By Reuters By Reuters July 8 at 8:47 AM

Stem cell tourism in which patients travel to developing countries for unproven and potentially risky therapies should be more tightly regulated, according to a group of international health experts.

With hundreds of medical centers around the world claiming to be able to repair tissue damaged by conditions such as multiple sclerosis and Parkinsons disease, tackling unscrupulous advertising of such procedures is crucial.

These therapies are advertised directly to patients with the promise of a cure, but there is often little or no evidence to show they will help or that they will not cause harm, the 15 experts wrote in the journal Science Translational Medicine.

Some types of stem cell transplant mainly using blood and skin stem cells have been approved by regulators after full clinical trials found they could treat certain types of cancer and grow skin grafts for burn patients.

But many other potential therapies are only in the earliest stages of development and have not been approved by regulators.

Stem cell therapies hold a lot of promise, but we need rigorous clinical trials and regulatory processes to determine whether a proposed treatment is safe, effective and better than existing treatments, said one of the 15, Sarah Chan of Britains University of Edinburgh.

The experts called for global action, led by the World Health Organization, to introduce controls on advertising and to agree on international standards for the manufacture and testing of cell- and tissue-based therapies.

The globalization of health markets and the specific tensions surrounding stem cell research and its applications have made this a difficult challenge, they wrote. However, the stakes are too high not to take a united stance.

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Sick people seeking unproven stem cell treatments are putting their lives at risk, experts warn, amid calls to urgently tighten global regulations on the potentially deadly "stem cell tourism treatments".

Stem cell tourism sees patients buy heavily marketed but largely unproven and potentially dangerous treatments. Some travel overseas and several have died, including a woman in Australia.

Writing in Science Translational Medicine, 15 experts from Australia, the UK, U.S, Canada, Belgium, Italy and Japan say the global marketing of unproven stem cell based treatments is growing in the likes of Japan, Australia and the U.S.

This is despite a lack of clinical evidence and public concern expressed by scientific organisations.

"Moreover, often, providers acknowledge neither this deficit nor the potential harms to patients who receive them," the paper read.

Contributors included Associate Professor Megan Munsie, a University of Melbourne stem cell scientist and co-author of 'Stem Cell Tourism and the Political Economy of Hope' (Palgrave Macmillan), and Professor Jane Kaye, a lawyer holding positions at Melbourne Law School and the University of Oxford.

Munsie said if a patient's own cells are used, Australia's industry is "virtually unregulated".

"We need immediate action in Australia and a coordinated international regulatory effort to curb this exploitative but growing industry."

Australian authorities issued warnings about unproven stem cell treatments in 2014 after Brisbane mother-of-two Kellie van Meurs died of a heart attack while undergoing the treatment for a rare neurological disorder in Moscow, Russia.

Some countries, such as Italy and Germany, have reportedly taken action against stem cell treatment providers. But the authors say such examples are rare.

"Effective measures for regulating this sector both nationally and internationally are urgently needed," the paper read.

The authors said stem cell treatments must be fully evaluated and regulated before use. Most countries, however, do not have clear rules or regulations.

"Evidence standards in the context of commercial advertising, market authorisation, and standard of care often vary considerably, as do the enforcement options available to national regulators," the paper read.

Some treatments using blood and skin stem cells have been rigorously tested and found they could treat certain types of cancer and grow skin grafts for burns patients.

But other potential therapies are only in the earliest stages of development and have not been approved.

"Stem cell therapies hold a lot of promise, but we need rigorous clinical trials and regulatory processes to determine whether a proposed treatment is safe, effective and better than existing treatments," one of the 15 experts, Sarah Chan of Britain's University of Edinburgh, told Reuters.

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LIMA Employers in the greater West Central Ohio region will collect $33 million in rebates from the Ohio Bureau of Workers Compensation in checks that will be mailed beginning next week.

BWC Administrator/CEO Sarah Morrison, in Lima to present a ceremonial check to local business leaders, said employers are free to spend their rebates as they wish, but she hopes they will consider investing in workplace safety.

We work with employers all over Ohio to prevent injuries and illness in the workplace, and they will tell you that investing in safety is a wise business decision, said Morrison, speaking at a press conference at the Lima/Allen County Chamber of Commerce. Safe workplaces mean fewer injuries, fewer medical claims and a stable workforce, all of which leads to a healthy bottom line for a business.

Morrison was joined by chamber President/CEO Jed Metzger and Tony Daley of Limas Spallinger Millwright Services Inc. Metzger and Daley accepted the check on behalf of employers in the entire region, which includes Allen, Auglaize, Shelby, Hancock, Putnam, and Van Wert counties.

Ohio Gov. John Kasich proposed the rebate in March. Its the third such rebate in the last four years, made possible by an improving safety climate, prudent fiscal management and strong investment returns. The plan to distribute rebates to more than 200,000 Ohio employers during the month of July was approved by BWCs Board of Directors in April. Visitbwc.ohio.govfor more details and eligibility requirements.

The plan also includes a $44 million investment innew health and safety initiativesto promote a healthy workforce and a culture of safety in every Ohio workplace. This includes a new wellness program for small employers, funding for programs to help firefighters and those who work with children and adults with disabilities, and an education campaign to address common injuries at work and in the home.

A healthy economy depends on a strong and healthy workforce, Morrison continued. And when the economy is healthy, we all benefit.

Rebate checks will be mailed in phases starting July 10.

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WASHINGTON (AP) Colon cancer. Uterine cancer. Pancreatic cancer. Whatever the tumor, the more gene mutations lurking inside, the better chance your immune system has to fight back.

Thats the premise behind the recent approval of a landmark drug, the first cancer therapy ever cleared based on a tumors genetics instead of the body part it struck first. Now thousands of patients with worsening cancer despite standard treatment can try this immunotherapy as long as genetic testing of the tumor shows theyre a candidate.

Its like having a lottery ticket, said Johns Hopkins oncologist Dr. Dung Le, who helped prove the new use for the immunotherapy Keytruda. Weve got to figure out how to find these patients, because its such a great opportunity for them.

Today, doctors diagnose tumors by where they originate breast cancer in the breast, colon cancer in the colon and use therapies specifically tested for that organ. In contrast, the Food and Drug Administration labeled Keytruda the first tissue-agnostic treatment, for adults and children.

The reason: Seemingly unrelated cancers occasionally carry a common genetic flaw called a mismatch repair defect. Despite small studies, FDA found the evidence convincing that for a subset of patients, that flaw can make solid tumors susceptible to immunotherapy doctors otherwise wouldnt have tried.

We thought these would be the hardest tumors to treat. But its like an Achilles heel, said Hopkins cancer geneticist Bert Vogelstein.

And last month FDA Commissioner Scott Gottlieb told a Senate subcommittee his agency will simplify drug development for diseases that all have a similar genetic fingerprint even if they have a slightly different clinical expression.

Its too early to know if whats being dubbed precision immunotherapy will have lasting benefits, but heres a look at the science.

WHOS A CANDIDATE?

Hopkins estimates about 4 percent of cancers are mismatch repair-deficient, potentially adding up to 60,000 patients a year. Widely available tests that cost $300 to $600 can tell whos eligible. The FDA said the flaw is more common in colon, endometrial and gastrointestinal cancers but occasionally occurs in a list of others.

Say, have I been tested for this?' is Les advice for patients.

MUTATIONS AND MORE MUTATIONS

Most tumors bear 50 or so mutations in various genes, Vogelstein said. Melanomas and lung cancers, spurred by sunlight and tobacco smoke, may have twice as many. But tumors with a mismatch repair defect can harbor 1,500 mutations.

Why? When DNA copies itself, sometimes the strands pair up wrong to leave a typo a mismatch. Normally the body spell checks and repairs those typos. Without that proofreading, mutations build up, not necessarily the kind that trigger cancer but bystanders in a growing tumor.

THE PLOT THICKENS

Your immune system could be a potent cancer fighter except that too often, tumors shield themselves. Mercks Keytruda and other so-called checkpoint inhibitors can block one of those shields, allowing immune cells to recognize a tumor as a foreign invader and attack. Until now, those immunotherapies were approved only for a few select cancers Keytruda hit the market for melanoma in 2014 and they work incredibly well for some patients but fail in many others. Learning whos a good candidate is critical for drugs that can cost $150,000 a year and sometimes cause serious side effects.

In 2012, Hopkins doctors testing various immunotherapies found the approach failed in all but one of 20 colon cancer patients. When perplexed oncologists told Vogelstein, a light bulb went off.

Sure enough, the one patient who fared well had a mismatch repair defect and a mind-boggling number of tumor mutations. The more mutations, the greater the chance that at least one produces a foreign-looking protein that is a beacon for immune cells, Vogelstein explained.

It was time to see if other kinds of cancer might respond, too.

WHATS THE DATA?

The strongest study, published in the journal Science, tested 86 such patients with a dozen different cancers, including some who had entered hospice. Half had their tumors at least shrink significantly, and 18 saw their cancer become undetectable.

Its not clear why the other half didnt respond. Researchers found a hint, in three patients, that new mutations might form that could resist treatment.

But after two years of Keytruda infusions, 11 of the complete responders have stopped the drug and remain cancer-free for a median of eight months and counting.

Catherine Katie Rosenbaum, 67, is one of those successes. The retired teacher had her uterus removed when endometrial cancer first struck, but five years later tumors returned, scattered through her pelvis and colon. She tried treatment after treatment until in 2014, her doctor urged the Hopkins study.

Rosenbaum took a train from Richmond, Virginia, to Baltimore for infusions every two weeks and then, after some fatigue and diarrhea side effects, once a month. Then the side effects eased and her tumors started disappearing. A year into the study she was well enough to swim a mile for a Swim Across America cancer fundraiser.

Nothing else had worked, so I guess we could say it was a last hope, said Rosenbaum, who now wants other patients to know about the option.

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Wall Street Journal (subscription)

Crispr Patent-Holders Move Toward Easing Access to Gene-Editing Technology Wall Street Journal (subscription) A holder of key patents to the Crispr gene-editing technology is willing to join a world-wide joint patent poola development that medical and legal experts think could hasten the development of new human therapies. The Broad Institute of MIT and ...

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Red Bull

5 ways CRISPR will save your life Red Bull Past tense, because of Clustered Regularly Interspaced Short Palindromic Repeats, or CRISPR for short. CRISPR works much like a DNA-level pair of scissors and glue stick. It dramatically lowers the bar for biotech innovation, making it 99 percent ... and more »

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After CRISPR, theres a new genetic technique with a tongue-in-cheek name in town: LASSO cloning.

Researchersfrom four institutions, including the US-based John Hopkins, Rutgers and Harvard, and the University of Trento in Italy, have developed a new technology tostudy large chunks of DNA and their function. The work behind it was recently published inNature Biomedical Engineering,and a patent was filed earlier this month.

This molecular tool is called long adapter single-stranded oligonucleotide, or LASSO for short. The lasso rope metaphor applies to the tools mechanism, which can capture and clone long sequences of DNA fragments. Fragment length had so far been the main challenge for cloning probes and the genome sequencing field at large. Next generation sequencing (NGS), which has gained a lot of attention in medical research, relies on sequencing short fragments that are then put together, like a puzzle, by bioinformatics tools. However, this method falls short for certain types of samples. Short reads capture only about 100 basepairs, or DNA letters, at a time, while LASSO can read more than1000 base pairs.

As a proof of concept, the researchers set out to test LASSO probes in biotechs favorite microorganism,E. coli. The tool managed to simultaneously clone over 3000 DNA fragments of the genome ofE. coli, capturing around 75% of the targets and leaving almost all of the non-targeted DNA alone, and the studys authors say theres still certainly room for improvement.

LASSO cloning should enable the scientific community to build libraries of a given organisms protein in a much faster and cheaper way, democratizing research that was so far only within the reach of big research consortia. The usefulness of such studies ranges from a better understanding of organisms to the ability to screen large libraries of natural enzymes and compounds that could be valuable leads in drug discovery,as it has been done before for some species likePenicilliumfungistrains, for example.

One of the organisms to be better studied is, of course, human beings. Researchers already tested LASSO cloning with human DNA, something has the potential to yield new biomarkers for a range of diseases. Another focus of interest is the human microbiome. As described in the same paper, LASSO was used to build the first protein library of the microbiome, and the research team hopes that it can improve precision medicine strategies that takeinto account the microbes living within us.

Images by DWilliam/Pixabay and Jennifer E. Fairman/John Hopkins University

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The Hindu

Sharks could hold genetic secret to long life: Study The Hindu The oldest and largest (502 centimetres female) Greenland shark analysed by the scientists were 392 years, plus or minus 120 years: in other words they were at least 272 years old. The study of the shark's DNA has shed new light on its behaviour, and ...

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CRISPR has ruffled feathers, but it may be capable of saving species

Frans Lanting/National Geographic Creative

By Adam Rutherford

KAKAPOS are fat New Zealand ground parrots that have stared into the abyss of extinction for decades. Conservationists have laboured to raise numbers from the moribund low 50s to a still ultra-critical 160 or so today.

Once a species becomes so depleted, however, a lack of genetic diversity can hinder its long-term salvation. A geneticist once told me of a crazy idea that might save the kakapo. He said that there are more stuffed kakapos in European museums than there are living birds. If we could extract DNA from those dead parrots, from a time when their numbers were large, we could genetically engineer the living birds to mimic the once healthy species by changing single letters of genetic code.

There are a lot of ifs here, but the modification of DNA itself even at the level of precision this mad scheme would require is eminently possible, thanks to a technology known by the acronym CRISPR. Ten years ago, identifying, characterising and modifying a gene then getting it back into an organism was a process that took weeks, months or years. With CRISPR you can perform the same process in days.

Incredibly, it looks as though CRISPR will live up to its hype, transforming every aspect of biology as genetic engineering did from the 1970s on. Tweaking individual letters of genetic code, it takes just hours to finely edit what evolution fashioned over billions of years. All aspects of the science of life are within CRISPRs reach: disease, conservation, synthetic cellular manufacture.

CRISPRs complex origins as a gene editing tool can reasonably be credited to a few key players: Jennifer Doudna is one of them. With her former colleague Samuel Sternberg, she has written a detailed account of the story so far. It may well end up being compared with the book that inspired a 12-year old Doudna in the first place: James Watsons The Double Helix.

But while Watsons iconic account of his and Francis Cricks discovery of the structure of DNA is dramatic and myth-making, bitchy and sexist, A Crack in Creation is thoughtful and thorough. Packed with amazing female scientists, it is thrilling, generous and no less personal. Its a good tale of how science works, tracing all the meandering paths that lead to discovery: meetings, chance encounters, ceaseless discussions, and the endless beavering of lab life.

Concern about genetically modifying people may once have seemed overheated. Thats about to change

A Crack in Creation is quite technical at times, and a touch bogged down with the clinical specifics of the many diseases that CRISPR may one day fix. The journey from the days of gene therapy to the first human CRISPR studies in China is no amble, either. Following these early Chinese studies, Doudna recommended an instant moratorium on human CRISPR experimentation. Similar moratoriums were called for in the first days of genetic engineering in the 1970s, and in recent years, following the experimental modification of virulent flu viruses.

Public concern about the genetic modification of people may have seemed overheated while we lacked the scientific chops to do anything significant. But that is about to change: CRISPR is powerful and potentially scary. Doudnas own ethical position comes into focus in the final chapter. Its a nuanced account, but she definitely inclines towards excising conditions like cystic fibrosis and Huntingtons disease from the human germ line.

A Crack in Creation touches the surface of these issues. It doesnt delve deep, but one book cannot do everything. Genetics has been in perpetual revolution for several decades now. Since the 1990s, when the Human Genome Project ground into action, there have been so many advances in our understanding of genetics and our ability to manipulate DNA that its hard to keep up. Doudna accounts for the many cracks in creation in the 21st century: developing RNAi, where genes can be silenced with tiny bits of ingested genetic code; the building of giant chromosomes to help us clone larger genes; and the manipulation of stem cells. All of these achievements resulted in Nobel prizes Doudnas must surely come soon.

We need scientifically informed public conversations about what we should do next with these powers, and Doudnas book is a good place to begin. The first gene engineers of the 1970s framed their discoveries by actively engaging with the ethical, legal and political ramifications of genetic engineering. So must we. As I write this, says Doudna, the world around us is being revolutionized by CRISPR, whether were ready for it or not. So strap in and get up to speed, because these days, the science of modifying life moves pretty fast.

This article appeared in print under the headline This changes everything

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As federal wildlife officials review the endangered status of the Florida panther, one scientist's work has been singled out as a focus: geneticist Melanie Culver.

In 2000, Culver and three fellow scientists published a study of the genetics of big cats that concluded that all the panthers, pumas and mountain lions in North America are actually a single sub-species.

In other words, according to the Culver study, Florida panthers are nothing special, genetically. They're just another big cat in a nation that contains thousands of them, some of which are already hunted. If the U.S. Fish and Wildlife Service adopts that point of view, it could lead to taking panthers off the endangered list.

But Culver, in an interview, said she believes the Florida panther still belongs on the endangered list -- just not the way it's listed now. The U.S. Geological Survey scientist concedes that making a change would require a complex solution.

"You'd have to de-list it and then petition it to be listed as another entity," she said. "That's a legal problem. They'd have to completely lose legal protection to be protected the right way."

Florida panthers have been listed as endangered ever since the first endangered species list was drawn up in 1967. They are also Florida's official state animal, voted in by schoolchildren over such other contenders as the alligator and the mosquito.

They have long been considered a distinct sub-species of the puma that roam wilderness areas of North and South America. At one time, scientists believed there were about 30 such sub-species.

Federal rules require the agency to review the status of each endangered or threatened species every five years, and the wildlife agency has announced that it's time for that routine review. But one aspect of the review won't be routine.

"One of the most interesting things we're going to review is the taxonomy," said Larry Williams, South Florida field supervisor for the federal agency. He specifically cited the Culver-led study as something that the agency will consider.

Questions have been raised for years about whether the Florida panther is really a distinct sub-species of the pumas found out West. The questions took a different turn after 1995, when state officials tried an unprecedented experiment to save the panther from inbreeding and genetic defects by bringing in eight female mountain lions from Texas to breed with them.

The cross-breeding saved the panthers, and sparked a baby boom. The panther population, estimated to number no more than 20 to 30 in the mid-1990s, now is estimated at around 200.

But it has raised questions among Southwest Florida residents about whether those are still Florida panthers and whether the state's estimates of the population are correct. Meanwhile some have cited the Culver study as an argument for eliminating their endangered status.

"There are tens of thousands of them throughout North America, they are overpopulated and legally hunted throughout much of their range," outdoorsman Mike Elfenbein of Port Charlotte, who helps run the "Panthers of South Florida" Facebook page, wrote in a 2015 letter to U.S. Rep. Vern Buchanan, R-Sarasota. "The 'Florida panther' is not now, nor was it ever in danger of going extinct."

But not everyone agrees wholeheartedly with the Culver study. Dave Onorato, a biologist with the Florida Fish and Wildlife Conservation Commission's panther study program, said one shortcoming is that the study used a small number of samples for the panthers.

He noted that when the state has done its own DNA tests, using an approach different from Culvers, "the panthers still cluster as their own sub-set, away from the Texas and Western sub-sets."

Elizabeth Fleming of the Defenders of Wildlife's Florida office contends that without a scientific consensus backing the Culver study's findings, the Fish and Wildlife Service should not change the panther's status.

"It is a native ranging animal, and we think it deserves a place in the Florida landscape," she said.

To Culver, though, the problem is that the panther should not have been put on the endangered list as a sub-species of puma. Instead, she said, panthers belong on the list as what's known as a "distinct population segment" of the puma.

In other words, the fact that this population of panthers is the only colony of pumas east of the Mississippi, and it's largely confined to the southern tip of Florida, still qualifies them as endangered, in her view.

While 200 panthers is an improvement, she said, it "isn't what we would consider sustainable. That's not great." Over time, genetic defects would creep back in, putting them back on the road to extinction, she said.

Whether the Fish and Wildlife Service follows Culver's advice is unknown. Williams wouldn't speculate on the outcome of his agency's review this week, except to say it would follow the latest scientific findings.

Four months ago the agency announced it was lowering the protection level of another famous Florida critter, the manatee, from endangered to threatened -- despite the objections of a majority of the public that commented on the move, as well as the scientists who had been asked to review it.

Senior news researcher Caryn Baird contributed to this story. Contact Craig Pittman at craig@tampabay.com. Follow @craigtimes.

Geneticist says Florida panther still deserves endangered species protection 07/08/17 [Last modified: Friday, July 7, 2017 4:15pm] Photo reprints | Article reprints

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ESPN senior writer Peter Keating joins OTL to share his findings on concussions in female athletes, featured in ESPN The Magazine and on espnW.com.

This story appears in ESPN The Magazine's Body Issue 2017. Subscribe today!

EVERY FOUR YEARS or so, some of the world's most prominent scientists gather to synthesize and summarize the latest in brain-injury research. Since first meeting in 2001, the assemblage, called the Concussion in Sport Group, has grown in size and influence. Doctors, athletic trainers and media types around the world take their cues from the recommendations it publishes and from the Sport Concussion Assessment Tool (SCAT) it has developed. When members gathered in Berlin last October, Jiri Dvorak, then FIFA's chief medical officer, said they worked on behalf of some 1billion professional and amateur athletes. For that 2016 symposium, around 400 medical and sports professionals met in the Grand Ballroom of the Ritz-Carlton hotel, with art nouveau stylings that hark back to the days before the world wars and trappings so posh that guests enjoy breakfast honey harvested from a rooftop beehive. Over two days, a stone's throw from where the Berlin Wall used to stand, the leading lights of the sports neuro-establishment made clear their role as gatekeepers of concussion research. Organizers closed the conclave to the media and swatted audience members off social media.

There was another group almost entirely shut out of the 5th International Consensus Conference on Concussion in Sport: female athletes.

Of the dozen sessions at the conference, not one was dedicated to sex or gender. Researchers made 24 oral presentations during the meetings; one focused on female athletes. Among the 202 research abstracts, nine, or less than 5 percent, studied women specifically. "Gender hasn't been a hot, hot topic," says one member of the Concussion in Sport Group.

Hot or not, the facts the conference could have displayed are shocking. Women suffer more concussions than men in the sports that both play, with an injury rate 50 percent higher, according to the most recent research. Female athletes with brain trauma tend to suffer different symptoms, take longer to recover and hold back information about their injuries for different reasons than males. Anyone involved in sports should have a grasp of these key facts. Yet the leading national and international guidelines for understanding sports concussions and returning injured athletes to play ignore key differences in how women and men experience brain injuries.

Here's what's even more stunning: All of that information was public knowledge eight years ago, when ESPN The Magazine first looked at the subject of concussions and female athletes ("Heading for Trouble," March 23, 2009)-and all of it is still true. The latest studies continue to find that women get brain injuries more often in sports also played by men. But research into why and how is lagging to nonexistent, as are efforts to reverse the trend. Which means millions of female athletes are putting their brains at risk unnecessarily.

"More and more of the athletes I have seen over time are young women, and I've found they get less information about concussion from their coaches, and from the media too, than men," says Jill Brooks, a clinical neuropsychologist who runs Head to Head Consultants in Gladstone, New Jersey, and who in 2004 conducted one of the earliest research reviews of sex issues in brain injury. "They are struggling to deal with their particular symptoms and often not being taken as seriously as they should be. The sports world is much more accepting of girls and women as athletes but still gives the topic of their concussions short shrift."

FEMALE SPORTS SCIENTISTS pioneered the initial research into sex, gender and concussions more than a decade ago. Dawn Comstock, a professor of epidemiology at the Colorado School of Public Health and a 4-foot-11 former rugby player, started tracking injuries among high school athletes in 2004 and began reporting sex differences in brain injury in 2007. In May 2016, she told the House Energy and Commerce Subcommittee on Oversight and Investigations: "In gender-comparable sports, so sports that both boys and girls play, by the same rules, using the same equipment, on the same fields, like soccer and basketball, girls have higher concussion rates than boys." Tracey Covassin, professor of kinesiology at Michigan State and a certified athletic trainer, has been studying college sports since 2003, with similar results.

But when it comes to looking deeper into the experience of concussions among female athletes specifically, researchers for the most part have been uninterested, unwilling or unfunded. The frontier of knowledge has been stuck for years in epidemiology-studies, again and again, of who encounters a health problem in the general population and when, rather than how and why it strikes a particular group. "There's a huge gap in the science of brain injury," says Angela Colantonio, director of the Rehabilitation Sciences Institute at the University of Toronto. "There has been a lack of explicit consideration given to sex and gender. We're just starting to scratch the surface."

A major problem with concussion research is that very few people conduct it who don't have a stake in its outcome. I think these folks didn't want to see their names used in lawsuits.

Katherine Snedaker, clinical social worker

In the 2017 Consensus Statement on Concussion in Sport, which 36 of the scientists who met in Berlin published in April, and which runs more than 7,000 words, "gender" never appears and "sex" only once. It's just one item on a laundry list of factors, such as age, genetics and mental health, that the document notes "numerous studies have examined" for their potential impact on how athletes heal from concussions. The consensus statement doesn't actually evaluate what such research has discovered about the effects of sex or gender, except to say there's "some evidence" that teenagers "might be" most vulnerable to persistent symptoms, "with greater risk for girls than boys."

Several Europe-based contact-sport federations fund the meetings of the Concussion in Sport Group. FIFA, the International Federation for Equestrian Sports, the International Ice Hockey Federation, the International Olympic Committee and World Rugby split the costs of the Berlin conference, totaling approximately 250,000 euros (about $284,000), according to two sources at the group. Any of those organizations could be threatened if evidence emerges that it should have managed repetitive blows to the head better among particular kinds of athletes, such as adolescents or repeat concussion victims-or females. And the 30 co-authors of the consensus statement who filed conflict of interest disclosures declared 132 potential entanglements among them. All of which has some brain-injury research advocates concerned that the authors might have hedged their conclusions to avoid exposing their patrons to financial or legal liability. "The statement is extremely disappointing," says Katherine Snedaker, a clinical social worker in Norwalk, Connecticut, and founder of the research and advocacy group Pink Concussions, who attended the Berlin conference. "But a major problem with concussion research is that very few people conduct it who don't have a stake in its outcome. I think these folks didn't want to see their names used in lawsuits."

Even one of the consensus statement's co-authors echoes this criticism. "A lot of intelligent brains have been added to the committee," says Robert Cantu, professor of neurosurgery at Boston University and a founding member of the Concussion in Sport Group. "But I think some are so happy to be part of all this, sometimes they don't look hard enough at the research. And you've got to ask if that serves as a huge protective force for the organizations who put up the money to fund the meetings."

"We reviewed the literature on clinical recovery from concussion," says Grant Iverson, a professor of physical medicine and rehabilitation at Harvard Medical School and co-author of the consensus statement. "We examined many predictors and modifiers. Sex was one of them."

But when it comes to women specifically, the group has a particularly egregious history. Its third consensus statement, published after parleys in Zurich in 2008, included two ambiguous sentences about whether sex or gender influences the likelihood or severity of concussion risk. Four years later, again after meetings in Zurich, the fourth consensus statement also devoted two sentences to females-the same two sentences. Those sentences even cited the same three sources. From 2008 to 2012, women's participation in sports grew rapidly, rising 13 percent in the NCAA alone. Public interest in concussions also exploded, as the NFL crisis reached full tilt. And during those years, about 300,000 females aged 19 or under went to U.S. emergency rooms with sports- or recreation-related brain injuries. Yet the international consensus found nothing new to learn or say.

"The topics we focus on, we go into pretty thoroughly," says one researcher in the group. "Other material, we pretty much don't touch at all. Which is how stuff slides from one year to the next, not only unchanged but not updated."

"It was a cut-and-paste job, down to the footnotes," says neuropsychologist Brooks, who attended two earlier international consensus conferences but was not invited to Berlin.

Andy Mead/YCJ/Icon Sportswire

Facing pressure, US Lacrosse recently adopted standards for women's headgear, but there's little research to inform guidelines.

MOST ATHLETES AND fans have learned about concussions from a decade of reports about former NFL players struggling with the long-term effects of taking blows to the head. As devastating as many of those stories are, the risks of brain injury can get worse the further competition moves from the epicenter of high-stakes sports that is professional football. Lower revenues and remote facilities can translate to poorer medical advice and treatment; scarcer media coverage sometimes means fewer people notice injuries in the first place. And these conditions often apply to women's collegiate sports, where some 214,000 female athletes compete under the regulatory umbrella of the NCAA. DivisionII women's soccer, for example, which Angel Mitchel played at Ouachita Baptist University in Arkansas.

Mitchel took to soccer from the age of 4, playing with her two older brothers in Mansfield, Texas, and dreaming of a pro career. "I would do whatever it took to play," she says. "Soccer was my life."

That all changed on Tuesday, Sept. 13, 2011, when Mitchel, then a sophomore at OBU and known by her unmarried name, Palacios, collided with a teammate while going for a header during a practice drill. The other player's skull crashed into Mitchel's face, knocking her dizzy and sending her to her knees. With her left eye already swelling shut, she lurched to the sideline, where she told her athletic trainer she felt sick. She had already suffered two concussions in high school.

The trainer asked whether Mitchel was dizzy. Was she nauseated? Did she have a headache?

"Yes ... yes ... yes," Mitchel replied.

She says the trainer sent her back to her dorm room with an ice pack. Nobody told Mitchel to see a doctor or checked on her that night. The team gave her an online neuropsychological test the next day, but the results weren't clear because she still couldn't use her left eye. Woozy, sensitive to light and stabbed by migraines, she stayed out of sight as much as she could for the rest of the week.

On Saturday, Mitchel says, her coach instructed her to run laps. She was still sick-she had thrown up earlier that day-and appealed to the trainer, who she says told her: "You don't want to make the coach mad."

I knew I wasn't right, and what was happening was wrong.

Angel Mitchel, soccer player

As Mitchel broke into a trot, the sun burned into her head, vomit swelled again from her guts and pain wracked her whole being every time her feet hit the ground. The intensity and folly of her pain fused into anger. "I knew I wasn't right, and what was happening was wrong," she says.

After a lap around the field, Mitchel stopped and decided she needed to go to an emergency room. Mitchel says that, after that, her coach said she could skip the rest of practice. In fact, he said, she should expect to sit out for a long time.

Doctors found that Mitchel had a severe concussion. She already had recall problems and diminished sensations in the left side of her body. And if she kept engaging in physical activity, she could permanently damage her brain.

Mitchel had a black eye for three months. Her migraines persisted for three years. She never played soccer again. Officials from OBU declined to comment.

Mitchel's experience is an extreme version of what many women experience after sports concussions: isolation, inadequate attention, improper clearance, intimidation. The NCAA for its part has been very late to respond to these issues. It didn't have any guidelines covering brain injury at all until 2010. It required schools to have personnel trained to handle concussions at contact-sports games only because of a massive settlement it reached in 2014. Mitchel, now 24, is justifiably proud of joining the legal action that led to that deal; "I know we have a long way to go," she says, "but it's a great start."

Yet the NCAA doesn't actually enforce how its members implement its new rules. It has never disciplined a school for failing to file a concussion plan or for maintaining inadequate personnel or for returning an injured player to the field. There's still no mention of sex or gender in its best practices for diagnosing and managing concussions or in the concussion fact sheets it distributes to students and coaches.

Maybe the best indication of the NCAA's priorities is simply this: Its chief medical officer has a staff of seven to address college-age health and safety issues from mental health to sexual assault. Meanwhile, its compliance desk has more than 50 employees who police amateurism among athletes.

For all that, Brian Hainline, the chief medical officer of the NCAA, says he has "fire in his eyes" about concussions, and he emphasizes that brain trauma in sports is an issue "much bigger than football." Indeed, in a column on the NCAA's website, he wrote: "We need to spread the word: Yes, female athletes also suffer with concussion, and they may be uniquely predisposed to this neurological event."

It's true that Hainline was close enough to Elliot Pellman, the notorious former chairman of the NFL concussions committee, for Pellman to blurb a book on back pain that Hainline published in 2007. And that in Hainline's early days on the job at the NCAA, it seemed as if he too might simply make excuses for how sports programs were treating athletes with brain injuries.

But Hainline has a touch of the seeker about him, and he has taken to his role as college sports' concussion-education booster-in-chief. His efforts helped create the Grand Alliance, a $30 million project the NCAA and Department of Defense launched in 2014 to study brain injury in student-athletes and cadets and promote concussion education. Over the past three years, the initiative has enrolled more than 28,000 subjects; 1,931 had concussions, and scientists are examining their brains and bodies over time. It's a highly regarded effort, and Hainline is enthusiastic about working with respected partners to assert leadership in brain-injury research. "We all need to take a step back and stop saying nothing is happening," he says. "Cooperation I never dreamed could happen is happening right now. Concussion has brought us to this place of magic."

But while about 35 percent of the athletes involved with Grand Alliance research are female-the largest cohort of women with concussions ever studied-the effort probably won't report anything new that's sex-specific for years, if ever. To see why, it helps to understand why women and men might experience concussions in different ways.

Scientists have known for a long time that women are more open than men about reporting injuries. Recent research shows they don't just describe more symptoms after concussions, they exhibit more too. An important example comes from Shannon Bauman, a sports physician who began studying brain injury after she got inadequate attention for a concussion she suffered playing hockey. From 2014 to 2016, Bauman tracked 207 injured athletes at Concussion North, the specialty clinic she runs in Barrie, Ontario. She found women averaged 4.5 objective signs of concussion, such as poor balance or vision, versus 3.6 for men. They also took longer to recover; 35 percent of females still showed symptoms six months after their injuries.

"Maybe the reason we talk more about our symptoms isn't because we're weak or vulnerable," says Snedaker, a former athlete who went through more than a dozen concussions of her own before becoming an advocate. "Maybe it's because we have more symptoms and they last longer."

Biomechanics might be one reason for that. On average, women have shorter and thinner necks than men and approximately 50 percent less neck strength. In general, that means females have less of a buffer against anything their heads might slam, whether it's a ball, another player's elbow or the ground. Their skulls experience greater acceleration when their bodies whiplash-and it's that motion that jars a brain and leads to a concussion, like scrambling a yolk without necessarily cracking an egg.

Further, different chemicals naturally course through the bodies of men and women. As a basic example, research has shown that fluctuating levels of estrogen leave women far more susceptible to migraines than men, and migraines and concussions seem to cause similar problems inside the brain. It also turns out that, until puberty (when sex hormones start flowing), young boys and girls get concussions at comparable rates and share similar symptoms. Some neuroscientists have wondered about the effects of sex-specific hormones that either stress or shield the brain when it's concussed.

In a series of groundbreaking studies that started 25 years ago, Robin Roof, then a researcher at Rutgers, found that progesterone, a female sex hormone, reduced brain swelling and improved cognitive function after injuries in rats. The implications were huge: Maybe progesterone could mitigate the impact of brain injury. But the subject wasn't studied much again until 2013, when a team from the University of Rochester recorded data on the menstrual cycles of women who went to emergency rooms with concussions. It found that females who were injured at a point in their cycles when their progesterone levels should have been high suffered more symptoms afterward. "That's counterintuitive, because in animal studies, progesterone has a neuroprotective effect," says Jeffrey Bazarian, one of the Rochester researchers. "But concussion might disrupt its production, shut it off and lead to an abrupt decrease in the blood."

That's an interesting theory, but it's speculative. Hormones interact with one another in complex ways. And large-scale clinical trials of progesterone on brain-trauma victims have failed to show any significant benefit. So Bazarian is left with a nagging question: "How can there be such a discrepancy between rodents doing so well with progesterone and what we've seen so far in humans?"

"We can look at reporting, and we can look at neck strength," Brooks says. "But we have got to get to how the brain works in men and in women, which means studying how hormones affect its function."

That, however, is not a subject the NCAA is pursuing in its research. Its Grand Alliance with the Defense Department is on its way to amassing more than 25 million data points from athletes, information that an "advanced research core" will study with sophisticated neuroimaging devices and comb for biomarkers, or substances in the blood that indicate brain injury. But it will not collect statistics on where female athletes are in their monthly cycles, nor will it analyze blood samples for sex hormones. Those are "interesting and important questions," says Steven Broglio, a professor of kinesiology at the University of Michigan and one of the scientists leading the Grand Alliance's research. "[But] no study can address every concern. Hopefully, future research will take on this challenge."

"I understand you have to pick the low-lying fruit first, but five years from now, it's going to be too late to go back and get this data," Snedaker says. "If you're not going to look at what makes us different, then don't put us in the studies."

BEHIND CLOSED DOORS, some women's sports advocates aren't comfortable looking for differences between male and female injuries. Treating male and female athletes differently could revert to stereotypes that women have been fighting for decades-that they aren't up to the challenges of sports or need special pleading or are simply weaker than men.

But medical science has a long history of judging females by male standards, all too often with terrible results. Medical schools typically use men's bodies to teach students about disease, and doctors are more likely to miss or wrongly diagnose symptoms among female patients. The classic example is a heart attack: Women are more likely to feel as if they have the flu than to experience chest pain. And medical research historically has used male subjects to study treatments, producing findings on everything from aspirin to Ambien that didn't apply accurately to women.

Brain injury, then, is one of many examples where even studies that include women almost never come to separate conclusions about them. In 2016, the Archives of Physical Medicine and Rehabilitation reviewed the scientific literature on concussion since 1980. It found that of 221 published papers, just 7 percent of them broke out their data by sex. "Brain science follows society," Brooks says. "Men are making a lot of the decisions about women's health. I've had to conclude that instead of making change from the top down, I have to try from the bottom up, helping one patient at a time [as they] become healthy, informed, strong women."

Sports concussions are an acute case because so much attention and funding has followed pro football. Most obviously, while the NFL's concussion studies have been riddled with junk science and conflicts of interest, the league has helped tilt research toward helmeted sports. Last September it pledged $60 million toward developing new concussion technology, possibly including a new helmet, and $40 million for researching head injuries. And now the NCAA and the DOD are entering the field.

Naturally enough, parents around the country, many concerned about long-term brain damage and CTE (chronic traumatic encephalopathy), have started to demand greater protection for their daughters-even when science isn't ready to tell them just what to ask for. For example, U.S. Lacrosse, facing pressure from alarmed advocates, parents and state legislators, recently adopted its first standards for women's headgear. It's still optional, but helmets must now meet new guidelines-even though the federation doesn't actually have any evidence that the new equipment will reduce concussions. "This is a national experiment," says Andy Lincoln, who conducts research for U.S. Lacrosse. "There is a need for more information on head impacts and exposures in women's and girls sports."

Yes, there is. So what happens next, as public opinion, and soon enough, lawyers, politicians and salesmen, fill the vacuum left by the institutions that govern women's sports and the scientists they sponsor?

"I'm very concerned," Hainline says.

Originally posted here:
Why does it seem like nobody cares about female concussions? - ESPN

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Two of possibly the greatest joys in life are food and sex. You can enjoy both separately or together, by yourself or with a partner (or group) and in general, each tends to complement the other rather well. That is, until one day they dont. The reason? Put simply, it comes down to that dreaded C-word.

Cholesterol: adversary to your arteries, the harbinger of heart-attacks, and you may be surprised to learn, an eradicator of erections. Before we get to that, though, lets start with what this accursed stuff actually is.

Cholesterol, explains Boston Medical Group, is a waxy, fat-like substance that travels around the body in blood particles called lipoproteins. There are two versions of cholesterol, the good kind and the bad. The first one, known as HDL, travels in the blood directly to the liver where it is broken down and used by the body. The bad one, LDL, travels through our arteries leaving a trail of plaque that damages, and ultimately blocks blood flow. This condition is called atherosclerosis, and is a precursor to heart attacks, strokes and, yep, you guessed it, erectile dysfunction.

An excess of cholesterol can lead to a complete blockage of the coronary artery, which will trigger a heart attack. Too much bad cholesterol (also known as LDL) in the bloodstream creates arterial plaque that damages and blocks blood flow. These blockages will result in inadequate circulation of blood throughout the body, which includes your nether regions.

So, what exactly does that imply for your sex life? Time for a little human biology lesson.

During the act of sexual stimulation, Boston Medical Group explains, the body releases chemicals that cause the penile arteries (corpora cavernosa) to relax. Basically, in the heat of the moment, your arteries relax allowing for better blood flow and, of course, the more visible physical attributes associated with having an erection.

By now you should be starting to connect the dots. The long and the, er, short of it is that reduced blood flow caused by the high presence of LDL cholesterol is directly linked to sexual disorders such as erectile dysfunction.

Dr. Michael Krychman, the executive director of the Southern California Center for Sexual Health and Survivorship, told Fox News that "as soon as a man presents with erectile dysfunction, we begin measuring cholesterol and blood pressure." Krychman added that furthermore, the same mechanisms through which men may suffer from sexual disorders caused by high cholesterol, hold similar effects for women.

"In the past we used to think if a woman is having sexual problems, shes frigid, and she needs to go home and have a glass of wine and relax," Krychman said. "However, there is emerging data associating underlying medical causes with female sexual dysfunction." In the case of women, Krychman explained, the fatty deposits caused by high cholesterol affects lubrication and libido.

Beyond blockages, LDL cholesterol also inhibits the production of nitric oxide, the artery-relaxing hormone required to produce an erection. LDL does this by reducing the arterys response to the hormone, which in turn decreases blood flow. And thats not the only hormone affected by high cholesterol. Production of testosteronewhich helps stimulate sexual drive in menis also limited by high cholesterol-caused lowered blood flow to the testicles, where the hormone is produced.

Now that weve covered the problem, lets look at ways to go about finding the solution. For starters, Krychman said, if you believe your high cholesterol is affecting your sex life you should consult a physician. In an article on Healthcentral, the author reiterates Krychmans point noting that men who develop erectile dysfunction without an obvious cause, such as from medication or physical injury, may have a 25% increased risk of cardiovascular disease over the next 5 years.

There are generally three basic ways to go about combating high cholesterol: diet, exercise, and medication.

In terms of diet, most physicians will generally suggest cutting out saturated fats. This Alternet article, for instance, suggests nine ways you can increase the presence of good cholesterol (HDL) in your diet. By enjoying a low carb diet, avoiding trans fats, and doing regular exercise, explains the author, a person can greatly reduce their risk of heart disease, and in turn, reduce the effects that cause erectile dysfunction. For more diet tips, heres a list of 14 other foods that help with circulation.

This 2013 study, published in the journal Medline, looked at erectile function in relation to mens weight loss. Drawing on data from 145 sexually active overweight/obese men, the study found that dysfunction level improved with a small weight loss - even for men who did not have clinical dysfunction, co-author Clare Collins, a professor of nutrition and dietetics at the University of Newcastle, told Alternet via email. The study further found that overweight men were more likely to suffer from erectile dysfunction.

The main message is that improving your eating habits so that you drop a small amount of weight can improve your sex life, said Collins, adding the important reminder: talk to your doctor if youre experiencing erectile dysfunction.

The main reason for this last bit of advice comes down to medication. Suzy Cohen, a pharmacist writing for Lifescript, points out that high cholesterol and erectile dysfunctionwhich are often experienced togetherremain two separate conditions requiring different treatment. If you have ED, Cohen notes, assume (until proven otherwise) that you have mild heart disease or pre-diabetes. As such, she continues, simply taking lipid lowering medications that bring down your cholesterol levels may still hold negative effects for erectile function, due to a lack of hormones.

Enter statins.

Statins are a type of medication known for lowering cholesterol, and through that process helping to reduce heart disease. According to the findings of a 2014 study published by the Journal of Sexual Medicine, statins might also help benefit men with erectile dysfunction.

In the past, research had shown that statins had a negative effect on testosterone levels. This meant that many physicians questioned the efficacy of cholesterol-lowering medication when it came to improving sexual health. But a 2014 study by researchers from the cardiovascular research department at Rutgers Universitys Robert Wood Johnson Medical School proved differently.

For the study, researchers conducted a meta-analysis of previous studies on erectile dysfunction and statins. 11 trials that measured erectile function using the International Index of Erectile Function (IIEF) were identified for analysis following a systematic search of MEDLINE, Web of Knowledge, the Cochrane Database, and ClinicalTrials.gov.

Whats the IIEF? The IIEF, taken from self-administered survey results, are a set of five questions, scored on a five-point scale that when totalled either indicates a low number, indicating poor sexual function, or the opposite.

Overall, the analysis revealed that their was statistically significant proof that statins caused a clinically relevant improvement of erectile function as measured by the five-item version of the IIEF in men who had both high cholesterol and ED. Specifically, the study found that, overall, IIEF scores rose by 3.4 points in men who took statins compared to the control, which represents a 24.3 per cent improvement.

The increase in erectile function scores with statins was approximately one-third to one-half of what has been reported with drugs like Viagra, Cialis or Levitra, Dr John Kostis, the director of Rutger Universitys Cardiovascular Institute who lead the study, said in an article in the Daily Mail. It was larger than the reported effect of lifestyle modification. For men with erectile dysfunction who need statins to control cholesterol, this may be an extra benefit.

Kostis went on to explain the teams understanding of their findings to the Daily Mail. They believe that the statins help to improve erectile function by assisting with blood vessel dilation, which in turn improves vascular blood flow to the penis.

Ultimately, a healthy lifestyle is the best method to prevent disease, including erectile dysfunction," said Kostis, adding that although statin therapy may only help some people suffering from ED, in the long-run it has been proven to reduce your chances of experiencing cardiovascular disease.

Rather than preventing the possibility of a heart attack in the future, he said, the more immediate benefit of improving erectile function might improve adherence to statin therapy.

So, at its worst statin therapy will only help high cholesterol sufferers with their hearts and at its best, it could also improve their situation in the bedroom. Kostis was sure to add that statins should not be recommended as a primary form of treatment for ED, if patients have healthy cholesterol levels. He added that in order to more fully investigate the link between statin therapy and ED would require a larger trial.

In the end, like most issues pertaining to your health, the best solution requires a holistic approach. If you find yourself with high cholesterol and erectile dysfunction, its time to change your ways. Remember, step one: consult your physician. From there, with the right combination of diet, exercise and medication you could keep enjoying those great fruits of life, long into your years.

Robin Scher is a freelance writer from South Africa currently based in New York. He tweets infrequently @RobScherHimself.

More:
How High-Cholesterol Foods Can Ruin Your Sex Life - AlterNet

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WVU researchers study leukemia, bone marrow treatments - The Dominion Post

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Professional medical organisations have raised concerns about these expensive cell therapies

Stem cell science is an area of medical research that continues to offer great promise. But as this weeks paper in Science Translational Medicine highlights, a growing number of clinics around the globe, including in Australia, are exploiting regulatory gaps to sell so-called stem cell treatments without evidence that what they offer is effective or even safe.

Such unregulated direct-to-consumer advertising typically of cells obtained using liposuction-like methods not only places the health of individuals at risk but could also undermine the legitimate development of stem cell-based therapies.

Many academic societies and professional medical organisations have raised concerns about these futile and often expensive cell therapies. Despite this, national regulators have typically been slow or ineffective in curtailing them.

As well as tighter regulations here, international regulators such as the World Health Organisation and the International Council on Harmonisation need to move on ensuring patients desperate for cures arent sold treatments with limited efficacy and unknown safety.

So whats on offer?

Hundreds of stem cell clinics post online claims that they have been able to treat patients suffering from a wide range of conditions. These include osteoarthritis, pain, spinal cord injury, multiple sclerosis, diabetes and infertility. The websites are high on the rhetoric of science often using various accreditation, awards and other tokens to imply legitimacy but low on proof that they work.

Rather than producing independently verified results, these clinics rely on patient testimonials or unsubstantiated claims of improvement. In so doing these shonky clinics understate the risks to patient health associated with these unproven stem cell-based interventions.

Properly administered informed consent is often overlooked or ignored, so patients can be misled about the likelihood of success. In addition to heavy financial burdens imposed on patients and their families, there is often an opportunity cost because the time wasted in receiving futile stem cells diverts patients away from proven medicines.

The many recent reports of adverse outcomes demonstrate the risks of receiving unproven cell therapies are not trivial. In the USA three women were blinded following experimental stem cell treatment for macular degeneration (a degenerative eye disease that can cause blindness). One man was rendered a quadriplegic following a stem cell intervention for stroke. And a woman whose family sought treatment for her dementia died in Australia.

Other notorious cases involving the deaths of patients include the German government shutting down the X-Cell Centre and the Italian government closing the Stamina Foundation it had previously supported.

Whats approved?

At present, the only recognised stem cell treatments are those utilising blood stem cells isolated from bone marrow, peripheral blood (the cellular components of blood such as red and white blood cells and platelets) or umbilical cord blood.

Hundreds of thousand of lives have been saved over the last half-century in patients with cancers such as leukaemia, lymphoma and multiple myeloma, as well as rare inherited immune and metabolic disorders.

A few types of cancer and autoimmune diseases may also benefit from blood stem cells in the context of chemotherapy. Different stem cells are also successfully used for corneal and skin grafting.

All other applications remain in the preclinical research phase or are just starting to be evaluated in clinical trials.

Often dismissed by for-profit clinics as red tape hampering progress, the rigour of clinical trials allows for the collection of impartial evidence. Such information is usually required before a new drug or medical device is released into the marketplace. Unfortunately, in the case of for-profit stem cell clinics, their marketing has gazumped the scientific evidence.

The action is required on many fronts. Regulators at both an international and national level need to tackle regulatory loopholes and challenge unfounded marketing claims of businesses selling unproven stem cell interventions.

Researchers need to more clearly communicate their findings and the necessary next steps to responsibly take their science from the laboratory to the clinic. And they should acknowledge that this will take time.

Patients and their loved ones must be encouraged to seek advice from a trained reputable health care professional, someone who knows their medical history. They should think twice if someone is offering a treatment outside standards of practice.

The stakes are too high not to have these difficult conversations. If a stem cell treatment sounds too good to be true, it probably is.

For more information on recognised stem cell treatments visit the National Stem Cell Foundation of Australia and Stem Cells Australia, Choice Australia, EuroStemCell, International Society for Stem Cell Research, and International Society for Cellular Therapy.

Megan Munsie, Deputy Director - Centre for Stem Cell Systems and Head of Education, Ethics, Law & Community Awareness Unit, Stem Cells Australia, University of Melbourne and John Rasko, Clinical Haematologist and President-Elect, International Society for Cellular Therapy., University of Sydney

This article was originally published on The Conversation. Read the original article.

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Private clinics' unproven stem cell treatment is unsafe and unethical - Business Standard

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Its hard to get away from stereotypes connected to our periods. The trope of women being angry, emotional and even less able to perform on the job during that time of the month is old and tired, but it persists. Even the president of the United States cant seem to stop bringing up blood in connection with prominent women he wants to disparage. Now, a first-of-its-kind study published July 4 in Frontiers in Behavioral Neuroscience provides some scientific proof for what most people with periods already know: Our hormones dont keep our brains from properly functioning.

More:What's happening to your body each day of your menstrual cycle

Researchers at University Hospital Zrich, led by Dr. Brigitte Leeners, monitored the estrogen levels of 68 women of varying ages throughout two menstrual cycles. During their periods, the subjects participated in neuropsychological tests to measure their visual memory, attention and cognitive bias. The researchers didn't take into account things like food cravings, emotions, or sexual stimuli for this study, because those measures "do not assess prefrontal cognitive abilities." They found no meaningful connection between estrogen levels and cognitive function. The biggest takeaway came from comparing the two cycles: Even when a person experienced some cognitive discomfort during one cycle, that same person often did not experience the same thing during the next period.

More:Periods don't stop women from becoming leaders negative stereotypes do

Previous studies looked at only one menstrual cycle, introducing bias and ultimately fueling stereotypes, according to Leeners.

They resulted in false positive associations and the false conclusion that womens cognitive performance is hormone regulated, she said. Such an assumption is the background of the myth that womens cognitive performance is strongly influenced by the menstrual cycle and any resulting prejudice toward womens abilities in private and professional life.

More:Premenstrual Dysphoric Disorder May Be Linked to How Cells Process Sex Hormones

These findings are great for science because they answer a big question that many researchers have blamed for a lack of research into womens health issues the difficulty of controlling for menstruation when studying pretty much anything else about the body or mind. Much medical research, for example, is done on men in part because researchers are reluctant to have to control for periods and because especially in the U.S. digging into potential gender differences in the body and brain is often controversial.

Dr. Louann Brizendine, a neuropsychiatrist and author of the books The Female Brain and The Male Brain, said the results seem to confirm decades of experience. She has found that about 80 percent of women report feeling more uncomfortable physical and mood symptoms during some cycles than during others, but only about 8 percent report debilitating noticeable discomfort during every period. That 8 percent is typically the group that makes its way to Brizendines clinic, the Womens Mood and Hormone Clinic at the University of California San Francisco. Brizendine opened the clinic in 1988 and says she hoped that by now there would be copycats around the country. Thats not yet the case, but she is hopeful that increased interest and funding for womens health will change that.

Dr. Mary Jane Minkin, an OB-GYN and professor at Yale University School of Medicine, cautions that this new research shouldnt keep doctors from taking menstruation-related health complaints seriously. Premenstrual dysphoric disorder, which causes significant and life-affecting mood shifts before ones period, affects about 5 percent of women and is often misdiagnosed. But the good news is that those symptoms and others such as cramping can usually be addressed with birth control, an SSRI or in some cases over-the-counter medication.

Ive been in practice since 1979, and I can honestly say I dont think Ive ever taken care of a patient in my life who was significantly impaired by one part of her cycle that she couldnt put her finger on the atomic button, Minkin told SheKnows. There are hormones at play with memory and cognition, but I dont think its anything that cant be overcome. Do some women feel depressed? Yes. Debilitated? No.

Next, Leeners team in Zrich plans to look into the science behind hormonal cravings. But for now, let's stop discounting the mental capacity of people who menstruate, OK?

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Surprise Period Hormones Don't Scramble Your Brain - SheKnows.com

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Q: Does having my thyroid removed affect my heart?

A: The thyroid is really important because thyroid levels control your energy level and heart rate, your bowel function and your concentration. When you have your thyroid removed, its really important to replace the thyroid hormone to the appropriate amount so you can still function normally. Your endocrinologist, primary care doctor or your cardiologist should be checking your thyroid hormones level, which is called the TSH, to make sure its where it needs to be. With too much thyroid hormone, your heart may be racing. If you have too little, your heart pumping function may be reduced. In extreme situations, you may even have very low energy and have something called myxedema coma. These are just a few examples of the effects of thyroid hormone on the heart.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Preventive cardiologistHaitham Ahmed, MD, MPH

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Does Having My Thyroid Removed Affect My Heart? - Health Essentials from Cleveland Clinic (blog)

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In BriefResearchers have identified a single gene deletion in E. colibacteria that influence longevity in C. elegans worms. This pointsto the role of gut bacteria in life extension and points to thepossibility of a life-extending probiotic in the future.

Researchers at the Baylor College of Medicine have found the key to longevity in Caenorhabditis elegans (C. elegans) worms and maybe, someday, humans. The team noticed that genetically identical worms would occasionally live for much longer, and looked to their gut bacteria to find the answer. They discovered that a strain of E. coli with a single gene deletion might be the reason that its hosts lives were being significantly extended.

This study is one among a number of projects that focus on the influence of the microbiome the community of microbes which share the body of the host organism on longevity. Ultimately, the goal of this kind of research is to develop probiotics that could extend human life. Ive always studied the molecular genetics of aging, Meng Wang, one of the researchers who conducted the study, told The Atlantic. But before, we always looked at the host. This is my first attempt to understand the bacterias side.

Even in cases like this, where it seems fairly obvious that the microbiome is influencing longevity, parsing out the details of how and why this happens among a tremendous variety of chemicals and microbe species is extremely complex. The team, in this case, was successful because they simplified the question and focused on a single relationship.

Genetically engineering bacteria to support and improve human health and even to slow aging and turning it into a usable, life-extending probiotic wont be easy. It is extremely difficult to make bacteria colonize the gut in a stable manner, which is a primary challenge in this field. The team, in this case, is looking to the microbiome, because the organisms used would be relatively safe to use because they would originate in the gut.

Clearly, researchers dont know yet whether these discoveries will be able to be applied to people, though it seems promising. Despite the obvious differences between the tiny C. elegans worm and us, its biology is surprisingly similar; many treatments that work well in mice and primates also work in the worm. The team will begin experiments along these same lines with mice soon.

Other interesting and recent research hoping to stop or slow the march of time includes work with induced pluripotent stem (iPS) cells, antioxidants that target the mitochondria, and even somewhat strangework with cord blood. It seems very likely that we wont have a single solution offering immortality anytime soon, but instead a range of treatment options that help to incrementally hold back time. And, with an improving quality of life, this kind of life extension sounds promising.

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This Study Could Help Extend the Human Lifespan - Futurism

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The Hindu

Nilgiris pale tiger an 'aberrant genetic mutation' The Hindu While the pale tiger of the Nilgiris has won global attention, it could be just an instance of an aberrant genetic mutation, say experts. This is interesting because no pale tiger has been recorded in south India so far, says Yadvendradev Jhala ... and more »

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Nilgiris pale tiger an 'aberrant genetic mutation' - The Hindu

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The world learned the details of the Islamic States systemic rape and slavery of women through shocking stories told to the New York Times in 2015.Our collective outrage also showed how war has changed. Rape, torture and slavery are considered beyond taboo; they are criminalized even in war. This archaic behavior is not supposed to happen in our modern world.

But thats a pretty recent development. Systemic rape used to go hand in hand with war as women, resources and landswere assimilated into the victors communities. The victorious menhad more children, more land and more power. Some researchers have argued that this is proof of the deep roots theory of war: Human males fight each other for reproductive advantage, proving that war is an evolutionary advantageous behavior.

But this theory has been hard to prove. In fact, studies of human groups and other primates have added to the evidence both for and against the controversial idea that humans were made for war, evolutionarily speaking. A January 2015study indicates that societies dont actually benefit from head-to-head action, though other forms of violence do pay off.

Harvard evolutionary biologists Luke Glowaki and Richard Wrangham studied the Nyangatom people of East Africa. The group are polygamous shepherds who raise small livestock and can have multiple wives. At times, the Nyangatom go to war with other groups. But there is a another pervasive and nearly constant form of violence in the group. Young riders make raids on nearby camps with the goal of stealing cattle. Glowaki and Wrangham asked if either or both of these types of violence was beneficial to the men who engaged in them. They measured by counting the the number of wives and kids they had.

This study is one of many that has heightened thedebate over how muchwar has had an impact on a warriors evolutionary success. At least in this society,sneaking around after dark and stealing cows may have beenmore consequential. Robert Sapolosky at the Wall Street Journal explained:

By contrast, lots of battle raidingopen-field, daytime combat with hundreds of participantsdid not serve as a predictor of elevated reproductive success, probably because such fighting carried a nontrivial chance of winding up dead. In other words, in this society, being a warrior on steroids did not predict reproductive success; being a low-down sneaky varmint of a cattle rustler did.

But researchers only discovered this by looking at the elders in the community. Stealthy animal raiding did lead to better outcomes but decades later. In Nyangatom culture, most of the stolen livestock goes to fathers and other paternal relatives rather than being kept by the young men who stole them. The male heads of families made marriage decisions for their younger relatives. So, while it this kind of violence makes a difference, the payoff is quite delayed. The researchers speculated the cattle-rustling effect would be stronger in a group where the raiders got to keep the livestock they stole and incentives were strengthened.

Other studies also point to the idea that inter-group warfare might not be beneficial, but intra-group violence is. Chimpanzee tribes, for example dont often go to war with other tribes. Instead the most common types of violence involve a group of males ganging up on one individual male. This often happens when conditions are crowded or there were increased numbers of males in the tribe. And the researchers found that chimps participation in violence happened outside of the spheres of human influence, meaning violence was not a behavior the chimpanzees learned from us.

But other evidence suggests that humans likely didnt participate in war as we know it until relatively recently. A 2013 survey of killings in 21 groups (foragers rather than shepherds) found that group warfare was rare compared to homicide. John Horgan categorized the evidence at Scientific American:

Some other points of interest: 96 percent of the killers were male. No surprise there. But some readers may be surprised that only two out of 148 killings stemmed from a fight over resources, such as a hunting ground, water hole or fruit tree. Nine episodes of lethal aggression involved husbands killing wives; three involved execution of an individual in a group by other members of the group; seven involved execution of outsiders, such as colonizers or missionaries. Most of the killings stemmed from what Fry and Soderberg categorize as miscellaneous personal disputes, involving jealousy, theft, insults and so on. The most common specific cause of deadly violenceinvolving either single or multiple perpetratorswas revenge for a previous attack.So it maybe that a proclivity for violence and an innate sense of revenge that perpetuates war, rather than war itself.

Another factor to consider is that while our common ancestors lived in groups like these thousands of years ago, almost no one does anymore. In fact, finding these undisturbed cultures is hard to do. Having more cows doesnt carry the same appeal it once did. Its unlikely stealing your neighbors TV for your uncle will fetch you a better bride. Some scientists worry that if we accept the idea that violence was a beneficial tool for our ancestors, it somehow overturns the societal progress that has moved us beyond the rape and pillage culture to something still imperfect, but largely more peaceful.

This is the biggest struggle with the deep roots theory of human violence. Just because something garnered an advantage thousands of years ago doesnt make it okay today. Harvard psychologist Steven Pinker, who has written a book on human violence, said in the Boston Globe:

romantics worry that if violence is a Darwinian adaptation, that must mean that it is good, or that its futile to work for peace, because humans have an innate thirst for blood that has to be periodically slaked. Needless to say, I think all this is profoundly wrongheaded.

Meredith Knight is a contributor to the human genetics section for Genetic Literacy Project and a freelance science and health writer in Austin, Texas. Follow her @meremereknight.

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Evolution and war: The 'deep roots' theory of human violence - Genetic Literacy Project

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Women's Health

8 Health Issues You Had No Idea Transgender and Gender-Diverse People Are Dealing With Women's Health Physician assistant Diane Bruessow, who works for the private medical office Healthy Transitions, says that doctors who don't work with transitions don't necessarily know the details of working with hormone therapy. That's why Alex Keuroghlian, M.D., M ... and more »

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8 Health Issues You Had No Idea Transgender and Gender-Diverse People Are Dealing With - Women's Health

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JENNIE McKEON @JennieMnwfdn

MARY ESTHER The tragic death of a 7-week-old child left in a van earlier this week is a reminder of how dangerous Florida heat can be.

Okaloosa County sheriff's deputies were called to a home in Mary Esther about 9:30 p.m. Sunday, where they found infant dead inside a van. A family member was not aware that the child's mother had placed the baby in the rear-facing car seat inside the van after church about 12:45 p.m.

Investigators are still waiting for results of the autopsy from the Medical Examiner's Office, sheriff's office spokeswoman Michele Nicholson said.

"This is a tragic event that we are continuing to investigate, and will provide more information when the evidence, facts and interviews are concluded and reviewed," she added in an email statement.

According to the website KidsAndCars.org, an average of 37 children in the United States die from heat-related deaths after being left inside vehicles. Since 1990, about 800 children have died of vehicular heat strokes.

Niceville physician Wayne Justice has made it a personal mission to help save families from experiencing those tragedies after reading about one in the summer of 2013.

"I know how busy life can be. I have two kids who were 7 and 4 at the time," Justice said. "I started to think ... when doctors put patients on ventilators we have sensors to measure carbon dioxide. I'd love to see some kind of device in cars that monitors temperature and carbon dioxide."

Justice enlisted friends Dr. Kit Kuss and engineer Mark Denney to come up with a prototype. In January 2016 they received a patent on the XTRAS (Extreme Temperature Rescue Alarm System). He sees the device being installed in the dome light or TV monitors in cars that could sense motion, CO2 levels and temperature.

"The device would alarm parents by phone or call 911," he said. "Maybe even crank up the car and turn the AC on. It could also save pets."

As a father and a doctor, Justice said he would like to see his prototype developed into a life-saving device. He's hoping to work with KidsAndCars.org, (KAC), which works to raise awareness about the dangers inherent to children in or around motor vehicles, and the National Highway Traffic Safety Administration to do more testing and get the finished device in cars.

"I see it as a baby shower gift," he said. "You give monitors and the XTRAS."

According to KAC, in more than half of the cases in which a child is left in a hot car, the person responsible for the child left them unknowingly. Neuroscientists say brains can go on "auto pilot" and go through the day's schedule without noticing changes in the routine.

Justice also points out children can get accidentally locked in cars with the child safety lock features.

"It's horrible and devastating," he said. "I would love to see this implemented in cars and save lives."

See more here:
Local doctor wants to save kids from hot cars - The Northwest Florida Daily News

Recommendation and review posted by sam

Thursday, July 06, 2017 3:51 p.m. EDT

By Andrew M. Seaman

(Reuters Health) - Young women who suffer a concussion may be at increased risk of menstrual irregularities, at least for a few months, suggests a new U.S. study.

Researchers found that young women were nearly six times more likely to have irregular menstrual cycles after a concussion, compared to young women who were treated for non-head-related injuries.

After a concussion, women should talk to their healthcare providers about the increased risk, said senior author Anthony Kontos, of the University of Pittsburgh Medical Center Sports Medicine Concussion Program. It's important, he added, "for care providers to be concerned about menstrual patterns and encouraging women to track that after their injury."

Irregular menstrual cycles may disrupt the body's hormones and lead to delayed body development in young women, Kontos told Reuters Health. Hormone disruption can also lead to poor bone health.

Concussions result from a hit or blow to the head that causes the brain to move back and forth or twist inside a person's skull, according to the Centers for Disease Control and Prevention.

A study last year by the Seattle Sports Concussion Research Collaborative estimated that up to 1.9 million children in the U.S. experience a sports-related concussion each year. Girls are also known to have a more difficult concussion recovery than buys, Kontos and his colleagues write in JAMA Pediatrics.

Hormone disorders are known to occur after traumatic brain injuries, they add. Some research has suggested menstrual disorders are more common after those types of injuries, too.

For the new study, the researchers recruited 68 girls and women, ages 12 to 21, who were recovering from concussions. The participants received a text message every Sunday night for about four months linking to a survey that asked about their menstrual cycle. They were asked about bleeding, new injuries, possibly pregnancies and birth control.

Sixty-one young women with non-head-related injuries were also surveyed every week.

About 24 percent of concussion patients had at least two abnormal menstrual cycles during follow-up, compared to 5 percent of patients with other types of injuries.

Kontos said concussions might increase the risk of irregular menstrual cycles by disrupting the hypothalamic-pituitary-ovarian axis, a group of hormone-emitting glands that often act in concert.

Dr. Jeffrey Bazarian, an emergency physician and brain injury expert at the University of Rochester Medical Center in New York, told Reuters Health a concussion could interfere with the pituitary gland in the center of the brain.

"Its possible that this also happens to males and the question is how does it effect them," said Bazarian, who was not involved in the new study.

The researchers can't yet explain their findings, however. Nor can the study prove concussions actually cause abnormal menstruation.

Kontos also said it's unclear whether the increased risk of abnormal menstrual patterns lasts beyond four months.

"We dont know beyond that," he said. "Its one of the studies wed like to do."

SOURCE: http://bit.ly/2sRbdp9 JAMA Pediatrics, online July 3, 2017.

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Concussions tied to menstrual problems in young women - WHTC

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Either the 22-year news embargo has been lifted or the Broadcasting Thought Police havent yet arrested WFANs Richard Neer for media malfeasance in the first degree. What he said on the air Monday morning, after all, previously was an act of sedition.

Neer cast some practical doubt on a fellow who for years was presented to Americans not only as the greatest in his sport (which was true for a while), but also as the worlds greatest son, husband, father and human: Tiger Woods. Yet Neers still at large, not yet in custody.

Neer noted that Woods, that morning, had tweeted he was out of drug rehab, although not quite. Drug and rehabilitation didnt make the cut. The message read: I recently completed an out of state private intensive program. I will continue to tackle this going forward with my doctors, family and friends.

Whatever this is.

Neer said this strikes him as one of those dubious two-week miracle cures, thus hes not convinced Woods is properly dealing with an addiction for which he might need intensive treatment.

Neer might have added that this tweet, in the month following Woods 3 a.m., lost-in-space, DUI arrest, carried the stink of a Team Tiger public relations ploy, as it was sent in the midst of the July Fourth holiday. Public relations folks often have high-profile clients choose to release statements that dont reflect particularly well on them at times that make the least possible news.

But what, other than Woods ability to shoot lower than everyone else, has not been accompanied by the doubtful, followed by media-excused absences of common sense?

He tweeted that after an intensive program he was working with my doctors.

In 2009, with the finest doctors in this country to select from, Woods and company chose Canadian Anthony Galea, who was flown to Florida a reported 14 times to treat Woods knee.

Two years later, Galea pled guilty to smuggling illegal drugs and human growth hormone into the United States.

Woods and Galea claimed the doctor administered no illegal treatments. So then why would Woods fly him in from Toronto? He couldnt have been similarly, legally treated by a U.S.-accredited physician?

But to even hint that this made less sense than it did nonsense went widely ignored. Woods was entitled to escape such logical doubt while his career has been laced with the stench of fraud.

His closely followed, far-flung and expensive amateur career surely was financed by his father after the monolithic rep firm, IMG, hired Earl Woods as a talent scout, as if Dad scouted other talent. Tiger then belonged to IMG the instant he turned pro, thus Team Tiger thumbed its nose at USGA rules prohibiting amateurs from having agents.

His come-out, attitude-enriched Nike commercial had Woods, who previously had insisted that he didnt want to be known for his race, saying, There are still courses in the United States that I am not allowed to play because of the color of my skin.

But as the most celebrated amateur since Bobby Jones, no such thing, as a Nike rep later admitted, was true. Woods, however, often played and practiced at a course in Houston that excluded women.

In 1997, when Woods skipped a PGA event in the U.S. to play a tournament in Thailand, the media reported Team Tigers claim: he was playing in Thailand to honor his mothers heritage. What a son!

That $500,000 appearance fee to play in Thailand? Shhh. Dont ruin it! After all, that weeks PGA Tour winner won only $270,000.

But Woods has always been guarded and enabled by fractional truths, if not lies, blissfully indulged or advanced by media.

Of course, no one rolled over and played dead for Woods more often than TV, its golf voices allowing him to be the only player entitled to act like a foul-mouthed spoiled brat, even into his late 30s, without a discouraging word about what was impossible for viewers to not hear or see.

During the 2010 Ryder Cup, as Woods and Steve Stricker were losing their second team match, NBCs Johnny Miller identified the problem: Stricker. It was his fault.

Yet it was clear to even miniature golfers that Stricker was playing better than Woods.

Into NBCs booth entered Colin Montgomerie, guest commentator. Apparently unfamiliar with the rules of Tiger Woods American TV coverage, the Scotsman volunteered that Woods was playing poorly.

He has hardly hit a fairway or green in regulation, Montgomerie said.

OMG! Awkward silence. Montgomerie had no idea that no matter how conspicuous the truth, youre not supposed to say that, not about Tiger Woods.

And so despite the rank pandering and Woods continuing free fall, the media have done Woods no favors.

FOX Sports boss and former ESPN shot-caller Jamie Horowitz, this week was fired for alleged sexual misconduct. Employees must attend seminars to deter sexual harassment, yet its their bosses who are fired for it.

Its odd, too, how defense lawyers make public declarations of hard facts without possibly knowing them. Horowitzs attorney, Patricia Glaser, immediately knew that FOX, not Horowitz, was the guilty party:

The way Jamie has been treated by FOX is appalling, she said. At no point in his tenure was there any mention from his superiors or human resources of any misconduct or an inability to adhere to professional conduct.

Does that mean FOX owed Horowitz a warning to cut it out?

Glaser continued: Jamie was hired by FOX to do a job that until today he has performed in an exemplary fashion.

How does she know? Did she shadow Horowitz at work?

Finally, she said, Any slanderous accusations to the contrary will be vigorously defended.

So how can she be sure shes not slandering those who fired him?

Many high-powered attorneys are like Mike Francesa. They can publicly claim anything about anything and anyone as fact without knowing if its true, never to be held accountable.

Game 5 of the 1956 World Series, and we can hear John Sterling: Casey Stengel has seen enough, Suzyn. He has brought in eighth-inning man Dellin Betances. That closes the book on Don Larsen: Seven innings, no runs, no hits, no walks.

FOXs commercials for Tuesdays All-Star Game are off by at least a half-hour. The game will not begin at 7:30 p.m., but sometime after 8 p.m.

Damien Wilson, the Cowboys linebacker who was arrested Tuesday on two counts of aggravated assault with a deadly weapon a car and a rifle is a University of Minnesota man.

After Joey Chestnut again won the 2017 Nathans Hot Dog Eating competition on July 4, reader Mark Woloshyn was disappointed that ESPN didnt post Chestnuts postgame exit velocity.

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WFAN voice breaks through media's wall of Tiger protection - New York Post

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...And this was the survivor.

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Riplay: He figured he could get an alien back through quarantine if one of us was... impregnated, of whatever you call it... then frozen for the trip home. Nobody would know about the embryos we were carrying; me and Newt. Hicks: No, wait a minute, we'd all know. Ripley: Yes, the only way he'd be able to do it is if he sabotaged certain freezers on the way home, namely yours. Then he could jettison the bodies and make up any story he liked. Hudson: You're dead... you're dog meat, pal!

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Wheatley: The reserve power ran out, so of course the whole Relaxation Center stops waking up the bloody test subjects. [...] And of course, nobody tells me anything. Nooooooo, why should they tell me anything? [...] And who's fault do you think it's going to be when the management comes down here and finds ten thousand flippin' vegetables. [...] We should get our stories straight. If anyone asks and no-one's going to ask, don't worry but if anyone asks, tell them as far as you know, the last time you checked, everyone looked pretty much alive. Alright? Not dead.

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Cryonics Failure - TV Tropes

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Colon cancer. Uterine cancer. Pancreatic cancer. Whatever the tumor, the more gene mutations lurking inside, the better chance your immune system has to fight back.

That's the premise behind the recent approval of a landmark drug, the first cancer therapy ever cleared based on a tumor's genetics instead of the body part it struck first. Now thousands of patients with worsening cancer despite standard treatment can try this immunotherapy as long as genetic testing of the tumor shows they're a candidate.

"It's like having a lottery ticket," said Johns Hopkins oncologist Dr. Dung Le, who helped prove the new use for the immunotherapy Keytruda. "We've got to figure out how to find these patients, because it's such a great opportunity for them."

Today, doctors diagnose tumors by where they originate breast cancer in the breast, colon cancer in the colon and use therapies specifically tested for that organ. In contrast, the Food and Drug Administration labeled Keytruda the first "tissue-agnostic" treatment, for adults and children.

The reason: Seemingly unrelated cancers occasionally carry a common genetic flaw called a mismatch repair defect. Despite small studies, FDA found the evidence convincing that for a subset of patients, that flaw can make solid tumors susceptible to immunotherapy doctors otherwise wouldn't have tried.

"We thought these would be the hardest tumors to treat. But it's like an Achilles heel," said Hopkins cancer geneticist Bert Vogelstein.

And last month FDA Commissioner Scott Gottlieb told a Senate subcommittee his agency will simplify drug development for diseases that "all have a similar genetic fingerprint even if they have a slightly different clinical expression."

It's too early to know if what's being dubbed precision immunotherapy will have lasting benefits, but here's a look at the science.

WHO'S A CANDIDATE?

Hopkins estimates about 4 percent of cancers are mismatch repair-deficient, potentially adding up to 60,000 patients a year. Widely available tests that cost $300 to $600 can tell who's eligible. The FDA said the flaw is more common in colon, endometrial and gastrointestinal cancers but occasionally occurs in a list of others.

"Say, 'have I been tested for this?'" is Le's advice for patients.

MUTATIONS AND MORE MUTATIONS

Most tumors bear 50 or so mutations in various genes, Vogelstein said. Melanomas and lung cancers, spurred by sunlight and tobacco smoke, may have twice as many. But tumors with a mismatch repair defect can harbor 1,500 mutations.

Why? When DNA copies itself, sometimes the strands pair up wrong to leave a typo a mismatch. Normally the body spell checks and repairs those typos. Without that proofreading, mutations build up, not necessarily the kind that trigger cancer but bystanders in a growing tumor.

THE PLOT THICKENS

Your immune system could be a potent cancer fighter except that too often, tumors shield themselves. Merck's Keytruda and other so-called checkpoint inhibitors can block one of those shields, allowing immune cells to recognize a tumor as a foreign invader and attack. Until now, those immunotherapies were approved only for a few select cancers Keytruda hit the market for melanoma in 2014 and they work incredibly well for some patients but fail in many others. Learning who's a good candidate is critical for drugs that can cost $150,000 a year and sometimes cause serious side effects.

In 2012, Hopkins doctors testing various immunotherapies found the approach failed in all but one of 20 colon cancer patients. When perplexed oncologists told Vogelstein, "a light bulb went off."

Sure enough, the one patient who fared well had a mismatch repair defect and a "mind-boggling" number of tumor mutations. The more mutations, the greater the chance that at least one produces a foreign-looking protein that is a beacon for immune cells, Vogelstein explained.

It was time to see if other kinds of cancer might respond, too.

WHAT'S THE DATA?

The strongest study, published in the journal Science, tested 86 such patients with a dozen different cancers, including some who had entered hospice. Half had their tumors at least shrink significantly, and 18 saw their cancer become undetectable.

It's not clear why the other half didn't respond. Researchers found a hint, in three patients, that new mutations might form that could resist treatment.

But after two years of Keytruda infusions, 11 of the "complete responders" have stopped the drug and remain cancer-free for a median of eight months and counting.

Catherine "Katie" Rosenbaum, 67, is one of those successes. The retired teacher had her uterus removed when endometrial cancer first struck, but five years later tumors returned, scattered through her pelvis and colon. She tried treatment after treatment until in 2014, her doctor urged the Hopkins study.

Rosenbaum took a train from Richmond, Virginia, to Baltimore for infusions every two weeks and then, after some fatigue and diarrhea side effects, once a month. Then the side effects eased and her tumors started disappearing. A year into the study she was well enough to swim a mile for a Swim Across America cancer fundraiser.

"Nothing else had worked, so I guess we could say it was a last hope," said Rosenbaum, who now wants other patients to know about the option.

This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

This story is part of Genetic Frontiers, AP's ongoing exploration of the rapidly growing understanding of DNA and new attempts to manipulate it.

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Tumor gene testing urged to tell if drug targets your cancer - ABC News

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