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Archive for the ‘Hormone Clinic’ Category

Acupuncture For Fertility And TCM Improve Chances Of Conception And Pregnancy And Mitigates Side Effects Of IVF Treatment – Press Release – Digital…

Acuwellness Center offers acupuncture for infertility. Research suggests that acupuncture, along with traditional Chinese medicine, can serve as an effective treatment for infertility and other reproductive disorders.

According to announcements released by Acuwellness Center, and Sharareh (Sherry) Daghighi DAOM, LAc, FABORM, the wellness center offers acupuncture for fertility. Research-backed evidence suggests that fertility acupuncture can be a useful treatment procedure to complement IVF and ART treatments. Combined with other TCM protocols, acupuncture can enhance physiological processes essential for fertility. Acupuncture as a treatment modality for infertility can assist in preparation for IVF, IUI, and other ART protocols. Fertility acupuncture helps control unwanted side effects associated with IVF and ART treatments. It improves implantation and pregnancy rates. The wellness clinic will coordinate with a subject's reproductive endocrinologist to prepare a custom infertility treatment plan to optimize her chances at conception.

Sources reveal that alternative treatment procedures that use acupuncture and herbs can improve the symptoms of many health conditions, including polycystic ovarian syndrome (PCOS), which is not an uncommon condition among women in the United States. PCOS can result in diabetes, hirsutism, infertility, and obesity. Acuwellness Center is also an established Encino dermatology clinic where eczema, psoriasis, acne, rosacea, fungal infections, etc. are treated using herbal formulations, dietary supplements, and acupuncture. The wellness clinic prescribes herbs for acne, and it has delivered excellent results in treating this condition. TCM eschews the use of topical ointments that may contain harsh chemicals. Acuwellness Center treats acne by recommending dietary and lifestyle changes, acupuncture, and herbal medicines. It prescribes Chinese herbs for eczema.

Sharareh (Sherry) Daghighi DAOM, LAc, FABORM, of Acuwellness Center said, At Acuwellness Center, we offer services such as acupuncture, herbal medicine, and nutritional consultation in a friendly, relaxing environment. Our areas of expertise are woman's health, fertility, internal medicine, and TCM dermatology. Our mission is to provide a tranquil, healing environment where your mind, body, and spirit can relax and recover from the stress of everyday living.

On acupuncture and herbs for premature ovarian failure, Daghighi said, Premature Ovarian Failure (POF) is defined as a cessation of ovarian function in women younger than 40 years of age. It is characterized by the occurrence of irregular and light menstruation (oligomenorrhea), primary or secondary amenorrhea (no menstruation) with elevated levels of gonadotrophins like follicle-stimulating hormone (FSH), and low estrogen levels. Women with POF will also have menopausal symptoms such as hot flashes, night sweats, vaginal dryness, irritability, difficulty concentrating, and decreased sexual desire.

She continued to say, Studies have shown that Acupuncture and herbal medicine can treat premature ovarian failure. Acupuncture can induce ovulation and regulate the menstrual cycle, other studies have shown some herbal formulas such as Zuo Gui Wan or a modification of this formula can induce ovulation, lower FSH levels, and regulate menstrual cycle for certain POF patients. At Acuwellness Center, we offer Acupuncture and herbal medicine services for infertility, including premature ovarian failure, we can help achieve your fertility goals or just reduce menopausal symptoms.

For more information, go to https://www.acuandherbs.com/infertility-acupuncture.html

Media ContactCompany Name: Acuwellness CenterContact Person: Sharareh (Sherry) DaghighiEmail: Send EmailPhone: (818) 642-3512Address:16260 Ventura Blvd, Ste LL16 City: EncinoState: CA 91436Country: United StatesWebsite: https://www.acuandherbs.com/infertility-acupuncture.html

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Acupuncture For Fertility And TCM Improve Chances Of Conception And Pregnancy And Mitigates Side Effects Of IVF Treatment - Press Release - Digital...

Fertility startups see burst in demand as minds turn to baby-making – Sifted

The coronavirus lockdown has led to rising interest in video games, sex toys, sourdough bread and alsobabies.

Or at least thats what may explain a spike in demand for some of Europes fertility startups over the past few months, according to founders interviewed by Sifted.

Startups such as ExSeed, which does at-home male fertility test, and Legacy, a sperm testing and freezing startup, have both recorded a jump in orders.

Switzerlands Legacy says its seen days where orders spiked to more than 10x usual volume and has had to launch additional capacity to handle the order volume for test samples.

Part of this is the natural growth of the company, but Id estimate at least 50% of the growth is attributable due to Covid-19 concerns, says chief executive Khaled Kteily.

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Kteily says there are worries that catching Covid-19 might affect male fertility. The increase in orders may have also been spurred by the temporary closure ofphysical clinics during lockdown, instead prompting couples to get treatment ready from home.

Meanwhile, Copenhagen-based ExSeed told Sifted the number of at-home male fertility tests priced at 150 have trebled during the lockdown. App-downloads, programme-subscriptions, and web traffic have also more than doubled since February across Denmark and the UK.

This boost is being matched by investor interest as well; ExSeed told Sifted it is now in the final stages of closing a round led by Hambro Perks, building on a previous raise of 1m.

Demand has also been way up for Paris-born Apricity, a digital-first fertility platform which offers at-home blood tests and consultations for women, followed by in-person treatment across a series of partner physical clinics.

Chief executive Caroline Noublanche thinks that the surge in interest is in part because people have had more time for themselves and to address important personal topics such as fertility

UK-based consultant Adrian Lower, who does not work with any of these startups but is a practising gynaecologist, agrees the lockdown has also given us the time to consider every aspect of our health, including our future fertility, adding he is not surprised that the pandemic has spurred a rise in demand for at-home services.

Covid-19 has highlighted just how precious our health is.

In recent years, the fertility industry has raised millions in venture capital funds, particularly in Northern Europe.

This is part of a broader rise in interest in digital doctor app startups such a Doctolib and Babylon Health which are reshaping our relationship with healthcare systems.

But it is also linked to the emergence of femtech as a significant investment category (set to be worth $50bn by 2025, according to Frost & Sullivan) dominated by big startups like Clue, Ava and Natural Cycles.

Now, coronavirus and the recent spike in demand for fertility tech has helped bring investment buzz back to this segment which stretches across supplements, ovulation trackers and testing kits for both men and women.

I have a lot of contact with potential investors during lockdown. Healthtech appears to them as one of the key areas of investment post-Covid and femtech is one of the subdomains VCs say they want to focus on, says Apricity chief executive Caroline Noublanche.

Spains WOOM a fertility tracker and community app for women also secured a $2m round just last month, pulling in two new investors.

Nonetheless, while people may have become more interested in their fertility in lockdown, it prompted some couples to delay parenthood for at least a short time.

Natural Cycles, a hormone-checking tool for women, told Sifted that the rate of users switching the app-mode from prevent to planning a pregnancy decreased by 3% week-over-week between March and April; perhaps triggered by fresh financial fears, relationship pressures, or illness. The company also said that it had seen a boost in orders for women wanting a natural birth control delivered right to the door.

Meanwhile, Maven a virtual womens clinic has recorded twice as many bookings for online mental health appointments across its fertility clients between March and May, suggesting the pandemic is putting an emotional strain on would-be parents.

WOOM also says it suffered a 25% traffic drop after the announcement of Covid-19 pandemic. Nonetheless, the startup says its traffic is now 19 points higher than pre-pandemic.

This boost seen by fertility startups will help shake off fears that the sector was at risk of seeing investment interest wane, as attention shifted to other areas of womens health like menopause, sex, endometriosis, and breastfeeding.

[Investors are] looking for the next big thing in femtech, Anya Roy, cofounder of Syrona Women told Sifted earlier this year, adding male investors were slowly seeing the investment benefits of womens health.

Two studies also recently cast doubt on the role of fertility apps and wearables role in assisting womens chances of conceiving, given their lack of scientific backing.

Nonetheless, investors say theres room for growth in the still-nascent fertility startup sector, with smartphones providing new tools to streamline the diagnosis and conception process. One in seven couples also still experience difficulties conceiving.

Its more crowded in the fertility and the contraceptive space, but theres no clear winner there yet, says Louise Samet, partner at venture capital firm Blossom Capital.

We havent seen a Spotify or a really large company come out in that space yet I think that theres still huge potential.

Traditional IVF clinics are also beginning to digitise to keep up with the boom of healthtech apps.

Salve is a startup that helps IVF with patient-doctor management via a white-labelled app, providing secure messaging and enhanced data sharing. Its chief executive Charlie Kenny tells Sifted they have signed over 30 new clinics worldwide since the coronavirus outbreak began, and has seen that rapid growth continue.

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Fertility startups see burst in demand as minds turn to baby-making - Sifted

Myriad Genetics Announces Publication of a Prospective Clinical Study of the EndoPredict Test in Women with Early-Stage Breast Cancer | 2020-06-04 |…

SALT LAKE CITY, June 04, 2020 (GLOBE NEWSWIRE) -- Myriad Genetics, Inc. (NASDAQ: MYGN, Myriad” or the Company”), a global leader in molecular diagnostics and precision medicine, today announced the publication of a prospective study demonstrating that the EndoPredict® test predicts which patients with ER+, HER2- early-stage breast cancer will benefit from neoadjuvant therapy. The article titled, The EndoPredict score predicts response to neoadjuvant chemotherapy and neoendocrine therapy in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer patients from the ABCSG-34 trial,” appeared online in the European Journal of Cancer.

This study demonstrated that the EndoPredict (EP) test predicted response to neoadjuvant chemotherapy or neoadjuvant endocrine therapy in women with ER+, HER2 negative early-stage breast cancer,” said Peter Dubsky, M.D., lead author, speaking on behalf of the Austrian Breast and Colorectal Cancer Study Group (ABCSG). Based on these findings and prior studies, we are confident the EndoPredict test can add valuable information to aid in personalized treatment selection in neoadjuvant therapy and provides an important basis for future design of neoadjuvant clinical trials.”

The primary objective of this prospective study was to test the predictive value of the EndoPredict test regarding tumor response after neoadjuvant chemotherapy (NaCT) or neoadjuvant endocrine therapy (NET) within the ABCSG-34 trial. The analysis included data from 217 women with HR+ breast cancer. Of these, 134 patients were assigned to receive NaCT (eight cycles of anthracycline/taxane) according to aggressive clinico-pathologic tumor features. The remaining 83 patients were clinically identified as having luminal A-like types of breast cancer and were assigned to receive NET (six months of letrozole). The primary endpoint was residual cancer burden RCB0/I (i.e., good tumor response) vs. RCB II/III (i.e., poor tumor response) at time of surgery.

In the neoadjuvant chemotherapy group, 125 patients had high EP scores and nine had a low EP score. The results show that 26.4 percent of those with a high score showed a good tumor response (RCB0/I) to neoadjuvant chemotherapy, while all patients with a low score showed only a poor tumor response (Table 1). In the luminal A” group receiving neoendocrine therapy, 39 patients had a high EP score and 44 had a low EP score. The results show that 27.3 percent of those with a low EndoPredict score and 7.7 percent with a high score achieved excellent tumor response (RCB0/I) to neoendocrine therapy (Table 1).

EndoPredict Low Score

EndoPredict High Score

0.0

%

26.4

%

p=0.0001

In this prospective study, we demonstrated that the EndoPredict test is a useful tool pre-operatively,” said Ralf Kronenwett, M.D., director of International Medical Affairs at Myriad. In two distinct ER-positive, HER2-negative cohorts selected by clinicians to receive neoadjuvant chemotherapy or neoadjuvant endocrine therapy, EndoPredict identified patients with poor neoadjuvant treatment response. Clinicians can use information to determine who might forgo these therapies prior to surgery.”

About EndoPredict EndoPredict is a second-generation, 12-gene molecular prognostic test for patients diagnosed with breast cancer. The test provides vital information that helps clinicians devise personalized treatment plans for their patients. EndoPredict has been validated in more than 4,000 patients with node-negative and node-positive cancer and has been used clinically in more than 20,000 patients. In contrast to first-generation multigene prognostic tests, EndoPredict detects the likelihood of late metastases (i.e., metastasis formation after more than five years) and, therefore, can guide treatment decisions regarding the need for chemotherapy, as well as extended anti-hormonal therapy. Accordingly, therapy decisions backed by EndoPredict confer a high level of diagnostic safety. For more information, please visit: http://www.endopredict.com.

About Myriad Genetics Myriad Genetics Inc., is a leading personalized medicine company dedicated to being a trusted advisor transforming patient lives worldwide with pioneering molecular diagnostics. Myriad discovers and commercializes molecular diagnostic tests that: determine the risk of developing disease, accurately diagnose disease, assess the risk of disease progression, and guide treatment decisions across six major medical specialties where molecular diagnostics can significantly improve patient care and lower healthcare costs. Myriad is focused on three strategic imperatives: transitioning and expanding its hereditary cancer testing markets, diversifying its product portfolio through the introduction of new products and increasing the revenue contribution from international markets. For more information on how Myriad is making a difference, please visit the Company's website: http://www.myriad.com.

Myriad, the Myriad logo, BART, BRACAnalysis, Colaris, Colaris AP, myPath, myRisk, Myriad myRisk, myRisk Hereditary Cancer, myChoice, myPlan, BRACAnalysis CDx, Tumor BRACAnalysis CDx, myChoice CDx, Vectra, Prequel, Foresight, GeneSight, riskScore and Prolaris are trademarks or registered trademarks of Myriad Genetics, Inc. or its wholly owned subsidiaries in the United States and foreign countries. MYGN-F, MYGN-G.

Safe Harbor Statement This press release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995, including statements related to the EndoPredict test adding valuable information to aid in personalized treatment selection in neoadjuvant therapy and providing an important basis for future design of neoadjuvant clinical trials; and the Company's strategic directives under the caption "About Myriad Genetics." These "forward-looking statements" are based on management's current expectations of future events and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by forward-looking statements. These risks and uncertainties include, but are not limited to: uncertainties associated with COVID-19, including its possible effects on our operations and the demand for our products and services; our ability to efficiently and flexibly manage our business amid uncertainties related to COVID-19; the risk that sales and profit margins of our molecular diagnostic tests and pharmaceutical and clinical services may decline; risks related to our ability to transition from our existing product portfolio to our new tests, including unexpected costs and delays; risks related to decisions or changes in governmental or private insurers’ reimbursement levels for our tests or our ability to obtain reimbursement for our new tests at comparable levels to our existing tests; risks related to increased competition and the development of new competing tests and services; the risk that we may be unable to develop or achieve commercial success for additional molecular diagnostic tests and pharmaceutical and clinical services in a timely manner, or at all; the risk that we may not successfully develop new markets for our molecular diagnostic tests and pharmaceutical and clinical services, including our ability to successfully generate revenue outside the United States; the risk that licenses to the technology underlying our molecular diagnostic tests and pharmaceutical and clinical services and any future tests and services are terminated or cannot be maintained on satisfactory terms; risks related to delays or other problems with operating our laboratory testing facilities and our healthcare clinic; risks related to public concern over genetic testing in general or our tests in particular; risks related to regulatory requirements or enforcement in the United States and foreign countries and changes in the structure of the healthcare system or healthcare payment systems; risks related to our ability to obtain new corporate collaborations or licenses and acquire new technologies or businesses on satisfactory terms, if at all; risks related to our ability to successfully integrate and derive benefits from any technologies or businesses that we license or acquire; risks related to our projections about our business, results of operations and financial condition; risks related to the potential market opportunity for our products and services; the risk that we or our licensors may be unable to protect or that third parties will infringe the proprietary technologies underlying our tests; the risk of patent-infringement claims or challenges to the validity of our patents or other intellectual property; risks related to changes in intellectual property laws covering our molecular diagnostic tests and pharmaceutical and clinical services and patents or enforcement in the United States and foreign countries, such as the Supreme Court decisions in Mayo Collab. Servs. v. Prometheus Labs., Inc., 566 U.S. 66 (2012), Ass’n for Molecular Pathology v. Myriad Genetics, Inc., 569 U.S. 576 (2013), and Alice Corp. v. CLS Bank Int’l, 573 U.S. 208 (2014); risks of new, changing and competitive technologies and regulations in the United States and internationally; the risk that we may be unable to comply with financial operating covenants under our credit or lending agreements; the risk that we will be unable to pay, when due, amounts due under our credit or lending agreements; and other factors discussed under the heading "Risk Factors" contained in Item 1A of our most recent Annual Report on Form 10-K for the fiscal year ended June 30, 2019, which has been filed with the Securities and Exchange Commission, as well as any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. All information in this press release is as of the date of the release, and Myriad undertakes no duty to update this information unless required by law.

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Myriad Genetics Announces Publication of a Prospective Clinical Study of the EndoPredict Test in Women with Early-Stage Breast Cancer | 2020-06-04 |...

Neal D. Shore, MD, FACS Discusses Impact, Treatment Implications of the Phase III HERO Trial – Cancer Network

Results presented at the 2020 ASCO Virtual Scientific Program demonstrated that once daily oral relugolix (Relumina), a gonadotrophin-releasing hormone (GnRH) antagonist, induced sustained castration in 96.7% of patients with advanced prostate cancer, meeting the trials primary endpoint. These findings met the superiority threshold for relugolix when compared with leuprolide (Lupron).

In an interview with CancerNetwork, Neal D. Shore, MD, FACS of the Carolina Urologic Research Center discussed the significance of these findings and the benefits of relugolix as a GnRH antagonist.

Transcription:

So, if I could summarize how this new once daily oral GnRH antagonist medication could change the landscape of treatment for our patients with advanced prostate cancer, I would say that historically and contemporaneously, we only have a parenteral administration of testosterone (T) suppression medications, whether they're given intramuscularly or subcutaneously, or by an implant. This trial, the HERO trial, now has established that once daily oral relugolix, a GnRH antagonist so you don't get surge of testosterone you avoid clinical flare, will offer patients and physicians another significant tool to consider for achieving testosterone suppression not only because it is highly effective in achieving testosterone suppression, but if patients choose to stop medication, their testosterone recovery is much faster so they get back to the benefits of having normal testosterone. And even more significantly, the mechanism of action of an antagonist over an agonist will afford patients and physicians some comfort in knowing that there's a marked decrease in the risk of having a cardiovascular event. Interestingly, during this time of concern, as it relates to the COVID pandemic, patients can take medication at home and don't necessarily need to come into the clinic and put themselves at risk for receiving a parental injection as well as the healthcare team. So, I think these are all very significant developments.

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Neal D. Shore, MD, FACS Discusses Impact, Treatment Implications of the Phase III HERO Trial - Cancer Network

Coming Together to Solve COVID-19 Mysteries | University of Pennsylvania Almanac – UPENN Almanac

Coming Together to Solve COVID-19 Mysteries

As the COVID-19 pandemic began to be felt, scientists at Penn started work todevelop a vaccineandassess possible treatments. But the scope of COVID-19 studies at the University goes much broader. Scientists whose typical work finds them investigating autoimmune disease, influenza, HIV/AIDS, Ebola, cancer, hemophilia and more, are now applying their deep understanding of biology to confront a novel threat.

What Does SARS COVID-19 Do To Our Lungs? Another respiratory infection, influenza, has been a focus of research led by Andrew Vaughan, Penn Vet assistant professor of biomedical sciences. But Dr. Vaughan didnt hesitate to begin studies of the novel coronavirus once its eventual impact became apparent. Now, graduate students and research specialists in his labworking no more than two together at a time to maximize social distancingare conducting new experiments focused more specifically on the biology of SARS-CoV-2, alongside parallel efforts by Edward Morrissey from PSOM. Knowing that the ACE2 receptor on lung cells is the gateway for the virus into the human body, theyre genetically manipulating alveolar type-two lung cells, which are particularly essential for continuing oxygen exchange deep in the lungs, to alter or block ACE2 gene expression to try to prevent viral entry.

Why are Men Worse Off Than Women? In a separate project, Dr. Vaughan is partnering with Montserrat Anguera, Penn Vet associate professor of biomedical sciences, to explore a curious feature of COVID-19 disease: the fact that more men than women become severely ill and die. A number of hypotheses have been put forward to explain the disparity, but the two labs are investigating one particular possibility.

Dr. Anguera had posted something on Twitter saying that the ACE2 gene happens to be on the X chromosome, meaning that women have two copies of it, said Dr. Vaughan. I immediately texted her and said, I think theres something to that.

Hormone expression levels are another factor that may influence sex differences in disease. Together, Drs. Anguera and Vaughans groups are both studying ACE2 expression and exposing alveolar type-two cells to various hormones to see how expression of viral receptors, ACE2 and others, changes. Ultimately wed like to see if this changes susceptibility to infection, working withSusan Weissand others, said Dr. Vaughan.

Do Genetics Influence Susceptibility? Individual differences in how people respond to infection may be influenced by their unique genomic sequences. PIK Professor Sarah Tishkoff of PSOM and SAS is probing the rich sources of genomic data her group already had in hand to look for patterns that could explain differences in disease susceptibility. Using genomic data from 2,500 Africans collected for another project, Dr. Tishkoffs team is looking for patterns of genetic diversity. Early findings suggest that natural selection may have acted upon on a version of the ACE2 gene, making it more common in some African populations with high exposure to animal viruses.

She is also collaborating withAnurag Vermaand Giorgio Sirugo of Penn Medicine to analyze genetic variation in samples from thePenn Medicine Biobank, looking in particular at people of African descent.

How is the Immune System Reacting? The immune system is what eliminates the virus, saidE. John Wherry, chair of Systems Pharmacology and Translational Therapeutics at PSOM. The immune system is what we need to activate with a good vaccine. But also, especially in many respiratory infections, the immune system is what also causes damage. A healthy outcome means your immune system is striking a balance between killing off the virus and not doing so much damage that it kills you.

Dr. Wherry and Michael Betts, professor of microbiology, have embarked on a study to discern both the magnitude of patients immune responses as well as their flavor, that is, what components in the immune system are being activated by the coronavirus. They are doing so by working with clinicians at HUP and, soon, atPenn Presbyterian Medical Center, to collect blood samples from patients with severe and more mild infections, as well as patients who have recovered from illness, to profile their immune reactions. Variety across patients strongly suggests that the treatments that work for one patient may not for another, Drs. Wherry and Betts note. They are speaking daily with their colleagues on the front lines of COVID-19 care, relaying what theyre finding out in the lab.

The PSOMs Ronald Collman, professor of medicine, andFrederic Bushman, William Maul Measey Professor in Microbiology, have been devoting attention to how the community of bacteria, viruses, fungi and parasites that dwell in the respiratory tract affect health and disease risk. They are now addressing that question in the context of COVID-19. According to Dr. Collman, The microbiome can help set the tone for the immune response to infections, influencing whether a patient ends up with mild or severe disease. And second, the microbiome is where infectious agents that can cause infection can arise from. So if a patient dies of an eventual pneumonia, the pathogen that caused that pneumonia may have been part of that individuals respiratory tract microbiome.

Working with nurses at HUP to collect samples, Drs. Collman and Bushman are analyzing the microbiome of both the upper and lower portions of the respiratory tract of COVID-19 patients. Their labs are using these samples to identify the types and quantities of organisms that compose the microbiome to find patterns in how they correlate with disease.

What Drugs Might Make An Impact? Absent a vaccine, researchers are looking to existing drugssome already approved by the US FDA for other maladiesto help patients recover once infected. Throughout his career,Ronald Harty, Penn Vet professor of pathobiology and microbiology, has worked to develop antivirals for other infections, such as Ebola, Marburg and Lassa Fever.

Though many of the biological details of how SARS-CoV-2 interacts with the human body are distinct from the other diseases Dr. Harty has studied, his group noticed a similarity: A sequence hes targeted in other virusesa motif called PPxYis also present in the spike protein of SARS-CoV-2, which the coronavirus uses to enter cells.

This caught our eye, said Dr. Harty, and piqued our interest in the very intriguing possibility that this PPxY motif could play a role in the severity of this particular virus. He is testing antivirals he has helped identify that block the replication of Ebola, Marburg and other viruses to see if they make a dent on the activity of SARS-CoV-2. Those experiments will be done in collaboration with colleagues whose labs can work in BSL-III or -IV laboratories.

Also of interest is the speculation that the coronavirus might disrupt cell-cell junctions in the human body, making them more permeable for virus spread.

Another faculty member is assessing whether a drug developed for a very different conditionpulmonary arterial hypertension(PAH)could serve coronavirus patients. Henry Daniell, vice-chair and W.D. Miller Professor in Penn Dentals department of basic and translational sciences, shared news that a drug grown in a plant-based platform to boost levels of ACE2 and its protein product, angiotensin (1-7), was progressing to the clinic to treat PAH. Dr. Daniell is now working withKenneth Margulies, PSOM professor of medicine and physiology and research and fellowship director of the Heart Failure and Transplant Program, to explore whether this novel oral therapy can improve the clinical course of patients with symptomatic COVID-19 infection.

Reduced ACE2 expression has been linked to acute respiratory distress, severe lung injury, multi-organ failure and death, especially in older patients. The earlier preclinical studies in PAH animal models showed that orally delivered ACE2 made in plant cells accumulated ten times higher in the lungs than in the blood and safely treated PAH. Now, new clinical studies have been developed to explore whether oral supplementation of ACE2 and angiotensin-1-7 can help mitigate complications of COVID-19 disease. The fact that freeze-dried plant cells can be stored at room temperature for as long as a year and can be taken at home by COVID-19 patients make this novel approach an attractive potential option.

This trial has been given a high priority by the Penn Clinical Trial Working Group, said Dr. Daniell. Im pleased that this looks to be on the cusp of moving forward to help the growing number of COVID-19 patients.

As the coronavirus began to spread in the US, Joshua Plotkin, Walter H. and Leonore C. Annenberg Professor of the Natural Sciences, began to raise alarms about Philadelphias St. Patricks Day parade. His studies of the 1918 flu pandemic had explored disease incidence and spread, and it was hard to avoid noticingthe role of the Liberty Loan paradedown Broad Street in triggering a rampant spread of flu back then. Now, with work conducted with two graduate students and faculty member Simon Levin fromPrinceton University, Dr. Plotkin has mathematically sound advice for policymakers hoping to effectively stem the spread of a pandemic. In apreprint on arXiv.org, they share optimal, near-optimal, and robust strategies.

Their analysis makes the realistic assumption that policymakers can only enforce social distancing for a limited amount of time and aims to minimize the peak incidence of disease. The optimal strategy, they found, is to start by introducing moderate social distancing measures to keep the incidence rate the same for a period of time. This would mean that every person with COVID-19 would infect one additional person. Then the intervention should switch over to a full suppressionthe strongest possible quarantinefor the rest of the period. At the end of that period, all restrictions would be lifted.

This works because you dont want to fully suppress disease spread right off the bat, said Dr. Plotkin, because then at the end, after you remove restrictions, there will be a second peak that is just as large as the first. By employing a moderate suppression at the beginning, youre building up a population of people who are going to recover and become immune, without letting the epidemic get out of control.

Dr. Plotkin and colleagues are hoping to share the findings widely to help navigate a likely second wave of COVID-19.

Adapted from a story by Katie Baillie, Penn TodayVisithttps://tinyurl.com/pennandcovid for the full story.

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Coming Together to Solve COVID-19 Mysteries | University of Pennsylvania Almanac - UPENN Almanac

The Best Over-The-Counter Products For Treating Hyperpigmentation – Harper’s Bazaar Singapore

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If you struggle with dark spots and discolouration, youre not alone. In fact, according to Dr. Dennis Gross, board-certified dermatologist and founder ofDr. Dennis Gross Skincare, the number one skin concern for women is not ageing or wrinkles, its hyperpigmentation. But what exactly is it and how do you treat it?

Hyperpigmentation, the term used to describe areas of unevenpigmentation, is caused when melanin (what gives your hair and skin its colour) is overproduced in certain spots, causing the area to look darker than your natural skin tone. Theses brown patches are most commonly caused by excessive sun exposure, hormone imbalances (as a result of birth control or pregnancy), and inflammation or injury to the skin (a breakout, abug bite, or even an area you might have scratched or picked at too much). Hyperpigmentation usually appears on the face, neck, and dcolletage.

Related article:15 Essential Beauty Treatments To Try Now That Youve Got The Time

Hyperpigmentation is notoriously difficult to treat, but it is doable. If youre really serious about it, its best to visit a dermatologist for in-clinic treatments such as light therapy and peels. However, theres also a host of pigmentation fighting products that you can add to your everyday routine. The key is to look for formulations that feature ingredients such as liquorice extracts, vitamin C and E, niacinamide, beta hydroxy acids, like salicylic, and alpha hydroxyl acids, like glycolic and lactic. Of course, the easiest way to deal with pigmentation is to avoid it altogether by using a good sunscreen and leaving spots alone, especially when theyre not ready. SPF will also help keep current pigmentation from darkening.

Related article:7 Zinc Oxide Sunscreens That Blend Like A Dream

While its unlikely a single product will completely erase dark spots, these ones will certainly help lighten them.

Emma Lewisham Skin Reset Pigmentation Correcting Serum

Emma Lewisham grew up worshiping New Zealands harsh summer sun and by her late 20s she started noticing discolouration and brown spots. But it was during her pregnancy that Lewishams uneven complexion really knocked her confidence. As a result, she set about creating a product that dealt with hyperpigmentation while remaining free of toxins, fillers, synthetic chemicals, and artificial colours and fragrances. Instead, Skin Reset is formulated from 24 of the most high-performing natural ingredients from around the world.

Each bottle contains 190 skin-beautifying ingredients such as organic prickly pear, which is known for its high concentration of vitamin E, and kakadu plum, which has the highest concentration of vitamin C in the world, alongside a host of other minerals, antioxidants, aminos, and omega fatty acids (3, 6, 9, and the rare beauty omega 7).

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Allies Of Skin Mandelic Pigmentation Corrector Night Serum

This next-generation overnight serum from home-grown clean skincare brand, Allies of Skin, is supercharged with a hardworking blend of 11% Mandelic, Lactic + Salicylic acid, 8 brighteners and 7 antioxidants and peptides, helping to treat stubborn pigmentation, melasma, large pores, persistent breakouts, uneven texture and even blackheads. While most AHA (Alpha-Hydroxy Acids) serums focus only on the exfoliation aspect that can sometimes lead to tightness and irritation, this multitasking booster is formulated to not only gently dissolve dead skin cells but also replenish moisture and strengthen the skins delicate barrier, with its hydrating blend of hyaluronic acid, niacinamide and essential fatty acids from organic rosehip and tamanu oil.

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Dr. Dennis Gross Skincare Professional Grade IPL Dark Spot Concentrated Serum

Part of Dr. Dennis Gross Skincares Clinical Grade range, the brands Professional Grade IPL Dark Spot Concentrated Serum boasts an innovative formula straight from his practice formulated to help fade the look of stubborn dark spots and discolouration for an even and radiant complexion.Jam-packed with 10% L-ascorbic acid, lactic acid, kojic acid,andarbutin, this pro-level formula is clinically shown to reduce the appearance of sunspots, age spots, and dark patches in just a few weeks.

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IDS Skincare Fair Complex

IDSis askincareline made to deliver highly visible results that surpass those achieved by most prescription products, without the side effects they often cause. The brands Fair Complex comes with a proprietary formulation of peptides and active ingredients that everyone can benefit from, regardless of skin tone. Alongside lines and wrinkles, skin dullness and hyperpigmentation it also works to target the signs of ageing. The skin-brightening formula is hydroquinone-free, but coupled with state-of-the-art ingredients and IDS patented NEULASTIN technology, it effectively prevents melanin over-production and visibly counteracts age spots and hyperpigmentation without irritations or side effects.

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Derma Lab Lumiclar Pure Vitamin C15

Formulated with 15% dermatological grade Vitamin C(one of the highest in the market), Derma Labs Lumiclar Pure Vitamin C15 penetrates deep into the skins epidermis and rapidly evens out the complexion for a radiant glow. Together with ultra-stable forms of ascorbic acid, skin becomes brighter, firmer, and more lifted. Vitamin Cs powerful antioxidant properties also reinforce the skins defence against free radicals, while the Derma Mimic Complex locks in moisture and strengthens skin barrier for hydrated, healthier skin.

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Drunk Elephant T.L.C Framboos Glycolic Night Serum

Drunk Elephants T.L.C Framboos Glycolic Night Serum is a high-tech gel that resurfaces dull skin, lifting dead skin cells away by gently dissolving the glue that holds them to the surface. Formulated with a combination of glycolic, lactic, tartaric, citric and salicylic acids, and blended with raspberry extract, T.L.C. Framboos sinks in easily and delivers an effective level of chemical exfoliation without the harsh side effects like dryness or sensitisation. Fine lines, wrinkles, and discolouration, along with excess oiliness and the appearance of pores, will appear dramatically reduced. Meanwhile, horse chestnut, bearberry, and white tea help to calm and soothe while improving the appearance of broken capillaries.

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Huxley Brightly Ever After Essence

A South Korean skincare brand that has recently launched in Singapore, Huxleys products are formulated around Sahara-sourced prickly pear, which is rich in vitamin E and brimming with antioxidants to prevent moisture from escaping while promoting healthy skin cell production for a more resilient, youthful appearance. The brands Brightly Ever After Essence offers a light, milky-textured formula that targets uneven skin tone, dark spots and hyperpigmentation. Its also enriched with niacinamide, a form of Vitamin B with brightening properties that aids in reducing dullness for an even skin tone.

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Related article:The Best Luxury Body Lotions To Try Now

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The Best Over-The-Counter Products For Treating Hyperpigmentation - Harper's Bazaar Singapore

Meet ACE2, the Enzyme at the Center of the Covid-19 Mystery – WIRED

During the first chaotic months of the Covid-19 pandemic, it was already clear that the novel coronavirus spreading around the world didnt affect everyone equally. The earliest clinical data out of China showed that some people consistently fared worse than others, notably men, the elderly, and smokers. It made some scientists wonder: What if the elevated risk of severe infection and death shared by these different people all boils down to differences in a single protein?

Here's all the WIRED coverage in one place, from how to keep your children entertained to how this outbreak is affecting the economy.

Jason Sheltzer, a molecular biologist at Cold Spring Harbor Laboratory, started talking about this possibility with his partner, Joan Smith, a software engineer at Google, during the early days of their New York lockdown. We thought maybe the simplest explanation could be if all these factors affected the expression of ACE2, says Sheltzer.

ACE2, which stands for angiotensin-converting enzyme 2, is a protein that sits on the surface of many types of cells in the human body, including in the heart, gut, lungs, and inside the nose. Its a key cog in a biochemical pathway that regulates blood pressure, wound healing, and inflammation. ACE2s amino acids form a grooved pocket, allowing it to snag and chop up a destructive protein called angiotensin II, which drives up blood pressure and damages tissues. But angiotensin II isnt the only thing that fits in ACE2s pocket. So does the tip of the mace-like spike proteins that project from SARS-CoV-2, the coronavirus that causes Covid-19. Like a key turning in a latch, the virus gains entry to the cell through ACE2, then hijacks the cells protein-making machinery to make copies of itself. An infection begins.

In the early days of the pandemic, the thinking went something like this: The more ACE2 a person has, the easier it should be for the coronavirus to invade and advance through their tissues, causing more severe forms of the disease. The more ways inside someones cells, the higher the persons risk. Thats the hypothesis Sheltzer and Smith were interested in investigating. They werent alone. As the virus spread beyond China, other high-risk groups surfaced: people with heart conditions, high blood pressure, diabetes, and obesity. Many people in these groups take medications that are known to boost ACE2 expression. So again, scientists wondered, could that protein be responsible?

But as researchers began to probe the relationship between ACE2 and this dangerous new disease, the data refused to line up in any neat, predictable patterns. What we know now is that there arent any simplistic, reductionist explanations that can unify all the clinical data thats been recovered so far, says Sheltzer. Instead, a more complicated picture has emerged. But its one that still has ACE2 at the center of the action.

Smoking Dials Up the ACE2

Sheltzer and Smith, confined to their home, couldnt run any experiments to tease out their initial hypothesis. Instead, they combed through existing data sets from both animal and human studies that measured the level of gene expression in various tissues. Over and over, they found that women and men produced similar amounts of ACE2 inside their lung cells. They also couldnt find any differences between young adults and older ones. Aging didnt change ACE2 one way or another. But the smokers were a different story.

When they looked at gene expression inside the lungs of smokers versus nonsmokers, they saw a huge spike in ACE2 coming from one particular kind of cell: secretory goblet cells. The job of these mucous-makers is to coat the inside of the respiratory tract, protecting it from any irritants you might breathe in (like say, tar, nicotine, or any of the other 250 harmful chemicals in cigarette smoke). The more people smoked, the more their goblet cells multiplied in an effort to trap these chemicals before they could damage surrounding tissue. Those expanding goblet cell army ranks fueled a surge in ACE2, as Sheltzer and his coauthors described in a study published in Developmental Cell in mid-May.

Read more:
Meet ACE2, the Enzyme at the Center of the Covid-19 Mystery - WIRED

Adenomyosis Treatment Market 2019 | Analyzing The Impact Followed By Restraints, Opportunities And Projected Developments | UpMarketResearch – Medic…

The Adenomyosis Treatment Market report includes overview, which interprets value chain structure, industrial environment, regional analysis, applications, market size, and forecast. This is a latest report, covering the current COVID-19 impact on the market. The pandemic of Coronavirus (COVID-19) has affected every aspect of life globally. This has brought along several changes in market conditions. The rapidly changing market scenario and initial and future assessment of the impact is covered in the report. The report provides an overall analysis of the market based on types, applications, regions, and for the forecast period from 2020 to 2026. It also offers investment opportunities and probable threats in the market based on an intelligent analysis.

This report focuses on the Global Adenomyosis Treatment Market trends, future forecasts, growth opportunities, key end-user industries, and market players. The objectives of the study are to present the key developments of the market across the globe.

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Key List Market Participants in the Market:Bayer AGFerring B.VJohnson & JohnsonNovartisMerckPfizerSpeciality European Pharma

By Types:Anti-inflammatory drugsHormone medicationsOther

By Applications:HospitalClinicOthers

Scope of the Adenomyosis Treatment Market Report:

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By Regions:North America (The USA, Canada, and Mexico)Europe (Germany, France, the UK, and Rest of Europe)Asia Pacific (China, Japan, India, and Rest of Asia Pacific)Latin America (Brazil and Rest of Latin America.)Middle East &Africa (Saudi Arabia, the UAE, South Africa, and Rest of Middle East & Africa).

Report Answers Following Questions:

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Adenomyosis Treatment Market Historic Data (2015-2019):

Adenomyosis Treatment Market Forecast (2020-2026):

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About UpMarketResearch:Up Market Research (https://www.upmarketresearch.com) is a leading distributor of market research report with more than 800+ global clients. As a market research company, we take pride in equipping our clients with insights and data that holds the power to truly make a difference to their business. Our mission is singular and well-defined we want to help our clients envisage their business environment so that they are able to make informed, strategic and therefore successful decisions for themselves.

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Adenomyosis Treatment Market 2019 | Analyzing The Impact Followed By Restraints, Opportunities And Projected Developments | UpMarketResearch - Medic...

Advanced Hormone Solutions – HORMONE THERAPY

I went in to premature menopause in 2008 and I was 38 years old at that time. My OB/GYN put me on HRT but after one year and a half, I started having palpitations and dizziness. After so medical tests, my doctors decided not to give me their HRT any longer. My OB/GYN strongly suggested to me not to take any oral hormones and I follow that recommendation for 8 years until I realized that my marriage was suffering because my libido was inexistent and having intercourse was extremely painful. That was not a good combination and I decided to start looking for getting help. I had other symptoms but after 8 years in menopause, those were manageable. So, I did some research and found Dr. Matos. Now, after two pellet therapies and a 4-week booster, I feel like a teenager. Sounds funny but it is true. Dryness is gone for good and my libido is back. I am sleeping at least 7 hours every day, I am gaining more energy, and my memory is getting stronger. Last week, I got my second pellet therapy and I have never been so excited to go to a doctors appointment in my entire live.This treatment works perfectly fine and I am encouraging my husband to give it a try.Thank you, Dr. Matos.

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Advanced Hormone Solutions - HORMONE THERAPY

Bills seek to limit puberty blockers, other treatment for transgender youth – KTAR.com

TUCSON For 17-year-old Fran Howard, receiving medical care has not always been easy. Howard identifies as nonbinary gender queer and uses they/them pronouns.

Years ago, Howard began seeking treatment to help transition but found it difficult to find a doctor who respected the decision and Howards medical needs.

I felt like I had to prove my identity, Howard said. Just being in a trans body and existing in the world is already so difficult, and going to the doctor is just this whole super invasive experience.

Legislation cropping up in statehouses across the U.S. could make that experience even more difficult.

In at least a dozen states, including South Dakota, Florida and Ohio, bills were introduced this year to make it harder for transgender minors to get medical treatment such as puberty blockers and other hormone therapies.

Some bills proposed criminalizing doctors who provide such treatment. Floridas measure carried a maximum penalty of up to 15 years in prison. Missouri physicians faced having their medical licenses revoked, and parents of children receiving treatment in that state would be reported to social services for child abuse.

Advocates for trans teens assert the proposals, though theyve not become law, are part of a larger push to discriminate against transgender people. They point to other bills including one passed by the Arizona House that would ban transgender athletes in girls sports. In Arizona, that measure stalled in the Senate.

The 2020 state legislative season has seen unprecedented attacks on LGBTQ people, and an alarming focus on bills that would harm trans youth, Rose Saxe, deputy director of the American Civil Liberties Union LGBT & HIV Project, wrote on the organizations website.

These efforts are part of an orchestrated national campaign led by groups like Heritage Foundation, Alliance Defending Freedom to demonize trans youth and drive a wedge among supporters of LGBTQ equality, Saxe continued. We cant let them succeed.

Ryan Anderson, a senior research fellow at the Heritage Foundation, disputed that.

He said the measures around medical treatment are meant to protect youth from making decisions they may later regret. He called treatments such as hormone therapy and puberty blockers experimental and unethical.

Its entirely appropriate for the government to say that physicians cant perform those procedures to protect children from the abuse of medicine, the misuse of medicine, he said.

In an email, Matt Sharp, senior counsel for the Alliance Defending Freedom, said: While approaches may differ, we should all agree that there is nothing natural or healthy about pumping kids full of puberty blockers and cross-sex hormones.

Children should not be pushed to receive experimental treatments that can leave them permanently sterile and physically marred for life.

Fran Howard, with the support of their mother, sought medical treatment at age 13 after questioning their gender identity. They found help at El Rio Health. After consultations, treatment started with puberty suppression and has progressed to testosterone.

Before transitioning, my mental health was in a really terrible place. Nobody saw me as who I was. I didnt see myself as who I was, Howard said.

Being able to transition has saved my life, and the fact that that is being challenged for other people is very frightening, because many people will not be able to survive.

Howards mother, Tina, said she raised her children in a gender-fluid home, avoiding assigning specific gender roles.

This is really about building a safe environment for trans individuals and their family, she said.

Pediatricians Andrew Cronyn and Tracey Kurtzman started the El Rio clinics transgender department five years ago, and theyve treated about 250 patients since.

Cronyn initially had planned to launch a program for the children of lesbian, gay and bisexual parents. But after posting a note on Facebook, he heard about a different need: appropriate primary care for transgender kids whose pediatricians wouldnt call them by their preferred names or pronouns or tried to convince them their gender assignment at birth was appropriate.

The kids we see will usually have been talking to their parents about gender at home for six months to a year before they even consider talking to a doctor about it, he said.

Cronyn works with patients parents to educate them about gender dysphoria, a condition in which people feel a conflict between the gender assigned them at birth and the gender they identify with.

For those beginning puberty, treatment may include drugs that inhibit or delay puberty. For older teens who have been persistent, consistent and insistent about their gender identity, Cronyn said, hormone therapy may be prescribed.

According to the Mayo Clinic, puberty blockers do not cause permanent changes in an adolescents body, and puberty can resume if the treatment is stopped.

A lot of people worry youre blocking it and youve changed their life completely, Cronyn said. And the truth is we havent. If they say, This isnt the right road for me, then we can stop the medicine and their puberty starts right where it was before.

Cronyn and other experts said they worry about efforts to try to restrict such care and the potential effects on the emotional health of transgender children.

Research published last year by the American Academy of Pediatrics found that transgender youth are more likely to consider suicide than other teens. The study found 34% of transgender adolescents reported experiencing suicidal ideation in the past year, while 61% reported having suicidal thoughts over their lifetime.

Alex Keuroghlian is an associate professor of psychiatry at Harvard Medical School, director of the Massachusetts General Hospital Psychiatry Gender Identity Program and also directs the National LGBT Health Education Center, a federally funded effort to improve health care for LGBTQ people. He co-authored a study published earlier this year in the journal Pediatrics showing a decrease in suicidal ideation among trans youth who had access to puberty blockers.

What we tell families is that in order to have a child who is healthy and happy and thrives, you need to affirm them in their gender identity, and these medical therapies help with that, Keuroghlian said. Its not a decision thats made thoughtlessly by patients families or their medical providers.

Research has found that among those who do seek to transition, a minority later change their minds. A 2015 survey of 28,000 people conducted by the National Center for Transgender Equality found 8% of respondents reported reversing their gender transition, and 62% of those who detransitioned did so only temporarily.

Fran Howard said such treatments changed their life.

I personally cant imagine that without the support of my family, and without medical intervention, that I would still be here today and that is true for a lot of kids, Howard said. For a trans person, this isnt the same as dyeing your hair color. Its being yourself. And to be denied that, it completely takes away somebodys human rights. People will die.

Read more:
Bills seek to limit puberty blockers, other treatment for transgender youth - KTAR.com

7 Surprising Warning Signs of Stress and How to Cope – LIVESTRONG.COM

From sleepless nights to a weakened immune system or overeating, you're probably familiar with the more common symptoms of stress. But stress can also trigger less well-known side effects (both mental and physical) that you might not expect.

Suddenly constipated? Stress might be the bane of your bowels.

Image Credit: gpointstudio/iStock/GettyImages

Here, Rosalind S. Dorlen, PsyD, a New Jersey-based, board-certified clinical psychologist and member of the psychiatry department at the Overlook Medical Center, shares some of the more surprising ways that stress may manifest in your body.

If you're feeling foggy or having a tough time focusing, stress may be the culprit, Dorlen says.

Indeed, stress and anxiety can hinder your attention and your ability to retrieve memories (or even make new ones), according to Harvard Health Publishing.

In fact, a November 2018 study in Neurology demonstrated that adults with higher levels of cortisol (the "stress hormone") exhibited impaired memory and lower brain volumes.

"Skin reactions like hives, viral exanthem (an eruptive skin rash), acne and cold sores seem to be an unfortunate example of collateral damage people experience under periods of extreme stress," Dorlen says.

Here's why: "Stress causes our bodies to make hormones like cortisol and epinephrine, which activate skin glands to produce oiliness, which can be a factor in acne and other skin-related conditions," she says.

What's more, during stressful times, we tend to neglect our usual self-care regimens (think: reduced sleep, skipping your face wash routine at bedtime, etc.) which can create or exacerbate existing skin vulnerabilities, Dorlen explains.

Lost your libido? "Heightened or chronic stress can interfere with our body's hormone levels, producing greater amounts of cortisol and epinephrine, and the effect can reduce sexual interest or desire," Dorlen says.

Think about it: If your body is in a constant reactive state of flight-or-fight, fear or paralysis due to stress, these conditions aren't exactly conducive to sexy time.

Indeed, an October 2013 study in the Journal of Sexual Medicine discovered that high levels of chronic stress were correlated with less sexual arousal in women. The researchers concluded that psychological distraction and increased cortisol played a major role.

And the physical effects of stress can be negative for men, too. According to Dorlen, "the long-term effects of stress can narrow and restrict blood flow, which is one of a number of factors associated with erectile dysfunction."

Conversely, it's much easier to get in the mood when you're feeling loose and relaxed. "That may be why so many couples enjoy expanded sexual interest and participation when on vacation," Dorlen says.

Have you suddenly noticed tension in your neck, back or shoulders? Stress may be the culprit.

Our bodies deal with stress by going into fight-or-flight mode, Dorlen explains, which means releasing hormones that ready our muscles to respond to whatever is threatening us. This can be helpful in the short term (think: running from a bear), but can cause issues if we're consistently under stress.

"Muscles tense up to protect themselves from injury during stressful conditions, so they may not get a chance to relax if the stress is continual," Dorlen says.

And to make matters worse, stress and anxiety can intensify your perception of muscular pain and decrease your ability to cope with it, according to the North American Spine Society.

Feeling on edge? Irritability is a common symptom of chronic and prolonged stress, Dorlen says. This may have something to do with your body's chemical reaction to stress.

When your body releases chemicals in response to a perceived threat, your heart and breathing skyrocket to help you spring into action. This may have helped you flee a hungry predator back in the day, but today it might just leave you feeling tense, moody and even angry.

A January 2015 study in the American Heart Journal found that high levels of anger appeared to be linked to mental distress and an increased cardiovascular risk, while another November 2015 paper in The Journals of Gerontology: Series B discovered an association between anger and stressors in caregivers.

Anyone who's ever experienced a "nervous stomach" knows that stress can go straight to your gut.

Chronic stress can cause a whole range of GI complications, including stomachaches, constipation and diarrhea, according to Dorlen.

That's because your gut and central nervous system are in constant communication, per John Hopkins Medicine. In fact, they're so intimately connected that your gut is often referred to as your "second brain."

From spilling coffee on your shirt to losing your keys and sitting in gridlock, everyday annoyances can be a headache literally.

It goes back to that fight-or-flight response. When your body enters this state and produces hormones like adrenaline and cortisol, it causes vascular changes that prep your muscles to deal with the danger. But this chain of events can also give you a migraine or headache, according to the Cleveland Clinic.

What's more, during periods of high stress, many people experience tightness in their neck, jaw and shoulders dubbed the "tension triangle" which only worsens tension headaches, per the Cleveland Clinic.

Roll out the yoga mat to help bust your stress.

Image Credit: shironosov/iStock/GettyImages

Though it's impossible to completely eliminate stress from your life, you can learn to better manage daily stressors and, in doing so, improve your overall wellbeing.

Here are some ways to help you cope:

Breathing exercises (like the 4-7-8 method) can calm your body's fight-or-flight instincts and elicit a relaxation response, according to Harvard Health Publishing.

Practicing meditation, which includes deep belly breathing, can help you let go of negative emotions that may be causing you mental and physical stress, per the American Psychological Association.

Getting your body moving with regular exercise and gentle movements like yoga, tai chi and stretching exercises can be good for reducing muscle tension and beneficial for busting stress, according to the Mayo Clinic.

Spending a few minutes each day practicing gratitude (think: writing down something you're grateful for) can help you feel happier, more positive and less stressed, per Harvard Health Publishing.

Link:
7 Surprising Warning Signs of Stress and How to Cope - LIVESTRONG.COM

(2020-2025) Pre-Menstrual Syndrome Market to Witness Robust Expansion throughout the Forecast Period – Cole of Duty

Latest Trending Report onPre-Menstrual Syndrome Market

The report titled Global Pre-Menstrual Syndrome Market is one of the most comprehensive and important additions to Alexareports archive of market research studies. It offers detailed research and analysis of key aspects of the global Pre-Menstrual Syndrome market. The market analysts authoring this report have provided in-depth information on leading growth drivers, restraints, challenges, trends, and opportunities to offer a complete analysis of the global Pre-Menstrual Syndrome market. Market participants can use the analysis on market dynamics to plan effective growth strategies and prepare for future challenges beforehand. Each trend of the global Pre-Menstrual Syndrome market is carefully analyzed and researched about by the market analysts.

Pre-Menstrual Syndrome Market competition by top manufacturers/ Key player Profiled: Alva-Amco Pharmacal Cos., Inc., Bayer, Inc., Chattem, Inc. (Sanofi), DEKK-TEC, Inc., G. R. Lane Health Products Ltd, McNeil Consumer Healthcare, MetP Pharma AG, Pherin Pharmaceuticals, Inc., Umecrine Mood AB, Novartis AG, GlaxoSmithKline Plc

Get PDF Sample Copy of the Report to understand the structure of the complete report:(Including Full TOC, List of Tables & Figures, Chart) : https://www.alexareports.com/report-sample/632324

Global Pre-Menstrual Syndrome Market is estimated to reach xxx million USD in 2020 and projected to grow at the CAGR of xx% during 2020- 2025. According to the latest report added to the online repository of Alexareports the Pre-Menstrual Syndrome market has witnessed an unprecedented growth till 2020. The extrapolated future growth is expected to continue at higher rates by 2025.

Based on region, the globalPre-Menstrual Syndrome market has been segmented into Americas (North America ((the U.S. and Canada),) and Latin Americas), Europe (Western Europe (Germany, France, Italy, Spain, UK and Rest of Europe) and Eastern Europe), Asia Pacific (Japan, India, China, Australia & South Korea, and Rest of Asia Pacific), and Middle East & Africa (Saudi Arabia, UAE, Kuwait, Qatar, South Africa, and Rest of Middle East & Africa).

Pre-Menstrual Syndrome Market Segment by Type covers: Analgesics (Pain Killers), Oral Contraceptive Pills (OCPs), Gonadotropin-Releasing Hormone (GnRH), Antidepressants, Ovarian Suppressors/Diuretics/Benzodiazepines

Pre-Menstrual Syndrome Market Segment by Industry: Hospitals, Clinic

After reading the Pre-Menstrual Syndrome market report, readers get insight into:

*Major drivers and restraining factors, opportunities and challenges, and the competitive landscape*New, promising avenues in key regions*New revenue streams for all players in emerging markets*Focus and changing role of various regulatory agencies in bolstering new opportunities in various regions*Demand and uptake patterns in key industries of the Pre-Menstrual Syndrome market*New research and development projects in new technologies in key regional markets*Changing revenue share and size of key product segments during the forecast period*Technologies and business models with disruptive potential

Key questions answered in the report:

What will the market growth rate of Pre-Menstrual Syndrome market?What are the key factors driving the global Pre-Menstrual Syndrome market size?Who are the key manufacturers in Pre-Menstrual Syndrome market space?What are the market opportunities, market risk and market overview of the Pre-Menstrual Syndromemarket?What are sales, revenue, and price analysis of top manufacturers of Pre-Menstrual Syndrome market?Who are the distributors, traders, and dealers of Pre-Menstrual Syndrome market?What are the Pre-Menstrual Syndrome market opportunities and threats faced by the vendors in the global Pre-Menstrual Syndromeindustries?What are sales, revenue, and price analysis by types and applications of Pre-Menstrual Syndromemarket?What are sales, revenue, and price analysis by regions of Pre-Menstrual Syndrome industries?

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Table of ContentsSection 1 Pre-Menstrual Syndrome Product DefinitionSection 2 Global Pre-Menstrual Syndrome Market Manufacturer Share and Market Overview2.1 Global Manufacturer Pre-Menstrual Syndrome Shipments2.2 Global Manufacturer Pre-Menstrual Syndrome Business Revenue2.3 Global Pre-Menstrual Syndrome Market OverviewSection 3 Manufacturer Pre-Menstrual Syndrome Business Introduction3.1 Alva-Amco Pharmacal Cos., Inc. Pre-Menstrual Syndrome Business Introduction3.1.1 Alva-Amco Pharmacal Cos., Inc. Pre-Menstrual Syndrome Shipments, Price, Revenue and Gross profit 2014-20193.1.2 Alva-Amco Pharmacal Cos., Inc. Pre-Menstrual Syndrome Business Distribution by Region3.1.3 Alva-Amco Pharmacal Cos., Inc. Interview Record3.1.4 Alva-Amco Pharmacal Cos., Inc. Pre-Menstrual Syndrome Business Profile3.1.5 Alva-Amco Pharmacal Cos., Inc. Pre-Menstrual Syndrome Product Specification3.2 Bayer, Inc. Pre-Menstrual Syndrome Business Introduction3.2.1 Bayer, Inc. Pre-Menstrual Syndrome Shipments, Price, Revenue and Gross profit 2014-20193.2.2 Bayer, Inc. Pre-Menstrual Syndrome Business Distribution by Region3.2.3 Interview Record3.2.4 Bayer, Inc. Pre-Menstrual Syndrome Business Overview3.2.5 Bayer, Inc. Pre-Menstrual Syndrome Product Specification3.3 Chattem, Inc. (Sanofi) Pre-Menstrual Syndrome Business Introduction3.3.1 Chattem, Inc. (Sanofi) Pre-Menstrual Syndrome Shipments, Price, Revenue and Gross profit 2014-20193.3.2 Chattem, Inc. (Sanofi) Pre-Menstrual Syndrome Business Distribution by Region3.3.3 Interview Record3.3.4 Chattem, Inc. (Sanofi) Pre-Menstrual Syndrome Business Overview3.3.5 Chattem, Inc. (Sanofi) Pre-Menstrual Syndrome Product Specification3.4 DEKK-TEC, Inc. Pre-Menstrual Syndrome Business Introduction3.5 G. R. Lane Health Products Ltd Pre-Menstrual Syndrome Business Introduction3.6 McNeil Consumer Healthcare Pre-Menstrual Syndrome Business IntroductionSection 4 Global Pre-Menstrual Syndrome Market Segmentation (Region Level)4.1 North America Country4.1.1 United States Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.1.2 Canada Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.2 South America Country4.2.1 South America Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.3 Asia Country4.3.1 China Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.3.2 Japan Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.3.3 India Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.3.4 Korea Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.4 Europe Country4.4.1 Germany Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.4.2 UK Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.4.3 France Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.4.4 Italy Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.4.5 Europe Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.5 Other Country and Region4.5.1 Middle East Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.5.2 Africa Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.5.3 GCC Pre-Menstrual Syndrome Market Size and Price Analysis 2014-20194.6 Global Pre-Menstrual Syndrome Market Segmentation (Region Level) Analysis 2014-20194.7 Global Pre-Menstrual Syndrome Market Segmentation (Region Level) AnalysisSection 5 Global Pre-Menstrual Syndrome Market Segmentation (Product Type Level)5.1 Global Pre-Menstrual Syndrome Market Segmentation (Product Type Level) Market Size 2014-20195.2 Different Pre-Menstrual Syndrome Product Type Price 2014-20195.3 Global Pre-Menstrual Syndrome Market Segmentation (Product Type Level) AnalysisSection 6 Global Pre-Menstrual Syndrome Market Segmentation (Industry Level)6.1 Global Pre-Menstrual Syndrome Market Segmentation (Industry Level) Market Size 2014-20196.2 Different Industry Price 2014-20196.3 Global Pre-Menstrual Syndrome Market Segmentation (Industry Level) AnalysisSection 7 Global Pre-Menstrual Syndrome Market Segmentation (Channel Level)7.1 Global Pre-Menstrual Syndrome Market Segmentation (Channel Level) Sales Volume and Share 2014-20197.2 Global Pre-Menstrual Syndrome Market Segmentation (Channel Level) AnalysisSection 8 Pre-Menstrual Syndrome Market Forecast 2019-20248.1 Pre-Menstrual Syndrome Segmentation Market Forecast (Region Level)8.2 Pre-Menstrual Syndrome Segmentation Market Forecast (Product Type Level)8.3 Pre-Menstrual Syndrome Segmentation Market Forecast (Industry Level)8.4 Pre-Menstrual Syndrome Segmentation Market Forecast (Channel Level)Section 9 Pre-Menstrual Syndrome Segmentation Product Type9.1 Analgesics (Pain Killers) Product Introduction9.2 Oral Contraceptive Pills (OCPs) Product Introduction9.3 Gonadotropin-Releasing Hormone (GnRH) Product Introduction9.4 Antidepressants Product Introduction9.5 Ovarian Suppressors/Diuretics/Benzodiazepines Product IntroductionSection 10 Pre-Menstrual Syndrome Segmentation Industry10.1 Hospitals Clients10.2 Clinic ClientsSection 11 Pre-Menstrual Syndrome Cost of Production Analysis11.1 Raw Material Cost Analysis11.2 Technology Cost Analysis11.3 Labor Cost Analysis11.4 Cost OverviewSection 12 Conclusion

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(2020-2025) Pre-Menstrual Syndrome Market to Witness Robust Expansion throughout the Forecast Period - Cole of Duty

4 common hair issues that could be symptoms other health concerns, according to the experts – VOGUE India

Just like eyes can be the window into the soul, hair can be a window into your health. While having a good hair day is tied into vanity, it can also suggest that your vitamin and mineral levels are all in balance, along with a strong immune system and metabolism. Greying early, losing clumps of hair or simply finding strands dull and unruly could be a sign that something else is going on, and can signal to you to reach out to a doctor. Not sure what's up? We spoke to the pros to find out how to know.

When you'll start to go grey is usually determined by genetics, and it isn't necessarily a sign that anything is wrong. But if you start to grey in your 20s, it could be too early. "Premature greying could be a sign of vitiligo or leukoderma, hypothyroidism and in some cases even Vitamin B12 deficiencies, informs Dr Satish Bhatia, dermatologist and cutaneous surgeon. He suggests getting Vitamin levels checked, as well as exploring other correlations, like smoking and tobacco use.

Heat styling and dye can cause damage to hair, leaving it looking frazzled and dry. But if you've used hair masks and laid off the heat tools, dry and dull hair could be a sign of a poor diet, or hypothyroidism. Cuticle is the hair's outermost protective layer. On healthy hair, these cells will lie smooth and flat," says Dr Bhatia. This is the reason for hair to reflect light, and appear smooth and shiny. If your diet lacks Omega 3 and Omega 6 fatty acids, you can see it in your strands being brittle. It's not just deficiencies, including too much Vitamin A in your diet and supplement intake can also cause dull, breakage-prone strands. Dull and dehydrated hair is also an obvious giveaway of iron deficiencies or anaemia, he says.

Dr Rigvita Yadav, senior consultant trichologist at Tricia Hair Clinic, Jean-Claude Biguine India explains that miniaturisation is the hormone-driven biological process in which strands shrink in size over time resulting in decrease in hair volume. She adds, In genetically-susceptible hair follicles, a hormone called dihydrotestosterone (DHT) can cause the hair follicle to shrink in size, resulting in production of thinner and weaker hair.

This kind of hair loss is mostly mediated by male hormone testosterone, and called androgenic alopecia. While it can affect both men and women, it is the cause of the common baldness in men. In women it is seen as broadening of the partition of the scalp, recession of the hairline or formation of the notches in the sides of the hairline. It can be seen as a genetic problem in women, however a substantial number of females dont have a family history and they should be investigated for PCOS and ovarian tumours, informs Dr Chaturvedi.

Telogen effluvium is by far the most common form of hair loss seen. In dramatic cases, it can result in a 25 per cent hair loss, points out Dr Chaturvedi. If you're seeing hair shed in clumps, it could relate to hormonal or gut issues. This is when a patient will complain that whenever they wash their hair, they can see large chunks falling out," says Dr Bhatia. Doctors say that you can see this stress-related hair fall after a definable precipitating event, which could include trauma, or illnesses like typhoid or malaria. Another important cause? An imbalanced diet. Crash diets, high protein diets that don't include carbs, or eating lots of processed foods can cause stress-induced hair fall, says Dr Yadav about the inflammatory foods that put pressure on the digestive and immune system.

Is your hair fall stress-related? Here's what you can do to stop it

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4 common hair issues that could be symptoms other health concerns, according to the experts - VOGUE India

PET/CT Imaging Potentially Useful in Evaluating mCRPC Treatment Response – Renal and Urology News

Metabolic imaging in conjunction with PSA testing could improve evaluation of treatment response and disease progression in men with metastatic castration-resistant prostate cancer (mCRPC), according to data presented during the American Society of Clinical Oncology 2020 Virtual Scientific Program.

Thisapproach would address a frequently observed paradoxical response to treatmentwhereby radiographic disease progression occurs despite stable or declining PSAlevels, according to investigators.

Ina study of 123 men with mCRPC who received second-generation hormone therapy(either abiraterone or enzalutamide) post-taxane-based chemotherapy,investigators found that nearly 40% of men experienced radiographic progressionas determined by serial imaging with C-11 choline positron emissiontomography/computed tomography (PET/CT) despite having stable or declining PSAlevels.

JamalAlamiri, MB, BCh, of Mayo Clinic in Rochester, Minnesota, and colleaguesdefined radiographic progression of disease by an increase in blood poolcorrected maximum standardized uptake value of the index lesion on C-11 cholinePET/CT scans. Patients underwent serial PSA testing and C-11 choline PET/CTscans every 3 to 6 months. They confirmed suspicious lesions using conventionalimaging, subsequent C-11 choline PET/CT evaluation, or by biopsy of themetastatic lesions whenever feasible.

Ofthe 123 men, 43% had radiographic disease progression while on abiraterone orenzalutamide, Dr Alamiris team reported. At the time of radiographicprogression, 60.4% of patients demonstrated a parallel rise in PSA levels(group A), whereas 39.6% had stable or declining PSA levels (group B).

Themedian PSA level at the time of radiographic progression was significantlyhigher for group A than group B (3.1 vs 1.3 ng/mL). Bone-predominanceprogression occurred more frequently in group B than group A (90% vs 65%). Themedian time until radiographic progression was significantly longer for group Athan group B (9.5 vs 3.9 months).

The study revealed the presence of 5or more metastatic lesions, bone metastatic lesions, and local or prostatic beddisease predicted a paradoxical response, Dr Alamiri told Renal & Urology News. Patients on enzalutamide were 4.6 timesmore likely to have a paradoxical response compared with those on abiraterone. Onmultivariable analysis, however, only local or prostatic bed disease remained asignificant predictor of paradoxical response.

As for why radiographic progressioncan occur despite stable or declining PSA levels, Dr Alamiri said itis possible prostate cancer cells gaintreatment-induced androgen-receptor (AR)-independent resistance mechanisms dueto exposure to multiple therapies. Invitro studies of cell lines have found AR-indifferent mCRPC cells that donot depend onAR pathways for growth. These cell lines showed resistanceagainst second-generation hormone therapies such as abiraterone andenzalultamide and expressed cross-resistance against taxane-based chemotherapy.It is unknown whether the genetic and molecular findings reported in thesestudies explain the paradoxical response described in our study, Dr Alamirisaid. Future studies performing genomic analysis on biopsy samples frommetastatic site from these patients are needed to see if they will mimic themolecular resistance mechanisms described in the in vitro studies.

Reference

Alamiri J, Ahmed ME, Andrews JR, etal. Radiographic paradoxical response in patients with metastatic castration-resistantprostate cancer (mCRPC) undergoing treatment with second-generation hormonetherapy (second-HT). Presented at the 2020 American Society of ClinicalOncology Virtual Scientific Program held May 29 to 31. Abstract 5577.

https://meetinglibrary.asco.org/record/188050/abstract

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PET/CT Imaging Potentially Useful in Evaluating mCRPC Treatment Response - Renal and Urology News

Radiation oncology appointments plummeted in the COVID-19 pandemicbut seem to be rising again – The Cancer Letter

publication date: May. 29, 2020

By Alexandria Carolan

This story is part of The Cancer Letters ongoing coverage of COVID-19s impact on oncology. A full list of our coverage, as well as the latest meeting cancellations, is availablehere.

Radiation visitsmuch like preventative screenings, surgery, chemotherapy and screeningwere delayed or canceled at the peak of COVID-19 in the United States.

Now, the patients are returning, in some cases creating small upticks in demand for treatments that were delayed in March, April and May. In a few institutions, the return of the patients is creating wich-welcomed backlogs.

In a survey conducted by the American Society for Radiation Oncology April 16-30, 85% of oncology practices said radiation oncology appointments at their practices had decreased by about a third, even though their doors remained open through the pandemic. ASTRO received responses from 222 physician leaders of radiation oncology practices.

In the survey, 82% of respondents cited delayed/deferred treatment and 81% cited decreases in the number of patients being referred for radiation therapy.

On average, radiation oncology practices reported seeing two-thirds of their typical patient volume in late April. Source: ASTRO.

What were trying to do with the survey data is to dive deeper into that. We dont have the answers yet, because we simply are still collecting the data. But one of the questions we do want to ask isif there is a differential impact of COVID specific to cancer care, and to radiation delivery, that may or may not require some kind of policy-level intervention, or practice-level intervention, David Schwartz, co-author of the ASTRO study, said to The Cancer Letter.

This is where its now a global, community-wide freakout. What impacts some of these things is not just the physicians, nor even the diseaseits also the patient and communitys response to an overwhelming threat. Youre seeing people not showing up for surveillance, said Schwartz, professor and chair of the Department of Radiation Oncology at University of Tennessee Health Science Center.

Data from another survey, conducted by the American Cancer Society Cancer Action Network, showed that 79% of patients in active cancer treatment reported a delay to their health care (up from 27% in a previous survey). Seventeen percent of patients in active treatment reported delays to their cancer therapychemotherapy, radiation, or hormone therapy. The survey polled more than 1,200 cancer patients and survivors.

There are certain feeder cancers that keep the radiation oncology units busy. Those need to be diagnosed as a process. That process was brokenis broken, Len Lichtenfeld, deputy chief medical officer at ACS, said to The Cancer Letter. A breast cancer patient needs radiation following a lumpectomy, a prostatectomy that needs radiation, lung cancer patients that may benefit from radiation.

In the ACS CAN survey, 17% reported that the threat of COVID-19 prevented them from seeing a doctor for an illness or injury for which they would have otherwise sought treatment. Among those who delayed or canceled care, 59% said the decision was made by their health care provider.

Nearly half (46%) of cancer patients and survivors reported a deterioration to their financial situation that affected their ability to pay for care, an increase from 38% in the ACS CAN survey released in April.

What were going to see is a backlog of more advanced presentations in the future, with patients whose care has been affected and delayed by the pandemic, Sue S. Yom, professor in the Departments of Radiation Oncology and Otolaryngology-Head and Neck Surgery at University of California, San Francisco, said to The Cancer Letter.

Radiation oncology is unique in that it requires such a specific commitment of time and resources over a very intensive period. I dont think that that is something that all patients have the ability to do right now, Yom said.

The uptick in demand for services is especially dramatic at New Yorks Mount Sinai Health System. Mount Sinai deferred appointments at the beginning of the crisis, and made room in its hospitals for an expected overflow of COVID-19 cases in the city. That overflow never came.

We have some outpatient facilities that patients were able to go to. Once we realized we were on the other side of the peak, and there wasnt really going to be a need to use our clinical areas, we started opening them up again and ramping up, Kenneth Rosenzweig, professor and system chair of radiation oncology at Mount Sinai Health System, said to The Cancer Letter.

As of today, the end of May, were actually at a higher volume of patients on treatment than our typical average, Rosenzweig said. I think part of that, another reason is that some of the patients who had been delayed are now on treatment. So, there was a bit of a backlogand now thats opened up.

Radiation appointments at Memorial Sloan Kettering Cancer Center plummeted during the peak of COVID-19. Now, MSK is seeing increases in radiation oncology appointments.

It was certainly expected that during that time where you would see, particularly in Aprilwhen the incidence [of COVID-19] was so high here, and we were seeing the ER flooded with patientsthat we would see a reduction in radiation oncology visits, Daniel Gomez, director of thoracic radiation oncology, and chief of radiation oncology, Manhattan Service, at MSK, said to The Cancer Letter.

Now that thats subsided, youre seeing the opposite effect, and with regard to patients wanting to come in and get their cancers treated.

On a policy level in the U.S., it is up to the states and counties to institute COVID-19 guidelines.

As the country learns how to deal with thisin policies, were downstream with those things. What might be going up in Tennessee might not be going up in New York or Chicago, Daniel V. Wakefield, co-author of the ASTRO survey, said to The Cancer Letter.

What well see as a patchwork quilt of changes based on local government ordinances across the country, on not just a state level, but really, on city-to-city level, said Wakefield, chief resident in the Department of Radiation Oncology at University of Tennessee Health Science Center and MPH 20 candidate at Harvard University.

Cancer hospitals are a part of this patchwork quilt.

What you are seeing is different phases of a pandemic. Everyones been in different acute and recovery phases, UCSFs Yom said. And I will say that now that San Francisco is sort of officially in reopening and recovery, we definitely are seeing a very dramatic uptick in our consultations. But, remember, the time from consultation to initiation of treatment can be a week to several weeks.

What were seeing now isnt reflected yet, but our numbers have been trending up for about the past week or two.

Many cancer experts have pointed out that COVID-19 has exacerbated health disparities, making the underserved more underserved (The Cancer Letter, May 22).

The maps that we see of COVID infection rate positivity can actually be overlayed onto cancer incidence and cancer mortality, said Schwartz, who is also in charge of COVID-19 testing and data collection in Memphis. It comes down to one overriding issue: social determinants of health.

This can be manifested as cancer, but also as chronic disease. And thats another issue that we see here in Memphisis that cancer incidences also overlap very tightly with the incidence of hypertension, especially uncontrolled hypertension, diabetes, stroke, heart attack, obesity, food insecurityall of those things, Schwartz said.

David Beyer, medical director of radiation oncology at the Cancer Centers of Northern Arizona Healthcare, has delayed radiation treatments and pivoted to telehealth whenever possible out of concern for the health of his staff and patients.

Beyer is the only physician at his clinic.

We dont know whats going to happen. We dont know who in our department is going to get sick. We are a small rural clinic, Beyer said. If I get sick or have to quarantine myself for two weeks, we have a serious problem. We have two radiation therapy technologists, and they actually deliver the treatments on a day-to-day basis to each patient. We have two of them. If one of them gets sick, or God forbid both of them get sick or have to self-quarantine, we have a problem.

Beyers clinic used to treat 25-30 patients per daynow he sees about 15-20.

There is one place where you can get screening mammograms. They are not doing screening mammograms right now, Beyer said. They made the same choice to shut down routine screening mammography. So, were not seeing breast cancer patients that otherwise mightve been diagnosed right now with an asymptomatic breast cancer.

Still, Beyers location in Sedona has been relatively spared from the coronavirus. As of May 25, his local hospital had one confirmed case of the disease. His staff members have been asking, When are we going to start seeing our new patients in person, instead of over the computer?

My answer is, Not yet, Beyer said. Were still sticking with the telehealth options as much as possible, so that we reduce the risk of exposing us and exposing them.

The next county over is the Navajo Nation. It exploded there. They have one of the highest rates of COVID anywhere in the country right now. Its not that its not closeits not right here. What were doing works right now, for us, Beyer said.

In Memphis, where ASTRO study architects Schwartz and Wakefield treat cancer patients, the spread of COVID-19 has been moderate. Nonetheless, the number of radiation oncology appointments at their clinic has declined.

Ours is a center where we dont have high concentrations of people living on top of each other like New York, or San Francisco, or Washington or Los Angelesand we experienced a much different pandemic, Wakefield said. Ours was more of a slow burn. And to be frank, now I think its starting to have more effect than what we were seeing in New York six weeks ago.

The population in Memphis tends to be poor and rural, Wakefield said. People drive their cars to the clinic rather than walk or take public transportation. High poverty rates and accompanying social risks leave its population and rural practices vulnerable.

In Memphis, there is a rural-urban divide, Schwartz said.

Memphis is in an agricultural area, but it represents the largest metropolitan area in this region of the mid-South. We do get rural populations, and do refer back patients to referral to rural practices, Schwartz said. My impression is that rural practices probably have been struggling, simply because they do depend very much on a steady stream of referrals to maintain the nuts and bolts of their practices.

Now, Schwartz and Wakefield are conducting a follow-up survey for ASTRO. That study is likely to show that demand for radiation oncology is continuing to rise.

Now, as the general relaxing of social distancing and restrictive measures have kind of been released at least to some degree, and the nation slowly returns to business, were starting to see a larger influx of patient numbers, Schwartz said. I also think, probably, the patients are more comfortable to come in.

Whatever loss of volume and losses of referrals that we got, I have to believe that the patients, too, are part of that issue. They simply did not feel comfortable coming in anywhere, let alone to a healthcare facility that was seeing patients with COVID, Schwartz said.

If patients are beginning to receive treatment for cancer that requires radiation after the fact, it may take weeks from there to show up in the data.

The number of cases of cancerthe screening test, the diagnoses, the visits starting with a primary care doctor, maybe a urologistall of those visits are way down, ACSs Lichtenfeld said. The normal progress of activity starts with diagnosis, and the treatment. And consequently, if the diagnoses are decreased because people arent going to see the doctor, then I wouldnt be surprised to see that radiation therapy is decreased.

One of the major messages thats been so hard to deliver during this pandemic has been, if you have to a or symptom of cancer, you need to see somebody and you need tonotwithstanding concerns about the risk of going to see a doctoryou have to break through that concern and get yourself taken care of.

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Radiation oncology appointments plummeted in the COVID-19 pandemicbut seem to be rising again - The Cancer Letter

Yearning to feel human contact once again – The Jewish Standard

As we begin to anticipate eagerly the loosening of the restrictions that have bounded our lives for the past many weeks, Ive been hankering most of all for resuming hugs with my grandchildren. All my friends who are blessed with being grandparents have been talking throughout the period of quarantine about their feelings of longing for the embrace of the kids.

It turns out that physical contact is a real need; it is vital for mental, emotional, and also physical health. Human beings are wired for contact. People who live alone as I do since the death of my husband three and a half years ago are starved for touch. An article that I read in Healthline makes clear that this deprivation doesnt apply only to sensual touch any and all positive touch is considered to be beneficial. Hot showers and rubbing your own feet can go only so far to relieve skin hunger.

In more than two months without physical contact with another person and in the environment of pervasive anxiety, my body has been releasing the stress hormone cortisol and has not enjoyed the release of oxytocin, sometimes called the love or cuddle hormone; its effects include increasing bonding and trust, which have been in short supply during this period of isolation. Thankfully, the two-dimensional social contacts enjoyed through Zoom meetings and FaceTime have countered the deprivation to some extent. But our bodies know that its not the same.

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After about two weeks into the restrictions, a package that I hadnt ordered arrived for me. My adult daughters had sent me an adorable stuffed animal, a Gund puppy with a sweet face and a soft body. They wanted me to have something to hug, and Im not embarrassed to admit that this sweet little dog has found a place on the pillow next to mine.

The mandated social distance exacerbated a brief emergency that I experienced in the kitchen one evening shortly after Passover. Following several weeks of isolation, my youngest daughter thankfully had recovered from symptoms of covid-19. She had come into my house more than 72 hours after she had tested negative for the virus, and we were being scrupulous to maintain a physical separation between us. I was in the kitchen cutting a bagel, and I carelessly sliced deep into the index finger on my left hand. Blood was gushing. Struggling to rip open the paper wrapping of several Band-Aids and keeping my pulsing, wounded finger under a stream of running cold water, I could hardly manage to wrap it by myself. But there was no way that I could ask for and receive help from my daughter.

My options were limited, because I wouldnt drive over to Holy Name Medical Center when hospital was overwhelmed with serious covid cases, and the nearby urgent care clinic had closed early on a Sunday evening. I had to do it myself, with advice on the phone from an AARP nurse, terrified that contact with another person could invite the disease. In emergency situations fear is especially palpable.

However, throughout the quiet weeks at home without physical contact, Ive had the recurring feeling that something sustaining in my life clearly has been missing.

Im becoming reconciled to the likelihood that some aspects of our earlier social life likely are gone forever. This springtime, most organizations are holding virtual galas on screen, so no handshakes or hugs are possible. But when these events do resume, perhaps by next fall or spring, people are going to hold back from the easy, warm welcomes of old, that involved physical touch. What will be the future of Israeli dance groups, square dancing, and choral singing, where people gather in close proximity? Will acquaintances who abstain from casual contact with people of the opposite sex hold back from supportive pats on the back and sweaty wedding dances with their friends of the same gender, understanding that danger could lurk again in droplets of perspiration? How sad it is that shaking the hand of a colleague will be perceived as a potential threat to well-being yet these are probable lasting legacies of the coronavirus. And after weeks of being cognizant of the need to cultivate compassion, I will keep in mind that there are people near and far who arent able to look forward to the restoration of positive touch in their daily lives.

As summer approaches, well bask in the comfort of cuddles with grandchildren once again, assuming that the kids will be trusting to join the embrace, after months of warnings to keep their distance. Well be able to enjoy the pleasures of a massage or a pedicure and having someone else wash our hair at the salon. Sitting close to friends and loved ones on the sofa while watching a movie and relaxing into a warm hug for several seconds are comforts too long denied that wont be taken for granted for some time to come. The restoration of positive touch is one of lifes blessings, for which we will share words of gratitude with family and friends for having come through the pandemic more or less intact. We could celebrate the first hug of renewed contact by citing the morning blessing of matir asurim, thanking God for setting us free from captivity.

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Yearning to feel human contact once again - The Jewish Standard

Baldock transgender man’s painful battle to live in a body that matches his identity – Hertfordshire Mercury

A Baldock transgender man has opened up on his battle with alcohol and his mental health as he desperately fights for a body to match his identity.

Kade Mynott, 32, suffered with severe mental health problems as he struggled to come to terms with his true self prior to coming out as transgender.

He also became dependent on alcohol for a number of years before he bravely told his family and friends how he felt.

Now he has started taking testosterone and hopes to soon have top surgery - but NHS waiting times can be long and Kade is having to wear a restrictive chest binder which affects his asthma.

To help, a Go Fund Me page has been set up to raise 8,000 to get Kade the surgery he so desperately wants.

Kade has now courageously shared his story and explained what it has been like to come to terms with his identity:

For the majority of Kade's life so far, he has struggled with his identity and his mental health.

Talking about his experience, he said: "I've struggled for a long time with mental health issues and it clouded my judgements for many years.

"I got into drinking alcohol to deal with my problems so it took me a long time to be able to deal with how I felt.

"I was alcohol dependant for 10 years but I managed to get myself off it after it made my mental health issues worse. I managed to go cold turkey and get myself off alcohol in 2016.

"In the years that followed things started to become a lot clearer about my identity. I didn't manage to come out as transgender until I was age 30 in 2018.

"The whole experience was one of the toughest things I have had to deal with, not knowing who you are is a horrible thing to have to deal with.

"But you add on top the hate you have for yourself and your body for not seeing the outside match the inside.

"I'd shown a lotof signs as a child growing up with having my hair cut short. Even at the age of three I was refusing to wear dresses and skirts and just wanted to wear trousers like all my boy cousins were doing.

"I managed to come out to my mum first - I'm very close to my mum and she is extremely understanding and I'm very lucky to have such a great mum.

"One of my aunties also told me, when I came out, that when I was four I told her I wanted to be a boy. So I guess I have always known but just never knew how to deal with it all.

"My family have been very supportive, my friends have also, which is a great help.

"Like I said, I am extremely lucky to have such a good family around me because I know a lotof people can be the opposite and be disowned for being this way."

Fortunately today, transgender people can now seek help from the NHS in the form of hormone therapies and surgery, and Kade has also managed to get help.

Kade explained: "I went to my GP first to start my journey and she referredme to a NHS Transgender Clinic in London but with such high demand in patients over the past years the waiting lists are just getting longer and longer.

"I've heard there was up to a three or more years waiting time and I was starting to struggle with the dysphoria even more, so I decided to go private to start testosterone treatment.

"I was so happy the day I had the appointment and was told I could start testosterone. I was given Testogel, which was the best option for me as - because of my mental health conditions - the injections could of made my mood more unstable.

A transgender person is someone whose personal idea of their gender does not match with their assigned gender role.

For example a transgender man was born a woman but identifies as a man.

However, under this term, a personal can also identify as a combination of the two sexes or as neither.

Often people who identify as transgender suffer from gender dysphoria where there feel distress because of a mismatch between their biological sex and gender identity.

This is a recognised medical condition and often surgery and hormone treatment as well as psychological support can help with this.

Anyone needing help should see their GP who can refer them to a Gender Identity Clinic (GIC).

More information about gender dysphoria can also be found on the NHS website.

"The effects were slow at first until about the three month mark then my voice started dropping and I'd started getting a lot of body hair growth, and hunger - I wasso hungry all the time!

"I'm only just seven months on testosterone so I've got a lot more to experience yet."

Kade now wants to undergo top surgery but waiting times on the NHS can be long depending on the individual surgeon and clinic.

The waiting time is now affecting Kade and he is desperate to finally feel like his true self.

In a hope to get the surgery quicker, he decided to set up a Go Fund Me page to raise 8,000 to have the surgery privately.

"As I said there is a long waiting list to get an appointment at the NHS gender clinic and even after the first appointment I'd have to wait longer for a second appointment to discuss the option of surgery," he continued.

"It's got too hard waiting especially as you see other parts of your body changing more masculine but there is still obvious signs of being female.

"I'm having to wear binders that restrict my breathing and effect my asthma just to hide my chest.

"I'd be extremely grateful for anyone that donated any money, even the littlest of money helps.

"It would make me so happy to finally be able to live in a body that matches how i feel inside."

Kade also has a message for anyone else who is currently struggling to come to terms with their identity.

He said: "Make sure you talk about it to somebody you think you can trust, just sharing it with someone even if its somebody online takes a big weight off of your shoulders.

"It's okay to be confused and it's okay to not feel like your in the right body you can do things to change it."

The rest is here:
Baldock transgender man's painful battle to live in a body that matches his identity - Hertfordshire Mercury

World Menstrual Hygiene Day 2020: Everything You Need To Know About Your Menstrual Cycle And Fertility – NDTV Doctor

Medical intervention is required in case you have an irregular menstrual cycle

World Menstrual Hygiene Day is observed on May 28. This day is meant to raise awareness about menstrual hygiene and reduce the taboo around menstruation. Menstruation is a physiological process which is directly related to and responsible for the ability to bear children. The time from the first day of a woman's period to the day before the next period is the menstrual cycle. This cycle of approximately 26-30 days involves a lot of changes that occur in a woman's body in preparation for a pregnancy.

The main reproductive organs in a female are the uterus and two ovaries. The female hormones oestrogen and progesterone rise and fall with the cycle to orchestrate the maturation and release of an egg from the ovary around mid-cycle, which is then implanted in the uterus if it is fertilised by the sperm. Else, the thick lining of the uterus is shed at the end of the cycle in the form of periods. The cycle goes through a series of hormonal changes from day one of the cycle to the 14 day when an egg is released from the ovary and the uterus prepares for pregnancy. Fertility is known to depend on the menstrual cycle.

Also read:Irregular Periods? 5 Possible Reasons Other Than Pregnancy Every Girl Must Know

The menstrual cycle is divided into two phases: the follicular or the first half phase and the luteal phase or the second half. Follicular phase begins on day 1 of the cycle, during which time the hormone oestrogen stimulates the ovaries for growth of eggs, and ends with the ovulation or release of one egg. Luteal phase begins with ovulation during which time progesterone prepares and thickens the lining of the uterus in case of a pregnancy and ends as shedding of this lining or menses in the absence of fertilization.

The length of the follicular phase may vary while that of luteal phase is around 14 days. While the length of the menstrual cycle varies from one woman to another, it usually lasts 287 days.

Each menstrual cycle has a fertile window. This is the period during which women can conceive. In a standard cycle, the fertile window begins 5 days before ovulation and ends on the day of ovulation. While it is difficult to precisely tell when ovulation occurs, most women usually ovulate around 10 to 16 days prior to the next period. The fertile window also varies from cycle to cycle.

Also read:6 Ways To Deal With Excruciating Pain During Periods

The length of your menstrual cycle says a lot.It may serve as a potential indicator of hormonal imbalances and whether ovulation is occurring in a regular manner. A normal length cycle points to regular ovulation while a short or long menstrual cycle suggests that ovulation is either not occurring or occurring irregularly. The fertility rate of women with long or irregular cycles is also decreased.

A shorty cycle usually lasts for less than 21 daysPhoto Credit: iStock

A short cycle, usually less than 21 days, may indicate that ovaries have fewer eggs and may point to imminent menopause. It may also suggest that ovulation is not occurring as it should. If further tests confirm the same, conception may be difficult. A longer cycle (>35 days) also suggests that ovulation is not occurring or is not occurring in a regular manner, thus making conception difficult. Bleeding for a longer period, say more than 7 days, may also suggest that ovulation is not occurring in a regular manner.

Menstrual cycle characteristics therefore appear to have a key link with the fertility potential. Normal menstrual cycle has a robust link with ovulation and fertility potential. If you are in the reproductive age group and wish to conceive but you have irregular menstrual cycles, you must consult a specialist.

Also read:Top 4 Yoga Asanas For Irregular Periods

Irregular or no ovulation decreases the odds of conception without medical intervention. A woman less than 35 years of age with normal cycles who has been unable to conceive after a year of trying should consult a specialist. A woman over 35 with a normal menstrual cycle who has been trying for 6 months and has had no success should also seek a specialist's advice. Normal menstruation indicates regular ovulation, but there may be other reasons for not being able to conceive. As for irregular cycles, we know that ovulation does not occur in a regular manner in such cycles and medical attention is thus required.

(Dr Veena Aggarwal, MD IJCP Group of Publications, Medical Advisor Medtalks.in. She practices in her own clinic in South Delhi)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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World Menstrual Hygiene Day 2020: Everything You Need To Know About Your Menstrual Cycle And Fertility - NDTV Doctor

What is Coronary Artery Disease (CAD)? And Other Questions – HealthCentral.com

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There are many different types of heart disease, but coronary artery disease, or CAD for short, is the most common. You might also hear it referred to as coronary heart disease or ischemic heart disease, but no matter what you call it, more than 18 million American adults have it, according to the Centers for Disease Control (CDC). And its not just a concern for older folks. Its the number-one killer of both men and women, a sobering 20% of them younger than 65. But there are things you can do, right now, to lower your risk of CAD. Well tell you how.

Coronary artery disease develops when your hearts all-important arteries become damaged. This damage, which happens in a number of ways well soon explain, causes your arteries to dangerously narrow, which can then cause blockages that prevent blood and oxygen from reaching your heart and the rest of your body. (And you probably dont need a website to tell you thats not good.)

Before we get into the nitty-gritty of what causes all those problems, lets do a quick review of how the circulatory system works:

You have arteries throughout your body. Along with your veins and capillaries, they comprise a 60,000-mile-long system of blood vessels.

Your arteries deliver oxygen-rich blood from your heart to every cell in the rest of your body.

Along the way, the blood transfers nutrients and picks up waste products from cells via tiny capillaries, and then it heads back to heart by way of the veins.

Once there, it enters the pulmonary circulatory system. The heart pumps it over to the lungs, where it unloads carbon dioxide and stocks up on a fresh supply of oxygen.

Then it's back over to the heart to do the whole thing again.

Your entire blood supplymore than a gallon of the life-sustaining stuffcycles throughout your body roughly every 30 seconds. Pretty amazing, right?

Whats more, your heart has its own network of arteries to support this critical work. Here are the main players:

In a healthy heart, blood flows unobstructed through the many arteries, providing all that your ticker needs to keep on pumpingand keep you alive. But when CAD develops, serious heart complications can result, including:

The culprit behind CAD is nearly always atherosclerosis. That mouthful of a name describes a process in which plaque builds up over time on the walls of one or more of your hearts arteries. Plaque is a mixture of cholesterol, fat, calcium, and fibrin (a substance that helps your blood to clot), and it tends to collect within the arteries where damage has occurred.

But what damages arteries in the first place?

So, it's like this: When the inside of your arteries get roughed up, it's easier for the plaque-forming compounds to gain a foothold. As it builds up, blood cant flow as easily as it once did. The result? Coronary artery disease.

As CAD progresses, plaque continues to accumulate. Your arteries become increasingly narrow, and you edge closer and closer to heart attack territory. Why? Because heart attacks are caused by partial or complete blockages of blood flow to the heart.

And know this: You dont need a complete blockage for plaque to be life-threatening. Even partially obstructed arteries are a major cause for concern. Why? Because:

Yes. While atherosclerosis is by far and away its most common cause, CAD can also be triggered by the rarer (but still possible) coronary artery spasm. This is also known as non-obstructive coronary artery disease.

Such spasms cause an artery to suddenly tighten, cutting off the flow of blood. They can be triggered by cocaine and nicotine use, or occasionally, severe cold or extreme emotional stress, according to the Mayo Clinic. While such spasms most often occur in people who already have CAD, they can also strike people whose arteries are healthy. For some, a spasm is an isolated event, but in others they occur more than once.

In addition, CAD can also be triggered by other, less-obvious culprits:

Endothelial dysfunction: This is when an artery does not expand to meet the need for increased blood flow, such as during exercise.

Birth defects: Some babies are born with structural damage to their hearts.

Coronary-artery dissection: This is a tear in the wall of one your coronary arteries, which traps blood between the arterial layers. Swelling results, which narrows or blocks the artery to potentially trigger an emergency situation like a heart attack. The reasons for such tears are unknown.

Autoimmune diseases: Conditions that cause chronic inflammation, such as lupus or Crohns disease, can lead to CAD because inflammation damages your arteries, which attracts plaque buildups.

Radiation therapy: This treatment can also cause damage to your arteries, leading to CAD.

A whole host of risk factors bump up your likelihood of developing atherosclerosis and, as a result, your odds of being diagnosed with CAD, as well. The good news? For a substantial number of them, lifestyle changes can make a huge difference. And while some risk factors are unchangeable (like your age and family history), others are within your power to eliminate altogether. Thats because living a healthier lifestyle can help reduce your odds of getting CAD.

Lets first examine the risk factors you cant do anything about (and get 'em out of the way):

Your arteries become more damage-prone the older you get. Its just part of the regular wear and tear of living. Youre most likely to develop CAD after you turn 65.

If a parent or sibling had CAD, especially at a younger age55 for your dad or your brother, 65 for your mom or sisteryour risk may be more than double that of people without a family history of heart disease, according to a 2019 study in the Journal of the American Heart Association. This can be due to lifestyle factors your family shared, such as smoking or a lack of exercise. Or it could be genetic.

For example, some people inherit a gene mutation that makes it likelier they will have high cholesterol, a contributor to CAD. Most often, this is caused by a mutation in the LDLR gene, which helps control the production of LDL (so-called bad cholesterol), which well get into shortly.

Men are more likely to develop CAD starting at an earlier age than women. For men, the risk tends to begin rising at about age 45. Womens risk starts to climb about 10 years later, at age 55. Experts believe this is because the hormone estrogen, which women have in greater amounts before menopause, provides some protection against CAD.

While you cant do anything to change the above, theres plenty you can do to change the risk factors below. Want some additional motivation? Improving a single risk factor often improves or even eliminates others.

Being sedentary, a.k.a. couch potato syndrome, contributes to many CAD risk factors, including HBP, obesity, diabetes, high cholesterol levels, and high triglycerides, a type of fat found in your bloodstream thats linked to atherosclerosis. When youre physically fit, your heart works more efficiently. That can improve your blood pressure. It can also help you achieve and maintain a healthy weight, which eases the burden on your heart. Plus, exercise reduces stress hormones, such as cortisol and adrenaline, that can otherwise strain your heart. And, it helps keep your cholesterol at healthy levels. Working out is basically magic for your whole body.

Lighting up damages your blood vessels. The toxic chemicals in tobacco smoke, such as carbon monoxide, may injure the walls of your arteries, and that in turn may trigger plaque buildups. Smoking also causes your blood vessels to constrict, which raises your blood pressure. Oh, and it may also thicken your blood, increasing your risk of clots by making clot-forming platelets stickier. If exercise is magic, cigarettes are kryptonite.

Does that mean you should switch to vaping? No way! E-cigarette vapor contains many toxic chemicals linked to heart disease, according to the AHA, which recently published a report that showed how vaping may harm your blood vessels in much the same way smoking cigarettes does.

Fortunately, the benefits of being smoke-free start the moment you quit. To help kick your smoking habit, check out the AHAs smoking cessation resources.

Hypertension, a.k.a. high blood pressure (HBP), stresses your arteries, causing them to harden and thicken, which makes it more difficult for blood to flow through them. The stress from HBP can also damage the lining of your arteries, and that damage may attract plaque buildups.

Carrying too many pounds increases your chances of diabetes, a major cause of heart disease. Excess weight also makes your heart work harder. That can raise your blood pressure, which then damages the inner lining of your arteries. If this seems like a chain reaction, it's because it often is. But what's important to remember? It goes the other way, too. Losing even a modest amount of weight can lower your blood sugar and your pressure.

You know the drill here: Diets high in saturated fat (like butter or beef) or trans fat (found in processed foods like cookies, crackers, and margarine), and refined carbs (like processed breads, pizza dough, pastries, and some breakfast cereals) really aren't great for your heart. Saturated and trans fats increase your bad cholesterol and decrease your good cholesterol. Meanwhile, refined carbs boost your blood sugar levels. Over time, that elevated blood sugar can lead to type 2 diabetes, a known risk factor for heart disease.

High cholesterol means you have elevated levels of low-density lipoprotein (LDL), or bad, cholesterol and low levels of high-density lipoprotein (HDL), or good, cholesterol. LDL cholesterol circulates throughout your body and can build up on the walls of your arteries, which makes them hard and stiff. This often happens when you dont have enough HDL at the ready; this blood fat actually sweeps up the excess LDL and takes it to liver to be processed as waste.

This sleep disorder causes repeated interruptions to your breathing throughout the night and has been linked to obesity and HBP, both major risk factors for CAD. Sleep apnea impacts blood pressure by causing frequent drops in blood oxygen levels during moments of interrupted breathingforcing your heart to work harder.

Your immune response can be triggered by plaque buildups in your arteries, leading to inflammation. Over time, low levels of chronic inflammation irritates your blood vessels and may make a plaque buildup more vulnerable to rupture.

Plaque buildup that leads to CAD often moves slowly, over many, many years. In fact, it can begin as early as childhood. But you wont necessarily know that you have it. Usually, symptoms of CAD dont begin until youre well into middle age or nearing retirement.

For some people, the first symptom of CAD will be a heart attack. This makes it critical to discuss your CAD risk factors with your doctor to determine the state of your heart health.

Symptoms of CAD include:

This is also known by its fancier name, angina. It occurs when your heart doesnt get enough oxygen-rich blood. You may feel pain, pressure, or a squeezing sensation in your chest. It frequently goes away when you rest.

Panting or struggling to get enough air can occur from restricted blood flow in your hearts arteries and the reduced amount of oxygen that results, often during or after physical activity.

Feeling exhausted after your normal activities or your usual exercise routine can also result from restricted blood flow and reduced oxygen-rich blood.

Pain in other parts of the body such as the neck, jaw, shoulder, and back may occur because some nerves in the heart are connected to these areas, so symptoms can be felt in these more distant places. Its not clear why this happens, but it may be due to the way your heart and brain are wired. When the brain sends out pain signals during a heart attack, those signals may activate nerves in a network in and around the heart.

The answer? Sometimes, yes. In fact, women are 50% more likely to report having a heart attack without obvious signs like chest pain, although it does remain their most common symptom, especially after age 65, when they no longer enjoy the protective effect of estrogen.

Among women, other common symptoms include:

Its thought the difference in heart attack symptoms between men and women may be a result of men having more plaque ruptureswhich occur suddenly and cause classic, chest-clutching symptomswhile women experience more plaque erosions, which happen slowly over days or even weeks, causing what are known as atypical symptoms, such as nausea, weakness, and light-headedness.

Your doctor will begin by reviewing your symptoms and taking a detailed health history, including your family history of heart disease. Youll also be asked to describe your daily habits that affect your health, such as diet and exercise. Your physical exam will include blood pressure measurements and blood tests, including cholesterol, triglycerides, blood sugar, and more.

Further testing likely will include:

This test records the electrical activity inside your heart and shows whether or not its beating normally. An EKG also reveals whether your heart is receiving an adequate amount of blood.

Your heart will be monitored via EKG while you walk on a treadmill or ride a stationary bike. This will determine whether your heart gets enough blood and oxygen during exertion. If you cant exercise, you will be given a nuclear stress test. A small amount of radioactive tracer gets injected into your bloodstream. Using special cameras, a doctor can track its movement through your heart, revealing areas that get insufficient blood flow.

This test uses sound waves to produce images of the heart that allow doctors to evaluate your hearts strength and how well it functions.

A thin tube called a catheter is inserted into a blood vessel near your groin and threaded through to your coronary arteries. A special type of ink will be injected into your arteries. The ink will show your doctor, via x-ray images, where your blockages are located. Catheterization is considered the gold standard for diagnosis. You will be awake but mildly sedated during this procedure.

A computed tomograpy (CT) scan measures the amount of calcium in your arteries. Why calcium? Its a component of the plaque buildup thats blocking your artery.

Treatment for CAD has several goals: to ease the hearts workload, to improve blood flow, and to slow or reverse plaque buildup in the arteriesall of which can help extend your life. There are a menu of treatment approaches to accomplish this, including:

What works best for you will depend on your individual health history, ability to change any unhealthy habits you might have, and what your doctor prescribes based on screening tests.

A critical part of any treatment plan, this parts largely up to you to focus on and continue over your lifetime. Medications and procedures may helpthey might even save your lifebut to be the healthiest you can be, you must do the heavy lifting.

Your goal: 150 minutes of moderate exercise, such as walking, each week. That breaks down to 30 minutes, five times a week. Before you start, ask your doctor what type of exercise program would be best for you. Often, the best way start is to put one foot in front of the other. You know: Take a walk.

Focus your food choices on fruits, vegetables, whole grains, and legumes such as beans, lean meat, and fish. Read food labels so you can avoid foods with saturated fats and/or trans fats as well as highly caloric foods loaded with sodium and/or sugar.

Your body mass index (BMI, a ratio of height to weight used to estimate body fat) should be in the normal range, between 19 and 25. Higher than that and you are overweight or, at 30 and above, obese. (Unless, that is, you're a serious gym bunny whose measurements in pure muscle defy regular BMI standards.) Start with small, achievable weight loss goals, because losing as little as five to ten pounds can pay dividends in health benefits, such as lower blood pressure.

It's true the more you smoke, the greater your health risks, but even light or part-time smokers should drop the habit. Women who are light smokers, for example, have a 500% higher risk of lung cancer than non-smokers. And light smoking may leave you with other forms of lung disease or cause a stroke, breast cancer, or cataracts, or the list goes on and on.

No one likes being stressed out. But did you know that too much stress harms your heart? It can boost your blood pressure and make you more prone to give into unhealthy temptations, like smoking and overindulging in junk food or alcohol. The AHA recommends stress management, which you can get with the help of a therapist, at a cardiac rehab program, through regular exercise, or simply by breathing deeply.

A variety of medications exist that can help reduce CAD symptoms such as chest pain as well as prevent the progression of the disease and prevent heart attacks.

Lowering blood pressure reduces your hearts workload. Beta blockers lower blood pressure by slowing your heart rate and easing the force of your hearts contractions. Calcium channel blockers work by relaxing your blood vessels. Some also will slow your heart rate, and they may be used for chest pain.

These drugs (like aspirin) help prevent the formation of dangerous blood clots, which can develop around plaque buildups.

This treatment, which includes nitroglycerin, dilates, or widens, narrowed arteries from CAD to boost blood flow to your heart, which in turn eases chest pain. Nitrates also widen the veins, which helps ease the strain on your heart.

These medications, which include common brand names like Lipitor and Crestor, are used to control cholesterol levels. This reduces plaque buildup in your arteries. Statins may also help clear existing plaque buildups. Other cholesterol-lowering drugs are available if you cant take statins.

This drug, often prescribed under the brand name Ranexa, helps ease chest pain (angina) if it persists despite the use of other therapies. It does this by improving blood flow, allowing the heart to work more efficiently.

When your arteries are severely blocked, you may require a procedure that opens them up to let a sufficient amount of blood flow to pass through. Such procedures include:

In this procedure, a surgeon takes an artery or vein from elsewhere in your bodyoften a leg, forearm, or your chestand uses it to connect your aorta to the blocked artery, rerouting blood flow.

A cardiologist threads a catheter through a blood vessel to the point of the blockage. There, a small balloon is inflated, which flattens the plaque on the wall of your artery. Then, a stent is implanted at the site to hold the artery open. This allows blood to flow more freely and prevents the collapse of the artery.

Current treatments and earlier diagnosis are helping people live better lives with CAD, but a lot of the work is up to you. Cardiac rehabilitation will help.

Cardiac rehab, which typically consists of 36 sessions over 12 weeks, offers:

The AHA recommends cardiac rehab for everyone with coronary artery diseaseeven if you havent suffered a heart attack. To participate, you will need a referral from your doctor. The AHA also suggests you initiate this discussion with your doctor. Dont wait for your physician, who may be very busy with many patients that day, to bring it upyour heart health is too important for you to remain passive. So be your own best advocate. It just may save your life. People who attend cardiac rehab after a heart attack reduce their risk of dying by more than 50% compared to those who dont attend, according to the CDC.

Worry is a strong wordso lets just say: Be proactive. CAD symptoms dont often begin until the plaque buildup has narrowed an artery by 70%. However, plaque can rupture, which causes heart attacks, and this commonly occurs when a blockage is only a 50% obstruction. If you have any CAD risk factors, discuss them with your doctor.

While chest pain and shortness of breath are hard to ignore, it can be difficult to decide whats important if you have vague symptoms like nausea. In most cases, after all, nausea is NOT due to CAD. But if you have known risk factors for heart disease and are worried that you may be having a heart attack, call 911 immediately.

Lifestyle modification is the cornerstone therapy for halting the progression of CAD. The most beneficial? Exercise. Regular workouts get your heart pumping; reduce inflammation, cholesterol and blood pressure; improve the health of your blood vessels; lower stress; and make you feeland even lookgood, too.

If you have heart disease, youre at higher risk of depression. That makes addressing mental health one of the most important things you can do for CAD. If youre not doing well emotionally, youll be less likely to take your medications as directed, and you might find it harder to stick to a healthy diet and a regular exercise routine. Talk to your doctor if you feel anxious or depressed.

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What is Coronary Artery Disease (CAD)? And Other Questions - HealthCentral.com

Global trade impact of the Coronavirus Bone Marrow Transplant Rejection Treatment Market Worldwide Growth Survey by 2028 – Cole of Duty

Global Bone Marrow Transplant Rejection Treatment Market Growth Projection

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The report suggests that the global Bone Marrow Transplant Rejection Treatment market is projected to reach a value of ~US$XX by the end of 2029 and grow at a CAGR of ~XX% through the forecast period (2019-2029). The key indicators such as the year-on-year (Y-o-Y) growth and CAGR growth of the Bone Marrow Transplant Rejection Treatment market are discussed in detail in the presented report. This data is likely to provide readers an understanding of qualitative and quantitative growth prospects of the Bone Marrow Transplant Rejection Treatment market over the considered assessment period.

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Global trade impact of the Coronavirus Bone Marrow Transplant Rejection Treatment Market Worldwide Growth Survey by 2028 - Cole of Duty

Coronavirus can infect and inflame the thyroid – Health24

An Italian teenager may be the first known case of a painful thyroid infection caused by the new coronavirus, doctors report.

A research team from Pisa, in northern Italy, said the 18-year-old woman's thyroid became sore and enlarged a few weeks after testing positive for the SARS-CoV-2 virus in late February. The condition, called thyroiditis, cleared up completely within a week after she was treated with the steroid prednisone.

Still, the doctors believe that "physicians should be alerted about the possibility of this additional clinical manifestation" tied to the new coronavirus, study leader Dr Francesco Latrofa, an endocrinologist at the University Hospital of Pisa, said in a news release from the Endocrine Society. He and his colleagues published the findings on 21 May in The Journal of Clinical Endocrinology & Metabolism.

"Covid-19 continues to show us many surprises," said thyroid expert Dr David Hiltzik, director of head and neck surgery at Staten Island University Hospital in New York City. "It has been shown to manifest in so many different organ systems throughout the body, so it is not surprising that the thyroid joins the many other areas that have been affected by the disease.

Heart palpitations and neck pain

"Thankfully, thyroiditis can easily be treated and should not be of great concern," added Hiltzik, who wasn't involved in the new research. "That being said, if a patient had the virus and presents with new neck pain they should get that evaluated."

In the Italian woman's case, she first got a nasal swab test for the new coronavirus on 28 February because her father had been hospitalised earlier with Covid-19. The test turned up positive, but she experienced only mild, transient respiratory symptoms at first.

However, by 17 March she revisited the Pisa clinic with fever, heart palpitations and neck pain. The neck pain got worse and her thyroid gland was painful and enlarged, the doctors said.

Tests confirmed thyroiditis. The patient was given prednisone, which relieved the neck pain and fever within two days. Any other remaining symptoms subsided within a week.

Post-viral thyroiditis

Latrofa and his group noted that thyroiditis has been seen with a myriad of infections, including mumps, Epstein-Barr, hepatitis E and HIV, so its appearance with SARS-CoV-2 isn't completely surprising. But to their knowledge, this is the first such case tied to the new coronavirus.

Dr Minisha Sood is an endocrinologist at Lenox Hill Hospital in New York City. Reading over the findings from Italy, she said it was "a classic presentation of post-viral thyroiditis, which is characterised by the onset of neck pain, fever and high thyroid hormone levels".

Sood said because of the intensity of neck pain the woman was experiencing, her doctors prescribed prednisone. However, in milder cases, a nonsteroidal anti-inflammatory pain reliever is often prescribed first, with a steroid prescribed later if needed.

In any case, "as an increasing number of post-viral symptoms are being attributed to Covid-19 or complications of Covid-19 such as thrombotic [clotting] events, the potential of subacute thyroiditis should not be overlooked," Sood said.

Image credit: Getty Images

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Coronavirus can infect and inflame the thyroid - Health24

Play: A joyful medicine – Public Affairs Office of Headquarters, US Army Combined Arms Support Command and Fort Lee

I have always been tempted to write a prescription that reads Go out and play just to see how the parent responds.

Turns out, there is no better time than this nearly three months into the social distancing, no public gatherings and shelter-at-home requirements to prevent the spread of COVID-19 to follow that exact recommendation.

As a pediatrician in Kenner Army Health Clinic, I have observed how this situation has not been ideal for people in general. They have been affected physically, emotionally, socially and economically. For children, there is another vulnerable plane, developmentally.

Lately, I have encountered an unusual number of TeleHealth concerns related to emotional, behavioral and developmental regression in youngsters. It is troubling to imagine the coronavirus mutating into a dreadful boogeyman that inflicts children with these mental health issues.

Its simple to beat the monster, though, with play which is defined in a 2018 American Academy of Pediatrics article as an activity that is intrinsically motivated, and entails active engagement and results in joyful discovery.It is not scripted play therapy, but genuine family activity that brings forth positive emotions while promoting child development and growth.

The Pediatric Journal magazine article further reads, When play and safe, stable, nurturing relationships are missing in a childs life, toxic stress can disrupt the development of executive function and the learning of prosocial behavior. In the presence of childhood adversity, play becomes even more important.

The article points out that age-appropriate play with parents and peers is a singular opportunity to promote the social-emotional, cognitive, language and self-regulation skills that build executive function and a prosocial brain which children need to thrive.

Research among preschoolers on the first day of school showed a twofold decrease in anxiety in medical terms, a reduction in the stress hormone salivary cortisol when randomly assigned to play intervention compared to listening to a teacher reading a story.

Laboratory scientists also have simulated the role of roughand-tumble play and learned that it can buffer symptoms of anxiety in animals that similarly showed a reduction in stress hormone that could be prolonged by the length and intensity of the activity level. The researchers observed increased brain competency in the subjects, witnessing the ability to solve mazes after two hours compared to the play-deprived group.

With the ongoing challenges of the pandemic, caregivers may want to invest in more meaningful play time with children, and while doing so, may even find themselves unexpectedly rewarded. By recreating their cherished childhood activities or sharing a favorite game with youngsters, some grown-ups may benefit from this renewed joy through a childs view. This benefit also is supported by a research.

Organized daily playtime at home during this pandemic may seem tiring to already stressed-out parents, but the rewards are worth the investment. Spontaneity is welcomed in this area and may surprisingly bring more fun. Encouraging children to plan the activity is a good tool for self-growth. Parents are not asked to be activity directors. Play should not be a dreaded chore and should never add more stress. And like any medicine, it should not be overdosed responsible adults have to work and rest, and children need downtimes as well.

With studies consistently showing the superior benefits of real-time social playing among young children, some limited age-appropriate screen time with parents co-watching or co-playing can be an occasional alternative. Play needs adult supervision because it can have a dark side when children are allowed to do as they please, leading to disagreements and even bullying. Homes should always be safe and nurturing a play hideout from the coronavirus boogeyman.

Playing is important for everyones well-being, and especially for the development of a young healthy child. While peer-to-peer play is almost impossible due to social distancing, families must strive together, more than ever, to create nurturing physical connections through playtime now; because playing is a medical necessity for children to thrive.

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Play: A joyful medicine - Public Affairs Office of Headquarters, US Army Combined Arms Support Command and Fort Lee

KC Concepcion says PCOS prevented her from accepting projects – Rappler

HEALTH REASONS. KC Concepcion says she been diagnosed with polycystic ovary syndrome or PCOS, which has prevented her from accepting showbiz projects. Screenshot from Instagram/@itskcconcepcion

MANILA, Philippines Actress KC Concepcion said she had been scaling back in accepting showbiz projects after she was diagnosed with polycystic ovary syndrome or PCOS.

In an interview with Tim Yap on his online show on Saturday, May 23, KC was asked why she has not been seen on television or movies, despite signing with Cornerstone Entertainment back in February.

"I am super, super grateful for work. But number one... I want to be super open about this because its something I also want to talk about in the future. I was diagnosed with PCOS," she said.

PCOS, according to the Mayo Clinic, "is a hormonal disorder common among women of reproductive age" which results in "infrequent or prolonged menstrual periods or excess male hormone (androgen) levels."

The condition is the reason why she gained weight, she said.

"I always wanted to be at my best, I want to be physically fit, and I want to look good, I want to get my body tight. When I look good, I feel good and thats what you serve people on screen. Its as simple as that, she said.

While she was on break, KC said that she was able to work on a lot of things, including her jewelry line Avec Moi. She is also set to revive KC's Closet to pre-loved items for charity.

KC said that she's been getting a lot of guidance with her PCOS thanks to her doctor in the US. I know a lot of women who have it. Its quite common in a way but not a lot of people talk about it. Thats something I want to talk about in depth later on in the future na because I dont think right now is the time. Wala pa ako masyadong information about it, she said.

(I still don't have much information about it.)

KC said she now ready to accept projects coming her way. Im super healthy now. Im so well. I take supplements, try to be as active as I can be."

Relationship with mom Sharon

In the same interview, Tim asked if KC has been in contact with her mom, Sharon Cuneta, and her family. KC is currently living by herself in her apartment .

KC said they've been checking up on each and that they've been sending each other food.

"That's our way of expressing our love is through gifts. I think my mom and I have the same love language, where we like to give each other gifts. I miss her, I love her so much. I think she is an amazing mom. At the end of the day, lahat ng nangyayari sa amin should stay in the family and just like any family, no one is perfect, she said.

(At the end of the day, whatever is happening in our family should just stay within the family and just like any family, no is perfect.)

Back in January, Sharon wrote a long post on social media, asking KC to come back to the family. The actress was not present during some of their holiday gatherings and Sharon's birthday celebration on ASAP.

Sharon told the media that the post was a case of a "mother missing her daughter."

The two have since ironed things out, with Sharon promoting KC's YouTube account in March.

KC said that like any other family, their relationship has not been perfect.

I dont really like talking about problems in public but people love us and have really welcomed us in their lives. I want to thank everyone that is there to support my relationship with my mom. Every day, you just want everything to be nice and light and happy, " she said.

"If there was time lost before, I think the most important thing is to both embrace each others imperfections and forgive and be loving towards each other. Thats the best we can do, she said. Rappler.com

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KC Concepcion says PCOS prevented her from accepting projects - Rappler

Covid-19 isolates patients from loved ones at time of greatest need – STAT

Amy Sapien had prepared for her April 13 surgery as best she could. She dyed her long blond hair a bright pink. She got a tattoo on her right calf of what she jokingly calls her spirit animal Dory, the blue fish from Finding Nemo, whose answer to lifes challenges is to say, over and over, Just keep swimming. Still, she was overwhelmed by dread early that morning as she kissed her husband, Callen, goodbye outside the Moffitt Cancer Center in Tampa, Fla., and walked alone through the bright, empty lobby. Her hands shook as she stepped onto the elevator and pressed the button with her elbow.

Her mind was a jumble. Everyone seemed so eerily expressionless from behind their paper masks that Sapien wondered for a moment whether shed walked onto the set of an alien abduction movie. She had been imagining for weeks what it would be like to leave the hospital without her left breast. Now her mind turned to an even more urgent fear: What if she became infected with the coronavirus during her short stay?

Sapien tried to replace her anxious thoughts with fighting ones. The 40-year-old hospital social worker made Tom Pettys lyrics her mantra: You can stand me up at the gates of hell, she sang to herself as she felt her consciousness give way in the operating room. But I wont back down.

When she came to three hours later, she pushed aside her worries about the treatment and procedures she still faced, nibbled on Saltines, and sipped ginger ale to stave off the nausea she felt from anesthesia. Then she reached for her phone, and recorded separate video messages for her two young boys.

Her blue eyes glazed thick from painkillers, she addressed her 3-year-old son, Corben. Smiling reassuringly, she told him to continue his toilet training with his grandmother, and that shed be home soon. Then she spoke to 7-year-old Landen. Hey. Im OK. Im out of surgery, she said in a near-whisper. With her bandage peeking from her pink surgical robe, she told him that shed be home the next day, and that they would soon be able to watch movies together from the bedroom recliner. I love you, I dont want you to worry about me, Landen, she said. OK? Im doing really good. Bye, honey.

Then she tapped send. Landen watched the video from his own hospital room across town, where he was being treated for leukemia.

Amy and Landen, two generations fighting cancer, are united by something else: They are going through the most frightening and painful moments of their lives without the family warmth and support that was standard practice at the nations medical centers until Covid-19. The pandemics broad impact on cancer care in the U.S. is well-known: non-essential surgeries, biopsies, and scans delayed, and clinical trials disrupted. But its in stories like the Sapien familys that one sees the depth of the harm its causing.

Amy was able to schedule the mastectomy right away only because her cancer was spreading, but she couldnt have her second breast removed at the same time since it was deemed elective. Instead shell have to undergo general anesthesia, surgery, and painful rehab again. While her husband was allowed in the waiting room during her first worrisome mammogram and ultrasound in early March, Amy had to go alone for her biopsy and the MRI that confirmed the diagnosis. Then she went by herself to her surgery, and recovered in isolation.

I didnt see anyone I knew for 36 hours after having a part of my body amputated, she said. Worse, though, was her inability to be with Landen as he lay tethered to a machine delivering a platelet transfusion.

While both parents, and sometimes his grandparents, had been able to reassure him through previous chemotherapy treatments, this time only his father could be present.

Theirs is an experience shared by cancer patients across the country, as Covid-19 separates them from loved ones and family at their time of greatest need.

In the exact moment where we could have reached out for everything our support system could offer, Amy said, we were forced to retract completely into ourselves.

It was last June, a few weeks before Landens seventh birthday, that his grandmother Sandra Sapien noticed a swollen gland on his slender neck. The family had just moved from a nearby town and had not yet met their new doctors, so Amy took Landen to a walk-in clinic to rule out strep. The test was negative, but the doctor suggested following up with a pediatrician and asked if there was a family history of leukemia. No, Amy said, alarmed. None at all.

Days later, at an appointment with Landens new pediatrician, Amy mentioned what the urgent-care doctor had said and asked if he could run some blood tests. Its never cancer, he told her. He diagnosed Landen with tonsillitis, and prescribed antibiotics. Landen seemed fine at his birthday party, and wolfed down pizza and the massive chocolate Minecraft cake his grandmother had made.

The morning of June 29, the family drove to a pet store to pick out a fish for Corben. As he deliberated among the bright blue and red beta fish, Landen turned gray and collapsed. Thinking that hed had a bad reaction to the antibiotics, Callen rushed him to the hospital.

In just a few hours, the couple went from worrying about whether rain would spoil that evenings fireworks to confronting every parents nightmare. After doctors ran a battery of tests, the Sapiens learned that their son was one of 350 to 525 U.S. children diagnosed with a rare form of leukemia each year. Overall, 3,500, or 4.7 out of 100,000, are diagnosed annually with childhood blood cancers.

Leukemia? Amy recalls asking, incredulous. My brain wasnt even linking up what the word was.

As a young woman, Amy had struggled with anxiety, but finally everything had fallen into place. She and Callen, 36, a strategist at a business software company, had solid, steady careers. Together since their first meeting at a college-town coffee shop 17 years ago, they had just purchased their dream home. Id finally convinced myself there were no monsters under my bed, she said.

Now the doctors were hospitalizing their son, and had begun a 3 1/2 year regimen of in- and outpatient chemotherapy treatments that during some stretches required daily infusions.

Callens mother and stepfather, colleagues, and friends rushed to help, providing lunches, dinners, even breakfasts, so the family could focus on Landen and managing his hospital schedule. Amys co-workers donated sick leave.

The couple tried to make life as normal as possible for Corben; both continued working, and resolved never to show their fear to their son. Nobody ever got a trophy for crying on the floor for three years, Amy said.

Early this winter, news of the pandemic began to percolate. Because Landens treatments impaired his immune system, he was at risk for opportunistic infections. The family had initiated a series of precautions: limiting visitors; carrying hand sanitizer; washing every item that came into their house. We were acting as if Covid existed before Covid existed, Callen said. We were already being hypervigilant.

One evening in mid-February, the whole family was gathered on the couples bed watching Ninjago. Amy was leaning against Callens arm, which had fallen asleep. When she wriggled away to release it, her left breast grazed his hand. In that split-second touch, he felt something unusual and hard. Whats that? he asked. Amy padded her breast with her fingertips, immediately detecting a small mass.

Her mother had had breast cancer, and her grandmother had died of the disease. But they had drank and smoked, lifestyle behaviors that increased their risk. Amy had had a baseline mammogram at 33, and had tested negative for the BRCA genes that dramatically increase the risk of breast cancer. I thought I had an insurance policy against having to go through this, she said.

When she turned 40 in October, her doctor had recommended that she get a second mammogram. But she had told herself she would schedule it until after Landen had completed his first year of treatment.

Now she feared the worst. Landens diagnosis had been improbable. Could the universe betray them twice? Im scared, she told Callen.

Landen, hypersensitive to any health news, looked up. Why?

Amy reigned herself in. I couldnt cry in front of him after watching him be poked and prodded hundreds of times and never complaining. Its not fair to expect a 7-year-old to do what I cant.

I couldnt cry in front of him after watching him be poked and prodded hundreds of times and never complaining.

She was sitting at her work desk when a nurse practitioner called her cellphone with the biopsy results: She had invasive lobular cancer. Amy tried to write down the diagnosis on the back of an envelope. The words went into my ears, but they just werent registering, she recalled. How do you spell that? she kept asking. She hung up and burst into tears. Its not fair, she said to her office mate, who was trying to console her. Were good people. It was supposed to be benign.

In those early weeks of the coronavirus, hospitals were just putting in place social distancing rules to protect patients from infection. Family members were prohibited or sharply limited from joining cancer patients as they go from diagnosis to surgery, from chemotherapy to recovery.

Suddenly, the Sapiens could no longer turn to their community for help either. Their kitchen, in disrepair after a massive leak, had only a working hot plate, but they couldnt accept meals. Amy, who has a well of close friends, couldnt see them on weekend lunch dates.

Cancer remains the second-leading cause of death in the U.S., and 1.8 million people are diagnosed annually. Many end up with plans of treatment that last for months, if not years, that require regular surveillance and lifesaving but immune-suppressing drugs.

In her job, Amy has worked with a series of vulnerable populations, from the homeless to veterans to the elderly. As she lurched alone from procedure to procedure at Moffitt, she of course understood that barring patients partners reduced the chance of infections by half. But she also knew that family members play an important role in making decisions about treatment. Its so hard to absorb what youre hearing when youre the patient, she said. That second pair of ears is so important in cancer treatment.

Meanwhile, St. Josephs Childrens Hospital, where Landen was being treated, issued similar restrictions. In the past, we allowed parents, grandparents, even siblings to accompany patients during treatment, said Don Eslin, Landens pediatric hematology oncologist. Now they can only have one parent.

As recently as February, he said, it was common for families whose children were being treated for blood cancers to share stories and encouragement in cafeterias and the waiting room.

Now that support is reduced to a wave from behind a mask down the hallway, Eslin said.

Doctors, too, saw their routines upended in unsettling ways. Eslin must sometimes deliver bad news by phone, something he has always striven to avoid. This is adding complexities to cancer care in a way we never imagined, he said.

Catherine Lee, Amys surgeon, feels most the loss of connection with patients. Since the third week of March, she has only been able to make eye contact with her patients at one of the most terrifying moments of their lives.

A breast cancer diagnosis is so intimate, Lee said. We always want our patients to feel that we are giving as much as we can to them in terms of support and compassion, and to reassure them that were doing as much as we can for them.

From behind her mask, she can only offer supportive words. They cant see my smile. I cant shake their hands, and I certainly cant give them a hug, she said.

In their brief meeting, Lee and Amy discussed Landens situation, and how Amy needed to be back on her feet as soon as possible.

As Lee reflected on the case during a FaceTime call, she paused for a moment: You know something? I dont even know what Amy Sapien looks like.

For the past seven weeks, she said, about the only thing I see of my patients is their breasts.

Amy is recuperating, working from home to help veterans navigate the Covid-19 crisis. She is never far from her sons, and tells them every day how lucky she feels to be their mother. Landen is now in maintenance therapy, and his doctors have replaced his grueling chemo infusions with an oral drug. Some days, his second grade teacher drops by, and they shout to each other through a closed window.

Earlier this month, she got the news that she wont need chemotherapy, but will be on hormone suppression treatments for at least the next decade, and will go into rapid menopause. It is highly likely that she will need a hysterectomy.

Still, she tries to focus on what she can control. She oversees Landens home schooling, which he does by Zoom with his teacher. She watches the boys as they make up imaginary games with their Duplos, and swim in the backyard pool when Landen is well enough. The family just got a new puppy, a brown Bernedoodle named River. The Sapiens had promised a party and a puppy as a way to mark the end of Landens infusions, and what they hoped would be the resumption of a more ordinary life. The puppy adds chaos but also normalcy.

Although Amy and Callen have tried to shield the children from the news, the pandemic is nonetheless a constant backdrop. Sometimes Landen wonders aloud about whether the virus could kill him or everyone in the family. And he worries about his mother, telling her recently that he hoped she wouldnt have to get an infusion port like his. Amy tries to reassure him.

I tell Landen being brave isnt not being scared, she said. Its being scared and doing it anyway.

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Covid-19 isolates patients from loved ones at time of greatest need - STAT

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