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The rise of ‘rich woman face’: how to halt the ageing process (for a certain price) – Telegraph.co.uk

'Let me tell you about the very rich,' wrote F Scott Fitzgerald. 'They are different from you and me.' Above all, in the lengths they will go to acquire, and preserve, perfect skin.

Sheikha Moza bint Nasser, the consort of the former Emir of Qatar, may well be the richest person I've ever met. She certainly has skin like no one else on the planet. She's 61 but looks about 40, with a face that seems to have no visible pores, perhaps because it's sculpted out of alabaster.

Admittedly, she is carefully made-up on a regular basis, so she would have been unlikely to want to attend a recent dinner party of Gwyneth Paltrow's in Beverly Hills, at which guests were banned from wearing any cosmetics at all. Kate Hudson and Demi Moore were among those who gamely took the challenge, the idea of which was to allow the assembled LA A-listers to show off their natural glow.

But they don't, of course, rely wholly on nature for their radiance. Moore's evening beauty routine (pared back to the minimum because, she says, "I like to keep it simple") includes eight separate products, with a total cost of 743.50, from a cleansing elixir to a 355 replenishing facial oil and a rose-quartz facial massager in the shape of a butterfly.

No wonder that, far from being petrified at the thought of the make-up-free dinner, she felt 'full of joy', according to her Instagram posts. Her face wasn't coated in foundation, but it was insulated by a thick layer of cash.

With skincare that promises actually to reverse the visible signs of ageing, beauty brands feel entitled to charge impressive sums. La Prairie has one serum, its Platinum Night Elixir, that sells for over 1,000 for 20ml. It costs about 10 more per gram than solid gold. Imagine if your cat knocked that one off the dressing table.

On the other hand, the scientist who developed it says the peptides and amino acids contained in a single daily drop will leave your skin visibly younger-looking and fresher in two weeks. Users say it feels like wrapping your face in cashmere.

La Prairie Platinum Rare Cellular Night Elixir 20ml, 1,018, Harvey Nichols

I rely on Dr Phillip Levy, a Swiss dermatologist and wound-healing specialist based in Geneva, whose moisturisers and serums are proven to revitalise dermal stem cells to kick-start your skin's own production of collagen. Another doctor - German-born Michael Prager, who operates from a clinic in Wimpole Street - emphasises the rejuvenating effects of combating pollution with an antioxidant cream that fights off free radicals.

Neither of these medical-grade ranges comes cheap, but though Dr Prager's day oil contains pure gold, at 225 for 30ml (drmichaelprager.com), it's not actually as expensive as buying the precious metal itself.

If you're going down the Sheikha Moza route to moneyed perfection with a lavish use of make-up, Gucci Westman is a name to conjure with. This make-up artist, who has worked with Natalie Portman and Nicole Kidman, has her own range, Westman Atelier.

Lip suede in Les Rouges, 75, Westman Atelier (net-a-porter.com)

Yes, the colours are lush but, even better, the brand is 'clean' - beauty-speak for vegan, against animal-testing, paraben-free and so on. Plus, the products moisturise, plump up collagen and soothe as you apply them. Even the mascara conditions your lashes. So what if it costs 58?

Equally impressive is Shiseido's luxury line, Cl de Peau, which does a foundation that's 250 for 27ml, in 13 shades. Again, it's a beauty treatment with SPF and moisturiser as much as a make-up product, and it's what I'll put on if I want anyone to tell me I look glowing.

But, of course, more precious than any cream or blush stick is a little personal attention. Dr Costas Papageorgiou operates out of Harrods and has fairly expensive-looking skin himself. He makes use of a battery of lasers, Botox, fillers and ultrasound, but the key to his success is the consultation that starts off the process.

The Foundation,250, Cl de Peau Beaut (harrods.com)

Seeing your own face in unforgiving 3D on a computer may be a shock, but it certainly helps pinpoint the areas you'd like him to focus on. He's very hot on correcting facial symmetry, which starts out pretty good in babies, but with time and use, the muscles on the face become less symmetrical as bits start to droop or wrinkle. Generally, the more lopsided you are, the more antique you look, and he can address that with filler, Botox and even thread lifts.

But I'm not one for the injectables. It's his Hybrid Energy Lift - a combination of ultrasound, infrared, light and laser - that I really rate (from 6,000 for 120 minutes, facialplasticslondon.com). It, too, stimulates collagen production, but it also gets rid of visible veins and redness, and even reduces big pores. I have had to change the tone of my foundation for a paler one since he did for my (mild) rosacea.

Radical3 Reboot Pro Peel, 89, Dr Levy (editorslist.co.uk)

The key, says Dr Papageorgiou, is to delay and reverse the "ageing cascade". This slow car crash of fine lines around the eyes, sun damage and heavy jowls is all thanks, he says, to "fat atrophy and bone resorption".

But subtlety is all - "A great result is one that shows no signs of intervention"- and nothing, he warns, can really be achieved unless you have a healthy diet, exercise and take vitamins.

Debbie Thomas, at her D.Thomas clinic in London, has a similarly personalised approach. You don't book in for a single treatment, you book for an hour of her expert time, and she'll use a cocktail of lasers, micro-needling and products depending on what you need (475 for a DNA Laser Complete 2 session, dthomas.com).

"I'm afraid,"she says, "traditional facials are not going to transform your skin for more than a few days. You need to upgrade to more advanced treatments if you want long-term results. And those will be more costly."And who can say it's not worth the money?

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Meet Betty Hay, the scientist who saw how cells grow and limbs regenerate – Massive Science

Limbs regenerate, embryos grow, and cancers invade.

In each of these processes, cells change dramatically. Betty Hay studied fascinating biological phenomena, relentlessly asking questions with her students and colleagues to understand how cellsbehaved. By the end of her life, she had made enormous research contributions in developmental biology, on top ofcommitting herself to mentoring the next generation of scientists and advocating for more representation of women in science.

She made significant contributions towards understanding cell and developmental biology

Betty Hay began as an undergraduate at Smith College in 1944. She lovedher first biology course and started working for Meryl Rose, a professor at Smith who studied limb regeneration in frogs. I was self-motivated and very attracted to science, she saidin an interview in 2004, Meryl at that time was working on regeneration and by the end of my first year at Smith I was also studying regeneration.

Hay regarded Rose as a significant scientific mentor in her life and followed his advice to apply for medical school instead of graduate school. She ended up attending Johns Hopkins School of Medicine for her medical degree while continuing her research on limb regeneration over the summers with Rose at Woods Holes Marine Biological Laboratory. She stayed at Johns Hopkins after to teach Anatomy and became an Assistant Professor in 1956.

The year after, she moved her studiesto Cornell Universitys Medical College as an Assistant Professor to learn how to use the powerful microscopes located there. Her goal was to use transmission electron microscopy (TEM), a method of taking high-resolution images, toseehow salamanders could regenerate an amputated limb. Nothing couldve kept me from going into TEM, she said later.

With her student, Don Fischman, they concluded that upon amputation, cells with specialized roles,known as differentiated cells and thought to be unchangeable, were able to de-differentiate and become unspecialized stem cells again. These cells without an assigned role could then have the freedom to adopt whatever new roles they required to regenerate a perfectly new limb.

Already making leaps in figuring out an explanation for the process of limb regeneration, Hay turned her attention from salamanders to bird eyes when she moved to Harvard University. She studied the outermost layer of cells on the cornea, known as the cornea epithelium. With the help of a postdoctoral scholar in her lab, Jib Dobson, and a faculty colleague, Jean-Paul Revel, they isolated, grew, and took pictures of cornea epithelium cells and demonstrated the epithelial cells could produce collagen.

Collagen is the main type of protein that weaves together to form the extracellular matrix, a connective tissue (the matrix) found outside of cells (extracellular). The collagen in the extracellular matrix provide structure, acting as a foundation for connective tissues and organs such as skin, tendons, and ligaments. Other scientists in the field were skeptical of the conclusion. They thought that one dedicated cell produced collagen, and nothing else.They dismissed the idea that cells in the cornea could somehow do the same. Despite their doubt, Hay, along with postdoctoral scholar Steve Meier, continued their studies. In 1974, they further showed that not only could epithelial cells produce collagen and extracellular matrix in different organ systems, but that the matrix could also tell other cells what type of cell to become.

She was a committed educator and mentor

Kathy Svoboda and Marion Gordon, two colleagues of hers, wrote about Betty Hay and described her not only as a superb cell and developmental biologist, but also as an educator and beloved mentor.

Limb regeneration in salamanders

Russell et al BMC Biology 2017

She was dedicated to teaching and influenced the careers of many junior and early-career scientists. In addition to working with and training her students to produce successful research and results, others mentioned how she would take the time to introduce students in her department to more established and prominent scientists in the field of cell biology. These actions reflected her belief that every student was worthy of being heard and introduced.

She held influential positions and advocated for more representation of women in science

At the time of her graduation from Johns Hopkins in 1952, she was one of only four women in her graduating class of 74 people. Afterwards, she experienced frequent moves for her career, going from Baltimore, to New York, to Boston. Despite how difficult it felt moving alone and leaving her personal relationships behind every time, she felt it was necessary for her career. In her mind, she strongly believed her research always came first, fueled by her intense desire to find answers, using the scientific approach.

She went on to serve as president for multiple professional societies, such as the American Association of Anatomists, the American Society for Cell Biology, and the Society for Developmental Biology, demonstrating her commitment to leadership and service. In two of these societies, she was the first woman to ever hold the position.

In 1975, she became the first female chair of what is now the Department of Cell Biology at Harvard University and held that position for 18 years. Even with these impressive milestones, she acknowledged one of her biggest obstacles to be achieving acceptance in the male professional world.

In 2004 and nearing retirement, Betty Hay would go on to say, I am very glad to see in my lifetime the emergence of significantly more career women in science, in an interview with editor-in-chief Fiona Watt for the Journal of Cell Science, this so enriches the intellectual power being applied to the field of cell biology.

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Bill Of The Month: Pricey Genetic Test For Essential Thrombocythemia : Shots – Health News – NPR

Michelle Kuppersmith's doctor recommended a bone marrow biopsy after suspecting she had a rare blood disorder. Though the biopsy was done by an in-network provider at an in-network hospital, Kuppersmith learned she was on the hook for $2,400 for out-of-network genetic profiling. Shelby Knowles for KHN hide caption

Michelle Kuppersmith's doctor recommended a bone marrow biopsy after suspecting she had a rare blood disorder. Though the biopsy was done by an in-network provider at an in-network hospital, Kuppersmith learned she was on the hook for $2,400 for out-of-network genetic profiling.

Michelle Kuppersmith feels great, works full time and exercises three to four times a week. So she was surprised when a routine blood test found that her body was making too many platelets, which help control bleeding.

Kuppersmith's doctor suspected the 32-year-old Manhattanite had a rare blood disorder called essential thrombocythemia, which can lead to blood clots, strokes and, in rare cases, leukemia.

Her doctor suggested a bone marrow biopsy, in which a large needle is used to suck out a sample of the spongy tissue at the center of the patient's hip bone.

Doctors examine the bone marrow under a microscope and analyze the DNA. The procedure allows doctors to judge a patient's prognosis and select treatment, if needed. Kuppersmith had heard the procedure can be intensely painful, so she put it off for months.

The biopsy performed by a provider in her insurance network, at a hospital in her network lasted only a few minutes, and Kuppersmith received relatively good news.

While a genetic analysis of her bone marrow confirmed her doctor's suspicions, it showed that the only treatment she needs, for now, is a daily, low-dose aspirin. She will check in with her doctor every three to four months to make sure the disease isn't getting worse.

All in all, Kuppersmith felt relieved.

Then she got a notice saying her insurer refused to pay for the genetic analysis, leaving her responsible for a $2,400 payment.

The patient: New York resident Michelle Kuppersmith, 32, who is insured by Maryland-based CareFirst Blue Cross Blue Shield. She works as director of special projects at a Washington-based watchdog group. Because she was treated in New York, Empire Blue Cross Blue Shield which covers that region handled part of her claim.

Total amount owed: $2,400 for out-of-network genetic profiling

The providers: Kuppersmith had her bone marrow removed at the Mount Sinai Ruttenberg Treatment Center in New York City, which sent her biopsy sample to a California lab, Genoptix, for testing.

Medical services: Bone marrow biopsy and molecular profiling, which involves looking for genetic mutations

What gives: The field of molecular diagnostics, which includes a variety of gene-based testing, is undergoing explosive growth, said Gillian Hooker, president of the National Society of Genetic Counselors and vice president of clinical development for Concert Genetics, a health IT company in Nashville, Tennessee.

A report from Concert Genetics, a company that helps clients manage genetic testing, found there are more than 140,000 molecular diagnostic products on the market, with 10 to 15 added each day.

The field is growing so quickly that even doctors are struggling to develop a common vocabulary, Hooker said.

Kuppersmith underwent a type of testing known as molecular profiling, which looks for DNA biomarkers to predict whether patients will benefit from new, targeted therapies. These mutations aren't inherited; they develop over the course of a patient's life, Hooker said.

Medicare spending on molecular diagnostics more than doubled from 2016 to 2018, increasing from $493 million to $1.1 billion, according to Laboratory Economics, a lab industry newsletter.

Charges range from hundreds to thousands of dollars, depending on how many genes are involved and which billing codes insurers use, Hooker said.

Based on Medicare data, at least 1,500 independent labs perform molecular testing, along with more than 500 hospital-based labs, said Jondavid Klipp, the newsletter's publisher.

In a fast-evolving field with lots of money at stake, tests that a doctor or lab may regard as state-of-the-art an insurer might view as experimental.

Worse still, many of the commercial labs that perform the novel tests are out-of-network, as was Genoptix.

Stephanie Bywater, chief compliance officer at NeoGenomics Laboratories, which owns Genoptix, said that insurance policies governing approval have not kept up with the rapid pace of scientific advances. Kuppersmith's doctor ordered a test that has been available since 2014 and was updated in 2017, Bywater said.

Although experts agree that molecular diagnostics is an essential part of care for patients like Kuppersmith, doctors and insurance companies may not agree on which specific test is best, said Dr. Gwen Nichols, chief medical officer of the Leukemia & Lymphoma Society.

Tests "can be performed a number of different ways by a number of different laboratories who charge different amounts," Nichols said.

Insurance plans are much more likely to refuse to pay for molecular diagnostics than other lab tests. Laboratory Economics found Medicare contractors denied almost half of all molecular diagnostics claims over the past five years, compared with 5-10% of routine lab tests.

With so many insurance plans, so many new tests and so many new companies, it is difficult for a doctor to know which labs are in a patient's network and which specific tests are covered, Nichols said.

"Different providers have contracts with different diagnostic companies," which can affect a patient's out-of-pocket costs, Nichols said. "It is incredibly complex and really difficult to determine the best, least expensive path."

Kuppersmith said she has always been careful to check that her doctors accept her insurance. She made sure Mount Sinai was in her insurance network, too. But it never occurred to her that the biopsy would be sent to an outside lab or that it would undergo genetic analysis.

She added: "The looming threat of a $2,400 bill has caused me, in many ways, more anxiety than the illness ever has."

The resolution: Despite making dozens of phone calls, Kuppersmith got nothing but confusing and contradictory answers when she tried to sort out the unexpected charge.

An agent for her insurer told her that her doctor hadn't gotten preauthorization for the testing. But in an email to Kuppersmith, a Genoptix employee told her the insurance company had denied the claim because molecular profiling was viewed as experimental.

A spokesperson for New York-based Empire Blue Cross Blue Shield, which handled part of Kuppersmith's claim, said her health plan "covers medically necessary genetic testing."

New York, one of 28 states with laws against surprise billing, requires hospitals to inform patients in writing if their care may include out-of-network providers, said attorney Elisabeth Benjamin, vice president of health initiatives at the Community Service Society, which provides free help with insurance problems.

A spokesperson for Mount Sinai said the hospital complies with that law, noting that Kuppersmith was given such a document in 2018 nearly one year before her bone marrow biopsy and signed it.

Benjamin said that's not OK, explaining: "I think a one-year-old, vague form like the one she signed would not comply with the state law and certainly not the spirit of it."

Instead of sending Kuppersmith a bill, Genoptix offered to help her appeal the denied coverage to CareFirst. At first, Genoptix asked Kuppersmith to designate the company as her personal health care representative. She was uncomfortable signing over what sounded like sweeping legal rights to strangers. Instead, she wrote an email granting the company permission to negotiate on her behalf. It was sufficient.

A few days after being contacted by KHN, Kuppersmith's insurer said it would pay Genoptix at the in-network rate, covering $1,200 of the $2,400 charge. Genoptix said it has no plans to bill Kuppersmith for the other half of the charge.

The takeaway: Kuppersmith is relieved her insurer changed its mind about her bill. But, she said: "I'm a relatively young, savvy person with a college degree. There are a lot of people who don't have the time or wherewithal to do this kind of fighting."

Patients should ask their health care providers if any outside contractors will be involved in their care, including pathologists, anesthesiologists, clinical labs or radiologists, experts said. And check if those involved are in-network.

"Try your best to ask in advance," said Jack Hoadley, a research professor emeritus at Georgetown University. "Ask, 'Do I have a choice about where [a blood or tissue sample] is sent?'"

Ask, too, if the sample will undergo molecular diagnostics. Since the testing is still relatively new and expensive most insurers require patients to obtain "prior authorization," or special permission, said Dr. Debra Regier, a medical geneticist at Children's National Hospital in Washington and an associate with NORD, the National Organization of Rare Diseases. Getting this permission in advance can prevent many headaches.

Finally, be wary of signing blanket consent forms telling you that some components of your care may be out-of-network. Tell your provider that you want to be informed on a case-by-case basis when an out-of-network provider is involved and to consent to their participation.

Bill of the Month is a crowdsourced investigation by Kaiser Health News and NPR that dissects and explains medical bills. Do you have a perplexing medical bill you want to share with us? Tell us about it here.

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Adventist Health, CancerIQ Collaboration Identifying More Patients for Guidelines-Supported Genetic Testing – Precision Oncology News

CHICAGO Adventist Health in Roseville, California, has expanded a program where they are more comprehensively evaluating patients in the primary care setting and within breast imaging centers for their inherited predisposition for cancer. Although using this strategy only a subset of patients will meet the criteria for genetic testing, the program is enabling the organization to better identify those who should be tested according to current guidelines.

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Rapid Results and More Screenings: New COVID-19 Tests Make Their Way to the Tri-State – NBC New York

What to Know

New coronavirus tests have sprung up in Long Island and New Jersey as the scientific community continues to do what it can to screen and diagnose COVID-19 cases as quickly and as efficiently as possible in an attempt to curb the spread of the virus.

Three Long Island urgent care locations are offering a test that is capable of delivering positive results of the coronavirus in as little as five minutes -- the first in the nation to provide the fastest available molecular point-of-care test.

American Family Care, the largest privately owned operator of urgent care and accessible primary care facilities in the United States, is the first health care provider in the nation to provide the rapid test for the detection of novel coronavirus (COVID-19) which delivers positive results in as little as five minutes and negative results in 13 minutes.

The three Long Island AFC Urgent Care locations began offering the rapid molecular testing as part of full examinations on Tuesday and will be testing patients on a regular daily basis starting Wednesday. The locations are:

However, the tests are only for symptomatic patients.Patients will be seen on a first come first serve basis. Only a limited number of tests can be performed at each location per day.AFC Urgent Care estimates up to 300 tests in total will be provided each day at these three locations combined.

AFC Urgent Care is also considering setting up exams and testing by appointment only. Patients are asked to visit location websites for up-to-date information and contact information.

"We are in the midst of a major health crisis, a pandemic, and testing provides an important tool for stopping the spread of the novel coronavirus. With Abbotts new molecular test, we have the capability of examining 2,000 patients each week at our three locations, Dr. Robert S. Levy, of American Family Care, said in a statement. Having results quickly provides important peace of mind for those who test negative and for those who test positive then know to immediately self-quarantine or seek further medical care.

Patients who are concerned that they may have coronavirus but are unsure of their symptoms are urged to call AFC Urgent Care to schedule an appointment to not overcrowd the locations. In some instances, patients may be pre-screened via a telehealth visit to determine if a novel coronavirus test is necessary.

On March 27, 2020, the U.S. Food and Drug Administration (FDA) granted emergency use to Abbott Laboratories for its rapid COVID-19 test for doctors offices and urgent care centers.

U.S. intelligence officials are accusing China of concealing the extent of the coronavirus outbreak. NBC New York's Jonathan Dienst reports.

The Food and Drug Administration issued emergency use authorization for the point-of-care test on Friday, the company saidin a statement.

Abbot Laboratories -- a Lake Bluff, Illinois, company makes diagnostics, medical devices, nutritionals and medicines -- said it plans to ramp up manufacturing so it can deliver 50,000 tests per day.This is the second Abbott test for the coronavirus to be launched. Between the two, the company expects to produce about 5 million tests per month, according to a company statement.

Meanwhile in New Jersey, Rutgers University launched a genetic testing service for the novel coronavirus allowing for thousands of samples to be analyzed daily.

RutgersRUCDR Infinite Biologicshas launched a test for the SARS-CoV-2 coronavirus and is using its automation experience and infrastructure to test as many as tens of thousands of samples daily.

A man in the UK is dressing up as Spider-Man to cheer up kids stuck inside during the coronavirus pandemic.

Additionally, RUCDR has also submitted an emergency use authorization request for a saliva collection method that will allow for broader population screening.

This effort will provide information that allows people who test positive to self-quarantine and, in turn, limit the spread of the virus.

The test is based on a Nobel Prize-winning laboratory technique that makes millions of copies of the SARS-CoV-2 virus nucleic acid (in this case RNA) in a sample. Testing a nasal or throat swab sample determines whether someone is infected, with results available to providers within three days. Saliva testing would be a new development and would allow testing without the need of a medical provider to take the sample. These alternate options will allow access of testing and screening to the most needed population.

The test is currently available to theRWJBarnabas Healthnetwork, which has partnered with Rutgers University, and includes Rutgers Robert Wood Johnson University Hospital, University Hospital in Newark and many other facilities including several county health departments.

The rapid deployment of the test throughout the state is a consequence of a partnership between RUCDR andAccurate Diagnostic Labs(ADL). RUCDR and ADL have a long-standing relationship where ADL provides reference lab services for RUCDR, which facilitates clinical trials that RUCDR supports.

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An antibody test for the novel coronavirus will soon be available – The Economist

Apr 2nd 2020

Editors note: The Economist is making some of its most important coverage of the covid-19 pandemic freely available to readers of The Economist Today, our daily newsletter. To receive it, register here. For more coverage, see our coronavirus hub

WHEN A NEW virus invades the human body, the immune system leaps into action. First to the scene are antibody molecules of a type called immunoglobulin M (IgM). These bind with proteins on a viruss surface, disabling it and marking it for destruction by cells called macrophages. A few days later the system produces a second type of antibody, immunoglobulin G (IgG), to continue the fight. IgMs are short-lived. They stick around in the bloodstream for three or four weeks before disappearing. IgGs, however, are the basis for a much longer-term form of immunity. This can last for many years, or even a lifetime.

Kits that test for these two types of antibodies when they have been raised specifically by SARS-CoV-2 should soon become available. The virus causing the covid-19 is already being detected with genetic tests, which look directly for current signs of infection in nasal or throat swabs. Tests to detect antibodies will also be able to identify those who have had infections in the past and may now be immune. In the short term, this will be important because it will permit the authorities to identify who may return to their jobs without risk of infecting others. That is particularly valuable in the cases of doctors, nurses and the numerous other health-care workers needed to look after those who are seriously ill. It will also help in the longer run, by revealing how far the virus has spread through a population, and thus whether or not herd immunity is likely to have built up. Herd immunity is the point where insufficient infectible individuals remain in a population for a virus to be able to find new hosts easily, and it is therefore safe to lift social-distancing and stay-at-home rules.

SARS-CoV-2 antibody tests have already been deployed in limited numbers in China, Singapore and South Korea. Several Western governments, including those of America and Britain, have been buying up millions of surplus antibody tests from China for use in their own countries. Several other types of these tests have also been developed by companies around the world. None, however, has yet been approved for widespread usefor, though such tests are reasonably easy to manufacture, ensuring that they give useful and reliable results is taking a lot of effort.

Each different design of test uses its own recipe of chemicals and processes. Physically, however, many resemble the self-contained plastic sticks employed in the version made by Biopanda Reagents, a British firm. A user first pricks a fingertip. Then he or she introduces a few drops of blood into an opening at one end of the stick. Inside, the blood goes through a series of chemical processes that can identify particular antibodies. It takes around 15 minutes to get a result, and this is displayed in a similar fashion to that used by a typical pregnancy testthe positive identification of an antibody resulting in a coloured line next to its label on the test stick.

There are three interesting signals. A solitary positive for IgM means the person has had a very recent (potentially current) infection. Positives for both IgM and IgG mean the user was infected some time within the past month. A positive for IgG alone means that the infection occurred more than a month ago, and the user should now be immune to a repeat of it. (A negative result probably means no infection, though it could also mean that it is too early in the course of an infection for antibodies to have appeared, since the first IgMs typically turn up only 7-10 days after an infection has begun.)

Before regulators can approve a test for widespread use, they need to validate it. How useful it is can be summarised by two numbers determined during this validation: its sensitivity and its specificity.

A tests sensitivity refers to how good it is at detecting the thing it is meant to detectin this case the IgM and IgG antibodies associated with SARS-CoV-2. A sensitivity of 95% means that, from 100 blood samples known (by other means, such as previous genetic testing) to be infected, the test will reliably tag 95 correctly as having the pertinent antibodies. The remaining five would be identified as having no antibodies presentin other words they would be false negatives.

The other significant number, a tests specificity, measures how good that test is at detecting only the antibodies it is meant to detect. There are seven human coronaviruses and, ideally, a test would detect only antibodies produced in response to SARS-CoV-2. A test with 98% specificity means that, of 100 known uninfected blood samples, 98 will come back (correctly) as negative and the final two will come back (falsely) as positive. Such false positives could have many causes. A common one is cross-reaction, in which a test responds to the wrong antibodies.

To work out a tests sensitivity and specificity, it needs to be checked against hundreds of samples of known status. Given the novelty of SARS-CoV-2, and therefore the lack of easy access to relevant blood samples, this takes time. The British and American authorities are assessing several tests, but have released no validation data as yet, and have been tight-lipped about when they will do so.

An ideal test would be 100% sensitive and 100% specific. In reality, there will always be a trade-off between the two. Make a test acutely sensitive, so that it gives a positive signal with even the tiniest amounts of a relevant antibody present, and it will get less specific. This is because such a fine chemical hair-trigger is likely to be set off by antibodies similar to, but not identical with the target. And vice versa.

This trade-off is not always a bad thing, for it allows different sorts of test to be used in different circumstances. For example, if the intention of testing is to identify doctors and nurses who have antibodies to SARS-CoV-2, so that they can safely return to work with infected patients, because they are themselves now immune to infection, then the most important thing is for a test to have a low rate of false positives. In other words, it needs a high specificity.

By contrast, if the idea is to gather transmission data, sensitivity is the priority. If someone were identified as having had an infection, further tests could trace which of that persons acquaintances were also infected, or had once been infected and were now immune. In these circumstances, a few false positives would not be a disaster. They would probably show up eventually, because those around the allegedly infected individual would not be infected as often as expected. A false negative, though, would mean lost information and a consequent lack of contact-tracing. That would be significant.

Testing of this sort will let doctors understand how a local cluster of infections grows, and therefore what action to take in order to break the chain (meaning, in practice, who needs to be quarantined). This kind of contact-tracing and isolation has been employed to great effect in South Korea through the use of genetic tests for the virus. Antibody tests will enhance the process, by capturing data on those infected in the past as well as the present.

Children are another group who could profitably be monitored using antibody tests. It is now well established that they are less likely than adults to present the symptoms of covid-19, and rarely suffer severe disease. It remains unclear, though, to what degree they are being infected silently, and are thus able to pass the infection on to others around them while apparently remaining healthy themselves. Antibody tests will reveal a fuller picture.

Antibody tests will no doubt also be in demand from members of the public wanting to know their immune statusfor their peace of mind if nothing else. This might be cause for conflict. Even when they are cleared for general use it will take time for manufacturers to ramp up the production of tests, and those working in health care and one or two other important areas, like teaching, policing and delivering groceries to stores and markets, will surely be at the head of the queue to be tested. It is therefore hardly surprising that unvalidated kits, purportedly for domestic use, are already being offered for sale by unscrupulous online suppliers. Britains medical regulator, for one, has had to take down several fraudulent websites and is warning people not to use any home-testing kits they find being sold online.

Even when more kits do become available (and with due acknowledgment to the different putative uses of different sorts of test) the next goal for most countries after protecting crucial members of the workforce will be population-level surveillance. This will, as a by-product, provide information to individual members of the public. But its primary purpose will be to track how the epidemic is progressing.

One of the most important elements of this analysis will be determining the rate of silent infectionwith all the implications that brings for herd immunity. Comparing recent test data from the Netherlands and Iceland hints at the gap in current knowledge of just how much silent infection there may be. Both countries use genetic testing for the virus, but the Netherlands only tests those with severe symptoms of covid-19, whereas Iceland has been testing widely, even people without symptoms. Unsurprisingly, but crucially, the Icelandic approach has revealed far more infections in younger people than the Dutch one (see chart). Moreover, according to Kari Stefansson, who is leading the Icelandic project, 50% of those who have tested positive reported no symptoms.

Mass testing will be laborious. It will mean taking regular blood samples from millions of people, even though the actual analysis will be done by robots in centralised high-throughput laboratories. To save effort, such projects might piggyback on a countrys blood-transfusion services, for donated blood is already subject to rigorous screening for pathogens.

German scientists have announced plans to start, this month, a reasonably large-scale surveillance project. It will monitor blood samples taken regularly from 100,000 participants. Those proving immune may be given a certificate exempting them from restrictions on working or travelling. If nothing else, that would certainly be an incentive to sign up.

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This article appeared in the Science and technology section of the print edition under the headline "Testings testimony"

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Why has the UK lagged behind in testing for the coronavirus? – The Guardian

Unlike some countries, we didnt go into this crisis with a huge diagnostics industry. We have the best scientific labs in the world, but we did not have the scale, Matt Hancock said this week, facing a barrage of questions on why the UK is lagging behind others on coronavirus testing.

The UKs health secretary said his German counterpart could call on 100 test labs and rely on the heavy presence of Roche, one of the worlds largest diagnostics companies, to achieve its current level of more than 50,000 tests a day. The UK had had to build from a lower base, he said.

Industry players say this is a fair characterisation. We have a lot of diagnostics capability in this country but what we dont have is the global diagnostics giants, said Tony Cooke of Cambridge Clinical Laboratories. Even when we have our own companies, a lot of the supplies are coming from the US or Germany.

The UK is not alone in struggling to meet demand. France has carried out even fewer tests than the UK, and Spain tried to bridge supply chain issues by buying millions of test kits from China that later had to be withdrawn after giving flawed results.

As well as Roche, which has developed a single machine that can churn out 1,000 test results a day, Germany also has Qiagen, a major supplier of genetic testing kits, which are being used to diagnose Covid-19. Both companies also produce reagents and components used in kits put together by other manufacturers. The US has called on Abbott, Thermofisher, Quest Diagnostics and Hologic.

The more distributed hospital lab system in countries such as Germany and Italy has also served them well in being able to increase testing for Covid-19. The NHS has spent years centralising its testing labs, which under normal circumstances was both economical and clinically robust. It has allowed labs to be aligned to standard diagnostic criteria and to use the same test kits, reagents and equipment from the same suppliers, allowing bulk purchases from single suppliers at a competitive price.

During a pandemic, however, this dependency on a handful of non-domestic suppliers, such as Roche, for kits and reagents becomes a fundamental flaw.

Allan Wilson, the president of the Institute of Biomedical Science, says the UK could have done a better job of surveying its diagnostic landscape and built a strategy around existing strengths, which include having a large number of research labs and smaller, but highly innovative diagnostics companies.

The re-engineering of HIV testing machines into 90-minute Covid-19 tests by Diagnostics for the Real World in Cambridge, which within a week will meet the entire testing requirements of Addenbrookes hospital in the city, is an example of the type of approach that could have been encouraged nationally.

We were slow to make that decision in testing and we approached it in too narrow a perspective, said Wilson. Were doing it regional locally, people forming and forging partnership arrangements, looking for support from universities and commercial companies.

Industry figures say that more could be done in future to nurture some of these startups and medium-sized companies into home-grown giants.

There is a record to show that innovative businesses started in the UK have this potential, but that beyond a certain level of success the companies tend to migrate to the US where venture capital and buyers are in more ready supply.

Medisense, which was spun out of Oxford University in the 1990s, revolutionised the blood glucose sensing industry in the 1990s, then was acquired by the US company Abbott. Solexa, a genetic sequencing company spun out of Cambridge, was acquired by Illumina in the US for about $650m in 2007 and is now worth about $40bn.

Gordon Sanghera, the chief executive of the sequencing and diagnostics company Oxford Nanopore, whose technology was used to characterise the very first example of the coronavirus in Wuhan, said Hancocks acknowledgement of the need to nurture a domestic industry was welcome and should not be forgotten after the crisis has passed.

Hancocks declaration that the UK needs a new diagnostic industry is right, and we have plenty of seeds, he said. Its the collaboration with the broader scientific community, and looking at access to capital for UK companies, that will make those seeds grow and bear fruit that helps people not only in the UK, but all around the world.

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We need to know who has had coronavirusnot just who has it now | Letters – Tampa Bay Times

How many have been infected?

I thank Dr. Charles Lockwood for his illuminating column. We must never forget that there are health as well as economic consequences in our efforts to combat this pandemic. He explains a crucial, but commonly misunderstood, point: What matters is the number of infections. We cannot know that until antibody tests become available. Estimating actual infections would inflate the numbers manifold, but would also provide the reassurances that many exposed are not infected, many infected are not sickened, many sickened are not threatened, and all except the smallest fraction survive with immunity, which will thwart further transmission considerably. Dr. Lockwood also clarifies the limitations of genetic testing, which has been widely misunderstood. It is of virtually no use to the individual. It is helpful to the community only when is integrated into systematic, gumshoe epidemiology where the test is only a lead into investigating and segregating the infected persons network of contacts. We will regret this misunderstanding. There was a time when tens of thousands of test kits focally applied to the initial set of hot spots, fully integrated into the investigative and segregation process and sustained until only embers remained, would have produced a different picture than we see today. Look at the numbers from South Korea, Singapore and a few other places to quantify my meaning and understand that they did not just test more. We are now testing more than they and now need tens of millions of kits. But we might not have had to do so with their snuffing rather than our flattening approach.

Pat Byrne, Largo

Thank you, Dr. Charles Lockwood, for highlighting the difference between reported coronavirus cases and the number of residents who are likely infected, but have only mild or no symptoms yet. People can be infected and contagious but have few symptoms for days, which gives people a false sense of wellness. Given the current level of testing, objective epidemiologists estimate that for every case reported by officials, there are likely 60 more in the community who are infected and contagious.

Robert More, Riverview

For those who choose to not practice social distancing by going on cruises, traveling, going to church, etc., I suggest a national database (lets call it the idiot database) of all who are caught. Then, when we have to make the hard decision of who gets medical care and who doesnt, it will be so much easier. If you are on the idiot database, you are excluded from medical care and basically on your own.

Leslie Moore, Weeki Wachee

Shutting down the state will accomplish little. Such an action would take its place alongside the texting-while-driving law, making us feel better to be doing something, while really doing nothing. People with average maturity and common sense will do the right without being threatened, while the self-absorbed will do whatever satisfies their immediate needs.

John Weiss, Spring Hill

We must not place our personal concerns ahead of those on the front lines and deplete supplies of personal protective equipment. But while a scarf or bandanna may not protect me from much, they do remind me not to touch my mouth and nose.

Jan Hyink, Seminole

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How Much Does in Vitro Fertilization Cost? – The Real IVF Cost Breakdown – GoodHousekeeping.com

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The question of the cost of in vitro fertilization is not a simple one. There are so many little factors that go into determining the cost, both from the patient (age, medical history, etc.), and from the procedural side (medications, monitoring, egg retrieval, and so on.). It all adds up. "The answers swing wildly when it comes to the price of in vitro fertilization," says Elyse Ash, founder and CEO of Fruitful Fertility, a fertility mentoring service.. "Mostly it depends on where you live, what types of procedures you're doing, which clinic you go to, and what kind of insurance you have."

Still, it's helpful to know what to expect before you start going down the IVF path so you can make a rough financial plan. Here are some of the costs to consider.

The types of procedures used, and hence the cost, vary from patient to patient. "Factors include patient age and past medical history, especially infertility history, which helps the doctor to determine what type of stimulation is best," says Dr. Alvin Gordon, M.D., the Chief Operating Officer of New Hope Fertility Center.

Once a patient history is taken, the medical team can determine if the best course of action is to do a conventional IVF, or if they qualify for something like New Hope's Natural Cycle IVF or Mini-IVF, which do not require as many fertility medications and are therefore less expensive.

There are other, personal choices that can affect the prices well. For example, "If the patient has low tolerance for pain and requires general anesthesia for the egg retrieval," Dr. Gordon says, "there's an additional cost for the anesthesiologist to administer the anesthesia."

When all is said and done, a plan is drawn up that includes monitoring, medication, egg retrieval, fertilization, caring for and storing the embryos, and possibly genetic testing, all of which come with their own price tags. According to the National Conference of State Legislatures (NCSL) which keeps track of state laws regarding fertility treatments, this all usually works out to somewhere between $12,000 to $17,000 per cycle of IVF. But again, this varies by state, by patient, and by procedure.

Dr. Gordon offers this as the approximate cost breakdown for in vitro fertilization:

In many instances, insurance can cover all or part of the costs of IVF. You can check the NCSL website to see if there are laws governing whether or not insurance has to offer coverage. These laws also vary widely: New Jersey, for example, requires health insurers to provide coverage for the diagnosis and treatment of infertility (including in vitro fertilization), while Arkansas says its state's Comprehensive Health Insurance Pool cannot include coverage for any expense or charge for in vitro fertilization, artificial insemination, or any other "artificial" means used to cause pregnancy.

When dealing with insurance, it's wise to make sure you understand exactly what it will cover beforehand to prevent sticker-shock after the fact. That means asking them separately about the medications, retrievals, transferring, testing, and monitoring, because insurance may cover some but not all of these things. Also, some insurance companies state that a couple must prove that they've had infertility for a certain number of years before they cover IVF (according to state laws in Texas and Hawaii, a couple must show they've been dealing with infertility for five years).

Apart from insurance, couples can also apply for grants to cover IVF treatments or look for treatment centers that are grant-winners. "We're the recipient of an infertility grant from the Department of Health, which provides income-based assistance to patients who do not have insurance coverage," Dr. Gordon says.

This, of course, does not include the cost of missed work to perform the procedures, prenatal care, or the labor and delivery that happens after IVF is successful costs that parents-to-be also have to plan for when creating a financial map to increasing their family.

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Sleep is the most underrated antioxidant – Times of India

Have you ever wondered what is the importance of day and night, what is the role of sleep, how do we set a good circadian rhythm?? Well all this revolves around the hormone Melatonin!!Setting up the circadian rhythm helps in production of good amounts of melatonin hormone. Melatonin does help in reducing the pigmentation, anti ageing and also reduces hair fall so on and so forth..Dr. Pallavi Sule, Mumbai based Dermatologist and Aesthetic Physician starts by first explaining the meaning of Melatonin, HOW DOES MELATONIN GET SECRETED?

So what's new about this hormone and why is it studied in more detail than before??

Dr. Pallavi Sule, explains, "Melatonin is also known for its antioxidant benefits!! We all are living in a very stressful environment, be it the external or internal stressors like pollution, food consumed (adulteration), solar radiation, sleep patterns, work environments and so forth!! Any kind of stress releases free oxygen radicals in the body, which damages our DNA, causing degenerative diseases and autoimmune diseases. Melatonin hormone serves as a potent antioxidant, presumptive anti aging substance and anti cancer agent."

Dr. Sule further elaborates on this imperative subject saying, "

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The Komen Columbus race is postponed, but heres how its still helping patients – Columbus CEO

Komen is providing breast cancer patients with transportation, food delivery and other resources to meet critical needs during the stay-at-home order issued by Gov. Mike DeWine.

One of Downtowns most visible, crowd-drawing events is on the postponed list. But the needs of the cancer patients it serves are not.

Citing concerns for the health and safety of participants, supporters and staff, Susan G. Komen Columbus recently decided to postpone the 2020 Komen Columbus Race for the Cure scheduled for May 16. The event is the largest Race for the Cure in the United States. Last year it drew more than 21,000 participants.

With its primary fundraiser on hold, Komen still tends to the real-time needs of people living with breast cancer. Were hoping we can still see pink. We have a vision for an actual race, says Julie McMahon, Komen Columbus interim executive director. But our primary mission is to help women today.

McMahon says Komen still provides transportation, food delivery and other resources to meet critical needs during the stay-at-home order issued by Gov. Mike DeWine. It is launching programs to provide special support to immunosuppressed patients so their treatment isnt disrupted, using sources like Uber Health for transportation and Amazon delivery for food.

Komen Columbus is hosting virtual support groups and wellness activities such as yoga and coping skills education, and its Facebook page livestreams content as well. This is only made possible by our tens of thousands of supporters here in Central Ohio. Our partners and sponsors have been amazing, McMahon says.

The Komen website details information on its response to the pandemic.

The organization is helping breast cancer patients grapple with unanswered questions, such as whether their treatment protocol makes them especially vulnerable at this time. For example, McMahon says, most hormone therapy does not cause immunosuppression, while most chemotherapy does. Its also talking with clients about whether treatment can be paused or delayed. For people about to start treatment, this is especially scary, she says.

She says the information provided by Komen is by no means medical advice but offers general guidance about questions that may be on patients minds or things to consider. Of course, you consult with your physician on your personal treatment.

Komen is guiding women on postponing routine screening mammograms so those resources can be targeted directly toward patients now undergoing treatment.

The re-allocation of resources now required during a world pandemic has immediate consequences for patients who are relying on clinical trials to give them hope. Research is affected, and many clinical trials are at a halt for women with no remaining options, McMahon says. We pray for them, and we pray with them.

Last years local Race for the Cure raised more than $1.3 million last yearwhich represents about 80 percent of the organization's annual budget. It uses the funds for education, screening and research. Money also is used for community outreach and programing for underserved and uninsured women.

The organization was about to host another fundraiser when Ohio Health Director Dr. Amy Acton closed the Arnold Expo and Classic to most spectators and visitors. When the CDC issued guidelines that limited gatherings to 50, we were very concerned. We want to be leaders and show how important we think this is, says McMahon, who has a background in public health and epidemiology.

The decision to postpone major events threw crucial fundraising support into a tailspin that will reverberate for months or years to come. We cant stop fundraising right now, but it will look differently. The Race for the Cure sustains us year-round. Its going to be difficult for us moving forward.

Laurie Allen is a freelance writer for Columbus CEO.

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5 Expert-Approved Supplements to Boost Your Immune System (and Beauty Routine) – STYLECASTER

The clich health is wealth mantra is timeless and now, more important than ever. Immune system supplements are flying off shelves and everyone (including myself) wants to do everything in their power to avoid illness and seasonal issues like allergies and the flu. But not so fast. Straight-forward as it may appear, its vitally important to remember that supplements made specifically for supporting your immune system arent a magic bullet cure for anything, though taking one certainly isnt a bad idea either.

Your immune system, aka the part of your body that helps prevent disease and illness, is composed of many, many cells and chemicals that work together toward one common goal. The upside of attempting to bolster this singular system is that there is actually more than one way to do it. Outside of the always-recommended healthy eating/drinking and daily exercise guidelines are supplements with the potential to give your body an extra layer of security against the bad stuff. Of course, its best to consult with a physician before starting one (especially if you have a health condition or take prescribed medication), but there are some options that are generally okay for most of us to try.

As someone who swears by daily supplements but definitely isnt a doctor, I knew getting the 411 on immune system boosters from Dr. Josh Axe, D.N.M., C.N.S., D.C was a smart move. The best-selling author just so happens to be the founder of Ancient NutritionandDrAxe.com, two very popular destinations that thankfully still have plenty of immune boosters in stock. Keep scrolling for his top-recommended options and why you need each one.

Ancient Nutrition.

Immune health is tied to gut health there are no two ways about it. Today, we know your gut houses between 70 percent and 80 percent of the cells that make up your immune system, which is why I believe maintaining the integrity of the gut is a crucial, and often underappreciated, form of supporting your immune system health. And this is nothing new. Theres a reason cultures all around the world relied on probiotic-rich, fermented foods like kefir, sauerkraut, kimchi, yogurt and apple cider vinegar over the centuries. In general, probiotics possess the capacity to support healthy immune system function and more.

Choosing survivable probiotic strains, though, is key in my viewpoint, because these strains are known to survive higher temperatures and a harsh environment (i.e., stomach acid). So while you may think you need to choose probiotics that require refrigeration, that isnt necessarily true. Our bodies generally run at 98.6 degrees Fahrenheit, so we selected hardy, no-fridge-required probiotic strains for Ancient Probiotics-Immune so they can make it to your digestive tract.

NutriFlair.

How many times growing up did your mother remind you to get enough vitamin C? Kiwi fruit, spinach, strawberries, oranges, and black currants serve as rich natural sources, but for times when you need more, we created a body-ready capsule version. (Editor note: Alternative above until Dr. Axes recommendation is back in stock.)

Ancient Nutrition.

One-third of Americans take multivitamins to help fill nutritional gaps, but how those vitamins are created varies greatly. Some contain filler ingredients, food dyes, artificial sweeteners, GMOs and even synthetic nutrients. These ingredients are often cheaper than sourcing the real thing, but I believe in feeding the body with what it knows and recognizes: whole food sources. Thats why our multivitamin helps you build a foundation with food-based ingredients and no fillers or synthetic ingredients, ever.

Solgar.

Vitamin D is involved with healthy immune system function, and our immune cells actually contain receptors for this vitamin. We can get vitamin D from foods like wild-caught salmon, beef liver and egg yolks, and our bodies naturally manufacture vitamin D, which is actually a hormone, with sun exposure.

But according to National Health and Nutrition Examination Survey statistics, were falling short. More than 90 percent of people with darker skin pigments living in the United States now suffer from vitamin D insufficiency, while 75 percent of the white population is deficient. Of course, this is one statistic, but the bottom line is that we are often coming up short on vitamin D.

Ancient Nutrition.

An essential trace mineral involved in hundreds of enzymatic functions in the body including supporting healthy immune system functions zinc plays a crucial role in overall wellness. Generally speaking, zinc catalyzes nearly 100 enzymes and is essential for proper protein synthesis in the human body. Zinc supports immune system health in its own right and also relies on vitamin C to maximize its role in the human body.

As humans, we need to take in zinc each day because our body doesnt manufacture it. Zinc-rich foods, including pumpkin seeds, lentils, chickpeas and cocoa powder, can help us get the zinc we need, although animal sources like grass-fed beef or kefir are often more bioavailable in the body. If supplementing is what youre looking for to hit your zinc goals, I recommend my supplement below because it pairs organic vitamin C with zinc to support zincs potential.

Our mission at STYLECASTER is to bring style to the people, and we only feature products we think youll love as much as we do. Please note that if you purchase something by clicking on a link within this story, we may receive a small commission of the sale and the retailer may receive certain auditable data for accounting purposes.

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What you need to know about your thyroid | News, Sports, Jobs – Lock Haven Express

Family Features Michele Adams is quick to say, I dont want to throw anyone under the bus, but it took her being hit by a car for her thyroid disease to finally be diagnosed.

Adams has always been an active person, but for a few years, she had felt tired and had a constant tightness in her throat. She was diagnosed with post-nasal drip but did not feel relief after a year of treatment.

I thought this exhaustion, hoarse voice and lump in my throat were just my new normal, Adams said. Id accepted it, and I shouldnt have.

During this time, Adams went on a bike ride in northeastern New Jersey something she still does frequently. However, on this day, Adams was struck by a car as she was biking.

The incident resulted in an MRI scan. Adams was not seriously injured, but doctors noticed something unexpected. The scan revealed nodules in her lower neck, which suggested thyroid disease?.

I now realize I had symptoms of a thyroid condition for years, Adams said. Id had it up to here with not feeling like myself. Once I had the MRI results, I knew to seek out a thyroid expert, and I found an endocrinologist.

What you probably do not know about your thyroid

Thyroid disease is more common than diabetes and heart disease, but more than half of Americans with thyroid disease are unaware, according to the American Association of Clinical Endocrinologists (AACE). This lack of awareness can endanger a persons health and well-being.

The thyroid is a butterfly-shaped gland located low in the front of the neck below the Adams apple. It produces thyroid hormones that influence almost every cell, tissue and organ in the human body.

Common signs of thyroid diseases include:

Unexplained changes in weight

Depression, anxiety or feelings of irritability

Changes in memory or ability to concentrate

Joint or muscle pain or weakness

Fatigue or trouble sleeping

Fast or irregular heartbeat

Irregular menstrual periods

Cheryl Rosenfeld, D.O., is a thyroid expert and AACE member. Rosenfeld is also the physician who treated Adams thyroid disease.

If the thyroid does not function correctly, it can affect every possible aspect of a persons life, Rosenfeld said. Remember that thyroid conditions can cause changes in mental health, including depression. Ive also spoken to patients whove experienced an inability to concentrate, which seriously affected their performance at work.

Several disorders can arise if the thyroid produces too much hormone (hyperthyroidism) or not enough (hypothyroidism).

Other thyroid diseases include:

Nodules

Thyroid cancer

Graves disease

Hashimotos thyroiditis

Thyroid eye disease

Undiagnosed thyroid issues can also place a person at increased risk for heart disease, osteoporosis, infertility and other serious conditions.

What to do if you are up to here with not feeling like yourself

Once I was placed on treatment for Hashimotos and hypothyroidism, my life changed completely, Adams said. My throat is no longer sore, and Im able to go out with my family or spend time at the gym without feeling completely drained of energy.

The first step to ensure your thyroid gland functions properly is to speak with a health care provider about your symptoms and whether a thyroid test is needed.

An endocrinologist is a specially trained doctor who is qualified to diagnose and treat hormone-related diseases and conditions, including thyroid cancer and all other diseases related to the thyroid gland.

Visit thyroidawareness.com to learn more about thyroid health.

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BY JEFFREY L. BAYLIFFDuring our virus closures and movement restrictions I thought it would be a perfect time to ...

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ENDO Online 2020: The Top Diabetes News From March 30 – Everyday Health

In light of the COVID-19 pandemic, ENDO 2020, the annual meeting of the Endocrine Society, was postponed until June 2020. In lieu of the meeting, which was originally scheduled for March 2831, 2020, in San Francisco, organizers held virtual news conferences March 30 and 31 to share the latest emerging science in endocrinology. All ENDO 2020 studies will be published in a supplemental issue of the Journal of the Endocrine Society.

The worlds first use of a drone to deliver insulin to a patient living in a remote community was performed late last year in Ireland, an accomplishment that has implications for wider use of drones to deliver medications in trying circumstances. Such circumstances might include infectious-disease pandemics like the COVID-19 outbreak.

An international team of researchers spent a year planning the drone test flight from Galway, Ireland, to the Aran Islands, about 12 miles off the west coast of Ireland. The drone was used to drop off insulin and return with the patients blood sample so that a doctor could check the patients glucose levels, says Spyridoula Maraka, MD, an endocrinologist at the University of Arkansas for Medical Sciences and the Central Arkansas Veterans Healthcare System in Little Rock.

The project was conceived after healthcare professionals in Ireland noted the difficulties people faced obtaining critically needed medications during a 2017 hurricane and a 2018 blizzard in Ireland, Dr. Maraka says. People with diabetes who require insulin could fall critically ill if they run out of their medication, she says. Drones are already used in remote parts of Africa to deliver blood supplies.

Medicine has a track record of practicing for emergencies before they happen, Maraka said. There are multiple medical delivery drone opportunities.

Irelands Diabetes Drone Mission was launched with a team of experts across different fields, including medical, pharmaceutical, technical, flight operations, telecommunications, and regulatory agencies. The team selected a Wingcopter 178 drone for the first flight and received Irish Aviation Authority approval to conduct the mission.

The team plans to scale up the program to deliver medications to remote areas in the future. It will be important to gain the publics confidence in the program, as well as negotiate with airspace authorities to allow delivery access, Maraka says. That may be challenging in more densely populated areas.

RELATED: 9 Diabetes Care Tips During the COVID-19 Pandemic

A common chemical called PFAS detected in the blood of pregnant women is linked to a higher risk of obesity in their granddaughters. PFAS per- and polyfluoroalkyl substances are man-made chemicals used as oil and water repellents and coatings for common products including cookware, carpets, and textiles, according to the Environmental Protection Agency. They are known as endocrine-disrupting forever chemicals because they persist when released into the environment and accumulate over time.

The study, by researchers at the Public Health Institute in Berkeley, California, featured an analysis of data from a project known as the Child Health and Development Studies. Blood samples from pregnant and postpartum women in the 1960s were collected and stored. In the early 2000s, the researchers measured the weight, height, and waist circumference of a subset of the study participants daughters and granddaughters. They determined the risk of total obesity and abdominal obesity in the daughters and granddaughters. The study included 213 sets of grandmothers, mothers, and granddaughters. The California Department of Toxic Substance Control then measured PFASs and other chemicals in the stored blood of the grandmothers.

The study showed that a granddaughters combined risk of abdominal and whole-body obesity increased 53 percent with a doubling of PFAS blood levels in her grandmother, when her grandmother also had lower cholesterol (in the bottom 25 percent). This translated to an estimated 2.3-fold increase in the combined risk of abdominal obesity and whole-body obesity for women whose grandmothers were in the top 25 percent of PFAS exposure compared with the bottom 25 percent of PFAS exposure. Cholesterol is somehow involved in the transport and metabolism of the chemicals, the researchers note.

Pregnancy appears to be based on our study and animal research and other work in progress a critical window of exposure for three generations in humans, says the lead author of the study, Barbara A. Cohn, PhD, the director of Child Health and Development Studies, who is based in Oakland, California.

These findings may help to explain the current U.S. and worldwide increases in obesity in young adults, she says. We dont understand the mechanisms for this association. We do know it has implications for the current epidemic of obesity if this can be confirmed.

Consumers can reduce their exposure to the chemicals by avoiding eating out of take-out and to-go food containers and using glass or stainless steel food storage containers. Another source of exposure is stain- and water-resistant carpet.

But, she says, Personal measures probably are not going to be enough because, like other legacy compounds, they have been so ubiquitous. There is so much everywhere.

RELATED: New Report Finds Toxic Forever Chemicals in Drinking Water in 31 States

People with diabetes who have a stroke have a better chance of preserving cognitive function if they have good blood glucose control after the stroke, according to a study from the Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University in Israel.

The study involved patients who had lacunar strokes, which are a common type of stroke that occurs in a blocked artery deep within the brain. The stroke can cause neurological damage. Researchers looked at 942 adults with diabetes who had a lucunar stroke to assess their A1C management following the stroke. A1C is a measurement doctors use to assess how well a person with diabetes is managing his or her glucose. Its also used to diagnose diabetes, according to the Centers for Disease Control and Prevention. The study showed better glucose management was linked to greater cognitive function and less cognitive decline. The research was observational, meaning that it only links better glucose management with cognitive benefits following stroke. A clinical trial could help prove a causal effect between the two, the authors said.

Still, Understanding potentially modifiable risk factors has large public health implications. One such factor may be A1C control, says the study's lead author, Tali Cukierman-Yaffe, MD, a physician and researcher at the Sheba Medical Center and the Sackler School of Medicine of Tel Aviv University. For example, she says, It may be that individuals with cognitive impairment who have difficulty managing their disease would have worse glucose control.

Current medical recommendations urge healthcare providers to screen older people with diabetes for cognitive impairment, she notes.

Cognitive assessment should be part of the routine checkup of older people with diabetes, she said. The reasons for that are, one, the relationship between cognitive dysfunction and diabetes self-care; and the other is that cognitive function is another complication of diabetes that we should be looking for.

RELATED: Why Some Researchers Are Calling Alzheimers a Type 3 Diabetes

A minimally invasive endoscopic technique that has been approved in Europe can help people with poorly managed type 2 diabetes improve their A1C. The procedure, called Revita duodenal mucosal resurfacing (DMR), has not been approved for use yet in the United States.

During the procedure, doctors insert a balloon catheter through the mouth into the duodenum, which is part of the upper small intestine. They deliver thermal energy to remove or ablate the duodenal lining. After the damaged duodenal lining is removed, a new layer of tissue eventually forms.

Data from a new study of 70 people, dubbed REVITA-2, showed that people who received DMR had improved blood glucose levels and liver insulin sensitivity three months following the procedure compared with patients who underwent a sham procedure.

The novel technique is based on research that shows the duodenal lining is critical to the hormone changes and hormone signaling that lead to insulin resistance. Destroying the lining can interrupt the process underlying diabetes, the study authors say.

A major question about DMR is how long the effects last. Researchers reported evidence that some patients have improved diabetes control for up to two years. But its not known if the procedure will have to be regularly repeated.

This procedure would be for patients who have not been helped by previous treatments, says the study investigator David Hopkins, MBChB, a physician and the director of the Institute of Diabetes, Endocrinology, and Obesity at Kings Health Partners in London. But, he adds, treatment earlier in the course of diabetes could likely produce the most benefit by changing the course of disease.

RELATED: How to Stabilize Your Blood Sugar

In another study on bariatric surgery released from ENDO 2020, researchers at the University of Michigan in Ann Arbor have found that bariatric surgery that takes place prior to the development of diabetes is more effective in facilitating weight loss.

Researchers studied 714 participants who had either gastric bypass or sleeve gastrectomy surgery. All of them had a body mass index (BMI) of more than 40 prior to surgery. Those without diabetes at the time of surgery had a 1.6 times higher chance of losing at least 50 percent of total body weight, regardless of the type of surgery.

The presence of diabetes before surgery is a predictor of future weight loss outcomes, says a study coauthor, Yingying Luo, PhD, of the University of Michigan.

The study suggests that having bariatric surgery before developing diabetes may be an important preventive strategy, says a lead researcher,Elif A. Oral, MD, of the University of Michigan. More research is needed to confirm the study results, the authors said. Yet doctors and patients should consider the timing of bariatric surgery.

We know that bariatric surgery may protect or delay the onset of diabetes, Dr. Luo says. We need a larger sample size. If we can find a true impact on the presence of diabetes, maybe it suggests we should take a step forward to have the surgery.

RELATED: Bariatric Surgery Cuts Heart Risks in People With Obesity and Diabetes

People with diabetes who lose a gland that helps lubricate the eye by producing tears may have elevated blood glucose levels, say the authors of a study from the University of California in San Francisco.

People with diabetes can experience dry eye and eye discomfort. They may have a loss of the meibomian glands in the eyes. The study looked at people with type 2 diabetes diagnosed with dry eye. People with higher A1C levels, a measure of blood glucose levels, were more likely to have the loss of the meibomian glands compared with those with more controlled A1C levels. Even among people who did not have diabetes, those with higher A1C levels had greater loss of meibomian glands.

Doctors should check the eyelids of individuals with diabetes who complain of dry eye, says the coauthor Gloria Wu, MD, an adjunct faculty member at the University of California in San Francisco.

Some people have severe discomfort and pain, she says. This is an easy diagnostic way of looking at diabetes.

RELATED: 5 Ways to Lower Your A1C Levels

People with type 1 diabetes using the Medtronic MiniMedTM 670G insulin pump system are able to maintain blood glucose levels in the targeted range over 71 percent of the time, according to a study that analyzed some 6 million days of real-world data.

The data compares favorably to the results found in clinical trials that led to approval of the device. The MiniMed TM 670G system is the first hybrid closed-loop system approved by the U.S. Food and Drug Administration (FDA) for people with type 1 diabetes.

Sometimes referred to as an artificial pancreas, the device consists of an insulin pump with a tiny infusion catheter worn under the skin and a small continuous glucose monitor that is also placed under the skin. The device measures glucose levels every five minutes and sends the results to the pump to dispense insulin as needed. Individuals upload data from the device to a website so that physicians can monitor their patients.

The real-world study involved more than 51,000 people. Researchers found that individuals were able to maintain blood glucose levels in the targeted range more than 71 percent of the time. When managing diabetes, the goal is to be in the target glucose range of 70180 milligrams per deciliter (mg/dL) more than 70 percent of the time.

Real-world experience does not necessarily live up to the results seen in a clinical trial that recruits highly motivated participants who are under close supervision, says the study's principal investigator, Robert Vigersky, MD, the chief medical officer of Medtronic Diabetes, in Northridge, California. Our results demonstrate that the glycemic control using the MiniMedTM 670G in the real world is excellent and mirrors the results of the small pivotal trials that led to the systems approval.

In February, the FDA announced Medtronic had recalled MiniMed 670G insulin pumps with broken or missing retainer rings following reports that a broken or missing part could lead to incorrect dosing. Insulin pumps with the retainer ring intact do not need to be returned to Medtronic.

The rest is here:
ENDO Online 2020: The Top Diabetes News From March 30 - Everyday Health

Recommendation and review posted by Bethany Smith

Tips to help you while flattening the coronavirus curve – Toronto Sun

By now we are all well-versed in the COVID-19 lingo of flattening the curve, self-quarantining and learning all about physical distancing. But life does tramp on, meals need to be made, and health continues to be our No. 1 priority.

Heres a sampling to help you make the best of the coming weeks, and to help you stay healthy and stable in these unstable times.

Chef Mareya Ibrahim, author of Eat Like You Give a Fork: The Real Dish on Eating to Thrive

BLUEPRINT YOUR FRIDGE:

Youve done the shopping and stocked your cupboards and fridge. Now what? Well-known celebrity chef Mareya Ibrahim, author of Eat Like You Give a Fork: The Real Dish on Eating to Thrive, says its now time to blueprint your fridge. Especially when you discover that $7 box of organic berries you recently purchased are covered in mould, and the spinach you thought would have been used by now has wilted and discharged green slime all over the floor of the crisper.

If you want your food to last and you dont want to search through the chaos of overstocking Ibrahim offers the following tips thatll save your food and your mind!

Mareya Ibrahims Refrigerator Essentials and Foodie Blueprint Tips:

THE TOP SHELF: Stock it with ingredients that help you create simple sauces and marinades, like low-sodium broths, stocks, veggie purees and nut milks.

FRIDGE BINS HOLD SMART SNACKING VEGGIES: The hearty ones that hold up nicely and dont require much prep, like grape tomatoes, miniature bell peppers, Persian cucumbers, and radishes. Keep them in open containers at eye level so theyre visible and ready to munch. These great raw veggie snacks will satisfy your need to crunch.

THE BOTTOM SHELF: Holds grab n go meals, prepped and ready for you and your family. You can also have veggies and fruit that can be easily converted into meals

CRISPER: Fill the crisper drawer and baskets with prewashed greens, ready to throw into a smoothie, salad, soup, or entree. Fill the meat/cheese drawer with precooked proteins and grains, including chicken, ground turkey, quinoa, farro, and such.

STOCK: the fridge door with sauces and toppings, pickles, etc. that will accessorize your meals with flavour. Check out Mareyaibrahim.com for more details; @EatCleaner

Dr. Alok Trivedi

BOOST TO STAY YOUR BEST: Doctors top tips to boost your immune system and stay healthy in this COVID-19 world.

Were all pulling together to reduce the spread of COVID-19 by focusing on things like social distancing, self-quarantining, washing hands and not touching our faces. But what else can you do to boost your immune system, optimize your health and stay safe?

Dr. Alok Trivedi is a U.S.-based human behaviour and performance expert and author of Chasing Success: Lessons in Aligned Performance, who has spent years studying the neurological and psychological connection to physical health. Here he offers some of his top tips to keep healthy, especially during these trying times of self-isolation and, in some cases, quarantine:

Drink a lot of water: Staying hydrated is always good advice. Coconut water is also a good alternative because it has a lot of potassium. When your sodium and potassium levels are in balance, youre going to be healthier.

Get enough vitamins and minerals: In other words, eat a lot of fruits and veggies, especially green vegetables. It is best to get the nutrients you need through real living food, but during this pandemic you can also supplement with the use of high-quality vitamins and minerals.

Boost your immune system with vitamin C, zinc and echinacea: Of course, always talk to your own personal physician first

Drink apple cider vinegar: Drink one to two tablespoons of apple cider vinegar mixed with water each day.

Avoid sugar and processed foods: This is also good advice in general, but even more so during these times. Sugar causes inflammation and obesity. If you cant cut it out altogether, eliminate it as much as you can. Similarly, avoid processed foods and stick to living foodswhich will aid in digestion.

Dont drink OJ: While orange juice may be high in vitamin C which can boost the immune system, its also loaded with sugar. Opt for eating a real orange instead which is much healthier and has loads of vitamin C.

Get a lot of aerobic exercise: The idea is to get the blood pumping and oxygenate the lungs. One of the simplest ways to do this is to go for a walk every single day. It can help protect you from viruses and is great for your overall health.

Avoid family arguments: If you are avoiding crowds and self-quarantining, you are going to be spending a lot of time around family. Tensions can quickly rise and you can become stressed. Too much stress lowers the white blood cell count, and white blood cells areneeded to fight off infection. Focus on coming together and appreciating the time together.

Do something productive toward combating the virus: Whether its social isolation, self-quarantining, washing your hands, wiping down surfaces in your home, doing something that gives you a sense of accomplishment toward beating the virus is a good immune system boost. It also changes your mental attitude for the better knowing you have taken steps to protect yourself and your family.

Check out Aloktrivedi.com for additional details.

PARAMOUNT STEPS UP

Paramount Fine Foods is taking steps to ease some of the burden caused by the ongoing COVID-19 pandemic by donating nearly 2,000 meals to food banks and shelters across the GTA to support the most vulnerable during these uncertain times.

Its about supporting each other and understanding that everyone is experiencing hardship right now, says Mohamad Fakih, founder of the Middle Eastern restaurant chain. We must come together as a community to best support one another and fight through this together as one strong entity.

The company will also be working with Feed Our Heroes, an initiative to support hard-working frontline health-care workers through meal delivery.

For additional details, check out Paramountfinefoods.com.

TEA FOR YOU AND ME

Feeling stressed (and who isnt during these trying times), then reach for a cuppa. A recent study by the Tea Advisory Panel has found that herbal infusions could benefit certain aspects of health. Herbal infusions are a good source of flavonoids and other polyphenols in the human diet. According to recent research on emerald.com, herbal infusions have long been used in traditional medicine and are a popular global beverage choice. These health benefits were based on 1-3 daily cups with infusion rates of up to 15minutes per cup. The panel suggested the following teas for various ailments:

German Chamomile sleep quality Spearmint osteoarthritic stiffness and hormone control

Lemon balm for stress

Rosehip primary dysmenorrhea, or something for menstrual cramps

For additional details, check out tea.ca.

A TOAST TO CANADA

Heres a bit of cheery news: The Okanagan Spirits Craft Distillery recently struck gold at the 2020 World Spirits Award, being named Distillery of the year and World-Class Distillery for 2020.

The company was awarded nine gold medals, four silvermedals and one bronze at the World Spirits awards in Austria. Okanagan Spirits Craft Distillery is Western Canadas original craft distillery, dating back to 2004. The distillery sprung from the idea of using 100% locally grown fruits and grains to make premium,world-class spirits just a tractor-ride away from the orchards and fields where the base ingredients were grown.

B.C.s original farm-to- flask distillery now offers a selection of more than 30 internationally awarded spirits. To have the honour of representing Canada and to come away with so many medals is a dream come true, says Okanagan Spirits president Tony Dyck.

Our entire team is so honoured to be in the company of some of the best distillers from around the world honestly, the magnitude of how this places craft Canadian spirits on the world map is only now starting to sink in.

Check out Okanaganspirits.com.

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Tips to help you while flattening the coronavirus curve - Toronto Sun

Recommendation and review posted by Bethany Smith

What Swiss researchers are doing to beat Covid-19 – swissinfo.ch

A colourisedscanning electron micrograph of a cell infected with SARS-COV-2 viruswhich causes the Covid-19 disease.

While Switzerland continues to be a hotspot for coronavirus cases, Swiss scientists and drug companies are playing an important role in the global effort to develop treatments or a vaccine for the virus.

The scientific community has responded much more effectively to the Covid-19 outbreak than to the SARS outbreak, Francesco Stellacci, professor at Lausannes Federal Institute of Technology (EPFL) said.

Stellacci has been working on developing a broad-spectrum anti-viral drug for the past 10 years. In an interview published by EPFLexternal link, he said data had been shared very quickly and everyone has helped each other out.

The scientific community truly grasped the importance of expanding the scope of research and sharing everything openly.

The collaboration appears to be bearing fruit. Only three months have gone by since Chinese health officials first informed the World Health Organization about a cluster of 41 patients with a mysterious pneumonia in Wuhan on December 31. Despite the short time frame, there is a lot of progress to report on the research side.

The Department of Immunology at the University Hospital in Bernhas been working on a vaccine since January. Initial sequences of the virus were quickly isolated. The vaccine has already been tested on animals.

Meanwhile,Peter Burkhard, an immunologist with a private laboratory in cantonBasel City, has alsodeveloped aprecursor of the Covid-19 vaccine, which has been tested on animals and he is now testing on himself. See the full report in this swissinfo.ch video .

There will soon be more research in the pipeline after the Swiss National Science Foundation (SNSF) put out an emergency call for proposals on research into coronaviruses on February 25 to tackle the current crisis and prepare for future likely epidemics. A sum of CHF5 million ($5.2 million) has been earmarked for projects.

The first call of its kind ever organised by the SNSF received 220 applications. The majority of projects were biomedical, including studies of viruses and infections, the immune response in humans and the spread of the disease.

The selected projects will provide a basis for the subsequent industrial development of active agents. The grants available are between CHF50,000 and CHF300,000 per project.

The best defence against this virus is a vaccine, but since it is likely to take at least 18 months to develop one, a broad-spectrum anti-viral drug could buy us some time, according to Franceso Stellaccio.

While a miracle cure is still the dream of all those working hard in the lab, Stellaccio explains that a less effective drug would also be beneficial to society.

Current data show that every person who catches the virus infects 2.6 other people on average. So a drug with an efficacy of 50% would reduce this figure to 1.3, and that would slow the viruss spread considerably.

It is often the case that a drug developed for one condition can turn out to be useful for other indications. In a promising development, Relief Therapeutics, headquartered in Zurich, is making progress with its erectile dysfunction drug Aviptadil, which has been found to be helpful in treating patients with Acute Respiratory Distress Sydrome (ARDS).

With the coronavirus, death is primarily caused by ARDS, in which severe inflammation causes the lungs to fill with fluid. Aviptadil is a patented formulation of Vasoactive Intestinal Polypeptide (VIP), a naturally occurring peptide hormone that is concentrated in the lungs.

Relief Therapeutics announced on March 26external link that it has filed an investigational new drug application with the US Food and Drug Administration (FDA), in collaboration with an American drug development company, NeuroRx. The application is for a phase two trial of Aviptadil in the treatment of acute and moderate respiratory distress in patients infected by the coronavirus.

Also in the last week, Swiss pharmaceutical giant Roche announced it was launching a clinical trial of a potential new Covid-19 drug, another case of repurposing. Roche is working with the FDA and the US government to initiate a phase three trial to evaluate the safety of Actemra, a drug used to treat two inflammatory diseases. The drug is known as RoActemra outside the US. As reported on March 20, the study will enrol about 330 patients globally starting next month, including in the US. Actemra works by inhibiting the bodys immune response.

Meanwhile, a number of Swiss university hospitals in Zurich, Lausanne, Geneva and St Gallen are preparing to carry out serological tests to detect the presence of Covid-19 antibodies in the blood.

The aim is to estimate the proportion of the population that is already immune to the disease. The higher the proportion, the better the protection against a second wave of infections.

"Today we know that we have a certain number of infected people but we dont have the exact denominator, because only symptomatic people are being tested. It would be useful to have those numbers to better manage the crisis as a whole, Gilbert Greub, senior physician at the Institute of Microbiology in Lausanne University Hospital told Swiss public television RTS.

Although many different avenues are being pursued simultaneously, there will be no quick fix to the immediate problem through a drug or vaccine. Professor Stellacci stressed the importance of managing the expectations of the public in this stressful time.

We have to be clearer about what were doing, the challenges we face and the time it will take. Otherwise we may be selling false hope.

Switzerland is oneof the countries most affected by the coronavirus, with more than 19,000 positive tests and more than 550deaths.

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What Swiss researchers are doing to beat Covid-19 - swissinfo.ch

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Cel MD Biotin Shampoo and Conditioner Review – Explosion

There are plenty of hair products out there that promise all kinds of miraculous results. If youre experiencing hair loss, hair thinning, or damaged hair, you might be at your wits end trying products to bring your hair back to health. With so many different options out there, its hard to know which product to choose. And how can you be sure whether any of them really work?

One of the latest big trends in the beauty industry is the use of natural plant stem cells to help replenish your hair and promote healthy growth. Companies claim that stem cell shampoo could be the answer to all your hair problems. We decided to test out the latest product from Cel MD, the Biotin shampoo and conditioner, and see the results it produced.

What is Cel MD?

Cel MD is a cosmetics company that utilizes patented techniques and cutting-edge science. Its aim is to bring the best in beauty treatments to retail. The company offers lots of different products, most of which use plant stem cells. These and other natural extracts help promote healthy skin and hair.

Stem cells are non-specialized cells that are found in our bodies. They can form any cell, meaning they have great potential for regenerating lost cells, particularly in our hair and skin. Stem cell products like shampoos use plant stem cells and extracts, which can help the body produce more stem cells naturally. This can, in turn, lead to healthier hair.

Biotin Shampoo and Conditioner Ingredients

Cel MDs Biotin shampoo and conditioner include the following active ingredients:

Biotin Stem Cell Shampoo and Conditioner Results

Biotin Stem cell Shampoo and conditioner are most effective for thin and flat hair. These products are supposed to promote new hair growth while also strengthening hair and preventing breakages and damage.

The shampoo is listed as being hypoallergenic, meaning its unlikely to cause any rashes or discomfort. I used the Biotin shampoo and conditioner for six weeks, during which time we followed the instructions provided. Both the shampoo and conditioner were used together, with a short, cold water rinse in between.

After just two weeks of using the product, I found that my hair was softer and looking healthier. I was able to grow my hair longer without suffering from the damaged look that had always happened previously. At the end of the six weeks, my hair was noticeably looking a lot thicker, shinier, and was softer to the touch. My hairstylist commented on how it had improved, and it was clear that the shampoo and conditioner were working their magic.

Originally posted here:
Cel MD Biotin Shampoo and Conditioner Review - Explosion

Recommendation and review posted by Bethany Smith

Hypergonadism: Symptoms, Causes, Treatment, and More

Hypergonadism is a condition in which your gonads overproduce hormones. Gonads are your reproductive glands. In men, gonads are the testes. In women, theyre the ovaries. As a result of hypergonadism, you can end up with higher-than-normal levels of testosterone and estrogen.

Hypergonadism is less common than hypogonadism. Hypogonadism is another term for abnormally low hormone production in the gonads.

Hypergonadism and hypogonadism are both treatable. However, depending on when they appear, they can affect puberty, fertility, and other issues related to development and reproductive health.

Hypergonadism that develops prior to puberty can lead to precocious puberty. Precocious puberty is the early and rapid onset of changes related to sexual maturity. Hypergonadism is one of several possible causes of precocious puberty.

In boys and girls, hypergonadism can bring on:

Some symptoms of hypergonadism and precocious puberty are unique to each sex.

In girls, hypergonadism can cause:

In boys, hypergonadism can cause:

Hormonal treatments aimed at slowing the onset of puberty can be effective, and may help to make for a more normal adolescence.

Doctors cant always diagnose the cause of precocious puberty. Some conditions that are associated with it include:

In mild cases of hypergonadism prior to puberty, the onset of physical and mood changes may not be abnormally early or significant enough to cause any psychological or long-term physical complications.

If hypergonadism develops after puberty, men may face early hair loss and women may have some facial hair growth.

The underlying cause of hypergonadism is often never identified. When the cause of is unknown, its known as idiopathic hypergonadism.

There are several health conditions that are known to cause hypergonadism. Some of them include:

Youre at a higher risk of hypergonadism if you use anabolic steroids. Thats because those supplements can lead to abnormally high levels of testosterone and other androgens (male sex hormones) as well as estrogen, a female sex hormone.

Aside from acne and other physical changes, such as facial hair on women and more breast tissue in men, hypergonadism can cause some more serious complications.

Hypergonadism can interfere with regular menstrual cycles. That can make it difficult for women to become pregnant.

Men may also have fertility challenges, especially if their hypogonadism was caused by anabolic steroid use. Anabolic steroids can affect testicular health, including reducing the production of sperm.

Generally, the complications associated with hypergonadism are related to the underlying cause. Treating the cause may help reduce symptoms and complications brought on by hypergonadism.

If you notice precocious puberty in your child or physical changes in yourself that may be related to hormonal abnormalities, discuss your concerns with a doctor.

If hypergonadism is suspected, your doctor may order a blood test to see if hormone levels are unusually elevated. Additional tests might include a pelvic ultrasound to get a more detailed view of the adrenal glands and other parts, such as the ovaries (for women). Brain imaging may be done to look for tumors of the pituitary gland.

Treating hypergonadism is difficult. The goal is to reduce hormone levels, which is more difficult than trying to increase hormone levels.

The hormonal treatments that are administered for hypergonadism include a combination of hormones tailored to your particular levels. This can be a slow process. It may take some time to find the right mix of hormones at the right dosages.

If a specific cause can be diagnosed, then treatment will also focus on caring for that condition. If a gland has a tumor, for instance, it may be necessary to surgically remove the tumor. If the cause is severe underactive thyroid, you may be prescribed strong doses of thyroid medication to help restore healthier body chemistry.

Hypergonadism, unlike hypogonadism, is a rare condition, often triggered by a more serious health problem. Treating that underlying cause and working with your doctor to help balance out your hormone levels may help you avoid or at least reduce hypergonadism complications.

One important key is to see a doctor as soon as you suspect that there may be hormone-related problems. An earlier start to hormone treatment may mean a faster resolution.

Read this article:
Hypergonadism: Symptoms, Causes, Treatment, and More

Recommendation and review posted by Bethany Smith

‘A Heck Of A Time To Get Cancer’: Hospitals Defer All But The Most Urgent Treatments – WBUR

As Krista Petruzziello puts it herself, she picked a hell of a time to get cancer.

She got the diagnosis early last month: Breast cancer. An early stage with an excellent prognosis, but still, shed need surgery and then hormone treatments. The surgery was scheduled for mid-April.

Then the coronavirus hit full force and turned the world upside down and her treatment plan as well. Her surgery was postponed indefinitely.

Right now, the risks outweigh the benefits for me, says Petruzziello, 48. The risk of infection and they need the ventilators in the OR.

Instead, shell start hormone treatment first, not a bad option because it could shrink the tumor in advance of surgery, she says, and is often used first in women with larger tumors. But its still disconcerting to know this is not the usual order.

Its like, 'Here's what we'd be doing in a normal world. But we can't do that for you, " she says. "So there are just concerns that come with that, obviously.

And I tend to be an anxious person anyway, she adds. So, you know, your mind just spins. And with her job as a licensed insurance agent also taken by the pandemic, there's nothing else to do but think about it right now.

Petruzziello is far, far from alone in grappling with concerns about a postponed procedure and wondering what the consequences will be.

In Massachusetts and around the country, hospitals are putting off all but the most urgent treatment to free up space and staff for coronavirus care and to keep vulnerable patients out of buildings that are documented infection hot spots.

Postponing elective procedures may sound like the care is optional, like cosmetic surgery. But the category comprisesmany much-needed treatments. They include hip and knee replacements for patients living in constant pain, mammograms and colonoscopies to screen for cancer, hernia surgery, kidney donation and much, much more.

At Massachusetts General Hospital, the orthopedics department which has 45 surgeons whose patients include sports stars is uneasily quiet now, running at only 3% to 5% of its usual volume, says its chief, Dr. Mitchel Harris. It has even given up its entire sports medicine clinic to be transformed into a respiratory care clinic, where the X-ray machines can serve COVID-19 patients instead of athletes.

Its treating only patients with urgent, time-sensitive issues," he says: broken bones and other trauma-related injuries, infections and spinal surgery where delay could lead to permanent damage.

Red Sox pitcher Chris Sale, who recently underwent elbow surgery in Los Angeles despite the pandemic, would not have been able to have surgery done here, Harris says.

Challenging Conversations, Uncomfortable Decisions

Across health care, disciplines from orthopedics to cardiology are having to figure out whats best for non-coronavirus patients during the pandemic.

These are complex adjustments, and they can be tricky to present to patients, says Dr. Harold Burstein, a medical oncologist at Dana-Farber Cancer Institute who has been working on national guidelines for breast cancer treatment during the pandemic.

We often map out a roadmap for patients, and we say something like, The first step is surgery, and then you'll get radiation, and then you'll get these hormone therapies, he says.

These days, with most surgeries canceled, many women will begin treatment with hormone therapies first, like Krista Petruzziello. Extensive evidence shows that for many patients, the outcomes can be just as good whether surgery comes first or second, Burstein says.

So for our patients, it's a real win-win, he says, in the sense that we can preserve these precious health care resources at a time of crisis, but we can also deliver very effective therapy without compromising long term results.

The trick is getting that across, he says: I liken this sometimes to going into a three-star Michelin Guide restaurant and saying, 'Instead of the appetizer and then the salad and then the main course and then the dessert, tonight we have a special: We're going to do the main course first and then we're going to have a salad and then an appetizer afterwards, then finish with a dessert. The point is, it all ends up in the same place, .

Overall, Dr. Burstein says, I think it is fair to say that we can come up with a good plan so that the vast majority of patients will have outcomes every bit as good as otherwise.

Thats particularly true for patients with early cancer, whether breast or prostate or other types that lend themselves to re-ordering the treatments. Theres more concern about patients with more advanced cancers who need to continue intensive treatment.

And research on disasters like Hurricane Katrina does suggest that they take a toll on how cancer patients fare, says Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

When we start postponing screenings for cancer early detection, when we start postponing chemotherapy, when we start postponing surgeries, I unfortunately have no doubt that we're going to see impact when we look back at this, he says. Obviously, patients who have more advanced disease, if any of their treatments are delayed, the impact is going to be more severe.

Normally, patients caught in a disaster area can be sent somewhere else for care, but there is no somewhere else for American cancer patients right now. And the disruption is likely to continue for months, Lichtenfeld says.

We're in uncharted territory, he says of treatment adjustments and delays. We don't know the impact of these changes. These are not things we want to do. These are delays that we have to do.

Hospitals will undoubtedly still treat severe, serious cancers, Lichtenfeld says, but may say no to some last-ditch treatments with low odds of success.

Right now, we're in a situation where we're going to have to make decisions that are not comfortable, he says.

It Doesnt Feel Elective To Them

Researchers have looked at the impact of delayed treatment in other contexts particularly long waiting lists and inability to afford care.

In the VA system, we found that longer appointment wait times negatively impact health care outcomes for very frail, geriatric populations, says Julia Prentice, who is now research director for the Betsy Lehman Center for Patient Safety. But these effects were not seen for less frail populations.

Not enough is understood about the impact of delays to be able to predict what effect the pandemic-related deferrals will have, she says.

But it is clear that telemedicine care is critical to make up for what would normally be office visits to monitor chronic conditions like diabetes. In the VA system, Prentice says, people with diabetes who had to wait longer to see doctors tended to have worse blood sugar control.

She has several extended family members whose elective procedures joint replacements and other orthopedic surgeries have been delayed, And it doesnt feel elective to them right now, she says.

But I will emphasize that the health care system is still doing the right thing by canceling these elective care procedures to protect the capacity, she says. It is just a very difficult tradeoff that we're grappling with.

And there could be an upside: The pandemic is creating an unfortunate but potentially illuminating natural experiment, says Dr. Bapu Jena, a professor of health care policy at Harvard Medical School. It could be that in some cases, people who must delay treatment end up better off, because their medical problem resolves on its own and treatment could have caused more harm than good. The widespread delays could bring such benefits to light, he says.

Krista Petruzziello, whose breast cancer surgery is on hold, is doing her best to find upsides, too. She has confidence in her doctors, including Dr. Burstein.

I'm lucky that I'm not a case where it's like if I don't get this surgery, I'm going to die, she says. No one is saying that. And they are telling me it's treatable and curable.

And luckily, I have a great support system at home and all my friends, she adds. One thing, though: I just miss hugging my friends.

Original post:
'A Heck Of A Time To Get Cancer': Hospitals Defer All But The Most Urgent Treatments - WBUR

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How Stress Hormones Work–and How to Harness Them – Inc.

A little bit of stress can push you to perform at your best. Let it get out of control, and you're at risk of burnout and serious health issues. While it's a simple enough concept to understand, effectively managing stress is much harder in practice. Case in point: 30 percent of Americans that visited a doctor between mid-2017 and mid-2018 went for stress-related issues, according to a survey conducted by media company Everyday Health.

Finding that Goldilocks-esque middle state--enough pressure to encourage mental sharpness, not enough to wear out the body and mind--is where most leaders want to be most of the time. Fortunately,psychologists and performance coaches say you can train your brain to get there--and even leverage stress in high-stakes situations.

It starts with understanding the roles that two hormones, adrenaline and cortisol, play in stress. Here's what you need to know:

Adrenaline and Cortisol

Whenever your body perceives a threat, like receiving an angry email or one more assignment on top of anoverwhelming workload,it releases a surge of adrenaline and cortisol into your system. A March 2019 article published by the Mayo Clinic effectively sums up each hormone's function:

Adrenaline increases your heart rate, elevates your blood pressure, and gives you an energy boost.

Cortisol suppresses functions that are unhelpful in fight-or-flight situations, like the digestive and reproductive systems, and sends signals to the parts of your brain that control mood, motivation, and fear.

Together, they can be a game-changer in high-stakes situations, says Jarrod Spencer, a sports psychologist and author who has worked with college athletes at the University of Maryland and Princeton University, among others. Stress, he says, can sharpen your focus to an extreme degree. That's why deadlines and time pressure can be so effective for performance: Cortisol enables above-average productivity, while adrenaline gives you energy to push your physical and mental capabilities.

A Double-Edged Sword

At the same time, staying levelheaded while stressed can be a challenge--and the same two hormones are to blame. "Your body is kicking into survival mode, and 99.9 percent of the time, you're not actually in a life-or-death situation," explains Graham Betchart, a mental skills coach who has worked with basketball stars like Ben Simmons and Karl-Anthony Towns, as well as staffers at venture capitalfirm True Ventures and Silicon Valley Bank. "You might just be having a talk with someone you work with, and all of a sudden, bang, you're in this very limited, primal state of thinking. You're basically dealing with old, hardwired instincts."

If you don't find ways to recover from stressful situations, you're subjecting your body to overexposure to adrenaline and cortisol, according to the Mayo Clinic. Over the long term, chronic stress increases your risk of anxiety, depression, digestive problems, headaches, heart disease, sleep issues, memory and concentration impairment, and other conditions.

Strategies for Stress

Humans have a built-in mechanism for managing stress as it's happening: The ability to breathe deeply. It's a short term, temporary fix--but a powerful one, says Louisa Sylvia, a staff psychologist at Massachusetts General Hospital and Harvard Medical School professor who often works with military veterans and service members. Sylvia explains that taking "big, deep belly breaths" helps with cardiorespiratory coupling--the synching of your heart rate, blood pressure, and breathing--which, in turn, helps you stay clearheaded under pressure.

Long term, Betchart adds, you can train your brain totake advantage of stress's positives while ignoring its negatives. He refers to his favorite method as the MVP technique:

Meditation, which trains your breathing and ability to stay mentally grounded in tough situations.

Visualizing yourself overcoming obstacles, which gives you the perspective you need to consistently realize that your stressors aren't life-or-death situations.

Positive self-talk, which motivates you to work hard at regularly managing your stress.

Practicing all three daily, Betchart says, can help you reframe the very nature of stress. "Stress is just energy, right? It's stress when you don't want the energy there, or you can't handle it," he says. "The person who understands how to reframe it into energy and opportunity already has a massive advantage--but you need that training on how to harness it. If you don't, it can overwhelm you."

Published on: Apr 1, 2020

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How Stress Hormones Work--and How to Harness Them - Inc.

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Thyroid Disease May Run in Your Family and You Might Not Know It – Health Essentials from Cleveland Clinic

Your thyroid gland plays a key role in making sure that yourbody operates at peak performance. It releases just the right amount of thyroidhormone to help regulate the bodys functions.

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

But if something is out of whack with your thyroid, you mayexperience:

Thyroid diseases generally arent preventable. (If youve been avoiding soy or cauliflower to decrease your risk thats just a myth.) But according to endocrinologist Christian Nasr, MD, many thyroid diseases do run in families.

Knowing your family history can help you stay one stepahead of complications from a thyroid disorder and related conditions, he says.

More than 75% of the time, patients with thyroid disease tell me that someone on one side of their family has thyroid disease, says Dr. Nasr.

The more family members that have thyroid disease, the greater the likelihood that there is a hereditary root. And the higher the chances the patient will experience a thyroid problem.

Autoimmune disorders seem to be a genetic link for some of the familial thyroid disorders, he notes. Autoimmune disorders occur when white blood cells go haywire and attack the cells that regulate body functions. The immune systems foul play could cause the thyroid gland to produce too much or too little hormone. So having an autoimmune disease may increase your risk for thyroid disease, Dr. Nasr says.

But this same action the white blood cells attacking bodycells could result in other autoimmune disorders like diabetes, lupus orrheumatoid arthritis, too.

In a family, the same person could have an autoimmunedisorder that causes hypothyroidism and another that causes diabetes, says Dr.Nasr. And you may have a different family member who has diabetes, but notthyroid disease.

The takeaway: Inform your healthcare provider if any autoimmune diseases run in your family, even if there isnt an obvious thyroid connection.

Dr. Nasr has found that even thyroid cancers that arentconsidered hereditary can have a family link. Ive had situations wheremultiple family members have had the type of thyroid cancer thats usually nothereditary, he says.

Clustering of cancers in families isnt unique to thyroidcancer. Some families carry a mutation that suppresses good genes in thebody, which can put them at risk for a variety of cancers.

Different syndromes can increase someones risk for certain types of cancer, Dr. Nasr explains. Cowdens syndrome, for example, increases your risk of thyroid, breast and uterine cancers. Your family history may not include thyroid cancer, but if we see a lot of breast and uterine cancers, we may want to investigate whether there is a syndrome that puts you at risk for thyroid nodules or cancer.

The takeaway: As with the autoimmune disorders, knowyour family history. This information helps your healthcare team find patterns thatmight indicate thyroid disease-causing gene mutations lurking in the background.

What if you dont know about your familys history withthyroid disease? These symptoms may indicate its time to seek medical care:

Once youve addressed your symptoms with your provider, theywill likely perform a neck exam and a simple blood screening test. If allsystems appear to be operating well, your doctor may recommend monitoring overtime. If any of the results are concerning, your doctor may refer you to anendocrinologist or order an imaging test. And if you have a strong family history, genetictesting may help you make important healthcare decisions.

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Thyroid Disease May Run in Your Family and You Might Not Know It - Health Essentials from Cleveland Clinic

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Celebrities that take HGH: Why do they need it? – – VENTS Magazine

Human Growth Hormone (HGH) therapy has been around for decades but has been reserved for specific patients. Those with HIV or children with a hormone deficiency were some of the patients who benefitted. However, in recent years, a new focus has targeted therapy to help adults with hormone deficiencies.

HGH is aproteinproduced by the pituitary gland. The hypothalamus and hormones in the intestinal tract and pancreas help to balance it. It thrusts into production during sleep, exercise or trauma with more produced at night than in the daytime, given rising to the term beauty rest as the hormone is also linked to anti-aging.

Production of the hormone decreases as we age and that can lead to problems typically associated with getting older like:

The purpose of the growth hormone in children is to help bones and muscles grow. It also helps with organ function. Hormone therapy in adults is linked to:

Manycelebritiesare reportedly using hormones, but many are doing it illegally. They do it for anti-aging or for muscle mass. This is something all doctors warn against because the growth hormone has some possible side effects including water retention, high blood sugar, and joint and muscle pain. Plus, for those who have normal hormone levels, illegal use of it and then stopping will cause your body to produce less. That leaves you worse off than before.

Most celebrities who take legal hormone therapy dont like to talk about it for a variety of reasons. Its a controversial subject and many deem it private. However, a handful of aging stars have come out to talk about their decision to go on legal hormone therapy.

Benefits of therapy were noted in a New EnglandJournal of Medicine study. Men on six months of therapy increased their muscle mass 8.8 percent and reduced body fat by more than 14 percent. While it is linked to anti-aging, there are no conclusive studies to prove that.

Those considering hormone therapy must get a prescription in order to go to Hormone Clinic. That includes going to a doctor, getting a blood test and probably some specialized testing on the pituitary gland and hypothalamus. Or, you can just call for free consultation toHGH Therapy Clinicand get all the instructions. This clinic, as long as other top-rated clinics, does not provide therapy for bodybuilders and only provides it to those with a hormone deficiency.

This therapy is administered by injection and should be part of a routine health management plan under a doctors care to avoid side effects. For more information about hormone therapy, fill in the contact form and the knowledgeable advisor will call you back.

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Celebrities that take HGH: Why do they need it? - - VENTS Magazine

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MD Medical Group opens COVID-19 drive-thru testing sites at 7 locations in Dallas-Fort Worth – Community Impact Newspaper

MD Medical Group now has drive-thru COVID-19 testing facilities at seven Dallas-Fort Worth locations. (Courtesy MD Medical Group)

The drive-thrus are open to adults and children age 2 and older from 8 a.m.-5 p.m. Monday-Friday. According to MD Medical Group, select locations have the ability to administer 1,200 tests per day.

Those looking to get tested must schedule an appointment by calling or texting 888-776-5252. Same-day appointments are available.

The drive-thru sites are intended to allow people to get tested for COVID-19 while reducing demand at local hospitals, according to the medical group.

Julia Robles, lead medical assistant at Clinicas Mi Doctor, said the health professionals at the clinic start by assessing whether a patient is showing symptoms of COVID-19 and whether they have been exposed to the disease.

We do a quick questionnaire, and then, we will test them for flu and strep first, Robles said. And then, if they meet the criteria, well go ahead and do COVID-19 testing on them as well.

MD Medical Group has drive-thru testing facilities at the following Dallas-Fort Worth locations.

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MD Medical Group opens COVID-19 drive-thru testing sites at 7 locations in Dallas-Fort Worth - Community Impact Newspaper

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Concurrent mllerianosis of the urinary bladder and the umbilicus presenting with umbilical bleeding: a rare case report and review of the literature -…

Young and Clement [3] reported the first case of mllerianosis in the urinary bladder in 1996 and defined this disease as a lesion seen at any site containing admixtures of endosalpingiosis, endometriosis, and endocervicosis. Twenty-one cases occurring in the urinary bladder have been documented in 19 articles (Table1) in the English literature, accounting for the majority of cases of mllerianosis [18]. Some sporadic cases have been reported in the ureter, spinal cord, inguinal lymph nodes and mesosalpinx [2]. To the best of our knowledge, this is the first report to describe mllerianosis of the umbilicus. Due to its rarity, the prevalence of mllerianosis is unknown.

Several hypotheses of the pathogenesis of mllerianosis of the urinary bladder have been proposed; however, the mechanism is not clearly understood. Implantation, one of the most discussed theories, suggests that mllerian tissue implants into the urinary bladder wall during pelvic surgery [3]. However, this cannot explain why mllerianosis is found in surgery-nave patients or in organs other than the urinary bladder. Ten of the 19 cases (52.6%) with detailed surgical records, the present case included, had not experienced any pelvic surgery such as hysterectomy or cesarean delivery. Another theory, metaplasia, advanced by Donne et al., [4] is based on the presence of two or more mllerian-derived tissues, which implies the potential of mllerian epithelium to differentiate rather than the implantation of a single type of the tissue. Moreover, of the 20 cases with marked tumor locations, a total of 16 tumors (80%) were situated on the posterior wall or the dome of the urinary bladder, a place adjacent to the peritoneum and more sensitive to female hormones. Koren et al. [9] in 2006 reported a case supporting the metaplasia theory with the metaplastic epithelium in continuity with the urothelium. The present case is also supportive of metaplasia because of concurrent occurrence of the bladder and the umbilical masses.

Mllerianosis of the urinary bladder mainly affects women of the reproductive age, with a mean age at diagnosis of 44.6years (range 27 to 70years). Of the total 22 patients with mllerianosis of the urinary bladder, five were postmenopausal females. The most common symptoms have been reported to be irritative voiding symptoms (54.5%) including frequency, urgency, urge incontinence and dysuria, abdominal/pelvic pain (45.5%) and gross hematuria (36.4%). These symptoms occurred cyclically in six cases (27.3%), mostly during the menstrual period. One patient with a tumor on the ureterovesical junction presented with renal colic [13]. Our case had none of the symptoms associated with bladder lesions, and only had umbilical bleeding.

Grossly, mllerianosis of the urinary bladder has been described as sessile polypoid, [17] submucosal, [6] or smooth with normal appearing overlying mucosa [14] on cystoscopic examinations. The gross appearance of the bladder tumor in our case revealed the similar findings as a mass with hemorrhage underneath the intact epithelium. Histologically, it revealed multiple foci of glands with variable size lined by tubal, endocervical, or endometrial epithelium situated in the lamina propria and muscularis propria [2, 15]. These glandular cells were immunohistochemically positive for ER and progesterone receptor (PR) [9]. In addition, the stroma surrounding the endometrial glands diffusely expressed CD10, and the epithelia showed positive staining for Ca-125 [15].

Both medical and surgical treatments can be used for mllerianosis of the urinary bladder. Regardless of the lack of consensus on the choice of therapy, most physicians and patients chose the surgical intervention in the reported cases, and most of the patients had a favorable prognosis. Sixteen patients underwent TURBT, only five of whom required subsequent medical treatment, [12, 13] or partial cystectomy [16, 18, 19] due to persistent symptoms or tumor recurrence. None of the four patients who underwent partial cystectomy had recurrence; by contrast, in two cases using gonadotropin-releasing hormone (GnRH) analogues to inhibit pituitary and gonadal function to reduce the tumor volume as medical treatment, cystoscopy showed smaller but persistent tumors at 3months and 2years of follow up. There was no documented distant metastasis or mortality in the cases with short-term follow-up (124months).

Mllerianosis of the urinary bladder mimics several bladder neoplasms such as cystitis glandularis and nephrogenic adenoma [9]. It is most important to differentiate between mllerianosis and invasive adenocarcinoma, both of which exist in the lamina propria and muscularis propria. A case of bladder endometrioid adenocarcinoma complicating mllerianosis has been reported [8].

In conclusion, mllerianosis is a rare neoplasm which mainly affects women of reproductive age. The common presentations of mllerianosis of the urinary bladder include irritative voiding symptoms, abdominal/pelvic pain and gross hematuria. In our case, multifocal mllerianosis were separately located on the urinary bladder and the umbilicus, which implies that the possibility of concurrent bladder mllerianosis should be considered when mllerianosis is found at other location. Despite a favorable prognosis in the majority of patients, in view of the importance of establishing the correct pathological diagnosis, we suggest treatment with a surgical intervention consisting of TURBT and partial nephrectomy if recurrence occurs with persistent symptoms.

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Concurrent mllerianosis of the urinary bladder and the umbilicus presenting with umbilical bleeding: a rare case report and review of the literature -...

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Lorena Borjas, a transgender Latina activist who fought for immigrants and sex workers, has died of Covid-19 – The Albany Herald

Even as Lorena Borjas was feeling ill and waiting on Covid-19 test results, she was worried about how transgender immigrants would cope with the pandemic.

That, according to her friends and chosen family, was typical of Borjas, a transgender Latinx activist from Queens who spent decades advocating for people from marginalized communities. Despite numerous challenges and traumas she faced in her personal life, she never took a rest from fighting for transgender women, undocumented immigrants, sex workers and those living with HIV/AIDS.

On Monday around 5:22 a.m., Borjas, 59, died from complications due to Covid-19 at Coney Island Hospital, according to her close friend Cecilia Gentili.

"Lorena spent her life tirelessly fighting and supporting our trans sisters, making sure they were treated with dignity and respect they deserve," Make the Road New York, an organization that fights for immigrant and working class communities, said in a statement. "We will truly miss her. May she rest in power and love."

She was a fighter and a leader

Borjas was like a mother to Gentili, she said -- one of many people in Queens' transgender Latinx community who shared that sentiment.

"You could aspire to be like her but you clearly know you won't be like her because you are not as selfless as she is," Gentili told CNN.

For more than 25 years, Borjas spent her days serving people in marginalized communities in whatever ways she could.

"Lorena brought light to us when we were living through a very dark time here in New York," said Cristina Herrera, founder and CEO of Translatina Network and a friend of Borjas' since 1987. "She brought us light when we were dealing with the crack epidemic, when we were dealing with the AIDS crisis, dealing with changes in immigration policies."

Borjas walked up and down the streets in her neighborhood of Jackson Heights, handing out free condoms to sex workers. She set up syringe exchanges to protect transgender people who were undergoing hormone therapy. She set up an HIV testing clinic in her own home.

Gentili recalled a time when she was tasked with connecting transgender patients to mental health services at a clinic she worked at. Borjas offered to introduce her to people in the community who could benefit from those services, asking Gentili to accompany her late one night while she was distributing condoms to sex workers.

"She wasn't expecting people to come to her," Gentili said. "She was going to them."

Chase Strangio, deputy director for transgender justice at the LGBT & HIV Project of the American Civil Liberties Union, said he first met Borjas in 2009 and started working closely with her in 2010 through his role at the Sylvia Rivera Law Project, where he was working on immigration and criminal justice issues.

At first, Borjas was a client, but "quickly she became a colleague and co-conspirator," he said.

"She brought people into the office every week who needed legal support and made sure that I was paying attention to the crisis of policing and deportation facing her community," Strangio wrote in an email to CNN.

The two worked together to support transgender Latina immigrants and others who were dealing with arrests, convictions and court appearances, he said. Eventually, they co-founded the Lorena Borjas Community Fund, which helps transgender people and others pay for legal costs and bail.

Bianey Garcia, an activist at Make the Road New York, said she first met Borjas when she was 17 -- during a time when she lived "a crazy life." One of her earliest memories of Borjas was when she invited her to a support group.

Later, Garcia, who was previously a sex worker, said she was arrested and incarcerated at Rikers Island. Borjas visited her at the jail complex, listened to her fears about deportation over the phone and eventually found an immigration lawyer to fight for her release.

"I really appreciated her for everything that she did when I most needed," Garcia said.

She faced her own challenges

Borjas came to the United States from Mexico in 1981 when she was 20, according to a short film called "The Story of Lorena Borjas." She considered herself a gay man at the time and didn't see a future for herself in Mexico, Borjas says in the film. So she emigrated in order to transition -- and to find professionals who could help her do so under medical supervision.

Though she successfully transitioned, she remained undocumented until 1986, when she was granted amnesty under a law enacted by President Ronald Reagan. She became a legal permanent resident in 1990. That same year, however, she was arrested on charges of prostitution and trafficking -- though she was a human trafficking victim herself.

Borjas' subsequent convictions meant she could not renew her status as a permanent resident or become a US citizen. Despite her circumstances, she began her life as an activist in 1995, organizing a transgender march to protest "police policies and systems" and helping transgender women with HIV/AIDS.

In 2017, Borjas was granted a pardon by New York Gov. Andrew Cuomo, finally easing her long-held fears of deportation.

"Lorena has done more than anyone else I know to shine a light on the epidemic of trafficking in transgender communities and to help other trans women escape exploitation," Lynly Egyes, who represented Borjas on behalf of the Transgender Law Center, said at the time.

She wanted to people to share joy

Borjas took care of people in ways big and small, friends said.

Aside from helping transgender immigrants navigate the legal system, she also made sure they had food to eat, a roof over their heads and a cell phone, according to Strangio.

Herrera added that Borjas would provide new immigrants with Metrocards so they could use the subway. She stayed up late talking to people and helping them deal with their problems. She'd call people to remind them about medical appointments -- and follow up to see whether they had made it and how things went.

"She just wanted people to be OK," Herrera said.

It was important to Borjas that people not only survived, Strangio said, but thrived and shared joy with each other.

In May 2012, a few months before Strangio was expecting a child, Borjas threw his family a surprise baby shower and bought them a car seat and a stroller.

"We had so much more access and privilege and yet she found a way to demonstrate that she was going to provide love and support to our growing family," he said. "This is what she did for everyone."

Monday night, about 250 people gathered for a virtual vigil to honor Borjas' life and legacy.

CNN's Maria Santana contributed to this report.

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Lorena Borjas, a transgender Latina activist who fought for immigrants and sex workers, has died of Covid-19 - The Albany Herald

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