1 febrile seizure presented to the emergency department (ED) with 2 days of vomiting and 1 day of diarrhea. He was accompanied by his nonEnglish-speaking mother, who reported several episodes of nonbloody, nonbilious emesis and dark brown, watery stools. The patient had decreased intake of solid foods, but he had been breastfeeding well. Because of his diarrhea, the patients mother was unsure how many voids he had had in the past day. He had not had fevers. The family history was significant for the patients father recently being diagnosed with hepatitis C. The patients mother brought him into the ED because of his symptoms and concern that he looked yellow.

In the ED, the patient was afebrile with normal vital signs for his age (including heart rate of 146 beats per minute), and he was well appearing and active with moist mucous membranes and a capillary refill of <2 seconds. However, the ED provider additionally documented that the patient appeared moderately dehydrated [and] slightly jaundiced, and he ordered a comprehensive metabolic panel (CMP). All values were within normal limits, including total bilirubin, except for a low bicarbonate of 16 mmol/L (normal 2130 mmol/L) and an elevated alkaline phosphatase (ALP) of 926 U/L (normal 129291 U/L). The provider consulted endocrinology for the elevated ALP, who noted a broad differential for elevated ALP and that transient hyperphosphatasemia is a diagnosis of exclusion. They recommended checking 25-hydroxyvitamin D, phosphate, and parathyroid hormone to

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An Explosive Workup for Diarrhea: The Cascade Effect From an Incidental Finding on a Laboratory Panel - AAP News

CARLSBAD, Calif., July 1, 2020 /PRNewswire/ --Qualigen Therapeutics, Inc. (NASDAQ: QLGN) ("Qualigen" or the "Company") announces it has submitted an official notification to the U.S. Food and Drug Administration ("FDA") to commence sales in the U.S. of the Company's FastPack SARS-CoV-2 IgGtest for COVID-19 antibodies. This test has already been submitted to the FDA for Emergency Use Authorization ("EUA"), but the notification enables Qualigen to commence sales even before the FDA considers or formally grants the EUA for the test. Qualigen expects sales and shipments of the new test to begin in mid-July.

The FastPackCOVID-19 antibody test is a chemiluminescent microparticle test intended for the qualitative detection (i.e., yes/no) of SARS-CoV-2 IgG antibodies in bloodto identify individuals with an adaptive immune response to the virus that causes COVID-19, indicating recent or prior infection of the disease (which, as a practical matter, is believed to be indicative of immunity against re-infection). Qualigen's FastPacktest uses a specific protein that is also used by major diagnostics companies including Abbott Laboratories, Roche Diagnostics and Bio-Rad Laboratories in their COVID-19 antibody tests. The important advantage of FastPackover testing in large commercial laboratories, however, is its ability to deliver accurate results far more rapidly, in this case under 10 minutes, in physician offices, clinics and hospitals.

"Of the different options available, we chose to develop a test specific to the IgG antibody because IgG represents the long-term immune response. We believe our test's combination of high speed and high accuracy provides the clinician with more useful and actionable information than other testing approaches," Michael Poirier, the Company's CEO, explained. "We believe that reliable, yet convenient testing at the point-of-care is critical to helping combat this virus and get Americans back to their normal routines."

The new test is designed for use with Qualigen's new FastPack PRO System point-of-care diagnostic instruments. The FastPack PRO System is an upgraded version of Qualigen's flagship FastPack IP rapid immunoassay diagnostic point-of-care system.

Qualigen has been producing high-quality diagnostic testing products for almost 20 years, and has established a strong reputation for delivering highly accurate point-of-care tests that help save people's lives.

About the FastPack SystemThe FastPack System is a rapid and highly accurate immunoassay testing system consisting of the FastPack Analyzer and the FastPack test pouch (a single-use, disposable, foil packet that includes the FastPack reagent chemistry). This "Laboratory in a Pouch" is installed in physician offices, clinics and small hospitals around the world, and quickly detects diseases and medical conditions at the point-of-care. Since the conception of the system, the Company has expanded its assay menu to 10 tests including tests for prostate cancer, thyroid function, metabolic disorders, antibodies against SARS-CoV-2, and research applications. Over the past 20 years, FastPack has generated more than $100 million in commercial sales. Qualigen's worldwide distributor for FastPack is Sekisui Diagnostics, LLC, a subsidiary of a multibillion-dollar Japanese chemical and technology company; Sekisui, in turn, works with national distributors including McKesson Corporation and Henry Schein Inc.

About Qualigen Therapeutics, Inc.Qualigen Therapeutics, Inc. is a biotechnology company focused on developing novel therapeutics for the treatment of cancer and infectious diseases, as well as maintaining and expanding its core FDA-approved FastPack System, which has been used successfully in diagnostics for almost 20 years. The FastPack menu includes tests for cancer, men's health, hormone function, vitamin D status and antibodies against SARS-CoV-2. The Company's cancer therapeutics pipeline includes ALAN (AS1411-GNP), RAS-F3 and STARS. ALAN (AS1411-GNP) is a DNA coated gold nanoparticle cancer drug candidate that has the potential to target various types of cancer with minimal side effects. The foundational aptamer of ALAN, AS1411, is also being studied for use in treating viral-based infectious diseases, including COVID-19. RAS-F3 is a small molecule RAS oncogene protein-protein inhibitor for blocking RAS mutations that lead to tumor formation, especially in pancreatic, colorectal and lung cancers. STARS is a DNA/RNA-based treatment device for removal from circulating blood of precisely targeted tumor-produced and viral compounds. Qualigen's facility in Carlsbad, California is FDA and ISO Certified and its FastPack product line is sold worldwide by its commercial partner Sekisui Diagnostics, LLC. For more information on Qualigen Therapeutics, Inc., please visit https://www.qualigeninc.com/.

Qualigen Forward-Looking StatementsThis news release contains forward-looking statements by the Company that involve risks and uncertainties and reflect the Company's judgment as of the date of this release. These statements include those related to potential future development, testing and launch of product candidates. Actual events or results may differ from our expectations. For example, there can be no assurance that the Company will be able to manufacture the FastPack Pro System instruments and SARS-CoV-2 IgGtest kits successfully; that any commercialization of the FastPack Pro System instruments and SARS-CoV-2 IgGtest kits will be profitable; that adoption and placement of FastPack Pro System instruments (which are the only FastPack instruments on which the Company's SARS-CoV-2 IgGtest kits can be run) will be widespread; that the Company's request to the FDA for Emergency Use Authorization will ultimately be approved; that the Company will successfully develop any drugs or therapeutic devices; that preclinical or clinical development of the Company's drugs or therapeutic devices will be successful; that future clinical trial data will be favorable or that such trials will confirm any improvements over other products or lack negative impacts; that any drugs or therapeutic devices will receive required regulatory approvals or that they will be commercially successful; that we will be able to procure or earn sufficient working capital to complete the development, testing and launch of our prospective therapeutic products; or that we will be able to maintain or expand market demand and/or market share for our diagnostic products. Our stock price could be harmed if any of the events or trends contemplated by the forward-looking statements fails to occur or is delayed or if any actual future event otherwise differs from expectations. Additional information concerning these and other risk factors affecting the Company's business (including events beyond the Company's control, such as epidemics and resulting changes) can be found in the Company's prior filings with the Securities and Exchange Commission, available at http://www.sec.gov. The Company disclaims any intent or obligation to update these forward-looking statements beyond the date of this news release, except as required by law. This caution is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.

SOURCE Qualigen, Inc.

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Qualigen Therapeutics Submits Notification to FDA to Commence Distribution of its FastPack COVID-19 Antibody Test - PRNewswire

Like most of us, Im doing my damnedest to stay healthy right now. Im social distancing and washing my hands almost obsessively. Im trying to eat as many vegetables as possible to ensure I'm getting health-supporting nutrients that I'm not exactly taking in via all the stress baking.

Its also not surprising that Ive been bombarded with news over the past few months about how to bolster my immune system. I cant scroll through my Instagram feed without seeing some influencer bragging about an immune-boosting smoothie or a supplement company promoting pills with elderberry and citrus.

Time-out, though. Immunity has a PR problem right now. The whole idea that you can power up your immunity in some quick-and-dirty way overnight (and, you know, avoid a cold or flu...or COVID-19) isn't actually how it works.

Think of immunity like this: If youre the star quarterback of your life, your immune system is like that super-jacked lineman whose number-one job is to protect you from all directions. And, separately (but still in that sports realm!), just like how strategic leadership can whip a team into shape, you can train your system to more efficiently pick off any opponentbug, virus, germthat comes your way. But that conditioning takes time and dedication.

So, taking a last-minute, reactionary approach to immunity is the opposite of how you should think about it, says Nicole Avena, PhD, visiting professor of health psychology at Princeton University. Immunity is a marathon, not a sprint. Because of that, there isnt any fast and easy way to immediately amplify yours. Youve got to take an all-in, holistic approach if youre going keep your immune system in fighting form, says Avena.

Recalibrating your immunity for the long game comes down to the classic health habits you hear time and time again: sleep, stress reduction, and sweating it out. The key is doing all of these to at least some degree and not expecting one to be the ultimate cure-all. You wont make your immune system healthier in a week by pumping yourself with vitamins because someone close to you is sick, says E. John Wherry, PhD, director of the Institute for Immunology at the University of Pennsylvania. But you absolutely can help your immunity by making certain lifestyle changes.

Nail Your Sleep Routine

Sleepspecifically getting at least seven hours most nightsmight be the Most Important Thing. The best data we have about how to improve immunity is on getting the right amount of good sleep, says Wherry. People who got six hours of shut-eye a night or less for one week were about four times more likely to catch a cold when exposed to a virus compared to those who got more than seven hours, according to a study published in the journal Sleep. (The risk of getting sick was even higher for those who snoozed less than five hours a night.)

Everything you do when youre awakeeating, digesting, working, walking, exercisingprompts your body to release inflammatory cells, says Rita Kachru, MD, section chief of the clinical immunology and allergy division and assistant professor at the David Geffen School of Medicine at UCLA. Sleep gives your body a break from all of that. Dont get hung up on one crappy night of Zs (or give yourself too much praise for one amazing one, for that matter); focusing on long-term, consistent good sleep habits is the way to go. Your building blocks, right here.

Mara de la Paz Fernndez, PhD, a sleep researcher and assistant professor of neuroscience and behavior at Barnard College of Columbia University

Mariana Figueiro, PhD, director of the Lighting Research Center and a professor of architecture at Rensselaer Polytechnic Institute

Mikka Knapp, a registered dietitian-nutritionist

Rebecca Robbins, PhD, a sleep researcher and co-author of Sleep for Success!

Megan Roche, MD, epidemiology researcher and Strava running coach

Its well established that stress prompts the release of cortisol, that fight-or-flight hormone that enables you to run for your life. When cortisol is high, your immune system isnt as active, says Daniel M. Davis, PhD, professor of immunology at the University of Manchester in England; your body sends all of its resources to the thing it thinks is most likely to kill you, and away from other stuff, like your protective network.

Dont stress? Ill just give up now, youre thinking. Stay calm and try this: Instead of attempting to eliminate negativity, refine the way you cope (with the genius advice ahead!)which will make the blues more manageable and mitigate that cortisol response, Davis says.

Joy Lere, a psychologist

Kevin Gilliland, PsyD, a clinical psychologist and executive director of Innovation360

Patricia Celan, MD, a psychiatry resident at Dalhousie University in Canada

Beatrice Tauber Prior, PsyD, a clinical psychologist

Working out creates inflammation in the body, but its the good kind, says Wherry. Its a little counterintuitive, because exercise actually disrupts your bodys homeostasis, he says. But when your sweat sesh is finished, your bod goes back to its status quokeeping your immunity on its toes in that brilliant way, he says. Research backs this up: Folks who exercise regularly develop more T cells (those destroyer white blood cells) than their sedentary peers, a recent study found. It also helps modulate the stress hormone cortisol, which, when raised, leads to inflammatory activity.

Some experts agree that overtraining (you know, that feeling when youve been pushing yourself too hard and youre feeling it) can hinder immunity. So if youre an everyday athlete, moderate exercise on a consistent basis is the end zone to aim for.

Jennifer Haythe, MD, a critical care cardiologist at Columbia University Medical Center

Lisa Ballehr, DO, an osteopathic physician and Institute for Functional Medicine certified practitioner

Ian Braithwaite, MD, an emergency physician at The Royal London Hospital

Kym Niles, certified personal trainer

Kristen Gasnick, board-certified physical therapist

Jenn Randazzo, registered dietitian

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How To Boost Your Immune System - 15 Tips From Experts - Women's Health

Rihaan* came out to his parents in the summer of 2008 three days after they created a profile for him on a matrimonial site. His conservative upper-class family in Pune reacted badly. There was confusion, rage, tears. My father begged me to meet a psychiatrist, who instantly diagnosed my condition as mother-fixation. Rihaans treatment started the same week. First it was coercion and counselling; then he was given medicines and dragged to brothels.

Then came the final sitting to reverse my orientation and cure the disorder. I was locked into a room wallpapered with pictures of nude men and they gave me some injections that made me throw up. I retched the entire day, collapsing in between, then waking up covered in vomit. Two days later the session was repeated and I was shown gay porn. Within a couple of weeks Rihaan was a defeated man. Panic rose in my chest even at the mention of same-sex attraction. My parents were summoned and officially informed that my conversion was complete. I lived like a zombie those days. I was heavily dependent on medicines and each time I tried to stop, I was ravaged by withdrawal symptoms. I contemplated suicide. Then, before I knew it, I was married to a cis woman.

Rihaans marriage lasted five months, but more than 10 years later, he still gets panic attacks. He has no career or confidence. I am unable to have a meaningful relationship and at times the shame and pain are unbearable, he says. Now, Rihaan is finally on the road to recovery.

Curing queerness

Not everyone is so lucky. Anjana Harish, the 21-year-old queer student from Kerala who was found dead in Goa last month, was also subjected to conversion therapy. Her friends say that Harish live-streamed a video revealing the torture she had to endure from pseudo-therapists.

Disturbingly, it looks like the discredited concept of conversion therapy is still being practised. Claiming to cure queerness, it can involve everything from shock treatment to exorcism and hormones to psychotropic drugs and kindling a sense of shame. According to medical experts, it causes irreparable damage to the mental health of victims.

Members of the LGBTQIA+ community say conversion therapy is practised in stealth. The patients are taken to psychiatric wards in hospitals or de-addiction centres with falsified files. When Jay*, a trans man from Ahmedabad, consulted a psychiatrist at a government facility for sex reassignment surgery, the doctor insisted that he go through conversion therapy first. I am a 43-year-old gazetted officer and I went there with some community members. If they could try to coerce me, think about what they must do to younger people with no support, says Jay.

Quacks and clerics

This so-called therapy is dished out not just by unscrupulous health professionals but also by preachers, naturopaths, shamans, and religious establishments. When Marie* told her parents in Coimbatore that she was a trans woman, they asked her to attend a course at an ashram the family used to frequent. On the second day of the course, I woke up in another place where I was held prisoner for two months, she says. I was slapped, body-shamed and sexually abused for being a sinner and acting against the divine plan.

Realising there was no point in fighting, Marie stopped reacting and convinced them that she had changed. I was sent home where I continued the charade for two more months. At the very first opportunity, I fled and never went back. Marie has since undergone sex reassignment surgery and works as a doctor in a hill station where nobody knows her past. I survived because I stayed vigilant from the beginning. Once they break your spirit, there is no going back.

Salmas* relationship with another girl became a scandal that rocked her hometown, Lucknow. It was a cleric who advised the family to keep her in isolation; she was raped multiple times by a close relative, a man she called kaka (uncle). In India, religious institutions and representatives play a big part in promoting conversion therapy. In the West, groups like Exodus International openly promoted conversion therapy across nearly 20 countries, but it has been more hush-hush here, with saints, pastors and babas doing it on the sly. Organised groups operate as de-addiction centres, prayer groups or ashrams.

Against the law

We condemn conversion therapy. Its unlawful, says P.K. Dalal, President, Indian Psychiatric Society (IPS). IPS has taken a strong stand against it. We have a protocol when it comes to such cases and we will soon be coming out with a statement, he adds.

Although there is no specific law prohibiting conversion therapy, legal experts emphasise that the practice violates the Right to Privacy enshrined under Article 21. If sexual abuse is involved, its an IPC offence anyway and now we have the Mental Healthcare Act, 2017, that gives a lot of agency to individuals, says Sandhya Raju, an advocate at the Kerala High Court and a member of the Human Rights Law Network. Once mental health review boards are constituted as part of enforcing the law, the community can use it to protect their rights.

If the practice is used against children below 18, the law is even more stringent. Parents can be booked under Section 75 of the Juvenile Justice Act, 2015. Prijith P.K., president of the Thiruvananthapuram-based Queerythm, which operates a 24x7 helpline for LGBTQIA+ people, says, Very often parents are involved, and doctors claim the treatment is for depression or schizophrenia. He thinks new legislation is needed to address the issue. While transpersons are protected under the NALSA judgment, other segments including gays, lesbians and bisexuals have no legal support. Same-sex marriages are still not legal in India. We talk about inclusivity and awareness, but legal backing is very important to achieve that goal. When the discrimination ends, the rest will follow, he says.

While most such practitioners are quacks, there are some who strongly believe they are offering a service. A Kerala-based psychiatrist who practises conversion therapy said, on condition of anonymity, that his patients undergo the treatment willingly as its easier to live as a heterosexual individual.

According to him, many of his patients now have a family and children. But he admits that many of them return due to marital discord and are on endless medication for depression.

A Hyderabad-based sexologist is equally confident. He offers different programmes tailored to the severity of queerness and says, You can fix most homosexuals with hormone therapy. Psychiatric interventions have been successful in most cases Ive treated. For example, testosterone injections can reverse same-sex desire to a great extent while some people respond to behavioural therapy.

He refuses to share his methods and says sexual deviance often springs from childhood sexual abuse and conditioning. He believes he is helping queer people by reaffirming their real orientation or gender identity, making them acceptable, and protecting the honour of their families.

Hypnotised, lobotomised

The origins of this clandestine practice date back to the 19th century, when deviant sexual orientations were considered sinful or criminal. One of the first documented cases comes from the accounts of Albert von Schrenck-Notzing, a German physician who reportedly used hypnosis to cure homosexuality in the 1890s.

By the early 1900s, practitioners worldwide began to use hypnosis as well as electroconvulsive therapy and sometimes surgical procedures like lobotomy. People were tortured, castrated and subjected to sordid corrective measures. Aversion therapy, of the kind Rihaan underwent, was portrayed in Stanley Kubricks 1971 film A Clockwork Orange.

In India, the Department of Psychiatry at AIIMS, New Delhi, conducted a study to reverse sexual orientation between 1977and 1982. The subjects were six homosexual people, who were administered electric shocks using an aversion therapy apparatus set at 50 volts to control their homoerotic fantasies. The report claimed that four persons were successfully reoriented. By the 2000s, several doctors and healers had popped up across the country.

In May this year, the U.N. published a report cataloguing the severe and everlasting impacts of conversion therapy. The report says, Attempts to pathologize and erase the identity of individuals, negate their existence as lesbian, gay, bisexual, trans or gender diverse and provoke self-loathing have profound consequences on their physical and psychological integrity and well-being. It urges governments to ban conversion therapy. So far only five countries Germany (for under-18s), Malta, Ecuador, Brazil, Taiwan have drawn up bills making it illegal, but efforts are on in other countries too.

At the most basic level, conversion therapy is unethical and a human rights violation. Even after the Supreme Court decriminalised consensual same-sex relationships by striking down Section 377 and came out with the historic NALSA judgment to protect transgender rights, Indian society is far from queer-friendly: LGBTQIA+ individuals still face violence, hostility and stigma. And a very real threat to their mental and physical health.

The Turing Effect

In January 1952, English mathematician Alan Turing, who played an important role in breaking German war codes during WW II,

was charged under the Criminal Law Amendment Act, 1885 for being in a sexual relationship with a man. Turing, who would later become famous as the father of modern computer science and artificial intelligence, was convicted. He was made to undergo hormonal therapy or chemical castration for one year, which reportedly made him impotent and led to the formation of breast tissue. Turing was also barred from continuing his government work.

In June 1954, two weeks before he turned 42, Turing was found dead at home, by apparent suicide, although subsequent reports claimed his death may have been due to accidental poisoning. Turings path-breaking research and his persecution were the subject of the 2014 Oscar-winning film, The Imitation Game, starring Benedict Cumberbatch. In December 2013, Queen Elizabeth II overturned Turings conviction. And in September 2016, the U.K. government said it would extend the retroactive exoneration to other men convicted similarly, under a new Alan Turing law.

*Names changed to protect identity.

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With more than two million new cases diagnosed in 2018, breast cancer is the most common cancer in women worldwide.[1] The disease represents about 25% of all cancers in women. Incidence rates vary widely across the world, from 27 per 100,000 in Middle Africa and Eastern Asia to 85 per 100,000 in Northern America. Breast cancer is also the fifth most common cause of death from cancer in women globally, with an estimated 522,000 deaths annually

An estimated 90% of all breast cancer is diagnosed at an early stage. [2] And approximately 70% of all breast cancers are HR+, HER2-, the most common subtype of the disease. [3] Even within this subtype, HR+, HER2- breast cancer is a complex disease, and many factors, including cancer which spread to the lymph nodes and the biology of the tumor, can impact the risk of recurrence. Recent data shows that about 30% of people diagnosed with HR+, HER2- early breast cancer are at risk of their cancer returning, potentially leading to incurable metastatic disease.[4]

Metastasized diseaseBreast cancer starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The malignant tumor is getting worse when the cells invade surrounding tissues or metastasize to distant areas of the body. In that case and in ths stage of breast cancer also referred to as stage IV breast cancer, spreads or metastasizes beyond the breast and nearby lymph nodes to other parts of the body. In the majority of cases, this includes the bones, lungs, liver, or brain.

Although an advanced disease, most women with metastatic or stage IV breast cancer are treated with systemic therapy. This treatment may include hormone therapy, chemotherapy, targeted therapy, or a combination of these options.

No an end-stage cancerWhile some people may refer to metastatic breast cancer as end-stage cancer, the disease is NOT hopeless and many people continue to live long, productive lives with breast cancer in this stage.

In an interview with The OncoZine Brief in December 2019, Susan Rafte describes her experience as a 25-year metastatic breast cancer survivor. While challenging, she became a peer-to-peer support volunteer through MD Anderson Cancer Center and has helped many patients with her peer support program. Rafte has also contributed to many research projects and committees as a patient advocate.

Listen to The OncoZine Brief: Susan Rafte: A 25+ Year Survivor of Metastatic Breast Cancer and Patient Advocate

A growing number of treatment optionsAnd while metastatic breast cancer may be treated in a different way than breast cancer diagnosed at an earlier stage, there is a wide variety of treatment options for metastatic disease. And investigators are studying new drugs in clinical trials.

Although metastatic breast cancer can be unpredictable, with hopeful times when patients are responding well to treatment and the disease is stable to scary time of progression, the result of ongoing research and development is that more and more patients are given the opportunity of living life to the fullest while, at the same time, being treated for metastatic disease.

Metastatic breast cancer can not be cured. But ongoing treatment may control the disease for a number of years. New treatment options may not only help patients live longer, but they can also help in relieving cancer-related symptoms, and improve the patients overall Quality of Life (QoL), something doctors describe keeping [the patient] feeling as good as they can for as long as they can. And Quality of Life, including issues related to sexual intimacy, is important for the overall health of patients as was demonstrated during a round table discussion with patients and physicians during the 2019 San Antonio Breast Cancer Symposium (SABCS).

With a growing number of treatment options, if one option fails, there is usually another option patients can try. For patients diagnosed with a metastatic disease today, there is, as a result, more hope for many years of good Quality of Life compared to patients diagnosed two decades ago. palliative

Listen to The OncoZine Brief: Candid Conversations on Mets, Sex, and Side Effects: a Panel Discussion With Breast Cancer Oncologists, Womens Health Experts, and Patients.

Clinical developmentClinical trials are an important step in establishing the safety and efficacy of potential new treatments. Clinical trials also help investigators decide if established side effects or adverse events as a result of a particular new treatment option are acceptable when weighed against the benefits of that particular treatment option.

But ongoing research is also instrumental in understanding breast cancer leading to a better understanding of the biology of the disease and help physicians to better (or earlier) detect and diagnose the disease.

According to the American Cancer Society, more than 1,000 investigational drugs are studies before just one makes it to clinical trials. And, on average, a new drug for the treatment of breast cancer may take 6 years and in some cases even longer before scientists begin are able to test a particular new drug in a clinical trial. And, the clinical trial process itself (from phase I to phase III and market approval) may add another 6 10 years to the development process.

ProgressEarlier this week, investigators at Oncolytics Biotech confirmed that they have dosed a first patient in the so-called phase II BRACELET-1 study (BReast cAnCEr with the Oncolytic Reovirus PeLareorEp in CombinaTion with anti- PD-L1 and Paclitaxel; NCT04215146), a clinical trial designed to evaluating Pelareorep-based combination therapies in patients with endocrine-refractory, HR+/HER2- metastatic breast cancer.

Pelareorep is a non-pathogenic, proprietary isolate of the unmodified reovirus, a first-in-class intravenously delivered immuno-oncolytic virus for the treatment of solid tumors and hematological malignancies. The investigational compound induces selective tumor lysis and promotes an inflamed tumor phenotype through innate and adaptive immune responses to treat a variety of cancers and has been demonstrated to be able to escape neutralizing antibodies found in patients.

In the study, being conducted under a co-development agreement with Merck KGaA and Pfizer, participating patients receive paclitaxel, pelareorep in combination with paclitaxel alone, or pelareorep in combination with paclitaxel and anti-PD-L1 checkpoint inhibitor, avelumab (Bavencio).

The randomized, open-label, BRACELET-1 study is designed to support the results of a prior successful phase II trial (IND-213) that showed a near doubling of overall survival (OS) with pelareorep treatment, by demonstrating pelareoreps ability to induce a robust anti-tumor immune response in an identical patient population (patients with HR+/HER2- metastatic breast cancer).

The ability of pelareorep-induced immune responses to enhance anti-PD-L1 therapy will also be evaluated through the inclusion of the paclitaxel-pelareorep-avelumab combination therapy cohort. Importantly, the trial also aims to validate peripheral T-cell clonality as a biomarker of pelareorep response in HR+/HER2- metastatic breast cancerm, which may aid in future registrational trial study design and patient selection.

MonarchEAnother clinical trial, the randomized, open-label, phase III monarchE study, is designed to investigate abemaciclib (Verzenio; Eli Lilly and Company) in combination with standard adjuvant endocrine therapy versus standard adjuvant endocrine therapy alone in patients with high-risk, node-positive, early-stage, hormone-receptor-positive, human epidermal receptor 2 negative, breast cancer. The study includes research on acquired genomic alterations in circulating tumor DNA (ctDNA)an area of particular interest as scientists try to understand how to individualize treatment for people living with HR+, HER2- advanced breast cancer.

Abemaciclib is an inhibitor of cyclin-dependent kinases (CDK)4 & 6, which are activated by binding to D-cyclins. In estrogen receptor-positive (ER+) breast cancer cell lines, cyclin D1 and CDK4 & 6 promote phosphorylation of the retinoblastoma protein (Rb), cell cycle progression, and cell proliferation.

In vitro, continuous exposure to abemaciclib inhibited Rb phosphorylation and blocked progression from G1 to S phase of the cell cycle, resulting in senescence and apoptosis (cell death). Preclinically, Verzenio dosed daily without interruption resulted in a reduction of tumor size. Inhibiting CDK4 & 6 in healthy cells can result in side effects, some of which may be serious. Clinical evidence also suggests that Verzenio crosses the blood-brain barrier. In patients with advanced cancer, including breast cancer, concentrations of abemaciclib and its active metabolites (M2 and M20) in cerebrospinal fluid are comparable to unbound plasma concentrations.

Investigators at Eli Lilly and Company recently presented data of a study of abemaciclib in combination with standard adjuvant endocrine therapy (ET) and confirmed that study has met the primary endpoint of invasive disease-free survival (IDFS), significantly decreasing the risk of breast cancer recurrence or death compared to standard adjuvant ET alone.

These results are from a pre-planned interim analysis of the phase III monarchE study making abemaciclib the only CDK4 & 6 inhibitors to demonstrate a statistically significant reduction in the risk of cancer recurrence for people with high-risk hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) early breast cancer. The established safety profile was consistent with that observed in other abemaciclib studies in the MONARCH clinical program.

When a [patient] is diagnosed with high-risk early-stage breast cancer, they strive to do everything in their power to prevent a recurrence. And as clinicians, we have the same goal, noted Maura Dickler, M.D., vice president of oncology, late-phase development, Lilly Oncology.

The monarchE [trial] was intentionally designed for people whose breast cancer is at a high risk of returning. We are incredibly excited by the results of monarchE and that we can potentially offer a new treatment option for patients with high-risk HR+, HER2- early breast cancer. This would not have been possible without the tremendous commitment from the people who participated in this trial.

ManufacturingAbemaciclib is Lillys first solid oral dosage form to be made using a faster, more efficient process known as continuous manufacturing, a new and advanced type of manufacturing adopted by the pharmaceutical industry.

Continuous production, which is contrasted with batch production, is a flow production method used to manufacture, produce, or process materials without interruption. The production method is called continuous production because the raw materials, either dry bulk or fluids that are being processed, are continuously in motion, undergoing chemical reactions or subject to mechanical or heat treatment. One of the benefits of this approach is that it eliminates, or significantly reduces, the hold times in-between steps that are typical in batch manufacturing. Lilly was one of the first companies to use this technology on a large scale basis.

Antibody-drug ConjugatesHuman epidermal growth factor receptor 2 (HER2) is a gene that can promote cancer progression when mutated or expressed at high levels. High expression levels of HER2 have been observed in different cancer types, including breast cancer. Several HER2-targeted therapies are approved for the treatment of HER2-overexpressing breast cancer.

One of these agents is the HER2-targeted antibody-drug conjugate (ADC), fam-trastuzumab deruxtecan-nxki (Enhertu; Daiichi Sankyo/AstraZeneca). The FDA-approval of the drug in late 2019, was based on the results of the registrational Phase II trial DESTINY-Breast01 of trastuzumab deruxtecan-nxki (5.4mg/kg) monotherapy in patients with HER2-positive metastatic breast cancer. All patients received prior trastuzumab, trastuzumab emtansine with the majority of patients (66%) receiving prior treatment with pertuzumab (Perjeta; Genentech/Roche).

The Phase II trial results showed a confirmed objective response rate of 60.3% (n=111, 95% CI 52.9-67.4) including a 4.3% complete response rate (n=8) and a 56.0% partial response rate (n=103). Median duration of response of 14.8 months (95% CI 13.8-16.9) was demonstrated as of 1 August 2019. [5] In addition, a median progression-free survival of 16.4 months (95% CI 12.7-not estimable), based upon a median duration of follow up of 11.1 months, was presented at the 2019 San Antonio Breast Cancer Symposium and published online in The New England Journal of Medicine.[6]

The approval oftrastuzumab deruxtecan underscores that this specifically engineered HER2-directed antibody-drug conjugate is delivering on its intent to establish an important new treatment for patients with HER2-positive metastatic breast cancer, noted Antoine Yver, Executive Vice President and Global Head, Oncology R&D, Daiichi Sankyo

Since the beginning of our clinical trial program four years ago, we have focused on the opportunity to transform the treatment landscape for patients with HER2-positive metastatic breast cancer, and we are extremely proud of how quickly we delivered Enhertuto patients in the US, as trastuzumab deruxtecan represents one of the fastest-developed biologics in oncology, Yver added.

In late May 2020, the drug was also approved in Japan.

Triple-negative breast cancerOne of the most difficult to treat forms of breast cancer is (metastatic) triple-negative breast cancer. Traditional breast cancer treatment options dont work because cancer cells in (m)TNBC cancer test negative for estrogen or progesterone receptors and dont make too much of the protein called HER2.

This disease, which accounts for about 10-15% of all breast cancers, is more common in women younger than age 40, African-American women, or women who have a BRCA1 mutation and differs from other types of invasive breast cancer in that they grow and spread much faster, have limited treatment options, and overall worse prognosis.[7]

In April 2020 a new treatment option for adult patients diagnosed with (metastatic) triple-negative breast cancer who have received at least two prior therapies for metastatic disease, received accelerated approval in the United States. The drug, sacituzumab govitecan (sacituzumab govitecan-hziy; Trodelvy) developed by Immunomedics, is a Trop2-directed antibody conjugated to SN-38, the active metabolite of the topoisomerase I inhibitor, irinotecan. Trop2 is a cell-surface receptor that is over-expressed in epithelial cancers, including TNBC. In addition to breast cancer, the uniquely targeting agent is being studied in phase III trials for urothelial cancer, glioblastoma, endometrial cancer, and prostate cancer.

Listen to The OncoZine Brief: Sacituzumab Govitecan, a Novel Treatment for Patients with mTNBC

The confirmatory multicentre, randomized, phase III ASCENT trial, which compared sacituzumab govitecan versus the physicians choice of chemotherapy in patients with mTNBC who have failed2 prior lines of therapy, was stopped earlier than planned after an independent Data Safety Monitoring Committee confirmed compelling evidence of efficacy in the treatment of patients with mTNBC.

An ongoing phase III study is comparing sacituzumab govitecan with the physicians choice of chemotherapy in patients with HR-positive/HER2-negative metastatic breast cancer (NCT03901339; TROPiCS-02). In addition, a phase I/II trial (NCT04039230) is investigating the novel antibody-drug conjugates in combination with talazoparib (Talzenna; Pfizer), a oncedaily oral PARP inhibitor approved for the treatment of gBRCAmutated HER2negative locally advanced or metastatic breast cancer. In addition, a phase I/II, open-label, multicentre, randomized umbrella study (NCT03424005; Morpheus-TNBC) is evaluating the efficacy and safety of multiple immunotherapy-based treatment combinations, including sacituzumab govitecan, in patients with mTNBC.

Precision oncologyPrecision oncology ensures that treatment is specifically designed and targeted to a specific form of cancer using a patients individual genetics the genes that are mutated and cause cancer to grow to create a personalized treatment protocol based on the genetic mutations. Such an approach may offer far better results with fewer side effects than standard chemotherapy.

Recently, two companies, Invitae Corporation and ArcherDX, confirmed that they entered into a definitive agreement under which Invitae will combine with ArcherDX to create a genetics leader with unrivaled breadth and scale in cancer genetics and precision oncology.

The combined company is expected to help transform care for cancer patients, accelerating the adoption of genetics through the most comprehensive suite of products and services available. Integrating germline testing, tumor profiling, and liquid biopsy technologies and services in a single platform may enable precision approaches from diagnostic testing to therapy optimization and monitoring, expanding access to best-in-class personalized oncology.

Rucaparib and lucitanibClovis Oncology, presented four abstracts showcasing non-clinical data from rucaparib and lucitanib development programs during the virtual meeting II of the American Association for Cancer Research (AACR), held June 22 24, 2020.

The presented data summarize findings from preclinical studies evaluating the pharmacokinetics (PK)/pharmacodynamics (PD) and anti-tumor activity of rucaparib, an oral, small-molecule PARP inhibitor in orthotopic and intracranial mouse models, and its synergy with CHK1 inhibition in tumor cell lines.

Additional presentations included findings from a study of the PK of lucitanib, an oral, potent inhibitor of tyrosine kinase activity, in a simulated patient population to inform dosing-regimen selection, and from a pre-clinical study evaluating the anti-tumor efficacy and mechanism of action of lucitanib in combination with a mouse ortholog of ALKS 4230, a selective agonist of the intermediate affinity IL-2 receptor, in a mouse colon cancer model. Lucitanib and ALKS 4230 are both development-stage compounds.

Data from our ongoing non-clinical studies underscore our commitment to pursuing innovative research that advances novel therapies for cancer patients, noted Patrick J. Mahaffy, President and Chief Executive Officer of Clovis Oncology.

In particular, we are pleased to present new, non-clinical data exploring the PK/PD of our PARP inhibitor Rubraca, evaluating the synergies of PARP and CHK1 inhibition in combination, as well as important data for lucitanib to understand optimal dosing and use in combination with other anticancer agents to treat solid tumors, Mahaffy added.

Modulating the effects of cortisolCorcept Therapeutics, a commercial-stage company developing novel drugs to treat severe metabolic, oncologic, and psychiatric disorders by modulating the effects of cortisol, presented updated genomic data from patients with adrenocortical carcinoma at the 2020 American Association of Cancer Research (AACR) Annual Meeting.

Excessive cortisol in patients with adrenal cancer causes Cushings syndrome and may also blunt the efficacy of immunotherapeutic agents such as checkpoint inhibitors, said Andreas Grauer, M.D., Corcepts Chief Medical Officer.

The data we are presenting informed our Phase Ib trial of our proprietary, selective cortisol modulator relacorilant in combination with the PD-1 checkpoint inhibitor pembrolizumab (Keytruda; Merck & Co) in patients with metastatic or unresectable adrenocortical cancer. Our trial examines whether relacorilant can, in addition to treating Cushings syndrome in these patients, also help immunotherapy achieve its maximum effect, by reducing the immunosuppressive effects of excess cortisol activity, Graucer concluded.

Clinical TrialsA Study to Assess Overall Response Rate by Inducing an Inflammatory Phenotype in Metastatic BReast cAnCEr With the Oncolytic Reovirus PeLareorEp in CombinaTion With Anti-PD-L1 Avelumab and Paclitaxel BRACELET-1 Study NCT04215146Study of Relacorilant in Combination With Pembrolizumab for Patients With Adrenocortical Carcinoma With Excess Glucocorticoid Production NCT04373265.ASCENT-Study of Sacituzumab Govitecan in Refractory/Relapsed Triple-Negative Breast Cancer (ASCENT)

References[1] World Health Organization. Breast cancer: prevention and control. Online. Last accessed on June 20, 2020.[2] Howlader N, et al. SEER Cancer Statistics Review, 1975-2013. Online. Last accessed on June 20, 2020.[3] Howlader N, Altekruse S, Li C. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;106(5).[4] Reinert T and Barrios CH. Optimal Management of Hormone receptor-positive Metastatic Breast Cancer in 2016. Ther Adv Med Oncol. 2015;7(6):304-20.[5] ENHERTU [fam-trastuzumab deruxtecan-nxki] US prescribing information; 2019.[6] Modi, S., et. al. Trastuzumab Deruxtecan in Previously Treated HER2-Positive Breast Cancer. NEJM. December 11, 2019. DOI:10.1056/NEJMoa1914510.[7] Bardia A, Mayer IA, Vahdat LT, et al. Sacituzumab Govitecan-hziy in Refractory Metastatic Triple-Negative Breast Cancer. N Engl J Med. 2019;380(8):741-751. doi:10.1056/NEJMoa1814213

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New Therapies may Offer Hope for Patients with Metastatic Breast Cancer - OncoZine

Precisely 32 pages into The Unwelcome Visitor, Loose Women panellist Denise Welchs chatty, conversational account of living with clinical depression, my stomach abruptly swooped upwards before plunging into liftshaft freefall.

This was not the plan. Having suffered from debilitating depressive episodes on and off since my early teens, I have deliberately body swerved what I term Low Mood Literature on the Tolstoyan grounds that each unhappy person is unhappy in their own way and its actually quite tedious (sorry) to plough through other peoples usually quite niche travails.

But these days theres a celebrity out there for every mental health cohort; the drinkers, the thinkers, the wild swimmers, free runners, gardeners and agoraphobics all have their various champions.

Thats not a bad thing but it is A Thing. Former Labour spin doctor Alistair Campbell is due to publish his Living Better: How I Learned to Survive Depression and I can safely predict there wont be much crossover between the readership of his book and Welchs. But by God, there will be a readership for both in the wake of the Covid-19 pandemic.

Theres a mental health tsunami on its way, says Welch, speaking to me on the phone from her home in Cheshire. As lockdown eases off so many people will need treatment, but the NHS just hasnt got the resources. So what are they to do?

Self-help memoirs are a start. Welch has written two best-selling autobiographies but The Unwelcome Visitor: Depression and How I Survive Itis different. It concentrates on her tormented inner life rather than the relentlessly upbeat pocket-rocket persona she projected in public.

Welch thinks as she speaks as she writes; calling her depression the unwelcome visitor is her one and only foray into metaphor.

The likes of Stephen Fry and Ruby Wax have written very eloquently about their mental health battles, she says. My tribe wouldnt be drawn towards someone who was Oxbridge-educated. My book is aimed at Becky from Bolton.

She needs help too. So does her husband and her friends. They need to understand that she cant just pull herself together, that she cant control the pain. Im relatable. I dont have the answers. I am just telling my story, my truth and if I can help people then that will be my proudest legacy.

Welch was 31, a hugely popular soap star and self-confessed party girl when severe post-natal depression hit after the birth of her first baby, Matthew. It never quite left.

The next thirty-one years have been spent learning how to manage her Unwelcome Visitor, the grim reaper who appears unbidden, draining the colour, leeching the joy from her world.

I tell her that despite my best efforts, her plain prose reduced me to rubble. I felt, as a young person might say, triggered when I abruptly welled up with tears of recognition at her shameful, secret post-natal trauma.

I wanted my feelings back: just to be able to experience emotions again, especially for my baby; just to be normal, Welch writes in The Unwelcome Visitor.

Even though Im not religious in the least, I used to pray, Dear God, please, please, help me to love my baby.'

I had no inkling that I would be spirited back to the aftermath of a wretched labour in 2008 when I too felt desolate, empty, mad and as terrified as she was of being unmasked as a wicked, unnatural woman devoid of maternal feeling.

I literally couldnt bear to look at my desperately-wanted second daughter, with her unnervingly intense brown gaze. Instead, I would fix my own eyes on the middle distance while baring my teeth in a caricature of a smile so she wouldnt guess I was broken.

For her part, Welch recounts that years later, long after baby Matthew had grown up to become Matt Healy, singer in the achingly cool band the 1975, he wrote a song She Lays Down, that painfully captured the slow-motion horror of post-natal depression.

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Denise Welch on her struggle with depression: 'I feel grateful that I'm still standing' - Telegraph.co.uk