MELVILLE, N.Y., Oct. 23, 2019 (GLOBE NEWSWIRE) -- BioRestorative Therapies, Inc. (the Company") (BRTX), a life sciences company focused on stem cell-based therapies, today announced that the Australia Patent Office has issued a Certificate of Grant for the Companys patent application titled Human Brown Adipose Derived Stem Cells and Uses.

This is the second patent issued for the Companys brown fat technology in Australia and adds to three other patents related to BioRestoratives metabolic program (ThermoStem Program) that have previously been issued to the Company in the United States and other countries.

This patent will allow for the protection of a specific isolated human brown adipose tissue stem cell line capable of differentiating into multiple cell types. This particular cell line possesses strong characteristics applicable for potential therapeutic uses for treating a wide range of degenerative and metabolic disorders, including diabetes, hypertension, cardiac deficiency and obesity.

This patent, granted by the Australian Patent Office for our metabolic program, adds to our growing family of IP surrounding and protecting our brown fat metabolic cell program, said Mark Weinreb, CEO of BioRestorative Therapies. In particular, our invention relates to an isolated brown fat stem cell line that we expect to be used in our development of cell-based therapies to treat metabolic disorders.

About BioRestorative Therapies, Inc.

BioRestorative Therapies, Inc. (www.biorestorative.com) develops therapeutic products using cell and tissue protocols, primarily involving adult stem cells. Our two core programs, as described below, relate to the treatment of disc/spine disease and metabolic disorders:

Disc/Spine Program (brtxDISC): Our lead cell therapy candidate, BRTX-100, is a product formulated from autologous (or a persons own) cultured mesenchymal stem cells collected from the patients bone marrow. We intend that the product will be used for the non-surgical treatment of painful lumbosacral disc disorders. The BRTX-100 production process utilizes proprietary technology and involves collecting a patients bone marrow, isolating and culturing stem cells from the bone marrow and cryopreserving the cells. In an outpatient procedure, BRTX-100 is to be injected by a physician into the patients damaged disc. The treatment is intended for patients whose pain has not been alleviated by non-invasive procedures and who potentially face the prospect of surgery. We have received authorization from the Food and Drug Administration to commence a Phase 2 clinical trial using BRTX-100 to treat persistent lower back pain due to painful degenerative discs.

Metabolic Program (ThermoStem): We are developing a cell-based therapy to target obesity and metabolic disorders using brown adipose (fat) derived stem cells to generate brown adipose tissue (BAT). BAT is intended to mimic naturally occurring brown adipose depots that regulate metabolic homeostasis in humans. Initial preclinical research indicates that increased amounts of brown fat in the body may be responsible for additional caloric burning as well as reduced glucose and lipid levels. Researchers have found that people with higher levels of brown fat may have a reduced risk for obesity and diabetes.

Forward-Looking Statements

This press release contains "forward-looking statements" within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and such forward-looking statements are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. You are cautioned that such statements are subject to a multitude of risks and uncertainties that could cause future circumstances, events or results to differ materially from those projected in the forward-looking statements as a result of various factors and other risks, including, without limitation, whether the Company will be able to consummate the private placement and the satisfaction of closing conditions related to the private placement and those set forth in the Company's Form 10-K filed with the Securities and Exchange Commission. You should consider these factors in evaluating the forward-looking statements included herein, and not place undue reliance on such statements. The forward-looking statements in this release are made as of the date hereof and the Company undertakes no obligation to update such statements.

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CONTACT:Email: ir@biorestorative.com

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BioRestorative Therapies Receives A Second Patent in Australia For Its Metabolic Program - Yahoo Finance

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United Therapeutics received a building permit Tuesday for a $9.5 million build-out of its cell therapy facility on the second floor of Mayo Clinics Discovery and Innovation Building.

The 21,843-square-foot space will house an automated stem cell manufacturing site, which is one of the first of its kind in the country. The Whiting-Turner Contracting Co. is the project contractor.

The technology, approved by the FDA in 2018, allows the Mayo Clinic Center for Regenerative Medicine to produce cells from the bone marrow of a stem cell donor in large enough quantities to be used as treatments in clinical trials. It allows for the treatment of multiple patients at the same time.

Construction began in 2017 on the $32.4 million building at 14221 Kendall Hench Drive. It held a grand opening in August.

The first floor houses three ex-vivo lung perfusion surgical suites used for lung restoration, another form of regenerative medicine. It turns donor lungs, which previously would have previously been unusable, into viable transplant organs. United Therapeutics also collaborates with Mayo Clinic on lung restoration.

The third floor houses the Life Sciences Incubator for biotech entrepreneurs, which offers coworking space, wet labs, business resources, networking and entrepreneurial training.

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United Therapeutics receives permit for cell therapy facility build-out at Mayo - Jacksonville Daily Record

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NEW YORK, Oct. 25, 2019 (GLOBE NEWSWIRE) -- BrainStorm Cell Therapeutics Inc. (NASDAQ: BCLI), a leader in the development of innovative autologous cellular therapies for highly debilitating neurodegenerative diseases, today announced that it will be presenting at the Dawson James Securities 5th Annual Small Cap Growth Conference, being held on October 28-29, 2019 at the Wyndham Grand Hotel in Jupiter, Florida.

Preetam Shah, PhD, MBA, Chief Financial Officer is scheduled to present on Tuesday, October 29th at 3:40 p.m. Eastern Time, in Track 2 - Preserve Ballroom B, with one-on-one meetings to be held throughout the conference.

Chaim Lebovits, President and CEO of BrainStorm said, We are pleased to have the opportunity to have Dr. Shah present at the Dawson James Small Cap Growth Conference. Dr. Shah, joined BrainStorm in September 2019, and we look forward to having him present the Companys growth strategy and future to a wide audience of accreditied investors.

About NurOwn NurOwn (autologous MSC-NTF cells) represent a promising investigational approach to targeting disease pathways important in neurodegenerative disorders. MSC-NTF cells are produced from autologous, bone marrow-derived mesenchymal stem cells (MSCs) that have been expanded and differentiated ex vivo. MSCs are converted into MSC-NTF cells by growing them under patented conditions that induce the cells to secrete high levels of neurotrophic factors. Autologous MSC-NTF cells can effectively deliver multiple NTFs and immunomodulatory cytokines directly to the site of damage to elicit a desired biological effect and ultimately slow or stabilize disease progression. NurOwn is currently being evaluated in a Phase 3 ALS randomized placebo-controlled trial and in a Phase 2 open-label multicenter trial in Progressive MS.

AboutBrainStorm Cell Therapeutics Inc.BrainStorm Cell Therapeutics Inc. is a leading developer of innovative autologous adult stem cell therapeutics for debilitating neurodegenerative diseases. The Company holds the rights to clinical development and commercialization of the NurOwn Cellular Therapeutic Technology Platform used to produce autologous MSC-NTF cells through an exclusive, worldwide licensing agreement. Autologous MSC-NTF cells have received Orphan Drug status designation from the U.S. Food and Drug Administration (U.S. FDA) and the European Medicines Agency (EMA) in ALS. BrainStorm has fully enrolled the Phase 3 pivotal trial in ALS (NCT03280056), investigating repeat-administration of autologous MSC-NTF cells at six sites in the U.S., supported by a grant from the California Institute for Regenerative Medicine (CIRM CLIN2-0989). The pivotal study is intended to support a BLA filing for U.S. FDA approval of autologous MSC-NTF cells in ALS. BrainStorm received U.S. FDA clearance to initiate a Phase 2 open-label multi-center trial of repeat intrathecal dosing of MSC-NTF cells in Progressive Multiple Sclerosis (NCT03799718) in December 2018 and has been enrolling clinical trial participants since March 2019. For more information, visit the company's website.

Safe-Harbor Statements Statements in this announcement other than historical data and information, including statements regarding future clinical trial enrollment and data, constitute "forward-looking statements" and involve risks and uncertainties that could causeBrainStorm Cell Therapeutics Inc.'sactual results to differ materially from those stated or implied by such forward-looking statements. Terms and phrases such as "may", "should", "would", "could", "will", "expect", "likely", "believe", "plan", "estimate", "predict", "potential", and similar terms and phrases are intended to identify these forward-looking statements. The potential risks and uncertainties include, without limitation, BrainStorms need to raise additional capital, BrainStorms ability to continue as a going concern, regulatory approval of BrainStorms NurOwn treatment candidate, the success of BrainStorms product development programs and research, regulatory and personnel issues, development of a global market for our services, the ability to secure and maintain research institutions to conduct our clinical trials, the ability to generate significant revenue, the ability of BrainStorms NurOwn treatment candidate to achieve broad acceptance as a treatment option for ALS or other neurodegenerative diseases, BrainStorms ability to manufacture and commercialize the NurOwn treatment candidate, obtaining patents that provide meaningful protection, competition and market developments, BrainStorms ability to protect our intellectual property from infringement by third parties, heath reform legislation, demand for our services, currency exchange rates and product liability claims and litigation,; and other factors detailed in BrainStorm's annual report on Form 10-K and quarterly reports on Form 10-Q available athttp://www.sec.gov. These factors should be considered carefully, and readers should not place undue reliance on BrainStorm's forward-looking statements. The forward-looking statements contained in this press release are based on the beliefs, expectations and opinions of management as of the date of this press release. We do not assume any obligation to update forward-looking statements to reflect actual results or assumptions if circumstances or management's beliefs, expectations or opinions should change, unless otherwise required by law. Although we believe that the expectations reflected in the forward-looking statements are reasonable, we cannot guarantee future results, levels of activity, performance or achievements.

CONTACTS

Corporate:Uri YablonkaChief Business OfficerBrainStorm Cell Therapeutics Inc.Phone: 646-666-3188uri@brainstorm-cell.com

Media:Sean LeousWestwicke/ICR PR Phone: +1.646.677.1839sean.leous@icrinc.com

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BrainStorm Cell Therapeutics to Present at the Dawson James Securities 5th Annual Small Cap Growth Conference - GlobeNewswire

Recommendation and review posted by Bethany Smith

The study, published in the Journal of Cannabis Research, looked at a number of studies covering cannabis use and the immune system, noting that little is known on circulating white blood cell counts and cannabis use.

The researchers looked at the National Health and Nutrition Examination Survey (20052016), a survey designed to be nationally representative of United States non-institutionalised population, and found that there was a modest association between heavy cannabis use and higher white blood cell count but that neither former nor occasional cannabis use was associated with total or differential WBC counts.

White blood cells are the cells in our body that function mainly as immune cells originating in the bone marrow.

Today, it is known that cigarette smoking generates several chemicals that are implicated in oxidative stress pathways and systemic inflammation and elevated white blood cell count in tobacco cigarette smokers have been well documented, whereas tobacco abstinence is associated with sustained decrease in white blood cell count.

The study highlights how cannabis is able to mediate its effects through the cannabinoid-1 (CB1) and cannabinoid-2 (CB2) receptors.

CB2 receptors can be found in numerous parts of the body related to the immune system, including bone marrow, thymus, tonsils and spleen. CB1 receptors are present in the central nervous system, and at lower levels in the immune system.

The effects of cannabinoids on hematopoiesis, and immune cell proliferation using animal and cell based models has been widely demonstrated and a number of studies have examined the association of cannabis use and white blood cell counts in human immunodeficiency virus (HIV).

The studies have shown a higher white blood cell count in HIV positive men who used cannabis.

Last year a study discovered certain cannabinoids that enhance the immunogenicity of tumour cells, rendering them more susceptible to recognition by the immune system. This discovery is important because the leading class of new cancer fighting agents, termed checkpoint inhibitors, activates the immune system to destroy cancer cells.

Enhancing recognition of cancer cells with cannabinoids may greatly improve the efficacy of this drug class. The Pascal study was the first to identify a mechanism in which cannabinoids may provide a direct benefit in immunotherapy.

When looking at white blood cell counts the study noted that: Several of the important study limitations merit attention. The observational nature of the study constrained causal inferences. Even though NHANES collects blood and urine specimens, drug testing is not conducted, and cannabis use was self-reported which may lead to non-differential misclassification bias. There was no available information on the route of administration of cannabis (smoking, ingestion, etc.) or cannabis preparation/potency.

In addition, the study is based on fairly recent NHANES surveys (200516) which might be more representative of the increasing cannabis potency compared to NHANES III (19881994) surveys.

A number of laboratory studies have reported suppression of immune responses with cannabinoid administration, and some epidemiological studies found lower levels of inflammatory biomarkers such as fibrinogen, C-reactive protein and interleukin-6 in adult cannabis users.

The study also noted that the reported anti-inflammatory effects of cannabis were greatly attenuated when body weight is controlled for and suggests that the inverse cannabis-body weight association might explain the lower levels of circulating inflammatory biomarkers in adult cannabis users.

The study highlights that these alterations of immune responses by cannabis use might be associated with increased susceptibility to infections and hence the higher white blood cell count, however, it notes that it is possible that the elevated white blood cell count and suboptimal health status contributed to cannabis use rather than cannabis use caused suboptimal health.

The study states: This hypothesis, though, cannot be tested as NHANES does not collect information on cannabis use motives. Another potential mechanism can be through the effect of cannabinoids on stem cells. Pre-clinical studies suggest that cannabinoids stimulate hematopoiesis and hence this stimulation to bone marrow tissues can be associated with increased circulating white blood cell count in cannabis users.

Positive associations between heavy cannabis use, and total white blood cell and neutrophil counts were detected. Clinicians should consider heavy cannabis use in patients presenting with elevated white blood cell count.

Research on cannabis use and the immune system is lacking and the study suggests further research is needed to understand the immune related effects of different modes of cannabis use.

The study noted: Research on heavy cannabis use and cardiovascular health is needed as systemic inflammation, increased cardiovascular risk and increased mortality risk have been all associated with white blood cell elevation within the normal physiologic range.

Studies with repeated measures are needed to study immunomodulatory changes in cannabis users, and whether the mode of cannabis use can differentially affect immune responses.

Additional research is needed to understand the immune related effects of different modes of cannabis use and to elucidate the role of proinflammatory chemicals generated from smoking cannabis.

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Cannabis use and the immune system: white blood cell count - Health Europa

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Nicole Duhaney couldnt believe her luck when she learned she was having identical twins.

I felt like had won the lottery, Duhaney, 21, told TODAY Parents. "It was the happiest surprise."

After being pregnant for what felt like an eternity, Duhaney and her boyfriend, Niles Liburd, finally welcomed sons Emre pronounced Em-ree" and Elijah on Dec. 23, 2018.

Our life seemed perfect, the mom from Huddersfield, England, said.

But just three weeks later, Elijah developed a lump on his cheek, and both babies developed colds they couldnt seem to kick. Suddenly, they were projectile vomiting.

Trending stories,celebrity news and all the best of TODAY.

At just 4 months old, Emre and Elijah were both diagnosed with childhood acute myeloid leukemia. The disease, also known as AML, is a type of cancer in which the bone marrow makes a large number of abnormal white blood cells, according to the National Cancer Institute.

Myeloid leukemia is the second most common pediatric blood cancer, but it's still relatively rare. In the United States there are roughly 500 children a year between the ages of 0 and 14 that are diagnosed with AML, according to Dr. Richard Aplenc, a physician-scientist within the Division of Oncology at Children's Hospital of Philadelphia.

Aplenc said it is not surprising that Emre and Elijah were diagnosed at the same time.

"If the twins are identical, then they share the same placenta and the same blood supply, so that leukemic cell goes to the other twin," Aplenc explained. "We know that if leukemia is diagnosed before a year or so, there is 100 percent chance that the other twin will develop it."

Tragically, 10-month-old Elijah passed away at home in Tuesday. Doctors allowed Emre, who is currently undergoing chemotherapy, to leave the hospital so he could say goodbye to his brother.

The love they had for each other was just unbreakable, Duhaney noted. "They didn't like to be separated."

She recalled how Elijah pulled his brother in for a kiss after a recent stem cell transplant.

Elijah was beautiful. Every person he met, he touched their heart," Duhaney said. There were times when I cried and he rubbed my tears away. I wish God took me instead of him.

As Duhaney and Liburd, 26, make funeral arrangements a GoFundMe has been set up to help the couple with expenses they are finding comfort in knowing Elijah took his final breaths at home.

He spent six months of his life in a hospital, Duhaney told TODAY Parents. His final night he was where he wanted to be, with the people who loved him him the most.

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Baby dies from AML, the same cancer his identical twin has - TODAY

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Image Source : PTI

Children, suffering from DMD, usually die of cardio-respiratory failure. Represtational image

Duchenne Muscular Dystrophy (DMD) is a deadly genetic disorder, 99.9 per cent people suffering from which, die between the age of 13 to 23 years. However, in a first, a 26-year-old patient from Lucknow has survived DMD by regularly taking stem cells for the last five years.

Children, suffering from DMD, usually die of cardio-respiratory failure. But with the stem cell therapy, this patient has not lost muscle power in last five years and heart and lung muscles and the upper half of the body are working well.

Dr. B.S Rajput, the surgeon who is treating this patient, said, "DMD is a type of muscular dystrophy and being a genetic disorder, it is very difficult to treat. Autologous (from your own body) bone marrow cell transplant or stem cell therapy in such cases was started in Mumbai about 10 years back.

Dr Rajput, who was recently appointed as visiting professor at GSVM Medical College, Kanpur, said he has treated several hundred DMD patients and recently this combination protocol was published in the international Journal of Embryology and stem cell research.

The patient's father is elated that his son has maintained well with this treatment and now has even started earning by working on computers.

According to Dr Rajput, this disease is endemic in eastern UP, especially Azamgarh, Jaunpur, Ballia and some of the adjoining districts of Bihar, and one out of every 3,500 male child, suffers from the disease.

Yet the disease is not given as much attention as it should be.

Dr Rajput, who is consultant bone cancer and stem cell transplant surgeon from Mumbai, said though patients in Uttar Pradesh and Bihar get financial support from the Chief Minister's Relief Funds, the treatment of autologous bone marrow cell transplant is not included in the package list of Ayushman Bharat scheme, which deprives many from getting the treatment.

The doctor further informed that efforts are being made to establish the department of regenerative medicine in the medical college, where bone marrow cell transplant and stem cell therapy would be done even for other intractable problems like spinal cord injury, arthritis knee and motor neurone disease.

ALSO READ |Fasting triggers regeneration of stem cells capacity: Study

ALSO READ |UK patient 'free' of HIV after stem cell treatment

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In a first, 26-year-old DMD patient in UP survives with stem cell therapy - India TV News

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Whether youve been recently diagnosed with multiple sclerosis (MS) or have been living with the condition for a while, chances are youll sometimes hear terms from your healthcare team that are new to you.

The following is a quick, alphabetical guide to the terminology you may need to know as you manage your condition:

Ankle-Foot Orthosis (AFO) A brace designed to support the position of the foot and motion of the ankle to compensate for nerve damage and muscle weakness in the area caused by MS and other movement disorders. An AFO is typically used to stabilize weak limbs or to reposition a limb with contracted muscles into a more normal position.

Autoimmune Disease Your immune system plays a major part of your bodys defense against bacteria and viruses by sending out cells to attack them once they enter your body. However, if you have an autoimmune disease, your immune system mistakenly attacks healthy cells in your body, causing them to weaken or break down. MS is thought to be just one example of an autoimmune disease. It has been suggested that in MS, your immune system may mistakenly attack the cells in your central nervous system.

Axon Long threadlike structures of nerve cells that send impulses to other cells in your body. Research suggests that damage to or loss of these fibers in progressive MS may be linked to worsening disability and more severe progression.

Central Nervous System (CNS) The group of organs in your body that includes the brain, spinal cord, and optic nerves. If you have MS, your bodys immune system may be working against the CNS, producing neurological symptoms such as muscle weakness and vision problems.

Cerebrospinal Fluid (CSF) A clear, colorless liquid that surrounds the brain and spinal cord to protect the CNS and assist in the circulation of nutrients and removal of waste products. In MS, damage to the myelin sheath of nerve cells causes certain types of proteins to be released into the spinal fluid. The presence of these proteins in the CSF, but not in the blood, may point to a diagnosis of MS.

Clinically Isolated Syndrome (CIS) A first episode of neurologic symptoms that lasts at least 24 hours and is caused by inflammation or demyelination (loss of the myelin that covers the nerve cells) in the CNS. People who experience CIS may or may not go on to develop MS. However, when CIS is accompanied by magnetic resonance imaging (MRI)detected brain lesions similar to those found in MS, you have a 60 to 80 percent chance of a second neurologic event and diagnosis of MS within several years, according to the National MS Society.

Cog Fog A commonly used term that refers to the cognitive changes experienced by many people with MS. According to MS Australia, approximately 50 percent of people with the condition will develop some degree of cog fog, or inhibited ability to think, reason, concentrate, or remember. For some, cognitive problems will become severe enough to interfere in a significant way with daily activities.

Corticosteroids (or Steroids) Prescription medication used to treat relapses in relapsing-remitting MS. Your doctor may prescribe intravenous (IV) corticosteroids if the symptoms of your relapse are causing significant problems, like poor vision or difficulty walking. These drugs work by suppressing the immune system and reducing inflammation in the CNS, and they may help relapse symptoms resolve more quickly. But they wont affect your ultimate level of recovery from a relapse or the long-term course of your MS. Methylprednisolone is a commonly used corticosteroid in MS.

Diplopia (or Double Vision) An eye problem in which you see two images of a single object. It may be present when only one eye is open (monocular) or disappear when either eye is closed (binocular). Diplopia is a common symptom of MS, and it occurs because of damage to the optic nerve.

Disease-Modifying Therapies (DMTs) Drugs designed to reduce new relapses, delay progression of disability, and limit new CNS inflammation in people with MS. Although there are multiple DMTs that have been approved by the U.S. Food and Drug Administration (FDA) for use in MS, these drugs generally work by reducing inflammation in nerve cells in theCNS.

Dysarthria A speech disorder caused by neuromuscular impairment and resulting in disturbances in motor control of the muscles used in speech. Its believed the demyelinating lesions in MS may result in spasticity, weakness, slowness, or ataxic incoordination of the lips, tongue, mandible, soft palate, vocal cords, and diaphragm, causing this speech impairment.

Dysphagia (Difficulty Swallowing) A condition that may occur in people with MS, leading to difficulty in eating solid foods or liquids, frequent throat clearing during eating or drinking, a feeling that food is stuck in the throat, or coughing or a choking sensation when eating or drinking. Its the result of nerve damage within the muscles that control swallowing.

Epstein-Barr Virus (EBV) A virus believed to be a possible cause or trigger for MS. Although the exact cause of MS remains unknown, researchers suggest an infectious agent may be involved in its development. Studies have found that antibodies (immune proteins that indicate a person has been exposed to a given virus) to EBV are significantly higher in people who eventually develop MS than in those who dont. Other research has noted that people with a specific immune-related gene and high levels of antibodies to EBV in their blood are 9 times more likely to develop MS than others.

Evoked Potentials A test that measures the speed of nerve messages along sensory nerves to the brain, which can be detected on your scalp using electrodes attached with sticky pads. Its sometimes used in the diagnosis of MS, because nerve damage can slow down the transmission of nerve signals. Evoked potential tests can indicate nerve pathways that are damaged prior to the onset of MS symptoms.

Exacerbation An occurrence of new symptoms or the worsening of old symptoms that may also be referred to as a relapse, attack, or flare-up. Exacerbations can be very mild, or severe enough to interfere with a person's ability to perform day-to-day activities.

Expanded Disability Status Scale (EDSS) A scale used for measuring MS disability and monitoring changes in the level of disability over time. Developed by neurologist John Kurtzke, MD, in 1983, the EDSS scale ranges from 0 to 10 in 0.5-unit increments (scoring is based on a neurological exam) and relies on walking as its main measure of disability. People with an EDSS of 1 have no disability and minimal loss of function, while those with an EDSS of 9.5 are confined to bed and totally dependent on others for functions of daily living.

Foot Drop (or Drop Foot) A symptom of MS caused by weakness in the ankle or disruption in the nerve pathway between the legs and the brain, making it difficult to lift the front of the foot to the correct angle during walking. If you have foot drop, your foot hangs down and may catch or drag along the ground, resulting in trips and falls. Foot drop can be managed with an AFO or other treatments.

Hematopoietic Stem Cell Transplantation (HSCT) A procedure designed to reboot the immune system, the National MS Society says, using hematopoietic (blood cellproducing) stem cells derived from a persons own bone marrow or blood. If your doctor recommends HSCT, youll undergo a chemotherapy regimen before these cells are reintroduced to the body via IV injection, where they will migrate to your bone marrow to rebuild the immune system.

John Cunningham (JC) Virus A common infection completely unrelated to MS that is found in as many as 90 percent of people, according to the UK's MS Trust. JC virus has no symptoms and is normally controlled by the immune system. However, if your immune system is weakened, the JC virus can reactivate, causing potentially fatal inflammation and damage to the brain known as progressive multifocal leukoencephalopathy (PML). Certain MS disease-modifying therapies have been linked with increased risk for PML.

Lhermittes Sign An electric shock-like sensation experienced by some with MS when the neck is moved in a particular way. The sensation can travel down to the spine, arms, and legs.

Lesion (or Plaque) Refers to an area of damage or scarring (sclerosis) in the CNS caused by inflammation in MS. These lesions can be spotted on an MRI scan, with active lesions appearing as white patches. With regular MRIs, a neurologist can tell how active your MS is.

Lumbar Puncture (or Spinal Tap) A procedure used for the collection of cerebrospinal fluid (CSF), sometimes done to help diagnose MS. For this procedure, your doctor will ask you to lie on your side or bend forward while seated, before cleansing an area of your lower back and injecting a local anesthetic. He will then insert a hollow needle and extract a small amount of spinal fluid using a syringe.

Magnetic Resonance Imaging (MRI) The diagnostic tool that currently offers the most sensitive noninvasive way of imaging the brain, spinal cord, or other areas of the body, according to the National MS Society. Its the preferred imaging method for diagnosis of MS and to monitor the course of the disease. MRI uses magnetic fields and radio waves to measure the relative water content in tissues, which is notable in MS because the layer of myelin that protects nerve cell fibers is fatty and repels water. In areas where myelin has been damaged by MS, fat is stripped away and the tissue holds more water. This shows up on an MRI as a bright white spot or darkened area, depending on how the images are made.

McDonald Criteria A guidance used in the diagnosis of MS, authored by an international panel of experts on the condition, originally in 2010. The guidance was updated in 2017. Among the key changes: advising for the use of brain MRI as part of the diagnostic process.

MS Hug A common symptom of MS. If you experience the MS hug, you may feel like you have a tight band around your chest or ribs, or pressure on one side of your torso. Some people find that it is painful to breathe. The MS hug can last for seconds, minutes, hours, or even longer.

Myelin A substance rich in lipids (fatty substances) and proteins that helps form the myelin sheath. In MS, particularly relapsing-remitting MS, an abnormal immune response produces inflammation in the CNS, effectively attacking the myelin in the cells.

Myelin Sheath An insulating layer of fatty substances and proteins that forms around the nerves in body, including those in the CNS. It allows electrical impulses to transmit quickly and efficiently along the nerve cells, but these impulses can be slowed if the sheath is damaged, causing MS.

Neurodegeneration Refers to the process by which the myelin sheath of cells in the CNS is damaged in MS. Its believed to be a major contributor to neurological disability in the condition, and may be the reason immune modulation treatments (disease-modifying therapy) are generally less effective in the progressive MS than in the relapsing-remitting MS.

Neurologist The point person for monitoring your MS treatment and managing MS symptoms. This specialist typically focuses on conditions affecting the CNS.

Neuropathic Pain A type of pain common in MS that results from changes or damage to the myelin sheath and the axons, or nerve fibers, it normally covers. MS-caused neuropathic pain may be chronic, intermittent, or occur only in response to a stimulus.

Neuropsychologist A specialist you may be referred to who helps you manage the cognitive effects of MS. Neuropsychological testing (or testing of the functioning of your brain) involves identifying memory or learning difficulties associated with MS. Cognitive rehabilitation may improve functioning.

Nociceptive Pain Caused by damage to muscles and joints, it can be either acute or chronic, and may not result from MS itself, but be caused by changes in posture or walking or the overuse of assistive devices in those with the condition.

Nystagmus A common eye abnormality in MS, its characterized by involuntary, rhythmic, back-and-forth motion of the eyeball, either horizontally or vertically. For those with nystagmus, the perception of the rhythmic movement of the surrounding stationary world (oscillopsia) can be disorienting and disabling.

Oligoclonal Bands (OCBs) Immunoglobulins, or proteins, that collect in blood plasma or cerebrospinal fluid (CSF). Although not every person with MS has OCBs, their presence can support a diagnosis of MS. Having OCBs is generally associated with a younger age of MS onset and a poorer prognosis.

Optic Neuritis An inflammatory condition that damages the optic nerve, a bundle of nerve fibers that transmits visual information from your eye to your brain, causing pain and temporary vision loss in one eye. Its been linked with nerve damage resulting from MS, and may be among the first symptoms a person with the condition experiences.

Pseudobulbar Affect (PBA) A neurologic effect experienced by roughly 10 percent of people with MS as well as some with Parkinsons disease or amyotrophic lateral sclerosis (ALS), according to the Multiple Sclerosis Association of America (MSAA). Its characterized by sudden, uncontrollable expressions of laughter or crying without an obvious cause, which can be distressing as well as embarrassing to those who experience it. PBA is believed to be a mood disorder related to the disruption of nerve impulses in the CNS, but its different from depression, which is also common in MS.

Pseudoexacerbation A temporary worsening of symptoms without actual myelin inflammation or damage. It is often triggered by other illnesses or infection, exercise, a warm environment, depression, exhaustion, and stress. Urinary tract infection (UTI) is the most common type of infection to cause a pseudoexacerbation.

Sclerosis A general hardening of the body tissue. The term multiple sclerosis refers to the multiple areas of scar tissue often called lesions that develop along affected nerve fibers and that are visible in MRI scans.

Spasticity A symptom of MS that causes your muscles to feel stiff, heavy, or difficult to move. When a muscle spasms, youll experience a sudden stiffening that may cause a limb to jerk. This may be painful.

Trigeminal Neuralgia (or Tic Douloureux) A type of neuropathic pain that occurs on the face (usually on one side only). Its a known symptom of MS, and you may experience it in your cheek; upper or lower jaw; inside the mouth; or in the area around your eyes, ears, or forehead. In MS, its typically caused by damage to the myelin sheath around the trigeminal nerve, which among other functions controls the muscles used in chewing. The condition is triggered by everyday activities, like tensing facial muscles while shaving or when chewing.

Vertigo An intense sensation of the surrounding environment spinning around one. In MS, vertigo is typically caused by growth of an existing lesion or development of a new lesion on the brain stem or cerebellum, the area in the brain that controls balance. It can also be a symptom of a problem with the inner ear, or it can be side effect of medication used to treat MS or other health conditions you may have.

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Speaking Multiple Sclerosis: A Glossary of Common Terms - Everyday Health

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By Alex Dobuzinskis

LOS ANGELES (Reuters) One toke for the road could end up being a total bummer for drivers who smoke pot, with several companies in the United States preparing to market cannabis breathalyzers as legalized marijuana spreads across the country.

Law enforcement agencies will require breathalyzers to detect marijuana as they are faced with the necessity of stopping more and more motor vehicles being operated under the influence of THC, said Brett Meade, a retired police chief and a senior program manager for Washington-based non-profit group the Police Foundation.

Nearly a dozen U.S. states allow recreational marijuana consumption and 33 states permit pot for medical use. But all states prohibit driving under the influence of marijuana.

Oakland, California-based Hound Labs is one of the companies developing a breathalyzer to detect THC the component in marijuana that gets people high and plans to market it in 2020.

Construction companies could be a big part of its market, said Hound Labs Chief Executive Officer Mike Lynn.

Nobody wants a crane operator 50 stories up to be smoking a joint, he told Reuters.

Lynn, a physician, said pregnancy tests, which can detect minute quantities of hormone, inspired him to tackle the challenge of measuring THC on users breath.

Separately, Cannabix Technologies Inc based in the Vancouver suburb of Burnaby is testing a pair of devices at different price points.

Its THC Breath Analyzer could be cheap enough at a few hundred dollars per unit to potentially allow parents interested in testing their teenager before turning over the keys to the family car, said Cannabix CEO Rav Mlait.

The U.S. court system would need to consider how to treat evidence from THC breathalyzers.

Assuming a motorist who tested positive with a THC breathalyzer was impaired behind the wheel could be problematic, said Stanford University law professor Robert MacCoun.

Unlike with alcohol, scientific research has not yet established firm correlations between the amount of marijuana people consume and how impaired they become, MacCoun said in an email.

Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, expressed similar concerns.

But he welcomed breathalyzers as an improvement over existing tests used by police and employers, such as urine analysis that is unable to determine whether marijuana was used recently with the potential for impairment, or days or weeks in the past. Breathalyzers are likely to only detect a user who consumed cannabis within the last few hours.

A test like that would frankly make sense, Armentano said. Just like we wouldnt allow employees to have a couple drinks and show up to work.

(Additional reporting by Jane Ross in Newark, California; editing by Bill Tarrant and Bill Berkrot)

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That last toke for the road could be a downer with pot breathalyzers coming - Physician's Weekly

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When you think of any sort of preconception or fertility treatment, such as hormone testing or in vitro fertilization (IVF), chances are you envision going into either your OB-GYN's office or a fertility clinic and encountering lots of doctors and a slew of needles. But just as services like grocery delivery and transportation are becoming increasingly app-based and tech-savvy, so too are fertility tests and treatments.

As the industry strives to increase access and convenience for patients with at-home options, it's important to remember that there's no one-size-fits-all in fertility treatments, says Chantae Sullivan-Pyke, M.D., a reproductive endocrinologist at Kofinas Fertility Group in New York City. Therefore you'll do well to consult a health care provider about whether an at-home treatment, test, or tracking system is right for you.

So just how much can (and should) really be DIY when it comes to bettering your odds of getting pregnant? We took a look at three of the latest at-home fertility products and services that aim to allow you to take matters of your fertility into your own handsand hometo weigh the pros and cons.

New Hope Fertility in New York City has an exclusive service called At-Home IVF, which is meant to cut out the stressful commute to and from a doctor's office. The kit includes an instruction card, color-coded individual packets with oral and vaginal medications that are numbered by day, a nasal spray which is used on days 12 and 13, and an ovulation testing kit with test strips. Day 14 is the only day that isn't "at-home," as it's when a patient will go into the clinic for egg retrieval.

The pros: "There is no need to go the the physician's office for monitoring, for bloodwork, or for ultrasounds," says Zaher Merhi, MD, FACOG, the director of IVF research and development in IVF technologies at New York'sNew Hope Fertility Clinic. "The woman will only go to the office on the day of the procedure, the egg retrieval. This translates into a tremendous advantage for the woman. She will have much less stress, no concerns about making and keeping appointments at the doctor's office, for women who already have a child there is no need to get a babysitter, and no worries about losing time from work."

The cons: A high chance of human error. Dr. Merhi has acknowledged previously it's a possibility, but the clinic has a built-in contingency plan. Of course, the patient needs to be hyper-vigilant and very motivated to adhere to the correct protocols, he told the New York Post. If an error occurs during the process, the clinic might offer a discount on future treatment and future monitoring would be done in the office versus at home.

The cost: The At-Home IVF kit costs $850. But compared to the cost of conventional IVF at New Hope Fertility which totals approximately $4,000 according to Dr. Merhi, trying the DIY method means a savings of $3,200.

New Hope isn't the only business selling more convenient, in-home kits. Modern Fertility is a hormonal testing kit that allows you to gain insight into the hormones that effect fertility with a finger prick. The blood sample is collected at home, then the test is shipped back to the company. They then provide customers with a report analyzing their hormone levels.

The pros: Knowledge is power. "I actually tried Modern Fertility at 38, a few months before getting married, and it was a 'fertility saver,'" says Ann Murray-Dunning, 40, an expectant mom from San Francisco. "I didn't realize how low my AMH was for my age (.6), and that this meant that my egg reserve was very low for my age. Due to this new knowledge, I sped up the timeline, if you will, and we turned to the pregnancy journey soon after. After some difficulties likely given my low AMH, I am now 18 weeks naturally pregnant with a healthy girl."

Murray-Dunning says she's so confident that all women should do tests like Modern Fertility that she bought a kit for her younger sister. "I talk to her about my challenges and suggested she do what I did earliertest early, so that she has the power of more time and planning," she notes.

The cons: Due to the nature of their profession, doctors are natural skeptics of any at-home hormone testing. "There are a number of at-home hormone tests. Some are reliable and some are not, but all should be confirmed and interpreted with a medical provider if someone is concerned about an underlying medical condition or if someone is struggling with fertility," says Emily Jungheim, MD, MSCI, a board certified reproductive endocrinologist and fertility expert at the Women & Infants Center in St. Louis, Missouri. "That's why we recommend using at-home hormone tests in conjunction with your doctor's care rather than in lieu of it."

The cost: Modern Fertility costs $159. Similar tests include EverlyWell (which costs $159 and looks at the hormones that influence normal ovarian function) and Proov (which costs $39.99 and zeros in on the ebb and flow of your progesterone levels).

Before trying intrauterine insemination (IUI), people hoping to conceive might be drawn to at-home conception aids. Take The Mosie Kit, an insemination syringe kit that was designed for women by women for home insemination and is geared to helping couples with unexplained infertility, the LGBTQ community, women suffering from vaginismus, endometriosis and tilted uterus, male factor issues (low motility, sperm count, and performance anxiety), as well as single mothers by choice.

The pros: "You can do almost anything from home nowadays with DIY kits, and the same goes with slinging sperm," says Aimee D. Eyvazzadeh, MD, MPH. "There are a lot of times when doing this is helpful, but the most helpful is when sex hurts. Then, you can take it into your own hands! I help about four to five patients a year get pregnant in this way, and The Mosie is actually something I've been doing with my patients for over 10 years! And it works."

The cons: A potential lack of information or misinformation. Dr. Eyvazzadeh says The Mosie works even better when patients are shown how to do it by their health care provider so they aren't "missing anything big picture."

Sheeva Talebian, MD, a board-certified reproductive endocrinologist at CCRM Fertility New York, agrees, emphasizing that couples who are turning to these aids because they're struggling with fertility concerns should work with a physician who can provide a comprehensive fertility evaluation. If male factor issues (determined by a semen analysis) are at play, an in-office intrauterine insemination (IUI) may be more effective than an at-home device, she says.

Dr. Eyvazzadeh is also concerned about false claims that other products (like one called The Stork OTC) advertise in regard to "higher pregnancy rates than are truly possible."

"To tell someone that it really increases their chances isn't fair or telling them the truth," Dr. Eyvazzadeh notes. "At-home inseminations aren't as successful as they describe on their website. I wish!"

The cost: The Mosie's two-pack insemination syringe kit costs $89.

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At-Home Fertility Tests and Treatments: Understanding the Pros and Cons - Yahoo Lifestyle

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CHARLESTON When Julia Shalhoup was getting ready to retire, she wasnt sure what she was going to do with her new freedom.

A breast cancer diagnosis just three days after her retirement answered that question.

I had so many doctors appointments. Thats all I did, she said.

At the time of her diagnosis, Shalhoup hadnt gone in for a mammogram in several years, she said.

This was despite a standing order for a mammogram.

It was not Shalhoups first experience with cancer.

Shalhoup, who was diagnosed with ulcerative colitis in 1991, found herself in the hospital in 1994 due to severe anemia caused by the disease.

A couple weeks later during a checkup of the colitis, they found an ovarian tumor.

It was totally encapsulated, but it was ovarian cancer, stage 1 and malignant. Had I not had the colitis, they wouldnt have found the ovarian cancer most likely, she said.

When I was diagnosed with the ovarian cancer I think I was in shock. I knew I wasnt feeling well, but I thought the symptoms were on account of the colitis. I was working raising kids and practicing (law).

By the time the cancer was removed, it had grown to the size of a grapefruit.

It was just a tough surgery, and recovery was tough, she said.

At first, Shalhoup was good about faithfully getting her recommended mammograms.

Once you tell physician youve had ovarian cancer, youre top of the list for other cancers, she said.

At a point, however, she felt too busy with her law practice and began to put it off.

I was remiss, she said. It was on my to-do list.

The breast cancer diagnosis in spring 2019 therefore came by accident.

As she was shutting down her divorce law practice that she had devoted nearly 20 years to, she sought treatment for an ulcer.

The physician ordered a scan of her abdominal area. Luckily, the scan included her chest and doctors identified the cancer.

She was fortunate. The cancer was identified at an early stage.

I felt good. You could barely feel the lump, she said.

Still, it was a shocker for the family.

At first, youre a little shocked, said Nick Shalhoup, her husband. I handle things pretty well and so does Julie, but I just felt bad. Especially right after she retired and then days later she gets the diagnosis. You think youre going to enjoy your free time and then you have to deal with this.

She did not require chemotherapy and instead went through a lumpectomy and 16 radiation sessions at the WVU Cancer Institute.

I was great up until the last week. I had a very significant exhaustion period. It felt like I had narcolepsy. Im a reader and I would open a book and start to read and fall asleep. The doctor assured me that was normal, Julia Shalhoup said.

Following treatment, she was prescribed Arimidex, a commonly prescribed therapy for post-menopausal women who have had hormone-receptor positive breast cancer to prevent recurrence.

Theres some pretty serious side effects that can affect the rest of your life and have nothing to do with the cancer, she said. For her, those come from the Arimidex.

Now, she deals with the side effects of that medication, which are hard to bear.

Ive been taking it for almost six weeks and I have at least four or five of the symptoms that are pretty difficult to take, she said.

These include back pain, hot flashes that she describes as more of an internal heat than what she experienced during menopause, and weakness and pain in the extremities.

I truly believe shes handled this very well. Obviously, she has her moments. Everyone would. Worst part has been the Arimidex. It has so many side effects, Nick Shalhoup said.

Julia Shalhoup said she shares her story not for sympathy, but to remind women of the importance of getting the recommended screenings.

I just feel hopeful that if I talk to enough people, theyll feel compelled to do mammograms, she said.

Finding the cancer at an early stage not only improves personal outcomes, but can give your family the information they need to make their own medical decisions.

Shalhoup said waiting for results of her daughters BRCA genetic testing was the hardest part of the process.

That was probably the most difficult two weeks of my life, just worrying about whether she had the genetic marker, she said. She did not have the marker.

Im telling everybody. Im telling everybody Im fine. The sympathy I dont need. I need to make sure that you reach out to every woman you know and say, You need to get this test. Theyre not painful anymore, she said. They used to be painful, but theyre not painful anymore.

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'You need to get this test': Julia Shalhoup stresses importance of mammograms after her own breast cancer experience - WV News

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Hypothyroidism is an opposite of hyperthyroidism; one condition may also lead to another. In these conditions, thyroid glands do not function as per the body need and thus, the condition erupts. Lets first understand about the condition.

Hypothyroidism is a condition in which thyroid glands do not produce enough thyroid hormone which means its underactive. Thyroid glands are in the front of the neck with two lobes at each side of the windpipe. These hormones are responsible for regulating bodys metabolism and therefore, any affect on its production can hurt the metabolic function. Thyroid hormone is regulated by thyroid-stimulation hormone which is produced by pituitary gland.

The thyroid gland produced two hormones TS3 and TS4. The symptoms of the condition include fatigue, intolerance towards cold, and muscle and joint pain. Other symptoms could be weight gain, constipation, dry skin and decreased sweating, high cholesterol and insomnia. In some extreme cases, there could be respiratory infections, depression and loss of libido.

Because the condition impacts the metabolism, processing sugar and carbs from processed food could get difficult for the body. Sugary food can also cause increase in inflammation in body further aggravating the condition. Also, sugar can only give short term energy boost. However, controlling your sugar intake can help in long-term regulation of sugar. It may help your skin condition and stress levels that can come with the condition. It could be difficult, but you start with processed food and additional sugar.

Vitamin B12 levels get decreased during hypothyroidism causing fatigue and tiredness. It also impacts vitamin B1 levels in body. Taking these supplements may help refurbish the deteriorating levels of vitamin B in body. Include more of peas, cheese, milk, sesame seeds and eggs in your diet. If in case you are planning to take supplements, make sure you discuss with your doctor once.

Ashwagandha is a herb that can be beneficial for health in many ways. It is called an adaptogenic herb that can prove to be magical in balancing the thyroid hormones. This herb is used to strengthen the immunity and thus, relieving stress and boosting stamina which are common during hypothyroidism. This supplement can be sued twice a day, or you may discuss it with your physician in case you are sceptical about the dose. As its natural, it will not have any side-effects.

Flaxseeds are a rich source of omega-3 fatty acids. This can be beneficial for hypothyroidism. Alpha-linolenic acid is the type of omega-3 fatty acid present in flaxseeds. This has proven benefits in regulating the production of thyroid hormones. They have phytoestrogenic properties that support sex hormones which in turn can regulate thyroid hormones. Magnesium and vitamin B12 present in flaxseeds help body fight symptoms of hypothyroidism. However, make sure you dont consume it in excess for it may have a reverse reaction. Limit it to a couple of spoons a day.

Coconut oil contains medium-chain fatty acids which are easier to break by the body. Ingredients that are easier to digest are important when the metabolic function of the body is affected. It helps in boosting metabolism, one of the biggest ill-effect of hypothyroid. It also helps in keeping your body temperature in control to help keep your intolerance towards cold at bay.

Ginger is full of benefitsit has potassium, magnesium and polyphenols. It has anti-inflammatory properties as well that will help relieve hypothyroidism symptoms. Ginger tea could be the best way to consume ginger to absorb most of its goodness.

Published : October 24, 2019 2:32 pm

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Here are how you can treat hypothyroidism at home - TheHealthSite

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ANKARA, TURKEY - NOVEMBER 14: A woman takes a pill on November 14, 2018 in Ankara, Turkey. (Photo ... [+] by Dogukan Keskinkilic/Anadolu Agency/Getty Images)

If you have high blood pressure, remembering to take your medication is so important.

In fact, the time of day when you take your medicine could influence your risk for complications such as heart attack and stroke, which is ultimately related to how well you manage your blood pressure.

The bodys natural rhythm, known as the circadian rhythm also affects how we respond to specific medications, the result of a complex interplay between your medication and cortisol, the chief hormone responsible for this rhythm.

Now, a new study recommends that you take your blood pressure medicine at bedtimeto lower your blood pressure during the night and early morninghelping to prevent elevation of blood pressure that normally occurs as you awaken.

The research was published earlier this week in the European Heart Journal.

There is a growing body of evidence which indicates that not only genetics, but the time of day you take a medicine may influence how effective it is for treating a particular condition.

The current study looking at this phenomenon represents the largest study to date of patients with high blood pressure, and included more than 19,000 persons (from 40 ambulatory blood pressure monitoring clinics in Spain) on medications to treat high blood pressure.

For the study, the patients were randomly assigned to one of 2 groups: one group took their pills in the morning, and the other group took them at bedtime. The investigators monitored the patients for over 6 years tracking their blood pressure.

Blood pressure normally drops as we fall asleep, reaching its lowest between midnight and 3-4 am. It gradually rises as we awaken thanks to release of cortisol from the adrenal glands. Those who do not experience a drop in blood pressure during sleep may, in fact, be at higher risk for heart attack and stroke.

The study found that those who took their medication at bedtime had a significantly lower average blood pressure both at night and during the day, dipping more at night compared to those who took their medication during the morning or daytime.

Study participants who took their medicine at night were 43% less likely to experience any cardiovascular event (heart attack, stroke, heart failure) compared with those who took it in the morning. Those who took their medicine in the nighttime also had a 49% lower risk for stroke, 34% lower risk for heart attack, and 42% lower risk for developing heart failure.

Overall, there was a 45% reduction in cardiovascular risk from any cause (composite score of risk of heart attack, stroke, coronary artery bypass grafting [CABG] or cardiac stent placement, heart failure) in those who took blood pressure medication at bedtime. There was also a 56 % reduction in risk from cardiovascular disease overall.

The results of the study, demonstrating an impressive reduction in risk for heart attacks and strokes, argue for taking blood pressure medicine at bedtime. While previous research has also shown reduction in cardiovascular effects with night time administration of blood pressure medication, this is the largest study to date.

That said, more research is still necessary to better understand if the effect seen in patients taking a specific class of medication in this study also applies to different classes of blood pressure medications. (Study participants took a variety of blood pressure medications including ACE inhibitors, ARBs, ACEI- ARB combination, diuretics, calcium channel blockers, beta-blockers.)

Additional research is also necessary for different ethnicities, as well as those who work various late or overnight shifts to see if taking blood pressure medications in the late evening before bed has the same effect on reducing stroke and heart attacks

While blood pressure has multiple genetic determinants, lifestyle choices also have a significant impact. To reduce blood pressure, its best to reduce alcohol intake, quit smoking, lose weight, reduce stress, exercise more, reduce salt intake, practice yoga or Tai chi, and embrace deep abdominal or diaphragmatic breathing and meditation.

Health care providers recommend that patients try to adhere to a schedule and take their medications at the same time every day. Interestingly, current guidelines dont provide any specific recommendation regarding timing for blood pressure medications, with many people choosing to take them in the morning.

If you take blood pressure medicine, your health care provider has indicated on your prescription when to take it. Its best to consult with your provider and inquire why they have prescribed to take in the morning or before going to bed.

One issue is whether taking blood pressure medicine at night time is the best clinical approach for all patients. Age is certainly one determinant as well as fall risk, since a lower blood pressure at night and early morning can place patients at higher risk for falls, especially in a dark room when attempting to use the bathroom.

Timing of blood pressure medicine is very patient-specific, said Satjit Bhusri, M.D., FACC, Assistant Professor of Cardiology, Lenox Hill Hospital, Northwell Health. There are many factors, including compliance, labile blood pressure, and other medications being administered at the same time.

In conjunction with your healthcare provider, the desire to change the timing of blood pressure medication ultimately involves the ability to lower cardiovascular risk. To achieve lower blood pressure while asleep, its vital that patients take their medicine at the same time every night.

The key here is routines, said Bhusri.An even routine has shown that patients are more compliant with taking their medications more regularly and not forgetting.

While a nighttime approach may achieve a lower mean blood pressure while asleep, helping to reduce cardiovascular risk, is compliance or consistency also playing a role?

The key play here is compliance of medication, offered Bhusri.Not missing a dosewe know one thing worse than an elevated blood pressure is swings in blood pressure due to periodic non-compliance.

If further trials continue to demonstrate reductions in cardiovascular risk with the night time approach, the issue is whether all patients should take their meds at bedtime.

This recommendation is a personalized one that should involve a joint physician-patient interchange, concluded Bhusri.

The Skinny on Blood Pressure

It turns out that your blood pressure begins to rise as you wake up in the morning, elevates through midday, but then actually reaches its lowest point of the day between midnight and 3-4 am.

That said, persons with

More here:
Day Or NightWhen Is The Best Time To Take Your Blood Pressure Medicine? - Forbes

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Questionable nutritional advice is easily amplified in our digital world, but older generations have always passed down health adages that younger generations found difficult to believe.

Did your parents ever encourage you to drink fish oil to boost brain power before an exam or offer mustard when you had a muscle cramp?

My folks believed ginger relieves nausea. I was curious whether these adages and folk remedies could withstand the scrutiny of science or if theyre bunk. I set out to research a few of them.

This well-known statement is based on an 1860s Welsh proverb that eating apples will diminish doctor visits. And it has actually been put to the test in a 2015 April Fools Day issue of JAMA Internal Medicine (while the topics were zany, the studies were real).

Researchers investigated whether people who reported eating apples daily actually had fewer annual doctor visits or were in better overall health. Of the 8,399 study participants, 753 ate at least one small apple daily.

The results showed that 39% of apple eaters avoided physician visits compared to 34% of non-apple-eaters, which was not a statistically significant difference.

Researchers did find that apple eaters were a bit less likely to require prescription medications compared to non-apple-eaters, leading the researcher to joke that an apple a day keeps the pharmacist away.

Of course, the doctor proverb shouldnt be taken literally, but the overall sentiment is true: Eating vegetables and fruits daily has health benefits. The mix of fiber, vitamins, minerals and phytonutrients may help reduce inflammation and combat cardiovascular disease and cancer.

This narrative traces back to World War II. In 1940, British Royal Air Force pilots used radar to shoot down enemy planes in the dark. To keep this technology a secret, the Ministry of Information propaganda was that the pilots had great visual accuracy because they ate carrots, which improved their night vision.

It seemed plausible, too, because carrots are rich in the antioxidant beta carotene, the precursor to vitamin A. Once absorbed by the body, vitamin A helps make rhodopsin, a pigment that helps eyes work better in low light. Carrots can help if you have vitamin A deficiency that causes poor night vision.

But of course they cant really help you (or Air Force pilots) see in complete darkness. So, yes, carrots are good for eyesight, but other foods rich in beta carotene, such as sweet potatoes, squash and leafy green vegetables, have the same benefits.

Weve all heard this one after Thanksgiving dinner: The turkey made you fall asleep! Turkey contains an amino acid (a building block of protein) known as tryptophan, which the body uses to generate serotonin, which helps promote sleep. So then there must be something to this whole turkey-sleep connection, right?

Not so fast. Turkey contains no more tryptophan than beef, eggs, fish or chicken, and tryptophan has a difficult time getting past the blood-brain barrier, so its not an effective sleep inducer on its own. But the effect of tryptophan increases when insulin levels are high as happens after you eat a carb-rich meal such as a Thanksgiving dinner with stuffing, potatoes and apple pie.

Its actually carbs that increase serotonin levels and help with the production of the hormone melatonin, which makes you sleepy. Eating a large meal can have a similar effect because theres increased blood flow to the stomach for digestion and decreased blood flow to the brain. Its definitely not just turkey that makes you sleepy.

This remedy has strong roots. More than 5,000 years ago, people from India and China used ginger as a tonic to treat many ailments. The most common and well-established historical use is to alleviate nausea and vomiting. Today, many clinical studies support the use of ginger for this purpose.

Research shows that ginger helps relieve nausea and vomiting caused by motion sickness, morning sickness in pregnancy, during chemotherapy treatments and post-surgically after anesthetic. Its thought that the constituents in ginger including gingerols and shogaols help speed gastric emptying, which relieves nausea.

Some people sip ginger tea for relief, while others prefer to take a ginger capsule, and studies show that both options can work. My mom used to open a can of ginger ale when I was queasy. While she was on the right track, it turns out that many soda brands use artificial flavoring rather than real ginger, so those are of little benefit.

In his 1930 short-story collection Very Good Jeeves, British author and humorist P.G. Wodehouse wrote: They say fish are good for the brain. Have a go at the sardines and come back and report. Wodehouse was onto something!

In 2016, researchers found that weekly consumption of fish was associated with high volume of gray matter, the dark tissue of the brain thats in charge of processing information and controlling vision and memory. Many people have postulated that the value of fish comes largely from omega-3 fats, which play many important roles in brain health.

Yet, interestingly, this study showed that any fish not just those high in omega-3 fat had this positive effect. Another review study found that fish intake may help delay cognitive impairment and Alzheimers disease but cast doubt as to whether the omega-3 fats are the reason.

That means taking omega-3 fish oil supplements (or drinking cod liver oil) for brain health might not cut it theres something about eating a whole fish fillet thats more beneficial.

Have you ever been jolted from sleep with a leg cramp or felt your calf seize after a run? Maybe you were told to take a shot of pickle juice or a teaspoon of yellow mustard. For years, people assumed this worked because the pickles and mustard contain fluids and sodium, which may help ease leg cramps caused by dehydration or an electrolyte imbalance.

But research doesnt confirm this reasoning. In one study, researchers induced leg cramps in male subjects, then gave them pickle juice or water. The pickle juice made the cramps go away faster, but the effect was not due to restoring body fluids or the water would have worked just as well.

Plus, the researchers found no changes in plasma electrolytes or volume in the five minutes after ingesting the pickle juice. They concluded that the benefit from pickle juice could not be explained by rapid restoration of body fluids or electrolytes.

Now researchers believe the problem is not actually with the muscle itself but with the motor neurons that send signals to it, which become hyperactive. The researchers hypothesize that strong flavors (as in mustard or pickle juice) stimulate neurons in the mouth and upper GI tract, which in turn restores the normal activity of the motor neurons involved in muscle cramping sort of like a distraction.

There are no rigorous studies to prove this interesting theory, so drinking pickle juice remains mostly unsubstantiated. But if it works for you, drink up.

Registered dietitian Cara Rosenbloom is president of Words to Eat By, a nutrition communications company specializing in writing, nutrition education and recipe development. She is the co-author of Nourish: Whole Food Recipes Featuring Seeds, Nuts and Beans.

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What science has to say about these age-old health adages - The Spokesman-Review

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I need a glass of water.

Just one more story?

Mommy, I had a bad dream.

Every parent faces bedtime-stalling tactics and sleep problems from time to time. But if your child has attention deficit hyperactivity disorder (ADHD or ADD), settling down for sleep and getting a good nights rest may be a daily challenge with serious health consequences.

Many American families today struggle to get enough sleep. A poll by the National Sleep Foundation, for example, found that more than one-third of parents report that scheduled evening activities impede a good nights sleep for their child. Whats more, one in four parents report that homework made it more difficult for their child to get a good nights sleep at least once in the preceding seven days. Add in the artificial light and noise from media, available at all hours of the day and night, and its a wonder any of us get any sleep.

The symptoms of ADHD exacerbate all of the things that make sleep difficult and elusive for so many people. Children and teens with ADHD are hypersensitive to environmental stimuli and their bodies react more strongly, making it harder to turn off their brains and settle down for sleep.

In addition, poor sleep is a self-fulfilling prophecy. Just one night of bad sleep can make a childs inattention and opposition even worse the next day, in turn making it even more difficult to get ready and settled for sleep the next night. The pattern repeats indefinitely if not arrested.

Patients may experience a vicious cycle of poor sleep exacerbating ADHD symptoms, which in turn make sleep worse. Poor sleep can also negatively affect learning and memory. Several studies in the past decade have found that.1,2

The reality is that kids learn as much during sleep as they do when theyre awake. Sleep is when learning is actually consolidated.

Sleep is critical, and hard to come by we get it. But what can parents do to help their children and teens overcome ADHD sleep problems?

Parents working through ADHD-impacted sleep issues should begin by consulting their childs physician.

Some ADHD stimulants can make sleep worse, so its important to talk with your provider about the time your child is taking the medication, how long the stimulants are lasting, when they are wearing off, and how they are affecting the childs sleep. Some stimulants have actually been shown to improve sleep in patients with ADHD, so talking with your healthcare provider about this is very important.

Assuming a childs sleep issues are not being caused by stimulant medications, parents should adopt a behavioral perspective and focus on basic sleep hygiene for children.

Its important to put both time and space boundaries around sleep, making it a special action that we want our kids to learn to do. That means starting the bedtime routine early enough to ensure adequate sleep for the childs age.

For school-age children, for example, start the bedtime routine by 7:30 pm at the latest to ensure children get the recommended 10 to 12 hours of sleep their bodies require. Sticking to a regular and consistent bedtime routine perhaps ending with some kind of positive ritual that the child enjoys reading a book, singing a song, saying prayers, or talking about the best part of their day can also help create a positive association with bedtime.

We want the childs brain to learn that going to bed and sleeping are where something nice happens and it feels good, he says.

ADHD teen brains need 8 to 10 hours of sleep a night. Since most classes begin before 8 am, that means aiming for a 9 pm bedtime. Teens should avoid heavy meals and vigorous exercise, as well as electronic screen use, an hour before bedtime. This means no texting, social media, or video games after 8 pm, which will no doubt be controversial in most households. The blue light from electronic screens affects the bodys pineal gland and actually physiologically decreases our production of melatonin, the hormone that regulates the sleep-wake cycle. Popular blue-light glasses filter the light, which may decrease the effects of screens on that hormone production, they cant take away the stimulating effects of media itself.

Even if blue-light glasses solve one piece of the problem, they arent going to help the body and the brain really relax and get ready for the sleep cycle. Modeling this no-screens-after-8 policy can be one of the most effective ways that parents can make this rule stick. Its also important to make it clear that the child is not in trouble and putting away phones at 8 is not a punishment, but rather a strategy for getting healthy and functioning well tomorrow.

If working together with your child is not helping to solve sleep issues, or if they do appear to be getting enough sleep and are still showing symptoms of being sleepy, its time to consider a formal evaluation by a sleep specialist. This may indicate a more serious sleep disorder such as sleep apnea or restless legs syndrome. The good news is that, for nearly all sleep disorders, there are effective treatments to help children and teens get the rest they need.

The content for this article came from the webinar titled Sleep and the ADHD Brain: Why Its Critical and How To Get More.

1 Sandoval, M. , Leclerc, J. A. and Gmez, R. L. Words to Sleep On: Naps Facilitate Verb Generalization in Habitually and Nonhabitually Napping Preschoolers. Child Dev. (2017). doi:10.1111/cdev.12723

2 Axelsson, E. L., Swinton, J., Winiger, A. I., & Horst, J. S. Napping and toddlers memory for fast-mapped words. First Language (2018).https://doi.org/10.1177/0142723718785490

Updated on October 23, 2019

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Treating ADHD Sleep Problems in Children and Teens - ADDitude

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Katie: Hi there and welcome to The Wellness Mama Podcast. Im Katie from wellnessmama.com. And Im right here as we speak with an expensive buddy, Razi Berry, whos the founder and writer of the journal, Naturopathic Physician Information & Assessment, which has been in print since 2005 and the premier consumer-based web site of Naturopathic Drugs, NaturalPath. Its important to test it out. The hyperlink shall be within the present notes. Shes additionally the host of The Pure Most cancers Prevention Summit and The Coronary heart Revolution-Heal, Empower and Comply with Your Coronary heart, in addition to the ever-popular 10 Week Sugar-Free Summer season Program. And were going to speak about her story as we speak. However from a near-death expertise as a younger lady that healed her coronary heart to later overcoming infertility, power fatigue, and fibromyalgia by Naturopathic Drugs, she has lived this mind-body therapeutic paradigm and now works to coach the world about it. Welcome, Razi, and thanks for being right here.

Razi: Hello, Katie. Its a number of enjoyable to be right here. Thanks.

Katie: And I really feel like I cant drop a line like that within the bio with out asking you to share your story. What was your near-death expertise as a toddler when you dont thoughts sharing?

Razi: Yeah, its fairly an incredible story. And its humorous as a result of I discovered much more about it as an grownup. So let me begin. Ill give the truncated model. However principally, once I was 14 years outdated, I used to be within the hospital in Phoenix Kidss Hospital and I used to be dying of coronary heart failure. Theres actually nothing that the docs may do. And so my household introduced in our household priest, Dr. Father McGuire, to do the final rites ceremony. And so for these of you that arent conversant in the final rites ceremony, its within the Catholic custom. Its type of like baptism is the sacrament if youre born and final rites is a sacrament if youre dying. So, you understand, it was a extremely troublesome time in our lives.

And the day after the sacrament was given, my mom was with my four-year-old brother within the room. Principally, they have been coming to have some remaining moments with me. And one of many docs was within the room. And he stated to my mom, This can be a disgrace, Mrs. Berry, as a result of shes doing it to herself. And once I heard that it was type of out and in of consciousness. And once I heard that I out of the blueI felt a lot disgrace, Katie, and a extremely unusual factor occurred. I didnt actually perceive till years later, as I out of the blue was wanting down on the physician when he stated that. And I used to be wanting down on my mom and down on my brother as if it was from the highest of the room. And the disgrace that I felt when he stated that was as a result of it was true. I used to be doing it to myself. I had an consuming dysfunction. I had anorexia nervosa and that was the reason for the guts failure.

Coronary heart failure is among the main causes of dying in extreme consuming issues. And so he was proper. And one thing in my psyche and my physique simply needed to flee that disgrace. After which out of the blue I used to be in, you understand, simply one other place. And it appeared prefer it lasted ceaselessly. In keeping with the nurse and the physician and the household that was round me, it was minutes. I name it the near-death expertise again then, my household stated that God healed you. However what occurred is after I got here again into my physique, I used to be healed. I ended up leaving the hospital with out an consuming dysfunction, with none medicines, and with a healed coronary heart.

In order that the expertise of what occurred like what did Ilots of people need to know like, What did you hear? What did you see? And, you understand, I heard issues and I felt issues and I noticed issues. However none of that was actually as vital as what occurred once I got here again in my physique as a result of what I noticed, Katie, is I had been so dissociated from myself, proper? Its important to be in a whole state of dissociation to not feed your self correctly, to not nourish your self. And as Ive grown and been concerned in naturopathic drugs and in well being basically, you understand, its actually clear to me that, thats actually the reason for many illnesses is that this dissociative state the place were not absolutely linked inside our our bodies. Were not listening to the messages and the alerts our physique provides us.

So, I now have a look at it as an awesome present as a result of previous to that, every time I used to be sick, my mother took us to the physician and so they gave us a shot or some drugs. However this time the docs couldnt do something. So then I assumed, Properly, what healed me then? If the physician didnt heal me the place does therapeutic come from? And it was type of a present to start with of simply this journey of simply discovering, you understand, whats therapeutic?

Katie: Wow. And I guess that has had far-reaching results all through your total life. Thats wonderful.

Razi: Yeah, it undoubtedly did. After which there have been instances the place I used to be sick and I didnt spontaneously heal, proper? So it brought about additional questions and additional investigation.

Katie: Properly, yeah. And I really feel like that brings up a lot attention-grabbing issues to consider, about that mind-body connection. I do know that is one thing that you justve talked about fairly a bit. However it additionally looks like one thing that folks could be, together with me, like so skeptical of at instances. Like realizing that wed even have the facility to try this. Like why do you suppose that second or that specific factor, like what modified in that for you that made that attainable?

Razi: So, sure, I perceive this skepticism that even I had for a extremely very long time about the entire concept of mind-body therapeutic. And I believe its as a result of we focus a lot on the thoughts or this ethereal other-world facet. What I actually suppose healed me was this integration that I had been type of residing with out my physique. I hadnt actually been listening and been in tune to my physique alerts which, you understand, all of us are born with. I imagine that were all born and designed with this good capacity to get info from the pure world round us and at all times know the precise choices to make. After which if we dont make the precise resolution for ourselves, then our physique, thoughts provides us different clues, whether or not its a sense, a sensation, a symptom that may carry us again. So I imagine that were all actually born with all the things that we have to know. And I believe that it was the precise coming again into my physique.

After that have, I grew to become so keenly conscious of my physiques messages of emotions and my physique. And I believe that was the present. However the wonderful factor is, and Ive been learning this for years now, is that you just dont need to have a near-death expertise to get actually extra in physique to get actually again in contact. However that was what I believe the present was. I believe it was the precise simply one thing thrust me again into that visceral phenomenological expertise of residing, of what its wish to be inside a physique. I imply, our thoughts is in our physique, proper? The chemical compounds that our physique produces to suppose cognition, feeling emotion, these are all neurotransmitters and peptides. Candace Pert referred to as them molecules of emotion. And he or she who was a pharmacologist who believed that it was these ideas and emotions, these chemical messengers that have been type of the mediator between our lived expertise of the physiology of our physique and the better world round us that were dont essentially see.

Katie: And from the sounds of your bio, your story undoubtedly doesnt cease there both as a result of it additionally says you overcame infertility, power fatigue, and fibromyalgia. Was {that a} related course of or was {that a} totally different a part of the journey for you?

Razi: So its humorous as a result of generally I believe youve questions after which life undoubtedly provides you a manner to determine the reply for that, proper? So I had been actually desirous about studying about how the physique heals and the way the thoughts and physique are linked. And I felt although a number of info was simply actually whoo-whoo, it was all primarily based on identical to, you understand, one other worldly psychic phenomenon, and never essentially one thing that was like aware and physiological collectively. And so, in my mid-20s, I obtained actually sick. At that time, you understand, this was, what, 16 years in the past, the docs didnt actually have a prognosis for fibromyalgia. So I used to be simply in extreme power ache. And I ended up on the Mayo Clinic after seeing a number of docs who stated, Oh, its the flu, or, You have to be pregnant.

At one time that ache was so dangerous that really bear in mind crawling throughout the ground to go to the lavatory. So the Mayo Clinic had some wonderful diagnostics, however that they had me on so many medicines and a few even like chemotherapeutic sort medicine. So my hair was falling out. And I simply went to the physician at some point and I used to be like, This simply isnt what I need. And so they stated, You already know, Im sorry. You simply have to go on incapacity. So at that second I fired my physician, and I simply went to Much like your story, Katie, I simply determined to take it by the reins and discover a health care provider that may actually hearken to me.

So there was a number of deep ache in these years, bodily ache after which the ache from having 5 miscarriages in six years. It was a extremely darkish interval. However I attempted to simply bear in mind what I had been studying in regards to the ideas of naturopathy, which I hope we get to speak about, and in addition, from what I discovered in my previous expertise with therapeutic that therapeutic occurs in your physique and never simply, you understand, in your thoughts. A whole lot of instances the docs simply needed to provide me one thing that may management my thoughts like assist me sleep or assist me get up or take care of melancholy and the anxiousness that ensued. And so the therapeutic occurred once I actually began to concentrate once more to whats my physique telling me? What are the messages that these signs imply? As a result of actually, once we type of flip it round, signs which appears so painful and so horrible, they really are an expensive a part of ourselves. They love us a lot that theyre actually asking us for one thing.

Katie: Yeah. And I really like that you just shared your story of your 5 miscarriages. And when youre snug speaking about it, Id truly love to speak about that for a minute as a result of I believe we as a society have gotten so significantly better about speaking about so many points of motherhood and of life expertise. And thats one whichs nonetheless so guarded and so painful I believe for thus many individuals however but Ive had a miscarriage. Youve had miscarriages. I believe its one thing thats truly extraordinarily widespread however but theres nonetheless a lot ache and disgrace hidden round that. So when youre snug sharing Id love to listen to slightly little bit of what your interior course of has been in therapeutic from that.

Razi: Sure, and I do know that, you understand, all forms of relationships, even motherhood, theres a spectrum, proper? Some folks really feel extraordinarily maternal. Some folks much less so. And I dont have any judgment there. However I occur to be only a very maternal leaning. So once I had my first two miscarriages, the docs have been like, Oh, that is, you understand, widespread. Even that was actually troublesome for me, Katie, as a result of myself and I believe a number of girls like as quickly as I came upon that I used to be pregnant, I started to kind a relationship with my unborn youngster, proper?

Such as you discuss and sing to your youngster. You dream about what the long run goes to carry. And also you put together, not only for their start, however for the life that you just need to assist them develop. So I felt like there werent a number of sources for me to actually mourn the loss, even when the pregnancies have been early. I felt when the pregnancies have been slightly bit additional alongside, there was extra, you understand, type of sympathy, I suppose. However I felt like there was an actual lack of capacity to seek out sources and I really feel like I actually needed to mourn it alone. I obtained to a degree like after about my fourth miscarriages, my associates stopped inviting me to child showers, to not be unkind, however as a result of they simply didnt know tips on how to take care of it, particularly as a result of a few of them had identified, you understand, I used to be pregnant for, you understand, few months and so they simply didnt know tips on how to take care of it. So, I actually needed to flip to, you understand, my household, my spirituality.

I want that I had like a extremely fantastic method to share. However one factor that Ive discovered after residing some extra years on this Earth is the easiest way that Ive discovered to take care of issues like loss usually are not a lot to give attention to my thought patterns as a result of, you understand, the rationale we ruminate and psychology will inform us the rationale that we predict again and again generally about issues is as a result of we so badly desire a resolution out of one thing painful and generally theres not essentially an answer. And so what I discovered is if you actually take excellent care of your physique, the thoughtsIm not saying mindset isnt vital, however if you actually hear into whats your physique asking you, like when youre in a time of grief after miscarriage and you are feeling drained on a regular basis, or youll be able tot sleep otherwise you simply hungry on a regular basis otherwise youre not hungry in any respect, you understand, these are totally different messages our physique is giving us. And I believe if We dont ever need to get caught in a rut, but when we take a while and simply enable our physique to precise themselves after which nourish and nurture our our bodies in line with these messages, for me, that was at all times the way in which out of grief or loss.

Katie: Yeah, I really like that. And I discovered for me even simply, yeah, having the ability to communicate it and discuss to others too additionally it felt like that gave credibility to that life and in addition simply actually helped to work by the method. And I really like that you just share so susceptible your story with a want to assist different folks. And I do know additionally as a part of your want to assist others youve been so concerned within the naturopath group and in naturopathic drugs for years. And so, for anybody listening whos not acquainted, Id love when you may stroll us by your course of with this and your publication and what youve discovered by all of these years of that deep involvement with naturopathic drugs.

Razi: Sure. So first, I need to say that Im a fan of all forms of well being practitioners and all well being therapeutic paradigms. I believe theres a spot for all of them. And I believe that every individual individually wants to decide on which is the perfect for them. I are inclined to really feel inclined and I imagine most all folks ought to have a naturopathic physician on their well being care staff and a few the reason why. So once we have a look at what naturopathic drugs is, its a really distinctive paradigm of drugs. So once we have a look at a doctoral stage of medical coaching, we principally have three important faculties of that. Theres osteopathy, which is a DO, a medical physician, which is an MD and a naturopathic physician, which is an ND. All of them have very related training so far as the variety of hours, the variety of pharmacology they should take, and issues like that.

And the place naturopathic drugs is slightly totally different, is after they get a number of vitamin, in fact, the entire like Hippocratic meals is drugs. However theres additionally these six ideas that underlie naturopathic drugs which are all framed round a therapeutic order, which makes it so distinctive. So the ideas, Ill undergo them in a short time. One is, first, do no hurt, which all docs actually take that oath that, you understand, you do the least poisonous, least forceful remedy first. Then is the therapeutic energy of nature. And in Latin, that is referred to as the vis medicatrix naturea. And the vis or the vise is that innate life drive that every one residing beings have. So crops, animals, people. Theres this life drive. Some folks name it God. Some folks name it universe. In naturopathy, its referred to as the vis. And its simply that factor that propels us in direction of homeostasis that enables us to expertise allostasis the place were always our our bodies are always altering to adapt to our surroundings. And we imagine that thats actually the pure state of all of us to have the ability to self-heal.

The following one is to determine and deal with the trigger. This has grow to be actually common in lots of paradigms in drugs now and Im so glad that to take a look at the basis trigger. And in naturopathy, were at all times type of peeling that onion slightly bit extra. So it doesnt simply cease at like, Okay, nicely, right heres the thyroid hormones. Its like, Properly, why is the thyroid behaving this fashion? And you then simply type of you retain wanting again till youll be able to actually discover the basis trigger. And a part of that or my favourite elements of that known as eradicating the impediment to remedy. So its not simply wanting on the trigger as a deficiency, but additionally taking a look at the reason for some form of extra or one thing pointless that must be stripped away.

The following one is docere, which is the basis of the phrase physician, which suggests to show. And it says that your physician can be a instructor. The physician doesnt trump your self-knowledge. The physician is your information that will help you self-heal. Deal with the entire individual is quantity 5. I believe once more, thats not as obscure because it as soon as was. However its wanting on the built-in complete of the physique, all of its bodily and religious and its energetic dimensions and the way you form of transfer by house, how you progress by the world. What are your relationships like? Whats your work setting? Whats your private home setting? And the final one is prevention, which, in fact, prevention is the perfect remedy if we may get again to this concept that we need to stop illness as an alternative of ready. Docs actually attempt Naturopathic drugs tries to actually educate these. So these are the ideas. And if I can for a second, Katie, simply type of clarify how they match into this actually distinctive framework. Its referred to as the therapeutic order. Can I do this?

Katie: Yeah, completely.

Razi: So the therapeutic order, when you think about a pyramid, and the very backside of the pyramid is the muse. And that basis is to ascertain the muse for optimum well being. In order thats the place you type of determine what the trigger is, you understand, past what a lab would present. You already know, lets have a look at way of life. Lets have a look at attitudes. Lets have a look at all of the totally different shifting elements in your life and even out of your previous. And you then assess the determinants of well being. What does this individual want with the intention to restore well being? So that is the muse. So that is earlier than dietary supplements are given. That is earlier than vitamin is given. First, thats decided. You then stimulate the self-healing mechanism. So generally a naturopathic physician will say, Yeah, you want thyroid medicine, however youre not prepared for it but. Your vitality isnt fairly there but.

So perhaps theres one other space. Perhaps they should strengthen one thing along with your pituitary. And theyre going to type of stimulate the physiques type of vitality so its prepared for remedy. Then, its if you look to assist and restore weaken programs. And that is the place a number of medical paradigms start and theres nothing mistaken with that. However as you see in naturopathy, theres a couple of steps that come earlier than that. So that is the place you type of support in just like the regeneration of broken organ programs or organs. After which the following step on prime of thats handle the bodily alignment. So whats the structural integrity of the bones, the muscle tissues, generally even posture? You already know, weve type of gotten so enthusiastic about new neat hacks that we overlook about easy issues like hydration and posture for well being.

Then above thats pure symptom management. So the physician first begins in these first steps Im speaking about earlier than we use pure substances to form of palliate signs. And that is the place the physician says, You already know, the symptom is the message. However in some circumstances simply to provide the affected person some aid or to permit the vitality to strengthen, well management these signs and we first attempt it with pure substances. Above that on this pyramid is the artificial aid of signs. Typically medicine are wanted to palliate a symptom to assist the individual. Once more, its to not remedy them. Its to type of assist the important drive, type of unlock the physiques power so it may possibly do its personal self-healing. After which the very tip is the high-force interventions. Typically theyre wanted. They by no means start there. And thats the place you generally suppress pathology. Its by no means the primary alternative, because it typically could be in, you understand, type of conventional drugs. And thats the therapeutic order.

Katie: I really like that. Its so sensible and its such a strong framework. And I believe, you understand, it addresses among the potential deficiencies of typical drugs. However Im additionally curious. I imply, I do know that thats the extra widespread paradigm within the U.S. So how do you see naturopathic drugs and traditional drugs working collectively if theyll or, like, how do you view these two?

Razi: Yeah, so I believe theyre fantastic enhances to one another. And I believe that is actually the place I really like the concept of affected person alternative as a result of, actually, theres so many various methods which you could deal with a illness. You possibly can deal with it by homeopathy, by herbs, by medicines, and nobody is basically going to know that apart from collectively along with your relationship along with your physician. So some folks select to just do typical drugs. Some folks select to do actually old fashioned nature care the place its like cold and hot water remedy, energetic, you understand, structural alignment, and issues like that. And a few folks like a mix of the 2.

I believe that like naturopaths are educated to work with typical medical docs and so they get among the similar coaching. They perceive pharmacology and, in truth, they need to take extra persevering with ed and pharmacology than MDs and DOs, which is form of ironic. However I believe they match collectively so completely as a result of having a naturopathic physician can type of simplyyou understand, the workplace visits are slightly bit longer and so they simply ask totally different questions. And so you need to use it alone or youll be able to simply type of decide and select. Like theres sure issues in my life that I exploit several types of naturopathic docs for, proper? So like if Im in a interval of stress and Ive a flare-up of my fibromyalgia, then Ive a health care provider, a naturopath, that Ive been working with for a very long time and I actually, actually know and belief her.

However final October I had this simply randomnicely, nothing is random, however this intestinal an infection that occurred in a single day and it ended me within the hospital going into sepsis. And, in fact, I wanted typical medical care as a result of what I wanted at the moment was on the very prime of the pyramid. I wanted a high-force intervention to do away with that in order that my physique may then heal. So what I did is I went to the hospital. I used to be there for per week, sadly, needing antibiotics, which I by no means actually need to use until Ive to. However then I had my naturopathic physician to assist me get better from that. So that they work collectively superbly.

Katie: Yeah, I completely agree. And I believe, you understand, you typically hear it stated that for any type of trauma or like acute factor we really are in the perfect place in your entire world relating to that. And I undoubtedly by no means need to low cost what typical drugs and what emergency drugs physicians can do as a result of its really wonderful and so they completely do save lives. Like for me, that was my third child had placenta previa. He was born C-section. With out that, we each would have died. My husbands appendix ruptured. Positively, a time for typical drugs. However I really like that with the 2 of them collectively, youre capable of then for issues that arent an acute drawback or one thing thats extra power, youre capable of go to the basis trigger. Even when you do Such as you stated, even when you want typical drugs too, to start with, to get to the purpose the place youll be able to truly heal and you then use naturopathic drugs to work by it, I believe theres a magnificence there in accessing all of those approaches now. And its simply so wonderful that we now have this. Its unbelievable.

Razi: I do know. Its stunning that we now have so many choices now. And Im actually grateful for that.

Katie: And I do know that you justveSo by publishing the Naturopathic Physician Information and Assessment youve written for nicely over a decade, 14 years now, hundreds of circumstances. Im curious if theres any takeaways or commonalities that you justve seen by all of these articles and that have and studying from all of these.

Razi: Yeah, so I dont write the circumstances. The docs submit the circumstances primarily based on an editorial calendar that I put collectively yearly. So Ive simply been capable of learn and publish, you understand, over 2,000 circumstances. And what I discovered to be actually an underlying theme and this isnt, you understand, something new however that in studying all of the SOAP notes that the physician sends in and what the care is and what the affected persons form of homework is, I discovered that theres actually an emotional facet to just about each state of illness. Theres at all times an emotional facet to it. And my dream is, and I believe its taking place increasingly that, a world the place all docs are form of educated to search for that and assist the affected person uncover that by self-awareness. The entire concept of docere, physician is instructor.

In my very own life, I do know that the way in which I manifest stress is thru my intestine. And so now realizing that and being conscious of it, you understand, when Ive issues that I can do or methods I can change my food plan or totally different self-care practices I can do it below instances of stress to assist type of stop a flare-up in that case. So, yeah, so its not any, like wonderful like biomarker that I came upon, though Ive seen a number of actually neat issues like that, however its simply that, you understand, were such emotional beings. And whether or not we enable that to stream freely by us or we block those who actually generally is a determinant of well being.

Katie: Yeah, I believe thats an ideal segue. I need to be sure we point out it. You have got each a podcast and a mission referred to as Love is Drugs. Like that could be a good title for the phase of your work with speaking in regards to the emotional aspect of it. So type of give us an outline of what thats and the place folks can discover it?

Razi: Thanks, Katie. Love is Drugs actually began again once I had that near-death expertise as a toddler. Once more, I dont know precisely what it was, all I do know it was an expertise that I had. It was a transformative expertise and all of us have them. Typically its simply holding one in all our youngsters and having this intense feeling of oneness, proper, with all the things or with God. Typically its climbing a mountain or being in nature. However there was type of a message in there. The message was that, you understand, I used to be beloved. There was love throughout me. And the way in which that the Earth is form of designed, if I can use that phrase, is to like us. The solar, you understand, rises each morning and the Earth biofield is giving, you understand, is an antioxidant for us and theres meals rising from the Earth. And theres folks round us to commune with. And theres simply love throughout us. And I imagine that love is the therapeutic elixir for all the things.

And once I say love, I dont actually imply essentially, you understand, a love relationship. However its how we transfer by our world. Its how we relate to one another. Its how we understand ourselves. Its how we transfer by our day, how we handle our physique, how we handle the those that we love. That to me is drugs. And I believe theres increasingly analysis to point out that. You already know, Im positive youve had, you understand, many, many visitors discuss loneliness is extra detrimental than cigarette smoking and emotions of isolation. Even when its self-reported could be, you understand, actual trigger for like coronary heart illness and even most cancers. So love is drugs. Its about simply type of that self-awareness of coming again into this concept that youve got all of the solutions inside you and the way you eat, breathe, transfer, communicate, suppose, and relate to the world round you and folks round you have an effect on each cell in your physique. And to me, thats what Love is Drugs is.

Katie: Thats superior. And Ill be sure hyperlinks are within the present notes so folks can discover you on that.

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Katie: Are there every other suggestions or workout routines that youd give us for these of us studying to connect with that type of interior knowledge or to work by that interior emotional aspect?

Razi: Sure. Im truly writing a e book proper now that however it gainedt be out for a yr on actually tips on how to reconnect. And theres a few easy suggestions. One method to actually reconnect along with your physique and this introspective sensitivity that we now have Interception is that this physiological means of understanding our interior physique. As an example, have you ever ever heard of the time period Mittelschmerz, Katie?

Katie: I havent.

Razi: Okay, Mittelschmerz is a German title for center ache and its a phrase that will get used when girls can really feel themselves ovulate. And so having the ability to type of perceive like be delicate to your coronary heart fee variability, adjustments in blood strain, and actually being in tune along with your our bodies known as interception. They discovered that folks like on the autism spectrum have much less capacity with folks with consuming issues, have much less capacity to actually hear to those inside physique alerts. And there was one research that confirmed that if you do energy posing, it may possibly assist strengthen your interceptive sensitivity, being extra conscious of them. And I believe its enjoyable as a result of its so easy and so like one thing I by no means would have considered. However energy poses or issues like this. Like youll be able to sit again in a chair in entrance of a desk or a desk and put your toes up, put your arms behind your head, type of like, Yeah, Ive obtained this. Im the boss right here. And its an influence pose. And an influence pose like that could be a physique motion that form of interprets right into a deeper understanding of your physique.

One other energy pose is standing up tall along with your toes about, you understand, hip-width aside and placing your two arms in your hips and simply type of standing tall. And I wish to put like a facial like a smile or type of unknowing grin on my face every time I do that energy pose. And I educate my children to do it too. Theyre a number of enjoyable. In the event that theyre making an attempt to decide, Ill say, Properly, do some energy posing and actually get linked along with your physique. So these are some actually enjoyable methods which you could get in contact. One other factor that I really like is Im so fascinated by the way in which our olfactory sense is linked to cognition. And cognition is a extremely vital a part of our instinct as a result of really, we predict with each cell in our physique. Weve obtained immunological reminiscence, mobile reminiscence. Our immune system has a reminiscence.

And so our olfactory sense is so linked to all these. In reality, it was just lately found that we now have olfactory receptors in our kidneys that assist sniff out like what the constituents of your blood are in your blood and assist management like blood strain and different like chemical regulation of the bloodstream. So one of many issues that I actually love to do to get actually in tune is a sensory detox. And one of many ones is with our olfactory, our sense of odor. So what I ask folks to do is for 2 weeks do away with something scented of their setting, even pure scents. So meaning no important oils, no perfumes, no deodorants, nothing scented, and type of get used to and conscious of the scents which are throughout you, even this scents which are coming from your personal physique, your breath, your armpits, simply the pores and skin, your hair, as a result of we soak up chemo alerts 24/7. After were asleep, once were awake, were taking in these chemical compounds from the world round us.

Typically theyre pheromones, however theres so many extra that were simply studying about. And that is knowledge that offers our physique info. In reality, there are some rat research that confirmed youll be able to breed a rat for a number of generations in complete sterility. So that they havent seen every other animals, no predators, or something for a number of generations. After which what they did is that theyI need to say generations. Rats dont stay a really very long time. So its not like tons of of years. However then what they do is that they introduce physique fluids from totally different different animals.

And thru posture and new habits, the rats may inform by the simply these pure chemical compounds coming from different animals our bodies and people too, they may inform if it was a predator, male or feminine, if it was in warmth. Like they may introduce a scent of like a younger feminine rat, after which the male rat would dont have any sexual posturing. But when it was like an older feminine rat if it was of I dont know when youd say childbearing age in a rat, however then that animal had like sexual posturing. So weve discovered a lot in regards to the world round us by this chemo sense of olfaction. And I believe its a extremely nice method to begin getting in tune along with your physique.

Katie: Thats so fascinating. Ive by no means heard that earlier than in regards to the kidneys having the olfactory sensors. Thats wonderful.

And it is smart too. The physique, I believe I imply, I nonetheless really feel like were solely barely beginning to perceive and contact on the knowledge of the physique. I believe were nonetheless going to be taught a lot. And Im wonderingso like being on this well being world myself, its like theres a lot info and weve discovered a lot knowledge of all of the issues that we ought to be doing. Im curious for you having, you understand, 14 years of publicity to this expertise, what are the issues that really stick and that you just implement in your every day life? So like in your morning routine or which are a part of your every day routine.

Razi: Yeah, so a number of them I believe youve most likely heard many instances earlier than, however I attempt to at all times get up naturally and have my children do this too. I really feel like that its simply so vital. And I seen only a large distinction. Similar to they are saying a toddler is aware of when it ought to be born by giving the moms alerts in an ideal setting, proper, I really feel like your physique simply is aware of when its time to get up. So I additionally do, you understand, go exterior first. And I at all times hug bushes. Its type of like I suppose a foolish geeky factor. However, you understand, the bushes roots are going to date down into the Earth and so theyre linked to different tree roots. And I even have some bushes in my yard that my late father had planted. So I make a ritual of it each morning to hug some bushes. And I simply actually really feel, you understand, the results of the Earths biofield and the daylight.

And I additionally, all through the day, I take these little self-awareness breaks however Im not a meditator. Truly, I hate yoga and I hate meditating and Im at all times embarrassed to say that however theyre two issues that I do know are so good for you however I simply dont like both of them. So I take the self-awareness breaks throughout the day. And right heres the way its totally different from meditation. And meditation typically says, you understand, Shut your eyes and breathe deeply. Properly, I say, Overlook that. I say, Hold your eyes open and breathe usually. I name it sleeping, child respiratory. While you breathe usually, youve, you understand, these sure ratios of various chemical compounds that assist your physique soak up oxygen. And, you understand, deep respiratory is sweet too, however to simply concentrate on the place your physique actually is at that second. So we hold our eyes open, and we breathe usually. And we hold our physique posture wherever its. Typically I ship a sign on my telephone to do that.

And also you guys discover issues like what am I listening to proper now? Proper now on my proper ear, I hear the neighbors lawnmower. After which I additionally really feel like my bra strap is slightly bit too tight. I really feel like I can really feel, you understand, what the chilly ground looks like on the underside of my toes. I can really feel, you understand, that my mouth is slightly bit dry, that I most likely ought to be consuming some extra water this morning. And I hear and really feel the air-con type of brush towards my left shoulder coming in from the room. So once I do these easy practices, generally Ill do it once Im cooking, slicing and onion. I discover the deep purple colour of the onion. I really feel what does the little muscle tissues in my eyes really feel like if they start to tear? Im open to the slicing sound.

And I attempt to simply get tremendous conscious of it, not simply in my head, in my complete physique. And what I discover is if you follow wherever your physique is at, youre type of coaching your self to know what your physique wants always. In any other case, once I dont do it, Im not going engaged on the pc after speaking to you for an additional hour with out consuming water, proper, as a result of were simply centered in our thoughts of what we should be doing. However once we take these little self-awareness breaks, it trains us to hearken to our our bodies.

Katie: Thats an awesome tip and thats what Ive by no means heard earlier than. Im additionally not an enormous fan of meditating. And like I do higher with one thing concrete such as you and Ive talked about earlier than, like chilly water or particular respiratory. And like I dont simply the concept of meditating however I really like these self-awareness check-ins. Thats an awesome concept.

Razi: Thanks, Katie. Its enjoyable too as a result of I believe like, Oh, my gosh like Ive been sitting with my legs crossed and my legs beginning to go to sleep. Like how lengthy was I gonna let myself do this, you understand? And thats not a significant factor thats a determinant of well being. However when you begin with the small issues, then I believe you grow to be extra conscious of the bigger issues in your life that your physique tells you it wants.

Katie: Yeah, thats such an awesome level. And our time is flying by so quick since youre really easy to speak to. However a pair questions Id like to ask towards the top and I do know that you justre additionally very well-read. So Im curious if theres a e book or variety of books which have actually had a dramatic affect in your life, and in that case, what theyre and why?

Razi: Okay, so one e book that I obtained in highschool that I used to be at like a storage sale, and its referred to as The Artwork of Loving by Erich Fromm. Have you ever heard of it?

Kaie: Ive heard of it. However Ive not learn it.

Katie: Okay, so Erich Fromm was I suppose hes like a psychoanalyst, a psychotherapist, and in addition only a social, I suppose thinker, and he was the primary individual to actually discuss love as one thing price taking a look at like in a tutorial form of manner. And theres a passage Id like or only a sentence or two Id wish to learn from his e book that basically modified my concept of what love is. And it says this. Love shouldnt be primarily a relationship to a selected individual. Its an perspective, an orientation of character, which determines the relatedness the individual to the world as a complete, not towards one object of affection. If an individual loves just one different individual and is detached to the remainder of his fellow-men, this love shouldnt be love however a symbiotic attachment.

And once I learn that was simply, you understand, a younger lady in highschool and I had my past love, my first boyfriend, and all of the marvel and type of angst that goes with that. And I used to be actually type of astounded by this little e book and the way it teaches rather a lot about self-responsibility and that love is definitelysuch as you dont fall in love. You stand in love. And it talks about love as an artwork so its referred to as The Artwork of Loving as every other endeavor that we do this we as people are referred to as even biblically when youre so inclined to like each other. Not from a non secular perspective, however it type of explores what does that seem like. And I believe if we actually observe that and look inside and love ourselves and love the folks, the world round us, I believe its actually an answer to a number of what ails us.

Katie: Ill be sure I add that within the present notes so folks can discover that e book. Thats attention-grabbing and, yeah, a brand new advice on right here. Lastly, is there any parting recommendation you wish to go away with the viewers as we speak?

Razi: Im at all times searching for recommendation myself and I undoubtedly suppose that Im type of a scholar of life as nicely. However I believe the perfect recommendation I might give is to at all times be sincere with your self. I believe that theres a number of methods particularly taking a look at social media and stuff that we type of, you understand, badass ourselves out of wanting on the fact, that we type of excessive 5 ourselves generally in a manner that may be truly type of aggressive and even passive-aggressive. And I believe that the easiest way in direction of happiness is to at all times simply be sincere with your self in each scenario that you justre in, whether or not its an sickness or pleasure, elevating your loved ones, being in a relationship, what youre consuming, a brand new train routine. I believe that basically being sincere with your self is a manner which you could by no means go mistaken.

Katie: I really like that. I believe its an ideal place to wrap up. And Ill ensure that the hyperlinks to all the issues weve talked about to naturopath and to your publication and podcasts and all the things are within the present notes at wellnessmama.fm. So when you guys are driving or exercising or no matter it could be, youll find these hyperlinks later at wellnessmama.fm. However, Razi, thanks a lot for being right here. Its at all times such a pleasure to talk with you.

Razi: It was numerous enjoyable. Thanks once more, Katie.

Katie: And because of all of you for sharing your most dear asset, your time, with us as we speak. Were each so grateful that you just did. And I hope that youll be part of me once more on the following episode of The Wellness Mama Podcast.

The rest is here:
283: A Entire-Particular person Strategy to Well being With Razi Berry - Editorials 360

Recommendation and review posted by Bethany Smith

An unexpected early morning phone call from the hospital is never good news. When Joy Johnson answered, her first thought was that Sharon Birzer, her partner of 15 years, was dead. Her fears were amplified by the voice on the other end refusing to confirm or deny it. Just come in and talk to one of the doctors, she remembers the voice saying.

Johnson knew this was a real possibility. A few weeks earlier, she and Birzer sat in the exam room of a lymphoma specialist at Stanford University. Birzers cancer had grown, and fast first during one type of chemotherapy, then through a second. Out of standard options, Birzers local oncologist had referred her for a novel treatment called chimeric antigen receptor T-cell therapy or CAR-T. Birzer and Johnson knew the treatment was risky. They were warned there was a chance of death. There was also a chance of serious complications such as multi-organ failure and neurological impairment. But it was like warning a drowning person that her lifeboat could have problems. Without treatment, the chance of Birzers death was all but certain. She signed the consent form.

Two side-by-side PET scans from researchers at Fred Hutchinson Cancer Research Center show a large tumor mass in the kidneyprior to CAR-T cell therapy (left) and two months after CAR-T cells were injected. For this patient, the tumor almost completely regressed.

Visual: Fred Hutch News Service

Johnson hung up the phone that early morning and sped to the hospital. She met with a doctor and two chaplains in a windowless room in the cancer ward, where happy photos of cancer alumni smiled down from the walls. This is getting worse and worse, Johnson thought. As she remembers it, the doctor went through the timeline of what happened for 10 minutes, explaining how Birzer became sicker and sicker, before Johnson interrupted with the thought splitting her world in two: I need you to tell me whether shes alive or dead.

Birzer wasnt dead. But she was far from okay. The ordeal began with Birzer speaking gibberish. Then came seizures so severe there was concern she wouldnt be able to breathe on her own. When it took a few different medications to stop Birzer from seizing, her doctors sedated her, put a breathing tube down her throat, and connected her to a ventilator. Now, she was unconscious and in the intensive care unit (ICU).

Birzer was one of the early patients to receive CAR-T, a radical new therapy to treat cancer. It involved removing Birzers own blood, filtering for immune cells called T-cells, and genetically engineering those cells to recognize and attack her lymphoma. CAR-T made history in 2017 as the first FDA-approved gene therapy to treat any disease. After three to six months of follow-up, the trials that led to approval showed response rates of 80 percent and above in aggressive leukemias and lymphomas that had resisted chemotherapy. Patients on the brink of death were coming back to life.

This is something I often dream of seeing but rarely do. As a doctor who treats cancer, I think a lot about how to frame new treatments to my patients. I never want to give false hope. But the uncertainty inherent to my field also cautions me against closing the door on optimism prematurely. We take it as a point of pride that no field of medicine evolves as rapidly as cancer the FDA approves dozens of new treatments a year. One of my biggest challenges is staying up to date on every development and teasing apart what should and shouldnt change my practice. I am often a mediator for my patients, tempering theoretical promises with everyday realism. To accept a research finding into medical practice, I prefer slow steps showing me proof of concept, safety, and efficacy.

CAR-T, nearly three decades in the making, systemically cleared these hurdles. Not only did the product work, its approach was also unique among cancer treatments. Unlike our usual advances, this wasnt a matter of prescribing an old drug for a new disease or remixing known medications. CAR-T isnt even a drug. This is a one-time infusion giving a person a better version of her own immune system. When the FDA approved its use, it wasnt a question of whether my hospital would be involved, but how we could stay ahead. We werent alone.

Today, two FDA-approved CAR-T products called Kymriah and Yescarta are available in more than 100 hospitals collectively across the U.S. Hundreds of clinical trials are tinkering with dosages, patient populations, and types of cancer. Some medical centers are manufacturing the cells on-site.

The FDA approved CAR-T with a drug safety program called a Risk Evaluation and Mitigation Strategy (REMS). As I cared for these patients, I quickly realized the FDAs concerns. Of the 10 or so patients Ive treated, more than half developed strange neurologic side effects ranging from headaches to difficulty speaking to seizures to falling unconscious. We scrambled to learn how to manage the side effects in real time.

Johnson and Birzer, who I didnt treat personally but spoke to at length for this essay, understood this better than most. Both had worked in quality control for a blood bank and were medically savvier than the average patient. They accepted a medical system with a learning curve. They were fine with hearing I dont know. Signing up for a trailblazing treatment meant going along for the ride. Twists and bumps were par for the course.

Cancer, by definition, means something has gone very wrong within a cell has malfunctioned and multiplied. The philosophy for fighting cancer has been, for the most part, creating and bringing in treatments from outside the body. Thats how we got to the most common modern approaches: Chemotherapy (administering drugs to kill cancer),radiation(using high energy beams to kill cancer), and surgery (cutting cancer out with a scalpel and other tools). Next came the genetics revolution, with a focus on creating drugs that target a precise genetic mutation separating a cancer cell from a normal one. But cancers are genetically complex, with legions of mutations and the talent to develop new ones. Its rare to have that one magic bullet.

Over the last decade or so, our approach shifted. Instead of fighting cancer from the outside, we are increasingly turning in. The human body is already marvelously equipped to recognize and attack invaders, from the common cold to food poisoning, even if the invaders are ones the body has never seen before. Cancer doesnt belong either. But since cancer cells come from normal ones, theyve developed clever camouflages to trick and evade the immune system. The 2018 Nobel Prize in Physiology or Medicine was jointly awarded to two researchers for their work in immunotherapy, a class of medications devoted to wiping out the camouflages and restoring the immune systems upper hand. As I once watched a fellow oncologist describe it to a patient: Im not treating you. You are treating you.

What if we could go one step further? What if we could genetically engineer a patients own immune cells to spot and fight cancer, as a sort of best hits of genetic therapy and immunotherapy?

For patients, the dreaded c word is cancer. For oncologists, its cure.

Enter CAR-T. The technology uses T-cells, which are like the bouncers of the immune system. T-cells survey the body and make sure everything belongs. CAR-T involves removing a persons T-cells from her blood and using a disarmed virus to deliver new genetic material to the cells. The new genes given to the T-cells help them make two types of proteins. The first giving the technology its name is a CAR, which sits on the T-cells surface and binds to a protein on the tumor cells surface, like a lock and key. The second serves as the T-cells caffeine jolt, rousing it to activate. Once the genetic engineering part is done, the T-cells are prodded to multiply by being placed on a rocking device that feeds them nutrients while filtering their wastes. When the cells reach a high enough number a typical dose ranges from hundreds of thousands to hundreds of millions they are formidable enough to go back into the patient. Once inside, the cancer provokes the new cells to replicate even more. After one week, a typical expansion means multiplying by about another 1,000-fold.

Practically, it looks like this: A person comes in for an appointment. She has a catheter placed in a vein, perhaps in her arm or her chest, that connects to a large, whirring machine which pulls in her blood and separates it into its components. The medical team set the T-cells aside to freeze while the rest of the blood circulates back into the patient in a closed loop. Then, the hospital ships the cells frozen to the relevant pharmaceutical companys headquarters or transports them to a lab on-site, where thawing and manufacturing takes from a few days to a few weeks. When the cells are ready, the patient undergoes about three days of chemotherapy to kill both cancer and normal cells, making room for the millions of new cells and eradicating normal immune players that could jeopardize their existence. She then gets a day or two to rest. When the new cells are infused back into her blood, we call that Day 0.

CAR-T uses genetically modified T-cells that have been engineered to recognize and attack cancerous cells. Visual: Kotryna Zukauskaite (Animation by Paige Stampatori)

I remember the first time I watched a patient get his Day 0 infusion. It felt anti-climactic. The entire process took about 15 minutes. The CAR-T cells are invisible to the naked eye, housed in a small plastic bag containing clear liquid.

Thats it? my patient asked when the nurse said it was over. The infusion part is easy. The hard part is everything that comes next.

Once the cells are in, they cant turn off. That this may cause collateral damage was evident from the start. In 2009 working in parallel with other researchers at Memorial Sloan Kettering Cancer Center in New York and the National Cancer Institute in Maryland oncologists at the University of Pennsylvania opened a clinical trial for CAR-T in human leukemia patients. (Carl June, who led the CAR-T development, did not respond to Undarks interview request.) Of the first three patients who got CAR-T infusions, two achieved complete remission but nearly died in the process. The first was a retired corrections officer named Bill Ludwig, who developed extremely high fevers and went into multi-organ failure requiring time in the ICU. At the time, the medical teams had no idea why it was happening or how to stop it. But time passed. Ludwig got better. Then came the truly incredible part: His cancer was gone.

With only philanthropic support, the trial ran out of funding. Of the eligible patients they intended to treat, the Penn doctors only treated three. So they published the results of one patient in the New England Journal of Medicine and presented the outcomes of all three patients, including Ludwig, at a cancer conference anyway. From there, the money poured in. Based on the results, the Swiss pharmaceutical company Novartis licensed the rights of the therapy.

The next year, six-year-old Emily Whitehead was on the brink of death when she became the first child to receive CAR-T. She also became extremely ill in the ICU, and her cancer was also eventually cured. Her media savvy parents helped bring her story public, making her the poster child for CAR-T. In 2014, the FDA granted CAR-T a breakthrough therapy designation to expedite the development of extremely promising therapies. By 2017, a larger trial gave the treatment to 75 children and young adults with a type of leukemia B-cell acute lymphoblastic leukemia that failed to respond to chemotherapy. Eighty-one percent had no sign of cancer after three months.

As a doctor who treats cancer, I think a lot about how to frame new treatments to my patients. I never want to give false hope.

In August 2017, the FDA approved a CAR-T treatment as the first gene therapy in the U.S. The decision was unanimous. The Oncologic Drugs Advisory Committee, a branch of the FDA that reviews new cancer products, voted 10 to zero in favor of Kymriah. Committee members called the responses remarkable and potentially paradigm changing. When the announcement broke, a crowd formed in the medical education center of Penn Medicine, made up of ecstatic faculty and staff. There were banners and T-shirts. A remarkable thing happened was the tagline, above a cartoon image of a heroic T-cell. Two months later, in October 2017, the FDA approved a second CAR-T formulation called Yescarta from Kite Pharma, a subsidiary of Gilead Sciences, to treat an aggressive blood cancer in adults called diffuse large B-cell lymphoma, the trial of which had shown a 54 percent complete response rate, meaning all signs of cancer had disappeared. In May 2018, Kymriah was approved to treat adults with non-Hodgkin lymphoma.

That year, the American Society of Clinical Oncology named CAR-T the Advance of the Year, beating out immunotherapy, which had won two years in a row. When I attended the last American Society of Hematology meeting in December 2018, CAR-T stole the show. Trying to get into CAR-T talks felt like trying to get a photo with a celebrity. Running five minutes late to one session meant facing closed doors. Others were standing room only. With every slide, it became difficult to see over a sea of smartphones snapping photos. At one session I found a seat next to the oncologist from my hospital who treated Birzer. Look, she nudged me. Do you see all these non-member badges? I turned. Members were doctors like us who treated blood cancers. I couldnt imagine who else would want to be here. Who are they? I asked. Investors, she said. It felt obvious the moment she said it.

For patients, the dreaded c word is cancer. For oncologists, its cure. When patients ask, Ive noticed how we gently steer the conversation toward safer lingo. We talk about keeping the cancer in check. Cure is a dangerous word, used only when so much time has passed from her cancer diagnosis we can be reasonably certain its gone. But that line is arbitrary. We celebrate therapies that add weeks or months because the diseases are pugnacious, the biology diverse, and the threat of relapse looming. Oncologists are a tempered group, or so Ive learned, finding inspiration in slow, incremental change.

This was completely different. These were patients who would have otherwise died, and the trials were boasting that 54 to 81 percent were cancer-free upon initial follow-up. PET scans showed tumors that had speckled an entire body melt away. Bone marrow biopsies were clear, with even the most sensitive testing unable to detect disease.

The dreaded word was being tossed around could this be the cure weve always wanted?

When a new drug gets FDA approval, it makes its way into clinical practice, swiftly and often with little fanfare. Under the drug safety program REMS, hospitals offering CAR-T were obligated to undergo special training to monitor and manage side effects. As hospitals worked to create CAR-T programs, oncologists like me made the all too familiar transition from first-time user to expert.

It was May 2018 when I rotated through my hospitals unit and cared for my first patients on CAR-T. As I covered 24-hour shifts, I quickly learned that whether I would sleep that night depended on how many CAR-T patients I was covering. With each treatment, it felt like we were pouring gasoline on the fire of patients immune systems. Some developed high fevers and their blood pressures plummeted, mimicking a serious infection. But there was no infection to be found. When resuscitating with fluids couldnt maintain my patients blood pressures, I sent them to the ICU where they required intensive support to supply blood to their critical organs.

We now have a name for this effect cytokine release syndrome that occurs in more than half of patients who receive CAR-T, starting with Ludwig and Whitehead. The syndrome is the collateral damage of an immune system on the highest possible alert. This was first seen with other types of immunotherapy, but CAR-T took its severity to a new level. Usually starting the week after CAR-T, cytokine release syndrome can range from simple fevers to multi-organ failure affecting the liver, kidneys, heart, and more. The activated T-cells make and recruit other immune players called cytokines to join in the fight. Cytokines then recruit more immune cells. Unlike in the early trials at Penn, we now have two medicines to dampen the effect. Steroids calm the immune system in general, while a medication called tocilizumab, used to treat autoimmune disorders such as rheumatoid arthritis, blocks cytokines specifically.

Fortuity was behind the idea of tocilizumab: When Emily Whitehead, the first child to receive CAR-T, developed cytokine release syndrome, her medical team noted that her blood contained high levels of a cytokine called interleukin 6. Carl June thought of his own daughter, who had juvenile rheumatoid arthritis and was on a new FDA-approved medication that suppressed the same cytokine. The team tried the drug, tocilizumab, in Whitehead. It worked.

Still, we were cautious in our early treatments. The symptoms of cytokine release syndrome mimic the symptoms of severe infection. If this were infection, medicines that dampen a patients immune system would be the opposite of what youd want to give. There was another concern: Would these medications dampen the anti-cancer activity too? We didnt know. Whenever a CAR-T patient spiked a fever, I struggled with the question is it cytokine release syndrome, or is it infection? I often played it safe and covered all bases, starting antibiotics and steroids at the same time. It was counterintuitive, like pressing both heat and ice on a strain, or treating a patient simultaneously with fluids and diuretics.

The second side effect was even scarier: Patients stopped talking. Some, like Sharon Birzer spoke gibberish or had violent seizures.Some couldnt interact at all, unable to follow simple commands like squeeze my fingers. How? Why? At hospitals across the nation, perfectly cognitively intact people who had signed up to treat their cancer were unable to ask what was happening.

Our nurses learned to ask a standardized list of questions to catch the effect, which we called neurotoxicity: Where are we? Who is the president? What is 100 minus 10? When the patients scored too low on these quizzes, they called me to the bedside.

Joy Johnson (left) and her partner Sharon Birzer. Birzer was one of the early patients to receive CAR-T, a radical new therapy to treat cancer.

Visual: Courtesy of Sharon Birzer

In turn, I relied heavily on alaminated booklet, made by other doctors who were using CAR-T, which we tacked to a bulletin board in our doctors workroom. It contained a short chart noting how to score severity and what to do next. I flipped through the brightly color-coded pages telling me when to order a head CT-scan to look for brain swelling and when to place scalp electrodes looking for seizures. Meanwhile, we formed new channels of communication. As I routinely called a handful of CAR-T specialists at my hospital in the middle of the night, national consortiums formed where specialists around the country shared their experiences. As we tweaked the instructions, we scribbled updates to the booklet in pen.

I wanted to know whether my experience was representative. I came across an abstract and conference talk that explored what happened to 277 patients who received CAR-T in the real world, so I emailed the lead author, Loretta Nastoupil, director of the Department of Lymphoma and Myeloma at the University of Texas MD Anderson Cancer Center in Houston. Fortuitously, she was planning a trip to my university to give a talk that month. We met at a caf and I asked what her research found. Compared to the earlier trials, the patients were much sicker, she said. Of the 277 patients, more than 40 percent wouldnt have been eligible for the very trials that got CAR-T approved. Was her team calling other centers for advice? They were calling us, she said.

Patients included in clinical trials are carefully selected. They tend not to have other major medical problems, as we want them to survive whatever rigorous new therapy we put them through. Nastoupil admits some of it is arbitrary. Many criteria in the CAR-T trials were based on criteria that had been used in chemotherapy trials. These become standard languages that apply to all studies, she said, listing benchmarks like a patients age, kidney function, and platelet count. But we have no idea whether criteria for chemotherapy would apply to cellular therapy.

Now, with a blanket FDA approval comes clinical judgment. Patients want a chance. Oncologists want to give their patients a chance. Young, old, prior cancer, heart disease, or liver disease without strict trial criteria, anyone is fair game.

When I was making rounds at my hospital, I never wandered too far from these patients rooms, medically prepared for them to crash at any moment. At the same time, early side effects made me optimistic. A bizarre truism in cancer is that side effects may bode well. They could mean the treatment is working. Cancer is usually a waiting game, requiring months to learn an answer. Patients and doctors alike seek clues, but the only real way to know is waiting: Will the next PET scan show anything? What are the biopsy results?

CAR-T was fundamentally different from other cancer treatments in that it worked fast. Birzers first clue came just a few hours after her infusion. She developed pain in her lower back. She described it as feeling like she had menstrual cramps. A heavy burden of lymphoma lay in her uterus. Could the pain mean that the CAR-T cells had migrated to the right spot and started to work? Her medical team didnt know, but the lead doctors instinct was that it was a good sign.

Two days later, her temperature shot up to 102. Her blood pressure dropped. The medical team diagnosed cytokine release syndrome, as though right on schedule, and gave her tocilizumab.

Every day, the nurses would ask her questions and have her write simple sentences on a slip of paper to monitor for neurotoxicity. By the fifth day, her answers changed. She started saying things that were crazy, Johnson explained.

One of Birzers sentences was guinea pigs eat greens like hay and pizza. Birzer and Johnson owned two guinea pigs, so their diet would be something Birzer normally knew well. So Johnson tried to reason with her: They dont eat pizza. And Birzer replied, They do eat pizza, but only gluten-free.

Johnson remembers being struck by the certainty in her partners delirium. Not only was Birzer confused, she was confident she was not. She was doubling down on everything, Johnson described. She was absolutely sure she was right.

Johnson vividly remembers the evening before the frightening early-morning phone call that brought her rushing back to the hospital. Birzer had said there was no point in Johnson staying overnight; she would only watch her be in pain. So Johnson went home. After she did, the doctor came by multiple times to evaluate Birzer. She was deteriorating and fast. Her speech became more and more garbled. Soon she couldnt name simple objects and didnt know where she was. At 3 a.m., the doctor ordered a head CT to make sure Birzer wasnt bleeding into her brain.

Fortunately, she wasnt. But by 7 a.m. Birzer stopped speaking altogether. Then she seized. Birzers nurse was about to step out of the room when she noticed Birzers arms and legs shaking. Her eyes stared vacantly and she wet the bed. The nurse called a code blue, and a team of more doctors and nurses ran over. Birzer was loaded with high-dose anti-seizure medications through her IV. But she continued to seize. As nurses infused more medications into her IV, a doctor placed a breathing tube down her throat.

Birzers saga poses the big question: Why does CAR-T cause seizures and other neurologic problems? No one seemed to know. My search of the published scientific literature was thin, but one name kept cropping up. So I called her. Juliane Gust, a pediatric neurologist and scientist at Seattle Childrens Hospital, told me her investigations of how CAR-T affects the brain were motivated by her own experiences. When the early CAR-T trials opened at her hospital in 2014, she and her colleagues began getting calls from oncologists about brain toxicities they knew nothing about. Where are the papers? she remembered thinking. There was nothing.

The CAR-T cells are invisible to the naked eye, housed in a small plastic bag containing clear liquid. Visual: Kotryna Zukauskaite (Animation by Paige Stampatori)

Typically, the brain is protected by a collection of cells aptly named the blood-brain-barrier. But with severe CAR-T neurotoxicity, research suggests, this defense breaks down. Gust explained that spinal taps on these patients show high levels of cytokines floating in the fluid surrounding the spine and brain. Some CAR-T cells circulate in the fluid too, she said, but these numbers do not correlate with sicker patients. CAR-T cells are even seen in the spinal fluid of patients without any symptoms.

What does this mean? Gust interprets it as a patients symptoms having more to do with cytokines than the CAR-T cells. Cytokine release syndrome is the number one risk factor for developing neurotoxicity over the next few days, she said. The mainstay for neurotoxicity is starting steroids as soon as possible. In the beginning we didnt manage as aggressively. We were worried about impairing the function of the CAR-T, she added. Now we give steroids right away.

But the steroids dont always work. Several doses of steroids didnt prevent Birzer from seizing. The morning after Johnsons alarming phone call, after the meeting at the hospital when she learned what had happened, a chaplain walked her from the conference room to the ICU. The first day, Johnson sat by her partners bedside while Birzer remained unconscious. By the next evening, she woke up enough to breathe on her own. The doctors removed her breathing tube, and Birzer looked around. She had no idea who she was or where she was.

Birzer was like a newborn baby, confused and sometimes frightened by her surroundings. She frequently looked like she was about to say something, but she couldnt find the words despite the nurses and Johnsons encouragement. One day she spoke a few words. Eventually she learned her name. A few days later she recognized Johnson. Her life was coming back to her, though she was still suspicious of her reality. She accused the nurses of tricking her, for instance, when they told her Donald Trump was president.

She took cues from the adults around her on whether her actions were appropriate. The best example of this was her I love you phase. One day, she said it to Johnson in the hospital. A few nurses overheard it and commented on how sweet it was. Birzer was pleased with the reaction. So she turned to the nurse: I love you! And the person emptying the trash: I love you! Months later, she was having lunch with a friend who asked, Do you remember when you told me you loved me? Birzer said, Well, I stand by that one.

When she got home, she needed a walker to help with her shakiness on her feet. When recounting her everyday interactions, she would swap in the wrong people, substituting a friend for someone else. She saw bugs that didnt exist. She couldnt hold a spoon or a cup steady. Johnson would try to slow her down, but Birzer was adamant she could eat and drink without help. Then peas would fly in my face, Johnson said.

Patients who experience neurotoxicity fall into one of three categories. The majority are impaired but then return to normal without long-term damage. A devastating handful, less than 1 percent, develop severe brain swelling and die. The rest fall into a minority that have lingering problems even months out. These are usually struggles to think up the right word, trouble concentrating, and weakness, often requiring long courses of rehabilitation and extra help at home.

Patients stopped talking. Some, like Sharon Birzer spoke gibberish or had violent seizures. Some fell into comas.

As Birzer told me about her months of rehab, I thought how she did seem to fall somewhere in the middle among the patients Ive treated. On one end of the spectrum was the rancher who remained profoundly weak a year after his infusion. Before CAR-T, he walked across his ranch without issue; six months later, he needed a walker. Even with it, he fell on a near weekly basis. On the other end was the retired teacher who couldnt speak for a week she would look around her ICU room and move her mouth as though trying her hardest and then woke up as though nothing happened. She left the hospital and instantly resumed her life, which included a recent trip across the country. In hindsight, I remember how we worried more about giving the therapy to the teacher than the rancher, as she seemed frailer. Outcomes like theirs leave me with a familiar humility I keep learning in new ways as a doctor: We often cant predict how a patient will do. Our instincts can be just plain wrong.

I asked Gust if we have data to predict who will land in which group. While we can point to some risk factors higher burdens of cancer, baseline cognitive problems before therapy the individual patient tells you nothing, she confirmed.

So we wait.

Doctors like me who specialize in cancer regularly field heart-wrenching questions from patients. They have read about CAR-T in the news, and now they want to know: What about me? What about my cancer?

So, who gets CAR-T? That leads to the tougher question who doesnt? That depends on the type of cancer and whether their insurance can pay.

CAR-T is approved to treat certain leukemias and lymphomas that come from the blood and bone marrow. Since the initial approval, researchers have also set up new CAR-T trials for all sorts of solid tumors from lung cancer to kidney cancer to sarcoma. But progress has been slow. While some promising findings are coming from the lab and in small numbers of patients on early phase trials, nothing is yet approved in humans. The remarkable responses occurring in blood cancers just werent happening in solid tumors.

Cancer is one word, but its not one disease. Its easier to prove why something works when it works than show why it doesnt work when it doesnt work, said Saar Gill, a hematologist and scientist at the University of Pennsylvania who co-founded a company called Carisma Therapeutics using CAR-T technology against solid tumors. That was his short answer, at least. The longer answer to why CAR-T hasnt worked in solid cancers involves what Gill believes are two main barriers. First, its a trafficking problem. Leukemia cells tend to be easier targets; they bob through the bloodstream like buoys in an ocean. Solid tumors are more like trash islands. The cancer cells stick together and grow an assortment of supporting structures to hold the mound together. The first problem for CAR-T is that the T-cells may not be able to penetrate the islands. Then, even if the T-cells make it in, theyre faced with a hostile environment and will likely die before they can work.

At Carisma, Gill and his colleagues look to get around these obstacles though a different immune cell called the macrophage. T-cells are not the only players of the immune system, after all. Macrophages are gluttonous cells that recognize invaders and engulf them for destruction. But studies have shown they cluster in solid tumors in a way T-cells dont. Gill hopes genetically engineered macrophages can be the stowaways that sneak into solid tumor and attack from the inside out.

Another big challenge, even for leukemias and lymphomas, is resistance, where the cancers learn to survive the CAR-T infusion. While many patients in the trials achieved remission after a month, we now have two years worth of data and the outlook isnt as rosy. For lymphoma, that number is closer to 40 percent. Patients celebrating cures initially are relapsing later. Why?

The CAR-T cells we use target a specific protein on cancer cells. But if the cancer no longer expresses that protein, that can be a big problem, and were finding thats exactly whats happening. Through blood testing, we see that many patients who relapse lose the target.

Researchers are trying to regain the upper hand by designing CAR-Ts to target more than one receptor. Its an old idea in a new frame: An arms race between our medicines and the illnesses that can evolve to evade them. Too much medical precision in these cases is actually not what we want, as it makes it easier for cancer to pinpoint whats after it and develop an escape route. So, the reasoning goes, target multiple pieces at once. Confuse the cancer.

Then theres the other dreaded c word: Cost. Novartis Kymriah runs up to $475,000 while Kite Pharmas Yescarta is $373,000. That covers manufacturing and infusion. Not included is the minimum one-week hospital stay or any complications.

They are daunting numbers. Some limitations on health care we accept maybe the patients are too sick; maybe they have the wrong disease. The wrong cost is not one we as a society look kindly upon. And drug companies shy away from that kind of attention.

Cost origins in medicine are notoriously murky. Novartis, confident in its technology, made an offer to offset the scrutiny in CAR-T. If the treatment didnt work after one month, the company said it wouldnt send a bill.

Not everyone agrees that cost is an issue. Gill, for example, believes the concern is over-hyped. Its not a major issue, he told me over the phone. Look, of course [with] health care in this country, if you dont have insurance, then youre screwed. That is no different when it comes to CAR-T as it is for anything else, he said. The cost conversation must also put CAR-T in context. Gill went on to list what these patients would be doing otherwise months of chemotherapy, bone marrow transplants, hospital stays for cancer-associated complications and the associated loss of income as patients and caregivers miss work. These could add up to far more than a one-time CAR-T infusion. A bone marrow transplant, for example, can cost from $100,000 to more than $300,000. The cancer-fighting drug blinatumomab, also used to treat relapsed leukemia, costs $178,000 a year. Any discussion of cost is completely irresponsible without weighing the other side of the equation, Gill said.

How the system will get on board is another question. Logistics will be an issue, Gill conceded. The first national Medicare policy for covering CAR-T was announced in August 2019, two years after the first product was approved. The Centers for Medicare and Medicaid Services has offered to reimburse a set rate for CAR T-cell infusion, and while this figure was recently raised, it remains less than the total cost. Despite the expansion of medical uses, at some centers referrals for CAR-T are dropping as hospitals worry its a net loss. And while most commercial insurers are covering CAR-T therapies, companies less accustomed to handling complex therapies can postpone approval. Ironically, the patients considering CAR-T are the ones for whom the window for treatment is narrowest. A delay of even a few weeks can mean the difference between a cure and hospice.

This, of course, poses a big problem. A breakthrough technology is only as good as its access. A major selling point of CAR-T besides the efficacy is its ease. Its a one-and-done treatment. Engineered T-cells are intended to live indefinitely, constantly on the alert if cancer tries to come back. Compare that to chemotherapy or immunotherapy, which is months of infusions or a pill taken indefinitely. CAR-T is more akin to surgery: Cut it out, pay the entire cost upfront, and youre done.

Birzer was lucky in this respect. I asked her and Johnson if cost had factored into their decision to try CAR-T. They looked at each other. It wasnt an issue, said Johnson. They remembered getting a statement in the mail for a large sum when they got home. But Birzer had good insurance. She didnt pay a cent.

One year after Birzers infusion, I met her and Johnson at a coffee shop near their home in San Francisco. They had saved a table. Johnson had a newspaper open. Birzer already had her coffee, and I noticed her hand trembling as she brought it to her mouth. She described how she still struggles to find exactly the right words. She sometimes flings peas. But shes mostly back to normal, living her everyday life. She has even returned to her passion, performing stand-up comedy, though she admitted that at least for general audiences: My jokes about cancer didnt kill.

People handed a devastating diagnosis dont spend most of their time dying. They are living, but with a heightened awareness for a timeline the rest of us take for granted. They sip coffee, enjoy their hobbies, and read the news while also getting their affairs in order and staying on the lookout, constantly, for the next treatment that could save them.

Hoping for a miracle while preparing to die are mutually compatible ideas. Many of my patients have become accustomed to living somewhere in that limbo. It is humbling to witness. They hold out hope for a plan A, however unlikely it may be, while also adjusting to the reality of a plan B. They live their lives; and they live in uncertainty.

I see patients in various stages of this limbo. In clinic, I met a man with multiple myeloma six months after a CAR-T trial that supposedly cured him. He came in with a big smile but then quietly began praying when it was time to view PET results. He asked how the other patients on the trial were doing, and I shared the stats. While percentages dont say anything about an individual experience, theyre also all patients have to go on. When someone on the same treatment dies, its shattering for everyone. Was one person the exception, or a harbinger anothers fate? Who is the outlier?

I look at these patients and think a sober truth: Before CAR-T, all would likely die within six months. Now, imagine taking 40 percent and curing them. Sure, a naysayer might point out, its only 40 percent. Whats the hype if most still succumb to their cancer? But there was nothing close to that before CAR-T. I agree with how Gill described it: I think CAR-T cells are like chemotherapy in the 1950s. Theyre not better than chemotherapy theyre just different. For an adversary as tough as cancer, well take any tool we can get.

There remain many questions. Can we use CAR-T earlier in a cancers course? Lessen the side effects? Overcome resistance? Streamline manufacturing and reimbursement? Will it work in other cancers? Patients will sign up to answer.

For now, Birzer seems to be in the lucky 40 percent. Her one-year PET scan showed no cancer. I thought of our last coffee meeting, where I had asked if she ever worried she wouldnt return to normal. She didnt even pause. If youre not dead, she said, youre winning.

Ilana Yurkiewicz, M.D., is a physician at Stanford University and a medical journalist. She is a former Scientific American Blog Network columnist and AAAS Mass Media Fellow. Her writing has also appeared in Aeon Magazine, Health Affairs, and STAT News, and has been featured in The Best American Science and Nature Writing.

Read more:
The CAR-T Revolution Is ... Messy - Undark Magazine

Recommendation and review posted by Bethany Smith

Breast cancer occurs in breast tissue, which both women and men have. Although its rare, male breast cancer does happen.

Its diagnosed and treated similarly in all genders, so early diagnosis remains key. The science around the cause of male breast cancer is unclear, according to the Mayo Clinic, same as most types of most cancer, though male breast cancer is even more mysterious.

People of all genders are born with some breast tissue and milk-producing glands (lobules) that transport milk to the nipples and fat. When a girl hits puberty, she develops more breast tissue, and boys do not. Boys, however, do still have the breast tissue with which they were born.

The most common type of breast cancer in men is ductal carcinoma, which begins in the milk ducts.

Just as with women, there is research indicating a family history of breast cancer increases the likelihood of a man getting the disease. Gene mutations like BRCA2 (the same mutation actress Angelina Jolie had that put her at a high risk of breast cancer) increases a mans risk of breast cancer and prostate cancer.

Older age remains a risk factor, as does exposure to estrogen, obesity or liver or testicular disease. Men who are born with Klinefelters syndrome, a genetic condition in which some boys have more than one copy of the X chromosome, also increase a mans likelihood of contracting breast cancer.

Early diagnosis and treatment is critical for best outcomes in male breast cancer, which can be harder since its not always the first condition tested for, so knowing the symptoms is important. These include a painless lump in or thickening of the breast tissue, changes to the nipple (redness, scaling or turning inward) or nipple discharge or changes to the skin covering the breast area. Men who see these symptoms should ask their doctor for further assessment.

According to the Mayo Clinic, diagnosis and treatment is similar to what women experience: clinical breast exams, medical imaging that enables the doctor to see problem areas, or a biopsy, during which the doctor extracts tissue from the suspected tumor and tests it.

Male breast cancer is often hormone-related, so doctors may recommend hormone therapy in addition to surgery, chemotherapy and radiation.

Originally posted here:
Breast Cancer in Men | Outlook - Big Bear Grizzly

Recommendation and review posted by Bethany Smith

This October, focus and awareness are being placed on a health crisis that affects one in every eight women in the United States.

Breast cancer is the second most common cause of death among women in the U.S. For Black women, its even more severe. With a 31% mortality rate, Black women have the highest risk out of all races in the country.

Its not hard to see why talking about breast cancer, telling stories of survival and learning about how it's treated can be life-saving for women. However, women are not the only ones whose lives are turned upside down by breast cancer.

Earlier this month, music executive Matthew Knowlesrevealed he was diagnosed with breast cancer this past July, which he immediately had a mastectomy to treat. Knowles told Michael Strahan in an exclusive interview with Good Morning Americathat he has the BRCA2 mutation gene, which triggers breast, prostate and pancreatic cancer as well as melanoma.

The rest of my life, I have to be very much aware and conscious and do all of the early detection - constant mammograms, constant prostate exams, constant MRIs, for the rest of my life, he said, impassioned by his new awareness and outlook.

Beyonce and Solanges father isnt the first Black male celebrity to be diagnosed with breast cancer: '90s talk show hostMontell Williamsand legendary actor Richard Roundtree were also diagnosed with breast cancer and had mastectomies as a result.

Breast cancer is widely known as a womens disease but still affects over 2,600 men a year, killing around 500 annually, according to data reported by the American Cancer Society. The data also states that much like Black women, Black men are at a higher risk than white men.

American Cancer Society researchers found that young Black men are 76% more likely to die from breast cancer than white men, again, generally because screenings are overlooked.

Once again, being Black at the doctors office proves to be a dangerous game. With our historically damaged trust of the medical community and gaping disparities for preventable and treatable diseases, Black men have to be as diligently aware of their health status as Black women, even for a disease that seems unlikely.

Along with Black men, and men in general, another often-overlooked affected demographic istransgender women. As more transgender women opt to forgo surgery and instead take gender-confirming hormone therapies, their chance of breast cancer increases as well. Based on a case study of 2,260 transgender women, the rate of breast cancer compared to cisgender men was almost 50% higher.

Not only does breast cancer generally fall below the radar of most men, but it also carries a stigma that could deter them. The pink ribbons and female-focused language could be a barrier when it comes to bringing these difficult topics up. Pulling more men into the conversation is another step in the right direction for our entire community.

Despite the rarity in occurrence, breast cancer should absolutely be added to the list of illnesses that Black men remain diligently aware of, not just for their own health but for the health of the children they have or may one day have.

In his public plea for awareness, Matthew Knowles also said his diagnosis prompted his family members to be screened for the BRCA2 gene mutation that caused his breast cancer.

This is genetics, it also means that my kids have a higher chance, a higher risk. Even my grandkids have a higher risk, Matthew told Strahan during his interview, And they handled it like they should, they went and got the test.

According to the Mayo Clinic, genetic testing can be done to screen for the three leading gene mutations that cause breast cancer, BRCA1, BRCA2 and PALB2.

These tests are covered by most insurance companies and even several state Medicaid programs. But the catch is men have to ask the right questions.

Even young Black men should ask their family members about medical history and check with their doctor about risk factors and whether they need to be screened for gene mutations.

Knowing that our symptoms and pain are often overlooked by color-blind doctors, our first line of defense in surviving breast cancer -- no matter what gender, no matter what age -- is to ask questions and stay informed.

Continue reading here:
Everything You Need To Know About Male Breast Cancer In Black Men - BET

Recommendation and review posted by Bethany Smith

The specimens held in natural history collections around the world represent the wealth, beauty and diversity of our planet. But rather than being an objective picture of life on Earth, these collections have long been the result of curatorial bias.

An example of this bias is that there is often an overrepresentation of mammals and birds in collections, despite the far more numerous and diverse invertebrates and plants. What's more, even within these groups there are certain biases in how they were collected.

By looking at the bird and mammal specimens held by five major natural history collections, including those at the Natural History Museum, researchers have been delving into whether there is an underlying sex bias - in others words, whether there were more male specimens in the collections than female ones.

Natural history galleries are often filled with male specimens that have big, showy characteristics The Trustees of the Natural History Museum, London

Dr Natalie Cooper, a researcher at the Museum, led the study which has been published in the journal Proceedings of the Royal Society B.

'We looked at over two million specimen records from the American Museum of Natural History, the Field Museum, Musum National d'Histoire Naturelle, the Smithsonian and the Natural History Museum London,' says Natalie.

'From that we found - perhaps unsurprisingly - that there was a bias towards male specimens. It is worse in birds than in mammals, with only about 40% of bird specimens being females, but around 48% female in mammals.'

Groups which show a particularly pronounced bias towards males are those which the males have ornamentations such as the birds of paradise, hummingbirds, carnivores andartiodactyls, like deer, antelope and cattle.

The disparity between the number of male and female specimens in the collections is not wholly unsurprising - it is often the males that have big, showy characteristics - but it might be expected that more recent scientific collections would try and redress this balance. The data, however, shows that this has not been the case.

This means that, for studies which have used natural history collections in everything - for example, biogeography, morphology, taxonomy, genetics and even parasitology - there is likely to be an underlying male bias in the data.

Females are often under represented in groups such as antelopes The Trustees of the Natural History Museum, London

Showing that there is a skew in natural history collections is one thing, but figuring out where it comes from is just as important.

'We were then interested in trying to work out why there is this bias, because obviously curators don't just throw away the female specimens,' explains Natalie. 'It must be something to do with how they were collected.

'That could be either passive, so something to do with how male and female animals behave in the field, or it could be active whereby collectors are deliberately choosing to target males.'

Male and female animals can and do behave differently in the wild. In some species, for example, males may range more widely and so could be more likely to fall into traps, or maybe their more conspicuous nature means that males are more likely to be spotted.

'It is really hard to collate data on the passive explanations,' says Natalie. 'Although from what we can tell there are not more males in most natural populations. In fact, even though many wild populations are female-skewed, we still find lots more males in the collections, so it does seem like there is some active choice going on.'

If uncorrected, then sex biases can lead to skews in data further down the line The Trustees of the Natural History Museum, London

The data showed that among mammals, collectors were more likely to select large individuals with some form or ornamentation or weaponry such as horns, antlers, mains or tusks. In birds, size was not as important as colouration, as it was the more brightly feathered individuals that were more likely to be collected.

Where you have birds in which the female is more colourful and bigger than the males, however, there are more females than males in the collections.

On the surface, a slight bias towards males in museum collections might not seem like much of an issue. But there are many aspects of a species' biology and behaviour that are affected by an animal's biological sex.

At a basic level, if a study is looking at the taxonomy of a species and there are significant differences between males and females in their morphology, any bias towards the males could result in it being difficult to identify females down to species levels, as females are underrepresented in collections.

These biases can go even deeper. For example, males can be more susceptible to parasites as testosterone inhibits the immune system. Where collections are sex-biased, research looking into infection and immunity within a species could be skewed.

In groups such as the birds of paradise, males frequently have more colourful, elobrate and conspicuous plumage The Trustees of the Natural History Museum, London

As research is advancing into more technical analyses, these biases can cause significant differences. Stable isotope ecology can use the chemicals found in tissue to figure out where an animal may have been living or migrating based on what they were eating during their lifetime. But some species may have sex-segregated diets, meaning that you cannot draw inferences about a species in general if the underlying data is overrepresented by one sex.

'You'd like to hope that visiting researchers would come to the Museum and are selecting specimens with a mind to getting an equal number of males and females,' says Natalie.

'But often when people are doing big studies, they might not even consider the sex. They are more interested in getting as many species represented as possible, or in some cases they might not have a choice due to a limited number of specimens for some species that are available in the first place.'

In the past, hunters often selected those animals with the biggest antlers and horns The Trustees of the Natural History Museum, London

In these situations, researchers simply need to be aware of the skews and build them into their analyses. This is something that is being seen more and more in science, from how crash test dummies have typically been based on the male body to how bulletproof jackets have been designed for men.

One of the most striking biases is seen when looking at type specimens. These are the individual specimens on which a species description is made, and so seen as a typical example of that particular species.

Of these, only 25% of bird and 39% of mammal type specimens were found to be female.

'This bias was found to be way more extreme,' says Natalie, 'but it is also funny because there is a way of fixing it and people don't seem to have bothered to take that option.

'You can have these things called paratypes, which are specimens collected at the same time as the type but will represent other parts of the species diversity. It would seem obvious to me to take an opposite-sex paratype, but people don't seem to be doing that.'

In groups such as hummingbirds, there is a higher porportion of males than females in collections The Trustees of the Natural History Museum, London

Natalie and her colleagues expected that there would be significant sex biases in the early 1800s as trophy hunters went out and selected the biggest and fiercest males, but the team assumed that it would get better over time. It didn't.

'It's exactly the same,' says Natalie. 'It's the most beautiful flat correlation that I've ever seen. It's glorious.'

Museums as whole, it turns out, are simply really bad at recording the sex of specimens in their collections. Of the two million that were looked at for this study almost half were unsexed, even in species where the sex is obvious. So one of the most basic things that could be done is to actually record the sex of an individual in the first place.

Continued here:
There are more male than female specimens in natural history collections - The Natural History Museum

Recommendation and review posted by Bethany Smith

In-The-News is a roundup of stories from The Canadian Press designed to kickstart your day. Here is what's onthe radar of our editorsfor themorning of Oct. 24.

What we are watching in Canada ...

The Alberta government is to table a budget today that will cut program spending by nearly three per cent.

But Premier Jason Kenney, in a TV addresslast night, reiterated that health and education funding will not bereduced and maintaining front-line services is a priority.

"This will be a challenging budget. It willnot be easy," said Kenney, adding the exact reduction figure is 2.8 per cent.

"These are necessary decisions. In fact, I would argue that they are long overdue. We must embrace transformative change to get a smarter government. That's not going to happen overnight."

The budget is the first one by Kenney's United Conservative government since it defeated the NDP in the spring election.

Kenneyhas promisedthe budget will be alandmark spending document that will balance the books in four years andreorient Alberta's economy long after that.

He has pledged to get it done bygetting more value for public money while reducing overall spendingand endinga recent run of multibillion-dollar deficits he says threaten to cripple future generations with unsustainable debt.

Also this ...

A judge in southwestern Nova Scotia is expected to deliver a decision today in the case against aformer police chief accused of sexually assaulting a 17-year-old girl.

John Collyer was the chief of police in Bridgewater, N.S.

He was placed on administrative leave from the Bridgewater Police Service in August 2016 after the province's Serious Incident Response Team confirmed it was investigating the alleged assault.

The 26-year veteran of the force was suspended in May 2017 after the independent police watchdog charged him with one count of sexual assault and two counts of sexual exploitation.

Thecomplainanttestified thatCollyer asked her an inappropriate question while the two were driving in May 2016before puttinghis hand between her legs and assaulting her.

Collyer has denied the accusations.

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ICYMI (In case you missed it) ...

Scientists have written the family tree for the tree of life.

Years of analysis, released in the journal Nature, has allowed researchersto pinpoint a billion years of evolutionary relationships between plants as different as cannabisand cucumbers, orchids and oaks.

"Everything isinterrelated,"says the University of Alberta's Gane Wong, one of the paper's dozens of co-authors.

Science has known for a long time that species with significant differences can be related through a common evolutionary ancestor. In plants, those relationships have been studied mostly through how they look or behave. Do they have trunks? Flowers? How do their seeds form?

Wong and his colleagues nearly 200 of them have been looking at how the links are expressed through genetics.

The team couldn't resolve everything. They couldn't find branches in the tree for about five per cent of species, either because there wasn't enough data or because it dated from so long ago it couldn't be read accurately.

But the work is already yielding concrete benefits. Proteins taken from an obscure algae species studied by the researchers were found to turn certain brain neurons on and off. Those proteins are now being used in clinical trials to treat blindness.

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What we are watching in the U.S. ...

Alberta's oilsands are at the centre of acourt battle in New York this week that legal experts say could affect future climate lawsuits in Canada.

"The evidence that's coming out through this case is absolutely relevant to other lawsuits," said Martin Olszynski, a University of Calgary professor who teaches environmental law.

New York'sattorney general is accusingExxon Mobil of misrepresenting the risks oilsands operations face as governments move to fight climate change.

Inthe case filed a year ago, the state claims Exxon told investors that it was evaluating projects based on a carbon price that was much higher than the oneused in calculations. That led investors to believe they faced a lower risk and alsoinflated evaluations of Exxon's oil reserves.

Exxonhas tried twice to block the case. The company's lawyer, calling the accusations bizarre and twisted,arguedTuesday that Exxon did nothing wrong.

Although the lawsuit deals with a wide array of the multinational's operations, the oilsands feature prominently as Exxon is a major player through its subsidiary Imperial Oil.

"In these parts of its business, Exxon often applied a much lower price per ton to a small percentage of its (greenhouse gas) emissions ... and held those lower costs flat far into the future," court documents say.

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What we are watching in the rest of the world ...

Authorities found 39 people dead in a truck in an industrial park in England and arrested the driver on suspicion of murder in one of Britain's worst human-smuggling tragedies.

Police were reconstructing the final journey of the victims as they tried to piece together where they were from and how they came to be in England.

"To put 39 people into a locked metal container shows a contempt for human life that is evil," said Jackie Doyle-Price, a member of Parliament who represents the area where the truck was found. "The best thing we can do in memory of those victims is to find the perpetrators and bring them to justice."

The truck and the trailer with the people inside apparently took separate circuitous journeys before ending up on the grounds of the Waterglade Industrial Park in Grays, 25 miles (40 kilometres) east of London on the River Thames.

British police said they believe the container went from the port of Zeebrugge in Belgium to Purfleet, England, where it arrived early Wednesday. Police believe the tractor travelled from Northern Ireland to Dublin, where it took a ferry to Holyhead in Wales before picking up the trailer at the dockside in England.

The truck's driver a 25-year-old man from Northern Ireland was arrested on suspicion of murder. He has not been charged and his name has not been released.

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On this day in1990

The RCMP announced it would allowIndigenousofficers to wear their hair in braids while in uniform.

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Weird and wild ...

ST. JOHN'S, N.L. Animallovers in Newfoundland and Labrador are seeking help for dozens of feral cats facing an uncertain futureas the humansinthe small town where they prowl prepare to relocate.

Residents of Little Bay Islands have voted to resettle the community, andthey have until the end of the year to move before services are withdrawn.

Little Bay Islands, off Newfoundland's northern coast,is one of manyruralcommunities in the province faced with a dwindling population. The 2016 census recorded just 71 people living in the town.

Asresidents grapple with theprospect ofleaving their homes behind, the question of what will happen to theferal felines remains.

Resident Carol Hull estimates there are between 35 and 40 "semi-feral" catsliving in the community.

Animal welfare groups in other parts of Newfoundland have become involved in the campaign to domesticate and find homes for some of the animals.

Hullis hoping for abump in funding for animal welfare groups willing to take them in.

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Your health ...

TORONTOAnew report from Young Adult Cancer Canada sheds light on such uniqueissues faced by the 22 young adult Canadians, ages 15-39, who are diagnosed with cancer each day.

The study surveyed 622 diagnosed young adults across Canada to explore the physical, social, financial, and emotional challenges they face as compared to their peers without cancer.

It found cancer in young adulthood can "disrupt an important period of development and identity formation, which tends to have a cascading impact on all areas of life."

Yet there arefew support programs geared tohelping these patients throughdiagnosis and recovery, the report says.

It also found one of the main issues facing young adults with cancer is financial strain. Treatment and recovery affect their ability to work, and not all treatment costs are covered by public health care in Canada.

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The games we play ...

When softball player and Olympic 2022 hopeful Natalie Wideman was handed a$6,000cheque and told the money came from women she did not know, she was speechless.

"I instantly broke down crying," says the 27-year-oldcatcherfrom Mississauga, Ont. "In our generation, there's so much stuff being put on women, comparing each other to each other and judging each other's choices.

"Women helping women is just really, really, special to me."

The money came from Canadian Athletes Now, or Canfund, via a campaign of professional women supporting female athletes.

The 150 Women campaign named for the minimum donation of $150 has cut $6,000 chequesto 109 female athletes in two years. Eight of them have won Olympic gold.

Donors range in age from 18 to 82 with $50,000 the highest single donation so far.

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This report by The Canadian Press was first published Oct. 24, 2019.

The Canadian Press

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The family tree for the tree of life and feral cats; In-The-News for Oct. 24 - Airdrie Today

Recommendation and review posted by Bethany Smith

The Eastland Companion Animal Hospital in Bloomington is asking dog owners if they want to participate in research on using stem cells to treat dogs with arthritis.

Local dogs wouldjoin a double-blind, placebo-controlled studyto show the effectiveness of stem cells in treating large dogs(70 pounds or more) with arthritis in up to two joints of the knee, hip, elbow, or shoulder. The veterinary clinic has partnered with Animal Cell Therapies, who it's worked with before, to bring this study to Bloomington.

Dr. Kathy Petrucci, founder and CEO of Animal Cell Therapies, explained how dogs will receive the treatment.

The dogs that will receive the stem cells will be sedated, Petrucci said. Depending on what joints are affected, they will receive up to two injections in the joint and they will also receive an IV dose of stem cells.

The FDA oversees the cells that are received from donors for the study. Mothers donating these cells are screened for diseases, and cells are tested for any infections to ensure safety.

Stem cell therapy has been controversial, especially related to humans.

I think a lot of the controversy comes from the misunderstanding of the cell types, Petrucci said. The research in stem cells first started centered around embryonic or fetal tissue use. Its controversial to use embryos and fetal tissues for treatment for anything. The fact that we are using a disposable tissue as our cell sources makes it not controversial at all.

Why Umbilical-Derived Cells

Petrucci explained why umbilical-derived cells are more effective in treating arthritis versus other sources.

We looked at fat, bone marrow, embryonic cells, Petrucci said. The embryonic cells are a lot more unpredictable, and the bone marrow cells are more difficult to work with and less predictable. We didnt think the fat cells are as potent as umbilical-derived cells. Umbilical-derived cells are a lot younger and theyre a little bit more predictable. They are more easy to collect. We obtain cells from donors when the tissue would be normally thrown away. Theres no surgery required, no extra biopsies to obtain fat, no bone marrow from research animals. Its a good, ethical source of stem cells.

Umbilical-derived stem cells have proven successful in past studies on treatment for arthritis, according to Petrucci.

We did a study at the University of Florida on elbows only and we had success with that study, Petrucci said. We had good success with dogs under 70 pounds and (less) success with dogs over 70 pounds, so we changed our dose, which is why were testing dogs 70 pounds and over in this study.

Criteria for eligibility includes dogs weighing 70 pounds or more, being one year of age or older, in general good health, no neurologic issues, arthritis in up to two joints of the knee, hip, elbow, or shoulder, and have all four functioning limbs.

Owners must bring their dogs back to the clinic after 30 days to check for progress and complete a questionnaire. About 50 to 100 dogs are expected to participate in the study.

People like you value experienced, knowledgeable and award-winning journalism that covers meaningful stories in Bloomington-Normal. To support more stories and interviews like this one,please consider making a contribution.

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Stem Cell Research - Full Story

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Bloomington Vet Joins Study For Stem Cell Therapy To Treat Dogs With Arthritis - WGLT News

Recommendation and review posted by Bethany Smith

Ewing sarcoma is a form of bone cancer that usually affects children and adolescents.

Ewing sarcoma can be very aggressive, but the cells tend to respond well to radiation therapy. Ideally, doctors will diagnose the cancer before it has spread.

According to the National Library of Medicine, an estimated 250 children in the United States receive a diagnosis of Ewing sarcoma each year.

In this article, learn more about Ewing sarcoma, including the symptoms, causes, and treatment options.

Ewing sarcoma is a rare type of cancer that usually starts in the bone typically in the pelvis, chest wall, or legs and occurs mostly in children and teenagers.

Dr. James Ewing first described Ewing sarcoma in 1921. He identified cancer cells that looked different than the cells in osteosarcoma, another type of bone tumor.

Doctors may also refer to this cancer type as the Ewing family of tumors. These tumors have distinct cells that usually respond well to radiation treatments.

This rare cancer type accounts for just 1.5% of all childhood cancers and is the second most common bone cancer type in childhood, after osteosarcoma.

Although researchers are unsure why some people develop Ewing sarcoma, they have identified mutations in certain genes in the tumor cells that cause this cancer.

These include the EWSR1 gene on chromosome 22 and the FLI1 gene on chromosome 11.

These genetic mutations occur spontaneously during a person's lifetime. The individual does not inherit them from a family member.

There are no known risk factors for Ewing sarcoma that make one person more likely than another to develop this cancer.

Ewing sarcoma can cause the following symptoms:

An estimated 87% of Ewing sarcomas are sarcoma of the bone. The other types form in the soft tissues, such as cartilage, that surround the bones.

Ewing sarcoma can spread to other areas of the body. Doctors call this process metastasis.

Areas that the cancer can spread to include other bones, bone marrow, and the lungs.

Doctors categorize Ewing sarcoma as one of three types according to its extent:

Before diagnosing Ewing sarcoma, a doctor will take a person's full medical history and ask them what symptoms they are having, when they noticed them, and what makes them better or worse. They will also perform a thorough physical exam, focusing on the area of concern.

A doctor will usually recommend an imaging study to view the bone or bones. These tests include:

If it looks as though a tumor may be present, a doctor will perform a biopsy, which involves taking a sample of bone tissue. They will send this tissue to a laboratory, where a specialist called a pathologist will check it for the presence of cancerous cells.

A doctor may also order blood tests, a bone marrow biopsy, and other scans when necessary. These tests can help determine whether the cancer has spread to other locations.

A doctor will work with a team of cancer specialists and surgeons to recommend and implement particular treatments.

Possible treatments for Ewing sarcoma include:

Doctors may use a combination of treatments depending on how far the cancer has spread and a person's overall health.

Research into new treatments for Ewing sarcoma is ongoing. Some doctors may inform their patients about clinical trials, which help test new treatments.

Possible complications of Ewing sarcoma include:

If Ewing sarcoma has spread to other areas of the body, it can be life threatening. For this reason, it is vital for a doctor to evaluate any symptoms as quickly as possible.

According to the American Academy of Orthopaedic Surgeons, an estimated two-thirds of people in whom cancer has not spread to other areas of the body survive at least 5 years after their diagnosis.

People who are more likely to have positive outcomes include those who have:

The likelihood of successful treatment is different for every individual, so people should speak to a doctor about their or their child's expected outlook.

Ewing sarcoma is a rare type of cancer that mostly affects young people.

When doctors detect it early enough, the condition usually responds well to treatment.

Anyone who notices signs or symptoms of Ewing sarcoma, such as a bone that breaks for no apparent reason or a painful lump or swelling, should speak to a doctor.

Excerpt from:
Ewing sarcoma: Causes, symptoms, and treatment - Medical News Today

Recommendation and review posted by Bethany Smith

NEW YORK, Oct. 24, 2019 (GLOBE NEWSWIRE) -- BrainStorm Cell Therapeutics Inc. (NASDAQ: BCLI), a leader in the development of innovative autologous cellular therapies for highly debilitating neurodegenerative diseases, today announced, Chaim Lebovits, President and CEO, will serve as a Keynote Speaker at Cell Series UK.Cell Series UK, will be held October 29-30, 2019, at London Novotel West, London, UK. The Conference, organized by Oxford Global, is one of the foremost events in Europe focused on regenerative medicine and cellular innovation.

Ralph Kern MD, MHSc, Chief Operating and Chief Medical Officer of Brainstorm, who will also participate at Cell Series UK stated, We are very pleased to have Chaim Lebovits presenting at this prestigious conference where global leaders in stem cell and regenerative medicine will have the opportunity to learn more about NurOwn and the critical research being conducted by the Company. Mr. Lebovits Keynote Address, Stem Cell Therapeutic Approaches For ALS, will be presented to leading members of the scientific and business community including potential partners and investors.

About NurOwnNurOwn (autologous MSC-NTF cells) represent a promising investigational approach to targeting disease pathways important in neurodegenerative disorders. MSC-NTF cells are produced from autologous, bone marrow-derived mesenchymal stem cells (MSCs) that have been expanded and differentiated ex vivo. MSCs are converted into MSC-NTF cells by growing them under patented conditions that induce the cells to secrete high levels of neurotrophic factors. Autologous MSC-NTF cells can effectively deliver multiple NTFs and immunomodulatory cytokines directly to the site of damage to elicit a desired biological effect and ultimately slow or stabilize disease progression. NurOwn is currently being evaluated in a Phase 3 ALS randomized placebo-controlled trial and in a Phase 2 open-label multicenter trial in Progressive MS.

AboutBrainStorm Cell Therapeutics Inc. BrainStorm Cell Therapeutics Inc. is a leading developer of innovative autologous adult stem cell therapeutics for debilitating neurodegenerative diseases. The Company holds the rights to clinical development and commercialization of the NurOwn Cellular Therapeutic Technology Platform used to produce autologous MSC-NTF cells through an exclusive, worldwide licensing agreement. Autologous MSC-NTF cells have received Orphan Drug status designation from the U.S. Food and Drug Administration (U.S. FDA) and the European Medicines Agency (EMA) in ALS. BrainStorm has fully enrolled the Phase 3 pivotal trial in ALS (NCT03280056), investigating repeat-administration of autologous MSC-NTF cells at six sites in the U.S., supported by a grant from the California Institute for Regenerative Medicine (CIRM CLIN2-0989). The pivotal study is intended to support a BLA filing for U.S. FDA approval of autologous MSC-NTF cells in ALS. BrainStorm received U.S. FDA clearance to initiate a Phase 2 open-label multi-center trial of repeat intrathecal dosing of MSC-NTF cells in Progressive Multiple Sclerosis (NCT03799718) in December 2018 and has been enrolling clinical trial participants since March 2019. For more information, visit the company's website.

Safe-Harbor Statements Statements in this announcement other than historical data and information, including statements regarding future clinical trial enrollment and data, constitute "forward-looking statements" and involve risks and uncertainties that could causeBrainStorm Cell Therapeutics Inc.'sactual results to differ materially from those stated or implied by such forward-looking statements. Terms and phrases such as "may", "should", "would", "could", "will", "expect", "likely", "believe", "plan", "estimate", "predict", "potential", and similar terms and phrases are intended to identify these forward-looking statements. The potential risks and uncertainties include, without limitation, BrainStorms need to raise additional capital, BrainStorms ability to continue as a going concern, regulatory approval of BrainStorms NurOwn treatment candidate, the success of BrainStorms product development programs and research, regulatory and personnel issues, development of a global market for our services, the ability to secure and maintain research institutions to conduct our clinical trials, the ability to generate significant revenue, the ability of BrainStorms NurOwn treatment candidate to achieve broad acceptance as a treatment option for ALS or other neurodegenerative diseases, BrainStorms ability to manufacture and commercialize the NurOwn treatment candidate, obtaining patents that provide meaningful protection, competition and market developments, BrainStorms ability to protect our intellectual property from infringement by third parties, heath reform legislation, demand for our services, currency exchange rates and product liability claims and litigation,; and other factors detailed in BrainStorm's annual report on Form 10-K and quarterly reports on Form 10-Q available athttp://www.sec.gov. These factors should be considered carefully, and readers should not place undue reliance on BrainStorm's forward-looking statements. The forward-looking statements contained in this press release are based on the beliefs, expectations and opinions of management as of the date of this press release. We do not assume any obligation to update forward-looking statements to reflect actual results or assumptions if circumstances or management's beliefs, expectations or opinions should change, unless otherwise required by law. Although we believe that the expectations reflected in the forward-looking statements are reasonable, we cannot guarantee future results, levels of activity, performance or achievements.

CONTACTS

Corporate:Uri YablonkaChief Business OfficerBrainStorm Cell Therapeutics Inc.Phone: 646-666-3188uri@brainstorm-cell.com

Media:Sean LeousWestwicke/ICR PR Phone: +1.646.677.1839sean.leous@icrinc.com

More here:
BrainStorm Cell Therapeutics' President and CEO to be Featured as Keynote Speaker at Cell Series UK 2019 - GlobeNewswire

Recommendation and review posted by Bethany Smith

BOSTON and LONDON, Oct. 22, 2019 (GLOBE NEWSWIRE) -- Orchard Therapeutics (Nasdaq: ORTX), a leading commercial-stage biopharmaceutical company dedicated to transforming the lives of patients with serious and life-threatening rare diseases through innovative gene therapies, today announced initial results from a clinical trial with a cryopreserved formulation of OTL-200, a gene therapy in development for the treatment of metachromatic leukodystrophy (MLD) at the San Raffaele-Telethon Institute for Gene Therapy (SR-Tiget) in Milan, Italy. The initial data show that cellular engraftment with OTL-200 using a cryopreserved formulation is similar to that observed using a fresh formulation with the longest patient having 12 months of follow-up since treatment. The data are being featured this week in a poster session at the European Society of Gene & Cell Therapy (ESGCT) Annual Congress in Barcelona, Spain.

MLD is a devastating and rapidly progressing disease with no standard treatment options. In its most severe forms, patients will not survive beyond their first decade of life.

These data compare the initial results of OTL-200 in the first four MLD patients treated using a cryopreserved formulation to a previously presented integrated analysis of 29 patients treated with a fresh formulation that demonstrated meaningful clinical outcomes. Hematopoietic stem cells are collected, purified and transduced in the same way for both formulations. For the cryopreserved formulation, following transduction, the gene-corrected cells are placed in a specific medium that allows them to be stably frozen. After successful testing and release, the cryopreserved cells are shipped to the site of care where they are thawed and administered to patients who have received conditioning.

Presenting the first supportive data on OTL-200 using a cryopreserved formulation represents a cross-functional effort involving our clinical, CMC and regulatory teams as we prepare for the upcoming European regulatory submission for MLD followed by a BLA in the U.S., said Mark Rothera, president and chief executive officer of Orchard. If approved, a cryopreserved formulation of OTL-200 would more readily facilitate global commercialization and patient access efforts, which are key elements in our mission to deliver potentially curative therapies to patients suffering from often-deadly rare diseases.

Mr. Rothera continued, With over 40 patients now treated using a cryopreserved formulation across our pipeline of six clinical-stage programs, we are confident our approach is supported by a robust set of evidence.

Study Results At the time of the analysis, four early-onset MLD patients (two late infantile and two early juvenile) have been treated with the cryopreserved formulation of OTL-200. All patients are alive and were followed for a minimum of one month, with the longest follow-up out to 12 months in the first patient treated (median follow-up of 0.38 years). The age at the time of treatment ranged from seven months to 42 months.

The initial results in patients receiving the cryopreserved formulation (n=4) demonstrated the following:

Figure 1. Profiles of VCN in bone marrow CD34+ cells: OTL-200 cryopreserved vs. OTL-200 fresh

https://www.globenewswire.com/NewsRoom/AttachmentNg/83f41457-927b-4b1b-9ac2-9d48ac10353a

Figure 2. ARSA activity profile in peripheral blood: OTL-200 cryopreserved vs. OTL-200 fresh

https://www.globenewswire.com/NewsRoom/AttachmentNg/393ca5f0-98ad-47f8-b723-35c5c6c08d8f

c = cryopreserved; f = fresh; Sbj. = subject

We are pleased that these initial data suggest that using gene-corrected cells that have been cryopreserved has a similar impact on clinical biomarkers for early-onset MLD patients as the OTL-200 fresh formulation, said Dr. Valeria Calbi, a hematologist at San Raffaele Scientific Institute and SR-Tiget and an investigator of the study. The four treated patients showed good levels of engraftment of gene-corrected cells and reconstitution of ARSA activity at multiple time points, as well as encouraging early trends in GMFM scores that we look forward to evaluating with additional follow-up. We believe that these data further support the positive benefit / risk profile of OTL-200 as a therapy with potential lifelong benefit for patients with MLD.

Next Steps for OTL-200 Orchard remains on track to submit a marketing authorization application, or MAA, in Europe for MLD in the first half of 2020, as well as a biologics licensing application, or BLA, in the U.S. approximately one year later.

About MLD and OTL-200Metachromatic leukodystrophy (MLD) is a rare and life-threatening inherited disease of the bodys metabolic system occurring in approximately one in every 100,000 live births. MLD is caused by a mutation in the arylsulfatase-A (ARSA) gene that results in the accumulation of sulfatides in the brain and other areas of the body, including the liver, the gallbladder, kidneys, and/or spleen. Over time, the nervous system is damaged and patients with MLD will experience neurological problems such as motor, behavioral and cognitive regression, severe spasticity and seizures, finding it more and more difficult to move, talk, swallow, eat and see. Currently, there are no effective treatments for MLD. In its late infantile form, mortality at 5 years from onset is estimated at 50% and 44% at 10 years for juvenile patients.1 OTL-200 is an ex vivo, autologous, hematopoietic stem cell-based gene therapy being studied for the treatment of MLD. OTL-200 was acquired from GSK in April 2018 and originated from a pioneering collaboration between GSK and the Hospital San Raffaele and Fondazione Telethon, acting through their joint San Raffaele-Telethon Institute for Gene Therapy in Milan, initiated in 2010.

About OrchardOrchard Therapeutics is a fully integrated commercial-stage biopharmaceutical company dedicated to transforming the lives of patients with serious and life-threatening rare diseases through innovative gene therapies.

Orchards portfolio of ex vivo, autologous, hematopoietic stem cell (HSC) based gene therapies includes Strimvelis, a gammaretroviral vector-based gene therapy and the first such treatment approved by the European Medicines Agency for severe combined immune deficiency due to adenosine deaminase deficiency (ADA-SCID). Additional programs for neurometabolic disorders, primary immune deficiencies and hemoglobinopathies are all based on lentiviral vector-based gene modification of autologous HSCs and include three advanced registrational studies for metachromatic leukodystrophy (MLD), ADA-SCID and Wiskott-Aldrich syndrome (WAS), clinical programs for X-linked chronic granulomatous disease (X-CGD), transfusion-dependent beta-thalassemia (TDT) and mucopolysaccharidosis type I (MPS-I), as well as an extensive preclinical pipeline. Strimvelis, as well as the programs in MLD, WAS and TDT were acquired by Orchard from GSK in April 2018 and originated from a pioneering collaboration between GSK and the San Raffaele Telethon Institute for Gene Therapy in Milan, Italy initiated in 2010.

Orchard currently has offices in the U.K. and the U.S., including London, San Francisco and Boston.

Forward-Looking StatementsThis press release contains certain forward-looking statements which are made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Such forward-looking statements may be identified by words such as anticipates, believes, expects, intends, projects, and future or similar expressions that are intended to identify forward-looking statements. Forward-looking statements include express or implied statements relating to, among other things, Orchards expectations regarding the timing of regulatory submissions for approval of its product candidates, including OTL-200 for the treatment of metachromatic leukodystrophy, the timing of interactions with regulators and regulatory submissions related to ongoing and new clinical trials for its product candidates, the timing of announcement of clinical data for its product candidates, including OTL-200, and the likelihood that such data will be positive and support further clinical development and regulatory approval of its product candidates, and the likelihood of approval of such product candidates by the applicable regulatory authorities. These statements are neither promises nor guarantees and are subject to a variety of risks and uncertainties, many of which are beyond Orchards control, which could cause actual results to differ materially from those contemplated in these forward-looking statements. In particular, the risks and uncertainties include, without limitation: the risk that any one or more of Orchards product candidates, including OTL-200, will not be successfully developed or commercialized, the risk of cessation or delay of any of Orchards ongoing or planned clinical trials, the risk that prior results, such as signals of safety, activity or durability of effect, observed from preclinical studies or clinical trials will not be replicated or will not continue in ongoing or future studies or trials involving Orchards product candidates, the delay of any of Orchards regulatory submissions, the failure to obtain marketing approval from the applicable regulatory authorities for any of Orchards product candidates, the receipt of restricted marketing approvals, and the risk of delays in Orchards ability to commercialize its product candidates, if approved. Given these uncertainties, the reader is advised not to place any undue reliance on such forward-looking statements.

Other risks and uncertainties faced by Orchard include those identified under the heading Risk Factors in Orchards annual report on Form 20-F for the year ended December 31, 2018 as filed with the U.S. Securities and Exchange Commission (SEC) on March 22, 2019, as well as subsequent filings and reports filed with the SEC. The forward-looking statements contained in this press release reflect Orchards views as of the date hereof, and Orchard does not assume and specifically disclaims any obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise, except as may be required by law.

1Mahmood et al. Metachromatic Leukodystrophy: A Case of Triplets with the Late Infantile Variant and a Systematic Review of the Literature. Journal of Child Neurology 2010, DOI: http://doi.org/10.1177/0883073809341669

Contacts

InvestorsRenee LeckDirector, Investor Relations+1 862-242-0764Renee.Leck@orchard-tx.com

MediaMolly CameronManager, Corporate Communications+1 978-339-3378media@orchard-tx.com

Figure 1

Profiles of VCN in bone marrow CD34+ cells: OTL-200 cryopreserved vs. OTL-200 fresh

Figure 2

ARSA activity profile in peripheral blood: OTL-200 cryopreserved vs. OTL-200 fresh; c = cryopreserved; f = fresh; Sbj. = subject

Read more:
Orchard Therapeutics Presents Data from OTL-200 in Patients with Metachromatic Leukodystrophy Using Cryopreservation - BioSpace

Recommendation and review posted by Bethany Smith

Across the US,more than 100,000 people are awaiting organ transplants. But there simply arent enough hearts, lungs, livers, and kidneys to meet demand, and 20 people die every day without the organs they need.For decades, scientists have dreamed of using animals to help fill the gap. Theyve been particularly interested in harvesting organs from pigs, whose physiology is similar to our own. Unfortunately, pigs also present some big biological challenges, including the fact that their genomes are chock full of genes that code for what are known as retroviruses, which could pose a serious threat to patients who receive porcine organs.

In 2015, George Church, a geneticist at Harvard University, announced a stunning breakthrough: Working with pig cells, he and his colleagues had managed to disable 62 copies of a retrovirus gene inone fell swoop.This would have been virtually impossible and a logistical nightmare with older forms of genetic modification, writes Nessa Carey in her new book, Hacking the Code of Life: How Gene Editing Will Rewrite Our Futures.But by using the new gene editing technology known as Crispr, the task was a relative cinch.

Its just one example of how gene editing is giving us the power to alter the genome with unprecedented speed and precision. Carey, a biologist with a background in the biotech and pharmaceutical industry, offersa brisk, accessible primer on the fast-moving field, a clear-eyed look at a technology that is already driving major scientific advances and raising complex ethical questions

Its giving every biologist in the world the tools to answer in a few months questions that some scientists have spent half their careers trying to address, Carey writes. Its fueling new ways to tackle problems in fields as diverse as agriculture and cancer treatments. Its a story that began with curiosity, accelerated with ambition, will make some individuals and institutions extraordinarily wealthy, and will touch all our lives.

Though there are several different approaches to gene editing, the most prominent and the one that really supercharged the field is Crispr. The technique, based on an anti-viral defense system thats naturally present in bacteria, requires two pieces of biological material: an enzyme that acts as a pair of minuscule scissors, slicing strands of DNA in two; and a guide molecule that tells the enzyme where to cut.

In bacteria, these guide molecules direct the enzyme to chop up the genomes of invading viruses, preventing them from replicating.

But in 2012 and 2013, two teams of scientists reported that it was possible to hack this system to slice into any strand of DNA, at any complementary location they chose.Researchers could, for instance, create a guide molecule that steered the enzyme to one specific gene in the mouse genome and insert the editing machinery into a mouse cell; the enzyme would then make its cut at that exact spot.

The cell would repair the severed DNA, but it would do so imperfectly, disabling the gene in question.In the years that followed, scientists refined the technique, learning to use it not only to inactivate genes but also to insert new genetic material at specific locations along the genome.

The approach is cheaper, easier, and faster than older methods of genetic engineering, which were first developed in the 1970s. In addition, as Carey explains, it can be used to create smaller modifications to the genome, and leaves fewer extraneous genetic elements. In its most technically exquisite form, gene editing leaves no molecular trace at all. It may just change, in a precisely controlled manner, one letter of the genetic alphabet.

The applications are almost endless.Gene editinghas immense potential for basic research; scientists can learn a lot about what genes do by selectively disabling them. In addition, researchers have used the technology to create a wide variety of organisms that could become valuable agricultural commodities, including mushrooms that dont brown; wheat that produces fewer gluten proteins;drought tolerant, high-yield rice and corn; disease-resistant pigs; and super muscular goats.

How these products will do on the market if they ever reach it remains uncertain.Globally, gene-edited organisms are regulated by a patchwork of conflicting rules. For instance,in 2018, the U.S. Department of Agricultureannouncedthat it would not regulate gene-edited crops that could otherwise have been developed through traditional breeding techniques. A few months later, however, the European Union said that it would subject gene-edited plants to stringent restrictions.

Beyond agriculture, gene editing has enormous potential for medicine. It might, for instance, become a much-needed treatmentfor sickle cell disease. That painful, debilitating disease results from a genetic mutation that causes patients to produce a deformed version of hemoglobin, a protein that helps red blood cells transport oxygen.Ina clinical trial currently underway, scientists are removing stem cells from the bone marrow ofsickle cell patients, using Crispr to edit them, and then infusing the edited cells back into patients.

Even if this trial succeeds, however, gene editing will not be a cure-all.It doesnt always work perfectly and can be challenging to administer directly to living humans (which is why some scientists are instead editing patients cells outside the body). Moreover, many diseases are caused by complex interactions between multiple genes, or genes and the environment. In fact, many of the most common and debilitating conditions arent likely to be good candidates for gene editing any time soon, Carey writes.

And, of course, the ethics of human gene editing can be enormously fraught. Thats especially true when scientists modify sperm cells, egg cells, or early embryos, making tweaks that could be passed down to subsequent generations.This kind of gene editing could theoretically cure some absolutely devastating genetic conditions, but we still have a lot to learn about its safety and effectiveness. It also raises a host of difficult questions about consent (an embryo obviously cannot give it), inequality (who will have access to the technology?), and discrimination(what will the ability to edit a gene related to deafness mean for deaf people, deaf culture, and the disability rights movement more broadly?).

Even in the face of these questions, at least one scientist has already forged ahead. In November 2018, He Jiankui, a researcher then at the Southern University of Science and Technology in China,shocked the worldby announcing that the worlds first gene-edited babies twin girls, who He called Nana and Lulu had already been born. Months earlier, when Nana and Lulu were just embryos, He had edited their CCR5 genes, which code for a protein that allows HIV to infect human cells. By disabling the gene, He hoped to engineer humans who would be protected from HIV infection.

The outcry was swift and harsh. Scientists alleged that Hes science was sloppyand unethical, putting two human beings at unnecessary risk.After all, there are already plenty of ways to prevent HIV transmission, and the CCR5 protein is known to have some benefits, including protecting against the flu.And He had raced ahead of the experts who were still trying to work out careful ethical guidelines for editing human embryos.He Jiankui has shot this measured approach to pieces with his announcement, and now the rest of the scientific community is on the back foot, trying to reassure the public and to create consensus rapidly, Carey writes.

Hacking the Code of Life doesnt break much new ground, and for readers who have been paying attention to Crispr over the past few years, little in the book will come as a surprise. But it does providea broad, even-handed overview of how much has already happened in a field that is less than 10 years old.

Carey swats down the most dystopian dreams about Crispr, like the prospect that criminals might edit their own DNA to evade justice. Shes similarly skeptical that well end up using the technology to create super-beings with enhanced genomes that will make them taller, faster, more attractive.

We actually understand very little about the genetic basis of these traits and what we do know suggests that it will be very difficult to enhance humans in this way, she writes.

But she also acknowledges real risks, including the possibility that the technique could be used to create dangerous bioweapons, that gene-edited organisms could destabilize natural ecosystems,and that our new, hardy crops could prompt us to convert even more of the Earths undeveloped places into farmland.

None of this means that the technology should be abandoned; it hasimmense potential to improve our lives, as the book makes clear.But it does mean we need to proceed with caution. As Carey writes, Ideally, ethics should not be dragged along in the wake of scientific advances; the two should progress together, informing one another.

Emily Anthes, who has written for Undark, The New York Times, The New Yorker, Wired, and Scientific American, among other publications, is the author of the forthcoming book The Great Indoors. Follow her on Twitter @EmilyAnthes

A version of this article was originally published on Undarks website as How Gene Editing Is Changing the World and has been republished here with permission.

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'Hacking the Code of Life': How gene editing will lead to disease cures and nutritionally enhanced food - Genetic Literacy Project

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