Archive for the ‘Hormone Physician’ Category

More than 37 million people are estimated to have chronic kidney disease (CKD), according to the CDCand 9 out of 10 people don't even know they have it. "There are a number of physical signs of kidney disease, but sometimes people attribute them to other conditions," says Dr. Joseph Vassalotti, Chief Medical Officer at the National Kidney Foundation. "Also, those with kidney disease tend not to experience symptoms until the very late stages, when the kidneys are failing or when there are large amounts of protein in the urine. This is one of the reasons why only 10% of people with chronic kidney disease know that they have it." Here are five sure symptoms of kidney disease, according to doctors. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Unexplained fatigue could be a sign of kidney disease, doctors warn. "In addition to filtering waste, healthy kidneys make a hormone called erythropoietin (EPO), which tells your bone marrow to make red blood cells. If your kidneys aren't working as well as they should, they won't make enough of this important hormone," according to Staci Leisman, MD, kidney specialist at Mount Sinai Hospital in New York City. "As a result, you produce fewer red blood cells, which could lead to a condition called anemia."

Foamy, discolored, bloody urine could be a sign of kidney disease, doctors warn. Changes in urinationfor example, urinating more or less than usualcould also be a red flag. "Even a little blood can change the color of urine dramatically," says nephrologist Juan Calle, MD.6254a4d1642c605c54bf1cab17d50f1e

Nausea and vomiting are often reported as particularly unpleasant symptoms of kidney disease. "The earliest signs are you may get nauseated especially in the morning, or you have an appetite and you smell food and then it just turns your stomach," says nephrologist James Simon, MD. "You are actually nauseated all day, a bitter and metallic taste in your mouth. Those are the earliest signs."

High blood pressure could be a sign of kidney disease, but physicians are unsure how they are connected. "High blood pressure may be a sign of kidney disease, or it may cause it. It's the chicken-or-egg dilemma," says Dr. Calle. "Anyone who has high blood pressure and diabetes needs to be screened for kidney diseases."

Knowing the risk factors for chronic kidney disease is key for prevention. "Primary risk factors include diabetes, high blood pressure, cardiovascular disease, a family history of kidney failure and age over 60," says Leslie Spry, MD, FACP. "Secondary risk factors include obesity, autoimmune diseases, urinary tract infections, systemic infections, and kidney loss, damage, injury or infection. Taking care of overall health helps protect kidney health. Wise practices include exercising regularly, low salt diet, controlling weight, monitoring blood pressure, cholesterol and glucose levels, not smoking, drinking moderately, avoiding non-steroidal anti-inflammatory drugs (NSAIDs) and getting an annual physical."

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Sure Signs You Have Kidney Disease, Say Physicians Eat This Not That - Eat This, Not That

According to the CDC, 37.3 million people in the U.S. have diabetes (11.3% of the population) and 96 million people aged 18 years or older have prediabetes (38.0% of the adult population).

"As recently as 50 years ago, type 2 diabetes was extremely rare. Now, around the world, the number of people with diabetes is increasing rapidly and is heading towards 643 million by 2030. This is a worldwide epidemic," says Adele Hite, PhD, MPH, RD. "In the past, type 2 diabetes was thought to be a progressive disease with no hope for reversal or remission. People were and sometimes still are taught to 'manage' type 2 diabetes, rather than to try to reverse the underlying process. But now people with type 2 diabetes can hope to regain their health." Here are five habits increasing your prediabetes risk. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Lack of sleep is strongly linked to both diabetes and prediabetes, doctors warn. "How does poor sleep contribute to obesity, diabetes, and metabolic issues? It's known that lack of sleep raises the stress hormone cortisol and increases glucose production, which raises your blood sugar," says Tony Hampton, MD. "Studies have shown that markers of increased insulin resistance appear after just one night of partial sleep deprivation. Symptoms of prediabetes can arise with as little as five days of sleep disturbances. Blood pressure also increases with sleep deprivation."

Excessive belly fat is particularly dangerous in raising the risk of prediabetes, studies show. "Being overweight is known to increase the risk of type 2 diabetes, but this study shows that not all fat is equal: where any excess fat is stored in the body has a big impact on disease risk," says Professor Mark McCarthy, University of Oxford.

If you're overweight or obese, even minor weight loss can help lower the risk of getting prediabetes, experts say. "If you have prediabetes, losing a small amount of weight if you're overweight and getting regular physical activity can lower your risk for developing type 2 diabetes," the CDC advises. "A small amount of weight loss means around 5% to 7% of your body weight, just 10 to 14 pounds for a 200-pound person."6254a4d1642c605c54bf1cab17d50f1e

Regular exercise is important for lowering the risk of prediabetes. "Even if you don't lose weight, exercise will make you stronger and healthier," says endocrinologist Douglas Zlock, MD, medical director of the diabetes center at John Muir Health. "Healthy habits can definitely postpone the onset of diabetes even if they don't prevent it."

There is evidence that stress can impact blood sugar control, helping raise the risk of prediabetes. "Most people with type 2 diabetes know the importance of exercising regularly, eating a healthy diet, and getting plenty of rest," says Dr. Joshua J. Joseph, endocrinologist at The Ohio State Wexner Medical Center. "But stress relief is a crucial and often forgotten component of diabetes management. Whether it's a yoga class, taking a walk or reading a book, finding ways to lower your stress level is important to everyone's overall health, especially for those with type 2 diabetes."

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Habits Secretly Increasing Your Prediabetes Risk, Say Physicians Eat This Not That - Eat This, Not That

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At a time when our bodily autonomy is under attack, women have become more vigilant about their basic human rights to equality, information, and the highest attainable standard of healthincluding sexual and reproductive health without discrimination. But the traditional healthcare system tends to treat the complex needs of women all wrong. It takes an acute approach rather than preventative. Disparate versus integrative. As a result, American women are suffering through a national infertility crisis and high maternal mortality (a rate of 23.8 to be exact, the worst among industrialized nations). The Covid-19 pandemic meanwhile has had lasting effects on the state of mental health for women, who are already twice as likely to experience depression and anxiety than men.

In an effort to change this, numerous founders are disrupting the wellness industry as we know it. We spoke with three who were unwilling to wait for the massive ship that is the American healthcare system to course correctone a former investment banker, another a former journalist, and the third a doctor-turned-serial entrepreneur. They recognize that, for women, innovation is a matter of life and death.

Kimberly Seals Allers, founder of Irth

(Image credit: Future)

With her first pregnancy, Kimberly Seals Allers, a former reporter at Fortune and editor at Essence, deployed her journalistic skills to research the best hospitals. But when she gave birth, her experience didnt match the glowing reviews.

I walked [into] a highly rated and best of hospital in New York City, having done months of due diligence and reading reviews, says Allers. But I left feeling disrespected, traumatized, and unseen.

This impacted her earliest memories of motherhood. I blamed myself completely, unaware that people are not being treated the same way even in the same place.

According to a White House statement issued on its first Maternal Health Day of Action in 2021, the U.S. has the highest maternal mortality rate of any wealthy nation. For women of color, the reality is stark. According to the CDC, Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related complications than white women. The pregnancy-related mortality rate for Black women with at least a college degree was 5.2 times that of their white counterparts.

So in February 2021, Allers launched Irth, an app that seeks to equalize the experience of delivering a child by giving women a central platform for rating and reviewing hospitals, OB-GYNs, and other pre- and post-natal care providers. Think of it like Yelp, but for childbirth, aimed at helping Black and Brown women access the best prenatal, birthing, postpartum, and pediatric services.

It started as a mommy-son project. Her youngest child, Michael, then a 13-year-old coding enthusiast, created the apps wireframes and soon, the duo started going to pitch competitions. I had this idea for an app and thought this would be a great way to bridge our worlds, says Allers. In 2018, they went to an MIT hackathon related to birth and breastfeeding and won the Media for Change award. There, they met an MIT engineer who went on to build Irths prototype, which enabled Allers to get more grant funding. To date, Allers has raised more than $850,000 in grants. I'm really proud of our origin story, she says.

Were turning our anonymized reviews into qualitative data...to give every Black birthing person a five-star experience while bringing life into the worldwhich is what we all deserve.

Earlier this year, she was invited to meet with Tim Cook during Apples Worldwide Developers Conference, where Apple recognizes trailblazing creators uplifting their communities through technology. Apple also featured Irth in a spotlight (opens in new tab) on the App Store to grow awareness. It was an incredible platform to share about Irth and our mission to remove the bias from birth, says Allers.

To date, Irth has more than 20,000 users and reviews from 48 states. Allers is most alarmed by the frequency at which women of color are going through similarly poor experiences, such as hearing negative comments from care providers about family size or marital status. There were too many reviews from fathers saying they were referred to as Mr. Baby Daddy while supporting their partner; Black women being coerced and admonished about birth control while in active labor, says Allers.

Right now, according to Allers, the number-one negative experience being reported on the Irth app nationwide is: "My requests for help were ignored or refused."Such medical racism has resulted in disrespect and death. A common thread in every maternal death story is that too many hospitals want to dismiss or explain away these reports of pain, instead of taking them seriously.

Irth has its sights on reform. The team of just 15 employees recently launched pilot programs with five hospitals to improve patient care for Black mothers. Allers says the hardest work is being done at the community level, encouraging more women of color to submit reviews. After all, it will take sheer volume to sound the alarm bells on one of the biggest failures of the countrys healthcare system.

Were turning our anonymized reviews into qualitative data to teach providers, payers, and hospitals how to give every Black birthing person a five-star experience while bringing life into the worldwhich is what we all deserve.

Rebecca Parekh, ceo and cofounder of The Well.

(Image credit: Future)

Step into The Well's New York City flagship, and one might wonder whether theyve entered a luxurious retreat in Montauk or Malibu. But smack in the middle of Manhattan, visitors to The Well can book meditation classes in a glowing white dome, access body treatments rooted in Traditional Chinese Medicine and Ayurveda, or try their hand at hydrotherapy, aromatherapy, meditation, and more.

Rebecca Parekh, cofounder and CEO, says the very premise of her business is to integrate holistic health into the urbanite's day-to-dayand that meant building a geographically accessible hub to promote such a lifestyle.

Our original business was a physical business and were remaining true to that because were passionate about the in-person experience and offering integrated wellness in big, busy cities, she says. Its not a common mindset in this Web3, Metaverse-obsessed startup world.

Burnout in her previous career led Parekh to rediscover the importance of holistic health. "I was an investment banker and was not modeling a wellness lifestyle; when it comes to getting swept into hustle-culture, I got disconnected," says Parekh, who worked at Deutsche Bank for 10 years. Her mom encouraged her to simply cook more and practice yoga daily. Parekh ultimately left banking, transitioning to work as Executive Director of the Global Foundation for Eating Disorders, and then COO for Deepak Chopra Radical Wellbeing.

She began envisioning a business that would promote health on a grander scale and on a daily basis. In 2016 she teamed up with cofounders Sarrah Hallock and Kane Sarhan to begin fundraising for The Well. It opened its nearly 15,000-square-foot Manhattan flagship, complete with a full-service restaurant and retail shop in September 2019just six months before the pandemic made in-person experiences practically obsolete.

Parekh and cofounders began offering digital wellness classes and services, such as a three-part webinar focused on how to ease the anxiety of returning to office work and the outside world after months in lockdown. It also focused on e-commerce for its line of vitamins, supplements, and personal care goods.

Although The Well nimbly pivoted to digital during the pandemic, its cofounders never abandoned their commitment to physical locations and products. Through a partnership with Auberge Resorts Collection, the company continued to invest in its second location at The Mayflower Inn & Spa in Connecticut, which opened in November 2020, then its third spot, Hacienda AltaGracia, in Costa Rica in 2021.

To date, The Well employs about 100 people and has raised roughly $50 million in venture capital. After surviving Covid-19 closures, the brand is set for expansion: Parekh says The Well will likely open two more locations by the end of the year, and confirmed the company is working on projects in Mexico, Miami, London, and Aspen.

While it grows via brick-and-mortar, the company is staying grounded in an industry driven by fads. Parekh credits The Wells medical and nutrition teams with vetting everything, from services offered to ingredients served in the restaurant. The rigorous standards are set forth by Frank Lipman, M.D., Chief Medical Officer and a renowned voice in integrative and functional medicine. He went from quack to guru, as [mainstream] folks are now believing in what hes been talking about for quite some time, says Parekh.

And in an industrywellnessthat can mean many things and nothing at once, The Well filters out fads by making sure each service fits within the brands key pillars: nutrition, body work, skincare, lifestyle, community, and, a newly added category: emotional wellbeing.

We focus on meeting people where they are at in their wellness journeys, says Parekh. Whether youre sick or not we believe yoga is medicine, along with the food we eat.

Parsley Health founder and CEO, Dr. Robin Berzin.

(Image credit: Future)

Just 13 percent of healthcare CEOs are femaleand even fewer are M.D.s. But Dr. Robin Berzin has defied these odds. In 2011, the graduate of Columbia Universitys College of Physicians and Surgeons cofounded Cureatr, an app that streamlines communication with physicians. That experience with health-tech inspired her to launch Parsley Health in 2016this time as a solo female founder.

Parsley Health is a functional medicine company that takes a preventive approach to chronic disease management. It uses a holistic snapshot of a patients sleep, fitness, nutrition, family history, and mental health to determine the best regimens and health protocols.

When we look at the body as an integrated systemrather than isolated partswere able to implement the right solution at the right time.

It has served tens of thousands of patients nationwide via telehealth, in addition to in-person clinics in New York City and Los Angeles. We have independent data showing that Parsley's approach to care improves health while reducing specialist referrals and prescription drug use, Dr. Berzin says. According to company data, by year two, patients have reduced their referrals to specialists by 77 percent. Those previously on chronic medications see a 65 percent reduction in prescription drug use.

We closely monitor their health to ensure that their concerns were heard, their treatments were working, and, ultimately, that we were measurably putting them on a path to feeling better, says Dr. Berzin. She points to the initial visitwhich takes 75 minutes, five times longer than the average appointment with a primary care physicianas the real changemaker.

Last year was a big one for Dr. Berzin. In response to the wellness wave sparked by Covid-19, she grew telehealth from seven states in 2020 to a nationwide operation in early 2021. She also raised a Series C round of venture capital, bringing the total raised to date to more than $100 million. She finished writing her first book, State Change (opens in new tab).

Last but not least, she welcomed her third child. In August 2021, she posted a beaming Instagram photo of herself just three weeks before giving birth, and wrote I convinced myself at 39 that I was too old to get pregnant easily, even though of course I know better. I help women beat the fertility odds every freaking day at work!

With a female physician and a mother of three at the helm, Parsley Health is a family practice with an emphasis on transforming womens healthcare. Its programs are designed to support women throughout their reproductive lifecycle: pre-conception, fertility, pregnancy, and postpartum. Last month, the company announced the launch of comprehensive menopause care.

Menopause affects more than 55 million American women and yet 73 percent of these women will suffer in silence without treatment. Perimenopause symptoms can start as early as age 45 while menopause can last for a decade. And, too often, according to Darcy McConnell, M.D., Director of Medical Affairs at Parsley Health, older women experience age-related conditions that are misattributed to menopause. For example, bloating and weight gain are often blamed on hormones, but can actually be due to high cortisol levels, leading to incorrect treatments.

Parsley Healths menopause protocol will deviate from the traditional practice of defaulting to hormone replacement therapy (HRT), which, according to Cancer.gov, is linked to numerous side effects including vaginal bleeding, dementia, and breast cancer. Parsley Healths holistic model instead takes a closer look at a womans metabolic health and mental health to offer a comprehensive system for monitoring multiple causes and conditions.

Dr. Berzin says Parsley Health aims to connect the dots, which traditional, patriarchal medicine has failed to do: When we look at the body as an integrated systemrather than isolated partswere able to implement the right solution at the right time, which halts the cycle of frustration women experience when theyre stuck in the revolving door of specialist referrals and prescription drugs.

(Image credit: Kanya Iwana / Brittany Holloway-Brown)

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Excerpt from:
The CEOs Disrupting and Democratizing Women's Health - Marie Claire

Data from the Phase 3 SPIRIT program showed MYFEMBREE reduced menstrual pain and non-menstrual pelvic pain in premenopausal women with endometriosis, and a loss of mean bone mineral density of less than 1% from baseline through one year of treatment Myovant and Pfizer will continue to jointly commercialize MYFEMBREE, with product available immediately Myovant to host conference call and webcast on Monday, August 8, 2022, at 8:30 a.m. Eastern Time / 5:30 a.m. Pacific Time

BASEL, Switzerland and NEW YORK, [August 5] (GLOBE NEWSWIRE) -- Myovant Sciences (NYSE: MYOV) and Pfizer Inc. (NYSE: PFE) today announced that the U.S. Food and Drug Administration (FDA) has approved MYFEMBREE (relugolix 40 mg, estradiol 1 mg, and norethindrone acetate 0.5 mg) as a one-pill, once-a-day therapy for the management of moderate to severe pain associated with endometriosis in pre-menopausal women, with a treatment duration of up to 24 months. The approval is supported by one-year efficacy and safety data, including 24-week data from the Phase 3 SPIRIT 1 and SPIRIT 2 trials, which were published in The Lancet, and the first 28 weeks of an open-label extension study for eligible women who completed either SPIRIT 1 or SPIRIT 2. MYFEMBREE also is approved for heavy menstrual bleeding associated with uterine fibroids in pre-menopausal women. Myovant and Pfizer will continue to jointly commercialize MYFEMBREE in the U.S. and product is available immediately.

Endometriosis is a painful, chronic disease with limited therapies to manage symptoms, said Juan Camilo Arjona Ferreira, M.D., Chief Medical Officer of Myovant Sciences, Inc. The new MYFEMBREE indication helps advance our mission to redefine care for women by helping address a disease with high unmet need, giving women and physicians a new meaningful treatment option to manage moderate to severe pain associated with endometriosis.

This approval is an important milestone reflecting Pfizer and Myovants commitment to womens health in areas of significant unmet need, said James Rusnak, M.D., Ph.D., Senior Vice President, Chief Development Officer, Internal Medicine and Hospital, Global Product Development at Pfizer. We look forward to making MYFEMBREE available to women with endometriosis and broadening their options in managing this complex disorder.

MYFEMBREE offers an effective, once-daily treatment option for the management of moderate to severe pain associated with endometriosis, with a treatment duration of up to 24 months. Endometriosis is a serious chronic condition that requires long-term interventions. Optimization of medical therapies is the recommended treatment paradigm. 1,2,3 MYFEMBREE introduces an option for up to two years of pharmacological management of moderate to severe pain associated with endometriosis in pre-menopausal women.

The data from the SPIRIT studies showed the clinical benefit that relugolix combination therapy can have on moderate to severe pain associated with endometriosis and how it can impact patients, said Linda Giudice, M.D., Ph.D., Distinguished Professor at the University of California, San Francisco (UCSF), and Chair, SPIRIT Program Steering Committee. This newly approved option for patients with pain from endometriosis offers the convenience of one pill taken once daily with a mean change in bone mineral density of <1% that did not appear to worsen at 12 months of treatment; however, monitoring is recommended.

This approval is supported by one-year data from the Phase 3 SPIRIT program, which included two 24-week multi-national clinical studies (SPIRIT 1 and SPIRIT 2) in more than 1,200 women with pain associated with endometriosis, as well as the first 28 weeks of an open-label extension study to assess its longer-term use. Overall, these studies showed MYFEMBREE reduced menstrual pain and non-menstrual pelvic pain with a loss of mean bone mineral density of less than 1% from baseline through one year of treatment.4

SPIRIT 1 and 2 each met their co-primary endpoints with 75% of women in the MYFEMBREE group in both studies achieving a clinically meaningful reduction in dysmenorrhea compared with 27% and 30% of women in the placebo groups at Week 24, respectively (both p <0.0001). For non-menstrual pelvic pain, treatment with MYFEMBREE demonstrated a clinically meaningful reduction in pain in 59% and 66% of women, compared with 40% and 43% of women in the placebo groups (p < 0.0001). Adverse reactions occurring in at least 3% of women treated with MYFEMBREE and greater than placebo were: headache, vasomotor symptoms, mood disorders, abnormal uterine bleeding, nausea, toothache, back pain, decreased sexual desire and arousal, arthralgia, fatigue, and dizziness.The open-label extension study for eligible women who completed either SPIRIT 1 or SPIRIT 2 showed mean bone mineral density loss of less than 1% from baseline through one year of treatment; some patients (19.7%) had losses >3%. Annual bone density measurement is recommended while treating women for endometriosis.

MYFEMBREE is available immediately to patients with moderate to severe pain associated with endometriosis with a prescription from their healthcare provider. Myovant and Pfizer also are committed to supporting women in the U.S. who are prescribed MYFEMBREE throughout their treatment journeys. The MYFEMBREE Support Program provides access support services, including insurance benefits checks, prior authorization support, co-pay support for commercially insured patients, and patient assistance for qualifying uninsured patients. Program terms and conditions apply. For more information and additional resources, please contact 833-MYFEMBREE (833-693-3627), 8 a.m. 8 p.m. Eastern Time, Monday Friday.

Myovant Conference CallMyovant will hold a conference call on Monday, August 8, 2022, at 8:30 a.m. Eastern Time / 5:30 a.m. Pacific Time to discuss the FDA approval of MYFEMBREE for the management of moderate to severe pain associated with endometriosis. Investors and the general public may access the live webcast here. The live webcast can also be accessed by visiting the companys investor relations page of Myovants website at: https://investors.myovant.com/.

Endometriosis can also impact general physical, mental, and social well-being, requiring a multi-disciplinary approach to care. Approximately 190 million women suffer from symptoms of endometriosis globally.5 In the U.S., there are approximately 7.5 million premenopausal women with endometriosis and approximately 75-80 percent of them are symptomatic.6,7,8,9 Many women with pain associated with endometriosis are not able to manage their pain symptoms with current treatment options, underscoring the high unmet need for this disease.10 It can take between four and eleven years to get an endometriosis diagnosis11,12,13 and for some women, current treatment options do not provide relief.14

About MYFEMBREEMYFEMBREE (relugolix, estradiol, and norethindrone acetate) is a once-daily oral treatment approved by the U.S. Food and Drug Administration for the management of moderate to severe pain associated with endometriosis, with a treatment duration of up to 24 months. It is also currently available in the U.S. for the management of heavy menstrual bleeding associated with uterine fibroids in premenopausal women, with a treatment duration of up to 24 months. MYFEMBREE contains relugolix, which reduces the amount of estrogen (and other hormones) produced by ovaries, estradiol (an estrogen) which may reduce the risk of bone loss, and norethindrone acetate (a progestin) which is necessary when women with a uterus (womb) take estrogen.

For full prescribing information including Boxed Warning and patient information, please click here.Indications and UsageMYFEMBREE is indicated in premenopausal women for the management of: Heavy menstrual bleeding associated with uterine leiomyomas (fibroids) Moderate to severe pain associated with endometriosisLimitations of Use: Use of MYFEMBREE should be limited to 24 months due to the risk of continued bone loss which may not be reversible.

IMPORTANT SAFETY INFORMATION

BOXED WARNING: THROMBOEMBOLIC DISORDERS AND VASCULAR EVENTS Estrogen and progestin combination products, including MYFEMBREE, increase the risk of thrombotic or thromboembolic disorders including pulmonary embolism, deep vein thrombosis, stroke and myocardial infarction, especially in women at increased risk for these events. MYFEMBREE is contraindicated in women with current or a history of thrombotic or thromboembolic disorders and in women at increased risk for these events, including women over 35 years of age who smoke or women with uncontrolled hypertension.

CONTRAINDICATIONSMYFEMBREE is contraindicated in women with any of the following: high risk of arterial, venous thrombotic, or thromboembolic disorder; pregnancy; known osteoporosis; current or history of breast cancer or other hormone-sensitive malignancies; known hepatic impairment or disease; undiagnosed abnormal uterine bleeding; known hypersensitivity to components of MYFEMBREE.

WARNINGS AND PRECAUTIONSThromboembolic Disorders: Discontinue immediately if an arterial or venous thrombotic, cardiovascular, or cerebrovascular event occurs or is suspected. Discontinue at least 4 to 6 weeks before surgery associated with an increased risk of thromboembolism, or during periods of prolonged immobilization, if feasible. Discontinue immediately if there is sudden unexplained partial or complete loss of vision, proptosis, diplopia, papilledema, or retinal vascular lesions and evaluate for retinal vein thrombosis as these have been reported with estrogens and progestins.

Bone Loss: MYFEMBREE may cause a decrease in bone mineral density (BMD) in some patients, which may be greater with increasing duration of use and may not be completely reversible after stopping treatment. Consider the benefits and risks in patients with a history of low trauma fracture or risk factors for osteoporosis or bone loss, including medications that may decrease BMD. Assessment of BMD by dual-energy X-ray absorptiometry (DXA) is recommended at baseline in all women. During treatment, periodic DXA is recommended for women with heavy menstrual bleeding due to uterine fibroids; in those with moderate to severe endometriosis pain, annual DXA is recommended. Consider discontinuing MYFEMBREE if the risk of bone loss exceeds the potential benefit.Hormone-Sensitive Malignancies: Discontinue MYFEMBREE if a hormone-sensitive malignancy is diagnosed. Surveillance measures in accordance with standard of care, such as breast examinations and mammography are recommended. Use of estrogen alone or estrogen plus progestin has resulted in abnormal mammograms requiring further evaluation.

Suicidal Ideation and Mood Disorders (Including Depression): Evaluate patients with a history of suicidal ideation, depression, and mood disorders prior to initiating treatment. Monitor patients for mood changes and depressive symptoms including shortly after initiating treatment, to determine whether the risks of continuing therapy with MYFEMBREE outweigh the benefits. Patients with new or worsening depression, anxiety, or other mood changes should be referred to a mental health professional, as appropriate. Advise patients to seek immediate medical attention for suicidal ideation and behavior and reevaluate the benefits and risks of continuing MYFEMBREE. Gonadotropin-releasing hormone receptor antagonists, including MYFEMBREE, have been associated with mood disorders (including depression) and suicidal ideation. Hepatic Impairment and Transaminase Elevations: Steroid hormones may be poorly metabolized in these patients. Instruct women to promptly seek medical attention for symptoms or signs that may reflect liver injury, such as jaundice or right upper abdominal pain. Acute liver test abnormalities may necessitate the discontinuation of MYFEMBREE use until the liver tests return to normal and MYFEMBREE causation has been excluded.

Gallbladder Disease or History of Cholestatic Jaundice: Discontinue MYFEMBREE if signs or symptoms of gallbladder disease or jaundice occur. For women with a history of cholestatic jaundice associated with past estrogen use or with pregnancy, assess the risk-benefit of continuing therapy. Studies among estrogen users suggest a small increased relative risk of developing gallbladder disease.

Elevated Blood Pressure: For women with well-controlled hypertension, monitor blood pressure and stop MYFEMBREE if blood pressure rises significantly.

Change in Menstrual Bleeding Pattern and Reduced Ability to Recognize Pregnancy: Advise women to use non-hormonal contraception during treatment and for one week after discontinuing MYFEMBREE. Avoid concomitant use of hormonal contraceptives. MYFEMBREE may delay the ability to recognize pregnancy because it alters menstrual bleeding. Perform testing if pregnancy is suspected and discontinue MYFEMBREE if pregnancy is confirmed.

Risk of Early Pregnancy Loss: MYFEMBREE can cause early pregnancy loss. Exclude pregnancy before initiating and advise women to use effective non-hormonal contraception.

Uterine Fibroid Prolapse or Expulsion: Advise women with known or suspected submucosal uterine fibroids about the possibility of uterine fibroid prolapse or expulsion and instruct them to contact their physician if severe bleeding and/or cramping occurs.

Alopecia: Alopecia, hair loss, and hair thinning were reported in phase 3 trials with MYFEMBREE. Consider discontinuing MYFEMBREE if hair loss becomes a concern. Whether the hair loss is reversible is unknown.

Effects on Carbohydrate and Lipid Metabolism: More frequent monitoring in MYFEMBREE-treated women with prediabetes and diabetes may be necessary. MYFEMBREE may decrease glucose tolerance and result in increased blood glucose concentrations. Monitor lipid levels and consider discontinuing if hypercholesterolemia or hypertriglyceridemia worsens. In women with pre-existing hypertriglyceridemia, estrogen therapy may be associated with elevations in triglycerides levels leading to pancreatitis. Use of MYFEMBREE is associated with increases in total cholesterol and LDL-C.

Effect on Other Laboratory Results: Patients with hypothyroidism and hypoadrenalism may require higher doses of thyroid hormone or cortisol replacement therapy. Use of estrogen and progestin combinations may raise serum concentrations of binding proteins (e.g., thyroid-binding globulin, corticosteroid-binding globulin), which may reduce free thyroid or corticosteroid hormone levels. Use of estrogen and progestin may also affect the levels of sex hormone-binding globulin, and coagulation factors.

Hypersensitivity Reactions: Immediately discontinue MYFEMBREE if a hypersensitivity reaction occurs.

ADVERSE REACTIONS: Most common adverse reactions for MYFEMBREE (incidence 3% and greater than placebo) were: Heavy menstrual bleeding associated with uterine fibroids: vasomotor symptoms, abnormal uterine bleeding, alopecia, and decreased libido. Moderate to severe pain associated with endometriosis: headache, vasomotor symptoms, mood disorders, abnormal uterine bleeding, nausea, toothache, back pain, decreased sexual desire and arousal, arthralgia, fatigue, and dizziness.

These are not all the possible side effects of MYFEMBREE.

DRUG INTERACTIONS: P-gp Inhibitors: Avoid use of MYFEMBREE with oral P-gp inhibitors. If use is unavoidable, take MYFEMBREE first, separate dosing by at least 6 hours, and monitor patients for adverse reactions. Combined P-gp and Strong CYP3A Inducers: Avoid use of MYFEMBREE with combined P-gp and strong CYP3A inducers.

LACTATION: Advise women not to breastfeed while taking MYFEMBREE.

About Myovant SciencesMyovant Sciences aspires to redefine care for women and for men through purpose-driven science, empowering medicines, and transformative advocacy. Founded in 2016, Myovant has executed five successful Phase 3 clinical trials across oncology and womens health leading to three regulatory approvals by the U.S. Food and Drug Administration (FDA) for men with advanced prostate cancer, women with heavy menstrual bleeding associated with uterine fibroids, and pre-menopausal women with moderate to severe pain associated with endometriosis, respectively. Myovant also has received regulatory approvals by the European Commission (EC) and the United Kingdom Medicines and Healthcare Products Regulatory Agency (MHRA) for women with symptomatic uterine fibroids and for men with advanced hormone-sensitive prostate cancer. Myovant has a supplemental New Drug Application under review with the FDA for updates to the United States Prescribing Information (USPI) based on safety and efficacy data from the Phase 3 LIBERTY randomized withdrawal study (RWS) of MYFEMBREE in premenopausal women with heavy menstrual bleeding due to uterine fibroids for up to two years. Myovant also is conducting a Phase 3 study to evaluate the prevention of pregnancy in women with uterine fibroids or endometriosis. Myovant also is developing MVT-602, an investigational oligopeptide kisspeptin-1 receptor agonist, which has completed a Phase 2a study for female infertility as part of assisted reproduction. Sumitovant Biopharma, Ltd., a wholly owned subsidiary of Sumitomo Pharma Co., Ltd., is Myovants majority shareholder. For more information, please visit http://www.myovant.com. Follow @Myovant on Twitter and LinkedIn.

About Pfizer: Breakthroughs That Change Patients LivesAt Pfizer, we apply science and our global resources to bring therapies to people that extend and significantly improve their lives. We strive to set the standard for quality, safety and value in the discovery, development and manufacture of health care products, including innovative medicines and vaccines. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as one of the world's premier innovative biopharmaceutical companies, we collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 170 years, we have worked to make a difference for all who rely on us. We routinely post information that may be important to investors on our website at http://www.Pfizer.com. In addition, to learn more, please visit us on http://www.Pfizer.com and follow us on Twitter at @Pfizer and @Pfizer News, LinkedIn, YouTube and like us on Facebook at Facebook.com/Pfizer.

Myovant Sciences Forward-Looking StatementsThis press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. In this press release, forward-looking statements include, but are not limited to, all statements reflecting Myovant Sciences expectations, including: statements regarding Myovants aspiration to redefine care for women and for men; the expectations regarding the continued commercialization of MYFEMBREE by Myovant and Pfizer jointly in the U.S. and the timeline of product availability; the expectations that MYFEMBREEs indication helps advance Myovants mission to redefine care for women by helping address a disease with high unmet need, giving women and physicians a new meaningful treatment option to manage moderate to severe pain associated with endometriosis in Dr. Arjona Ferreiras quote; the expectation of making MYFEMBREE available to women with endometriosis and broadening their options in managing this complex disorder in Dr. Rusnaks quote; and the expectations of the MYFEMBREE Support Program for patients and the features of such program.Myovant Sciences forward-looking statements are based on managements current expectations and beliefs and are subject to a number of risks, uncertainties, assumptions, and other factors known and unknown that could cause actual results and the timing of certain events to differ materially from future results expressed or implied by the forward-looking statements, including unforeseen circumstances or other disruptions to normal business operations arising from or related to the COVID-19 pandemic and the conflict in Ukraine. Myovant Sciences cannot assure you that the events and circumstances reflected in the forward-looking statements will be achieved or occur, and actual results could differ materially from those expressed or implied by these forward-looking statements. Factors that could materially affect Myovant Sciences operations and future prospects or which could cause actual results to differ materially from expectations include, but are not limited to, the risks and uncertainties listed in Myovant Sciences filings with the United States Securities and Exchange Commission (SEC), including under the heading Risk Factors in Myovant Sciences Quarterly Report on Form 10-Q filed on July 27, 2022, as such risk factors may be amended, supplemented, or superseded from time to time. These risks are not exhaustive. New risk factors emerge from time to time, and it is not possible for Myovant Sciences management to predict all risk factors, nor can Myovant Sciences assess the impact of all factors on its business or the extent to which any factor, or combination of factors, may cause actual results to differ materially from those contained in any forward-looking statements. You should not place undue reliance on the forward- looking statements in this press release, which speak only as of the date hereof, and, except as required by law, Myovant Sciences undertakes no obligation to update these forward-looking statements to reflect events or circumstances after the date of such statements.

Pfizer Disclosure NoticeThe information contained in this release is as of August 5, 2022. Pfizer assumes no obligation to update forward-looking statements contained in this release as the result of new information or future events or developments.

This release contains forward-looking information about MYFEMBREE (relugolix 40 mg, estradiol 1 mg, and norethindrone acetate 0.5 mg), a new indication in the U.S. for the management of moderate to severe pain associated with endometriosis in pre-menopausal women, and a collaboration between Pfizer and Myovant Sciences to develop and commercialize relugolix in advanced prostate cancer and womens health, including their potential benefits, that involves substantial risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statements. Risks and uncertainties include, among other things, uncertainties regarding the commercial success of MYFEMBREE; the uncertainties inherent in research and development, including the ability to meet anticipated clinical endpoints, commencement and/or completion dates for clinical trials, regulatory submission dates, regulatory approval dates and/or launch dates, as well as the possibility of unfavorable new clinical data and further analyses of existing clinical data; the risk that clinical trial data are subject to differing interpretations and assessments by regulatory authorities; whether regulatory authorities will be satisfied with the design of and results from the clinical studies; whether and when applications may be filed for any other potential indications for MYFEMBREE; whether and when regulatory authorities may approve any such applications for MYFEMBREE that may be pending or filed, which will depend on myriad factors, including making a determination as to whether the products benefits outweigh its known risks and determination of the products efficacy and, if approved, whether MYFEMBREE will be commercially successful; decisions by regulatory authorities impacting labeling, manufacturing processes, safety and/or other matters that could affect the availability or commercial potential of MYFEMBREE; whether our collaboration with Myovant Sciences will be successful; uncertainties regarding the impact of COVID-19 on Pfizers business, operations and financial results; and competitive developments.

A further description of risks and uncertainties can be found in Pfizers Annual Report on Form 10-K for the fiscal year ended December 31, 2021 and in its subsequent reports on Form 10-Q, including in the sections thereof captioned Risk Factors and Forward-Looking Information and Factors That May Affect Future Results, as well as in its subsequent reports on Form 8-K, all of which are filed with the U.S. Securities and Exchange Commission and available at http://www.sec.gov and http://www.pfizer.com.

1American Society for Reproductive Medicine (ASRM), Treatment of pelvic pain associated with endometriosis: a committee opinion. Fertil Steril. 2014;101(4):927-35.2Becker CM et al. ESHRE guideline: endometriosis, Human Reproduction Open. 2022 Feb 26;2022(2): hoac009. 3Taylor HS et al. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet 2021;397(10276):839-52 4Giudice LC, et al. Lancet. 2022 Jun; 399(10343): 2267-2279. 5Adamson, G. et al. Journal Endometriosis. 2010; 2:3-66US census 2019 (table 1; approx. 75 million women in the US ages 15-49). Available online at https://data.census.gov/cedsci/table?q=United%20States&t=Age%20and%20Sex7Shafrir. Best Pract Res Clin Obstet Gynaecol. 2018 Aug; 51:1-15 8Fuldeore Gynecol Obstet Invest. 2017;82:453-461 9Bulletti J Asist Reprod Genet 201010Becker CM, et al. Fertil Steril. 2017 Jul;108(1):125-136. 11Zondervan KT, et al. NEJM. 2020;382(13):12441256 12Nnoaham KE et al. Fertil Steril. 2011;96(2):366.e8373.e8 13Ballard K et al. Fertil Steril. 2006;86:1296301 14Soliman et al. J Womens Health. 2017. 26(7): 788-797

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Myovant Sciences and Pfizer Receive U.S. FDA Approval of MYFEMBREE, a Once-Daily Treatment for the Management of Moderate to Severe Pain Associated...

Pancreatic cancer is considered one of the deadliest cancers because it's difficult to diagnose and is oftentimes discovered in later stages when treatment isn't effective. According to the American Cancer Society, "About 62,210 people (32,970 men and 29,240 women) will be diagnosed with pancreatic cancer. About 49,830 people (25,970 men and 23,860 women) will die of pancreatic cancer. Pancreatic cancer accounts for about 3% of all cancers in the US and about 7% of all cancer deaths." While genetics and age do play a role in the risk of pancreatic cancer, so do unhealthy habits. Eat This, Not That! Health spoke with Dr. Michael Chuong, medical director of Proton Therapy, physician director of MRI-Guided Radiation Therapy, and director of Radiation Oncology Clinical Research at Miami Cancer Institute, part of Baptist Health South Florida who shares ways to help lower your risk of pancreatic cancer. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Chuong says, "The pancreas is an organ in the upper abdomen that is responsible for making digestive enzymes and also regulating blood sugar by secreting hormones such as insulin. Pancreatic cancer is the 4th most common cause of cancer-related death in the United States. The death rates are especially high because pancreatic cancers are usually not diagnosed until advanced stages when cancer cells have already spread to other organs."

Dr. Chuong explains, "The main risk factors for pancreatic cancer include smoking, a diet high in saturated fats and processed meats, obesity, physical inactivity, and chronic pancreatitis. About 5-10% of individuals diagnosed with pancreatic cancer have a genetic predisposition and may have others in their family also diagnosed with the same disease."

According to Dr. Chuong, "Pancreatic cancer forms when changes, also known as mutations, occur in the DNA of normal pancreas cells leading to uncontrolled growth that the body cannot control. The exact mechanisms behind the cause of these changes are largely unknown although are thought to be caused by environmental, dietary, and sometimes hereditary factors."

"The only known cure for pancreatic cancer is surgery, which is usually only effective when pancreatic cancer is diagnosed at an early stage," Dr. Chuong says. "Some patients with advanced pancreatic cancer who are not initially candidates for surgery might eventually become eligible depending on how their cancer responds to chemotherapy and sometimes also radiation therapy."6254a4d1642c605c54bf1cab17d50f1e

Dr. Chuong states, "The most common symptoms of pancreatic cancer include unintentional weight loss, loss of appetite, upper abdominal pain, jaundice (yellowing of the skin and eyes), dark urine, and clay-colored stools. If you develop these symptoms, then seek immediate medical attention."

"Cigarettes contain carcinogens that have been directly linked to an increase in developing pancreatic cancer," Dr. Chuong tells us.

Dr. Chuong emphasizes, "Exercise regularly and maintain a healthy weight. Obesity is a known risk factor for pancreatic cancer."

Dr. Chuong advises, "Develop healthy eating patterns that include plenty of fruits, vegetables, and whole grains. Avoid eating large quantities of processed meats and highly processed foods. Also, avoid heavy alcohol consumption that can result in chronic pancreatitis, which is a risk factor for developing pancreatic cancer."

Heather Newgen

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Simple Ways to Avoid Pancreatic Cancer, Say Doctors Eat This Not That - Eat This, Not That

For medical professionals working in reproductive health care and the patients they serve the Supreme Courts decision to overturn Roe v. Wade worsened an already confusing maelstrom for providing care. Although there is consensus among the scientific community that birth control and abortion are critical forms of medical care that help manage medical conditions and save lives, the politics of reproductive health care are beyond fraught. Not only are doctors afraid to provide evidence-based care (theyre trying to squeeze in phone calls to their lawyers between appointments with anxious patients) but patients may now be afraid to be honest with their doctors.

The need for precision medicine in the reproductive health care sphere has never been greater: for much of the country, the risks of unwanted pregnancy are exacerbated by abortion legislation and unscientific political rhetoric around birth control.

More than 47 million American women aged 15-49 were using contraceptives as of 2019, and nearly 30% have tried five or more methods of birth control. The top reason for discontinuing the use of hormonal contraceptives like the pill? Side effects. Because of this, the use of less effective methods of birth control, such as withdrawal, have increased exponentially.

There are a wealth of options when it comes to birth control almost 200 hormonal medications on U.S. markets but doctors rely on the CDCs MEC plus a haphazard method of trial and error when it comes to prescribing patients. The gap in research and data when it comes to disorders that differentially impact women exacerbates this. When it comes to reproductive health disorders its even more glaring: although one in three women will have severe reproductive health issues in her life, less than 2.5% of publicly funded medical research has focused on female reproductive health disorders.

Its no wonder that theres increasing resistance to birth control. The combination of bad personal experiences resulting from an insufficient standard of care with a social climate of misconception and stigma has led many to write off contraceptives entirely.

It can be challenging for patients to separate fact from fiction when it comes to reproductive health care. Missouri lawmakers falsely claimed that IUDs were abortifacients as a way to undermine birth control funding. Several states have advanced legislation known as heartbeat bills that purport to ban abortions beginning when the fetuss heart starts beating, but the laws actually ban it before the embryo has even developed into a fetus, let alone has a heartbeat. If patients solely listened to their political leaders, some of whom do not seem to understand the basics of reproductive systems, they would be in major trouble. Medical professionals are urgently needed to combat misinformation and help patients to understand the complex realities of accessing birth control, and can do so by taking advantage of the benefits of precision medicine.

Using precision medicine can help doctors capitalize on the life-changing benefits of hormonal birth control and avoid dangers for high risk patients through analyzing the patients hormones, genetic makeup and other biological markers to make informed choices about which medicine to prescribe. Our dynamic hormone ranges and genetics are unique to each of us; birth control should not be one size fits all. A form of birth control that could worsen acne for one woman would help alleviate it for another. Some of these differences, like the presence of thrombogenic mutations can be the difference between life or death, and yet, these genetic risk factors arent routinely screened prior to prescribing contraceptives. And hormonal birth control, when prescribed accurately, can have a range of impactful health benefits beyond preventing pregnancy: it can help regulate the menstrual cycle, alleviate cramps, PMS and anemia; clear up acne, and is often prescribed for a range of other reproductive health issues. Beyond birth control, moving towards precision medicine in reproductive health care can also alert physicians to potential problems down the road and improve the depth and accuracy of patient care overall.

Even though the waves of legislation impeding reproductive health care access are daunting, this is actually a moment of tremendous options when it comes to contraceptives. The tools and resources are out there for physicians to respond to this challenging time and be galvanized by the urgent needs of patients. Doctors working in reproductive health care have a major task before them, but can be the leaders in advancing the standard of care for birth control, and demanding their patients continued right to the best birth control for their bodies.

Photo:FotografiaBasica, Getty Images

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Reproductive healthcare is under attack. Precision medicine is more important than ever - MedCity News

Heavy periods after 40 (also called menorrhagia) may be common and perfectly normal for many people but, at least until menopause begins, they can be hugely disruptive to daily life and cause discomfort, embarrassment, and stress to those experiencing them. While the world has become a lot more open to talking about menstruation, this is one part of the cycle thats often left hidden.

In my South Asian culture, periods are taboo full stop. Its a subject for mothers and aunts ears only, never to be discussed outside the home and never to be discussed in front of men, so I grew up never talking about the subject and only my mother knows how much pain Ive been in over the years. When I hit my 40s, my periods got worse and now, I have a heavy one every month that makes me feel sick and keeps me in bed with a hot water bottle. Its not something thats spoken about in mainstream media and South Asian women often feel ashamed to talk about it to anyone but their friends.

If youre suffering from painful and heavy periods, whether you're experiencing perimenopause symptoms or not, youre not alone. Here, we speak to several women who noticed changes in their periods after 40, and with insights from Dr Danielle Russell (opens in new tab), a leading GP specializing in womens health, we explain why heavy periods after 40 with clots are normal, the causes, and when to seek help.

Unfortunately, yes, heavy periods after 40 with clots are normal and its common for women to experience this, explains Dr Russell, as heavy periods are caused by a drop in progesterone levels.

Its something that women over 40 tend to experience regularly as this is the age when many begin experiencing early menopause symptoms, when the body stops releasing eggs. For example, one study by the University of Michigan School of Public Health (opens in new tab) looked at women aged between 42 and 52 and found that almost 80% would consider the blood flow during their period to be heavy, with more than 90% having periods that lasted longer than they did before.

The drop in progesterone leaves relatively more estrogen to thicken up the lining of the womb so that there is more to shed during a period, Dr Russell says. Cycles can also become irregular during this time, so a skipped or delayed period leaves more time for the lining of the womb to thicken up.

This lining also becomes very vascular, she continues, making clots more likely. "During heavy flow days, usually during the first few days of the period, there is more blood present that coagulates in the uterus and vagina, and this comes out as clots."

(Image credit: Getty Images)

Just because its normal in many cases, it doesnt mean its not very difficult and no one should have to deal with the symptoms unmanaged. When I went to see my GP about heavy periods after 40, they told me it was perfectly normal to experience the changes and to keep an eye on it if it lasts longer than seven days or the clotting gets worse - and Im not the only one.

Laura Hitchcock, 48, is the editor of Dorsets Blackmore Vale and had long-but-normal periods until the birth of her third child, at which point everything changed. I suffered menorrhagia and it never really stopped. There was awful bleeding but thankfully no pain, ever, with clots for years. My fourth child four years later didnt ease things up much, she tells woman&home.

Im still waiting for the alleged light periods of aging and perimenopause. I dont have to take tranexamic and mefenamic acid now, but I always double-up super-plus Tampax, plus nighttime pads, change them every couple of hours, and I have three days of hideous bleeding. Its graphic, horror-film level, every single month. Then after this, there are another four days of what I think most women my age would call a heavy period.

(Image credit: Getty Images)

Its a situation that Irem, who is 51 and lives in Newcastle Upon Tyne, can relate to as shes always suffered with medium to heavy periods, but in the last five years, its become ridiculously heavy. So much so that I use three packets of bedtime ones in my seven to 10-day period. From day one, I'm exhausted. It's an effort to get up, get ready, and do life. The constant checking youre not leaking, especially when you work in an office full of men and no women. You dont have that support of pointing behind and whispering am I ok?!, she says.

Its not just something that happens on the lead up to perimenopause and menopause though. Some people experience heavy periods throughout their life, like Sarupa Shah, 49, from London. I have always suffered from heavy periods and clots, with my first one every lasting for three months, aged 13. Ive always had severe cramps, clotting, and heavy and tender boobs with it too, she says.

(Image credit: Getty Images)

Ive worn a tampon and pads for years and still have accidents. Recently, I had to do a long trip in the car so I just sat on a towel, just in case. I also prefer to wear leggings and trousers when I have my period as it feels safer, like its holding everything in place.

Shah, like myself and most others who experience these heavy periods, wants more conversation about periods as its still seen as taboo. I dont think we talk about period health enough or understand that it isnt a light flow for most women and we carry so much shame about it like as women theres something wrong with us.

Yes, there are treatment options available for heavy periods, including the Mirena coil, hormone replacement therapy (HRT), or non-hormonal options like tranexamic acid or non-steroidal anti-inflammatory tablet.

Non-invasive treatment options are widely available and its these that seem to have the most effect. Tablets such as tranexamic acid or non-steroidal anti-inflammatory tablets are beneficial, Dr Russell says. If these options have been tried unsuccessfully, then there are more drastic treatment options such as surgery.

Tranexamic acid is a commonly used medicine to help control bleeding of various types, including dental and nose bleeds, as well as menstrual bleeding. It normally comes in tablet form, the NHS (opens in new tab) explains, but it's also available in liquid, mouthwash, and injection forms.

Lesley Bourne, 50, from Buckinghamshire, originally had a Mirena coil (another treatment option) fitted for her heavy periods but it stopped working, leading to a heavy bleed and a trip to the emergency room one evening. Here, she wasn't seen by the gynecologist. Instead, she was given tranexamic acid and sent home.

Two days later I started clotting and went to A&E again, only to be told Im menopausal and its common. Then I went to my GP to have the coil taken out but that wasnt possible, so now I finally have a gynecologist appointment next month. But its taken three referrals and Im taking norethisterone to stop the bleeding, but I still lose a clot of blood here and there and get crampy pains.

Norethisterone is another drug used in the treatment of adverse gynecological issues, confirms the National Institute for Healthcare and Excellence (opens in new tab), but this is a progesterone hormone replacement.

Other options include the Mirena coil, also known as the hormone coil, which is placed in the uterus and acts to thin the lining of the womb so there is less to shed, explains Dr Russell. The Mirena coil has the added bonus that it can also be used as contraception and as part of HRT if needed.

Unfortunately, the coil doesnt work for everyone. It was the treatment that Bourne found beneficial when she had it fitted four years ago for heavy periods and it worked to begin with, as her periods stopped completely. But when the coil stopped working, she lost a lot of blood. They were big huge clots and only stopped after two hours, then two days later it started again. Only it was worse and it wouldnt stop, she tells woman&home.

Hormone replacement therapy (HRT) can also be used to balance hormones, which can then help with the control of periods and other symptoms of perimenopause, Dr Russell says.It's traditionally a treatment for those experiencing menopause, but has its uses here as well for those experiencing heavy periods as it also boosts low hormone levels.

A review by the University of Edinburgh (opens in new tab) confirms this, following an examination of multiple studies using the method. They found that HRT was effective at reducing menopausal symptoms with 'add-back' hormones.

Ultimately though, if youre struggling with heavy periods after 40, its best to discuss the options with your doctor to see which might be best for you.

(Image credit: Getty Images)

Millions of people around the world experience heavy periods after 40 around the world, which means you shouldnt have to put up with pain or discomfort if youre experiencing them. There is usually an underlying pathology for heavy periods, explains Dr Hina Pathak Sra, a consultant gynecologist at Harley Street's Cosmebeaut (opens in new tab).

You should see a doctor about heavy periods after 40 with clots if:

Any woman above the age of 40 years old with a change in their bleeding pattern or anyone who starts having heavy periods should see a GP to be referred to a gynecologist to organize an ultrasound scan to check endometrial thickness [thickness of the lining of the womb] and have an endometrial biopsy [biopsy of the lining of the womb]. This is to rule out any adverse changes on the endometrial cells, Dr Pathak says.

Link:
Heavy periods after 40 with clots: Causes and treatment | Woman & Home | - Woman & Home

More women are turning to medical cannabis to seek relief from menopause and perimenopause symptoms, research suggests.

For instance, a 2020 study shows that about 1 in 4 female veterans use cannabis to treat menopause symptoms.

And now, new research, recently published in the journal Menopause, suggests that the number of both menopausal and perimenopausal women using medical cannabis for symptom relief could be much higher.

This study suggests that medical cannabis use may be common in midlife women experiencing menopause-related symptoms, said Dr. Stephanie Faubion, medical director of the North American Menopause Society, in a press release.

Still, experts caution that the effects of cannabis on menopause symptoms like anxiety, depression, sleep, and pain have not yet been fully established.

Healthcare professionals should query their patients about the use of medical cannabis for menopause symptoms and provide evidence-based recommendations for symptom management, Faubion added.

The new study involved more than 250 perimenopausal and postmenopausal women who were recruited through targeted ads about womens health and cannabis use.

Over 83% of study participants said they regularly used cannabis to treat menopause-related symptoms, which was defined by researchers as at least once per month.

The study shows that cannabis was most commonly used to ameliorate sleep and mood or anxiety issues. The majority of participants (84%) said they smoked cannabis for symptom relief, with 78% of participants reporting the use of edibles.

Despite the seemingly positive findings, the study has a built-in bias since participants were recruited because of their interest in cannabis.

Theres no value in terms of its numbers or validity, Dr. Felice Gersh, an OB-GYN and founder of the Integrative Medical Group in Irvine, California, told Healthline.

But it does bring up the important subject about the suffering that women go through in menopause with no assistance from the medical establishment.

Gersh said that very few of her patients report using cannabis to treat menopause symptoms.

I call cannabis green medicine, Gersh said. This is a potential tool, but we have no data on efficacy or safety. It really is a medication that should be talked about with a physician, and patients should realize that there are more tested options, like hormone therapy.

According to Gersh, the new research has possibly overestimated the use of cannabis.

Still, a prior 2020 study suggests that 1 in 4 female veterans used cannabis to treat menopause. In fact, the researchers found that more women were using cannabis to treat menopause symptoms than were using hormone therapy or other traditional types of menopause symptom management.

This is disturbing because hormone therapy is the most effective therapy we have for menopause symptoms, and the benefits typically outweigh the risks for women in their 50s and within 10 years of menopause, Faubion told Healthline. Cannabis, on the other hand, is not a proven therapy for menopause.

Dr. Aaron Gelfand, an OB-GYN at ChoicePoint, an addiction treatment center in New Jersey, explained that numerous physiological systems are thought to be influenced by the endocannabinoid system, which is activated by plant-based cannabinoids like CBD and THC. These systems include:

According to Gelfand, cannabis is also used to help treat anxiety and depression, sleep, and even vaginal dryness among menopausal women.

The amygdala is responsible for emotions, behavior, and motivation, Gelfand told Healthline. During menopause, all of these are heightened. Upon taking cannabis in any form, the response is suppressed, causing less anxiety and depression.

Still, Gelfand said using cannabis to aid sleep may have mixed results in people experiencing menopause.

While THC usually has a sedative effect, it can also have a stimulating impact on certain users, particularly those who are new to [cannabis] use or who are taking greater amounts, he explained. In these circumstances, smoking [cannabis] before bed may make it harder to fall asleep.

Conversely, Gelfand said that at smaller doses, CBD seems to encourage alertness. At greater concentrations, however, CBD may induce sleepiness.

As for treating vaginal dryness, Gelfand pointed out that the use of CBD-containing products in the vaginal or vulvar tissues has not been supported by any well-controlled clinical research.

If Gersh were to recommend cannabis for menopause symptom relief, she said she prefers hemp-based products like CBD over products containing THC, the main psychoactive ingredient found in cannabis.

CBD and other cannabinoids like THC bind with receptors in the brain that are associated with memory, cognitive function, and pain.

Women who are going through menopause often find relief from common symptoms of menopause for exactly that reason, Mitchell H. Stern, president and CEO of California-based cannabis producer Burning Bush Nurseries told Healthline.

Some CBD brands have begun to cater to the unique needs of this emerging market by infusing their products with things like hibiscus, sage, and other natural herbs that have been helping menopausal women find relief for thousands of years, he added.

Experts have cautioned that the purported benefits of using cannabis to treat menopausal symptoms require further study.

While there has not been adequate research into the use of cannabis for menopausal symptoms, I would be reluctant to advise the use of cannabis with THC for this purpose, Dr. David Culpepper, clinical director of Telehealth company LifeMD, told Healthline.

In my experience, most of the anti-inflammatory and other health benefits patients receive from cannabis products come not from THC, but from CBD, which is a benign, non-psychoactive compound. Its possible that women using cannabis for menopause are reaping the benefits of the CBD, while unnecessarily intoxicating themselves with THC.

As with other experts, Culpepper recommended that people experiencing menopause try CBD to help relieve their symptoms instead of cannabis products containing THC.

The proliferation of medical cannabis in the United States has contributed to an increasing number of menopausal and perimenopausal women using the drug to treat their associated symptoms.

But some experts say these numbers may be overestimated, and caution that research on safety and effectiveness is still limited.

Until more rigorous research is conducted, experts recommend hormone therapy as a first-line treatment or may suggest trying CBD products as an alternative.

If you are experiencing symptoms associated with menopause or perimenopause, ask your doctor about the safest treatment options available to help you find relief.

Original post:
Cannabis Increasingly Used for Menopause Symptom Relief. Is It Safe? - Healthline

Wilmington, Delaware, United States, Aug. 09, 2022 (GLOBE NEWSWIRE) -- Transparency Market Research Inc. - The value of the global endocrine testing market stood at US$ 5.5 Bn in 2018. The global market study on endocrine testing expects the market to rise at a CAGR of 6.4% during the forecast period, from 2019 to 2027. The global market for endocrine testing is expected toexpand faster asmetabolic and endocrineproblems become more common. The marketis also anticipated to develop as diabetes prevalence rise across the globe.

Endocrine glands, which are a component of the endocrine system, produce hormones right into the bloodstream. Testing is done to check the levels of endocrine hormones in biological samples, including luteinizing hormone,follicle stimulating hormone, insulin,estradiol, and many others. These tests assist identify deviations in hormone secretion, such as hypersecretion or hyposecretion, which can lead to endocrine illnesses such asmenopause, infertility, thyroid dysfunction, and variousother conditions. Ongoing trends of the endocrine testing market

Endocrine testing has increased as a result of a number of illnesses, including various forms of diabetes and PCOS and it is also expected to present positive endocrine testing market outlook. For instance, a study reported in Current Diabetes Reports found a substantial increase in the incidence of PCOS and diabetes. Therefore, the rise in endocrine and metabolic diseases is a major driver that is predicted to fuel the expansion of the globalendocrine testing market in the years to come.

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Global Endocrine Testing Market: Key Players

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Global Endocrine Testing Market: Segmentation

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End User

Modernization of healthcare in terms of both infrastructure and services have pushed the healthcare industry to new heights, Stay Updated with Latest Healthcare Research Reports by Transparency Market Research:

Brachytherapy Devices Market: The brachytherapy applicators segment is estimated to expand at a CAGR of 8.4% and account for the dominant share of the brachytherapy devices market during the forecast period.

Hyperbaric Oxygen Therapy Devices Market: The global hyperbaric oxygen therapy devices market is expected to reach the value of US$ 7.3 Bn by the end of 2028.

IBD (Ulcerative Colitis and Crohn's Disease) Treatment Market: The global IBD (ulcerative colitis and Crohn's disease) treatment market was valued at ~US$ 15.5 Bn in 2018 and is projected to expand at a CAGR of ~6% from 2019 to 2027.

Hemophilia Treatment Drugs Market: The global hemophilia treatment drugs market was valued at US$ 9,500 Mn in 2017 and is anticipated to reach US$ 15,000 Mn by 2026, expanding at a CAGR of 5% from 2018 to 2026.

Critical Limb Ischemia Treatment Market: The global critical limb ischemia treatment market is driven by rise in prevalence of critical limb ischemia. Growth of the market is also attributed to increase in awareness about critical limb ischemia and rich product pipeline.

Menopausal Hot Flashes Treatment Market: Growing population of elderly women worldwide coupled with rise in menopausal hot flashes symptoms is a major factor responsible for the growth of global menopausal hot flashes treatment market.

Substance Abuse Treatment Market: The global substance abuse treatment market is anticipated to cross US$ 23.1 Bn by 2031. The global market is projected to grow at a CAGR of 8.5% from 2022 to 2031.

Glioblastoma Multiforme Treatment (GBM) Market: The global glioblastoma multiforme (GBM) treatment market is expected to reach the value of US$ 3.72 Bn by the end of 2028.

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Endocrine Testing Market is Estimated to Progress at a CAGR of 6.4% during the Forecast Period, notes TMR Study - GlobeNewswire

Ruth M. ORegan, MD, professor, chair, Charles Ayrault Dewey Professorship of Medicine, Department of Medicine, the University of Rochester, physician-in-chief, Strong Memorial Hospital, associate director, Education and Mentoring, the Wilmot Cancer Institute at University of Rochester, discusses the development of oral selective estrogen receptor degraders (SERDs) in hormone receptor (HR)positive breast cancer.

The randomized phase 3 EMERALD trial (NCT03778931) evaluated the oral SERD elacestrant vs standard endocrine therapy in pretreated patients with advanced or metastatic estrogen receptorpositive, HER2-negative breast cancer. Data from the study showed an advantage for the oral SERD over standard therapy, ORegan says. Although it was a modest difference, elacestrant appeared to have efficacy in HR-positive breast cancer harboring ESR1mutations, ORegan adds.

The development of elacestrant and other oral SERDs could provide a treatment advantage over the SERD fulvestrant, which is administered through intramuscular injection, ORegan notes. Additionally, oral SERDs won't have the same bioavailability issues as fulvestrant, and evaluating these agents further will be crucial, ORegan explains. Adjuvant studies are being planned with oral SERDs, though there have not been much compelling data in the metastatic setting, and there are adverse effects, such as gastrointestinal toxicity, that need to be considered. ORegan adds.

Ultimately, oral SERDs would represent a more convenient treatment option for patients, ORegan continues. In the early phase setting, encouraging data have been observed for the combination of oral SERDs with CDK4/6 inhibitors, and these regimens could be further explored in the future, ORegan concludes.

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Dr. O'Regan on the Development of Oral SERDs in Breast Cancer - OncLive

Ohio Congressmen Troy Balderson and Bill Johnson visited Ohio Universitys Athens campus today to tour facilities and learn more about OHIO's myriad contributions to Appalachian Ohio and the state through research, innovation, engagement, and experiential learning.

OHIO, which was designated anational public R1 research universityin 2022, provides more than 28,000 students with opportunities to access a high-quality education not just in the classroom but also through hands-on service to the community. During their visit, Balderson and Johnson learned more about OHIOs world class research programs, discussed how OHIO is adapting its curriculum in order to meet the career needs of students on the regional campuses, and gained insight into how OHIO Is a leader in a health education and outreach.

Ohio University is deeply committed to the success of our students and the communities we serve, Ohio University President Hugh Sherman said. I am grateful to Congressman Balderson and Congressman Johnson for taking time to discuss the Universitys many contributions, through its statewide footprint, to help uplift the region and state.

During their visit, the two Congressmen toured theInstitute for Sustainable Energy and the Environment (ISEE),theInstitute for Corrosion and Multiphase Technology (ICMT), theEdison Biotechnology Institute (EBI), and spoke with faculty leaders in each of the labs, as well as from theHealth Collaborative.

While visiting the ISEE, Balderson and Johnson heard fromJason Trembly, professor of mechanical engineering and director of the ISEE, about the institutes national leadership in developing transformational techniques to convert coal, coal waste, and carbon ore into high-performance, safe, carbon sequestered products for building and energy applications. According to Trembly, these materials transform pre-incineration coal waste long thought to be a worthless, noxious liability that is littered across Appalachia from a century of mining into useful products that our country needs to grow, all while creating manufacturing jobs in impoverished, former coal communities.

Trembly also attributes part of the ISEEs success to the partnerships established across the Appalachian Region including those with CONSOL Energy (Canonsburg, Pa.), Engineered Profiles (Columbus, Ohio), CFOAM (Triadelphia, W.Va), Koppers (Pittsburgh, Pa.), Omnis Energy (Greene Co., Pa.), AmeriCarbon (Morgantown, W.Va), and General Motors (Detroit, Mich.).

Next, the Congressmen visited the ICMT to speak with Russ College professor and director of the institute,Srdjan Nesic, about the institutes innovative research that is helping to slow down corrosion, creating job opportunities for the region, and expanding experiential learning opportunities to students from undergraduate to doctoral level.

The ICMT has been advancing research in corrosion for 30 years. A largescale operation, the institute is a training ground for undergraduate and graduate students. The size of a football field, the ICMT is one of the largest research facilities of its kind in the world and partners with some of the worlds leading oil and gas, chemical, and engineering companies such as Exon Mobile and Shell, to predict and resolve their corrosion problems to help keep oil and gas production and transportation efficient, reliable, and safe.

For our students, it is an incredible opportunity to get to work and learn firsthand in a large, world-class research facility such as this, Nesic explained. We have one of the biggest operations in the world for corrosion research and partnerships with industry giants that students have the ability to connect with and present to. It is a lot of practical and experiential work that helps prepare them for jobs in the industry all over the world.

One of the biggest innovations to come out of the ICMT is a software package,MULTICORP, that provides new capabilities and enhancements to allow researchers and scientists to significantly expand the scope of internal pipeline corrosion analyses and help them find better solutions.

Also during their visit, the Congressmen visited the EBI to learn fromDr. John Kopchick, Goll-Ohio Eminent Scholar and professor of molecular biology and principal investigator at EBI, about how the institute implements research for the discovery of novel human therapeutics, therapeutic targets, and diagnostics, as well as the importance of protection of the intellectual property that result in patents. He explained how the EBI discovered a growth hormone receptor antagonist which is now an FDA approved drug called Somavert that has been marketed worldwide for patients with a rare growth hormone condition called acromegaly and has yielded more than $110 million in royalties to Ohio University that is used to advance the discovery process and help train undergraduate, graduate, and medical students.

Having our guests see first-hand the excitement, commitment, and dedication of the students and research scientists to their particular projects allows them better understand and appreciate the enthusiasm, passion, and devotion that permeates EBI and its mission, Kopchick said. Reading about an institute/program is one thing; seeing it in action is very distinctive and special.

Kopchick alone has mentored over 300 undergraduate and 35 graduate students, 42 post-doctoral fellows, and many international visiting scientists/clinicians on the basics of molecular and cellular biology and the precise protocol used in experiments.

Following their time at OHIO and in the EBI, many graduates remain in the Athens, Southern Ohio, or state of Ohio to practice medicine and further their research, while others go on to continue their education or take their knowledge from OHIO across the world. According to Kopchick, regardless of where graduates end up, they remain the best ambassadors, spreading the word of the research enterprises and advancements being made at OHIO and in the EBI all over the globe.

The Congressmen also heard from leaders at OHIOsHeritage College of Osteopathic Medicine,College of Health Sciences and Professions, and theVoinovich School of Leadership and Public Serviceabout their efforts to make health care more easily accessible throughout the region.

As a top producer of health professionals in the state, OHIO -- which has been named among the top 10 largestSchools of Nursingin the country andOhios top provider of primary care physicians--serves its community and the surrounding region through outreach programs likeMobile Health Clinicsand theDiabetes Institutewhere patient education and care delivery programs help improve treatment for those in Appalachia with diabetes.

OHIO is also a founding member of theOhio Alliance for Innovation in Population Health, which brought together multiple universities and agencies to tackle some of the states largest population health challenges including health care access, low birth weight, infant mortality, addiction issues and more. In addition to tackling addiction through Ohio Alliance, the Voinovich School has also partnered with county Alcohol, Drug Addiction and Mental Health boards, prevention providers, among many others, to coordinatea new statewide center of excellenceto help expand prevention resources, training and support.

As educators, we believe we have a role to play in building and supporting community leaders and strengthening local economies, especially in underserved and rural parts of the state, Sherman added. I hope the conversations and experiences that were had today shed light on the need to continue to advance education, research, and service.

For more information onOhio University and its contributions to the region and experiential learning, visithttps://www.ohio.edu/forward.

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Ohio Congressmen Balderson and Johnson get firsthand look at OHIO's contributions to region through research, outreach, and experiential learning -...

Music icon and Grease star Olivia Newton-John passed away on Monday at the age of 73, according to an announcement made by her husband, John Easterling, on Facebook.

Though Newton-John may be best remembered for her singing and acting talents, she was also a fierce advocate for breast cancer, openly sharing her own battle with the disease while working to raise awareness and funds to further education and treatments.

Newton-John first found a lump in her breast in 1992. After being diagnosed with breast cancer, she was treated and went into remission.

In 2013, her breast cancer returned in her shoulder, followed by her back in 2017.

In September 2018, she revealed she was receiving treatment for cancer at the base of her spine.

Olivia has been a symbol of triumphs and hope for over 30 years sharing her journey with breast cancer, Easterling wrote in his announcement.

Despite her challenges, Newton-John thrived while living with breast cancer for three decades.

In addition to inspiring others with the story of her breast cancer journey, Newton-John helped raise funds in 2008 to build the Olivia Newton-John Cancer and Wellness Centre in Melbourne, Australia, which continues to sponsor global research into plant medicine and cancer.

Since Newton-Johns first diagnosis in the 1990s, breast cancer detection and treatment methods have seen many advancements.

Dr. Peter Schmid, medical director at Perci Health, an online platform that gives people access to multidisciplinary cancer specialists, says breast cancer survival rates have more than doubled in the past 40 years.

He notes that 76% of people with breast cancer now live 10 or more years, according to research by Cancer Research UK.

This is because cancer detection has improved, and treatment has become more targeted, resulting in more people being able to have the relevant treatment, he explains.

For metastatic breast cancer, where the cancer has spread to other parts of the body, the 10-year survival rates are lower depending on how advanced your cancer is, he adds. However, the good news is that new treatments are becoming available even for those with very advanced disease.

Schmid says some of the major advancements in breast cancer detection and treatment over the past 20 years, include improved screening programs, novel therapies such as immunotherapy, and genetic profiling.

Where screening is concerned, Schmid says 3D mammography allows for more precise images, meaning doctors can detect cancer at earlier stages.

Meanwhile, Immunotherapy using the bodys immune system to recognize and kill cancer cells has shown great results for triple-negative breast cancer, he explains.

While treatments for breast cancer have advanced greatly over the past 30 years, health experts say prevention is still the best medicine.

Theres no single cause of breast cancer. It results from a combination of the way we live our lives, our genes, and our environment, clarifies Lisa Jacques, lead cancer nurse at Perci Health.

While there are no definitive ways to prevent breast cancer, she says there are some lifestyle changes you can implement to help lower your risk.

Research has found that alcohol consumption can increase the risk of breast cancer by up to 7 to 16%.

Jacques stresses that there is no safe amount of alcohol when it comes to reducing your breast cancer risk but she advises limiting your alcohol intake to a maximum of 14 units per week. This is roughly equivalent to six pints of beer or one and a half bottles of wine per week.

Quitting smoking is also significantly beneficial.

Theres growing evidence that smoking can increase the risk of breast cancer and the risk is higher if you have a significant family history of breast cancer, Jacques points out.

However, quitting smoking can be challenging for many. Thats why Jacques advises consulting with a medical practitioner who may be able to point you in the direction of effective smoking cessation programs.

Maintaining a healthy weight is also key when it comes to lowering your breast cancer risk.

Try to stay active where possible, Jacques advises. You dont need to do high intensity workouts or pay for a gym membership. A short daily walk outside, which is low impact and free, can make all the difference.

Like many cancers, early detection can improve survival rates for cancer, and thats why checking your breasts on a regular basis is paramount.

Jacques advises checking for lumps once a month, ideally on the same day each month, by lifting your arms up and rubbing your hand around the breast in a circular motion.

Its key to know your body and know what is new or unusual. For example, you might notice a change of size, feel of the skin, notice a rash, lumps, or nipple changes, says Jacques.

You might also notice some pain. However, pain isnt always present so you shouldnt rely on this on its own, she adds.

If you do notice any changes, its imperative that you speak with your medical practitioner or oncology team.

Nevertheless, Jacques stresses the treatments available and the overall outlook for breast cancer patients today have improved by leaps and bounds, in part due to the advocacy efforts of people like Newton-John.

Many people now live long and happy lives after a cancer diagnosis, Jacques says.

Link:
Olivia Newton-John's 30-Year Cancer Journey Inspired Millions - Healthline

Researchers recommend having a low clinical threshold for the diagnosis of Hashimotos encephalopathy in patients who reveal no apparent cause for their altered mental status, given the heterogenous nature of the conditions presentation.

Plasmapheresis may be an option for patients with Hashimotos encephalopathy who are unresponsive to steroids and intravenous immunoglobin (IVIG) therapy, according to a case report published in Cureus.

Hashimotos encephalopathy is often called steroid-responsive encephalopathy associated with autoimmune arthritis (SREAT). However, the cases presented highlight the heterogenous nature of Hashimotos encephalopathy, describing 2 patients who found relief using plasmapheresis (PLEX) therapy when treatment with steroids was unsuccessful.

The first case involved a 42-year-old female patient with a past medical history of type 2 diabetes mellitus, hypertension, and hypothyroidism. The patient presented with an altered mental status following total thyroid resection for papillary thyroid cancer.

She was found comatose with an initial Glasgow Coma scale of 4 only a few hours after presenting with a normal state of health. She was electively intubated and admitted to the intensive care unit.

Extensive testing did not reveal the etiology of her acute encephalopathy. Initial evaluation for acute encephalopathy showed a normal computed tomography of the head. Infectious workup blood cultures, urine cultures, and screenings were all negative.

A complete blood count and complete metabolic panel showed no leukocytosis or metabolic derangements. Her thyroid-stimulating hormone was only mildly elevated at 5.04 MIU/L (reference range: 0.27-4.2 MIU/L); however, inflammatory markers were significantly elevated.

A lumbar puncture revealed an elevated opening pressure of 40 mmHg and a mildly elevated protein CSF concentration, but no evidence of underlying infection or oligoclonal banding. The patient underwent unremarkable magnetic resonance imaging.

A continuous electroencephalogram revealed diffuse, generalized slowing, consistent with a moderate nonspecific encephalopathy. After the patient was extubated, her persistent encephalopathy prevailed.

Further workup with a systemic autoimmune screen ruled out any cause of autoimmune cerebritis. Additional biopsies revealed nothing significant.

Subsequent treatment attempts with a course of empiric high-dose corticosteroids and IVIG therapy were futile. The patient remained encephalopathic 3 months following presentation, dependent on nasogastric feeding.

When inflammatory markers remained elevated, but a CSF autoimmune panel returned negative, physicians began to consider Hashimotos encephalopathy. Her serum theroid antibodies revealed normal titers or thyroid peroxidase antibodies but significantly elevated anti-thyroglobulin antibody 154.1 IU/mL (reference range: 0.0-0.9 IU/mL).

After a discussion across specialties, plasmapheresis (PLEX) therapy for 10 sessions was implemented.

With each session, the patient demonstrated significant improvement. By her second session, she became alert and oriented. Repeat anti-thyroglobulin antibody testing revealed significant improvement.

She was able to tolerate an oral diet, converse, and respond to commands. She was successfully discharged, with no recurrence during 2 years of follow-up.

The second case involved an 18-year-old male patient with a history of cerebral palsy. The patient presented to the hospital with a generalized tonic-clonic seizure. His caregiver stated that the patient was able to conduct a normal conversation and perform small tasks without difficulties at baseline.

Initially, the patient was successfully managed with intravenous lorazepam and midazolam. However, the patient remained encephalopathic with catatonic postures after the termination of his seizure.

The patient was unable to follow commands or speak meaningful sentences. Initial concerns for malignant catatonia were excluded by the psychiatry team.

Examination revealed no leukocytosis, anemia, or metabolic derangements. The patient had a normal TSH and free T4.

Diffuse, generalized slowing consistent with a moderate encephalopathy was observed in this patient as well. Neuroimaging with CT head and a lumbar puncture were generally unremarkable, though a minor elevation in CSF protein was noted.

For this patient, a complete serum and CSF autoimmune panel were negative, dismissing concerns about possible autoimmune encephalitis.

Physicians collected thyroid antibodies to determine whether Hashimotos thyroiditis could be excluded. The patient was found to have an elevated thyroid peroxidase antibody level of 80 IU/mL (reference range: 0-26 IU/mL), and an elevated thyroglobulin antibody of 22 IU/mL (reference range 0-0.9 IU/mL).

A decision was made to treat the patient for SREAT, or Hashimotos thyroiditis.

A course of IV methylprednisolone and subsequent IVIG therapy caused no improvement in the patients clinical status. Physicians decided to proceed with 10 sessions of PLEX therapy.

By the fourth session, the patient was more alert and less catatonic. The patient improved from a state of complete inattentiveness and disorientation to being alert and oriented to time, place, and person. He also became able to converse with his mother and returned to his functional baseline.

After tolerating all 10 sessions, the patient was discharged. The patient has not reported recurrence since discharge, according to the report.

These cases highlight the varied nature of the clinical presentation of Hashimotos encephalopathy. In both cases, a significant increase in the patients thyroid antibody titer was observed, with a negative CSF autoimmune panel and significant elevation in inflammatory markers.

Hashimotos encephalopathy is considered a rare disease, and currently has no definitive diagnostic study. As demonstrated by the 2 reported cases, the majority of neurological studies including a lumbar puncture, cEEG, and brain MRI, reveal only nonspecific findings.

Despite a majority of cases being characterized by an elevation in thyroid antibodies and a positive response to corticosteroid therapy, the authors suggest that positive thyroid antibody titers should not be reliably used in the diagnosis of Hashimotos encephalopathy. They recommend that empiric therapy be considered based on high clinical suspicion, even when initial thyroid antibody testing is negative.

Though they encourage further research assessing the benefit of long-term immunosuppression and other treatments for this patient population through randomized controlled trials, they encourage the use of PLEX therapy in certain patients.

Reference

Karan A, Nuthulaganti S R, Zhang Y, Kandah F, Gutierrez M, Reddy P. Two perplexing cases of Hashimotos encephalopathy unresponsive to steroid and intravenous immunoglobin therapy. Cureus. 2022;14(7):e26853. https://www.cureus.com/articles/101825-two-perplexing-cases-of-hashimotos-encephalopathy-unresponsive-to-steroid-and-intravenous-immunoglobulin-therapy. Published July 14, 2022. Accessed July 20, 2022.

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Plasmapheresis is Viable Treatment Option for Patients with Hashimoto's Encephalopathy Nonresponsive to Steroids - Pharmacy Times

If youre going bald, youre far from alone. Nearly 70% of American men experience some amount of noticeable hair loss by their mid-30s, according to the American Hair Loss Association. By age 50, about 85% of mens hair is significantly thinning. And sure, you can always shave your head and let bygones be bygones. But many men love a full mane, making hair loss a disease of the spirit that leaves sufferers vulnerable to dropping cash on treatments that often leave them disappointed, says Spencer Kobren, founder of the American Hair Loss Association and the International Alliance of Hair Restoration Surgeons. So what causes hair loss, and is there anything you can do to prevent it?

Ninety-nine percent of all products and services that claim to stop, prevent, or treat hair loss don't work, Kobren says. He notes that social media has attracted additional medical misinformation and phony, bogus products and services. These products dont get at the root of the problem. But there are real ways to prevent hair loss, once you cut through all the BS. This is what you need to know.

The most common type of hair loss is called androgenic alopecia, which is sometimes referred to as male or female pattern baldness, depending on the sex of the person who has it. This condition, which affects about 98% of people with hair loss, is caused by a combination of genetics and levels of androgens, a type of sex hormone. The main culprit of male pattern baldness (including a receding hairline) is dihydrotestosterone, a byproduct of testosterone that shrinks hair follicles of those who are genetically predisposed, Kobren says.

Alopecia areata universalis is far rarer, with fewer than 200,000 people living with it in the United States. Its a very difficult disease to treat, Kobren says. Its exact cause is unknown. However, researchers think that the condition, which causes the complete loss of hair on the scalp and body, occurs when someones immune system mistakenly attacks the hair follicles, according to the National Institutes of Healths Genetic and Rare Diseases Information Center. This type of hair loss often results in bald patches, and their hair that regrows may stay intact or may be lost again.

Traction alopecia is hair loss caused by frequently wearing hairstyles that create a lot of pulling on the hair and scalp, such as heavy braids or tight ponytails. That causes a type of scarring alopecia. And once that happens once the scalp and the hair follicles are damaged to that degree hair no longer grows, Kobren says. As many as half of all Black women experience this type of hair loss, according to Johns Hopkins Medicine. But there are steps people can take to prevent or slow traction alopecia, such as wearing looser braids or dreadlocks and removing braids, weaves, and extensions within a certain time period (three months for braids; two months for the other styles).

If youre noticing hair loss, dont panic, Kobren says. Bring the issue up with your doctor so they can determine whats causing the hair loss and discuss treatment options with you.

If youre hoping to to manage hair loss with medication, early intervention is key, Kobren says. A few different types of medications are available, including finasteride and minoxidil. Other medications are also sometimes used off-label. Its important to buy these medications through a physician rather than purchasing them from an online supplier, because the latter could switch the type of generic you receive without telling you, which could impact the effectiveness of the treatment, Kobren notes.

Hair transplant surgery is a last resort, he says. Two types of hair restoration procedures are currently available, but 70% of people who have them end up with results that make them feel anywhere from dissatisfied to disfigured. These surgeries also typically arent covered by insurance unless the hair loss is due to a severe injury.

An alternative to treating hair loss is embracing it. Shave your head and see how you fare, if you can deal with that, Kobren says. Because the road to recovery and trying to treat hair loss, whether it's surgical procedures or even FDA-approved medication, that's a long road and it's a real commitment.

Not subscribed to Fatherlys newsletter yet? Were not mad, just disappointed.

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What Causes Hair Loss? And How To Stop Hair Loss In Its Tracks. - Fatherly

Breast cancer survivors often experience symptoms of declining estrogen levels, including hot flashes, night sweats, vaginal dryness, and urinary tract infections. While hormone replacement therapy (HRT) can be an effective treatment for these adverse effects, some types of HRT have been associated with a higher risk of breast cancer recurrence, according to BreastCancer.org.

The American Cancer Society warns that higher estrogen levels may heighten the risk of breast cancer growth, and doctors may caution women with a history of breast cancer to not take types of systemic HRT that affect the entire body. HRT has also been linked to cardiovascular risks, such as heart disease, stroke, and blood clots.

A study published this month in the Journal of the National Cancer Institute, however, found that menopausal hormone therapy for breast cancer survivors is not associated with breast cancer reoccurrence.

Scientists in Denmark analyzed data from the countrys national prescription registry regarding postmenopausal women diagnosed between 1997 and 2004 with early-stage breast cancer who received no treatment or five years of hormone therapy. Among 8,461 women who had not received vaginal estrogen therapy or menopausal hormone therapy before a breast cancer diagnosis, 1,957 and 133 used vaginal estrogen therapy or menopausal hormone therapy, respectively, after diagnosis.

In accordance with national treatment guidelines during the study period, all patients were allocated either to five years of tamoxifen (one of the most widely used breast cancer treatments) or an aromatase inhibitor (which lowers estrogen levels by stopping an enzyme in fat tissue), or both treatments in sequence.

The researchers observed no higher odds for cancer returning or death in those who had the therapy compared with those who didnt.

These results suggest that breast cancer survivors on tamoxifen with severe symptoms [of genitals and urinary tract] can take vaginal estrogen therapy without experiencing an increase in their risk for breast cancer recurrence, said Elizabeth Cathcart-Rake, MD, who wrote in an accompanying editorial to the investigation.

Study authors noted, however, that a subgroup analysis revealed an increased risk of recurrence, but not death, in patients receiving vaginal estrogen therapy with aromatase inhibitors.

Patients who are taking aromatase inhibitors should try alternative strategies for management of genitourinary symptoms because vaginal estrogen therapy will likely increase their risk for breast cancer recurrence, said Dr. Cathcart-Rake, who is a physician at the Mayo Clinic in Rochester, Minnesota.

Overall, Cathcart-Rake sees the investigation helping to clarify the potential safety and hazards of taking such treatments. This large cohort study helps to inform the nuanced discussions between clinicians and breast cancer survivors about the safety of vaginal estrogen therapy, she said.

BreastCancer.org recommends that because the risks and benefits are different for every woman, breast cancer patients should educate themselves and talk to their doctor to decide if HRT is right for them.

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Hormone Replacement Therapy Not Linked to Breast Cancer Recurrence, Study Finds - Everyday Health

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Association of hormone replacement therapy with risk of gastric cancer: a systematic review and meta-analysis | Scientific Reports - Nature.com

FLINT, Mich., Aug. 2, 2022 /PRNewswire/ -- Forum Health Akron, integrative and functional medicine practice part of the nationwide Forum Health network, has welcomed Tammy Guseman MHA, MSN, APRN, CNP to its practice.

Forum Health Akron, formerly Revitalize Med, is led by board-certified physicians including Dr. Tara Scott. Using a functional and integrative approach, this clinic specializes in women's health, hormonal imbalance, thyroid disorders, infertility, nutrition, and more to optimize its patient's health and well-being.

"Tammy is a welcome addition to our growing team," said Dr. Scott. "Her years of experience in family medicine, and dedication to a functional and integrative approach make her a great fit."

Tammy Guseman is a board-certified family nurse practitioner who has experience in both inpatient and outpatient settings. She made the decision to focus her career on using an integrative approach to hormone balancing after her own positive experience with functional medicine.

"I am excited to continue my career with Forum Health Akron," said Tammy. "Functional care has benefitted me personally and I have seen first-hand the profound healing it offers my patients."

Tammy received her bachelor's and master's degrees from Walsh University, and a master's degree in healthcare administration from Ohio University. She is continuing to expand her education in bio-identical hormone replacement therapy through coursework from the American Academy of Anti-Aging Medicine (A4M).

"Adding Tammy to the team will allow us to continue to provide top-quality service to our patients," said Adam Puttkammer, president of Forum Health. "We are always striving to support our teams with experienced and knowledgeable providers."

"Tammy's commitment to continued education and personal interest in functional and integrative medicine aligns perfectly with our values at Forum Health," said Phil Hagerman, chief executive officer at Forum Health.

For more information on Forum Health, including how to join one of our practices, visit http://www.forumhealth.com.

About Forum Health, LLC

Forum Health, LLC is a nationwide provider of personalized healthcare. Steeped in the powerful principles of functional and integrative medicine, Forum Health providers take a root-cause approach to care. They listen and dig deep exploring lifestyle, environment, and genetics to help each patient achieve their ultimate health goals. Members have access to advanced medical treatments and technology, with care plans informed by data analytics and collaborative relationships. To learn more, visit forumhealth.com.

SOURCE Forum Health, LLC

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Forum Health Akron Welcomes Experienced Nurse Practitioner to Growing Team - PR Newswire

South Carolina became the seventh state last month to permit health care providers to decline to serve people if they feel doing so would violate their religious beliefs.

As a result, more than 1 in 8 LGBTQ people now live in states where doctors, nurses and other health care professionals can legally refuse to treat them, according to the Movement Advancement Project, an LGBTQ think tank. In addition to South Carolina, Mississippi, Alabama, Arkansas, Tennessee, Ohio and Illinois have similar measures in effect.

The conflict between patient needs and religious directives has been a serious problem in the past, and I dont see any sign of that issue being resolved quickly and easily.

Jenny Pizer, lambda legal

Advocates and legal experts say the laws will further raise the barriers to health care for lesbian, gay, bisexual, transgender and queer patients.

We often are worried that the expansion of religious rights in these contexts will be taken as a license to discriminate, said Jenny Pizer, the law and policy director for the LGBTQ legal advocacy group Lambda Legal.

Proponents of such legislation, however, say the measures dont allow providers to discriminate against or target LGBTQ people.

South Carolina state Sen. Larry Grooms, who supported his states law, the Medical Ethics and Diversity Act, told NPR in June that its based on procedure, not on patients.

This is America, where you should have the freedom to say no to something you dont believe in, he told NPR.

Although religious freedom or conscience measures, as theyre often called, dont explicitly list LGBTQ people among those who may be refused treatment, advocates say that in practice they are affected disproportionately.

Ivy Hill, the community health program director for the Campaign for Southern Equality, which promotes LGBTQ equality across the South, said transgender people are among those who will be the most negatively affected.

When we have laws in place that make it easier for providers to discriminate, of course its not going to do anything but make it worse, said Hill, who uses gender-neutral pronouns. The people who are already on the margins of the margins are going to be the ones who are most deeply impacted by stuff like this.

Even before the new law went into effect, they said, many trans people they work with in South Carolina struggled to find gender-affirming health care providers in the state willing to help them gain access to hormone therapy, leading some of them to travel to North Carolina to get care.

Hill said doctors usually dont tell trans people that they wont treat them for religious reasons, which makes it hard to know how often it happens. Research has found that LGBTQ people, particularly transgender people, are more likely to face medical discrimination.

A study published in 2019 found that 16 percent of LGBTQ adults, or about 1 in 6, reported experiencing discrimination in health care settings. A 2020 survey from the Center for American Progress, a liberal think tank, found that 16 percent of LGBTQ people, including 40 percent of transgender respondents, reported postponing or avoiding preventive screenings because of discrimination.

Maggie Trisler, who works in tech, said she had a great relationship with her primary care provider in Memphis, Tennessee, for about a year and a half in 2016 and 2017. He asked her in-depth questions about her health and the band she plays in, and he said he was going to take his wife to see her play.

Then, in March 2017, Trisler came out to him as transgender, and she said he suddenly became very cold and told her he doesnt know anything about the standards of care for transgender people. He began to blame pain she was having on her weight, she said.

It suddenly went from the best doctor-patient relationship Ive ever had to just the absolute least helpful, most frustrating that Ive had, she said.

Three months later, Trisler said, the doctor effectively although not explicitly told her he couldnt see her anymore.

He did say that he was deeply uncomfortable treating me with [hormone replacement therapy], he wasnt comfortable providing HRT, and if I was seeking that elsewhere, then maybe I should seek medical care elsewhere, she said.

Trisler added that she was lucky to have good insurance and that it was easy for her to change doctors, although she acknowledged that she is coming from a rather privileged position and that what was just a nuisance for her could have been a critical roadblock for others.

While LGBTQ people have long faced barriers to health care because of religious refusals, Pizer said, such religious objections can violate both state and federal law in some cases.

Pizer pointed to a 2005 case in which the North Coast Womens Medical Care Group in Southern California denied infertility treatments to her client Guadalupe Lupita Benitez because she is a lesbian. The providers argued that it was within their religious rights to refuse to offer treatment to Benitez, but the California Supreme Court decided that religious rights protected under California law dont excuse violations of the states nondiscrimination law.

The court found that when doctors are practicing in a particular field and offering services generally, according to patient needs in their field, they cant pick and choose among patients in ways that violate the nondiscrimination law, Pizer said.

Pizer said the problem with laws like South Carolinas Medical Ethics and Diversity Act is that they use broad language that doesnt give examples of situations in which a religious objection in medicine would violate medical standards or federal law. Many hospitals, including some that are religiously affiliated, receive federal funding. As a result, if they were to provide fertility treatments to heterosexual people and not to LGBTQ people, they would violate Section 1557 of the Affordable Care Act, which the Biden administration hopes to strengthen to better protect access to abortion and gender-affirming services.

Pizer said the issue is becoming more prominent and contentious as Catholic-affiliated institutions control an increasing proportion of the U.S. hospital system. As NBC News reported recently, more than 1 in 7 U.S. hospital patients are cared for in Catholic facilities.

The conflict between patient needs and religious directives has been a serious problem in the past, and I dont see any sign of that issue being resolved quickly and easily, Pizer said. A hospital thats operating in a community to serve the community more broadly should not be imposing their religious beliefs on people that are not part of that faith or that are at the hospital for medical services, not religious services.

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More than 1 in 8 LGBTQ people live in states where doctors can refuse to treat them - NBC News

For this episode ofThe Vitals,Oncology Nursing News met with Sarah Donahue, MPH, NP, a nurse practitioner at the University of California San Francisco Health, to discuss findings from the findings of DESTINY-Breast04 trial (NCT03734029).

DESTINY-Breast04, a phase 3, open-label pivotal trial, randomly assigned patients with unresectable or metastatic HER2-low breast cancer to receive the fam-trastuzumab deruxtecan-nxki (Enhertu) at 5.4 mg/kg every 3 weeks (n = 373) or physicians choice chemotherapy at locally approved dosing (n = 184). All enrolled patients had already received at last 1 prior line of therapy in the metastatic setting.1,2

The primary end point was progression-free survival (PFS) in patients with hormone receptorpositive breast cancer. The median PFS in the primary end point population was 10.1 months (95% CI, 9.5-11.5) with the antibody-drug conjugate vs 5.4 months (95% CI, 4.4-7.1) with standard of care (HR, 0.51; 95% CI, 0.40-0.64;P< .0001). The median overall survival was 23.9 months (95% CI, 20.8-24.8) vs 17.5 months (95% CI, 15.2-22.4), respectively (HR, 0.64; 95% CI, 0.48-0.86;P= .003).1,2

These findings, according to Donahue, will result in the addition of another therapy that patients with unresectable or metastatic HER2-low breast cancer can benefit greatly from.

One significant part [of] this trial is that included such a large population of patients, Donahue says. It really captured most patients with metastatic breast cancer[there were] patients with liver metastases, lung metastases, and brain metastases that were stable. It really covered a very large representative group of patients.

Further, Donohue adds, The data that were presented at the [2022 ASCO Annual Meeting] showed that the patients that received the trials trastuzumab deruxtecan had a much [improved] PFS compared with those patients that were on the physicians choice of chemotherapy. [Investigators] found that they could increase the median PFS from 5 months to about 10 months, so they could double it, Donahue explains. It was similar with the patients with hormone [receptor]positive diseases, as with the entire population. It did not matter what the hormone receptor status was for these patients, [they all] received that benefit.

If you liked todays episode ofThe Vitals, please consider subscribing to our podcast on Apple Podcasts, Spotify, Google Podcasts, Amazon Music, and many of your other favorite podcast platforms, to get a notification every time a new episode is posted. While you are there, please take a moment to rate us!

Thanks again for listening toThe Vitals. Be sure to never miss a beat withOncology Nursing News.

References

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Sarah Donahue Highlights Destiny-Breast04 Trial Takeaways for Patients With HR+, HER2-Low Metastatic Breast Cancer - http://www.oncnursingnews.com/

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At-home PCOS tests may provide an insight into hormone levels that a person can then share with their doctor or healthcare professional. However, alone, they are unable to diagnose PCOS.

Sex and gender exist on spectrums. For the purposes of this article, we use female to refer to a persons sex assigned at birth.

Polycystic Ovary Syndrome (PCOS) is a common condition that affects a females ovaries. People with PCOS are often unable to ovulate which can lead to irregular menstrual cycles. PCOS is also linked with the development of other conditions in later life, such as type 2 diabetes and high cholesterol levels, and other cardiovascular issues. PCOS is also one of the most common causes of infertility.

The exact cause of PCOS is unknown, although researchers and healthcare professionals usually cite a combination of genetic and environmental factors. According to a 2019 study, although PCOS is proven to be extremely heterogenetic, it has not yet been possible to find a single gene variant that underlies to condition.

Some common symptoms of PCOS are:

Symptoms usually appear in a females teenage years or early twenties, with most caused by higher than average androgen levels, also known as the male sex hormone.

A 2021 study found that hyperandrogenism facilitates the growth and advancement of PCOS. Higher levels of androgen can also cause the follicles to enlarge, forming cysts on the ovaries.

When diagnosing PCOS, doctors and healthcare professionals typically use the Rotterdam Criteria. The criteria include:

A person must display two of the three criteria for a doctor to diagnose PCOS.

When diagnosing PCOS, doctors and healthcare professionals look for three or more typically indicative symptoms. If a person experiences this number of symptoms, or if they have any general concerns about PCOS, they should speak with their doctor as soon as possible.

At-home PCOS tests look for female hormonal imbalances, with high androgens levels possibly indicating PCOS.

The types of samples needed for an at-home test include:

The majority of tests provide a lancet so a person can take a blood sample using the finger-prick method.

Results are typically available within a few days of the lab receiving the test samples from the female.

Only a doctor or qualified healthcare professional can make a formal PCOS diagnosis.

However, anyone can use an at-home PCOS test if they feel they may have a hormonal imbalance. The results from such tests can help a doctor in their diagnosis.

Below, we look at some at-home PCOS tests that a person may consider.

This at-home test measures key hormone levels. The hormones tested include those related to stress, sex, and those responsible for the development of ovarian follicles. However, the test is not suitable for those on hormonal contraception, hormone replacement therapy, steroid or testosterone-containing medications including gels, creams, patches, and oral medication.

A person orders their test online and the company will deliver the test for free, in a discrete package.

Individuals should collect their samples in the morning, before eating or drinking. They should collect the saliva sample first, as taking blood can sometimes raise cortisol levels.

A person should then return their packaged sample on the same day, using the prepaid shipping label provided. The sample is sent to one of the companys CLIA-certified and ISO-accredited laboratories for analysis.

Results will display via an individuals online LetsGetChecked account, within 25 days. If necessary and at no extra cost, a person can discuss their results with a member of the companys nursing team for advice on the next steps.

It is important to note that, due to state restrictions, this test is not permitted for use in New York.

Some pros and cons of the LetsGetChecked PCOS Test include:

Pros

Cons

Modern Fertility is a reproductive health company that gives personalized fertility tests and follow-up information from a licensed nurse. Part of its fertility test includes looking at the hormones associated with PCOS, due to its link to fertility difficulties.

The Modern Fertility Hormone Tests measures up to eight hormones, two of which link to PCOS testosterone and androgens. It also looks at AMH levels, that, when raised, AMH may indicate large numbers of undeveloped follicles in ovaries.

Initially, a person orders their test online that a doctor will review and personalize based on any birth control they may take. They can then choose to take the test at home or opt to visit a local Quest Diagnostics lab.

If taking the test at home, a person should follow the sample collection and packaging instructions and return the test the same day. The company will provide results via an individuals online profile within a few days.

The company offers aftercare that includes:

There are some pros and cons that a person may consider, such as:

Pros

Cons

Everlywell Womens Health test is suitable for people at all stages of life. It tests for hormonal imbalances which could indicate PCOS.

A person orders an online test that comes with prepaid return packaging. Upon receipt of the testing kit, the individual must register the test on the companys website, using the unique ID number provided.

The test has easy-to-follow instructions so a person can take a finger-prick blood sample and a saliva sample that they should return the same day. The results are available to view via the companys online platform within a few days.

The results include a personalized report explaining the results and some online resources for continued learning with healthcare professionals.

Below are some pros and cons for a person to consider:

Pros

Cons

A person orders their test online and the company will ship a testing kit. Shipping is free for those in the U.S., Canada, Puerto Rico, and the U.S. Virgin Islands.

The test is urine-based, and according to the companys website, it tests urine because it provides more accurate results than simply testing cortisol or sex hormones alone. DUTCH requires a person to collect four or five dried urine samples over 24 hours, using the test strips the company provides. The dried samples are suitable for international shipping as they are stable for several weeks.

A full timeline of how and when to collect the samples is available via the company website. Once an individual returns their samples and the lab receives them, they will process the samples and provide results within 510 days.

The company advises people not to take oral DHEA 48 hours prior to testing, or oral estrogen or pregnenolone 72 hours prior to testing.

Restrictions apply for ordering tests in New York, Rhode Island, and Maryland.

Some pros and cons that a person may consider, include:

Pros

Cons

Individuals should speak with a doctor if they are experiencing symptoms that interfere with their everyday life.

If a female has taken an at-home PCOS test, they should share their results with their doctor to help them provide a formal diagnosis. Although at-home PCOS tests can provide information on hormonal imbalances, only a doctor can provide an official PCOS diagnosis.

Here are some common questions about at-home PCOS tests.

A person may notice if they experience symptoms of PCOS, but only a doctor can officially diagnose it. At-home PCOS tests can provide a doctor with the results to help with diagnosis.

There is no test that definitively diagnoses PCOS. However, many people with PCOS have a hormonal imbalance. Hormone testing can help to identify whether key hormones are outside of expected limits and help a healthcare professional make a more accurate diagnosis.

A doctor can diagnose PCOS by initially discussing a females medical history and symptoms. They may then complete physical exams or arrange for an imaging test, such as an ultrasound.

PCOS is a hormonal disorder that affects a persons ovaries. Symptoms can range from mild to severe and include pelvic pain, oily skin, and weight gain. Symptoms typically present in a persons teenage years through to their early 20s.

At-home PCOS tests look at an individuals hormones, as for many people, hormonal imbalances are a typical sign of PCOS. Testing samples are typically blood, saliva, or urine.

Although at-home test results can show irregularities with hormones, they are not indicative of a formal PCOS diagnosis. For this, a person must consult with a doctor or qualified healthcare professional.

Read more:
4 at-home PCOS tests in 2022: What to know, how to choose, and more - Medical News Today

Having a normal blood pressure level is necessary for overall well-being.Blood pressure is essential because it helps the flow of blood from the heart to other areas of the body like organs, tissues and arteries and having high blood pressure can cause serious long-term health issues. But the good news is there's several ways to get blood pressure under control. Eat This, Not That! Health spoke with Dr. Bayo Curry-Winchell, Urgent Care Medical Director and Physician, Carbon Health and Saint Mary's Hospital who shares causes of high blood pressure and how to help prevent it. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Curry-Winchell says, "Your blood pressure is the (normal) pressure created by blood flowing in your arteries. This pressure might change throughout the day based on multiple things such as exposure or response to mental or physical stressors. It's important to remember having high blood pressure is considered a silent disease. Therefore, there is no guarantee you will experience any symptoms or warning signs that you have high blood pressure (defined as a number greater than 120/80). The only way to know is to get your blood pressure checked."

Dr. Curry-Winchell tells us, "A blood pressure greater than 120/80 can increase your risks of having a stroke, heart attack or developing heart disease. A higher-than-normal blood pressure can cause damage to the arteries affecting the amount of blood flow to organs such as your eyes, brain, heart, and kidneys."

"You can't always tell! Not everyone gets a warning sign they have elevated blood pressure," says Dr. Curry-Winchell. "Because high blood pressure is a silent disease some of my patients discover they have high blood pressure after a heart attack or stroke. The only way to know is to get it checked. I recommend purchasing a blood pressure cuff that you can use at home that records your readings."

According to Dr. Curry-Winchell, "You are at increased risk if you have a family history of hypertension, getting older (aging), diagnoses with chronic health conditions such as diabetes, eat a high salt diet, are considered overweight, drink large amounts of alcohol, and use tobacco."6254a4d1642c605c54bf1cab17d50f1e

Dr. Curry-Winchell explains, "There are several causes that increase your risk for developing high blood pressure including family history, age, lifestyle choices, etc. It is often socialized that elevated blood pressure is more common amongst African Americans. The reason is multi-faceted and not due to race/ethnicity; it is due to access to quality care, medical racially based algorithms, distrust of healthcare, and social, economic, and environmental determinants of health to name a few."

Dr. Curry-Winchell shares the following ways to have a normal blood pressure level.

"Stay Active

Participating in low or high impact exercising for approximately 5 days a week for approximately 30 minutes a day can lower your risks.

Lower Stress

I encourage my patients to find ways to lower their stress each day. Take the time to invest in yourself and find ways to bring a sense of joy or relaxation to your day. It can be as simple as closing your eyes and thinking about absolutely nothing, listening to music, singing in the shower, or reading one page in the book you have been wanting to read.

Eating Heart Healthy Foods

A balanced diet of fruits, vegetables, carbohydrates, and protein that includes low sodium (salt) options can help decrease your risks.

Quit Smoking

Smoking (nicotine) cigarettes causes your heart rate and blood pressure to increase. When this happens over an extended period and multiples times a day you increase your risks of developing hypertension.

Drink Less or Refrain from Alcohol

Alcohol increases several hormones such as renin, vasopressin (antidiuretic) and cortisol (stress hormone) which helps regulate blood pressure. Why does this matter? An increase in these hormones such as renin causes blood vessels to narrow, decreasing the amount of blood flowing to organs. Vasopressin, an antidiuretic hormone, allows your body to hold on to more fluid. Alcohol quells this function which in turn increases urination and risks for dehydration."

Heather Newgen

More:
The #1 Cause of High Blood Pressure According to Science Eat This Not That - Eat This, Not That

To the Editor:

Re Why Is the Right Forcing Women Who Miscarry to Suffer?, by Michelle Goldberg (column, July 19):

They dont tell you this in medical school, but to be an OB-GYN physician is to know heartache up close and personal, over and over again. I have been a practicing physician in Portland, Ore., for the last 37 years. My colleagues span the political spectrum, but almost everyone I have known has put the interest of the mothers life before that of the embryo or fetus. And if for reasons of conscience they could not, they would find another provider who could.

With the Dobbs decision, my specialty has been thrown into disarray. Miscarriage is one of the most common conditions we treat, as it occurs in about 10 to 20 percent of known pregnancies.

These new laws in anti-choice states just ban termination of pregnancy, some immediately after fertilization. They have no subtlety, they have no algorithms to guide practice.

Now providers are in an extremely precarious situation, risking prosecution. When the only exception for pregnancy termination is the mothers risk of death, how close must she be for them to act? Most pregnant people are young and healthy, and they cope well with blood loss and infection, until suddenly they do not, and by then it may be too late to save them.

America will now see what happens when politicians exploit the care of women for their political gain. It is brutal. Anyone who thought it would take a long time to see the consequence of banning a common medical procedure will soon see the tears, blood and death that we told them was coming. It is inevitable, and it will continue.

Marguerite P. CohenPortland, Ore.The writer is a fellow of the American College of Obstetricians and Gynecologists.

To the Editor:

Re Risks to Patients as Doctors Deal With Abortion Exceptions (news article, July 21):

As a Missouri resident living under a new abortion ban, I am enraged and disgusted. Advocates warned of the dangers of bans for years, unheeded. Even now, as doctors describe how pregnant women will die from substandard care as a result of this ban, our leaders shrug.

Days after Missouri enacted an abortion ban except in medical emergencies, I called the attorney generals office for clarification. I shared that I had experienced two life-threatening conditions in my last pregnancy, and I was concerned that my obstetrician might be constrained if a similar complication arose today.

The staff attorney told me that he was unable to offer guidance, as giving legal advice could jeopardize his law license. I replied that this ban could jeopardize my life. His response? That I could leave the state.

Unfortunately, I worry that many Missouri families like mine will take him up on his suggestion. I worry that our womens health providers will choose to practice elsewhere. I worry that Missouris elected officials will be shortsighted enough to celebrate these losses. The state deserves better.

Katy NimmonsSt. Louis

To the Editor:

Re Im Terrified for My Patients, by David N. Hackney (Opinion guest essay, July 10):

Dr. Hackney describes the pain experienced by a pregnant woman who learns that her child has a lethal condition yet has no option but to carry to term. While accurate, the potential pain of learning your fetus has a serious abnormality goes well beyond this.

A variety of severe, life-altering birth defects and genetic syndromes can be diagnosed prenatally, and many of these conditions are not lethal or not lethal immediately but serious enough that the affected child faces a lifetime of severe disability and, in many cases, pain.

Being told in the middle of a much wanted pregnancy that your child will have severe neurological or physical disabilities, that she will never walk, or talk or even be able to roll over by herself, and yet will survive, is as devastating as being told your child will die at birth, but with far different consequences.

Despite Justice Amy Coney Barretts assertion, these children are unlikely to be adopted. It is unethical to diagnose a medical condition and not provide the patient with reasonable and safe therapeutic options, but the laws of many states now make it impossible to do the ethical thing. More pain for everyone.

Katharine WenstromProvidence, R.I.The writer is a professor at the Alpert Medical School of Brown University and past president of the Society for Maternal Fetal Medicine.

To the Editor:

Dr. David Hackney joins so many doctors highlighting the serious life and health risks pregnant women now face. President Biden and Congress cannot restore comprehensive abortion rights in any manner that will survive future elections.

So congressional Democrats should immediately legislate a strong national right to abortion if continued pregnancy would risk the life, physical health or mental health of the mother, or if the fetus will not survive.

Further, there should be reasonable protection for medical providers who perform these medically necessary procedures. Otherwise, physician hesitation may cost womens lives.

I would hope there might be bipartisan support for this.

Without these protections, hikes to doctors liability insurance could render obstetrics care grossly overpriced and take already scarce funding away from all medical care.

Mary Jo NapoliColumbus, Ohio

To the Editor:

Re Abortion Bans Will Affect Both Rich and Poor Americans (Opinion guest essay, July 7):

Elizabeth Spiers describes the impact of abortion restrictions as a crisis for all American women, with delays in therapeutic abortions resulting in fatal consequences. As an emergency physician who routinely cares for women with pregnancy-related complications, I echo Ms. Spierss concerns.

I frequently treat obstetric emergencies. In recent weeks I cared for pregnant women with the following complications: ectopic pregnancy, undetectable fetal heartbeat with decreasing pregnancy hormone levels, and copious vaginal bleeding with an open cervix.

My patients were not asked their political affiliation or religious persuasion. I didnt need to know whether their pregnancies were planned or desired. My focus was on the timely care of three vulnerable patients, with pain and bleeding, who looked to our medical team for compassionate treatment and emotional support. All three patients had therapeutic abortions.

As abortion bans proliferate throughout our country, I feel fortunate to practice in New York Citys public hospital system, where the law supports sound medical decision making combined with a womans choice. No time for complacency, however. The lives and well-being of millions of women will depend on it.

Bonny J. BaronBrooklyn

Read this article:
Opinion | New Risks Facing Doctors and Their Pregnant Patients - The New York Times

Study participants

We evaluated data from 70 consecutive patients with PAI on conventional steroid treatment in a real-life study. Patients were consecutively referred to the Division of Endocrinology of Palermo University from January 2012 to December 2020. Patients were on conventional steroid treatment (cortisone acetate and HC), administered twice or three times a day. Thirty-five patients, 15 males and 20 females, maintained conventional steroid therapy (17 cortisone acetate and 18 HC) (group A) while the other 35, (16 who were on cortisone acetate and 19 who were on HC), 11 males and 24 females, were switched from conventional steroid treatment to DR-HC (group B) administered orally in the morning in a fasting state. Patients had a 60-month follow-up. In group A there were 5 women in menopause, while in group B there were 6 women in menopause. Exclusion criteria were the following: age18years, secondary AI (SAI), treatment with other steroids (prednisone), pregnancy, breastfeeding, premature ovarian failure, hypoparathyroidism, hyperparathyroidism, treatment with estrogens and underweight (BMI<18.5kg/m2). The switch to DR-HC was judged to be appropriate on clinical grounds in those patients who complained of fatigue and weakness, presented hyponatraemia (<134mmol/L) or hypoglycaemia (2.78mmol/L) or showed more than two comorbidities such as diabetes, osteoporosis/osteopenia, arterial hypertension and central obesity. The switch from HC to DR-HC was made with an equivalent dose, while the dose was reduced from cortisone acetate to DR-HC taking into consideration the minor steroid activity of cortisone acetate compared to HC and patients clinical characteristics.

PAI was diagnosed as recommended by international guidelines9.

In detail, among the total of 70 patients, 42 had autoimmune polyglandular syndrome (APS), while 28 had isolated autoimmune AI. Among patients with APS, 26 had combined Addisons disease and autoimmune thyroid disease, 6 had combined Addisons disease, type 1 diabetes mellitus and autoimmune hypothyroidism and 10 had combined Addisons disease, autoimmune hypothyroidism and celiac disease. Patients with celiac disease were on a stable gluten-free diet. All patients with PAI were also on stable treatment with fludrocortisone (0.050.1mg/day, once). Patients with hypothyroidism were treated with levo-thyroxine at the average dose of 1.21.5 mcg/kg. Patients with type 1 diabetes were on basal-bolus treatment on flash blood glucose monitoring. Five postmenopausal women had been treated with DHEA for a ranging period of 618months, before being included in the study.

During the 60-month treatment period, the conventional steroid and the DR-HC doses were changed based on the physicians judgement of a patients need in both groups of patients (Table 1). Each patient received instructions for treatment in special or emergency situations. Patients treated with DR-HC were instructed to add a rescue dose of HC during an intercurrent illness or stress (5 or 10mg according to severity of stress and symptoms). Overall, 8 patients had to take a rescue dose of HC, 5 of them less than 10 times and 3 of them from 20 to 30 times during the 60-month period.

The current study was carried out in accordance with the recommendations of the Paolo Giaccone Policlinico ethics committee, with written informed consent from all subjects. All subjects gave written informed consent in accordance with the Declaration of Helsinki. The protocol was approved by the Paolo Giaccone Policlinico ethics committee (protocol 06/2021).

At baseline and after 18, 36 and 60months of conventional steroid and DR-HC treatment, clinical and bone metabolic parameters were evaluated.

Anthropometric parameters such as BMI and waist circumference (WC), measured at the midpoint between the lower rib and the iliac crest, were evaluated. In addition, sodium, potassium, serum 25hydroxyvitamin-D (vitaminD), parathyroid hormone, calcium, phosphorus, creatinine, osteocalcin and bone alkaline phosphatase were assayed.

The blood sample was taken about 2h after steroid administration (patients took the dose in the morning on waking) to avoid patients experiencing fatigue or other symptoms due to delayed intake of the drug.

In both groups, hypovitaminosis D was observed at baseline and a pharmacological supplementation was started in 26 patients of group A and 25 of group B, at the mean dose of 800 UI/day and maintained during the follow-up. Hypovitaminosis D was defined as a serum 25-hydroxy vitamin D level below the normal range (<30ng/ml). All patients supplemented with vitamin D reached the threshold of 30ng/ml.

BMD was measured by DXA at lumbar spine and femoral neck (Hologic Horizon Inc., QDR-4500W Waltham, MA) at baseline and after 18, 36 and 60months of follow-up.

In patients aged 50 or more, BMD was expressed as the T-score, comparing the results with those obtained in a sex-matched Caucasian population at the peak of bone mass. A T-score less than or equal to 2.5 SD at the neck or spine was defined as osteoporosis, whereas osteopenia was defined as a T-score between 1 and 2.5 SD. In patients younger than 50years, the results were expressed as a/the Z-score, comparing the results with those obtained in an age and sex-matched Caucasian population. A Z-score of 2.0 SD or lower was used to define a BMD below the expected range for age10. The coefficients of variation in the DXA measurements for BMD, bone mineral content (BMC) and area were 0.61%, 2.98% and 2.89%, respectively.

We also evaluated rib, femoral neck and hip fractures rate during the follow-up in both groups.

Sodium, potassium, serum 25hydroxyvitamin-D (vitamin-D), parathyroid hormone, calcium, phosphorus, creatinine, osteocalcin and bone alkaline phosphatase were measured with standard methods (Modular P800, Roche, Milan) at our hospital centralized laboratory. The intra- and interassay coefficients of variation were the following: Sodium 0.5% to 1.2% and 1.28% to 1.44%, respectively; potassium 1% to 2.1% and 2.2% to 3.08%, respectively; vitaminD 0.9% to 1.6% and 1.7% to 2.56%, respectively, parathyroid hormone 1.2% to 2.6% and 2.8% to 3.9%, respectively; calcium 1.8% to 3.5% and 3.75% to 4.23%, respectively; phosphorus 1.6% to 3.3% and 3.5% to 4.2%, respectively; creatinine 1.7% to 2.9% and 3.3% to 4.6%, respectively; osteocalcin 1.9% to 3.3% and 3.6% to 4.9%, respectively; bone alkaline phosphatase 2.7% to 3.6% and 3.8% to 5.2%, respectively.

The Statistical Packages for Social Science SPSS version 19 (SPSS, Inc., IBM, New York, USA) were used for data analysis. The normality of quantitative variables was tested with the Shapiro-Wilk test. The baseline characteristics of the groups were presented as meanSD for continuous variables, while the rates and proportions were calculated for categorical data. The differences between groups were performed using ANOVA for quantitative variables and the 2-test for categorical variables. A comparison between numerical variables at baseline, 18-, 36- and 60-month follow-up was performed with the Friedman analysis. In addition, multiple linear regression analysis was performed to identify independent predictors of the dependent variables lumbar spine and femoral neck T and Z scores and of dependent variable fracture. A p value<0.05 was considered statistically significant.

Read more:
Long-term outcomes of conventional and novel steroid replacement therapy on bone health in primary adrenal insufficiency | Scientific Reports -...

Emily Daniels, who lives with her husband and their young son in Golden, CO, was 32 years old, and in the 33rd week of her pregnancy, she began feeling tightness in her chest.

She wisely had it checked out, and a CT scan found two blood clots in her lungs. The scan also discovered a mass, which a biopsy confirmed was stage IV lung cancer.

Daniels, who has never smoked, was shocked to hear the diagnosis.

Her doctors arent sure how she got cancer. But they told her it was best to induce labor for the sake of the babys health and the mothers.

I had undergone a year and a half of fertility treatment, and if I had to guess, my body wasnt strong enough in that stress mode because of fertility and the hormones. It made things go crazy in my body, she told Healthline.

My doctor thinks this is valid. But we dont know.

Daniels is still living with lung cancer. Shes been through chemotherapy and several other treatments and procedures. Its been difficult, and her life has changed dramatically.

But shes taking it all in stride because shes still alive. And her baby boy, Brady, is now four and a half. Daniels will soon celebrate her 37th birthday.

Lung cancer has given me a perspective on what is important and how you want to live your life, she told Healthline. I want to live every day with no regrets.

Today is World Lung Cancer Day, and the American Lung Association released the Lung Health Barometer, a new survey revealing critical lung cancer awareness statistics.

The good news is that lung cancer overall is down.

The bad news is that it remains the leading cause of cancer death in the U.S.

Smoking is still the most common cause of lung cancer, but an increasing percentage of lung cancer patients like Daniels who have never smoked and are under age 40 are being diagnosed with the disease.

While rates of lung cancer have fallen in the last 15 years because tobacco control is better and there are more preventive measures, theres a higher percentage now of never smokers who are getting lung cancer, David Tom Cooke, MD, F.A.C.S. chief division of general thoracic surgery at UC Davis, told Healthline.

Cooke said there are multiple reasons why people who have never smoked get lung cancer.

They include exposure to second-hand smoke, radon, asbestos fibers, air pollution, toxins from increasing wildfires worldwide, and genetic factors.

Its important to look at the big picture. The death rate from lung cancer has been falling in our country for 10 years, Cooke said.

Thats because of tobacco recovery and prevention, advances in surgery for early stage, immunotherapy, and precision medicine.

The adoption of precision medicine includes the deployment of liquid biopsies, which are simple blood tests that look at circulating tumor DNA in the blood, Cooke said.

These assays can detect cancer and find driver mutations. Its a promising technology, and its most effective in patients with advanced lung cancer, Cooke said.

It makes sense that the more cancer you have in [your] body, the more you will have circulating tumor DNA in [the] blood.

He said that its not as effective with early-stage lung cancer when the tumor is very small and may not be shedding DNA into the bloodstream.

According to the American Lung Association survey, lung cancer is the leading cause of cancer deaths in the U.S., but the disease often remains in the shadows.

Its estimated that more than 235,000 Americans will be diagnosed this year with lung cancer.

But only 29% of Americans know that lung cancer is the leading cause of cancer deaths in the U.S.

Only about one in four respondents (26%) knew that the lung cancer survival rate increased by over 30% in the past ten years.

Seventy-three percent of adults have not spoken with their doctor about their risk for lung cancer, and only 40% are concerned they might get the disease.

And nearly 70% of respondents were unfamiliar with the availability of lung cancer screening for early detection of the disease.

The American Lung Association is working to defeat lung cancer.

To do so, the organization is engaging a variety of tactics and stakeholders to address the disease.

This low awareness is due in part to an undeserved stigma that has followed lung cancer for decades. The fact is that anyone can get lung cancer, and no one deserves it, Harold Wimmer, national president and CEO of the American Lung Association, said in a press statement.

The good news is that the lung cancer survival rate has risen substantially, and awareness of this deadly disease has steadily increased, he stated.

Greater awareness of lung cancer is key to securing research funding, encouraging lung cancer screening, reducing stigma around this disease, and ultimately, saving lives, Wimmer said.

Read the rest here:
Lung Cancer Remains the Leading Cause of Cancer Deaths in the U.S. - Healthline

For anyone who doesnt have a thyroid condition, it might be easy to forget about the gland in the front of their neck that controls hormone production. But behind the scenes, the thyroid does a lot of work to help metabolize and maintain blood pressure, body temperature and heart rate.

Thyroid disease affects approximately 20 million people in the US and about one in eight women. The two most common types of thyroid disorders are hyperthyroidism and hypothyroidism.

Hyperthyroidism produces too much thyroxine hormone (an overactive thyroid) and hypothyroidism does not produce enough (an underactive thyroid). Although the two conditions have different signs and symptoms, there can be some overlap.

There is no replacement for getting the proper diagnosis and starting medication when necessary, said Vatche Zohrabian, DO, primary care physician with the Hartford HealthCare Medical Group, but there are some lifestyle modifications that can help augment conventional treatment and help keep your thyroid on track.

Here are the five things Dr. Zohrabian recommends you do to upkeep a healthy thyroid:

Dr. Zohrabian encourages anyone who experiences the following symptoms to have their thyroid function checked by their primary care provider:

Continue reading here:
Five Easy Steps to Keep Your Thyroid Healthy - Health News Hub