Archive for the ‘Hormone Physician’ Category

After Rehema was pressured to abort and began a chemical abortion, she reached out and received help from the Abortion Pill Rescue Network in Nairobi, Kenya, and was able to save her unborn son through Abortion Pill Reversal (APR).

Taken by her mother to no less than three abortion facilities, having witnessed the callousness toward life present in the abortion industry, and facing losing a place to live because of her conviction to try to save her unborn son, she is thankful for his life and hopeful for the future.

God has a purpose for my life in this boy, she said. So definitely He will make a way.

And trust me, Rehema stated. (Chemical) abortion can be reversed. I am a living testimony.

Tweet This: And trust me, (chemical) abortion can be reversed. I am a living testimony.

Rehema also said it was God who brought her to Heartbeat Internationals Abortion Pill Rescue Network (APRN). She acted quickly, the reversal has been successful, and she wanted to share her experience.

[Click here to subscribe to Pregnancy Help News!]

Hers is the latest story of a woman falsely made to feel like she had no other choice but to abort.

It is also the story of yet another life saved through the APRN, which consists of more than 600 health care professionals prepared to administer an FDA-approved drug that has successfully stopped abortions after a mother requests intervention. Along with the 600-plus health care practitioners, some 300 pregnancy help organizations in the APRN network also assist women who choose to try and save their baby by initiating the Abortion Pill Reversal (APR) process.

The abortion pill, also known as medication abortion, chemical abortion, RU-486 or self-managed abortion, refers to the drugs mifepristone and misoprostol, taken to abortion a child within the first 10 weeks of a pregnancy.

That first pill, mifepristone, blocks the effects of progesterone the natural hormone that women produce which provides the essential nutrients needed for their developing baby to thrive. The second drug in the chemical abortion process, misoprostol, is taken 6-48 hours later, typically at home, causing cramping and bleeding associated with emptying the mothers uterus, when she then delivers her deceased child.

A chemical abortion can be reversed after taking mifepristone and before misoprostol.

APR works by giving the mother extra progesterone up to 72 hours after she takes the first chemical abortion drug. The treatment has the best chance for success when started within 24 hours. APR is a new application of an FDA-approved progesterone treatment used beginning in the 1950s to stop miscarriages. To date, more than 900 lives have been saved through APR.

The APRN continues to expand internationally, and the month of March saw a record number of moms beginning the abortion pill reversal process through the Network.

Rehema shared her story with Heartbeat National after confirming that her unborn son was healthy following initiation of the APR regimen.

She had gotten a call from her mother on April 21, telling her she would be taking her for an abortion, the reason being that Rehema and the babys father are of different faiths.

They went to a Marie Stopes abortion facility where after an ultrasound Rehema was told she 22 weeks and 4 days pregnant. With their standard cut-off for conducting abortions at 20 weeks, Rehema said the facility declined to do the procedure.

But her mother didnt relax, she said, taking her to another local Marie Stopes location, where they also declined to conduct the abortion.

Rehemas mother took her to another abortionist who regardless of her childs gestational age agreed to perform the abortion.

Asking the abortionist what would happen if her baby survived the procedure and was born - and crying - she said he indicated in no uncertain terms that he knows how tosilencesuch children, which disturbed her.

I got goosebumps all over, she said. I told him to give me time to think.

Rehema said she went home, but her mother was just too persistent, kept mocking her, and so on April 25 she decided to visit one of the abortion contacts her mother had found.

And they gave me mifepristone and told me to swallow it immediately, Rehema said, immediately sorry for the decision.

I was desperate, she continued. I didnt know who to talk to on the night of the 25th I cried a lot.

I was feeling guilty, she said. How could I kill my innocent little one? I just saw how healthy he was during the ultrasound

I was losing it, Rehema told Heartbeat International. Then I decided to go through Google

God directed me to APR, said Rehema. And I sent an email.

Tweet This: God directed me to Abortion Pill Reversal

In no time I got a How may I help you? she recounted.

Rehema talked to several APRN consultants, whom she said have been calling, texting and emailing her, as well as checking in with her over social media.

May God bless you all, she said of the consultants.

Rehema was connected with a doctor in the APRN who began the APR protocol.

This one is just an angel in human flesh, she stated of the physician.

The doctors office worked with her financially on treatment, she said, even though she did not have much money, and everyone at the clinic where she has been receiving treatment has been friendly.

I am assured everything is fine, no complications at all, Rehema told Heartbeat.

And guess what guys ware having a healthy baby boy!!

Isnt our God a wonderful God she exclaimed. Isnt He the most merciful and most forgiving?

Rehema then came home and found her mother waiting.

She said her mother told her that since she didnt want to abort, that she should know she is in this alone, and to leave her place.

Despite this Rehema has remained hopeful and happy to have her son.

She said she just wants to have a new start.

I have seen the worst, but I conquered, Rehema told Heartbeat. Much love and God Bless!!

Tweet This: I have seen the worst, but I conquered. Much love and God Bless!! Mom whose baby was saved with APR

The APRNs consultants remain in contact with Rehema. Pregnancy Help News and Heartbeat International will monitor her situation and publish updates when possible.

Editors note: Heartbeat International manages the Abortion Pill Rescue Network and Pregnancy Help News.

Read the original:
I have seen the worst, but I conquered - mom pressured to abort looks forward with hope after baby saved with APR - Pregnancy Help News

More men than women have fallen severely ill or died from COVID-19, and now two clinical trials will probe whether sex hormone differences might explain the trend, The New York Times reported.

Since the COVID-19 pandemic first emerged in China, men around the world have been more likely to require intensive medical care or die from the disease than women, according to the Times report. For instance, men make up about 75% of the COVID-19 patients in intensive care or on ventilators at Cedars-Sinai Medical Center in Los Angeles, Dr. Sara Ghandehari, a pulmonologist and intensive care physician, told the Times. And as of early April, infected men in New York City were dying at about twice the rate of infected women, according to NPR.

The trend may be related to the high prevalence of heart and lung conditions in men, who also generally smoke cigarettes, consume alcohol and are exposed to outdoor air pollution at higher rates than women, Sarah Hawkes, professor of global public health at University College London, told NPR on an episode of Morning Edition. In addition to these factors, though, "there's quite a lot of good evidence that ... female immune systems are essentially a lot stronger," she added.

Related: 10 deadly diseases that hopped across species

The sex hormones estrogen and progesterone, which women produce in larger quantities than men, help to regulate the female immune system and may grant women special resistance against infections and harmful immune system responses, the Times reported. With that in mind, scientists at Cedars-Sinai and the Renaissance School of Medicine at Stony Brook University plan to treat small groups of COVID-19 patients with the hormones, to see if they make a difference.

"We may not understand exactly how estrogen works [to counteract COVID-19], but maybe we can see how the patient does," Dr. Sharon Nachman, the principal investigator of the Stony Brook University trial, told the Times.

The Stony Brook trial will include 110 patients with confirmed or presumed cases of COVID-19 who develop at least one serious symptom, such as high fever, shortness of breath or pneumonia, but do not yet require mechanical breathing support through intubation, according to ClinicalTrials.gov. All men ages 18 and older may enter the trial, as well as women ages 55 and older (women's estrogen levels tend to decline after menopause.) Half the participants will be treated with an estrogen patch placed on their skin for one week, while the other half will receive standard medical care.

Previous research suggests that extra estrogen could help clear the virus from the body, as well as support repair of damaged tissues once the COVID-19 infection begins to subside, Nachman said.

Participants in the Cedars-Sinai trial will receive progesterone, rather than estrogen, as progesterone may have anti-inflammatory properties and could prevent the onset of a so-called cytokine storm, wherein inflammatory chemical signals go haywire and damage the body, Ghandehari told the Times. The study will include 40 hospitalized men with mild to moderate COVID-19 infections. Half of those men will receive two shots of progesterone a day for five days. Both the estrogen and progesterone trials will monitor the severity of patients' illnesses through time, comparing the treated groups with the untreated groups.

Both trials bank on the idea that heightened levels of estrogen and progesterone may help the body fight COVID-19 infection, but not all the data supports that notion, Sabra Klein, who studies sex differences in viral infections and vaccination responses at the Johns Hopkins Bloomberg School of Public Health, told the Times.

"Older men are still disproportionately affected" by COVID-19 compared with older women, whose hormone levels dip dramatically following menopause, she said. "That suggests to me it's got to be something genetic, or something else, that's not just hormonal," she said. That said, infusions of estrogen and progesterone may still modulate the male immune system in a beneficial way, Klein added.

"You could get a beneficial effect in both men and women," she said. "But if women are better at recovery at 93 years old, I doubt it's hormones."

Originally published on Live Science.

The rest is here:
Doctors are testing whether estrogen could help men fight COVID-19 - Live Science

Period acne , or a flare-up of acne every month which coincides with the occurrence of your period, is not something so uncommon. Along with pollution, makeup, sun exposure and so many other external factors, it is important to understand what happens to your skin during periods. Just before your period date, the levels of female sex hormones fluctuate and these fluctuations may stimulate oil glands to increase oil production and results in acne breakouts. These hormonal fluctuations may also be responsible for other fun period things like, moodiness and sore breasts. Overall skin tends to be more sensitive during periods and its hard to prevent acne for good but can be minimised.

The hormones fluctuate continuously throughout the menstrual cycle, the duration of which on an average is 28 days in a woman. The levels of female sex hormones, estrogen and progesterone rise during the first and last half of the menstrual cycle, respectively. As you approach your periods the level of both these hormones fall but the level of testosterone, a male hormone which is produced in small amount in females remains constant. Thus the level of testosterone being relatively higher before and during your periods. Due to these hormonal shifts, a females skin undergoes all sorts of changes.

The secretion of sebum from sebaceous glands is stimulated by increased progesterone during the middle of menstrual cycle. Rise in the level of testosterone before and during periods also stimulates the sebaceous glands and thus more sebum is secreted. This increased sebum effects different women differently. For some, may produce a healthy glow on the skin, whereas in others, due to excess oil along with dirt, debris and dead skin cells the skin pores become clogged and cause premenstrual acne.

Sometimes, the immune system produces a reaction to Cutibacterium acne, an acne causing bacteria and this immune reaction to the bacteria and its metabolites results in inflammation accompanying pimples before periods.

Acne thats related to period is more likely to flare up during the week leading up to period or during period. It tends to clear up or improve when period is ending or over. And if you already have acne, then you might notice it getting worse during this time.

A pimple is not just a pimple, these are different types of blemishes. These are Blackheads, Whiteheads, Papules, Nodules, Cyst and knowing the difference between them , can narrow down the best acne treatment.

1. Birth Control Pills :-Increase a protein (Sex Hormone Binding Globulin , SHBG) in blood which soaks free testosterone. Thus less amount of available testosterone is there for causing acne. Also increases estrogen level. But be patient, as there is initial increase in acne on using these pills for three to four months but this subsides as the body adjusts to the pills. Before using, take advice from your doctor.

2. Spironolactone :-It is an anti-androgen drug. It reduces the level of testosterone which reduces oil production. It may not suit all women, hence, always consult your physician.

3. Weight loss :-Obesities reduces Sex Hormone Binding Globulin, SHBG and also increases testosterone. Anything, which reduces SHBG , may result in acne. Thus eat a well balanced and healthy diet and avoid junk food. Also follow a exercise routine and maintaining an optimum and healthy weight may help in controlling acne before period.

a. Wash your face two to three times a day with oil free cleanser

b. Use an Over the Counter anti-acne cream to remove excess oil

c. Avoid makeup, containing oil

d. Remove makeup and clean your skin before going to bed

e. Take a shower after exercising

5. Reduce your stress level.

6. Isotretinoin:-If other treatments havent worked for you or you suffer from severe cystic acne, then try this. It is a vitamin A derivative. The drug may cause various side effects and is not safe in pregnancy. Thus, before using , discuss all risks and side effects with your physician.

Your doctor may prescribe you low dose tetracycline for five days, which you may use few days before beginning of your period.

While breakouts may annoy you as an adult but acne typically lessen after a certain age, because with age the amount of hormones the body produces begin to decrease.

Period acne can be difficult to prevent completely. But some simple steps you can take to keep your skin relatively clear and healthy.

First of all, mix baking soda with water and make a paste.

Applying this paste on the face and let it dry.

When it dries well, wash the face with lukewarm water.

This vitamin capsules may prove to be a better option for curing acne scars.

Break the capsule of vitamin E and apply it on acne scars.

You can use this remedy once a day.

Citric acid is believed to be very beneficial in reducing irritation, removing scars and removing wrinkles in the skin.

Aloe vera gel works like magic to remove blemishes.

Sleep using this gel at night and wash face in the morning.

Results will start appearing soon.

Some other home remedies :-

a. Tea tree oil.

b. Turmeric.

c. Honey.

d. Warm compress.

e. Warm green tea bag.

f. Cold compress.

g. Neem facepack.

Link:
Periods and Acne: Are They Related ? - Krishi Jagran

Director General of Health Ashley Bloomfield has had to walk back comments made by himself and the prime minister yesterday about the country having achieved elimination.

New Zealand has been hailed in international media including TheNew YorkTimesand TheDaily Telegraphas having won the battle in eliminatingCovid-19.

While elimination has been achieved at alert level four giving Dr Bloomfield the confidence to move the country into level three the war has not been won.

At yesterdays daily press conference Bloomfield was asked whether New Zealand had achieved elimination.

It was his answer that weve achieved [elimination] through alert level 4 and the prime minister chipping in that New Zealand currently had eliminated the virus that resulted in yesterdays confusion.

Realising the waters had been muddied, Bloomfield arrived at Parliament today armed with a clarification.

Asked whether he accepted yesterdays remarks had given the country and the rest of the world a false impression, and whether he was concerned New Zealanders would be breathing a sigh of relief at a time they should still be vigilant, Bloomfield didnt mince his words.

I can just clarify we havent eliminated it, and we havent eradicated it.

He said elimination is about having a low number of cases, and a knowledge of where theyre coming from and identifying people early.

Then its a case of stamping out the virus and continuing to maintain strict border restrictions to be sure no new cases are being imported.

Elimination is by no means eradication and the Prime Minister Jacinda Ardern said this is a situation of entering into the world of epidemiologist-speak.

And they know well what each of these terms mean in a health sense, but of course in an every day sense they mean, often, something different.

Elimination doesnt mean zero cases we will have to keep stamping Covid out until theres a vaccine, she said.

Nationals health spokesperson Michael Woodhouse said Bloomfield probably felt the need to clarify on behalf of the prime minister.

This underscores the importance of talking in plain English. The public are not epidemiologists, they dont have the same information the prime minister has and its really important they get on the same page, talk in English, and make it clear to New Zealanders where were at and how weve got to stay there.

Bloomfield finished todays media conference doing his best to unmuddy the waters.

Well I hope my explanation today has helped to clarify if there was mud yesterday, the water is clearer today and I hope you all have a good understanding of that and New Zealanders do.

Like many people today, Bloomfield said he too enjoyed a take-away coffee but he warned how important it is not to undo the good work that has already been done.

And that means not congregating with friends outside cafes or restaurants.

Read the rest here:
Famotidine heartburn drug is being tested in NY hospitals for Coronavirus Treatment - News Brig

Importance Of Maintaining Normal HGH Levels In Adults

While most individuals may associate the term HGH with the growth of organs and tissues throughout childhood, it is also a vital substance for older adults. As an individual grows in age after they have reached their third decade of life, they experience a natural reduction in the amount of this hormone that is produced by the pituitary gland in the brain. Changes that take place in an individuals body that may be attributed to a natural decrease in human growth hormone secretion may include: Increased quantity of adipose tissue, especially in the abdominal area Reduced hair and or nail growth Decreased levels of energy and stamina Reduced vision Foggy memory Inability to focus Weakened immune system Decreased muscle mass and strength Reduced ability to control blood sugar levels Poor sleep quality Greater risk of osteoporosis developmentMany of these changes related to aging and reduced secretion of growth hormone in older adults are amplified in individuals who are affected by a condition that is referred to as HGH-deficiency.

According tohghtherapydoc.com, Human growth hormone deficiency develops in an individual when their pituitary gland does not produce an adequate amount of growth hormone for their respective life stage. Maintaining normal levels of growth hormone in the years following the third decade of life is crucial to keeping vital organs and tissues healthy and maintaining an optimal quality of life.

HGH is a type of peptide hormone that is produced by an individuals body in order to promote processes of cell reproduction, cell growth, and cell regeneration. When an individuals pituitary gland secretes growth hormone, it is only available in its active form in the bloodstream for several minutes. An organ that is referred to as the liver takes the growth hormone in the bloodstream and synthesizes it into numerous substances that are called growth factors. The quantity of these growth factors experiences a parallel reduction in quantity with the reduction of growth hormone secretion as an individual grows older.Fortunately, HGH can be replaced in the body through the use of human growth hormone therapy or HRT. Treatment with the use of HRT in men is known to: Help tighten loose skin that has lost its elasticity Help treat erectile dysfunction Increase the growth of hair Improve cognitive function Reduced risk of cardiovascular diseaseTreatment with the use of HRT in women is known to: Balance out the ratio of body fat and lean muscle tissue Normalize irregular sleep patterns Increase skin elasticity Promote a strong immune system Increase bone strength, reducing the risk of osteoporosis Reduced risk of cardiovascular diseaseAn increase in the synthesis of a substance that is called collagen is how human growth hormone helps increase an individuals muscle strength and endurance. Growth factors that are produced by this hormone have an ability to increase the speed of bone regeneration in an individual, making them less susceptible to fractures and breaks. HGH helps an individual maintain a proper body fat percentage through speeding up the process of lipid breakdown or lipolysis.

Numerous actors and actresses have utilized HRT to help decrease their unpleasant symptoms that have manifested due to age-related decreases in human growth hormone secretion.Sylvester Stallone, the actor who plays the famous Rocky Balboa, has discussed his use of human growth hormone under the advice and supervision of his physician in several interviews. Sylvester does not feel that it is a magic potion of sorts, but HRT helps with his levels of endurance and reducing the amount of recovery that is required following exercise. Both of which he has claimed to place wear and tear on his body as he grows older.Actress Suzanne Somers began HRT prescribed by her physician when she didnt feel like herself anymore due to the effects of aging. She utilizes it to help protect her body against the diseases of aging, increased quality of life, and increased bone density. She explains that the benefits of HRT correlate with being prescribed the correct amount, and taking excessive amounts can be dangerous.If the symptoms of low growth hormone secretion sound oddly familiar to you as an aging adult, you may be experiencing the beginning stages of human growth hormone deficiency. While the secretion of HGH does decline over time, it should not impair the quality of your everyday life. Reach out to your physician to see if you may be able to benefit from therapy with the use of HRT.

https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/growth-hormone/art-20045735https://draxe.com/nutrition/human-growth-hormone/https://www.medscape.org/viewarticle/458624https://www.metro-md.com/why-hollywood-celebrities-use-hgh/https://ventsmagazine.com/2019/08/15/growth-hormone-use-in-hollywood/https://www.hghexpert.com/135/are-top-celebrities-using-hgh/

View original post here:
HGH And Celebrities: Why Actors Over 50 Resort To HRT - CelebMix

In this article, global expert in life sciences pricing and all aspects of market access, Raf De Wilde, debunks this perceived contradiction and discusses specific strategies to avoid, delay or accommodate price competition to achieve long-term sustainability.

Over the years, the threat of pricing competition has increasingly become a concern. In a Valid Insight webinar on Sustainable price competition contradiction in terms?, we discussed how price competition occurs, its potential impacts, as well as some tips for how companies can alleviate price competition.

How pricing competition occurs

If prices escalate, payers can promote pricing competition. First, they declare that certain products are therapeutic equivalents and that they prefer the cheapest version. They then request price proposals from companies and award most or all of the sales to the one with the cheapest offer. Often, payers pit two companies against each other. This tendering process has become a formalised procurement approach for several major payers.

The award criteria for tenders vary some are based solely on cheap pricing, while others consider additional criteria such as payment terms, flexibility of supply, and value-added services. Tenders also vary in terms of customer size (nationwide, regional, group/single client). Subsequently, tendering can also impact the bottom line the greater the payers buying power and the more focussed they are on cheap pricing, the greater the risk for price erosion. A country tendering all-or-nothing on the lowest price can make a company win or lose an entire market at once. It is also risky for the customer; once they award one company, competitors who are back-up suppliers may exit the market completely.

Avoiding or delaying pricing competition

A well-substantiated argument for product differentiation will deter payers from claiming that all available products are equal. If a product has a clearly demonstrated higher therapeutic value, there will be pressure on payers to prefer that product because there can be ethical repercussions to prescribing lower value treatments that produce fewer positive health outcomes just because they are cheaper.

A significantly higher therapeutic value can be typical for breakthrough products, which are rare to come by. Hence, it is highly recommended for companies to also differentiate through other features that are not easy to replicate.

Pharma companies can develop products that offer advanced administration. For instance, Merck Seronos EasypodTM is a device for injecting the growth hormone Saizen (somatropin).[2] The tools development took 10 years and involved several observational studies that highlighted improved adherence. Therefore, there are two hurdles for competitors: to develop a similar technology and then substantiate that their version of the product offers even more value. For the drug Saizen, Merck Serono was able to move out of tenders and into contracts.

Differentiation can also be achieved through innovative patient access schemes and value-adding services (e.g. diet/lifestyle programmes and patient counselling).

If avoiding pricing competition is not possible, delay it instead. Companies can argue against the illegality of prioritising commercial impact over medical impact, rely on physician lobbying, or raise the publics awareness of the risks of preferring cheaper yet potentially lower quality medications.

Handling unavoidable pricing competition

Ultimately, however, discussion about tendering always seems to make its way back onto the negotiation table. So, what can companies do when price competition can neither be avoided nor delayed?

Companies can be given pricing/tendering training in the form of a special pricing simulation computer game. Two companies (or teams) play the game, which involves 6 hypothetical client hospitals (programmed with buying behaviours and perceptions) that at the start of the game demand an all-or-nothing deal. The simulated market becomes highly competitive with the entrance of a better value product and then later a biosimilar/generic competitor. The two companies must come up with the best offer to secure a years worth of sales. As the companies place their bids (annually for 6 years), the computer chooses the most logical and attractive offer.

Based on results from more than 60 different games conducted in the last 15 years, it has been observed that the average price quickly descends over the simulated 6 years. Less experienced people tend to be more aggressive in driving down price. The lesson here is that although payers can encourage price competition, the severity of the price competition is something that the industry itself can still influence. There is the need for companies to carefully react to price changes so that the amplitude of price erosion is minimised.

To read the rest of this blog, please visit: https://www.validinsight.com/how-to-weather-pricing-competition/

See the original post:
How to weather the pricing competiton - PMLiVE

Please Note: This article is never meant to treat or diagnose any illness. It is only written for informational purposes. Please see a licensed healthcare professional If you have any health concern at all.

With so many different weight loss products available on the market today, it can be quite daunting to research and chose the right one. The problem is most of these so-called weight loss and fat burners are nothing more than a scam.

MUST SEE: Shocking New Resurge Report This May Change Your Mind

While researching Resurge reviews online we realized most reviews do not fully explain the link between deep sleep weight loss and how ground-breaking this information is. This article will go into detail about this topic because after all that is the basis of why this supplement was created.

Most people are familiar with the typical and more well-known weight loss brand names on the market but now we are seeing more and more novel brands advertised online. One such product is Resurge supplement. It is described as a supplement that when used as directed it may not only promote safe weight loss but also other benefits such as deep sleep. In fact, Resurge supplement is advertised as a deep sleep weight loss supplement. The creator of the product claims there is a direct link between sound sleep and weight loss.

Resurge Supplement Explained:

This dietary supplement is a Non-GMO and vegetarian supplement that contains 120 capsules in the bottle which are manufactured at an FDA-approved facility. Each bottle provides a full 30-day serving. It is important to note that this supplement doesnt treat any specific medical condition.

Resurge is a unique formula made of a blend of all-natural ingredients in the proper ratio that targets different aspects which may lead to weight loss and fat burning. The other benefits besides weight loss include boosting the metabolism, boosting the immune system, blood flow improvement, therapeutic deep sleep and relieving harmful stress for the individual.

MUST SEE: Resurge Reviews: What Theyll Never Tell Anyone

It is a very well wounded supplement that claims to work regardless of the individual changes their diet or exercise program. It is designed to make weight loss easy for the user.

Resurge Review Reports online are even showing that many users are having success even in the most stubborn hard to melt areas of the body.

The Truth About Deep Sleep and Weight Loss:

Resurge supplement claims to fight Shallow Sleep. Let us define what is meant by Shallow Sleep.

Shallow sleep can be explained simply by stating when individuals are sleeping too lightly they are in shallow sleep. Many individuals over the age of 40 find that they are not getting enough deep sleep. These individuals typically wake up easily from almost anything. That would include light noises, movement in the room where the individual is sleeping and even temperature changes.

Shallow sleep is responsible for many health issues and has a direct connection to weight gain.

Lets dig deeper now into Deep Sleep and Weight Loss:

Studies like the one conducted at the University of Colorado are showing that even mild lack of sleep can bring about weight gain and it happens quite rapidly.

Sleeping only 5 hours a night for just one week showed that the study participants gained an average of 2 pounds in a week.

Lack of sleep causes a change in the bodys hormones. In particular the hormones responsible for appetite and food cravings. When an individual is sleep deprived the brain does not make correct decisions about food. Individuals lacking sleep become much more impulsive regarding junk foods and unhealthy snacks.

There was also a study showing that adequate sleep led to reduced sugar cravings and consumption.

A study from the American Journal of Clinical Nutrition found that individuals who were lacking sleep were more prone to eat at night and typically craved high carbohydrate foods.

Yet another study from the University of Chicago showed that individuals getting less than 8 hours of sleep each night gained double the fat compared to the individuals getting the proper amount of sleep each night.

To make matters even more complex, many people who are over the age of 40 are shown to not get anywhere near the deep restful sleep needed each night.

This is why Resurge supplement was specifically formulated to target individuals over the age of 40.

This may be the answer to weight loss for individuals over 40 years old helping those people reach the necessary deep level of sleep to help control certain hormones, fight junk food cravings and finally lose weight safely.

Who Created this Supplement?

The creator of Resurge is John Barban who has a Masters degree in both nutrition and Human Biology. He is a certified kinesiologist and very well-known health coach and has certification with NSCA, ACE PT, CSEP and CSCS.

John Barban is not only the creator of Resurge Supplement, he is also the creator of some of the best-selling weight loss and health products such as Thin from Within and Flat Belly Forever along with many other popular products created. John also worked with popular brand names such as Nutraceuticals, MuscleTech, Slimquick and others.

Mr. Barbans biggest discovery was the link between deep sleep and weight loss and that was his basis of the formulation of Resurge supplement product.

Who Would Benefit From Using Resurge Supplement?

Resurge is designed for individuals 40 years of age and older with no medical condition underlying that want to lose over 10 pounds of weight.

When an individual reaches about the age of about forty years old the metabolism can slow down and the deep sleep quality can be greatly diminished. Resurge supplement is designed to combat this specifically.

Resurge Supplement Ingredients:

Ashwagandha: The berry and root of this plant is used to help with stress.

Melatonin: Can help greatly with sleep deprivation issues. It is a safe hormone.

L-Theanine: Found in certain foods such as tea and specific mushrooms. It may help with anxiety and proper heart rate.

Hydroxytryptophan: May help with mood and sleep. It is an amino acid that seems to help serotonin levels.

Arginine: Supports the immune system and hormone functions. It is said to have cardiovascular benefits as well.

Lysine: This amino acid may help burn fat.

Magnesium: Also shown to help with sleep among other benefits.

Zinc: This mineral may help with morning mind alertness.

Resurge side effect Reports:

There are no reports of any known side effects of this supplement. The ingredients in this formula are well researched and known to be safe when used as directed.

Resurge Dosage Instructions:

Individuals should take 4 capsules each day. It is best to take the supplement capsules about 30 minutes before bedtime. Each bottle should last 30 days when taken as directed.

What are the Pros of Taking Resurge?

What are the CONS of Taking Resurge?

Our Resurge Verdict:

Weight loss can require commitment each day until the desired weight is reached. Once the desired weight is finally met there is still ongoing weight management. Many people cannot follow such a stringent weight loss or exercise program.

ALSO SEE: We Found the Best Price For Resurge Here

Resurge may be the answer for all of those people who do not want to change their daily eating habits but still want to see some real weight loss benefits. This formula has so many benefits that should not be ignored.

The price is fair and the best thing is the full money-back guarantee.

Caution Should Always Be Used When Buying Resurge

According to David Kingston, a research analyst for Investigative-Reports, Consumers should only purchase Resurge supplement directly from the official website. That is the only way to guarantee your purchase is safe along with your order being backed by the full money-back guarantee

The Official Resurge Website

Photo: Shutterstock

Visit link:
Resurge Reviews: What They'll Never Tell Anyone - The Good Men Project

Dulaglutide treatment reduces binge eating behaviors in individuals with type 2 diabetes (T2D) and binge eating disorder (BED) more effectively than treatment with a sulfonylurea, according to the results of a 12-week, open-label, prospective controlled study published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews.

Studies have shown that activation of the naturally-occurring hormone glucagon-like peptide-1 (GLP-1) increases satiety because of its involvement in the slowing of gastric emptying and decreasing intestinal motility. Moreover, magnetic resonance imaging studies have shown that GLP-1 receptor activation can affect appetite regulation and therefore may counteract food cravings and overeating, and preclinical studies have indicated that GLP-1 agonists reduced binge eating in animal models.

Dulaglutide is a synthetic GLP-1 analog that has been shown to be effective in reducing the body weight of patients with T2D when compared with insulin glargine or other oral hypoglycemic drugs, and has been shown to improve the quality of life in these individuals. Whether treatment with dulaglutide can reduce the frequency of binge eating episodes and improve anthropometric and metabolic variables better than treatment with other diabetes medications in individuals with T2D and BED has not yet been determined.

To examine this, 60 patients with T2D (46.6% men) with BED were randomly assigned into treatment groups that received either 150 mg/wk of dulaglutide or 60 mg/d of gliclazide modified release for 12 weeks in addition to their daily dose of 2 to 3 mg of metformin. To be included in the study, individuals were required to have been diagnosed with T2D and only be using metformin for treatment, to have hemoglobin 1Ac (HbA1c) between 7.5% and 9%, to be <65 years of age, and to have met Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) criteria for BED in an Eating Disorder Examination interview conducted by a physician after a positive score on the self-reported Binge Eating Scale questionnaire. At baseline, the average age of patients was 54.67.7 years, average body mass index (BMI) was 36.46.2 kg/m2, and 80% of patients were categorized as obese (BMI 30 kg/m2).

After 12 weeks, patients treated with dulaglutide had greater decreases in binge eating behavior (P <.0001), body weight (P <.0001), BMI (P <.0001), percentage body fat mass (P <.0001), and HbA1c (P =.009) compared with individuals treated with gliclazide. Additional analysis showed that binge eating behavior was independently and directly related to changes in body weight (P <.0001) and HbA1c (P =.033).

Overall, the study showed that dulaglutide is more effective than gliclazide in improving binge eating behaviors and related metrics. The effect sizes of dulaglutide on body weight, BMI, and body fat composition were significantly greater in the current study than in previous studies of dulaglutide for longer durations in patients with diabetes who did not have BED, indicating that the drug may be especially effective in patients with binge eating behaviors. These results, when considered along with the results of another study that showed liraglutide improved binge eating behaviors in nondiabetic patients, support GLP-1 analogs as a potential treatment for BED.

A limitation to this study was its small sample size and short duration, warranting longer studies with larger patient samples and additional treatment groups.

Reference

Da Porto A, Casarsa V, Colussi G, Catena C, Cavarape A, Sechi L. Dulaglutide reduces binge episodes in type 2 diabetic patients with binge eating disorder: a pilot study [published online March 31, 2020]. Diabetes Metab Syndr. doi:10.1016/j.dsx.2020.03.009

This article originally appeared on Endocrinology Advisor

Here is the original post:
Dulaglutide Reduces Binge Eating in Patients With T2D and Binge Eating Disorder - Psychiatry Advisor

The expression scared to death is true, experts say, as fear can trigger a heart attack and during the current coronavirus chaos, its important to calm your fears, protecting your emotional and mental health as well as your heart.

Dr. Gabe Mirkin tells us that 1 of the 1st recorded cases of death by fear occurred in the classic Sherlock Holmes detective story, The Hound of the Baskervilles.

It was written in 1901 by Sir Arthur Conan Doyle, who was not only a popular author but a brilliant physician who had extraordinary insight into the causes of disease long before there was scientific evidence to support his views,Dr. Mirkin said.

In the classic story, Sir Charles Baskerville died from an apparent heart attack surrounded by the paw prints of a huge dog that, as legend would have it, killed one of his evil ancestors. Now 100 yrs on, an article in the British Medical Journal proposed that being scared to death should be called, The Baskerville Effect.

In the US the Felony Murder Rule allows prosecutors in all 50 states to bring 1st-degree murder charges against a defendant if someone dies during a crime such as burglary, rape, or kidnaping, even if the defendant did not intend to kill the victim.

Dr. Mirkin says that when people are frightened their adrenal glands release adrenaline that helps the flight-or-fight response. Adrenaline makes the heart beat faster to bring more blood to the muscles and also shunts blood from the intestines to your muscles. The hormone opens calcium channels in heart muscle cells, which fills these cells with calcium to keep the heart muscle contracted and prevents the muscle from relaxing.

This can cause an irregular heartbeat, which can kill you, says Dr. Mirkin.

While it is highly unlikely that fear could kill a healthy person with a strong heart, those with an underlying heart condition should be careful if they suffer any of the following symptoms:

Be kind to everyone, including you, to reduce fear and anxiety. Follow the guidelines for social distancing and play it smart. Take action, face fear.

Have a healthy day, Keep the Faith!

Baskervilles, coronavirus, death, fear, heart, hound, kill, kindness, murder, Sherlock Holmes

Paul A. Ebeling, polymath, excels in diverse fields of knowledge. Pattern Recognition Analyst in Equities, Commodities and Foreign Exchange and author of The Red Roadmasters Technical Report on the US Major Market Indices, a highly regarded, weekly financial market letter, he is also a philosopher, issuing insights on a wide range of subjects to a following of over 250,000 cohorts. An international audience of opinion makers, business leaders, and global organizations recognizes Ebeling as an expert.

Read this article:
Fear Can Kill, So Be Kind to Everyone During this Virus Chaos - Live Trading News

(Reuters) Immunomedics Inc won an accelerated approval from the U.S. Food and Drug Administration for Trodelvy, its therapy for a form of invasive breast cancer that has worsened despite two prior rounds of treatment, the company said on Wednesday.

Trodelvy injection, approved to treat metastatic triple-negative breast cancer, comes with a boxed warning the FDAs harshest that flags risks of severe diarrhea and neutropenia, an abnormally low count of a type of white blood cell. (https://bit.ly/2XW5G3z)

The therapys label specified that its continued approval may depend upon verification of clinical benefit in supporting trials.

The FDA had declined to grant accelerated approval for the breast cancer therapy in January last year https://www.reuters.com/article/us-immunomedics-fda/immunomedics-cancer-treatment-fails-to-win-accelerated-approval-from-the-fda-idUSKCN1PC03G.

Patients with triple-negative breast cancer test negative for hormone receptors or HER2, meaning their tumors do not respond to hormone therapy or to therapies like Roches blockbuster Herceptin.

As per the U.S. Centers for Disease Control and Prevention, breast cancer is the second most common cancer among women in the United States with 41,487 women dying of female breast cancer in 2016 https://gis.cdc.gov/Cancer/USCS/DataViz.html, the latest year for which data is available. Triple-negative breast cancer accounts for about 10-15% of all breast cancers, according to the American Cancer Society.

(Reporting by Saumya Sibi Joseph and Shivani Singh in Bengaluru; Editing by Maju Samuel and Shailesh Kuber)

Follow this link:
FDA grants accelerated approval for Immunomedics breast cancer therapy - Physician's Weekly

By Deborah J. Nelson

(Reuters) Scientists are baffled by how the coronavirus attacks the body killing many patients while barely affecting others.

But some are tantalized by a clue: A disproportionate number of patients hospitalized by COVID-19, the disease caused by the virus, have high blood pressure. Theories about why the condition makes them more vulnerable and what patients should do about it have sparked a fierce debate among scientists over the impact of widely prescribed blood-pressure drugs.

Researchers agree that the life-saving drugs affect the same pathways that the novel coronavirus takes to enter the lungs and heart. They differ on whether those drugs open the door to the virus or protect against it. Resolving that question has taken on new urgency after an April 8 report by the U.S. Centers for Disease Control and Prevention showed that 72% of hospitalized COVID-19 patients 65 or older had hypertension.

The drugs are known as ACE inhibitors and ARBs, broad categories that include Vasotec, Valsartan, Irbesartan, as well as their generic versions. In a recent interview with a medical journal, Anthony Fauci the U.S. governments top infectious disease expert cited a report showing similarly high rates of hypertension among COVID-19 patients who died in Italy and suggested the medicines, rather than the underlying condition, may act as an accelerant for the virus.

Efforts to understand how the virus uses the pathway to the heart and lungs, and the role of the medicines, are complicated by a lack of rigorous studies.

There are millions of Americans that take an ACE inhibitor or AR daily, said Dr Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness in Baltimore. This is one of the most important clinical questions.

An estimated 100 million U.S. residents suffer from high blood pressure, which increases the risk of heart disease, stroke and kidney failure. About four-fifths of them need to take prescription drugs to control it, according to the CDC. ACE inhibitors and ARBs are widely prescribed to patients with congestive heart failure, diabetes or kidney disease. The drugs account for billions of dollars in prescription sales worldwide.

The absence of clear answers on how the drugs impact COVID-19 patients has sparked rampant speculation in correspondence and editorials posted on medical journal websites and those where scientists share unreviewed, pre-publication study drafts.

Many patients are agonizing over whether their medicines will help or hurt them. Doris Kertzner, 88, of Redding, Conn., said she has carefully followed experts guidelines for preventing infection and keeps her distance from others in her retirement community. Now she has a new worry: She takes losartan, an ARB, and cant decide whether to stop.

Dropping the medicine presents its own problems in dealing with her high blood pressure.

Its gotten very complicated, she said.

Dr Carlos M. Ferrario a researcher at the Wake Forest University School of Medicine and co-author of widely cited studies on ACE inhibitors understands patients plight.

There is a lot of paranoia and a lot of speculation with very little fundamental, convincing information, he said.

The National Institutes of Health in the United States has put out a call seeking proposals for studies into the issue. An independent consortium of researchers has launched a global study to analyze health records for thousands of COVID-19 patients in the United States, Europe and Asia. That project is part of the Observational Health Data Sciences and Informatics program, an open-source research platform that enables large-scale studies.

Dr Marc Suchard a biostatistician at the University of California, Los Angeles who is leading the study said that it aims to determine whether the medicines make infections more likely or more severe or, by contrast, whether they help protect against the virus. Suchard said he expects a preliminary report within two weeks.

MORE TARGETS FOR THE VIRUS

There is evidence that the drugs may increase the presence of an enzyme ACE2 that produces hormones that lower blood pressure by widening blood vessels. Thats normally a good thing. But the coronavirus also targets ACE2 and has developed spikes that can latch on to the enzyme and penetrate cells, researchers have found. So more enzymes provide more targets for the virus, potentially increasing the chance of infection or making it more severe.

Other evidence, however, suggests the infections interference with ACE2 may lead to higher levels of a hormone that causes inflammation, which can result in acute respiratory distress syndrome, a dangerous build-up of fluid in the lungs. In that case, ARBs may be beneficial because they block some of the hormones damaging effects.

Novartis International AG and Sanofi SA are among the major drugmakers selling ACE inhibitors and ARBs.

Sanofi spokesman Nicolas Kressmann said that patients should consult their doctors on whether to continue taking the drugs but that the company has found insufficient evidence that they worsen COVID-19 through its own assessment of available scientific data.

The company reviewed several recent studies from China that came to conflicting conclusions about whether COVID-19 patients with hypertension fare worse than other patients, he said.

Novartis has not issued any guidance to clinicians or patients and defers to scientists studying the issue, said spokesman Eric Althoff.

Researchers and doctors generally agree that people with severe hypertension or heart failure should keep taking the drugs because of the high risks of stopping. The debate centers on how to advise the many patients with milder conditions who take the drugs. Two camps have emerged one calling for no action unless the drugs are proven dangerous, the other for some limits on their use until they are proven safe.

The Centre for Evidence-Based Medicine at University of Oxford in England has recommended that clinicians consider withdrawing the medicines in patients with mild hypertension if they are in a high risk group, such as medical workers and replacing them with alternative blood pressure-lowering drugs.

The New England Journal of Medicine (NEJM) took the opposite tack, highlighting the drugs potential in fighting coronavirus and recommending patients continue taking the drugs until more about the risks is known. Several of the scientists who co-authored it had done extensive, industry-supported research on antihypertensive drugs.

CONFLICTS OF INTEREST

Dr Kevin Kavanagh, founder of Health Watch USA, a patient advocacy organization, questioned whether scientists who are funded by the drug industry should be advising clinicians, given the high stakes.

You need to consider stepping back, and let others without a conflict of interest try to make a call, Kavanagh said.

His organization recommends that doctors temporarily avoid putting new patients on the drugs and warn those currently on them to take extreme precautions to avoid virus exposure.

Dr Scott David Solomon, a co-author of the NEJM article, conducts industry-financed research but said it has no influence on his position.

Not only is there no compelling evidence that we should be discontinuing those medications, but theres reason to think that doing so might actually cause harm, said Solomon, who is the director of noninvasive cardiology at Brigham and Womens Hospital in Boston.

The lack of consensus leaves doctors to navigate the issue patient by patient. Alexander, of Johns Hopkins, is trying to strike a balance in his own practice. Patients with more severe blood-pressure problems may need to keep taking the medicines, he said, while patients with milder or newly diagnosed cases could instead take one of the literally dozens of alternative hypertension treatments.

Rest assured, he said, there are dozens of scientific teams working feverishly to put this question to bed.

(Reporting by Deborah Nelson; Editing by Brian Thevenot)

See the rest here:
Blood-pressure drugs are in the crosshairs of COVID-19 research - Physician's Weekly

Photo illustration by Slate. Photo by Getty Images Plus.

Two emergency physicians, based at two different hospitals in the New York metropolitan area, are logging their days for Slate. At the end of each shift, they write a response to three questions: What was today like? How did it compare with yesterday? And how do you feel? We have offered them anonymity so that they can write freely about their experiences. Dr. Kelly Keene and Dr. Lauren Serino are pseudonyms. Read Week 1here, Week 2here, and Week 3 here.

Im not Jewish, but we had a Passover Seder with my boyfriends family over Zoom after my ER shift today. This was preceded by us watching the Rugrats Passover episode, both for a bit of lighthearted comic relief as well as for a quick refresher on the Ten Plagues.I am struck by how eerily some current events are mirroring some of the Ten Plagues: First, the snow turned red as blood at the North and South poles, then the hail in upstate New York, the swarms of Locusts in Africa, etc.Is this coronavirus but a form of pestilence, or is it causing the darkness in this modern day plague?

Having trained in an intense ER residency, Im used to seeing all sorts of critical situations. Ive delivered babies in the ER parking lot; Ive seen horrific trauma in which the entire inside of human anatomy was visible; I regularly deal with strokes, sepsis, heart attacks, broken bones, head bleeds, failing organ transplants, etc.Im used to handling acutely psychotic patients, severely demented patients, drunks, drug addicts; I have often been yelled at, cursed at, spit at, even hit and kicked.Yet nothing has compared to what we are seeing now with COVID. For the first time in my life, going to work scares me, and coming home from work scares me even morebecause of the concern that I might bring the infection home to my boyfriend.More and more colleagues (nurses, PAs, attending physicians, residents) are falling sick. Two young residents in NYC reportedly died from the coronavirus.

I can only imagine how this is affecting the residents across the country, the ones who are just starting out in hospitals, and are there to learn the ropes.Some have already been infected, others have sent their spouses and children away to avoid infecting them.They have all been working exhausting 12-hour back-to-back shifts, and the usual venues of decompression (e.g., bars, restaurants, movie theaters, friendly get-togethers) have all been shut down. But beyondthe devastating effects on their psyche, it has been detrimental to their education, too.This is supposed to be a time of training and learning, of honing their craft. But the chain of command has been upended by this: Medical students are being graduated early to start pitching in, residents are now acting as workhorses, and fellows have had their fellowships discontinued and asked to work as attendings. I worry about their well-being, yes, but I also worry about the future of the U.S. medical landscape as we practice wartime medicine.

If I had wanted to be in the military, I could have had my medical school paid for by thegovernment.

Speaking of wartime medicine Ive been reading the many articles and commentaries calling the ER and hospitals a war zone and referring to health care staff as heroes of the COVID war.I find the war metaphor both apropos and vexing. The number of projected COVID-related deaths, even with social distancing, is still projected to be between 100,000 and 240,000.By comparison, about 60,000 were killed on the battlefield in the Vietnam War.Navy ships have been deployed and Army field hospitals have been mobilized in multiple regions of the country.The hospital wards are filled with patients lined up on vents, not even a curtain between them for lack of space. There are refrigerated trucks parked outside hospitals serving as temporary morgues holding piles of dead bodies. It looks like a war.

But it is vexing to hear health care workers being compared to military personnel. Yes, we signed up to be front-line staff in treating illness and injuries.We did not sign up to be in combat, we did not sign up to go into battle against COVID without proper personal protective equipment, and we certainly did not sign up for endangering our loved ones.If I had wanted to be in the military, I could have had my medical school paid for by the government. Instead, I, along with many other physicians, chose to go hundreds of thousands of dollars in debt to go to medical school and sacrifice a decade of my life to train to be a civilian physician.Let me be clear:Soldiers are not sent to war without necessary equipment; firefighters do not rush into burning buildings without respirators.Why is this lack of PPE acceptable for the health care profession?

The health care system in the United States has been faulty for a long time.Front-line staff in hospitals have been asking for updated equipment for years.Instead, often our profit-driven system focused on improving Press Ganey (customer satisfaction) scores rather than upgrading supplies that would actually enable better health care.Will this COVID pandemic finally highlight the problems and help drive a proper response from the health care systems and the government?Or will it all fade away in short memory, with our dead colleagues counted as fallen heroes and collateral damage from the COVID war?

Dont get me wrong, I am proud to work alongside my ER family, andit is nice to be considered heroic. But that is not how I think of myself. I hope people realize that this is the job we have always donewe have always been front-line staff, treating the sick and injured, serving as the safety net for marginalized populations.I am heartened by the many reports of people coming together all over the world to help one another in this time of crisis. I just hope this moment lasts longer than the pandemic itself.

I woke up to three boxes on my doorstep filled with face shields and a text from NYCPPE saying that our GoFundMe money is stretching even farther, and to expect another delivery of 500 N95s this week. New York is starting to get what passes as a modicum of control over new COVID cases, but the long haul has only just started. Slightly less contagion is still vastly too much, and the supplies will have to stretch.

The newspaper reports a plateauing death toll, the accompanying graphic is that familiar stretched curve. I drink my still-terrible coffee, a reminder that Ill never have the option to quit medicine and become a barista. Ive been waking up to headlines about mortality and economic devastation caused by the coronavirus for over a month now, and it has started to feel mundane. I was already refilling my mug when I realized that my anxiety was absent, replaced by a sense of routine. What is the epidemiological equivalent of the banality of evil? Maybe, the prosaicism of pathology. I finished my breakfast, checked the mail, bleached the door handle, and watched a COVID treatment panel discussion about the utility of blood thinners in the acute phase of disease, all things that are starting to seem like second nature now.

What is the epidemiological equivalent of the banality of evil? Maybe, the prosaicism ofpathology.

On the panel, a few doctors from New York were discussing what theyve been seeing in terms of clinical picture and treatments that are workingor not. Two of the doctors described scenes that told very different stories.One told the story I have been watching unfoldERs crowded to the point of collapse, a crushing number of deaths, the shocking acuity and multi-organ-system derangement in even the younger patients. But the other spoke of an experience more in line with the overall datayes, far too many young in the ICU, but the elderly and comorbid older patients making up the bulk of the dying, the hospital strained, but able to keep up.

ProPublica has an interactive ZIP code map that updates daily with the number of cases in each NYC area. The first doctor worked in an area with 71 percent greater number of infections than the city average. The other? In an area with 60 percent less than the average. Even in the pandemic epicenter, eight miles made a vast difference.

Poverty is a terminal illness in itself, and its why the hardest hit neighborhoods, in the hospitals where Ive spent my career, report the highest piles of bodies. Bodies who had insufficient access to preventive medical care, healthy diets, and too many people squeezed into a tiny apartment. COVID can kill you no matter how much money you have. But not having it correlates closely with the risk factors that make it much more likely to kill you and the people you love.

Short of a vaccine, theres no way to immediately solve this entrenched problem just by recognizing its there. But that doesnt make it any less important to acknowledge and, maybe, to rememberif we are wise enough to learn from some of our myriad mistakes during the pandemic. The virus, more than anything, reminds us that the world is interconnected. None of us are separate. And devastation in one community is not only their loss but may set off a chain of contagion that affects people more broadly, whether thats a few miles or a continent away.

Before bed, I called a friend who wanted to congratulate me on the slowing of NYC deaths. I assured her it wasnt all my doing, but thanks. She laughed. She has an innate optimism Ive always been jealous of.

This too shall pass, I said, but it sounded dismissive and, more than that, untrue. Sometimes, the ghost of an experience sticks around simply because it enjoys the haunt. I wonder if COVID will be that way: One of my colleagues said shes going to take the next two weeks recovering from the last two weeks, and then repeat the process for the foreseeable future. Maybe, instead of passing, the realists alternative is, This too shall become normal.

Today was hard. I keep looking for a more evocative adjective, but I just keep coming back to this: Today was hard. I turned in my badge at the hospital that Ive worked at for the last five years. There has been mounting violence in the ER and not enough done to protect its workers. Things had become dangerous there, long before the presence of the virus. In a few days, I start at a new hospital. There will be some familiar faces there. Still, its hard.

A 73-year-old male patient is rushed in, his oxygen saturating reading 56 percent (normal is over 95 percent). He is visibly in respiratory distress, breathing shallowly and rapidly, able only to eke out one word at a time. We place a nonrebreather mask on him to give him maximal oxygen, but his saturation only improves to about 85 percent. Knowing time is limited,I had to ascertain his code status, specifically, whether he would want to be placed on a ventilator when he could no longer support his own breathing.He made it clear between labored breaths that intubation was something he would never want, understanding that he would die the minute he tired out from his puffing and panting.He told me of his wife of 45 years, now home alone, unable to be by his side because of the no-visitor rule that most NYC hospitals have instituted.

We have one iPad in the ER to allow patients to FaceTime with their loved ones, but it is currently being used in the next room by a 56-year-old man, also critically ill from COVID, telling his children in Chicago he loves them before being induced into a medical coma for intubation.I pull out my cellphone and helped my patient FaceTime his wife. I hold back tears as they exchanged what might be their last loving words to each other.Overhead on the PA system, I hear more calls of rapid responses for admitted patients who are decompensating on the hospital wards, and then upgrades to code blue, for patients who are dying on the wardsdying so utterly alone, with no one to hold their hand.Death has always been a sad part of my job, but now we are the ones saying goodbye for the patients. Having to do so remotely, over a phone or tablet, seems that much worse.

Hairdressers have a mafia, of which I knew next to nothing prior to the pandemic, and which Im intensely grateful to know now. Their magic is how, over the course of an hour, $500 could be amassed and, three days later, 5 gallons of barbicide and boxes upon boxes of gloves appeared at my doorstepjust in time to add them to my next PPE deliveries tomorrow night. Disinfectant online is still almost universally sold out. But, no worries, they know a guy.

Meanwhile, friends who have never cooked a day in their life have become master bread bakers. The clumsiest amongst us has taken a daily ballet class, and isnt half bad. Some are learning to program or play the guitar.

There have been a lot of unexpected things happening during the pandemic. But none have amused me more than this: My friends keep calling me for medical advice. This in itself isnt uncommon. Strangers will try showing me their rashes at dinner parties when they find out what I do. But this time, its couples who dont live together, each member contacting me separately, and all with the same question:

When can we have sex again?

Im almost positive, based on the conversation, that neither knows the other is calling to ask. Its romantic, really. Couples, isolated in different apartments, perhaps one or both sick, so concerned for the others welfare above their own animal needs that they arent willing to risk it without medical clearance.

Somehow, on my days out of the hospital, I have become the Dr. Ruth of the coronavirus.

And today, when the first of the couples who called me reached back out, each barely an hour aparthe to announce that he is now asymptomatic going on three weeks after being sick with COVID, and she to say she remained perfectly healthy and her roommate had chosen to move out and isolate back homeI was finally able to give someone medical advice they actually wanted to hear.

My contract at my new position was canceled today. The positionone requiring procedural experience, best filled by a critical care doc, i.e., an intensivist or someone like meis now going to be filled by hospitalists: doctors who only work on the hospital floor and dont have the procedural training I do. Apparently the people hiring think this can be taught in a pinch, and that other docs, possibly from specialties that dont usually do floor medicine, can take over for those hospitalists if needed.

Another contractthis one for per diem assistance in a busy systemwas supposed to start placing me on shifts to help during the peak of our crisis. The company offering me that contract told me to be prepared to start three days after I was hired, and then it never called. Another doc was also waiting for that same call. It never came.

Since the start of the pandemic, NYC has been asking doctors from other places to come help and fight the COVID crisis. It was akin to a call to arms during a war: Do you have or did you have a medical degree in any state? Are you able-bodied enough, even if you are sick or old? Are you willing to be a hero on the front lines? Theres honor to be won in a war, son, do your part.

Health care workers from all over the country were directed to a NYC Department of Health online portal for assistance with placement, so that doctors could be matched with the hospitals that needed them most.

Ive spent my career in NYC. I was prepared to jump in, so I reached out directly to the places that I knew were being hit hard to see if I could offer my services, forgoing the delays inherent in a bureaucratic government website. Friends, doctors Id trained with, doctors already living and working throughout the city who wanted to be of broader use, did the same.All of us were already familiar, in a way those out-of-towners were not, with what a 12-hour shift in a COVID-saturated urban ER was like.

But the hospitals seemed strangely uninterested; their rhetoric didnt match their actionsit was hard to get in contact with anyone. Getting in touch with someone at the VA took five calls, three emails, a week, and then finally I received the internal email address of the physician recruitment team. That address bounced back. Hospitals took my CV, my phone number, then never followed up. During this time, I received calls from recruitersmiddlemen hired at a high premium by hospitals during staffing shortagespromising jobs at some of these same hospitals. Companies that took my CV said they had immediate need, and then, again, went silent. Friends and colleagues mentioned they were in the same situation, even though we were in the thick of the patient crush.

Strange.

Days passed. Finally, two hospitals said they would start the credentialing process and would need us to start immediately. We opened our schedules. Committed and then

Crickets.

As this was happening, volunteers were placed through the city DOH website. Many physicians I spoke with directly, some retired with medical conditions in high-risk age groups, were volunteering to do what seemed to be the necessary thing and return to work, and many were placedwithout pay, in overcrowded ERs, without adequate PPE. Not shockingly, some began to get ill. Already, some health care workers had died.

Meanwhile, other doctor friends and I kept trying to work. We kept wondering, too, why werent we being hired?

Hospitals were willing to pay premiums in some situations: They offered large hourly rates to out-of-state physicians who were being asked to come live in hotels and be deployed wherever they were needed each day, to work 13-hour days, 14 days in a row without a day off, in physically and emotionally strenuous environments. Premiums one anonymous administrator told me they prefer to pay because offering hazard pay to local per-diem physicians sets a bad precedent, and wages are sticky. Its harder to reverse a temporary increase in rate or decrease the number of shifts for local new per-diems than it is to just spend more on doctors who will get on a plane and quietly leave at the end of their tenure. I rarely see the ER staffing agencies hospitals use to execute these callous strategies mentioned in news stories. Theyre an invisible part of the system.

Theres nothing like a pandemic to bring out the opportunists.

Most of us have been OK with living our lives as if taking care of others is more important than taking care of ourselves. Hospitals exploit this feeling.

Doctors learn the business of the body, not the business of medicine. But modern health care is an industry with a bottom line measured in dollars, not wellness. As we train, were told to stay in our lanean important lane, to be sureand just worry about being good healers. The rest, the pesky business of how the wheel turns, can be managed by the rapidly expanding pool of administrators. In staying in our lane, we dont feel the insidious ways the business of medicine has eroded the value of the doctor-patient relationship. Instead, patients have become a commodity and physicians a cog. Were blind to the chaos and danger around us. We might note how focused administrators are on metrics of efficiency and patient satisfaction scores, even if efficiency doesnt mean quality, and higher patient satisfaction scores are linked to higher overall mortality rate. But were hired to provide the services approved by the hospital, and insurers, which is frequently not to our own standards of patient care.

Doctors learn the business of the body, not the business of medicine. But modern health care is an industry with a bottom line measured in dollars, notwellness.

I see this dynamic continuing in the midst of the COVID crisis. As hospitals and politicians continue calling for help in public, the rhetoric has been that there are too few doctors to manage the crisis. They said this even as doctors were fired or told to leave midshift for wearing their own protective equipment. Colleagues who were pointing out dangerous practices for both employees and patients were asked or pressured into leaving. Colleagues who were lower risk and looking for fairly paid work were passed over because other health care workerswho were made to believe there were no other doctors available to workwere being brought in as unpaid labor. They were told there was no money to be found, despite high reported revenues and administrative salaries in the multimillions.

In writing this I wondered if this is the time to talk about how the business of health care is affecting us, as hospitals proclaim extreme need while not hiring available doctors. But there is no way to separate the business from the care anymore. Were no longer given the luxury of that separation, because it is the business and the bottom line that has created this situation where the sacrifice of health care lives is considered inevitable.

Even as our sense of purpose is being preyed upon, were afraid well be seen as selfish if we ask for reasonable compensation, even as administrative bloat continues to increase, and insurers continue to collect their premiums. We worry that society sees us as greedy opportunists, even as we must practice medicine in unsafe conditions, at the whims of insurers and hospital authorities who profit from our sense of obligation and decide how we provide care, and then sends us out to be the messenger, placing us between the patients and their policies. We know how much everyone loves the messenger.

It seems that I have inadvertently become the messenger. So here is my message: If hospital systems really cared about healthof their workers, their patients, their communitiesthey have been extremely good at hiding it from me and all the physicians who have been looking to work within their walls.

The language of war, or sacrifice, is used when you want to mentally prepare people for a certain amount of unavoidable front-line losses. The system leverages our sense of moral obligation to exploit us.

A robust 72-year-old man is sitting up on the stretcher, talking on the phone with his family member about having to be admitted for his new onset atrial fibrillation, an irregular heart rhythm. During his 3.5 hour ER stay, I saw the cardiology team come by his side four times, checking to see if a medication has successfully converted his rhythm back to normal. I look at my resident in disbeliefneither of us had ever seen cardiology swing by to see a stable patient in the ER so frequently.

Another man comes in requesting a urinary suprapubic catheter change, a fairly simple and quick procedure.But he demands that a urologist perform the exchange and refuses to let ER staff touch it.Apologetically, I explain the situation on the phone with the urology consultant and he replies, No problem, Ill come and take care of you. Im sure you guys have your hands full in the ER.

Next comes a 40-year-old female who returns to the emergency room for a repeat beta-HCG level, a pregnancy hormone we need to recheck because she might be having an ectopic pregnancy.Because she was seen by our OB-GYN team a couple days prior, I call the OB-GYN consult just to touch base, mostly to ensure the patient has follow up.To my surprise, the consultant comes by the ER to see the patient, even though I told her it was not necessary.Again, my resident and I exchange a lookour consultants have all been exceptionally nice and helpful during this whole time of COVID crisis.

Largely, I attribute this niceness to medical professionals coming together in solidarity, supporting each other in this pandemic.Across the country, many subspecialty health care providers (cardiology, gastroenterology, etc.) have been recruited to the ERs and to the inpatient units to assist with the influx of COVID patients.The rest of them, who have been experiencing a lower volume than usual, have been trying to pitch in any way they can. It is incredibly touching to feel the support of colleagues, to know we are there for each other, even if we may often have disagreements in normal times (e.g., surgical services often punting patients to medicine rather than admitting them to their own service).

But on a lighter note, I also think Ive been seeing consultants in the ER more frequently partly because they are bored, and partly because they are just excited to see patients with diseases that are non-COVID-related.

During a telemedicine consult this morning, my patient seemed apologetic and uncomfortable, as if he was speaking through gritted teeth.

Im having terrible abdominal pain, he said.

When did it start?

A week ago.

He described severe, acutely worsening lower abdominal pain, the inability to have a bowel movement for over five days, and a history of obstruction. He was vomiting. It didnt look right, like dark, wet coffee grounds. Every tiny movement to his trunk felt like knives in his abdomen. Im getting lightheaded, he said, quietly, as if he was confessing a secret. The tenor of his voice revealed that he knew this wasnt going to be solved with a phone call.

Sir, you

He cuts me off. I really dont want to go to the hospital

You have to.

I dont want to get the virus. He sounds like hes about to cry.

I think about the tally of COVID deaths being recently adjusted for presumed cases found deceased at home. I wonder how many all-causes of death are increasing because the fear of COVID outweighs the fear of their current illness. In fairness, the fear of COVID is the fear of dying alone, without your family, shrouded in wires. I get it.

We complain about the frustrations caused by patients who show up in the middle of a busy shift complaining of two years of back pain, or requesting a pregnancy test, or with a bug bite. But when the volume of non-COVID patients dropped precipitously, we knew the worried well didnt make up that large of our patient population.

I feel like there are only bad and less-bad options when it comes to managing health care right now, even as we fall back from the initial surge ofcases.

There are still appendicitis, heart attacks, and strokes happening in the community. There are broken bones, bleeding in pregnancy, and kidney stones. We have been asking where our patients went, but we know where they went. Or rather, where they didnt go. They remain the most adherent to the stay-at-home orders. They are delaying or forgoing care, simmering in their otherwise-treatable pathologies at home.

Finally, finally, I was able to convince him to go. He put on a fabric mask and a pair of ski goggles and let me call the ambulance because he was too weak to drive. I couldnt promise him that he wouldnt catch COVID in the ER. The oppositeIm worried that he will, and will be at increased risk of death because of his comorbidities. But while COVIDmightkill him, without treatment his obstruction, internal bleeding, and infection certainly will.

I feel like there are only bad and less-bad options when it comes to managing health care right now, even as we fall back from the initial surge of cases. I have to consider my advice carefully, leveraging as many outpatient and telemedicine treatment options as I safely canwhich is vastly more than I have ever used before.The number of people whose chronic and acute medical conditions will make it worse for them should they catch COVID are, of course, the same people whose conditions will be worsened by trying not to. COVID is a chameleon, constantly presenting in new and wildly varied ways. I wish we had planned for the ways it might kill a person without them ever catching it at all.

This afternoon I went to a party on Zoom hosted by a group out of London called the Co-Reality Collective. It was largehundreds of people, multiple roomsand most people were costumed, friendly, and eager to connect across time and miles. The theme was moon landing, and at midnight their time, we stopped to share a screen. The host cued up a movie that revealed our place in the universe: floating on a small blue dot in a mote of sunlight. This passage from Carl Sagans Pale Blue Dot was narrated:

Our planet is a lonely speck in the great enveloping cosmic dark. In our obscurity, in all this vastness, there is no hint that help will come from elsewhere to save us from ourselves. To me, it underscores our responsibility to deal more kindly with one another

Ive been struggling with feeling like the distance between where were at now in the pandemic timeline and the light at the end is as vast as that between Earth and sun. But as the movie ended and everyone shared how grateful they are for the support, even the online support of strangers, then got up to have a digital dance party, I realized that what were doing isnt socially distancing at all. Its only physically distancing.

I stopped by my old hospital tonight to drop off a surprise donation: a plexiglass intubation boxmeant to decrease COVID exposure during aerosol-producing procedures. My favorite senior resident was on the night shift. Ive known him since he was an intern and I was a relatively new attending. He was having a hard time then, and reminded me of myself when I felt like I didnt fit into the department my first year of residency. I hoped I could model myself after the attendings who supported me, in some small way, and be a nonjudgmental ear. A safe person to come to.

Hey, thanks for looking out for us, he said as I handed over the box.

No problem.

Youve been really vocal about the stuff that affects us even when we cant be. Its appreciated.

I nodded, hoping he knows that I wont stop feeling a responsibility toward them even if Im not there for shifts.

Oh, hey, you also still owe me that bottle of Champagne, so maybe dont forget that next time?

I laughed.

If a resident does a spinal tap and the lab reports that it has returned without a single drop of blood in it, we call it a Champagne tap. Its a demonstration of the residents skill. To congratulate them, you gift a bottle of Champagne. Its supposed to be a reward for thefirsttime they do it, not the hundredth. But, as he reminded me, these are unprecedented times.

I like Dom, but Veuve will do.

The guy in apartment 1A has a knack for walking by the laundry room in the brief moments just after I have stripped completely naked and am shoving my COVID-contaminated scrubs into the laundry, but before I have covered myself up with a robe. Prior to the pandemic we had only nodded congenially at each other if we passed the mailbox. Now we just sidestep one another and keep moving.

I was outside tonight, in the middle of the large complex of apartment buildings where I live, when the clapping started. Ive heard it some days at 7 p.m. when Im not at work, but today was the first time I wasnt inside from the vantage of my own room. I looked up and saw as windows burst open and bodies leaned out, clanging pots and pans, yelling thank you. The shouting is ostensibly for the health care workers, yes, but also for one another. I can feel how badly those bodies want to burst out of their apartments like the cherry blossoms on the branches of the trees in Prospect Park.

Even as the number of overall cases is decreasing, there is still a mounting number of colleagues and friends becoming ill. As time goes on, we are losing our degrees of separation between someone who has died or is critical.

My mom said on the phone today that she and my dad are going stir-crazy. I feel like we will never see you again! She said it in a jesting tone, but I know she means it. They live across the country. Theyre scared. Theyre worried about me. I also wonder how long its going to be. Its been on my mind since my friends mother passed away from COVID a few days ago. He cant go to the funeral. But worse, so much worse, he wasnt able to go hold her hand in the hospital as he knew she was dying. Forget the memorial, its what he couldnt do for her while she was alive that guts himand so many in his situationnow. I wish I could say I cant imagine that scenario, but I can, and it makes me wonder, not just when I will see my parents again, but what I will have to do to make visiting an 85- and 73-year-old safe.

The goal of curve-flattening was to give the health care system a chance to prepare. There was no way that we would have a vaccine by now, but Id hoped that we would have a better handle on the ever-evolving and truly baffling pathophysiology of virus. Or a medication we could rely on. Even just reliable access to PPE. The goal wasnt just to decrease the crush of initial patients, which, thank goodness, is starting to work. The problem is, unless our only goal was to delay the inevitable, we have to know what we are replacing lockdown with.

The WHO has outlined six conditions for any government that wants to start lifting restrictions:

1.Disease transmission is under control

2.Health systems are able to detect, test, isolate and treat every case and trace every contact

3.Hot spot risks are minimized in vulnerable places, such as nursing homes

4.Schools, workplaces, and other essential places have established preventive measures

5.The risk of importing new cases can be managed

6.Communities are fully educated, engaged, and empowered to live under a new normal

I find most of these infuriatingly vague, and its hard to imagine implementing No. 2 successfully in democratic societies. But they make a good pointother than controlling transmission with further lockdown, I dont see how we have made strides on Nos. 26. Even No. 1 could be easily reversed.

Im anxious for reliable antibody testing to actually be available, since weve been hearing rumors of it here in NYC for a while now. I called the DOH today to ask how, as a health care worker, I could get tested, but Im not optimistic, since the consultant didnt know any more than I did. I still put my hopes in vaccine challenge trials. Maybe the Plaquenil study Im in will show positive results. On an emerging expert panel I took part in the other day (experts on any novel pathogen being the people who are seeing enough cases that they can say, Here are all the weird things that Im witnessing, heres what didnt work, heres what did) we tried to put together a wish list of practical actions that would fulfill the WHO conditions. Without large-scale national coordination, local behavioral changes will only put out satellite fires. Theres no question that we will move forward somehow. Thats the only directiontogo. I just hope that the way forward comes with an actual, specific plan.

Slate is making its coronavirus coverage free for all readers. Subscribe to support our journalism.Start your free trial.

Link:
For the First Time in My Life, Going to Work Scares Me - Slate

When one is struck by the coronavirus, symptoms can range from none to fatal. But for the many million in between who are infected by the novel pathogen and then recover, just how damaging are the lingering effects?

Medical researchers are on the quest to find out.

Anytime you get really sick, it is possible that it affects your different organ systems, leaving varying degrees of compromise, or you may have none at all, Dr. Eric Carter, physician and co-CEO of medical app DocClocker, told Fox News. We still dont fully understand the immune response and if recovery and immunity development offer any level of protection against reinfection and disease severity.

Thus, while the prognostic symptoms of coronavirus, formally called COVID-19, have been well-documented ranging from fevers and a loss of taste to breathing problems and pneumonia scientists are purporting to piece together what may happen to those who contract the illness and recover.HOW IS THE CORONAVIRUS MUTATING INTO DIFFERENT STRAINS?

Studies to date have shown that the vast majority of those who are infected are on the mild scale and should recover with no lasting effects. But for more serious cases, especially those who require a ventilator and/or ICU treatment which is around 20 percent of those hospitalized, the possibility of lasting lung damage or severe respiratory affliction is a very real threat.

For more than 80 percent of patients infected with the coronavirus, recovery is likely to be complete. However according to a recent study from Hong Kong, about 20-30 percent of hospitalized patients will have decreased lung capacity due to pneumonia and inflammation caused by the disease or by the ventilator treatment itself, explained Dr. Steven Berk, executive vice president and dean of Texas Tech Health Sciences Center School of Medicine.

He also noted that patients who develop acute respiratory distress syndrome and require long-term mechanical ventilation, sometimes a week or more, are most likely to have persistent shortness of breath, and evidence of scarring or pulmonary fibrosis.

A report published earlier this month in the medical publication journal Cellular & Molecular Immunology from researchers at Fudan University in Shanghai and the New York Blood Center noted that when researchers instituted contact between coronavirus and lab-grown T lymphocytes referred to as T cells the virus paralyzed these critical cells, which help identify and expel pathogens in the body. The researchers also found that SARS, a related coronavirus, could not infect T cells.

Disturbingly, the study also indicated that damage to the T lymphocytes paralleled that caused by HIV.

Moreover, preliminary studies out of China have also underscored that around 12 percent of survivors of severe cases endured protracted heart issues, and some showed signs of impaired liver function.

Given that the virus itself is only a few months old, having originated out of China at some point late last year, experts have only small-scale, immediate term studies to go on, and are mainly looking at data from related viruses SARS and MERS to gauge a more in-depth understanding.

Those with SARS pneumonia had shortness of breath and evidence of pulmonary fibrosis one month after infection. Most patients improved over time, Berk continued. Patients with SARS continued to excrete the virus, sometimes for more than 20 days. Those who had developed acute respiratory distress syndrome (ARDS) remained short of breath for months or for a lifetime.

Texas and Arizona-based hormone specialist Dr. Elizabeth Lee Vliet also pointed out that, in examining the long-term adverse effects of a variety of viral illnesses, problems include lungs illnesses, as well as issues with neurological systems showing cognitive and nerve dysfunction, heart damage viral cardiomyopathy that can lead to congestive heart failure as well as kidney impairment that in astringent cases can lead to progressive kidney failure.

We have known that severe viral illnesses can lead to severe fatigue that can become debilitating, she said. Those are the major organ systems we already know can be damaged by severe viral illnesses with known viruses, so I plan to be monitoring my patients for the emergence of such problems as we go forward.

From Vliets purview, long-term consequences will more commonly be seen in older patients who have pre-existing conditions such as heart disease, kidney disease and pulmonary fibrosis.

And for those just weeks or months in recovery with now negative test results, it is not only the enduring physical ramifications such as reported breathlessness, lung pain, or fatigue that plague, but the psychological distress, isolation and fear of a relapse that medical professionals are monitoring.

From the original SARS outbreak in 2003, we see that psychiatric illness is the most notable long-term outcome, said Dr. Melissa Nolan, an infectious disease expert, and professor at the University of South Carolina. Including post-traumatic stress disorder and depression.

Berk concurred that anxiety, depression, and muscle weakness were also common.

But if the novel pathogen has proven anything to date, it is that uncertainty and outliers are its hallmarks.

It will also be very important to determine the level of antibody developed to coronavirus, as investigators also determine the level of antibody that guarantees protection against a second infection, Berk added.

Go here to read the rest:
Coronavirus crisis: What are the potential long-term health impacts? - New York Post

Young girl watching as mother uses spoon to serve meal, vegetarian food, family dinner time, healthy ... [+] eating

The novel coronavirus pandemic is unleashing havoc on every aspect of society medical, cultural, financial. Zooming in from macro to micro, we see that the viral outbreak is clearly impacting our day-to-day living including our eating patterns. Environmental stressors often do. Who hasnt participated in emotional eating? I certainly have! At this unprecedented time, stress levels are exceedingly high, and being sustained at this level for an indefinite length of time, as COVID-19 does not appear to dissipate anytime soon.

Eating While Stressed

According to a study by Yale researchers, stress may contribute to an increased risk for obesity and other metabolic diseases. Uncontrollable stress, in fact, changes eating patterns and the consumption of hyperpalatable foods, like those late-night Oreo cookies or Cool Ranch Doritos.

Our good habits are being challenged by our natural tendencies to snack more while at home which can include comfort foods, explained W. Scott Butsch, MD, MSc, Director of Obesity Medicine, Bariatric and Metabolic Institute at the Cleveland Clinic. That, together with a baking pandemic, could add more calories to the day.

High-sugar, processed foods increase the risk of metabolic syndrome, diabetes, heart disease and ... [+] obesity which increase our risk for infections such as COVID-19

Not all eating patterns have been unhealthy. In the wake of the COVID-19 pandemic, were eating out less frequently. No more work lunches or social dinners to fill up on endless appetizers and booze. But the stressors of this sudden new normal are also changing our dietary habits for the worse.

Theres a well-documented relationship between stress and weight gain, according to Julius Wilder, MD, PhD, Assistant Professor of Medicine at the Duke Division of Gastroenterology. Increased stress levels lead to a rise in the stress hormone, cortisol, which can result in an increased appetite. Dr. Wilder continued: The weight gain in the current pandemic is further accentuated by a decrease in daily exercise and an increase in alcohol consumption.

Does Stay at Home Translate to Binge at Home?

Since the start of the pandemic, public health professionals have been advising us to avoid social gatherings by staying home. During daily White House press briefings and on nearly every major news outlet the nations top infectious disease physician, Dr. Anthony Fauci, in his delightfully-prominent Brooklyn accent, has explained the rationale of physical distancing in reducing transmission of this highly infectious coronavirus. But have public health pundits inadvertently triggered a different health problem overeating?

Food is medicine. Healthy foods can help us fight infection. A poor diet, in contrast, can increase ... [+] inflammation and the development of metabolic syndrome, cancer and other chronic illnesses.

I think several emotions are at play here, Dr. Butsch reflected. More stress, more fear, more boredom lead to comfort foods, more snacking, more carbs.

Some folks are combating their boredom and loneliness by watching TV and movies, but that can be associated with mindless snacking of chips and popcorn as well as consumption of alcohol, all of which can contribute to weight gain.

Seven Ways to Maintain a Healthy Food Regimen

1.Take an Emotional Break. In the midst of SO much uncertainty, give yourself permission to indulge on your favorite cheesecake, parmesan truffle fries or Pinot Grigio! But in moderation perhaps a glass of wine each night or a few cookies per week.

2.Make a Schedule. Heres a sample: prepare breakfast (maybe a fruit smoothie or scrambled eggs); do a zoom meeting or other work; exercise at noon (see #5); grab a healthy snack (see #3); squeeze in some more work; make dinner; watch TV/movie, read, wind down.

Snacks can be healthy and delicious! Berries are high in antioxidants which can boost the immune ... [+] system.

3.Prepare healthy snacks. Im always snacking between meals, and there are plenty of healthy options. My favorites include carrot sticks; apple slices or celery sticks with peanut butter; and roasted almonds. Its also okay to indulge in your favorite sweet/salty treat (e.g. Kit Kat and Pringles are often in my kitchen)see #1.

4.Portion control. While at home, its easy to consume an entire large bag of potato chips or 6-pack of beer which can contribute to unintentional weight gain. Try to measure out portions of food and transfer into smaller bowls or plates.

Running, jogging or brisk walking - while physically distanced - are effective means of staying ... [+] healthy

5.Regular physical activity. Moderate exercise releases endorphins which reduce stress and improve mood. Simply walking for 20-30 minutes, getting out of the house, breathing fresh air can help de-stress, says Dr. Butsch.But home exercises can be just as effective check out the many fun and free YouTube workout videos! (Mike Chang is one of my favorites)

6.Get plenty of sleep. Studies supported by the National Institutes of Health suggest an association between sleep deprivation, weight gain and obesity. Poor sleep alters the levels of endocannabinoid which affect appetite and the brains reward system.

7.Mindful practice. Daily meditation can reduce stress, improve attention and help us be more mindful of our food choices. According to Harvard Health, mindful eating means being fully attentive to your food as you buy, prepare, serve and consume it. Next time youre cooking, bring all your senses to the meal smell the onions and garlic, feel the ripe tomato, hear the pepper shaker and taste the spices in your turkey chili.

A healthy diet is essential to boosting the body's immune system and ability to fight off ... [+] infections.

For many, unfortunately, food choices arent choices at all. People living in food deserts have limited options for fruits, vegetables, whole grains and lean meats. We need to invest in public health programs that enable marginalized communities access to healthy foods and other support services (preparation, storage, etc.)

Common sayings in clinical nutrition circles are food is medicine and you are what you eat. Both phrases resonate when one considers that the leading causes death heart disease, diabetes, cancer are largely preventable by following a healthier diet. Good nutrition is essential to a strong immune system which in turn will help shield us from, say, an infectious pathogen like the COVID-19 virus. But its also okay to treat yourself to a snack or drink that puts a smile on your face.

Read more:
Fighting The COVID-15: 7 Ways To Maintain A Healthy Weight During Social Isolation - Forbes

LifeGaines Medical and Aesthetics in Boca Raton serves South Floridians with age management therapies. Dr. Gaines discusses NAD's role in keeping a vibrant immune system. He is also conducting Physician Telehealth Consultations for those who want to achieve health and beauty goals during this time.

BOCA RATON, Fla., April 24, 2020 /PRNewswire/ --Dr. Gaines recently sent a message to his patients about keeping a healthy immune system, which also needs to be shared with the greater South Florida community.

NAD+'s Role in Keeping A Healthy Immune System

As people continue to cope with the pandemic, most people have thought about their immune system but have not considered the role NAD+ plays and how it can affect their response to a deadly virus.

NAD+ (Nicotinamide Adenine Dinucleotide)is a critical coenzyme found in every cell of one's body and helps the immune system function at its best by repairing and remodeling cells.

A viral infection causes free radicals to form which causes DNA damage. In order to repair DNA, the body needs high levels of NAD+. When people are young, high levels of NAD+ are present in their cells, but as people age, those levels deplete and can make people more susceptible to infection.

NAD+ IV therapyis a good solution to replenish one's NAD+ levels in the fight against viruses but it has many additional benefits. It is usually recommended in a series of 3 weekly treatments by LifeGaines, but will be customized based on each patient's specific needs. The NAD+ IV therapy is a slow drip process, so it takes time to enter into your system, generally 3-4 hours per treatment. NAD+ IV therapy can;

For more information on NAD+ IV Therapy, call the office of LifeGaines at (561) 931-2430.

Also, LifeGaines advises its patients to maintain their goals of health and beauty by participating in a telehealth consultation with Dr. Gaines.

Issues that can be addressed in a telehealth consultation:

Complimentary aesthetics consultations can determine someone's needs for:

Any new patient virtual appointment will receive10% off a future in-office service! Inquire about Telehealth consultations. Call (561) 931-2430.

Dr. Richard Gaines is the Chief Medical Officer of LifeGaines Medical and Aesthetics, an age management medical practice located in Boca Raton, FL. His new practice offers a complete regenerative medicine program for men and women, including hormone optimization, sexual health, as well as facial rejuvenation.

LifeGaines Medical & Aesthetics is located at 3785 N. Federal Hwy, Suite 150 Boca Raton, FL 33431. Go to http://www.lifegaines.comto learn more. For any media inquiries, contact Kellie Keitel at kellie@lifegaines.com.

Related Images

inquire-about-telehealth.png Inquire about Telehealth consultations. Call (561) 931-2430. LifeGaines Medical & Aesthetics is located at 3785 N. Federal Hwy, Suite 150 Boca Raton, FL 33431. Go to http://www.lifegaines.com to learn more.

View original content to download multimedia:http://www.prnewswire.com/news-releases/dr-gaines-of-lifegaines-informs-patients-about-nads-role-in-keeping-a-healthy-immune-system-dr-gaines-is-also-conducting-telehealth-consultations-with-patients-301046832.html

SOURCE LifeGaines

Read the original:
Dr. Gaines of LifeGaines informs patients about NAD's Role in Keeping a Healthy Immune System. Dr. Gaines is also conducting Telehealth Consultations...

In the 10 years since Caster Semenya won the 2009 World Championships at just 18 years old, the sports world has whittled her story down to one thing: her body.

Narrow hips. Wide shoulders. Pronounced jawline. Manly.

Based on the tones of disgust used to discuss her physicality, one might think that Semeya is the only runner to ever possess a body that so greatly differed from everyone elses in the field. It seems the sports world has forgotten the peculiarities of Ira Murchisons stocky, 54 frame, which earned him both the nickname Human Sputnik and an Olympic gold medal in the 4x100. Or that world record-holder Usain Bolt was taller with longer legs than any of his competitors.

Unlike those men, Semenyas body is often deemed unwanted and out of place, most notoriously by her sports governing body. Throughout her career, World Athletics, formerly the International Association of Athletics Federations, has insisted she undergo intrusive testing and hormone regulation, and ultimately banned her from competition after instituting rule changes that seemingly targeted her in 2019.

But Semenya is not alone. Burundian runner Francine Niyonsaba, one of Semenyas competitors in the 800-meter run, has since revealed she is one of a growing number of female athletes, mostly from the Global South, whose hyperandrogenism puts them directly in the crosshairs of World Athletics regulations. Former top junior-athlete Annet Negesa, an intersex runner from Uganda, recently disclosed that she underwent invasive surgery at the behest of World Athletics doctors to ensure she could continue competing. Complications from the procedure left her damaged both mentally and physically.

Underlying this harsh, discriminatory treatment is not simply an adherence to faulty biological metrics or antiquated, binary conceptions of gender, though these aspects have undoubtedly played a role. In fact, sex verification practices originated in the 1950s out of the as yet unfounded suspicion that some countries were allowing men to compete disguised as women, and involved little more than asking athletes to remove their undergarments. (Some of the athletes subjected to this scrutiny, like 1932 Olympic gold medalist Stella Walsh, were discovered to have genetic conditions resembling intersex characteristics.)

Semenyas treatment is rooted in something far more disturbing. As early as the 16th century, European explorers who made their way to the African continent began remarking on the anatomical features of the populations they encountered. To the Europeans, the dark skin, strong builds, and wide lips and noses they encountered resembled those of apes, so much so that they began perpetuating the idea that Africans regularly copulated with monkeys. Over time, such beliefs took on a more gendered tone, with comparisons made between African and European women that not only promoted arbitrary markers of racial difference and inferiority, but also justified the exclusion of African women from the category of woman altogether.

World Athletics remains committed to a centuries-old, white supremacist notion that defines womanhood in terms of the white, cisgendered female body, rendering everyone else, especially women of African descent, socially unacceptable abberations.

World Athletics describes its mission as fostering athletic excellence and enhancing sport to offer new and exciting prospects for athletes. Yet it has historically done so by enabling vile attitudes towards black women and the bodies they inhabit.

In 1897, just 15 years before World Athletics was founded, British missionary Sir Albert Cook, a medical doctor by training, wrote broadly and unabashedly about his ethically dubious biopsies of women in present-day Uganda, remarking:

Who has not been struck by the extraordinary narrowness of the Negroid hip? Viewed behind in the erect position at the level of hips the female Negroid body is narrow and round as compared with the broad beam of the average European woman, and when the dried pelvises of each are placed alongside each other the explanation is obvious, the Mugandas bone looks like that of a child in size and in the fineness of its structure.... The negroid races have a shape of pelvis which is intermediate between the protomorphean races and those of the higher civilised types.... The brim, as in the apes, is longoval in shape.

It is difficult to overemphasize how critical Cooks now-disproven studies were in the development of racialized ideas around femaleness and womanhood, and ultimately the dehumanization of black womens bodies. He would become a two-time president of the British Medical Association and was knighted by way of King George V after his studies of African womens anatomy became popular. Cook exemplified to the colonizing world the knowledge that could be seized upon through engagement with the African other.

Before Cook, Sarah Baartman, more commonly known by her derogatory nickname The Hottentot Venus, encompassed Western societys fixation on black womens bodies. Captured and enslaved in what is now South Africa (Semenyas home country), Baartman was brought to Europe in 1810 and exhibited in circuses and public squares until her death, when scientists assessed and dissected her elongated labia. That work was promoted as more evidence that black womens so-called deficiencies made them less womanly than their white counterparts.

The impact of such ideas can still be seen today within the medical community through widespread diagnoses of labial hypertrophy, a medical term for an elongated labia, despite the fact it is not a major (nor, for the most part, even minor) health concern. The rise of labiaplasties a procedure that shortens and reduces the overall length and size of the labia reifies the idea that the legitimacy of female genitalia should be defined by its distance from the physiology of the black, female body.

And while some might dismiss the relevance of these concepts today, chalking them up to a long-ago historical era of overt racism, they nonetheless helped Europeans institutionalize racism in areas like sports. As a result, the medical knowledge that informs society and World Athletics standard of womanhood is deeply rooted in racism, to the extent that black women like Semenya, Niyonsaba, and Negesa never really stood a chance.

Take sex hormones, for example. The idea that there are racial differences in testosterone and estrogen levels, particularly between black and white groups, is widely held yet highly controversial. The belief that black women are more masculine than just about every other race of women is rooted in the 17th and 18th centuries, and based on the notion that people of African descent are animalistic and aggressive. Fast forward to 1995, when popular psychologist J. Philippe Rushton argued that black people are less intelligent and more impulsive than white and Asian people, in large part due to their heightened levels of testosterone. Though Rushtons work has been subjected to criticism over the years, his book Race, Evolution, and Behavior is in its third edition. Rushton himself was elected to the prestigious Canadian Psychological Association, and received a one-time Guggenheim fellowship. Scientists have spent the last few decades refuting Rushtons claims, and ironically fanning the flames of racial pseudoscience.

Some studies suggest that among older women in the U.S., black women possess lower levels of estradiol, a form of the female sex hormone estrogen, than white women. On the surface, this may appear to be the source of World Athletics highly racialized policies. But it is important to note few studies have assessed racialized hormone disparities among women of different races, and even fewer studies with results that can actually be replicated. More common, as one might imagine, are studies that explore racial differences in sex hormones among men. Some show, contrary to popular belief, testosterone levels are quite similar between black and white men, while free estradiol levels are much higher in black men than men of other races. But even those results have been questioned by endocrinologists, biologists, and doctors due to conflicting studies in the field.

World Athletics relative lack of interest in variance in mens bodies illustrates, by contrast, just how disproportionately unfair it has acted towards women. In his 1996 book Darwins Athletes, historian John Hoberman argues this discrepancy is due to a fixation on black athletic aptitude that goes back centuries. In 1851, physician Samuel Cartwright wrote that, It is not only in the skin that a difference of color exists between the negro and the white man, but in the membranes, the muscles, the tendons, and in all the fluids and secretions. Cartwrights work, which Hoberman claims was read widely by slaveholders, gave (pseudo-) scientific, biological justification for maintaining racial hierarchy and slavery, even as moral opposition grew in other parts of the United States. Implicit in Cartwrights work was the idea that black mens physicality is acceptable only when it can be manipulated for profit.

Today, we see Cartwrights legacy in sports. Exceptional male bodies, often characterized by great strength and size, often inspire awe, and not ire, because for the last century sports institutions have forged and refined mechanisms to make money off of them. Strong womens bodies, however, havent yet been nearly as profitable, and thus have been much more easily derided.

From an interracial lens, black athletes are only considered worthy of wealth once theyve proven their value beyond any reasonable standard. Until then, they are denied the same fame, wealth, and recognition that white competitors more easily receive. In their analysis of the rise of Kenyan athletes in the middle and long distance winners circle, John Bale and Joe Sang show that, when confronted with the domination of African-American sprinters from the top of the 20th century onward, white sprinters from Europe quietly retreated to the longer distances while sports writers claimed black athletes lacked the stamina and strategic acumen to succeed in those races. Further, when black athletes began performing better than whites, race officials would either give white athletes another opportunity to run, or disqualify the faster times run by their black counterparts. Such was the case when African runners Humphrey Khosi and Bennett Makgamathe bested white runners in a 1962 meet held in Mozambique, but were denied victory by officials.

Now, World Athletics has established development centres throughout Africa and many other parts of the Global South, hoping to recruit and cultivate the very talent it once sought to restrict from success in competition. Some argue that regional development centres are actually a way to export these athletes to the West so that they can compete for nations like Britain and France. And still, these centres cater to the cultivation of male athletes, leaving women behind even in countries with more liberal attitudes towards womens participation in sports.

World Athletics simply sees little use in acknowledging and developing female talent, particularly black female talent in the Global South. As exemplifiers of a particular strain of racialized thinking, those women, to them, are not real women. And when World Athletics refuses to elevate the athletic prowess of a black woman, within a body that defies centuries of white supremacist, colonial, gender-essentialist myths, it chooses, instead, to humiliate her on every level.

In this era of sports and protest, perhaps a movement of solidarity from other runners could rise up, forcing World Athletics to reevaluate its stance. But track and field is still an intense, cutthroat competition. Many contestants instead see a chance to fill a void atop the podium, or worse, proliferate their own racism without fear of backlash. British middle-distance runner Jemma Simpson described racing with Semenya as literally running against a man. Australian Madeleine Pape recently defended Semenya, and expressed regret at having joined the chorus of voices condemning her performance as unfair. Black female athletes from sub-Saharan Africa occupy a position of heightened marginality; the chances of them receiving widespread support were miniscule from the jump. Ironically as some of the worlds fastest runners, they havent been able to garner the momentum needed to create a different outcome.

And yet, these women shouldnt need to advocate for themselves. As society continues to confront the racial legacies of social institutions in other ways, sports organizations like World Athletics have a clear opportunity to address the harm done as a result of the implementation of racist, sexist ideas. No more hiding behind biased science, doctors, and metrics. Semenya, Niyonsaba, Negesa, and other African female athletes with hyperandrogenism need not alter or manipulate themselves to fit ideals of womanhood that were constructed explicitly around their exclusion. Their bodies are simply not the problem.

They never were.

Read the original here:
Caster Semenya and the cruel history of contested black femininity - SB Nation

Dr. Lori Brotto and Dr. Peter Leung, professors in the UBC department of obstetrics and gynaecology, and Dr. Kendall Ho, professor in the department of emergency medicine, have been awarded the 2019 Faculty of Medicine Distinguished Researcher Awards. The annual awards recognize faculty who have made significant contributions in basic science research in the areas of health and life sciences, as well as clinical and applied research to improve health outcomes of populations.

Dr. Lori Brotto

Dr. Lori Brotto, the Canada Research Chair in Womens Sexual Health at UBC and executive director of the Womens Health Research Institute, was recognized for her contributions to the field of womens sexual health and mental health. Her research has influenced the assessment and treatment of sexual dysfunction around the world.

It is such an honour to receive this award because it recognizes the important contributions that psychology makes to the field of medicine, and I am proud that our evidence-based psychological treatments have been implemented in so many medical centres, Dr. Brotto said. Moreover, to be recognized for my research in womens health is so important because womens health continues to be misunderstood, misdiagnosed, and dismissed. In my mind, research is the route towards ending these gender-based biases, and I am happy that my research has played one small part in doing so.

Dr. Brottos research has also influenced local clinical practice through the introduction of psychological skills training for treating womens chronic genital pain in hospital-based programs. Her recommendations for mindfulness and psychological approaches to treating sexual dysfunction have also appeared in the International Consultation on Sexual Medicine. Dr. Brotto has published her research in more than 170 peer-reviewed publications, regularly participates in media interviews, and wrote Better Sex Through Mindfulness to translate her research to the public. Dr. Brotto is a Fellow of the Royal Society of Canada and the College of New Scholars, Artists and Scientists.

Dr. Peter C.K. Leung

Dr. Peter C.K. Leung, the faculty of medicines former associate dean of graduate and postdoctoral education, was recognized for his work in womens reproductive biology and medicine. Dr. Leungs research seeks to understand hormonal factors in womens reproductive health and improve the treatment of reproductive health and gynaecologic cancers

This honour is a recognition of the collective efforts of a great many postdoctoral researchers, graduate students, staff and visiting scholars who I have been privileged to work with, said Dr. Leung. Their talents and dedication to scientific pursuit are deeply appreciated.

Dr. Leung has received worldwide recognition for discovering and categorizing the human gene encoding the genadotrophin-releasing hormone receptor (GnRH), which is a key regulator of reproduction. His findings have influenced further research and clinical practice, including treatments and therapies for infertility, endometriosis and uterine fibroids, as well as prostate cancer. Dr. Leung has established international academic and research partnerships between UBC and top universities, and published more than 420 peer-reviewed papers in academic journals. He has received the Medical Research Council of Canada Scientist and Michael Smith Foundation for Health Research Distinguished Scholar awards among many others. Dr. Leung is a Fellow of the Royal Society of Canada and Canadian Academy of Health Sciences.

Dr. Kendall Ho

Dr. Kendall Ho, the lead investigator for Digital Emergency Medicine at UBC and an attending emergency physician at Vancouver General Hospital, was recognized for his contributions to research in digital health. Dr. Ho leads a research program integrating digital applications to enhance health outcomes of diverse patient populations.

I am very honoured and humbled to be selected for this award, Dr. Ho said. I feel very fortunate to be in the field of emergency medicine, being a member of the UBC faculty of medicine, and pursuing my vocation in Canada. All of these factors allow me to develop my scholarship and knowledge translation in digital health with strong clinical grounding, fertile innovative milieu, rich contexts of care, and meaningful partnerships across Canada and globally, so as to make positive impact to patient care. This award recognizes this diverse tapestry upon which I am nurtured and grow as a clinician-researcher.

Dr. Ho is a national leader in digital health with an extensive clinician-researcher career. His most recent project, TEC4Home, investigates home monitoring of patients with heart failure to help improve the lives of patients through digital health practices. Dr. Hos research regularly informs provincial and national health policy-making organizations, such as the B.C. Ministry of Health and Health Canada, on digital health. He has significantly impacted the training of health professionals in digital health, as well as published more than 100 articles in peer-reviewed journals. Dr. Ho is a Fellow of the Canadian Academy of Health Sciences and has received numerous awards and recognition, including, most recently, the Canadian Medical Association Physician Changemaker.

More here:
Three faculty members recognized for outstanding contributions to health research - UBC Faculty of Medicine

In recent weeks, a flurry of headlines about healthcare workers treating people with COVID-19 have utilized a wide array ofmilitary metaphors: Doctors are fighting on the frontlines without sufficient ammunition. They are battling the enemy. They are at war.

But we are not at war. And we certainly have not enlisted. We are doctors. What we are doing is working extraordinarily hard to keep our patients alive.

Are there similarities between treating an enormous number of patients with a rapidly spreading, potentially fatal virus and armed conflict against an enemy invader? Perhaps. But the differences are just as, if not more, important.

To adopt a wartime mentality is fundamentally to allow for anall-bets-are-off, anything-goes approach to emerging victorious. And while there may very well be a time for slapdash tactics in the course of weaponized encounters on the physical battlefield, this is never how one should endeavor to practice medicine.

Of course, we all want to contain the virus, posthaste, and to treat as many as patients as we possibly can. But todo so under the banner of war implies the necessity of a heedless approach that leaves both doctors and patients open to an indefensible level of risk.

In medicine, emergencieseven pandemicsare never an excuse for shortcuts. If the careful study of our own mistakes and oversights has taught us anything it is that, even in the most critical of situations, we must confirm the birthdate on every wristband and review every item on the checklist. In day-to-day practice, these procedures may begin to feel redundant and banal, but they are what keep us from operating on the wrong limb or ordering insulin for the wrong patient.

In times of crisis such as this when levels of the stress hormone cortisol are high and health care workers are particularly susceptibleto distraction and exhaustion, our reliance on basic safety protocols is more important than ever.

Wartime rhetoric, the kind that pervades nearly every news article about those of us who are involved in the care of COVID-19 patients, calls this logicinto question. It makes a desperate appeal to the necessity of chaos. It argues for the inevitability of abandoning the rule of law in exchange for the promise of a swift resolution. And, in so doing, it sends a precarious message.

Furthermore, using militaristic dictionto describe doctors' sense of duty conflates and confuses the reality of our responsibilities. Until a few months ago, those involved in the practice of modern medicine could be reasonably confident that, regardless of the patient's ailment, the provider was not putting their own lifeat risk in the process of proffering treatment (although of course, with regard toinfectious, communicable diseases, some chance of contagion always exists).

Now, doctors from every specialty have been redeployed. And while every health care worker involved in efforts to mend the afflicted deserves the utmost in admiration and accolades, it is incumbent upon the media to tread lightly with language suggesting that giving our lives to this pandemic is in any way our charge.

A wartime mindset demands death, suffering and sacrifice in the service of one's country. But aglobal pandemic should not demand the same of its medical workforce. Young doctors who have not yet finished school should not feel pressured into risking their own lives in response to the promise ofmartyrdom or glory. Older doctors, or those with conditions that put them at greater risk of becomingseriously ill, should be encouraged to stand up for their own needs without fearing any form of dishonorable discharge. In times of war, following orders may mean every single recruit charging ahead, even in sub-optimal conditions, even without proper equipment. But applying such a framework to our current situation would do more harm than good. War is dangerous by definition, but danger should never be inherent to the hospital.

Of course, it is important to acknowledge that the linguistic militarization of modern medicine is hardly a novel phenomenon. The British physician Thomas Sydenham (posthumously annointed the English Hippocrates) is credited with inviting armor into Western medical discourse by writing, in his 1676 Observationes Medicae, that a"murderous array of disease has to be fought against, and the battle is not a battle for the sluggard."And this pandemic is not the first to borrow language from the special forces. In 1918, the flu outbreak that ravaged the United States took place while this country was also, quite literally, at war. It is unsurprising, then, that the sudden arrival of a deadly and unbridled illness was characterized as an invasion, an attack, and as dangerous as poison gas shells.

In spite of their age, however, these military metaphors are not dead. And, the problem with the inexact use ofliving metaphors is that they have the potential to influence the ways we think and behave. As George Lakoffand Mark Johnson write in Metaphors We Live By, The heart of metaphor is inference[and] because we reason in terms of metaphor, the metaphors we use determine a great deal about how we live our lives.

Thus, we must be extremely careful about the words we, and others,use to describe the job we do.

None of this is to suggest that doctors arenot brave. Every medical professional I know is eager to assist, in every possible capacity, in tending to the ill and taming this outbreak. And, indeed, we are more than willing to fightwith insurance companies, hospital administrators and lawmakersin order to get what we need to care for our patients.

This evening at 7 PM, a collective roar of gratitude, composed ofdrums, chimes, and all manner of vocalization, sprang forth from thousands of balconies,windows, roofs and fire escapes, briefly enlivening the all-but-empty streets of New York City. I listened from insidemy bedroom, where I have been quarantined for almost a week, recovering from the virus that has tormented the hospital where I work for more than a month. I was still too weak to join in the appreciative outcry, but I am in full agreement with the sentiment. After all, there is undeniable strength, great honor and inconceivable sacrifice in what we do.

Go here to see the original:
Military Metaphors Distort the Reality of COVID-19 - Scientific American

The American Civil Liberties Union filed a lawsuit Wednesday challenging Idahos first-in-the-nation law banning biological males who identify as female from competing against girls and women in school sports.

The lawsuit, filed in U.S. District Court in Boise, named as the plaintiff Lindsay Hecox, a transgender track athlete at Boise State University, as well as 17-year-old girls soccer player at Boise High School who is not transgender, but fears the law could invade her privacy by requiring her to prove her sex if challenged.

In Idaho and across the country, transgender people of all ages have been participating in sports consistent with their gender identity for years. Inclusive teams support all athletes and encourage participation this should be the standard for all school sports, said Gabriel Arkles, senior staff attorney with the ACLUs LGBT & HIV Project.

The lawsuit, which argued that the law violates the plaintiffs constitutional rights under the Equal Protection Clause, named as defendants Idaho school officials and Republican Gov. Brad Little, who signed HB 500 into law on March 30.

I think that the issue is the girls right to participate without having to be concerned about who theyre competing with, Mr. Little told KTVB-TV in an interview last week. And thats why I signed the bill.

The bills sponsor, Republican state Rep. Barbara Ehardt, a former Division I college basketball athlete and coach, argued that allowing transgender athletes to compete in girls and womens sports creates an unfair playing field, citing the natural physical advantages of boys and men.

It is sad to think that there are those who would prevent girls and women from competing in their own sports while continuing to give more opportunities to boys and men, said Ms. Ehardt in an email.

The bill states, Athletic teams or sports designated for females, women, or girls shall not be open to students of the male sex.

For athletes whose sex is disputed, a student may establish sex by presenting a signed physicians statement that shall indicate the students sex based solely on (a) The students internal and external reproductive anatomy; (b) The students normal endogenously produced levels of testosterone, and (c) Analysis of the students genetic makeup.

Ms. Ehardt said an athletes sex could be determined through routine sports physicals that students undergo before participating on school teams, but Mr. Arkles said the law subjects all female athletes to the possibility of invasive genital and genetic screenings.

In Connecticut, the conservative Alliance Defending Freedom sued in February on behalf of three teen girls track athletes sued to overturn state rules allowing transgender participation in girls sports, arguing that their scholarship opportunities have been threatened after losing races to transgender competitors.

The Justice Department issued last month a statement of interest challenging the Connecticut Interscholastic Athletic Conference, saying that interpreting Title IX to encompass gender identity would turn the statute on its head.

Title IX and its implementing regulations prohibit discrimination solely on the basis of sex, not on not on the basis of transgender status, and therefore neither require nor authorize CIACs transgender policy, said the DOJ statement.

The Idaho lawsuit, which was filed by the ACLU as well as attorneys from the law firm Cooley, LLP, took the opposite stance.

By discriminating and invading privacy, HB 500 violates the U.S. Constitution and Title IX, and we look forward to presenting our arguments to the court, said Kathleen Hartnett of Cooley, LLP in San Francisco.

While similar bills were filed this year in other states, Idaho was the first state to impose an outright ban on participation of transgender athletes and the only with a statewide law regulating transgender and intersex athletes in the country, said the ACLU.

Ms. Ehardt, who played point guard at Idaho State University, said she felt an obligation to preserve the same opportunities for those girls who follow.

Boys and men are just physically bigger, stronger and faster, she said. We cannot compete against the inherent physiological advantages that they possess, regardless of hormone usage.

Read the original:
Idaho sued over first-in-nation law banning transgender participation in girls' sports - Washington Times

Privacy Policy

This Privacy Policy details how LoudCloudHealth (hereinafter known as Website, we, and us) protects and uses collected information. The online information practices outlined in this Privacy Policy relate to any personally identifiable information, anonymous data collection and reporting.

Information We Collect

Personally identifiable information we collect from you includes (but is not limited to) your name and your email address. None of this information will be collected without your explicit consent.

We collect non-sensitive information, such as your IP address, by using cookies. This standard technology gathers how the site is used and is implemented by many commercial websites. For more information, take a look at our Cookie Policy below.

We may collect anonymous, non-personally identifiable data (such as website visits). These statistics are for internal purposes and do not hold any personal information, nor they can be used to collect it.

How We Use Collected Information

Collected information strictly serves the purposes that are clearly stated before you are asked to provide personal information. We will only send promotional emails to your email address if you have explicitly signed up for that service. To make our site easier for you to use and to customize user experience, as well as create and publish content most relevant to you. To provide feedback for any inquiries that you may have, any surveys or questionnaires. To handle complaints or provide operational notices.

Who We Share Collected Information With

We never sell or rent collected information, nor do we distribute personal information in any way. The only circumstances under which your personal information may be disclosed are the following:

If we are required to do so by law or regulations; To protect the property and rights of LoudCloudHealth; If our records indicate any form of fraudulent or deceptive activities of which a governmental agency should be made aware; If your communication on the Website suggests possible harm to others.

Security of Gathered Information

We have implemented all the appropriate physical and electronic procedures in order to prevent unauthorized access or disclosure of your personal information.

External Link Policy

Our Website shares links to other websites. As stated in our Terms of use, we do not have control over the content nor the behavior of external sites. Therefore, we hold no liability for the privacy or protection of the information you provide on third-party websites.

Cookie Policy

Cookies are small files placed on your hard drive by a web server. They cannot run programs or deliver viruses to your computer. They are uniquely assigned to you, and their only purpose is to provide you with an optimal browsing experience.

You have the ability to accept or decline cookies. Many web browsers accept cookies automatically. To disable them, you will need to modify your browsers settings. Doing so will significantly affect the full features of the Website.

Go here to see the original:
Best CBD Oil for Sleep That Will Make You Doze Off in a Second - LoudCloudHealth

DUBLIN--(BUSINESS WIRE)--The "Hormone Replacement Therapy Market Size, Share & Trends Analysis Report by Product (Estrogen, Human Growth), by Route Of Administration (Oral, Parenteral), by Type Of Disease, by Region, and Segment Forecasts, 2020 - 2027" report has been added to ResearchAndMarkets.com's offering.

The global hormone replacement therapy market size is expected to reach USD 39.6 billion by 2027, expanding at a CAGR of 7.7%. A significant rise in the incidence rate of hormonal disorders in the newborns, adults, and elderly and populations is driving the market. The Prader-Willi syndrome (PWS) affects one in every 15,000 newborns, thereby boosting the demand for the therapy.

Estrogen replacement hormone therapy helps in reducing the vaginal indications of menopause, such as dryness, burning, itching, and pain during intercourse. Estrogen is available in the forms of pill, gel, skin patch, cream or spray form. It is highly successful for treating problematic menopausal night sweats and hot flashes. Around 45% of women between the ages of 40 to 60 years of age were reported taking counseling sessions from a physician regarding the advantages and disadvantages of using hormone replacement therapy (HRT) after menopause.

Growing awareness about menopausal signs and the treatment options is growing the HRT market. Owing to the significant development for ERT, there has been an initiation of very safe treatment options for the patients situated in various geographies of the world. For example, augmentation of innovative drug delivery systems like transdermal estrogen patches and vaginal estrogen drugs.

Further key findings from the report suggest:

Key Topics Covered:

1. Methodology and Scope

2. Executive Summary

2.1 Market Outlook

2.2 Segment Outlook

2.2.1 Product

2.2.2 Route of Administration

2.2.3 Type of Disease

2.2.4 Region

2.3 Competitive Insights

3. Market Variables, Trends & Scope

3.1 Market Segmentation

3.2 Penetration & Growth Prospect Mapping

3.2.1 Market Driver Analysis

3.2.2 Market Restraint Analysis

3.3 Hormone Replacement Therapy Market: Business Environment Analysis Tools

3.3.1 Porter's Five Forces Analysis

3.3.2 PESTEL Analysis

4. Hormone Replacement Therapy Market: Product Analysis

4.1 Hormone Replacement Therapy Product Market Share Analysis, 2019 & 2027

4.2 Hormone Replacement Therapy Product Market: Segment Dashboard

4.3 Market Size & Forecasts and Trend Analyses, 2016 to 2027 for the Product Segment

4.3.1 Estrogen Hormone Replacement Therapy

4.3.2 HGH Replacement Therapy

4.3.3 Thyroid Hormone Replacement Therapy

4.3.4 Testosterone Hormone Replacement Therapy

5. Hormone Replacement Therapy Market: Route of Administration Analysis

5.1 Hormone Replacement Therapy Route of Administration Market Share Analysis, 2019 & 2027

5.2 Hormone Replacement Therapy Route of Administration Market: Segment Dashboard

5.3 Market Size & Forecasts and Trend Analyses, 2016 to 2027 for the Route of Administration Segment

5.3.1 Oral

5.3.2 Parenteral

5.3.3 Transdermal

5.3.4 Others

6. Hormone Replacement Therapy Market: Type of Disease Analysis

6.1 Hormone Replacement Therapy Type of Disease Market Share Analysis, 2019 & 2027

6.2 Hormone Replacement Therapy Type of Disease Market: Segment Dashboard

6.3 Market Size & Forecasts and Trend Analyses, 2016 to 2027 for the Type of Disease Segment

6.3.1 Menopause

6.3.2 Hypothyroidism

6.3.3 Male Hypogonadism

6.3.4 Growth Hormone Deficiency

6.3.5 Others

7. Hormone Replacement Therapy Market: Regional Analysis

7.1 Hormone Replacement Therapy Regional Market Share Analysis, 2019 & 2027

7.2 Hormone Replacement Therapy Regional Market: Segment Dashboard

7.3 Regional Market Snapshot (Market Size, CAGR, Top Verticals, Key Players, Top Trends)

7.4 Market Size, & Forecasts, and Trend Analysis, 2016 to 2027

7.4.1 North America

7.4.2 Europe

7.4.3 Asia Pacific

7.4.4 Latin America

7.4.5 Middle East and Africa (MEA)

8. Competitive Analysis

8.1 Strategic Framework/ Competition Categorization (Key innovators, Market leaders, emerging players

8.2 Vendor Landscape

8.3 Company market position analysis (Geographic Presence, Product Portfolio, Strategic Initiatives, Employee Strength)

8.4 Company Profiles

Companies Mentioned

For more information about this report visit https://www.researchandmarkets.com/r/rowxnu

See the original post here:
Insights into the Worldwide HRT Industry to 2027 - Featuring Abbott Laboratories, Novartis & Pfizer Among Others - ResearchAndMarkets.com -...

As scientists around the world race toward finding an effective treatment and cure for COVID-19, health officials in China have started encouraging an alternative type of medicine to help those who get sick with the respiratory infection traditional herbal remedies.

Using herbs for illness isnt a novel idea. For thousands of years, herbs like licorice, ginger, and ephedra have been used to treat respiratory infections like the flu and pneumonia.

Some remedies, like forsythia, were put to the test for SARS and found to be somewhat effective in laboratory studies.

Anecdotally, people have claimed herbal medicines have kept them healthy or improved their symptoms, but the bulk of research on herbs is inconclusive. Health experts warn that we dont have enough data to support the use of herbal remedies for COVID-19.

Though we may eventually find that certain herbs may be beneficial for the coronavirus, the science is scarce and now is not the time to start experimenting with herbal remedies on your own if you contract COVID-19.

Everything has to be taken with an understanding that we dont have any data with the coronavirus, Dr. Felicia Gersh, the founder and director of the Integrative Medical Group of Irvine in Irvine, California, told Healthline. Who knows what the future may bring.

Herbal remedies have long been used to treat infections and viruses, such as the common cold, influenza, fever, and even herpes.

Some are thought to enhance the immune system and put the body in a healthier position to fight infections. Others are believed to be powerful antivirals that block certain viruses from replicating in the body.

But just because weve seen some promise with other illnesses does not mean people should assume herbal remedies provide the same benefit with COVID-19.

Every virus is unique in its structure and behavior. The herbs that seem to work for other viral infections will need to be tested to see if they also hold up against COVID-19.

This ones a little bit more of a dangerous virus, said Jeffrey Langland, PhD, an assistant research professor at Arizona State Universitys Biodesign Center for Immunotherapy, Vaccines and Virotherapy and associate professor of medical microbiology at the Southwest College of Naturopathic Medicine in Tempe.

Historically, theres been a major lack of evidence surrounding natural medicines.

For one, its been difficult to secure the necessary funding to study the health effects of plants and herbs. The United States is a very pharmaceutical-driven society, so thats where the priority has historically been.

Research has also been somewhat inconsistent. There are so many parts of a plant the root, stem, leaf, flower and its hard to get studies that consistently analyze the same portion of a plant.

Langland has been leading up a team of researchers who have been studying if and how certain herbs could potentially be used to treat COVID-19.

His team is testing over 30 herbs, and looking at each plants antiviral and immune-supportive properties.

Langland is hopeful theyll find a treatment, but says it will take time to get the results and put the science behind botanicals.

Even for those herbs we find effective, we want to go through and make sure we look at any sort of toxicity, and sort of side effects that may be associated with them, look at quality of extracts, and start to move that forward, Langland said.

Were not going to jump and throw this out there for people to start using without regarding things like safety, Langland added. Just like any pharmaceutical, we cannot rush this.

Just like any other medicine, herbal remedies could cause adverse side effects.

Take licorice, one of the remedies that officials in China have recommended for COVID-19.

According to Gersh, licorice is thought to be an effective treatment for herpes viruses.

Licorice paste, when applied to a herpes sore, can prevent the virus from replicating and stop it in its tracks, says Gersh. But it also has a major downside.

It can activate a hormone in the body called aldosterone which causes fluids retention and can actually induce hypertension, Gersh said.

Because hypertension is a huge risk factor for COVID-19 complications, Gersh said she would be concerned about using licorice, especially in high quantities, in someone with coronavirus.

St Johns wort is a widely available supplement but it can cause issues if a person is on medication.

It can interact with other medications that a patients on and block their absorption in the body and prevent them from acting, Langland said.

Furthermore, some peoples immune systems are overreacting to COVID-19, triggering widespread inflammation that can be even more problematic than the infection itself.

Certain herbs, if misused, could boost the immune system even more and lead to a cytokine storm, or a fatal overactive immune response, according to Gersh.

One of the biggest problems, according to Langland, is that many herbal and natural remedies are low quality.

There is so much herbal medicine that is adulterated, which means the product youre buying has been spiked with other botanicals or doesnt contain any of the botanicals that are labeled on the bottle, Langland said.

If you are getting the product from a local health store, theres a good chance you arent getting a high quality product, he added.

You cant assume every herb is safe. It may have some properties that could be potentially harmful, Gersh said.

If you are considering trying herbal remedies for COVID-19, keep in mind that we dont fully understand the risks and benefits.

How a botanical works in one persons body may be drastically different from how it behaves in another, depending on their health, age, and symptoms.

With botanicals, you want to treat people individually, Langland said, noting how the type of herb and dosage would likely vary from person to person.

If people are curious about herbal remedies, its best to consult a physician or naturopathic doctor who is well versed in various herbs and their properties.

I wouldnt advocate that people willy-nilly start taking all kinds of herbal products and not have a clue whats in it, Gersh said.

You want to have data, and be aware of any potential side effects before you take herbal products for an infection as potentially life threatening as COVID-19.

Health officials in China are recommending traditional herbal remedies for COVID-19, but many experts warn that we dont have enough data on COVID-19 to understand how different herbs may affect peoples health.

Though herbal remedies may seem harmless, if misused, they could increase a persons risk for COVID-19. We may find that certain herbs are effective in preventing and treating COVID-19 in some people, but there currently isnt enough data regarding the use of herbal remedies for the new coronavirus.

See original here:
Herbal Remedies and COVID-19: What to Know - Healthline

Infertility is a disease that affects millions of people in the United States but is rarely discussed openly. Twelve percent of married women between the ages of 15 and 44 experienced infertility, along with just over nine percent of men in that age group, according to a 2013 report from the Centers for Disease Control and Prevention. Those numbers translate to about one in eight couples who have trouble getting or staying pregnant. There are a variety of treatments for infertility, but they can be costly and are not accessible to everyone.

Guest host Anita Rao talks about infertility with Dr. Steven Young of UNC fertility, associate professor Belle Boggs, fertility advocate Nichelle Sublett, reproductive endocrinologist and infertility specialist Dr. Desire McCarthy-Keith, and Liberty Barnes, medical sociologist and ethnographer.

On this episode of Embodied, a series about sex, relationships and your heath, guest host Anita Rao talked to doctors, experts and those with firsthand knowledge about the issues surrounding infertility in American culture. Dr. Steven L. Young joined Rao to talk about who is affected by infertility, what causes it and what treatments are available. He is a professor of obstetrics and gynecology at the University of North Carolina School of Medicine and a physician at UNC Fertility.

Dr. Young also talked about the technology available today that is advancing fertility treatments.

Preimplantation genetic testing allows looking at all the chromosomes with a pretty good accuracy now say 98 to 99 percent accuracy, he explained. And so one can choose among many embryos the best one by finding which ones have normal chromosomal complement.

CDC statistics show African American women are more likely to be infertile than white women, but they are almost half as likely to seek treatment as white women. Dr. Desire McCarthy-Keith explored the reasons why black women are more likely to experience problems with fertility and why they are less likely to seek treatment. McCarthy-Keith is a reproductive endocrinologist and infertility specialist at Shady Grove Fertility Atlanta.

She said knowledge is power and recommends that women who would like to have children investigate their ovarian reserve.

Women need to understand that we are on a timeline with our fertility from birth. - Dr. Desiree' McCarthy-Keith

You can have an ultrasound at the beginning of a menstrual cycle to look at the ovaries and see how many follicles or little egg sacs are developing in the ovaries. There's a hormone test that can be done called AMH, which stands for anti-mllerian hormone. It's a simple blood draw that will measure this hormone level in your blood. And that level is a reflection of how much activity and follicle development there is in the ovary, she said.

Nichelle Sublett and Belle Boggs share their personal journeys with infertility. Sublett had five miscarriages over five years. She is a fertility advocate and Mrs. North Carolina 2018. She discussed the emotional and psychological impacts of pregnancy loss.

It really is a death. I know some people may not understand that, but this is a child that you hoped and dreamed for, and you had plans for. And you've probably mapped out half their lives by the time you see your positive pregnancy test, Sublett said.

It's absolutely the hardest thing my husband and I have ever been through, was going through those five miscarriages. - Nichelle Sublett

Boggs is an associate professor in the department of English and director of the Master of Fine Arts program in creative writing at North Carolina State University. She struggled with fertility for five years, and during that time wrote the memoir and cultural history The Art of Waiting: On Fertility, Medicine and Motherhood (Graywolf Press/2016).

Cost was a big factor for Boggs and her husband when it came to fertility treatments.

Only 16 states in the whole country have laws requiring health insurance companies to write fertility care into their policies. And North Carolina is not one of those states, she explained.

Medical sociologist and ethnographer Liberty Barnes digs into how cultural stereotypes play into who receives fertility treatment. She also discusses the financial barriers to fertility treatment, LGBTQ couples and her book, Conceiving Masculinity: Male Infertility, Medicine, and Identity (Temple University Press/2014).

There was a lot of care in the medical system around protecting these men's masculine identities, I would argue, and that it was about making sure that men felt comfortable in the clinic. - Liberty Barnes

Barnes also described the historically inaccurate statistics used in the United States when it comes to fertility.

We were looking at the statistics that we use in the United States to track infertility and the statistics we've used since 1955 The study is reproduced every five to 10 years in waves. Women of color were not included in the study until the fourth wave, which wasn't until 1970. Men were not included until this century until 2002. And there were no questions asking about the sexual orientations of the respondents until 2002.

Note: This program originally aired July 18, 2019.

Read more here:
Fertile Ground: The Silent Struggle Of Infertility - WUNC

One thing that everyone can agree on right now is that the times we are living through are full of stress.

The worldwide outbreak of COVID-19, or coronavirus disease 2019, has resulted in abrupt and shocking changes to our lifestyles that we had little warning about and time to plan for and little to no control over.

We are living in confusion and fear as we try to avoid contagion and deal with the new social and economic realities. Considerable uncertainty exists about the future.

If any combination of factors leads to stress, the current times are full of them. Not only is the situation surrounding the virus causing stress, but that stress can impact how our bodies respond to the virus if we are exposed.

Some health-care experts warned that stress is contributing to complications and fatalities for those who become infected.

Many factors can affect an individuals response to illness, including age, gender, other medical conditions, lifestyle, genetics, socio-economic status and access to health care. These factors can generally be identified and measured to some degree.

However, defining stress is totally subjective, an individual factor that is not only hard to quantify but one for which experts do not have a common definition.

The National Institutes of Health of the U.S. Department of Health and Human Services describes stress as a physical and emotional reaction that people experience as they encounter changes in life. The changes we react to are called stressors.

Stress is normal, and the American Institute of Stress noted that some degree of stress is beneficial. It activates the fight or flight response whereby humans react to threats in their environment. A real-time example would be the immediate reaction to the sound of a fire alarm, causing a response to take quick action to extinguish the fire or escape.

The stress associated with a positive life changes, for example, a promotion at work, can be motivational and challenging.

However, when stress becomes overwhelming and persistent, it can negatively impact a persons health. People may perceive stressors differently. A change that one person may take completely in stride or consider a challenge may be perceived as a dire threat by another.

Many times, people dont realize the effects that situations are having on their health.

Some typical physical reactions to stress that people may experience include accelerated heartbeat, shortness of breath, tense muscles, headache, upset stomach and insomnia. Emotional reactions may include anxiety, depression, moodiness, irritability, feeling overwhelmed and loneliness.

Research shows that intense and prolonged stress can weaken the immune system. For example, the substance gamma interferon, which is produced in the body to activate the immune system, can be reduced by stress. Corticosteroid, a stress hormone, can lower the number of lymphocytes, which are infection-fighting cells.

People can become more prone to illnesses and less able to fight them off. In addition, the immune system becomes weaker with age, and older people cannot fight infections as well as the young can. Older people are also more likely to become infected, and the infection is more likely to be fatal.

Studies also show that once an infection, such as the influenza virus, takes hold, it can suppress the immune response and allow a secondary infection to move in. Often, a bacterial infection like pneumonia will follow a viral infection like influenza.

Just about every bodily system can be affected by stress. Stress can cause the airway between the nose and lungs to constrict, leading to rapid breathing (hyperventilation) and shortness of breath.

These respiratory changes can be deadly in someone infected with COVID-19, especially if the patient has a condition like asthma or emphysema. This makes hospital ventilators critical because ventilators move oxygen into and out of the lungs of people who cannot breathe sufficiently on their own.

Physicians have long recognized that stress plays a role in a patients recovery.

Audrius Plioplys, M.D., a retired pediatric neurology specialist with over 45 years of experience, has served as medical director for several pediatric skilled-nursing facilities and was on the staff of Michael Reese and Mercy hospitals.

The longtime resident of North Beverly shared some insights on the subject.

Certainly, stress can produce or contribute to many illnesses, said Plioplys. I have seen quite a few patients with epilepsy where stress clearly exacerbates their seizures.

My medical expertise is neurology. In clinical practice, I have many cases where stress will exacerbate, or even cause, headaches, both tension headaches and migraine headaches.

Plioplys said it would be no surprise to learn that stress is contributing to the prevalence, severity and fatality rates of the coronavirus pandemic.

Even before this pandemic, concern has grown about rising levels of stress in the U.S.

At a 2017 conference, former U.S. Surgeon General Vivek H. Murthy, M.D., gave a presentation on the public-health consequences of stress. He cited such factors as a 24/7 work culture; fewer supportive, in-person social connections; financial challenges; relationship/family issues; and health problems.

For years, public-health professionals have offered advice on flu stress to get through annual flu outbreaks. The precautions that are being instituted nowwashing hands, avoiding crowds, etc.have been shared numerous times before.

Mental-health professionals have also studied and written about the increased stress that can develop from watching or listening to hours of bad news on subjects such as terrorist bombings, school shootings, natural disasters and, now, the virus pandemic.

Studies conducted after the 9/11 attacks on the World Trade Center showed that excessive following of media coverage caused some people to experience post-traumatic stress symptoms even though they were nowhere near ground zero.

Fortunately, helpful coping mechanisms for dealing with stress are available. First and foremost, it is important for people to learn to recognize how their body and mental states are reacting to stressors, such as working from home or missing church. They may not be able to control the situation, but they can control their response.

In his presentation, Murthy recommended several buffers, including getting enough sleep, increasing social connections and practicing meditation or other contemplative activities. The beneficial results of these buffers for individuals also positively affect families, workplaces and society.

Plioplys also recommended meditation.

One of my standard recommendations for treating headache patients, said Plioplys,is meditation, specifically for the purpose of decreasing stress.

Indeed, of the many therapies suggested to deal with stress that have been studiedfrom relaxation techniques to yoga to aromatherapymeditation has shown the most positive results.

Advice for news consumers is to be informed without becoming overwhelmed; watch, read or listen to objective news services that offer helpful advice and limit exposure, especially before going to bed at night. Avoid repetitive, sensational coverage that only heightens negative emotions.

Coping mechanisms to avoid include those that lead to unhealthy habits like over-eating and over-imbibing in alcohol. Ultimately, these reactions lead to more problems than to solutions. The same is true for self-medicating. Taking any kind of over-the-counter or natural supplement should always be first discussed with a physician.

Isolation, feelings of loneliness or loss of control can increase stress, which is not good news given the current shelter-at-home directives. This is especially true for the elderly and the poor who have less access to computers and less technological know-how to reach out to others via the internet and social media. Family, friends and caregivers should be aware of this and help as they can.

Many good websites are available with information on stress and how to deal with it. Look for those connected to government and professional health-care organizations and to sites affiliated with hospitals and medical centers.

Although many physicians offices and clinics are temporarily closed for non-emergency in-person visits, these practitioners are still available by phone or videoconference. They can help with advice and referrals.

On April 11, Gov. J. B. Pritzker acknowledged that this is a time of crisis and announced a new service, Call4Calm, that will be available through the state to allow Illinois residents to speak for free with mental-health professionals about issues related to the coronavirus pandemic.

We are living in a deeply unprecedented moment, and holding the emotional ramifications of that inside will only be harder on you, Pritzker said. Please know that you dont have to feel it all alone. I want you to know that were here to help.

Residents can text the word TALK, or for service in Spanish the word HABLAR, to 552-220.

They will be asked for their first name and ZIP code, which will be used to connect callers with a health-care provider in their area. People can also seek information for other pandemic-related issues by entering key words such as shelter and unemployment.

By taking a positive approach to dealing with negative situations, we can all get through the stress of these troubling times.

Link:
Stress plays big role in people's reaction to pandemic - The Beverly Review

People with hypothyroidism who choose dried thyroid extract (DTE) over levothyroxine alone perceive that it works better, but patients may not be aware of the risks, new research suggests.Those were some of the findings from the qualitative analyzes of nearly 700 online posts from three popular online hypothyroid forums, which found that 75% of patients felt they did better with DTE than standard levothyroxine therapy (LT4). .

The results were due to be presented at the Endocrine Society annual meeting in late March, but the meeting was canceled due to the COVID-19 pandemic. They were subsequently published online April 3 in Medicine by Freddy J.K. Toloza, MD, a postdoctoral researcher at the University of Arkansas for Medical Sciences, Little Rock, and a research collaborator at the Mayo Clinic, Rochester, Minnesota, and colleagues.Made from dried pork thyroid glands, DTE is not approved by the U.S. Food and Drug Administration because it predates the agency, but it was protected and is legally sold by prescription under the names of Nature Thyroid, Thyroid USP and Armor Thyroid.

DTE is currently used in 10-29% of hypothyroid patients, despite concerns about the risk of side effects associated with hyperthyroidism.

"Current guidelines (American Thyroid Association) strongly suggest the use of levothyroxine over DTE as thyroid replacement therapy. We agree with this recommendation due to concerns about the side effects of DTE," Toloza told Medscape Medical News."However, additional research needs to be done to understand if this recommendation applies to all hypothyroid patients," he added, and for those patients taking DTE, more research is required to determine who is at risk for side effects and the methods to prevent them. .Toloza said hypothyroid patients taking DTE frequently described the lack of individualized treatments and the feeling of not being heard as problems influencing their choice.

"These findings reinforce the need for patient-centered approaches in current clinical practice. Physicians must listen carefully to their patients and consider their individual needs and the context of each patient," he noted.A select group of patients improves in combination with T4 / T3When asked to comment, endocrinologist Rachel Pessah-Pollack, MD, of New York University Langone Health, told Medscape Medical News: "Animal-derived desiccated thyroid hormone contains both T4 and T3. We generally do not recommend use this because it can vary in concentration, which means that the actual preparation is not physiological. "Pessah-Pollack, co-author of the 2012 American Thyroid Association and American Association of Clinical Endocrinologists Joint Clinical Practice Guidelines on Hypothyroidism, added that one of the main concerns about the use of DTE is the risk of iatrogenic hyperthyroidism, which could lead to atrial fibrillation and fractures

"That is one of the main factors that drives many professional societies to really use caution with regard to DTE. That is also the reason why large societies recommend not using DTE based on the evidence to date." , He said.

However, the whole question of "combination therapy" in hypothyroidism is debatable. Doctors may also prescribe a "combination" of synthetic levothyroxine (LT4) and treatment with triiodothyronine (LT3); This, along with the use of DTE products, has been a topic of debate for many years.

The current guidelines (2014) of the American Thyroid Association do not specifically rule out the use of synthetic LT4 / LT3 therapy, but "recommend only against routine use of combination therapy." And while they do not expressly endorse the use of DTE, they did delete a statement that "should not be used."

"There is definitely a select group of patients who do better on T4 / T3 combination therapy, and we are still trying to delineate who that population is," Pessah-Pollack told Medscape Medical News.

"As long as these patients are closely monitored and aware of the risk of hyperthyroidism and their levels are followed to ensure that they are not hyperthyroid, in selected cases this is appropriate."

"But the first line is to ensure that a good evaluation is done Clearly, this helps us understand that we do need more studies in this area, well-designed and blinded studies to really help us get to the bottom of this controversy."

Those taking DTE cite improved symptoms, well-beingToloza and colleagues analyzed 673 posts from three online forums, Medscape's parent company WebMD, PatientLikeMe, and Drugs.com, selected from an initial 1235 post because they included more comprehensive information.

Approximately half (51%, n = 257) of the patients had primary hypothyroidism / Hashimoto's thyroiditis, 25% (n = 126) had postsurgical hypothyroidism, and 16% (n = 81) had postablation hypothyroidism. Among the 172 publications in which DTE dose information was available, the mean dose was 84.1 mg / day. The duration of treatment varied widely, from 2 weeks to 45 years.

Among the publications describing the source of the DTE prescription, initial interest was primarily patient-driven in 54% (n = 88), while 46% (n = 74) said a physician fueled their interest in try the DTE. (Type of clinician not reported.)

Among the publications that mentioned the source of DTE, local pharmacies were the most common (63%, n = 75), followed by pharmacies outside the United States (31%, n = 37) and online (6%, n = 7).

Previous thyroid treatments were mentioned in 300 publications, of which 93% mentioned monotherapy with LT4.

Among the reasons for switching to DTE, there were no improvements in clinical symptoms (47%, n = 75), development of side effects (24%, n = 38), no change in general well-being (22%, n = 36). ), and without changes in laboratory work (7%, n = 12).

The perceived benefits of DTE included an improvement in clinical symptoms (56%, n = 155), a change in general well-being (34%, n = 94), the possibility of reaching a previous state of health (7%, n = 19) and a low cost compared to the previous treatment (3%, n = 8).

Specific symptoms reporting improvement included fatigue (28%, n = 43), weight gain (17%, n = 26), and neurocognitive symptoms (5%, n = 8). The average time to notice the benefits with DTE was approximately 30 days, but it varied widely from 2 days to 4 months.

Most publications (77%, n = 99) stated that DTE was more effective than their previous therapy, while 13% (n = 17) described it as equally effective and 10% (n = 13) said it was less effective.

DTE side effects were described in 20% (n = 136), including weight loss (15%), fatigue (11%), palpitations (11%), heat intolerance (11%), sleep disorders (10%), high blood pressure (7%) and hair loss (5%).

"Doctors think they know how you feel"A qualitative analysis of the publications yielded five main themes: experience with previous therapies before starting DTE, perceived effectiveness and benefits of DTE, side effects of DTE, need for individualized therapy for hypothyroidism, and barriers to obtaining DTE.

One patient posted, "Synthroid (levothyroxine) did not help and gives me negative side effects my endocrinologist attributed all side effects to everything except Synthroid."

Another wrote: "(The armor) changed my life I'm glad I found a medication that makes me feel normal again everyone has improved; the mood, the skin (no itching), no pain head, goiter is depressed. "

Others cited the lower cost of armor compared to Synthroid.

However, some expressed negative experiences with DTE, such as: "My doctor hoped this medication would help with brain fog, energy, and tiredness. I experienced the opposite."

And some were unable to obtain it. One wrote: "Doctors think they know how you feel and don't even tell you about Armor. I asked my doctor and they said there weren't enough studies to show its effectiveness."

Better evaluation, more data neededPessah-Pollack noted that the study data does not address whether the patients' initially prescribed doses of levothyroxine were optimal, noting that changes are sometimes needed, such as during pregnancy, after weight gain, or if the patient is taking other certain medications.

"It is unclear from the symptoms reported by the patient whether they actually had an evaluation of their thyroid levels to ensure that their thyroid hormone dose was correct before switching to T4 / T3 replacement There are many factors that they should be taken before deciding that the drug itself is not working. "

What is urgently needed, he said, are "well-designed, blinded studies that look at this controversy."

"Here, we don't know why patients feel better We need to do additional work that includes validated symptom questionnaires and comparing the thyroid levels of patients on armored thyroid with those on levothyroxine monotherapy."

Toloza agrees: "It cannot be said that DTE works better for the user due to the limitations and nature of the data used in our study."

"However, our findings are in line with previously published research, which has shown that a subset of patients may prefer ETD to levothyroxine and have greater satisfaction with this treatment. However, the reason behind this has not yet been established. understands well, "and should be further investigated.

Pessah-Pollack has reported being an advisor to Boehringer Ingelheim-Eli Lilly and Radius Health, and moderator for Sanofi.

Medicine Published online April 3, 2020. Summary

For more news on diabetes and endocrinology, follow us on Twitter and Facebook.

. (tagsToTranslate) hypothyroidism (t) thyroid disorder (t) goiter (t) hyperthyroidism (t) chronic lymphocytic thyroiditis (t) adverse effects (t) side effects (t) patient safety (t) thyroid (t) Endocrine Society

See more here:
Patients say dissected thyroid is better than standard therapy - NewsDio