The Covid-19 pandemic is one of the greatest challenges modern medicine has ever faced. Doctors and scientists are scrambling to find treatments and drugs that can save the lives of infected people and perhaps even prevent them from getting sick in the first place.

Below is an updated list of 20 of the most-talked-about treatments for the coronavirus. While some are accumulating evidence that theyre effective, most are still at early stages of research. We also included a warning about a few that are just bunk.

We are following 20 coronavirus treatments for effectiveness and safety:

Tentative or

mixed evidence

We are following 20 coronavirus treatments

for effectiveness and safety:

Tentative or

mixed evidence

We are following 20 coronavirus treatments

for effectiveness and safety:

There is no cure yet for Covid-19. And even the most promising treatments to date only help certain groups of patients and await validation from further trials. The F.D.A. has not fully licensed any treatment specifically for the coronavirus. Although it has granted emergency use authorization to some treatments, their effectiveness against Covid-19 has yet to be demonstrated in large-scale, randomized clinical trials.

This list provides a snapshot of the latest research on the coronavirus, but does not constitute medical endorsements. Always consult your doctor about treatments for Covid-19.

New additions and recent updates:

Added ivermectin, a drug typically used against parasitic worms that is being increasingly prescribed in Latin America. Aug. 10

Updated descriptions for several treatments. Aug. 10

We will update and expand the list as new evidence emerges. For details on evaluating treatments, see the N.I.H. Covid-19 Treatment Guidelines. For the current status of vaccine development, see our Coronavirus Vaccine Tracker.

WIDELY USED: These treatments have been used widely by doctors and nurses to treat patients hospitalized for diseases that affect the respiratory system, including Covid-19.

PROMISING EVIDENCE: Early evidence from studies on patients suggests effectiveness, but more research is needed. This category includes treatments that have shown improvements in morbidity, mortality and recovery in at least one randomized controlled trial, in which some people get a treatment and others get a placebo.

TENTATIVE OR MIXED EVIDENCE: Some treatments show promising results in cells or animals, which need to be confirmed in people. Others have yielded encouraging results in retrospective studies in humans, which look at existing datasets rather than starting a new trial. Some treatments have produced different results in different experiments, raising the need for larger, more rigorously designed studies to clear up the confusion.

NOT PROMISING: Early evidence suggests that these treatments do not work.

PSEUDOSCIENCE OR FRAUD: These are not treatments that researchers have ever considered using for Covid-19. Experts have warned against trying them, because they do not help against the disease and can instead be dangerous. Some people have even been arrested for their false promises of a Covid-19 cure.

EVIDENCE IN CELLS, ANIMALS or HUMANS: These labels indicate where the evidence for a treatment comes from. Researchers often start out with experiments on cells and then move onto animals. Many of those animal experiments often fail; if they dont, researchers may consider moving on to research on humans, such as retrospective studies or randomized clinical trials. In some cases, scientists are testing out treatments that were developed for other diseases, allowing them to move directly to human trials for Covid-19.

All treatmentsWidely usedPromisingTentative or mixedNot promisingPseudoscience

Antivirals can stop viruses such as H.I.V. and hepatitis C from hijacking our cells. Scientists are searching for antivirals that work against the new coronavirus.

PROMISING EVIDENCE EVIDENCE IN CELLS, ANIMALS AND HUMANSEMERGENCY USE AUTHORIZATIONRemdesivirRemdesivir, made by Gilead Sciences, was the first drug to get emergency authorization from the F.D.A. for use on Covid-19. It stops viruses from replicating by inserting itself into new viral genes. Remdesivir was originally tested as an antiviral against Ebola and Hepatitis C, only to deliver lackluster results. But preliminary data from trials that began this spring suggested the drug can reduce the recovery time of people hospitalized with Covid-19 from 15 to 11 days. (The study defined recovery as either discharge from the hospital or hospitalization for infection-control purposes only.) These early results did not show any effect on mortality, though retrospective data released in July hints that the drug might reduce death rates among those who are very ill.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS, ANIMALS AND HUMANSFavipiravirOriginally designed to beat back influenza, favipiravir blocks a viruss ability to copy its genetic material. A small study in March indicated the drug might help purge the coronavirus from the airway, but results from larger, well-designed clinical trials are still pending.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS, ANIMALS AND HUMANSMK-4482Another antiviral originally designed to fight the flu, MK-4482 (previously known as EIDD-2801) has had promising results against the new coronavirus in studies in cells and on animals. Merck, which has been running clinical trials on the drug this summer, has announced it will launch a large Phase III trial in September.Updated Aug. 6

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS Recombinant ACE-2To enter cells, the coronavirus must first unlock them a feat it accomplishes by latching onto a human protein called ACE-2. Scientists have created artificial ACE-2 proteins which might be able to act as decoys, luring the coronavirus away from vulnerable cells. Recombinant ACE-2 proteins have shown promising results in experiments on cells, but not yet in animals or people.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS AND HUMANS IvermectinFor decades, ivermectin has served as a potent drug to treat parasitic worms. Doctors use it against river blindness and other diseases, while veterinarians give dogs a different formulation to cure heartworm. Studies on cells have suggested ivermectin might also kill viruses. But scientists have yet to find evidence in animal studies or human trials that it can treat viral diseases. As a result, Ivermectin is not approved to use as an antiviral.

In April, Australian researchers reported that the drug blocked coronaviruses in cell cultures, but they used a dosage that was so high it might have dangerous side effects in people. The FDA immediately issued a warning against taking pet medications to treat or prevent Covid-19. These animal drugs can cause serious harm in people, the agency warned.

Since then a number of clinical trials have been launched to see if a safe dose of ivermectin can fight Covid-19. In Singapore, for example, the National University Hospital is running a 5,000-person trial to see if it can prevent people from getting infected. As of now, theres no firm evidence that it works. Nevertheless ivermectin is being prescribed increasingly often in Latin America, much to the distress of disease experts.Updated Aug. 10

NOT PROMISING EVIDENCE IN CELLS AND HUMANS Lopinavir and ritonavirTwenty years ago, the F.D.A. approved this combination of drugs to treat H.I.V. Recently, researchers tried them out on the new coronavirus and found that they stopped the virus from replicating. But clinical trials in patients proved disappointing. In early July, the World Health Organization suspended trials on patients hospitalized for Covid-19. They didnt rule out studies to see if the drugs could help patients not sick enough to be hospitalized, or to prevent people exposed to the new coronavirus from falling ill. The drug could also still have a role to play in certain combination treatments.

NOT PROMISING EVIDENCE IN CELLS, ANIMALS AND HUMANSHydroxychloroquine and chloroquineGerman chemists synthesized chloroquine in the 1930s as a drug against malaria. A less toxic version, called hydroxychloroquine, was invented in 1946, and later was approved for other diseases such as lupus and rheumatoid arthritis. At the start of the Covid-19 pandemic, researchers discovered that both drugs could stop the coronavirus from replicating in cells.

Since then, theyve had a tumultuous ride. A few small studies on patients offered some hope that hydroxychloroquine could treat Covid-19. The World Health Organization launched a randomized clinical trial in March to see if it was indeed safe and effective for Covid-19, as did Novartis and a number of universities. Meanwhile, President Trump repeatedly promoted hydroxychloroquine at press conferences, touting it as a game changer, and even took it himself. The F.D.A. temporarily granted hydroxychloroquine emergency authorization for use in Covid-19 patients which a whistleblower later claimed was the result of political pressure. In the wake of the drugs newfound publicity, demand spiked, resulting in shortages for people who rely on hydroxychloroquine as a treatment for other diseases.

But more detailed studies proved disappointing. A study on monkeys found that hydroxychloroquine didnt prevent the animals from getting infected and didnt clear the virus once they got sick. Randomized clinical trials found that hydroxychloroquine didnt help people with Covid-19 get better or prevent healthy people from contracting the coronavirus. Another randomized clinical trial found that giving hydroxychloroquine to people right after being diagnosed with Covid-19 didnt reduce the severity of their disease. (One large-scale study that concluded the drug was harmful as well was later retracted.) The World Health Organization, the National Institutes of Health and Novartis have since halted trials investigating hydroxychloroquine as a treatment for Covid-19, and the F.D.A. revoked its emergency approval. The F.D.A. now warns that the drug can cause a host of serious side effects to the heart and other organs when used to treat Covid-19.

In July, researchers at Henry Ford hospital in Detroit published a study finding that hydroxychloroquine was associated with a reduction in mortality in Covid-19 patients. President Trump praised the study on Twitter, but experts raised doubts about it. The study was not a randomized controlled trial, in which some people got a placebo instead of hydroxychloroquine. The studys results might not be due to the drug killing the virus. Instead, doctors may have given the drug to people who were less sick, and thus more likely to recover anyway.

Despite negative results, a number of hydroxychloroquine trials have continued, although most are small, testing a few dozen or a few hundred patients. A recent analysis by STAT and Applied XL found more than 180 ongoing clinical trials testing hydroxychloroquine or chloroquine, for treating or preventing Covid-19. Although its clear the drugs are no panacea, its theoretically possible they could provide some benefit in combination with other treatments, or when given in early stages of the disease. Only well-designed trials can determine if thats the case.Updated Aug. 10

Most people who get Covid-19 successfully fight off the virus with a strong immune response. Drugs might help people who cant mount an adequate defense.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS AND HUMANS Convalescent plasmaA century ago, doctors filtered plasma from the blood of recovered flu patients. So-called convalescent plasma, rich with antibodies, helped people sick with flu fight their illness. Now researchers are trying out this strategy on Covid-19. In May, the F.D.A. designated convalescent plasma an investigational product. That means that despite not yet being shown as safe and effective, plasma can be used in clinical trials and given to some patients who are seriously ill with Covid-19. Tens of thousands of patients in the U.S. have received plasma through a program launched by the Mayo Clinic and the federal government.

The Trump administration has praised convalescent plasma, despite the lack of evidence yet that it works. The first wave of trials have been small and the results have been mixed. Large randomized clinical trials are underway, but theyve struggled to enroll enough participants, some of whom worry they will receive a placebo instead of the treatment itself.

Experts say that its vital to complete these trials to determine if convalescent plasma is safe and effective. If these trials are successful, it could serve as an important stopgap measure until more potent therapies become widely available.Updated Aug. 10

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS, ANIMALS AND HUMANSMonoclonal antibodiesConvalescent plasma from people who recover from Covid-19 contains a mix of different antibodies. Some of the molecules can attack the coronavirus, but many are directed at other pathogens. Researchers have sifted through this slurry to find the most potent antibodies against Covid-19. They have then manufactured synthetic copies of these molecules, known as monoclonal antibodies. Researchers have begun investigating them as a treatment for Covid-19, either individually or in cocktails.

Monoclonal antibodies were first developed as a therapy in the 1970s, and since then the F.D.A. has approved them for 79 diseases, ranging from cancer to AIDS. Since the start of the pandemic, researchers have found dozens of monoclonal antibodies that show promise against Covid-19 in preclinical studies on cells and animals. Companies like Eli Lilly and Regeneron recently began clinical trials studying monoclonal antibodies. Several other firms, as well as teams at universities, are slated to enter the race soon as well.Updated Aug. 10

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN CELLS, ANIMALS AND HUMANSInterferonsInterferons are molecules our cells naturally produce in response to viruses. They have profound effects on the immune system, rousing it to attack the invaders, while also reining it in to avoid damaging the bodys own tissues. Injecting synthetic interferons is now a standard treatment for a number of immune disorders. Rebif, for example, is prescribed for multiple sclerosis.

As part of its strategy to attack our bodies, the coronavirus appears to tamp down interferon. That finding has encouraged researchers to see whether a boost of interferon might help people weather Covid-19, particularly early in infection. Early studies, including experiments in cells and mice, have yielded encouraging results that have led to clinical trials.

An open-label study in China suggested that the molecules could help prevent healthy people from getting infected. On July 20, the British pharmaceutical company Synairgen announced that an inhaled form of interferon called SNG001 lowered the risk of severe Covid-19 in infected patients in a small clinical trial. The full data have not yet been released to the public, or published in a scientific journal. On August 6, the National Institute of Allergy and Infectious Diseases launched a Phase III trial on a combination of Rebif and the antiviral remdesivir, with results expected by fall 2020.Updated Aug. 10

The most severe symptoms of Covid-19 are the result of the immune systems overreaction to the virus. Scientists are testing drugs that can rein in its attack.

PROMISING EVIDENCE EVIDENCE IN HUMANS DexamethasoneThis cheap and widely available steroid blunts many types of immune responses. Doctors have long used it to treat allergies, asthma and inflammation. In June, it became the first drug shown to reduce Covid-19 deaths. That study of more than 6,000 people, which in July was published in the New England Journal of Medicine, found that dexamethasone reduced deaths by one-third in patients on ventilators, and by one-fifth in patients on oxygen. It may be less likely to help and may even harm patients who are at an earlier stage of Covid-19 infections, however. In its Covid-19 treatment guidelines, the National Institutes of Health recommends only using dexamethasone in patients with COVID-19 who are on a ventilator or are receiving supplemental oxygen.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN HUMANS Cytokine InhibitorsThe body produces signaling molecules called cytokines to fight off diseases. But manufactured in excess, cytokines can trigger the immune system to wildly overreact to infections, in a process sometimes called a cytokine storm. Researchers have created a number of drugs to halt cytokine storms, and they have proven effective against arthritis and other inflammatory disorders. Some turn off the supply of molecules that launch the production of the cytokines themselves. Others block the receptors on immune cells to which cytokines would normally bind. A few block the cellular messages they send. Depending on how the drugs are formulated, they can block one cytokine at a time, or muffle signals from several at once.

Against the coronavirus, several of these drugs have offered modest help in some trials, but faltered in others. Drug companies Regeneron and Roche drug both recently announced that two drugs called sarilumab and tocilizumab, which both target the cytokine IL-6, did not appear to benefit patients in Phase 3 clinical trials. Many other trials remain underway, several of which combine cytokine inhibitors with other treatments.Updated Aug. 10

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN HUMANS EMERGENCY USE AUTHORIZATIONBlood filtration systemsThe F.D.A. has granted emergency use authorization to several devices that filter cytokines from the blood in an attempt to cool cytokine storms. One machine, called Cytosorb, can reportedly purify a patients entire blood supply about 70 times in a 24-hour period. A small study in March suggested that Cytosorb had helped dozens of severely ill Covid-19 patients in Europe and China, but it was not a randomized clinical trial that could conclusively demonstrate it was effective. A number of studies on blood filtration systems are underway, but experts caution that these devices carry some risks. For example, such filters could remove beneficial components of blood as well, such as vitamins or medications.Updated Aug. 10

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN HUMANS Stem cellsCertain kinds of stem cells can secrete anti-inflammatory molecules. Over the years, researchers have tried to use them as a treatment for cytokine storms, and now dozens of clinical trials are under way to see if they can help patients with Covid-19. But these stem cell treatments havent worked well in the past, and its not clear yet if theyll work against the coronavirus.

Doctors and nurses often administer other supportive treatments to help patients with Covid-19.

WIDELY USEDProne positioningThe simple act of flipping Covid-19 patients onto their bellies opens up the lungs. The maneuver has become commonplace in hospitals around the world since the start of the pandemic. It might help some individuals avoid the need for ventilators entirely. The treatments benefits continue to be tested in a range of clinical trials.

WIDELY USEDEMERGENCY USE AUTHORIZATIONVentilators and other respiratory support devicesDevices that help people breathe are an essential tool in the fight against deadly respiratory illnesses. Some patients do well if they get an extra supply of oxygen through the nose or via a mask connected to an oxygen machine. Patients in severe respiratory distress may need to have a ventilator breathe for them until their lungs heal. Doctors are divided about how long to treat patients with noninvasive oxygen before deciding whether or not they need a ventilator. Not all Covid-19 patients who go on ventilators survive, but the devices are thought to be lifesaving in many cases.

TENTATIVE OR MIXED EVIDENCE EVIDENCE IN HUMANS AnticoagulantsThe coronavirus can invade cells in the lining of blood vessels, leading to tiny clots that can cause strokes and other serious harm. Anticoagulants are commonly used for other conditions, such as heart disease, to slow the formation of clots, and doctors sometimes use them on patients with Covid-19 who have clots. Many clinical trials teasing out this relationship are now underway. Some of these trials are looking at whether giving anticoagulants before any sign of clotting is beneficial.

False claims about Covid-19 cures abound. The F.D.A. maintains a list of more than 80 fraudulent Covid-19 products, and the W.H.O. debunks many myths about the disease.

WARNING: DO NOT DO THISDrinking or injecting bleach and disinfectantsIn April, President Trump suggested that disinfectants such as alcohol or bleach might be effective against the coronavirus if directly injected into the body. His comments were immediately refuted by health professionals and researchers around the world as well as the makers of Lysol and Clorox. Ingesting disinfectant would not only be ineffective against the virus, but also hazardous possibly even deadly. In July, Federal prosecutors charged four Florida men with marketing bleach as a cure for COVID-19.

WARNING: NO EVIDENCEUV lightPresident Trump also speculated about hitting the body with ultraviolet or just very powerful light. Researchers have used UV light to sterilize surfaces, including killing viruses, in carefully managed laboratories. But UV light would not be able to purge the virus from within a sick persons body. This kind of radiation can also damage the skin. Most skin cancers are a result of exposure to the UV rays naturally present in sunlight.

WARNING: NO EVIDENCESilverThe F.D.A. has threatened legal action against a host of people claiming silver-based products are safe and effective against Covid-19 including televangelist Jim Bakker and InfoWars host Alex Jones. Several metals do have natural antimicrobial properties. But products made from them have not been shown to prevent or treat the coronavirus.

Note: After additional discussions with experts we have adjusted several labels on the tracker. The Strong evidence label has been removed until further research identifies treatments that consistently benefit groups of patients infected by the coronavirus. In its place, Promising evidence will be used for drugs such as remdesivir and dexamethasone that have shown promise in at least one randomized controlled trial, and Widely used for treatments such as proning and ventilators that are often used with severely ill patients, including those with Covid-19. And we may reintroduce the Ineffective label when ongoing clinical trials repeatedly end with disappointing results.

Sources: National Library of Medicine; National Institutes of Health; William Amarquaye, University of South Florida; Paul Bieniasz, Rockefeller University; Jeremy Faust, Brigham & Womens Hospital; Matt Frieman, University of Maryland School of Medicine; Noah Haber, Stanford University; Swapnil Hiremath, University of Ottawa; Akiko Iwaskai, Yale University; Paul Knoepfler, University of California, Davis; Elena Massarotti, Brigham and Womens Hospital; John Moore and Douglas Nixon, Weill Cornell Medical College; Erica Ollman Saphire, La Jolla Institute for Immunology; Regina Rabinovich, Harvard T.H. Chan School of Public Health; Ilan Schwartz, University of Alberta; Phyllis Tien, University of California, San Francisco.

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Coronavirus Drug and Treatment Tracker - The New York Times

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DUBLIN, Aug. 11, 2020 /PRNewswire/ -- The "Global Induced Pluripotent Stem Cell (iPS Cell) Industry Report" report has been added to ResearchAndMarkets.com's offering.

Since the discovery of induced pluripotent stem cells (iPSCs) a large and thriving research product market has grown into existence, largely because the cells are non-controversial and can be generated directly from adult cells. It is clear that iPSCs represent a lucrative market segment because methods for commercializing this cell type are expanding every year and clinical studies investigating iPSCs are swelling in number.

Therapeutic applications of iPSCs have surged in recent years. 2013 was a landmark year in Japan because it saw the first cellular therapy involving the transplant of iPSCs into humans initiated at the RIKEN Center in Kobe, Japan. Led by Masayo Takahashi of the RIKEN Center for Developmental Biology (CDB), it investigated the safety of iPSC-derived cell sheets in patients with macular degeneration. In another world-first, Cynata Therapeutics received approval in 2016 to launch the world's first formal clinical trial of an allogeneic iPSC-derived cell product (CYP-001) for the treatment of GvHD. Riding the momentum within the CAR-T field, Fate Therapeutics is developing FT819, its off-the-shelf iPSC-derived CAR-T cell product candidate. Numerous physician-led studies using iPSCs are also underway in Japan, a leading country for basic and applied iPSC applications.

iPS Cell Commercialization

Methods of commercializing induced pluripotent stem cells (iPSCs) are diverse and continue to expand. iPSC cell applications include, but are not limited to:

Since the discovery of iPSC technology in 2006, significant progress has been made in stem cell biology and regenerative medicine. New pathological mechanisms have been identified and explained, new drugs identified by iPSC screens are in the pipeline, and the first clinical trials employing human iPSC-derived cell types have been initiated. The main objectives of this report are to describe the current status of iPSC research, patents, funding events, industry partnerships, biomedical applications, technologies, and clinical trials for the development of iPSC-based therapeutics.

Key Topics Covered:

1. Report Overview

2. Introduction

3. History of Induced Pluripotent Stem Cells (IPSCS)

4. Research Publications on IPSCS

5. IPSCS: Patent Landscape

6. Clinical Trials Involving IPSCS

7. Funding for IPSC

8. Generation of Induced Pluripotent Stem Cells: An Overview

9. Human IPSC Banking

10. Biomedical Applications of IPSCS

11. Other Novel Applications of IPSCS

12. Deals in the IPSCS Sector

13. Market Overview

14. Company Profiles

For more information about this report visit https://www.researchandmarkets.com/r/kpc95y

About ResearchAndMarkets.comResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

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Opportunities in the Global Induced Pluripotent Stem Cell (iPS Cell) Industry - PRNewswire

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A Doctor's Journey

I started to realize something was wrong when I saw a patient who was on 10 medications. The first five dealt with ailments while the second five were for the side effects of the first five. Despite the medications, the patient didn't feel any better. This was the beginning of my inquiry into another way to practice medicine.

Sometimes our practice gets lumped into the alternative medicine category. And while we are open to additional ways to treat illness, our protocols are based on science and deduction.

As it relates to hormone balancing, we practice integrative medicine, which is sometimes confused with functional medicine. We will examine all of your hormones including thyroid, adrenals and sex hormones and ensure that they are in balance with each other as opposed to just being within the normal ranges.

We believe that medications are not always the answer and can often mask the true underlying conditions and imbalances. Even my kids chuckle when they see drug commercials that spend 15 seconds on the benefits and 45 seconds on the side effects.

And unfortunately 'healthcare in the U.S. is mistitled. It should be called sick-care because most people only engage the medical system when theyre sick, not when theyre healthy.

Our "hormone specialists" believe the following:

We believe that most people dont want to be on medications or live a sub-standard life but they often don't know what else to do.

At our core, we believe that from an evolutionary standpoint, the body is built to heal itself. Our job is to clear the obstacles and support the body, before resorting to more invasive measures. If this belief makes us alternative medicine doctors, then so be it.

We look forward to meeting you!

- Lauren D. Loya, M.D.

Founder and Medical Director of The Hormone Center

At The Hormone Center, we put an underlying focus on the cause, not the symptom. We are an integrative medicine practice and put our clients first. Some of our most sought-after services include:

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The Hormone Center - Integrative Medicine | Hormone ...

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For people with gender dysphoria, hormone therapy can significantly reduce mental distress and improve quality of life. NYU Langones multidisciplinary transgender program takes an intensely personalized approach to these treatments, centered on the individual patients goals, life circumstances, comorbidities, and evolving clinical response.

Although many medical centers offer gender-affirming hormone therapy, NYU Langone does so under the direction of an endocrinologist who specializes in transgender care. For these patients, the clinicians expertise can be crucial to optimizing outcomes, explains Michele B. Glodowski, MD, clinical instructor in the Department of Medicine, whose fellowship training included extensive clinical rotations at the University of Colorados Integrated Transgender Program.

Gender-affirming hormone therapy typically uses different doses and modalities from hormone replacement therapy for postmenopausal cisgender women or cisgender men with low testosterone. The risk of complications, including certain types of cancer, may be heightened as well. With testosterone, we often see weight gain, changes in LDL and HDL cholesterol, elevations in hematocrit, and increases in insulin resistance and blood pressure, Dr. Glodowski notes. Feminizing regimens, such as estradiol, can also trigger weight gain, raise the risk of cardiovascular disease, and often affect liver enzymes and triglycerides.

Besides enhancing her ability to monitor and manage side effects, Dr. Glodowskis training helps her tailor treatment to patients unique needs. Theres a whole spectrum of gender identity and gender expression, she says, so its important to provide a whole spectrum of care. It looks different for every individual. Some patients, for example, may identify as definitively male or female, others as nonbinary or gender-fluid. Some may choose to have hormone therapy in conjunction with gender confirmation surgery; others may choose hormonesor surgeryalone. And a wide range of external factors may influence patients therapeutic pathways.

Theres a whole spectrum of gender identity and gender expression, so its important to provide a whole spectrum of care.Michele B. Glodowski, MD

Even in 2020, people still lose their jobs or get kicked out of their homes because theyre trans, Dr. Glodowski observes. I want to make sure patients are comfortable with all the social aspects that can come into play with gender transition. If someone says, Im not ready to come out at work yet, we might slow the process down a bit. If they say, my parents have 30,000 questions, we might arrange a visit with mom and dad. Patients may wish to have their eggs or sperm frozen before hormone therapy begins, to preserve their fertility. Those who do sex work might benefit from screening for sexually transmitted diseases, or consultation with a social worker who can connect them with supportive services.

In collaboration with her colleagues in the multidisciplinary transgender programwhose specialties include plastic surgery, gynecology, and urology, in addition to endocrinologyDr. Glodowski is able to ensure that patients receive precisely the care they require.

NYU Langone Health has been certified for 7 consecutive yearswith a score of 100 percentby the Human Rights Campaign Foundation Healthcare Equality Index Report, which evaluates the work of medical facilities in providing equal healthcare access to LGBTQ+ Americans. One factor in that success is the centers patient-centered approach to transgender care.

In some practices, patients can walk into the office and have someone use the wrong pronoun, Dr. Glodowski says. The doctor might see them briefly, write a prescription, and thats basically it. At NYU Langone, everyone from the receptionists to the medical assistants to the physicians have been trained to be sensitive to gender identity. I spend 40 minutes with each new patient, and 20 minutes with any follow-ups. In addition, we have one clinic a week specifically dedicated to gender-affirming hormone therapy.

The 2019 coronavirus disease (COVID-19) pandemic has also made telehealth a crucial component of the transgender programs endocrinology practice. Although the crisis has waned in New York City, many patients prefer to continue with video visitsciting both safety and convenienceafter an initial in-person consultation. At the height of the pandemic, many providers turned to telehealth to limit in-person visits for non-urgent care, Dr. Glodowski explains. But there is a high rate of suicidal ideation and suicide in patients who are trans-identified. For this patient group, almost all care can be described as urgent, especially for someone whos new to hormones and may be experiencing severe dysphoria.

With those who are beginning a course of hormone therapy, Dr. Glodowski typically schedules a video visit to discuss treatment goals, the expected timeline of physiological changes, and potential side effects. We want to make sure that every patient is very well informed, she explains. As treatment progresses, she will order lab work and discuss results with patients via video link, as well as checking on therapeutic progress and the patients comfort level with the regimen.

Whether a visit is in-person or remote, she adds, its always essential that we provide patients with a safe, gender-affirming space.

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Helping Transgender Patients Reap the Benefits & Navigate the Challenges of Hormone Therapy - NYU Langone Health

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Increasing evidence suggests that COVID-19 can cause blood clots, and the risk for those complications may be increased among people who are pregnant or who take estrogen-containing medicine (including some kinds of birth control). So researchers are warning that we need to learn a lot more about how these two factors could converge with potentially lethal results.

In a recent article, published last month in Endocrinology, the two authors lay out the emerging connection between COVID-19 and blood clotsand call for more research into how the coronavirus might impact those who are already at risk for developing blood clots.

People who already are at an increased risk for blood clots and the complications associated with them (such as pulmonary embolism, deep venous thromboembolism, and strokes) include those who are pregnant, those who are taking hormonal birth control, and those on oral estrogen therapy (hormone replacement therapy). So, the authors write, its worth examining whether or not people in those groups who also get COVID-19 are at an especially high risk for blood clots and health issues related to them.

To be clear, there are currently no reports of increased cases of COVID-related blood clots among those who are pregnant, on birth control pills, or taking estrogen therapy, co-author Daniel Spratt, M.D., director of reproductive endocrinology and infertility at Maine Medical Center and professor of Medicine and Obstetrics-Gynecology at Tufts University School of Medicine, tells SELF. However, its definitely plausible those two things in combination would increase your risk, Taraneh Shirazian, M.D., gynecologist at NYU Langone Health, tells SELF, because both being in one of those elevated-risk groups and having COVID-19 individually increase the risk.

However, were still learning quite a bit about how COVID-19 affects the body, including how it might contribute to blood clots. [Were] realizing that were just at the beginning of getting information and understanding if theres a risk or not, Dr. Spratt says.

What we do know is that the association between COVID-19 and blood clots is there, especially among young and otherwise healthy patients, Dr. Spratt says. In general, age and underlying health conditions tend to be some of the most powerful risk factors for severe complications of COVID-19, but that doesnt seem to be the case for coronavirus-related blood clots.

We also dont yet know why or how the infection causes blood clots. There are essentially two major theories right now, Dr. Spratt says, and its likely that both may be at work to different degrees in different patients. According to one theory, the virus responsible for COVID-19 affects the lining of the arteries and veins, setting off a series of molecular signals that make clotting more likely. The second theory has more to do with platelets, a type of blood cell thats involved in clotting. It appears that the coronavirus somehow makes platelets hyperreactive, possibly causing them to clot more frequently.

We also know that theres an association between the hormone estrogen and blood clots, Dr. Shirazian says. In particular, people who are pregnant, taking birth control pills, or taking estrogen therapy are known to be at a higher risk for developing blood clots, she explains. We know a little bit more about why people in these groups may be more likely to experience clots.

During pregnancy, there are physical changes taking place that simply make it more likely for blood to coagulate (a hypercoagulable state, as its known in medical literature). A pregnant person has a 50% increase in blood volume, Dr. Shirazian explains, but also has a significant slowing of blood flow. That creates a situation where theres slowing of the blood and these clots can start [to form] inside of blood vessels, she says.

More here:
What People Taking Birth Control Should Know About COVID-19 and Blood Clots - Self

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Design

The study was designed as a single-center, prospective, double-blind, randomized, placebo-controlled trial, which randomized participants into two groups in a 1:1 ratio. The study adhered to CONSORT guidelines and was approved by the Institutional Review Board of the Faculty of Medicine, Chulalongkorn University (IRB No. 039/2561). The study was also reviewed by the Thai Clinical Trial Registry Committee and prospectively approved for registration since 2018-02-19 11:33:21 and Thai Clinical Trial Registry identification number TCTR20180219001. After approval, participants were included from August 2018 to March 2019. A thorough explanation of the study details was given to all enrolled women. Informed written consent was obtained prior to the start of the study.

Literate Thai women aged 4570years who experienced spontaneous menopause attending the General Gynecologic Clinic, Climacteric and Gender Health Clinic at King Chulalongkorn Memorial Hospital were recruited. Menopause was defined according to WHO criteria as the cessation of the period for at least 12 consecutive months [17].

These women were asked for their vaginal atrophy symptoms and other detailed histories. Participants were included if they reported at least one self-assessed vaginal atrophy symptom in moderate or severe intensity and reported engaging in penile-vaginal penetrative sexual intercourse at least once a month. Those with pathological or surgical causes of menopause, using menopausal hormone therapy (MHT) or non-hormonal treatment that might affect the vaginal epithelium, having abnormal vaginal bleeding/discharge without prior appropriate investigation and treatment, cervical or vaginal surgical history within the previous 3months, history of sex steroid hormone use 2months prior to study, history of psychiatric disorders or having partner with sexual dysfunction, contraindications for MHT including personal or family history of estrogen-related cancer, severe liver or kidney diseases and any suspected allergy to MHT, were excluded from the study. The recruited subjects were then asked to complete a 19-item Thai version of the Female Sexual Function Index questionnaire, and those that scored >26.55 points were then excluded as having no FSD. The Thai version of the Female Sexual Function Index questionnaire was validated in previous study among Thai postmenopausal women, aged 4060years, with high reliability coefficients and internal consistency (r=0.790.86, Cronbachs alpha value=0.82) [18]. After pelvic examination and test for vaginal pH, those with pH more than 5 were qualified for the study as they were likely to have poor estrogenic vaginal mucosa and might benefit from the treatment.

A computer generated block of four randomizations was used to randomize participants into two groups in a 1:1 ratio. The allocation and concealment of placebo and the drugs into identical opaque envelopes were done by a nurse who was not involved in contacting with patients or analyzing any data, thus blinding investigators, assessors, cytologist, microbiologist and all participants.

The sample size of this study was estimated based on our pilot study, conducted with 10 participants enrolled in both arms. The following formula was used for comparing continuous data in a randomized controlled trial [19].

$$ {displaystyle begin{array}{c}{n}_{trt}=frac{{left({z}_{1-frac{alpha }{2}}+{z}_{1-beta}right)}^2;left[sigma {}_{trt}{}^2 + frac{sigma {}_{con}{}^2}{r}right]}{varDelta^2}\ {}r=frac{n_{con}}{n_{trt}},varDelta ={mu}_{trt}-{mu}_{con}end{array}} $$

According to our pilot study, trt (mean value) and trt (standard deviation) of total FSFI at 12week follow up in treatment group were 26.8 and 5.7, respectively; con and con of total FSFI at 12week follow up in control group were 23.0 and 4.7, respectively. The ratio between groups (r) was set as 1 for 1:1. With using =0.05 and =0.2, the sample size needed for this study was 30 participants per group. Predicting a 10% drop out rate, the sample size was increased to 33 participants per group.

After completion of history taking and filling all the questionnaires, participants who met the inclusion criteria mentioned above were asked to undergo a pelvic examination, all conducted by single investigator (T.B.). A dry speculum was inserted without lubrication. A pH-indicator strip (pH range 014, Merck, Germany) was placed over the upper to the middle third of the lateral vaginal wall with contact time between the pH-indicator strip and the examined vaginal wall for 3s.

Two dry cotton buds were used to scrape contralateral vaginal wall. Each cotton bud was smeared onto each different glass slide. One slide was left to air dry and sent for evaluation of Normal Flora Index (NFI) with Gram staining by single microbiologist (T.C.), unaware of treatment allocation, participant symptoms and characteristics. NFI, representing vaginal microenvironment, consisted of 4 parameters, i.e., the number of lactobacilli, pathogenic microorganisms, leukocytes, and vaginal pH. Each parameter was graded on a 4-point scale (Table1). Pathogenic microorganisms included Gardnerella, Bacteroides, Mobiluncus and gram-variable bacilli [21, 22].

The other slide was fixed with 95% ethanol solution for 30min and sent for staining in accordance with Papanicolaou test. The slide was evaluated for Vaginal Maturation Value (VMV) by single cytologist (C.A.), unaware of treatment allocation, participant symptoms/characteristics. VMV, calculated from the formula: (% of intermediate cells 0.5)+(% of superficial cells 1), is considered as a surrogate of vaginal epithelium estrogen status [23, 24,25,26].

The number of lactobacilli, pathogenic microorganisms and VMV was evaluated under the microscope with 1000x magnification (HPF). The number of leukocytes was evaluated under the microscope with 400x magnification.

Participants were then examined with transvaginal ultrasonography for baseline endometrial thickness [Samsung SONOACE R7, 2D imaging mode, grayscale 256 (8 bits), EVN49 probe 3.5MHz, single operator (T.B.)]. Blood samples were taken for baseline hematocrit, SGOT, SGPT, alkaline phosphatase, total cholesterol, LDL, HDL, triglycerides and estradiol level. The samples were analyzed immediately, or stored at 4 degrees Celsius until analysis no more than 24h later. All blood sample analyses were done with routine laboratory testing platform for research projects at the King Chulalongkorn Memorial Hospital, strictly adhering to the manufacturers protocol and in accordance with the laboratorys standard operating procedures for good laboratory practice.

After the recruitment process, participants were randomized into the conjugated estrogens or the placebo groups. The estrogens or placebo was given in numbered as identical opaque envelopes with instruction leaflet. The treatment arm was conjugated estrogens tablet (EstromonTM, 0.625mg). The placebo arm was lactose 90%, polyvinyl pyrrolidone K30 5%, magnesium stearate 3%, talcum 1% erythrosinelahe dye 1% and water which was evaporated completely during manufacturing. The placebo was made by the Faculty of Pharmaceutical Science, Chulalongkorn University and was visually identical to the conjugated estrogens tablet. No participants reported allergic reactions to lactose, talcum or any substances used in the study. Participants were required to insert each pill vaginally as deeply as possible every day for 3weeks. After 3weeks of participation, the investigator called to each participant to check on adherence, problems of drug administration or adverse reactions and willingness to continue the study, after which participants were advised to continue the study by inserting a pill vaginally twice weekly on every Monday and Friday night for the next 9weeks. The regimen was extrapolated from recommendation for treating dyspareunia with conjugated estrogen vaginal cream [11].

After the 12th week of study, each participant came back for reevaluation of symptoms, filling out questionnaires, undergoing pelvic examination for vaginal pH, smear for NFI and VMV, transvaginal ultrasonography and blood samples.

The primary outcome of this study was the changes of FSFI of the two treatment arms. FSFI was one of the validated standard questionnaires frequently used for assessing female sexual function and quality of life in clinical trials or epidemiological studies concerning sexual study [20, 27]. Since there were no validated measurement tools specifically designed for female sexual function and dysfunction in menopausal population, and FSFI was frequently used in researches concerning female sexual function and quality of life in menopausal population, the index was selected for this study. The questionnaires consisted of 19 self-reporting rating-scale items, assessing 6 domains of sexual function; desire, arousal, lubrication, orgasm, satisfaction and pain. Each item has a scaled response ranging from 0 to 5 or 1 to 5; with higher scores representing better sexual function (Table1). Each domain score is calculated by summation of scores from every item in the domain multiplied by the domain factor (i.e., 0.6 for desire, 0.3 for arousal and lubrication, 0.4 for orgasm, satisfaction and pain), thus the full score of each domain is 6. The possible full scores of total FSFI ranges from 2.0 to 36.0, with cut-off point of 26.55 or less considered FSD in premenopausal and postmenopausal women population [28]. However, there is no specific cut-off score for FSD in a population with GSM [29].

Secondary outcomes were changes in vaginal pH, VMV, NFI, and the Most Bothersome Symptoms (MBS). The MBS, also known as the vaginal atrophy symptoms consists of 4 symptoms; vaginal dryness, vaginal/vulvar irritation/itching, vaginal/vulvar soreness, and dyspareunia. Each symptom is self-graded by participants on a 4-point scale (0=no symptom, 1=mild, 2=moderate, 3=severe) [30]. Only those reported at least one self-assessed vaginal atrophy symptom in moderate or severe intensity were included. The safety parameters assessed were changes in hematocrit, SGOT, SGPT, alkaline phosphatase, total cholesterol, LDL, HDL, triglycerides, estradiol level and endometrial thickness.

IBM SPSS statistics version 18.0 for Windows was used for statistical analysis. The treatment effect was evaluated with intention-to-treat analysis, with missing data assumed by multiple imputation method. Baseline demographic characteristics were presented using descriptive statistics; mean and standard deviation (SD), median and interquartile range (IQR), or number and percentage as appropriate. Primary and secondary outcome comparisons between groups were evaluated with Mann-Whitney U test or analysis of covariance (ANCOVA), with treatment arm as a fixed effect in the model and the baseline value used as a covariate, according to data distribution characteristics. P-value of less than 0.05 is determined statistically significant.

Continued here:
Effects of vaginal administration of conjugated estrogens tablet on sexual function in postmenopausal women with sexual dysfunction: a double-blind,...

Recommendation and review posted by Bethany Smith

Set on Spains Costa Blanca, SHA Wellness Clinic is one of the worlds premier wellness destinations. This health resort has been known to attract everyone from elite athletes, to Hollywood celebrities and Victorias Secret models, as well as assorted oligarchs and billionaires. They come to lose weight, detox, or participate inSHAs Healthy Aging program. Others want to reset their minds and bodies, adopt new healthy habits, or simply get away from it all.

Set on a hillside overlooking the Mediterranean Sea, SHA Wellness Clinic is one of the world's ... [+] premier wellness destinations.

Devised by wellness guru Alfredo Bataller, the immensely successful SHA method is based on aholistic approach to wellness that combinesthe latest advances in Western medicine and progressive natural therapies, with a particular focus on healthy, balanced nutrition and exercise.

Since reopening in July, SHA has introduced a series of new services specially designed for the COVID-19 era. Immunotherapy and lymphocyte profile consultations have been added to all bookings to assess the state of the guests immune system, while a new immune system strengthening pack has also been developed. A comprehensive SHA insurance covers medical and related expenses in the event of positive COVID-19 test on arrival.

People from all over the world come to SHA Wellness Clinic in Spain to reset their bodies and minds.

So, how can we apply the SHA method to our everyday lives to give our immune systems an extra boost in times of COVID-19? Here are some tips from Alfredo Bataller and his team of experts at SHA Wellness Clinic:

Alfredo Bataller, founder of SHA Wellness Clinic: A balanced diet that includes plenty of fruit and vegetables, vitamin C and antioxidants helps reinforce the immune system andprevent disease. Its highly recommended to choose fruit and vegetables that are in season to ensure that they are as fresh and nutritious as possible.

Melanie Waxman, healthy nutrition expert: To keep the immune system in perfect working order, we should enjoy a diet based on fresh food that helps to maintain the balance of the intestinal microbiota. It should include whole grains, beans, seaweed (spirulina), nuts, seeds, green leafy vegetables, such as kale, onions, garlic, leeks and asparagus, and fruit, such as apples.

The diet at SHA Wellness Clinic is based on organic, seasonal fruit, vegetables, seeds, nuts, and ... [+] some fish and seafood. Like this red shrimp ceviche with cucumber and yellow aj peppers.

Luis Ganso, personal trainer: Moderate exercise, such as 30 minutes of fast-paced walking, has been shown to improve the function of the immune system. This type of exercise strengthens our respiratory capacity, mobilizing antibodies and white blood cells to circulate more quickly, and detect and neutralize external attacks. Meanwhile, raising the body temperature helps to prevent the development of infection.

Alfredo Bataller: Its always a good idea to spend some time during the day walking outdoorspreferably in nature. Spending time outdoors is important for breathing fresh air and absorbing the vitamin D provided by the sun, which is so crucial to support calcium absorption and the proper functioning of the immune system.

Exercise is always good for us and even better if we can do it outdoors. "Spending time outdoors is ... [+] important for breathing fresh air and absorbing the vitamin D provided by the sun," says SHA's founder Alfredo Bataller.

Alfredo Bataller: Exercise is always good, even if we may have lost motivation during lockdown or if we feel tired or low on energy. Exercise strengthens the immune system and makes our bodies secrete happy hormones, or endorphins, while reducing the level of the stress hormone, cortisol. Stress is harmful to the body, and, having less of it actually strengthens the immune system.

Rachel Rose, body and mind expert and yoga coach: Stable mental health is basic to managing stress, which, in turn, impacts the immune system. Lymphocytes are found in lymph nodes and organs, and in the blood. Lymph nodes are the bodys first line of defense against disease.Breathing is directly related to lymph flow, and lymph flow is directly related to immunity.

The diaphragm muscle, located between the lungs and the abdomen moves down when we inhale and up when we exhale. This movement causes a series of pressure differences that generate movement in the body. Lymph flow, or the mechanism that transports thelymph containing our infection-fightingwhite blood cellsthroughout thebody, is one of the most crucial movements supported by deep breathing.

Some people come to SHA to get fit, detox or lose weight, while others just want to get away from it ... [+] all.

Alfredo Bataller: Getting quality sleep is essential to reinforcing our immune system, while not getting enough sleep can cause our immunity to decline, making us more prone to infectious diseases. Adults should sleep at least seven to eight hours a day.

Maria Romeralo, healthy nutrition expert: When we start the day with sugary coffee and a pastry, we instantly feel good and full of energy. However, after a while, our energy levels drop and our bodies demand more sugar. This is why its important to avoid refined sugar, artificial sweeteners and honey at breakfast.

At SHA, we serve miso soup for breakfast. Miso soup is a great source of protein, vitamins, minerals and enzymes. You can make it even richer by adding wakame seaweed, onions, tofu, carrots or pumpkin. It's a wonderful way to cleanse the body while providing quality nutrients. Miso is a fermented food and therefore a source of probiotics that also help strengthen our immune systems.

Miso soup is a breakfast staple at SHA Wellness Clinic. It is a great source of protein, vitamins, ... [+] minerals and enzymes.

Alfredo Bataller: Confinement can lead to loneliness, sedentariness and depression, all of which are detrimental to the proper functioning of the immune system. Contact with our loved ones helps calm the mind, enables us to cope with the stress of these uncertain times, and also reduces the risk of obesity and alcohol and tobacco abuse.

Melanie Waxman, healthy nutrition expert: Its important to transition to a healthy lifestyle gradually, with a view to maintaining it long term. At SHA, we give our guests the necessary tools to start leading that lifestyle once they leave: healthy cooking classes, yoga classes, outdoor exercise, nutrition and medical advice on everything from quitting smoking, to sleeping, and strengthening the cognition. Once back in their routine, theyre encouraged to adopt these activities until they become habits.

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10 Ways To Boost Your Immune System In Times Of COVID-19, According To SHA Wellness Clinic - Forbes

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This story was published in partnership with The 19th, a nonprofit, nonpartisan newsroom reporting on gender, politics and policy.

Eugene Robinson recovered from his double mastectomy on a hospital porch in Durham, North Carolina. It was August 1956, and as a Black child in the Jim Crow South, Robinson wasnt allowed to heal next to White patients.

Sarah Robinson, Eugenes mother, brought a daughter to the hospital. She returned home with a son. It was his third of four surgeries. Two of his nine siblings had undergone similar operations, but his relatives never talked about the fact that androgen insensitivity syndrome, a genetic intersex condition, ran in the family.

Nearly 65 years later, Sean Saifa Wall, 41, sifts through Robinsons medical records, looking for answers about his uncles story that might shed light on his own. Wall, like Robinson, is intersex.

Sean Saifa Wall is a co-founder of the Intersex Justice Project, which has protested intersex surgeries at Lurie Children's Hospital of Chicago for years. Since the 1960s, medical convention has been that intersex variances should be "corrected," often through a combination of surgeries and hormone therapy starting from infancy or before a child can consent.(Photo: Sarah-Ji/Intersex Justice Project)

Intersex is an umbrella term for people with variations in sex characteristics that dont fit neatly in the binary of male or female. Some intersex people are born with varying reproductive anatomy or sex traits some develop them later in life.About 1.7 percentof people are born intersex, according to a 2000 report byDr. Anne Fausto-Sterling.

Since the 1960s, medical convention has been that intersex variations should be corrected, often through a combination of painful surgeries and hormone therapy starting from infancy or before a child can consent. But on July 28, the Ann and Robert H. Lurie Childrens Hospital of Chicago became the first hospital in the United States to suspend the operations. The news comes after a three-year campaign against the hospital led by Wall and Pidgeon Pagonis, co-founders of the Intersex Justice Project.

Activists have been protesting intersex surgeries since 1996, when a group demonstrated outside the American Academy of Pediatrics convention in Boston. Since then,the U.N. has condemned the surgeries,which remain legal in almost every country in the world,as irreversible and unnecessary procedures that can cause permanent infertility and lifelong pain, incontinence, loss of sexual sensation, and mental suffering.

Wall knows that pain intimately.

Wall came out as gay at age 14. Then, he came out as transgender. In both cases, his mom lost it, he said. She was like, Why do you want to wear mens clothes, mens underwear?

But Walls oldest aunt reminded his mom about his intersex uncle, now deceased. His aunt said, Do you not remember playing with Queen Esther as a child?

And my mom was like, Whos that? And shes like, 'Thats Gene.

Wall says the memory blew my moms mind for seven years she had a sister. Looking back, she did remember Esther.

Eight of his family members were intersex, Wall says. The more that Wall started to talk about himself, the more his family opened up about their own histories.

Up until the time he was 13, Walls mom resisted doctors insistence that he have surgery to remove undescended testes, he says. She saw his older intersex siblings suffer through their own operations and thought they were unnecessary.

They told my mom that the testes were cancerous, Wall said. So his mom agreed to the surgery. Wall never had cancer.

He had spent two years under the care of a doctor that he says studied him, asking him questions about whether or not hormones made him less gay. Still, it wasnt until college, while doing a Yahoo internet search, that Wall pieced together that he is intersex.

I was so angry, he said. I was like, Oh, this is not fair. Its not right.' I didnt talk about it for a while. I would tell people here and there, but I didnt talk about it publicly because I had so much shame.

I was so angry. ... I would tell people here and there, but I didnt talk about it publicly because I had so much shame.

When he was 25, he started taking testosterone, something he wanted to do as a trans person to confirm his gender. But he wasnt metabolizing the testosterone the way most people on the hormone do.

I think I felt really suicidal, he said, referring to people constantly misgendering him. But I knew that if I took my own life, that no one would ever know what happened to me, and no one would ever know my side of the story.

Thats when Wall decided to start organizing for intersex rights.

For 19 years, Lurie patient Pidgeon Pagonis also believed they had survived ovarian cancer. The surgeries and exams started before Pagonis could remember, at 6 months old. They had another operation when they were 3 or 4 years old, and another when they were 10.

Pidgeon Pagonis, co-founder of the Intersex Justice Project, at a protest in 2017.(Photo: Sarah-Ji/Intersex Justic Project)

Since I was like 11 they would always just lift my shirt off, touch my chest and then pull my pants down and look at my vulva area, Pagonis recalls. And then theyd ask me questions like, How are you? How are your grades?

Pagonis thought that because of the cancer, they would never be able to have a baby. In truth, Pagonis never had cancer. Years of intersex surgeries to make their body conform to the idea of the female sex had left them unable to feel most sexual sensation.

They spent 18 years in and out of Lurie for surgeries, hormones and exams. Doctors would ask Pagonis if they had questions. Pagonis wanted to know why they were experiencing puberty differently than other kids.

I didnt know I had a vaginoplasty, and I didnt know I was intersex, Pagonis said. I did not know I had a castration, and I did not know I had a clitorectomy at that point. I thought I survived cancer.

Pagonis attended college practically in the shadow of the hospital at DePaul University, watching doctors come and go as they studied for finals. It wasnt until they learned about intersex issues at DePaul that they realized that all those visits to Lurie hadnt been about cancer at all.

I just thought these were my doctors that I had to go to because I had cancer when I was a kid, Pagonis said. And also, I was so unlucky that I had this urethra problem.

No other major U.S. hospital has ever stated that they dont perform intersex surgeries, so Lurie was far from the only institution performing such procedures. However, Lurie has enjoyed a sterling reputation among LGBTQ+ people since 2013, when it opened one of the first pediatric gender clinics in the nation under the leadership of Dr. Robert Garofalo, a nationally renowned expert in transgender health. Under Garofalos leadership in the Gender & Sex Development Program, Lurie became thefirst hospital in the United Statesto adopt a trans-inclusive policy for its young patients.

That prestige made Lurie a prime target for a campaign to end intersex surgeries. Intersex activists have long pointed to a disconnect between the gender-affirming care for trans and non-binary youth at the hospital and surgeries done on intersex children without their knowledge or consent.

The truth of the matter is they are very distinct and separate populations in many ways, said Garofalo. But there are areas where there are some overlaps.

And those cast a pall on the gender clinic as calls to end the surgeries overwhelmed its social media channels.

The Intersex Justice Project Pagonis and Walls organization of intersex activists of color led its first protests against Lurie in 2017 and again in 2018, when the Androgen Insensitivity Syndrome-Differences of Sex Development Support Group held its conference in Chicago. About 70 people showed up to protest outside Lurie. Since that time, Lurie has been the target of a relentless campaign to end the surgeries, and protests outside the hospital have only grown.

In July, Pose star Indya Moore excoriated the hospital for using their image to promote LGBTQ+ inclusion.

You cannot stand W/ trans ppl & step ON intersex ppl! Moorewrote on Twitter. The tweet set off a firestorm of bad press for the hospital as an old petition against the surgeries at Lurie racked up 45,000 signatures.

Garofalo said the hospital has long been revising its polices on intersex care, but it had never apologized for the harm those surgeries had caused.

I mean, the truth of the matter is that it has been uncomfortable for me at times, conceded Garofalo, who does not oversee intersex care at the hospital.

On July 28, the same day the hospital announced it was suspending the surgeries, the hospital apologized.

We empathize with intersex individuals who were harmed by the treatment that they received according to the historic standard of care, and we apologize and are truly sorry, the hospitalstatedin a letter signed by President and CEO Dr. Thomas Shanley. When it comes to surgery, we are committed to reexamining our approach.

Intersex is an umbrella term for people with variations in sex characteristics that dont fit neatly in the binary of male or female. About 1.7 percentof people are born intersex, according to a 2000 report byDr. Anne Fausto-Sterling.(Photo: Oleksii Liskonih, Getty Images/iStockphoto)

A number of staffers within Lurie pushed for an end to the surgeries, most notably transgender research coordinator Dr. Ellie Kim, who publicly criticized the practice.

I really owe Ellie a debt of gratitude for really stepping forward and not being shy about her thoughts on the matter, Garofalo said. And to that extent, Im really proud to be where Im at.

Luries end to intersex surgeries marks a watershed moment for intersex rights. Lurieis rankedamong the top pediatric hospitals in the nation, and intersex rights activists hope that other hospitals follow suit.

But for advocates like Wall, the campaign has also taken a deep toll. Pagonis and Wall garnered support and educated the public by sharing intimate personal stories. Its largely considered disrespectful for reporters to ask transgender people about their surgeries or genitalia. Intersex activists dont have that luxury yet, says Hans Lindahl, director of communications for youth intersex organization InterAct.

Something that we say a lot is that we have not yet had our Laverne Cox moment, said Lindahl. Were still so under the purview of being medicalized that I think theres a pressure that we almost have to tell these stories at this point in our movement in order to get people to listen.

For Pagonis and Wall, that has meant revealing details about their own traumas, sexual experiences, anatomy and family histories.

And largely lost in this moment is the history of intersex surgery itself. Intersex operations were born out of gynecology, a practice developed byJames Marion Sims, who performed brutal experiments on enslaved Black women without anesthesia. Although intersex surgeries were popularized in the 1960s, doctors had been doing them for years before, as Walls family history shows.

Wall says his family was already harassed as a Black family in the segregated South. But a Black family with three kids whose sex characteristics varied meant they were tormented endlessly.

So for me, my intersex story comes out of this legacy thats rooted in the South, thats rooted in North Carolina, Wall said. By the time this intersex variation appeared in my family, there was knowledge and awareness of it, but people didnt talk about it, because there was shame and stigma and secrecy.

Read or Share this story: https://www.usatoday.com/story/news/politics/2020/08/10/activists-against-intersex-surgeries-mark-lurie-win-heavy-cost/3320963001/

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After years of protest, a top hospital ended intersex surgeries. For activists, it took a deep toll. - USA TODAY

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For a world crippled by the coronavirus, salvation hinges on a vaccine.

But in the United States, where at least 4.6 million people have been infected and nearly 155,000 have died, the promise of that vaccine is hampered by a vexing epidemic that long preceded COVID-19: obesity.

Scientists know that vaccines engineered to protect the public from influenza, hepatitis B, tetanus and rabies can be less effective in obese adults than in the general population, leaving them more vulnerable to infection and illness. There is little reason to believe, obesity researchers say, that COVID-19 vaccines will be any different.

Will we have a COVID vaccine next year tailored to the obese? No way, said Raz Shaikh, an associate professor of nutrition at the University of North Carolina-Chapel Hill.

Will it still work in the obese? Our prediction is no.

More than 107 million American adults are obese, and their ability to return safely to work, care for their families and resume daily life could be curtailed if the coronavirus vaccine delivers weak immunity for them.

In March, still early in the global pandemic, a little-noticed study from China found that heavier Chinese patients afflicted with COVID-19 were more likely to die than leaner ones, suggesting a perilous future awaited the U.S., whose population is among the heaviest in the world.

And then that future arrived.

As intensive care units in New York, New Jersey and elsewhere filled with patients, the federal Centers for Disease Control and Prevention warned that obese people with a body mass index of 40 or more known as morbid obesity or about 100 pounds overweight were among the groups at highest risk of becoming severely ill with COVID-19. About 9% of American adults are in that category.

BMI of 30 is at risk

As weeks passed and a clearer picture of who was being hospitalized came into focus, federal health officials expanded their warning to include people with a body mass index of 30 or more. That vastly expanded the ranks of those considered vulnerable to the most severe cases of infection, to 42.4% of American adults.

Obesity has long been known to be a significant risk factor for death from cardiovascular disease and cancer. But scientists in the emerging field of immunometabolism are finding obesity also interferes with the bodys immune response, putting obese people at greater risk of infection from pathogens such as influenza and the novel coronavirus. In the case of influenza, obesity has emerged as a factor making it more difficult to vaccinate adults against infection. The question is whether that will hold true for COVID-19.

A healthy immune system turns inflammation on and off as needed, calling on white blood cells and sending out proteins to fight infection. Vaccines harness that inflammatory response. But blood tests show that obese people and people with related metabolic risk factors such as high blood pressure and elevated blood sugar levels experience a state of chronic mild inflammation; the inflammation turns on and stays on.

Adipose tissue or fat in the belly, the liver and other organs is not inert; it contains specialized cells that send out molecules, like the hormone leptin, that scientists suspect induces this chronic state of inflammation. While the exact biological mechanisms are still being investigated, chronic inflammation seems to interfere with the immune response to vaccines, possibly subjecting obese people to preventable illnesses even after vaccination.

An effective vaccine fuels a controlled burn inside the body, searing into cellular memory a mock invasion that never truly happened.

Blunted response to vaccines

Evidence that obese people have a blunted response to common vaccines was first observed in 1985 when obese hospital employees who received the hepatitis B vaccine showed a significant decline in protection 11 months later that was not observed in non-obese employees. The finding was replicated in a follow-up study that used longer needles to ensure the vaccine was injected into muscle and not fat.

Researchers found similar problems with the hepatitis A vaccine, and other studies have found significant declines in the antibody protection induced by tetanus and rabies vaccines in obese people.

Obesity is a serious global problem, and the suboptimal vaccine-induced immune responses observed in the obese population cannot be ignored, pleaded researchers from the Mayo Clinics Vaccine Research Group in a 2015 study published in the journal Vaccine.

Vaccines also are known to be less effective in older adults, which is why those 65 and older receive a supercharged annual influenza vaccine that contains far more flu virus antigens to help juice up their immune response.

By contrast, the diminished protection of the obese population both adults and children has been largely ignored.

Im not entirely sure why vaccine efficacy in this population hasnt been more well reported, said Catherine Andersen, an assistant professor of biology at Fairfield University who studies obesity and metabolic diseases. Its a missed opportunity for greater public health intervention.

In 2017, scientists at UNC-Chapel Hill provided a critical clue about the limitations of the influenza vaccine. In a paper published in the International Journal of Obesity, they showed for the first time that vaccinated obese adults were twice as likely as adults of a healthy weight to develop influenza or flu-like illness.

Curiously, they found that adults with obesity did produce a protective level of antibodies to the influenza vaccine, but they still responded poorly.

That was the mystery, said Chad Petit, an influenza virologist at the University of Alabama.

One hypothesis, Petit said, is that obesity may trigger a metabolic dysregulation of T cells, white blood cells critical to the immune response. Its not insurmountable, said Petit, who is researching COVID-19 in obese patients. We can design better vaccines that might overcome this discrepancy.

Historically, people with high BMIs often have been excluded from drug trials because they frequently have related chronic conditions that might mask the results. The clinical trials underway to test the safety and efficacy of a coronavirus vaccine do not have a BMI exclusion and will include people with obesity, said Dr. Larry Corey, of the Fred Hutchinson Cancer Research Center, who is overseeing the phase 3 trials sponsored by the National Institutes of Health.

Although trial coordinators are not specifically focused on obesity as a potential complication, Corey said, participants BMI will be documented and results evaluated.

Dr. Timothy Garvey, an endocrinologist and director of diabetes research at the University of Alabama, was among those who stressed that, despite the lingering questions, it is still safer for obese people to get vaccinated than not.

The influenza vaccine still works in patients with obesity, but just not as well, Garvey said. We still want them to get vaccinated.

This story was first published Aug. 6, 2020, by Kaiser Health News (KHN), a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

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Americas obesity epidemic threatens effectiveness of any COVID vaccine - The CT Mirror

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Stomach pain is something pretty much everyone is acquainted with at some point in their lives. While some conditions are mild enough to be treated with at-home remedies, its possible youre dealing with something more serious if your pain is severe or happening all the time. So you definitely want to get to the bottom of that tricky Q: Why does my stomach hurt?

There are various causes of stomach pain, which can be acute or chronic and can be caused by issues relating to the stomach, appendix, gallbladder, spleen, bowel, liver, gynecological issues, or other issues, says Michael D. Dann, MD, a gasteroenterologist at Manhattan Gastroenterology in New York City. A thorough examination and further investigation can help you to understand and properly treat the cause of your pain.

Because the list of possible causes is pretty long, Dr. Dann recommends that all persistent or intense abdominal pain always be evaluated with a thorough consultation and examination by a gastroenterologist for an accurate diagnosis and treatment plan. While there are tons of totally harmless reasons that you're stomach hurts (hi, indigestion!), you def want to rule out a serious illness or condition.

Read on for 32 potential causes of stomach pain, as well as how to identify and treat them.

IBS is one of the most common causes of abdominal pain, says Dr. Dann. Symptoms typically include pain in the belly and abdomen area that is nagging and chronic, altered bowel habits, nausea, and vomiting.

How to treat it: Treatment will vary depending on symptoms can include dietary modifications, medication, and lifestyle behavior changes (think: adapting new stress management techniques, as stress can exacerbate IBS symptoms).

Symptoms of lactose intolerance include a crampy abdominal pain (often in the lower abdomen), bloating, flatulence, nausea, diarrhea and vomiting, all after eating dairy products that contain the sugar molecule lactose.

How to treat it: The most obvious way to treat lactose intolerance is to eliminate or limit dairy products from your diet, says Dr. Dann. You can also take an enzyme replacement to relieve symptoms, or treat secondary causes of lactase deficiency, such as with calcium and vitamin D supplementation.

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Patients with gastroesophageal reflux disease (GERD) typically complain of heartburn, regurgitation, and difficulty swallowing, says Dr. Dann. However, some patients may also deal with abdominal or chest pain, nausea, chronic cough, hoarseness, or wheezing.

How to treat it: Mild and intermittent symptoms can be managed with lifestyle and dietary modification, says Dr. Dann. Medication may be needed for persistent or frequent symptoms and can include antacids, histamine H2 receptor blockers (such as Pepcid, a.k.a. famotidine), or proton pump inhibitors such as Prilosec (omeprazole). Severe symptoms may require surgery.

4. Gas and bloating

Gas in your digestive tract comes from either swallowed air and the normal breakdown of certain undigested foods by harmless bacteria that are naturally present in the large intestine, per Dr. Dann. Although it can often cause embarrassing moments, its a normal aspect of digestion. Gas pain and other symptoms like burping, flatulence, bloating, and cramping can be exacerbated by certain foods such as dairy products and artificial sweeteners, according to the Mayo Clinic.

How to treat it: If its not related to another condition, gas can often be treated and managed with various over-the-counter medications (such as Beano or Gas-X) and dietary changes. If you experience chronic gas and severe pain, it could be a sign of another underlying GI condition, which a doc can help to diagnose.

5. Food poisoning

Food poisoning results from eating contaminated food, causing symptoms such as nausea, vomiting and diarrhea, in addition to abdominal pain, according to the Mayo Clinic.

How to treat it: Food poisoning can often be treated at home by replacing fluids and electrolytes and letting it run its course. But if you experience severe symptoms like dehydration, bloody stool, and a fever over 100 degrees, you should seek medical attention.

6. Indigestion

Indigestion is pretty much just the formal name for having an upset stomach, marked by upper abdominal pain, often after a meal. Other symptoms can include gas and nausea, according to the Mayo Clinic.

Gastritis is the term for inflammation involving the lining of the stomach. Symptoms are similar to GERD and include abdominal discomfort/pain, heartburn, nausea, and vomiting. Gastritis can be caused by irritation due to excessive alcohol use, stress, medication such as anti-inflammatory drugs, bile reflux, and infections caused by bacteria like Helicobacter pylori, the latter of which can also lead to ulcers and stomach cancer.

How to treat it: Treatment depends on the specific cause, of course. For example, acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances. Medications that block or reduce acid production and promote healing can also help, as can antacids and antibiotics to treat H. pylori infection.

This condition typically includes upper abdominal pain with the pain occasionally localizing to one side, says Dr. Dann. Additional symptoms include abdominal bloating, fullness, nausea, and the inability to eat a full meal, or feeling full after only a small amount of food.

How to treat it: To treat this condition, with the guidance of a doctor, discontinue use of nonsteroidal anti-inflammatory drugs and work to eliminate H. pylori with appropriate medications to promote ulcer healing, says Dr. Dann.

This is the term used to describe gastrointestinal symptoms where the cause seems to be unknown. Symptoms of functional dyspepsia can overlap with GERD and gastritis, says Dr. Dann.

How to treat it: Patients under 60 years of age should be tested and treated for H. pylori, says Dr. Dann. This sometimes will include an upper endoscopy, particularly if theyre over age 60. Patients who are H. pylori negative or who continue to have symptoms after gettiing rid of the bacteria should be treated with antisecretory therapy with a proton pump inhibitor.

These are the terms for inflammation in the lining of the intestines and colon, respectively. Symptoms will vary based on the location and cause. In both cases, the underlying cause could be due to a condition such as Crohns disease or even something more benign such as a lack of blood flow to the abdominal area, says Dr. Dann. Patients with infectious colitis generally have diarrhea associated abdominal pain, which may be severe.

How to treat it: Depending on the severity of symptoms, antibiotics may be needed.

Acute appendicitis typically presents initially with pain around the belly button which radiates into the right lower quadrant of the abdomen area, says Dr. Dann. It is associated with nausea, vomiting, and loss of appetite.

How to treat it: For patients with non-perforated appendicitis (meaning the appendix hasn't bursted), you'll likely need an appendectomy in a fairly timely fashion. If the appendix hasnt been ruptured, you may be able to treat it solely with antibiotics. If the appendix has ruptured? You'll need emergency surgery.

Gallstones can cause intense discomfort or sharp pain located in the right upper quadrant or other area below the chest. That's because gallstones occur when digestive fluid deposits have hardened in the gallbladder, and these "stones" have temporarily blocked the duct, causing discomfort and pain. The pain may radiate to the back and right shoulder blade and symptoms can also include nausea, vomiting, and sweating. Pain can last 30 to 90 minutes at a time, and an abdominal examination unfortunately wont tend to show much, says Dr. Dann.

How to treat it: During a gallstone attack, pain can be controlled with nonsteroidal anti-inflammatory drugs. Elective gallbladder removal should be considered for patients with gallstones on imaging to prevent future attacks and complications of gallstone disease, says Dr. Dann.

This is the term for when inflammation occurs in the gallbladder, typically from a clogged duct (like from a gallstone). Acute cholecystitis symptoms can include severe, prolonged, steady pain (like for more than four to six hours) involving the right upper quadrant. You may also have a fever and an elevated white blood cell count, and you may be hypersensitive when you put pressure on the area below the ribs while breathing deeply.

How to treat it: This is a more serious condition that requires hospitalization, says Dr. Dann. Treatment will include intravenous hydration (meaning through an IV), pain meds, IV antibiotics, and surgery to remove the gallbladder.

Acute cholangitis can present similarly to acute cholecystitis but is typically more severe, says Dr. Dann. It occurs when a stone becomes impacted in ducts draining bile from the liver into in the small intestine, leading to an infection. Symptoms include fever, jaundice (yellowing of the skin or the whites of the eye), and abdominal pain. The abdominal pain is typically vague and located in the right upper quadrant.

How to treat it: Similarly to the previous condition, treatment will include hospitalization with intravenous hydration, pain medications, antibiotics, and surgery.

The OG reason for going gluten-free, celiac disease sufferers tend to experience abdominal pain and excessive flatulence in addition to diarrhea, which is often foul-smelling due to malabsorption, says Dr. Dann. Symptoms can present as early as infancy but most commonly present between the ages of 10 and 40. Patients may also experience weight loss, anemia (low red blood cell count), neurologic disorders from deficiencies of B vitamins, and osteopenia (thinning of the bones) due to vitamin D and calcium deficiencies.

How to treat it: Most patients can manage celiac disease with a gluten-free diet, as well as by monitoring and reporting any complications to their doctor.

Pancreatitis can be acute and chronic. The pain is typically severe and can even radiate to the back. Symptoms can also include nausea and vomiting, and you might feel a little bit of relief when you sit upright or lean forward, says Dr. Dann.

How to treat it: Most cases of pancreatitis require hospitalization, along with fluid replacement and pain meds.

Hepatitis is when there is inflammation in the liver due to one fo the five hepatitis infections. Patients with acute hepatitis may have pain in the right upper quadrant, fatigue, nausea, and vomiting. Other symptoms include jaundice, dark urine, and light colored stools.

How to treat it: Treatment will vary depending on the underlying cause and may require hospitalization for supportive care, says Dr. Dann.

Gastroparesis is a condition when the stomach can't properly empty itself of food contents. In addition to abdominal pain, a person with gastroparesis will have nausea, vomiting, early satiety, bloating, and in severe cases, weight loss. The cause is often unknown, but gastroparesis can be seen in diabetics and post-surgery patients.

How to treat it: Treatment typically includes making changes to your diet, getting your blood sugar levels and changes under control if you're diabetic, and hydrating. Medication such as metoclopramide (Reglan) may be necessary, and some patients may require a feeding tube, says Dr. Dann.

Kidney stones occur when a stone passes from the kidney into the ducts carrying urine to the bladder. Mild to severe pain is the most common symptom and can occur in the back or abdomen. Additional symptoms include nausea, vomiting, painful or urgent urination, and blood in the urine.

How to treat it: Kidney stones are most often treated with pain medication and hydration until the stone passes naturally through your urinary system. Large stones may require additional treatment, like lithotripsy (a procedure used to help break up the stones) or surgical removal.

Bladder infections can definitely cause abdominal pain, as well as painful and urgent urination, and/or blood in the urine. If its a kidney infection youre dealing with, you may also have a fever, chills, thigh pain, and joint tenderness.

How to treat it: Most cases can be treated with a course of oral antibiotics, though severe cases may require hospitalization and IV antibiotics. In rare cases, surgery may be required, says Dr. Dann.

You may be surprised by this, but symptoms for acute myocardial infarction (the medical term for heart attack) can include abdominal pain, belching, nausea, and indigestion, as well as shortness of breath or chest pain.

How to treat it: Management will depend on the underlying cause but will always requires prompt recognition and hospitalization, says Dr. Dann. Heart attacks are no joke.

Endometriosis is a disorder in which tissue that normally lines the uterus grows outside of it, often leading to lower abdominal/pelvic pain. Symptoms include painful periods with abdominal cramps, painful during sex, and/or infertility. Endometriosis can also lead to bowel and bladder issues, says Dr. Dann.

How to treat it: Initial treatment typically includes oral contraceptives and nonsteroidal anti-inflammatory drugs, says Dr. Dann. However, recurrence rates are high if you stop taking medication. If treatment isnt successful, surgery to remove the tissue growth is an option.

Also known as leiomyomas, uterine fibroids typically lead to chronic lower abdominal/pelvic pressure or pain. Symptoms will vary depending on the size and number of fibroids and can include abdominal tenderness and low-grade fever, and your gyno may be able to feel large fibroids during an external abdominal exam.

How to treat it: Treatment can include oral contraceptives or GnRH agonists (medications that affect hormone levels). Some women also find relief with an IUD as a birth control method. In other cases, myomectomy (a surgical procedure to remove uterine fibroids) might be necessary.

Ovarian cysts are solid or fluid-filled sacs or pockets in or on top of an ovary. Pain is often a sign that the cyst has ruptured or burst, says Dr. Dann. The most common symptom is lower quadrant pain, and especially pain after sex.

How to treat it: Ovarian cysts can often be managed with monitoring by your doctor and with over-the-counter pain-relief meds. In severe cases, surgery may be required.

This pain can occur in the middle of your menstrual cycle, coinciding with timing of ovulation. It may be right- or left-sided, depending on which side youre ovulating from during that cycle.

How to treat it: This pain usually goes away within 24 hours, says Dr. Dann. You can treat it with over-the-counter nonsteroidal anti-inflammatory drugs such as ibuprofen. If ovulation is particularly painful for you, taking birth control pills to prevent ovulation may be a solution worth talking to your gyno about.

An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus, typically on the fallopian tube. It typically occurs during the first trimester, with symptoms such as abdominal pain and or vaginal bleeding that can be life-threatening.

How to treat it: With an early diagnosis, most patients may be treated with a drug called methotrexate (MTX). But in some cases, a woman may need surgery, says Dr. Dann.

Pelvic inflammatory disease (PID) typically includes acute lower abdominal and or pelvic pain. Patients may also have pelvic organ tenderness and evidence of inflammation of the genital tract. Any sexually active woman is at risk of developing PID, and it most often happens when an STD is left untreated, causing this infection of the reproductive organs.

How to treat it: Treatment can include antibiotics used to treat gonorrhea, chlamydia, and other bacterial infections. Severe or complicated PID may require hospitalization.

Ovarian torsion occurs when an ovary becomes twisted around the ligaments that hold it in place. Symptoms can include moderate to severe pelvic pain, typically associated with nausea, a noticeable mass or bloating in the pelvic area, and sometimes vomiting, says Dr. Dann.

How to treat it: Ovarian torsion can sometimes resolves itself, but it often involves surgery. Surgical removal of the ovary may sometimes be required as well, says Dr. Dann.

Ovarian cancer has a reputation as a silent killer, as its often asymptomatic until its in an advanced stage. But early symptoms may include bloating or abdominal/pelvic pain, urinary urgency or frequency, and postmenopausal bleeding.

How to treat it: Treatment will require surgery followed by chemotherapy, says Dr. Dann.

Ovarian hyperstimulation syndrome (OHSS) can cause abdominal discomfort from enlarged ovaries in women undergoing fertility treatment. Early symptoms are usually mild to moderate and begin four to seven days after the ovulatory dose of the human chorionic gonadotropin (hCG) hormone. Late symptoms are typically more severe and begins at least nine days after the ovulatory dose of hCG during a conception cycle.

How to treat it: Mild or moderate OHSS and can be managed with analgesics such as Tylenol (acetaminophen), and by avoiding intense physical activity, says Dr. Dann.

Endometritis is the inflammation of the inner lining of the uterus, a.k.a. the endometrium. It typically involves lower abdominal and pelvic pain, as well as painful periods with cramping, pain during sex, and/or infertility. It can also lead to bowel and bladder issues, notes Dr. Dann.

How to treat it: Most infections are mild and cured with antibiotic therapy, though some may require IV antibiotics or curettage, a surgical scraping procedure to remove the affected tissue.

Crohns disease is another type of inflammatory bowel disease that causes inflammation in the digestive tract. Its marked by symptoms such as abdominal pain, severe diarrhea, cramping, and bloody stool, according to the Mayo Clinic. If you have have symptoms that could be consistent with Crohns disease or have already been diagnosed, you should always be evaluated with a thorough consultation and examination by a physician for an accurate diagnosis and treatment plan, and to exclude a more serious or urgent condition, says Dr. Dann.

How to treat it: While theres unfortunately no cure for Crohns, its often treated and managed with medications such as corticosteroids, immune system suppressors, and antibiotics. In severe cases, surgery may be required.

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Why Does My Stomach Hurt? 32 Causes Of Stomach Pain And Bloat - Women's Health

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The Bone Marrow Transplant Rejection Treatment market report offers an all-inclusive analysis of this industry vertical with emphasis on the key growth drivers, limitations, and opportunities shaping the market dynamics in the upcoming years.

As per the report, the market is projected to show decent growth, recording a CAGR of XX% over the analysis period (2020-2025).

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Regional scope: North America, Europe, Asia-Pacific, South America, Middle East & Africa, South East Asia

Product terrain: Azathioprine, Adrenocorticotropic Hormone, Cyclophosphamide, Cyclosporine A and Others

Applications spectrum: Hospital, Clinic and Others

Competitive landscape: Bellicum Pharmaceuticals, Inc., Cell Source, Inc., Boryung Pharmaceutical Co., Ltd., Bio-Cancer Treatment International Limited, Capricor Therapeutics, Inc., Biogen Inc, CellECT Bio, Inc., Cantex Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Cell2B S.A., Dompe Farmaceutici S.p.A., F. Hoffmann-La Roche Ltd., Cleveland BioLabs, Inc., Generon (Shanghai) Corporation Ltd., Dr. Falk Pharma GmbH, Cytodyn Inc., Compugen Ltd., Fate Therapeutics, Inc., Escape Therapeutics, Inc., Cynata Therapeutics Limited, Gilead Sciences, Inc., GlaxoSmithKline Plc, Idera Pharmaceuticals and Inc

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Chapter 1 Industry Overview

Chapter 2 Production Market Analysis

Chapter 3 Sales Market Analysis

Chapter 4 Consumption Market Analysis

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Chapter 6 Major Manufacturers Production and Sales Market Comparison Analysis

Chapter 7 Major Product Analysis

Chapter 8 Major Application Analysis

Chapter 9 Industry Chain Analysis

Chapter 10 Global and Regional Market Forecast

Chapter 11 Major Manufacturers Analysis

Chapter 12 New Project Investment Feasibility Analysis

Chapter 13 Conclusions

Chapter 14 Appendix

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Bone Marrow Transplant Rejection Treatment Market Size, Share, Statistics, Demand and Revenue, Forecast 2025 - CueReport

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From Runner's World

If you follow the more esoteric health scene circles, you'll have come across Dutch extreme athlete Wim Hof a man so fond of the cold that he holds the current world records for swimming under ice and prolonged full-body contact with ice. He believes that leaving your central heated palace for the elements comes with a 'cascade of health benefits', from enhanced sleep to the production of endorphins and a fortified immune system. Given the current state of the UK heatwave now's the time to brave it, hey?

While the prospect of dunking yourself in a paddling pool of cubed frozen water might feel like one for the, erm, future even in this heatone impact of Hof's influence is the proliferation of people taking cold showers, for their alleged health benefits.

While still not an enticing prospect, they're eminently more accessible than climbing Mount Kilimanjaro in shorts (another achievement of the 60-year-old). But are they backed up by science?

Here's those that have grounding in research.

Youve heard about athletes taking ice baths after training to promote recovery? Well, the principles behind taking a cold shower instead are very similar.

Cold generally stimulates a response of the blood vessels, which causes vasoconstriction (narrowing of the blood vessels), says Hasit Jethwa, health and fitness tutor at The Training Room.

Essentially, this occurs in order to direct the blood to where its needed the most, in this case, vital organs. So, blood is forced to return to the heart where it can then be transported to the lungs to replenish and this oxygenated blood can then be pumped around the body, meaning you are now getting fresh oxygen and nutrients to the right areas.

'The cold also helps to reduce any potential inflammation you might experience post exercise, which can help to speed up your recovery and reduce your aches and pains.

According to a study from experts at Virginia Commonwealth University School of Medicine, taking cold showers for two to three minutes, once or twice a day, preceded by a five minute 'adjustment period' of slowly cooling water, could be a helpful part of relieving the symptoms of depression.

How? The team put the positive findings down to the fact that exposure to cold activates the sympathetic nervous system and, due to the high density of cold receptors in the skin, sends lots of electrical impulses from peripheral nerve endings to the brain. While they concluded that larger studies would be requited to corroborate the findings, it's a promising start.

Theres a reason why you put ice on a burn or a bad back cold can have anaesthetic-like effects says findings published in the North American Journal of Medical Sciences.

The principles are the same as those outlined by Jethwa above: cold constricts blood vessels, reducing swelling and it also potentially slows the rate at which pain signals are transmitted to the brain.

This one is pending further research. But one 2016 study found that participants were 29% less likely to need to call in sick to work, when they practiced the hot-to-cold approach of showering. The data showed a link between those who have a hot shower, with 30-90-second bursts of cold water reported fewer sick days than those who took warm showers.

This is supposedly due to the increase in metabolic rate caused by the shock of temperature change, says Jethwa. Your body then accelerates its functions, in order to try and compensate.

No surprises with this one the reduced difference in temperature of a cold shower comes as a bit of a shock to your body.

This places your body under stress, says Jethwa. Which sends your sympathetic nervous system into a fight or flight response so, you may, all of a sudden, feel much more focused and alert.

Being under the physical stress of cold temperatures means your requirement for oxygen also greatly increases, which promotes a higher breathing rate and forces more oxygen into the body.

Story continues

The key word here is support. Yes, a study published in Cell revealed that exposure to cold temperatures can protect against obesity, improve your metabolism and alters the composition of your gut bacteria so its better suited to burn fat but the studies were based on mice placed in cold conditions for ten days.

However, there is evidence that taking a cold shower can activate brown fat, a type that helps to generate heat around the body by burning calories.

Cold water is great for the skin, says Kay Greveson, Aesthetic Nurse Practitioner at Regents Park Aesthetics. Even a simple splash of cold water after cleansing can give you brighter skin.

In addition to this, to lock in our core temperature our skins pores shrink, which can help improve the overall texture and appearance of the skin, says Dr. Michael Barnish, Aesthetic Doctor at the Dr. Jonquille Chantrey Clinic.

Oh, and those benefits weve already mentioned that cold reduces inflammation and boosts your bodys immune response? Well those both work together to reduce the lifespan of spots.

Pretty impressive stuff.

Perhaps one for the brave to try out in a study from 2000, researchers placed participants in 14 degree C water for one hour. It may sound extreme, but the experience did trigger a reduction in levels of cortisol the stress hormone in the body.

As Jethwa has already identified, cold showers cause the bodys blood vessels to constrict. Blood rushes around to the organs to stay warm promoting blood flow. An improved circulation is associated with better cardiovascular health meaning your heart stays healthy and happy.

However, its also important to remember that cold temperatures force your heart to work harder to keep your body warm which could, in turn, according to the British Heart Foundation, put your health at risk.

The takeaway? There are many other ways of keeping your heart healthy like a balanced diet and exercise plan so dont rely on cold therapy alone.

Keen to give it a go? Great. But before you dive right in, like with anything new, cold showers are worth giving your body time to adjust to.

There is not really an optimum way of taking a cold shower, says Jethwa. Some people may have a short, five to 10-minute shower at a consistently cool temperature, whilst others may vary between heat and cold intermittently.

Ultimately, its about what works best for the individual, as everyones bodies are different. With some trial and error, you should be able to figure out which method is the most effective for your body.

And remember, cold showers arent for everyone. If you have a history of heart conditions, high blood pressure, a weakened immune system or any concerns as to whether cold showers would be of benefit to you, seek the advice of a medical professional, first.

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9 cold shower benefits that will make you want to turn down the heat - Yahoo Lifestyle UK

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Global Bone Marrow Transplant Rejection Treatment Market, by ApplicationsHospitalClinicOthers

The Major Players Reported in the Market Include:Bellicum Pharmaceuticals Inc.Bio-Cancer Treatment International LimitedBiogen IncBoryung Pharmaceutical Co. Ltd.Bristol-Myers Squibb CompanyCantex Pharmaceuticals Inc.Capricor Therapeutics Inc.Cell Source Inc.Cell2B S.A.CellECT Bio Inc.Cleveland BioLabs Inc.Compugen Ltd.Cynata Therapeutics LimitedCytodyn Inc.Dompe Farmaceutici S.p.A.Dr. Falk Pharma GmbHEscape Therapeutics Inc.F. Hoffmann-La Roche Ltd.Fate Therapeutics Inc.Generon (Shanghai) Corporation Ltd.

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INDIANAPOLIS, Ind. --Raena Eldridge of the Texas A&M womens swimming and diving team earned a conference-level nomination for NCAA Woman of the Year, as announced by the NCAA Tuesday afternoon. While 161 female student-athletes in total were nominated, Eldridgeis one of 59 student-athletes nominated from the Division I level. She is joined by Kentuckys Asia Seidt as the Southeastern Conferences nominees.

The NCAA Woman of the Year program is rooted in Title IX and has recognized graduating female college athletes for excellence in academics, athletics, community service and leadership since its inception in 1991.

Eldridge graduated from A&M in May with degrees in animal science and genetics, while also earning a business minor. She boasted a 3.979 cumulative GPA through her five years in Aggielandand has begun Vet School at NC State. Eldridge wasnamed the Arthur Ashe, Jr., Female Sports Scholar of the Year, awarded to one male and one femalestudent-athlete each year that exhibit academic excellence as well as community activism in addition to their athletic contributions.The Rockwall, Texas, native was A&M's female nominee for the H. Boyd McWhorter Scholar-Athlete Post-Graduate Scholarship, and for the second year in a row, was named the Bill Erwin Female Scholar-Athlete of the Year at A&M's annual Building Champions Awards. She earned College Swimming and Diving Coaches Association of America (CSCAA) Academic All-America honorable mention accolades as a sophomore and garnered first team honors as a junior and senior.

A team captain for her final two seasons, Eldridge was a part of four consecutive SEC Team Championships throughout her career. She was a two-time CSCAA All-American and earned All-SEC Second Team honors as a sophomore. Eldridge helped earn big points for the Aggies at SEC Championships as a sophomore, helping the 200 medley relay team reach the podium with a second-place finish, while adding a fifth-place finish with the 200 free relay squad. Individually at SEC Championships, she contributed a pair of top 16 finishes in the 100 back and 50 free that season. Eldridge also swam on winning teams in the 400 free relay and 400 medley relay to help the Aggies win the team title at the 2017 U.S. Open.

Away from the pool and the classroom, Eldridge served as a Student Technician at the Genetics Research Lab and as a member of the Pre-Vet Society. She was a project leader for the Aggie Research Scholars Program and started SPLASH, a non-profit organization that teaches swimming and swim safety. Eldridge also contributed her time at Save Our Streets Ministries in Bryan since 2016, mentoring elementary school girls.

The Woman of the Year Selection Committee, made up of representatives from the NCAA membership, will now choose the Top 30 honorees 10 from each division from the conference-level nominees. The Top 30 honorees will be announced in September. From there, the selection committee will narrow the pool to three finalists from each division. The NCAA Committee on Womens Athletics will select the 2020 Woman of the Year from the nine finalists.

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DENVER, Aug. 11, 2020 In a pioneering study, CCRM Fertility has identified epigenetic alterations in sperm from men age 50 and older that predispose children to neurodevelopmental disorders, such as autism, bipolar disorder and schizophrenia. CCRM Fertility's groundbreaking research was published in the July issue of Aging Cell.

Led byCCRM Fertility's Scientific and Genetics DirectorMandy Katz-Jaffe,Ph.D.,the study examined sperm samples of men age 50 and older compared to their younger counterparts, as well as embryos that were created using donor eggs from young, fertile women.

By analyzing the sperm's DNA through a process known as whole-genome bisulfite sequencing, CCRM Fertility found significant methylation (the "on and off switch" for the expression of genes) alterations in both sperm and embryos from fathers age 50 and older. The abundance of methylation alterations was most associated with genes associated with neurodevelopmental disorders including autism, schizophrenia and bipolar disorder.

"While we have known that there is a correlation between advanced paternal age and risks of offspring neurodevelopmental disorders, this is the first time we've been able to identify an associated mechanism and inheritance," explains Dr. Katz-Jaffe. "It's an exciting breakthrough as we continue our researchinvestigating the male sperm genome, advanced paternal age risks and future healthy offspring."

William Schoolcraft, M.D., CCRM Fertility founder and medical director, adds,"Oftentimes, men fail to realize there is an ideal timeframe for their own roles in fertility. We hope our research raises further awareness around the male biological clock and encourages men in their 30s and 40s who plan to have children in the future to consider freezing their spermto maximize the chance of having a healthy baby."

About CCRMFertilityFounded by Dr. William Schoolcraft in 1987, CCRM(Colorado Center for Reproductive Medicine)Fertilityis the nation's leader in fertility care and research.CCRMFertilityspecializes in the most advanced fertility treatments, with deep expertise in in vitro fertilization (IVF), fertilityassessment, fertility preservation, genetic testing, third party reproduction and egg donation.Unlike many other fertility clinics that outsource their specialists and testing needs, CCRMFertilityleverages its own data, as well as a dedicated team of in-house reproductive endocrinologists, embryologists and geneticists in order to deliver industry-leading outcomes. CCRMFertilityoperates 11 fertility centers (including 26 offices) throughout North America, serving prospective parents in major metropolitan areas, including Atlanta, Boston, Dallas-Fort Worth, Denver, Houston, New York, Northern Virginia, Minneapolis, Orange County, San Francisco Bay Area and Toronto. For more information, visitwww.ccrmivf.com,become a fan onFacebook,or follow us onInstagramandTwitter.

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CCRM Fertility Identifies Epigenetic Alterations in Sperm and Embryos of Older Men that Predispose Children to Autism and Other Neurodevelopmental...

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Alcohol abuse is a serious problem worldwide. In England alone, over 350,000 alcohol-related hospital admissions and over 5,000 alcohol-related deaths were reported in 2018. Long-term alcohol abuse can have many harmful effects on our body. But one of the organs most affected by alcohol is the brain. Even moderate consumption changes brain structure and leads to cognitive issues, such as declines in memory and problem-solving.

Alcohol use is habit forming and can eventually lead to alcoholism. And though there are many treatments available for alcoholism, research shows these interventions often fail with less than 20% of patients remaining alcohol free after intervention. Like every addiction, alcoholism is a disease and not a choice, so finding the root cause of it will make treatment easier.

Although genetics and the environment you live in are known to play a role in developing alcoholism, these factors dont tell us how dependence occurs.

However, past research has found hints that the brains immune system cells (known as microglia) may be involved in addiction, including to cocaine and tobacco). One study even found that alcohol exposure and withdrawal in rats increased microglia numbers in the brain, before any other signs of alcohol-induced decline.

Another two recent studies have investigated brain changes seen in people and animals with alcohol dependence. Each of these studies found a common culprit: inflamed microglia.

Microglia are the brains resident immune system cells. Their main role is to guard and maintain balance in the brain. When microglia detect a threat, they respond by becoming inflamed and attacking. Normally, they return to normal after the threat is gone, but sometimes when inflammation becomes uncontrollable such as with Alzeimers disease it can lead to brain degeneration.

One recent study used mice to study the effect of alcohol dependence on the brain.

In the brains of male mice that had alcohol dependency, research found there were more microglia cells in the medial prefrontal cortex, a region associated with pain, decision making, and memory processes. Similar results have also previously been found in humans.

They then examined what effects microglia depletion had on alcohol dependent mice by looking at their alcohol seeking behaviour, and anxious behaviour during alcohol withdrawal. The researchers found both factors were lowered when the microglia cells were reduced in the brain.

They also saw gene changes with microglia depletion. Genes involved in inflammation and immune responses were expressed less after depletion. The expression of genes involved in alcohol consumption, and alcohol dependence also changed when microglia had decreased. They also found that microglia depletion weakens brain circuits involved in the development of dependence and relapse behaviour in rodents.

A second study looking at both rodent and human brains also showed microglia is involved in alcohol dependence.

The researchers of this study used brain imaging, microglia depletion, and studies of post mortem brains, to examine changes that occur in alcohol dependence. For the brain imaging part, they used a variation of MRI scans, called DTI-MRI in humans and rats, focusing on a measure called mean diffusivity.

As DTI-MRI is based on the diffusion of water in tissues, mean diffusivity essentially shows the amount of diffusion of water molecules in tissues, with more dense and structurally-intact tissues having lower mean diffusivity. Mean diffusivity has previously been shown to change in the brain in inflammatory and degenerative conditions (including Alzheimers Disease and even psychosis). The researchers therefore chose to look at mean diffusivity as neuroinflammation is also involved in alcoholism. The researchers wanted to examine whether changes in mean diffusivity would be found between alcoholics and non-alcoholics, which hasnt been done before.

Indeed their findings showed that mean diffusivity is overall higher in the brain of alcohol dependent rats and humans. They also found additional changes in how certain neurotransmitters including dopamine, which is involved in alcohol dependence move and are distributed in the brain.

The researchers went on to examine the microglia in the brains of rats with alcohol dependence, and rats with previous dependence who had abstained from alcohol for a week. They found a decreased amount of microglia in specific brain regions of dependent rats (including the hippocampus, which is involved in memory, and the nucleus accumbens, which is involved in the reward system). The microglia in the brains of alcohol dependent rats were also in their inflamed form.

Although this study showed a decrease in microglia numbers whereas the previous study saw an increase this might be because the researchers looked at different brain regions and used different research methods and animal models. However, both studies give hints towards how microglia functions during alcohol consumption and dependence, may differ in different brain regions.

The researchers also found that depleting microglia from the brain, or inducing microglias inflammatory response, led to similar results to each other, as both increased the mean diffusivity. Changes in microglias form when inflamed were also similar to the ones they observed in dependent rats. They concluded that the changes in the brain areas they studied could be explained by an inflammatory reaction of microglia caused by alcohol.

One limitation of both studies findings is that they used both only male rodents and male humans. However, both studies exhibit how alcoholism is a complex disease that produces clear changes in the brain.

Examining how exactly microglia is involved, and being able to interfere with their responses, could lead to better understanding and detection of addiction to alcohol, and give a good stepping stone for future targeted interventions.

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Alcohol addiction: could the brain's immune system be the key to understanding and treating alcoholism? - The Conversation UK

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MedicalResearch.com Interview with:

Caspar van der Made, MDResident in Internal Medicine, PhD-studentAlexander Hoischen, PhDGeneticist, Assistant professor,Departments of Human Genetics and Internal Medicine

Radboud University Medical enterNijmegen, The Netherlands

First author Caspar van der Made is a resident in Internal Medicine and PhD-student on the topic of immunogenomics.Alexander Hoischen is geneticist with a special focus on the application of genomic technologies in primary immunodeficiencies and last author of this study.

MedicalResearch.com: What is the background for this study?

Response: This study was initiated to investigate the presence of monogenic factors that predispose young individuals to develop a severe form of COVID-19. It has become clear that several general risk factors such as obesity, hypertension and diabetes mellitus increase the risk of developing severe coronavirus disease. However, even though differences in interindividual genetic make-up are thought to influence the immune response to SARS-CoV-2, such specific genetic risk factors had not yet been identified.

We therefore chose to study young brother pairs (sharing half of their genomes) without any general risk factors that nevertheless contracted severe COVID-19.

We hypothesized these highly selected case series may offer the most optimal chance of identifying a (possible X-linked) primary immunodeficiency specific to COVID-19.

MedicalResearch.com: What are the main findings?

Response: In this case series, two young brother pairs of which all four individuals with a mean age of 26 years required mechanical ventilation at the ICU were enrolled and studied. We performed rapid clinical whole-exome sequencing of the patients and segregation in available family members to identify loss-of-function variants of the X-chromosomal TLR7. This gene encodes the toll-like receptor 7 protein that plays a critical role in the innate immune response against coronaviruses, predominantly by mediating the production of type I interferons. Especially in SARS-CoV-2 infections this response is crucial, as the virus has evasive mechanisms to disrupt a proper type I interferon response. In primary peripheral blood mononuclear cells extracted from the patients, we have shown that the transcription of type I-interferon genes was lower in patients upon stimulation with the TLR7 agonist imiquimod, as compared to controls. Furthermore, the production of the type II interferon IFNg was also decreased in patients.

MedicalResearch.com: What should readers take away from your report?

Response: To our knowledge this is the first report that proposes a specific monogenic factor to develop severe COVID-19. We aim to highlight the important contribution of genetics in the susceptibility to develop COVID-19 and hope to create awareness among physicians to consider genetic evaluation of young patients with unexplained severe COVID-19.

The finding of TLR7 deficiency in these patients furthermore underlines the importance of an intact type I and II interferon response to fight off SARS-CoV-2 and provides insight in the timing of possible treatment options.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: While the TLR7 deficiency is most likely a rare phenomenon, with an estimate of 1:10,000 TLR7 mutation carriers in the general population; our findings shall be replicated and expanded by others. Similar to other rare disease genetic studies, this shall allow additional insides into disease pathogenesis in general. Further research should focus on the elucidation of the exact role of TLR7-signaling in the pathogenesis of SARS-CoV-2 and ultimately the exploration of rational treatment options.

Also, these findings may provide part of the explanation for the male sex bias observed in COVID-19, which should be addressed more in-depth. More generally, we encourage further studies towards the identification of other genetic risk factors and applaud the efforts already undertaken by other large consortia.

MedicalResearch.com: Is there anything else you would like to add?

Response: We are very grateful to the families that participated in this study, and would like to acknowledge our interdisciplinary team of collaborators.

Any disclosures?

No relevant conflict of interest for any of the authors.

Citation:

van der Made CI, Simons A, Schuurs-Hoeijmakers J, et al. Presence of Genetic Variants Among Young Men With Severe COVID-19.JAMA.Published online July 24, 2020. doi:10.1001/jama.2020.13719

https://jamanetwork.com/journals/jama/fullarticle/2768926

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The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

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In the past, the medicine people took for their ailment was primarily their food, the vegetables and other natures proceeds that were used as medicinal herbs. These served as nutritious food and medication, they boosted the bodys immune system and helped it fight various health conditions.

With the coming of scientific research, many of these modes of treatment phased out and were replaced by scientific inventions, the conventional drugs as they are known as today. However, interest and research on the benefits of some of these plants and herbs have been rekindled.

This is even more so now that it is known that they have various health benefits. One of such plants is the hemp plant.

Known botanically as cannabis sativa, this is a plant that has gained much relevance and popularity today because of both its fiber and edible seeds content. Many times, many people confuse it with the cannabis from which marijuana is made.

This is mostly because they are both from the cannabis family. The main difference however is in the amount of THC that they both contain. THC is the compound responsible for the psychoactive effect you can get from using marijuana. Marijuanas THC content is high while that of the hemp plant is low and wouldnt get you high. You can read more about it here.

One of the unique qualities of this plant is that it is a dioecious plant which means that it produces plant with both male and female characteristics. The opposite of this would be to be monoecious, which means that it would contain both male and female characteristics in it.

However, what is mostly used and is more popular is the female cannabis sativa. Thus, when it comes to the cultivation of cannabis, the females are usually more regarded because they are responsible for creating the flowers and the seed.

The fact that the female hemp plant is more used doesnt make the males less useful. They are actually very important. In fact, their uses are quite many. Some of its uses include the following:

You can visit https://cheefbotanicals.com/do-male-hemp-plants-produce-cbd/ to find out more its other uses.

At about six weeks, farmers should be able to differentiate between the sex of their produce, however, for newbies and even for old hands, a careful reminder is always a good thing.

This difference can be deduced when the crux of their branches, more popularly known as the plant nodes, are carefully observed. While the male plants grow small pollen sacks, the females grow bracts and as they mature, its bracts will grow hair like wisps that will catch the pollens from the males. It is also important to know that there are hermaphrodite species that have both male and female characteristics. While they might be useful to the farmer early on, the genetics of their offspring will only get weaker and weaker and there wouldnt be any variety amongst them.

The point is this, though it may seem that the male hemp plant does not have much market value compared to the female, they still remain quite useful.

If you previously had no idea that this plant family was divided into two genders, this article has brought that to your attention. If you on the other hand already knew this but did not know that the male variation offered any kind of value, now you also know differently thanks to this article.

With the information you have received in this article, you are now better informed and will now look at this previously despised plant differently.

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Uses of the Male Hemp Plant - Trill

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Deletions spanning the STS (steroid sulfatase) gene at Xp22.31 are associated with X-linked ichthyosis, corneal opacities, testicular maldescent, cardiac arrhythmia, and higher rates of developmental and mood disorders/traits, possibly related to the smaller volume of some basal ganglia structures. The consequences of duplication of the same genomic region have not been systematically assessed in large or adult samples, although evidence from case reports/series has indicated high rates of developmental phenotypes. We compared multiple measures of physical and mental health, cognition and neuroanatomy in male (n=414) and female (n=938) carriers of 0.8-2.5Mb duplications spanning STS, and non-carrier male (n=192, 826) and female (n=227, 235) controls from the UK Biobank (recruited aged 40-69 from the UK general population). Clinical and self-reported diagnoses indicated a higher prevalence of inguinal hernia and mania/bipolar disorder respectively in male duplication carriers, and a higher prevalence of gastro-oesophageal reflux disease and blistering/desquamating skin disorder respectively in female duplication carriers; duplication carriers also exhibited reductions in several depression-related measures, and greater happiness. Cognitive function and academic achievement did not differ between comparison groups. Neuroanatomical analysis suggested greater lateral ventricle and putamen volume in duplication carriers. In conclusion, Xp22.31 duplications appear largely benign, but could slightly increase the likelihood of specific phenotypes (although results were only nominally-significant). In contrast to deletions, duplications might protect against depressive symptoms, possibly via higher STS expression/activity (resulting in elevated endogenous free steroid levels), and through contributing towards an enlarged putamen volume. These results should enable better genetic counselling of individuals with Xp22.31 microduplications. The Author(s) 2020. Published by Oxford University Press.

PubMed

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Medical and neurobehavioural phenotypes in male and female carriers of Xp22.31 duplications in the UK Biobank. - Physician's Weekly

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Female anglerfish with a parasitic male fused to the underside of her body

Deep-sea anglerfish are unique and unusual for many reasons. They have strangely shaped bodies with horrifying teeth, attract prey using a lure attached to their snouts, and reproduce by fusing their bodies with their mates. Now, a new study suggests that these anglerfish have modified immunity genes that make this form of sexual parasitism possible.

Deep-sea anglerfish are commonly found below depths of 1,000 feet. Light, food, and mates can be hard to come by in these environments, so anglerfish have adopted a unique strategy to produce offspring. Tiny male anglerfish, which can top out at 1 centimeter in length, will attach to female anglerfish that are many times larger than they are. This arrangement can be temporary or permanent, depending on the species. But, in some cases, the skin, veins, gills, and stomachs of the two fish will connect during the mating process and they will become fully enjoined.

Such an event should trigger an aggressive immune response, such as when the body rejects an organ transplant or detects a pathogen. That anglerfishes do not have such a response could suggest that male and female anglerfishes (1) share similar genetics that allow them to harmoniously connect or (2) are genetically adapted to suppress their immune responses when they mate.

Genetic analysis by the scientists involved indicated that there is a consistent difference in immunity genes between species that temporarily attach versus those that permanently attach. Specifically, when looking at a group of immunity genes known as MHC genes, temporarily associated pairs had a greater diversity of these MHC genes compared to those that become permanently affixed to one another. Additionally, species that do not form such attachments had aicada genes, whereas intertwined species lacked this aicada gene.

Reduced genetic variation indicates that species whose mates fuse together may have evolved so that mating does not compromise their health or chances of successfully reproducing by triggering an immune response. It is unclear whether sexually parasitic mating itself has driven these changes in immunity genes or if there are other underlying causes. But, the multitude of unique adaptations that anglerfish possess means that there are many more questions waiting to be answered.

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Sexual Parasites And Altered Immune Systems Help These Deep-Sea Fish Mate - Forbes

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Beth Burger, Columbus Dispatch Published 10:39 a.m. ET Aug. 8, 2020

An Asian Longhorned tick, which is potentially fatal to livestock, was found in May 2020 in Gallia County in southern Ohio. The invasive tick, which is now in 14 states, has the ability to self-reproduce, hatching up to 2,000 eggs. It is brown in color and about the size of a sesame seed.(Photo: File)

It has the capacity to wipe out livestock, cause anemia and transmit diseases.

The Asian Longhorned tick can wage a campaign of destruction even though its only the size of a sesame seed.

So far, only one of its kind has been documented in Ohio. But experts warn: One is all it takes to become established in a new habitat.

The female Asian Longhorned tick has the ability to reproduce without males. She can produce up to 2,000 eggs by herself, said Risa Pesapane, assistant professor of veterinary preventive medicine at Ohio State Universitys School of Environment and Natural Resources.

The Ohio tick was confirmed after a stray 7-year-old male beagle was found in late May along a road in Gallia County in southern Ohio as part of Pesapanes study.

Her study partners withGigis, a nonprofit that brings dogs from shelters to their campus in Canal Winchester, where veterinarians administer care to them.

Were using the dogs to get a better idea of the health of the dogs in the area as well as what ticks are out there. And then that can be extrapolated to other studies like public health studies, said Dr. Colleen Shocking, a veterinarian who is also the director of education, outreach, and the parvovirus treatment center at Gigis. Our role is we pull (ticks) off. We also pull some blood from the dogs, which doesnt hurt them at all. We do that anyway to check for tick diseases.

The dogs are then transferred to adoption agencies, which leads them to finding permanent homes.

Bucky the beagle, who had the Asian Longhorned tick partially engorged when he was found, now has a home.

The tick had been on the dog for a couple of days, at least. Its really impossible to know specifically where that dog was when it picked up the tick, said Pesapane, who suspects the tick likely came across the Ohio River border from West Virginia.

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The ticks can travel on wildlife, including deer and birds. While they can feed on humans, its not their preference, experts said.

There have been no documented cases of humans catching diseases from this variety of tick.

But in the laboratory, they have demonstrated that this tick can acquire and transmit Rickettsia, Pesapane said, and that can lead to Rocky Mountain Spotted Fever, a bacterial disease that can cause fevers and a severe rash in humans.

Cattle attacked by Asian Longhorned ticks are at risk of contracting Theileria, a blood-borne parasite that can cause anemia, which can be fatal.

Researchers are looking at a well-established population of Asian Longhorned ticks in Virginia where there was an outbreak. The two are likely linked, the U.S. Department of Agriculture said.

That is what causes severe anemia and illness in cattle. So we do have one instance where a natural population of this tick was vectoring disease, but not to dogs and not to people, Pesapane said.

Even without the tick transmitting diseases, cattle owners should be vigilant, she said.

You get these really heavy infestations and even in absence of a vector-borne disease, they still could cause substantial blood loss in cattle and stress, Pesapane said.

The tick, which is native to east Asia, has been in the U.S. since 2010, said Denise Bonilla, a veterinary services entomologist with the USDA.

There was no smoking gun, she said. We know that from some of the population genetics work being done by several different universities that there was definitely more than one introduction in the United States, but we dont know how those happened.

Ohio and Rhode Island are the latest states where the tick has been found. That brings the total to 14 states, which also includes Kentucky and Pennsylvania. There have been no reports in Indiana or Michigan yet.

I dont think that people should be scared of this. You keep a good eye on your animals, Bonillasaid. You make sure that you practice looking at yourself and your family for ticks when youve been out in the environment, and doing quick tickremoval.

The ticks are the size of a period at the end of a sentence when theyre born. They move quickly, similar to spiders. Experts recommend keeping grass cut and brush removed to keep ticks at bay.

Experts warn that Ohio will continue to see more types of ticks and the population will likely increase due to symptoms of climate change with warming temperatures.

This is definitely thought to be linked to climate change as the warming climate allows habitats to be more suitable for these ticks, and the winters arent as harsh. You have more calendar days of the year that are above 40 degrees when the ticks are out looking for hosts, Pesapane said. Youre getting more encounters with people who are out enjoying the weather.

If cattle producers spot unusual-looking ticks or large infestations, notify your veterinarian or contact the Ohio Department of Agricultures Division of Animal Health at 614-728-6220.

This report was provided by the Columbus Dispatch, part of the USA TODAY Network.

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Their study on intimate orientation ended up being one thing of an anomaly. Maybe perhaps perhaps Not which he had not seriously considered it in past times.

Exactly exactly What finally changed the way of their research, though, was a profoundly individual crisis. An emergency room physician, died after a four-year struggle with AIDS in 1990 LeVays partner, Richard. Richard and I also had invested 21 years together, he recalls, their sound nevertheless getting during the memory. It had been while searching after him that I made a decision i needed to complete different things with my entire life. You recognize life is quick, along with to consider what is very important for your requirements and what exactly isnt. Id a psychological need certainly to make a move more personal, one thing related to my homosexual identification.

LeVay had been pelted with concerns. Some critics questioned whether the AIDS virus could have skewed his results because his gay subjects had died of AIDS. LeVay believes that highly not likely. He would additionally a part of their study six heterosexuals whod died of AIDS and saw no huge huge difference in INAH3 size patterns between these clients and the ones that has died of other noteworthy causes. (however, to assuage their fascination, LeVay later examined mental performance of a HIV-negative man that is gay had died of lung cancer: I became extremely, extremely stressed once I decoded that test, he admits. Id have lost a large amount of faith during my information if it situation had contradicted it. Yet that brain, too, dropped in to the gay-typical range. )

Anne Fausto-Sterling, a developmental geneticist at Brown University and another of LeVays primary academic experts, ended up being those types of whom questioned the way in which he interpreted their information. He stated a wide variation in the dimensions of these mind nuclei in homosexual and right guys, she states, but there was clearly nevertheless a diverse overlap between right and gay. Exactly just What he really discovered had been a distributional distinction, with some larger-than-average nuclei at one end, several smaller-than-average nuclei in the other, therefore the the greater part dropping in between. Also when we could say many people at one extreme were straight, and a lot of during the other extreme were gay, that tells us small in regards to the bulk at the center in which the ranges overlap. If LeVay picked a size that is nucleus the center, he couldnt inform if it had been heterosexual or homosexual.

Fausto-Sterling also took problem with LeVay for reducing the numerous simple colors of peoples sex to a dichotomy that is gay-straight. there are numerous gradations in intimate orientation. Just just exactly What do you really call males who possess intercourse along with their spouses while fantasizing about guys? Or dudes who will be mostly right who pick up male prostitutes, or transsexuals, or serial bisexuals who may switch between solely homosexual and solely right relationships? How can you count intimate behavior that modifications with time in various circumstances? She described LeVays research as an element of a reification of sexualities into a binary scheme. It maps very badly onto truth and makes taking into consideration the biology extremely tricky.

The general publics reaction to LeVays research had been equally spirited. a number of it absolutely was stuff that is loony LeVay claims with a grin. crazy theories that it is all as a result of diet. Then there have been the letters from spiritual zealots, flatly stating that being homosexual is just a choice that is sinful since it states when you look at the Bible. Some people branded LeVay a biological bigot and called his work an expression of internalized homophobia in the gay community. One critic stated i desired to show its maybe not my fault i am homosexual, states LeVay, plainly pained. we thought their charging I happened to be a conflicted man that is gay a bit down- color; i have been available about being homosexual since I have ended up being a teen. LeVay additionally rejects another critique: Some state my work means homosexual guys are just straight males by having a gap within their hypothalamus, so it pathologizes homosexual guys. I do not purchase it. To express that, you had need certainly to contemplate it pathologizing to express that gay guys have one thing femalelike, that we do not see as real. I do not think there is any such thing pathological about being a female.

However the more response that is typical passion. Letters poured in from homosexual males and their loved ones. Many men that are gay my study with their moms and dads, especially if they certainly were significantly estranged from their website. And parents, in turn, composed to express the research assisted them comprehend their young ones. It really is obvious that LeVay takes pleasure in realizing that lots of people are finding their labors helpful.

Some moms and dads think about me because the individual fuckcams cams who took them from the hook, LeVay claims, smiling. They tend to see could work as evidence that being homosexual is hereditary. It is a blunder i will be sympathetic with, because We occur to think people that are gay probably are created homosexual. Since we think about might work going for the reason that way, he adds wryly, Im not completely uncomfortable with this response.

In reality, LeVay has very long suspected that homosexuality operates in families and it has an inherited componenta suspicion strengthened by present double studies done by psychologist Michael Bailey of Northwestern University and psychiatrist Richard Pillard of Boston University. The studies also show that identical twinswho share the exact same genesare about two times as very likely to both be homosexual or lesbian as are fraternal twins, who share only half their genes. Theyre also five times almost certainly going to both be homosexual than are used brothers who share an upbringing but no genes. That obviously shows that genetics is the reason an amazing small fraction for the causation that is total claims LeVay. As anecdotal proof, he showcases a grouped household snapshot of himself and their four brothers: Two. 5 of us are homosexual, he states. (One bro is bisexual. ) You understand, my dad has not been comfortable that i am gay. He does not accept. Since all of the children from their 2nd marriage are right, he insists it really is all inherited from our moms region of the family members.

LeVays disapproving daddy may be vindicated yet. Final July, LeVay points down, Dean Hamers group during the National Institutes of Health situated an area from the X chromosome of homosexual brothers that could end up in carry a gay gene or genes; the X chromosome is, most likely, constantly the caretakers hereditary share to her sons. So how a gene in this area might create some body homosexual stays anybodys guess: perhaps it influences just how intercourse- associated structures are formed within the hypothalamus. In terms of intimate attraction and behavior, LeVay suspects, people are mostly shaped in utero. Something different is going on as soon as the brain that is gay itself in fetal life, he claims. If we place my cash anywhere, it is in the discussion of intercourse hormones plus the brain. There might be differences that are genetic how a fetuss mind cellular receptors react to intercourse hormones such as for example testosterone.

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Their study on intimate orientation ended up being one thing of an anomaly. Maybe perhaps perhaps Not which he had not seriously considered it in past...

Recommendation and review posted by Bethany Smith

Trusted Business Insights answers what are the scenarios for growth and recovery and whether there will be any lasting structural impact from the unfolding crisis for the Alopecia market.

Trusted Business Insights presents an updated and Latest Study on Alopecia Market 2019-2029. The report contains market predictions related to market size, revenue, production, CAGR, Consumption, gross margin, price, and other substantial factors. While emphasizing the key driving and restraining forces for this market, the report also offers a complete study of the future trends and developments of the market.The report further elaborates on the micro and macroeconomic aspects including the socio-political landscape that is anticipated to shape the demand of the Alopecia market during the forecast period (2019-2029).It also examines the role of the leading market players involved in the industry including their corporate overview, financial summary, and SWOT analysis.

Get Sample Copy of this Report @ Alopecia Market by disease (Androgenic Alopecia, Alopecia Areata, Cicatricial Alopecia, Traction Alopecia, Alopecia Totalis, Alopecia Universalis, and Others, by drug type (Corticosteroids, 5 Ar Inhibitors and Others), by gender (Male, Female); by route of administration (Topical, Injectable and Oral) and distribution channel (Retail Pharmacies, Hospital Pharmacies and Online Pharmacies)-Global Industry Analytics COVID-19 Business Impact, and Trends, 2020-2026

Abstract

The report covers forecast and analysis for the Alopecia market on a global and regional level. The study provides historic data from 2016 to 2019 along with a forecast from 2020 to 2026 based on revenue (USD Billion). The study includes drivers and restraints for the Alopecia market along with the impact they have on the demand over the forecast period. Additionally, the report includes the study of opportunities available in the Alopecia market on a global level. In order to give the users of this report a comprehensive view on the Alopecia market we have included competitive landscape and analysis of Porters Five Forces model for the market. The study encompasses a market attractiveness analysis, wherein disease, drug type, gender, route of administration, distribution channel, and regional segments are benchmarked based on their market size, growth rate and general attractiveness.

The word alopecia means hair loss. Alopecia isnt limited to the scalp; its possible on the body anywhere. The hair cycle comprises of three phases: Anagen, which is called as growth phase. Second phase is catagen, also called as rest phase and the fading phase, which is called as telogen phase. Ninety percent of the hair is in the development period (anagen) and the remainder, which corresponds to ten percent in the resting and shedding phases. When the hair falls out, this is the telogen phase and the hair is going to regenerate, and it begins to develop again in the (development) anagen process. Alopecia can be subdivided into two broad categories: scarring and non-scarring. Non-scarring or androgenic alopecia is the most common form. Many men start losing hair in the 20s, while women start losing their hair in their 40s or 50s. As a person grows older they lose hair. The pattern is the disparity between masculine hair loss and female hair loss. Front and temporal zone are the area where men usually lose hair because this area is more sensitive to di-hydrogen testosterone. while women appear to lose hair from the scalps central field. Female hair loss will also not result in complete baldness, while male hair loss can result in complete baldness. Males do not loose hair in the back of the scalp as this area is androgenic hormone resistant.

The study provides a decisive view on the Alopecia market by segmenting the market based on disease, drug type, gender, route of administration, distribution channel, and regions. All the segments have been analyzed based on present and future trends and the market is estimated from 2020 to 2026. Based on disease, the market is segmented into androgenic alopecia, alopecia areata, cicatricial alopecia, traction alopecia and others. The study projects that the alopecia areata will dominate the Alopecia market owing to the upsurge in the number of patients suffering with the alopecia areata.

Based on drug type, the market is segmented into corticosteroids, 5 ar inhibitors, potassium channel openers and others. Corticosteroids segment is expected to dominate the market due to the more number of patients being treated by Corticosteroids in treatment of alopecia areata. Based on gender, the market is segmented into male and female .Based on distribution channel, the market is segmented into Retail Pharmacies, Hospital Pharmacies and Online Pharmacies. The regional segmentation includes the current and forecast demand for North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. Geographically speaking, North America dominated the alopecia market. Large alopecia patient pool, availability of developed infrastructure, growing awareness and presence of key players has led to increased demand for alopecia treatment.

The increase in lifestyle spending as well as growing peoples awareness drives the growth of the market for alopecia treatment. In addition, the rise in the occurrence of chronic diseases, like acute stress disorder, polycystic ovary disease (PCOD), hyperthyroidism, hypothyroidism, cancer, lupus, and hypopituitarism is accelerating the growth of the demand for alopecia treatment. Increasing aging population and increasing people concerned with improving the hair is expected to boost the market for alopecia treatment. The increasing demand for surgical hair transplants and increased customer awareness of possible treatment, like prp treatment which in turn boosts the growth of the market for alopecia treatment. However, the high cost and adverse effects associated with treatment may hamper the growth of the market for alopecia tretment.

Key players within global Alopecia market include Cipla Inc., Dr. Reddys Laboratories, Johnson and Johnson AG, Ranbaxy Laboratories Ltd, Transitions Hair Pty Ltd., Sun Pharmaceutical Industries Ltd., Merck & Co., Inc., Transitions Hair Pty Ltd, Cirrus Hair Centers, Lexington International LLC, Vita-Cos-Med Klett-Loch GmbH, Follica, Inc., and Capillus. amongst others.

The report segments global Alopecia market as follows:

Global Alopecia Market: Disease Segment Analysis

Androgenic alopeciaAlopecia areataCicatricial alopeciaTraction alopeciaAlopecia TotalisAlopecia UniversalisOthers

Global Alopecia Market: Drug type Segment Analysis

Corticosteroids5 AR InhibitorsPotassium Channel openersOthers

Global Alopecia Market: By Gender Segment Analysis

MaleFemale

Global Alopecia Market: By Route of Administration Segment Analysis

TopicalOralInjectable

Global Alopecia Market: Distribution channel Segment Analysis

Hospital PharmaciesRetail PharmaciesOnline Pharmacies

Global Alopecia Market: Regional Segment Analysis

North America

The U.S.Canada

Europe

FranceThe UKSpainGermanyItalyRest of Europe

Asia Pacific

ChinaJapanIndiaSouth KoreaSoutheast AsiaRest of Asia Pacific

Latin America

BrazilMexicoRest of Latin America

Middle East & Africa

GCCSouth AfricaRest of Middle East & Africa

Quick Read Table of Contents of this Report @ Alopecia Market by disease (Androgenic Alopecia, Alopecia Areata, Cicatricial Alopecia, Traction Alopecia, Alopecia Totalis, Alopecia Universalis, and Others, by drug type (Corticosteroids, 5 Ar Inhibitors and Others), by gender (Male, Female); by route of administration (Topical, Injectable and Oral) and distribution channel (Retail Pharmacies, Hospital Pharmacies and Online Pharmacies)-Global Industry Analytics COVID-19 Business Impact, and Trends, 2020-2026

Trusted Business InsightsShelly ArnoldMedia & Marketing ExecutiveEmail Me For Any ClarificationsConnect on LinkedInClick to follow Trusted Business Insights LinkedIn for Market Data and Updates.US: +1 646 568 9797UK: +44 330 808 0580

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Global Alopecia Market was valued at approximately USD 2.40 billion in 2019, and is expected to generate revenue of around USD 4.45 billion by end of...

Recommendation and review posted by Bethany Smith

A good plot twist is one that seamlessly fits into the story, while leaving the audience gasping in shock, prompting them to revisit the film, simply to figure out the clues.

Disclaimer: Spoilers Ahead

In no particular order, here are some of the most epic plot twists that movies have gifted us, over the years:

Can there be more 'Bollywood' plot reveal than a song? Mehbooba Mehbooba wins the cake for the most filmy yet perfect plot reveal.

Admit it, no one predicted that.

When her husband cheats on her, Amy plans the perfect revenge - frame him for her murder and escape the married life.

The climax, when Vidya Bagchi's real identity is revealed, is even more shocking than watching insurance agent-cum-contract killer Bob Biswas pushing her in front of a train.

The scene where a supposedly blind pianist watches a crime scene being cleaned up, is peak black comedy. But, the last scene where Akash hits the can with his stick, thereby proving he regained his eyesight, is as shocking as it comes. Talk about going down the 'rabbit' hole!

For a children's movie,Makdeeprovided a surprisingly intelligent take on the evils of superstition and a thoroughly terrifying witch.

Unless you had already read the book before, there's no way you guessed the twist.

Patrick Bateman fashions himself to be a serial killer, convincing the audience along the way, only to realize he is a sadist suffering from vivid delusions. What a 'killer' imagination!

The fact that Scabbers is Peter Pettigrew almost trumped this scene. But you can't think of Harry Potter without thinking of Snape 'always' being there for Lily's son, Harry.

Three blind men rob a bank and get the man who hired them convicted -Aankhenisundoubtedly one of Hindi cinema's finest heist movies.

The police can not convict the Salgaonkars because the body of the boy whose murder the family is accused of,is never discovered. However, the bigger reveal was why the murder took place in the first place.Drishyam left the audience pondering how far would parents go for their children.

The horror film that proved, quite literally, that racism kills.

Leaving the melodrama aside,Humraazactually served a fair share of plot twists. But the first twist, where it is revealed that Priya (Ameesha Patel) and Karan (Akshaye Khanna) are partners, and the climax where Priya and Raj (Bobby Deol) outsmart Karan, are especially noteworthy.

One of Manoj Bajpayee and Urmila Matondkar's finest performances,Kaunalso happens to be a brilliant psychological thriller where the woman being hunted is actually the serial killer.

Okay, in hindsight, maybe the clues were all there. But when theGuptfirst released, the plot reveal was shocking, to say the least.

Orphan took the phrase 'there's more to it than meets the eye' quite literally when it revealed that Coleman's adopted child is actually a33-year-old woman suffering from hypopituitarism.

A fine example of DiCaprio's acting prowess, Shutter Island ends with a question most people struggle to answer - is it better 'to live as a monster, or to die as a good man?'

Though the Kim family discover a fair share of secrets when they infiltrate theParks home, the biggest twist for the audience is revealed at the end - when Ki-taek's new living quarters are revealed.

Before Shah Rukh Khan became the industry's favourite romantic hero, he was the villain who pushed his girlfriend off a balcony. And scared the sh*t out of every person in the audience.

Honey Trehan's debut filmleft the audience shocked when it revealed that Vasudha, a victim of child sexual abuse, is the one who kills her uncle after years of abuse. However, equally shocking was the fact that her mother had been complicit in hiding the abuse.

How many of these did you predict when you first watched the film? Let us know in the comments section below.

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20 Of The Most Shocking Plot Twists In Movies That We Never Predicted - ScoopWhoop

Recommendation and review posted by Bethany Smith

DUBLIN, Aug. 10, 2020 /PRNewswire/ -- The "Lactoferrin Market Size, By Product, By Application, Sales Channel, By Region, Trend Analysis, Competitive Market Share & Forecast, 2016-2026" report has been added to ResearchAndMarkets.com's offering.

The increasing consciousness amid consumers concerning health and diet, along with the rising prevalence of skin-related health circumstances, is predictable to boost the demand. Lactoferrin is alleged to have antiviral, antibacterial, antiparasitic, catalytic, and anti-allergic functions and properties, which is predicted to drive the product demand from pharmaceutical and personal care industries.

The acne cure market is also consequently predictable to see healthy development during the estimated period. Numerous clinical trials have proven the capability of lactoferrin to treat acne and other such skin disorders efficiently.

Due to its anti-provocative properties, lactoferrin eliminates the main food foundation for pathogens by nullifying its contributors. Increasing consumer consciousness towards gut fitness, joined with the increasing demand of lactoferrin to avoid bad-tempered bowel drive and bloating and reduces colonic inflammation, is expected to boost this section's request for the prediction period. Consumer consciousness due to product advertising creativities taken by brand owners coupled with an inclination toward organic products with minimum side effects and higher efficiency is probable to additional boost the demand.

Rising health awareness among consumers is a significant cause driving the development of the lactoferrin addition market as lactoferrin controls iron metabolism, acts as an antibacterial agent, has antioxidant properties and thus, helps in refining immunity. Besides, there has been a growth in the request for sports diet products due to the growing fitness trend among youths, which is likely to drive the lactoferrin addition market as lactoferrin offers nourishing value and is easy to eat.

The Asia-Pacific developed as the leading regional section in 2019. China, India, and Japan were found to be the most important local markets for the product. This important share of Asia Pacific can be attributed to the growing spending volume of the consumers. The presence of a major consumer base in these countries, along with increasing birth rates among the population, is anticipated to create development opportunities.

Growth Drivers

Rising Awareness Amongst Consumers Regarding Health and Diet

The increasing awareness amongst consumers regarding health and diet, along with the rising prevalence of skin-related health conditions, is predictable to increase the request. Lactoferrin is assumed to have catalytic, antiviral, antibacterial, anti-parasitic, and anti-allergic functions and properties, which is expected to drive the product demand from pharmaceutical and personal care industries.

The acne treatment market is also consequently expected to witness strong development during the prediction period. Numerous clinical trials have proven the capability of lactoferrin to efficiently treat acne and other such skin circumstances.

Strong Growth Potential in the Developing Countries

The consumer's fondness for cosmeceutical products that syndicate cosmetic and pharmaceutical features, such as acne conduct and anti-aging, is increasingly becoming famous and is projected to see growth at 10%-20% per annum in the Asia-Pacific region. Personal care is the primary market in China, Australia, and India. Lactoferrin is expected to record a surging demand in acne care products.

Lactoferrin, combined with vitamin A and zinc, acts as a critical ingredient for mild to moderate acne. Dairy proteins are measured the most significant foundations of bioactive peptide. There has been a growth in the usage of these peptides in various sports nourishment and nutraceuticals, due to the rise in mindfulness on numerous health issues, along with rising people and growing disposable income.

Key Topics Covered

1. Research Framework

2. Research Methodology

3. Executive Summary

4. Global Lactoferrin Industry Insights4.1. Industry Value Chain Analysis4.2. DROC Analysis4.2.1. Growth Drivers4.2.2. Restraint4.2.3. Opportunities4.2.4. Challenges4.3. Technological Landscape/Recent Development4.4. Regulatory Framework4.5. Company Market Share Analysis, 20194.6. Porter's Five Forces Analysis4.7. Impact of COVID-19

5. Global Lactoferrin Market Overview5.1. Market Size & Forecast by Value, 2016-20265.1.1. By Value (USD Million)5.2. Market Share & Forecast5.2.1. By Product5.2.1.1. Spray Dried Powder5.2.1.2. Freeze-Dried Powder5.2.2. By Application5.2.2.1. Food & Beverage5.2.2.2. Personal care products5.2.3. By Sales Channel5.2.3.1. Direct Sales5.2.3.2. Indirect Sales5.2.4. By Region 5.2.4.1. North America5.2.4.2. Europe5.2.4.3. Asia-Pacific5.2.4.4. Latin America5.2.4.5. Middle East & Africa

6. North America Lactoferrin Market

7. Europe Lactoferrin Market

8. Asia-Pacific Lactoferrin Market

9. Latin America Lactoferrin Market

10. Middle East & Africa Lactoferrin Market

11. Company Profiles11.1. NOW Foods11.2. Jarrow Formulas11.3. Life Extension11.4. Fonterra Cooperative Group11.5. Glanbia Nutritionals11.6. Synlait Milk Ltd.11.7. Metagenics, Inc.11.8. Naturade11.9. Ingredia SA11.10. Agennix Inc.11.11. Morinaga Milk Industry Co. Ltd.11.12. Other Prominent Players

For more information about this report visit https://www.researchandmarkets.com/r/d8jcpk

Research and Markets also offers Custom Research services providing focused, comprehensive and tailored research.

Media Contact:

Research and Markets Laura Wood, Senior Manager [emailprotected]

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Global Lactoferrin Market, Forecast to 2026 with Profiles of NOW Foods, Jarrow Formulas, and Life Extension Among Others - PRNewswire

Recommendation and review posted by Bethany Smith