Archive for the ‘Hormone Clinic’ Category

How to relieve constipationEat in a relaxed state

Make sure you dont stress eat, otherwise you will continue to be constipated.

Hannah said: The one reliable way of ensuing costively is moving your bowel after each meal which would require you to eat in a relaxed state at a table with out your phone or computer so you are burning up cortisol (the stress hormone).

You should also avoid eating in the car or walking, and be sure to chew your food until it turns to a liquid.

Hannah explained: Remember a stressed state equals constipation! The very act of eating food creates peristalsis along the tract- a series wave-like muscle contractions that move food to different processing stations in the digestive tract.

This will stimulates defecation. The process of removing faces from your bowels.

For this movement to occur, the gastrocolic reflex should be unconscious.

The gastrocolic reflex is a physiological reflex that controls the movement of the gastrointestinal tract after a meal.

When you feel the urge to go to the toilet, just go!

Hannah said: Your gut is wired to nature. The more you suppress the need, the harder and drier the stool becomes.

This in turn can cause the internal bleeding of the tract, and you dont want this.

Although this would normally be a minor issue if the digestive tract is severely bleeding it could be life-threatening.

Hannah said: As Annie said: when a girl/boys gotta go! So remember to never suppress the need!

In fact, you could try to go to the toilet twice a day.

Hannah suggested: Raise your standards to two bowels movements everyday, I dare you.

You will feel emotionally and physically free. You cant beat a good full, clean bowel movement!

Hannah said: Constipation is not a symptom of a poor diet, its a sign that the entire digestive system is sub optimal.

Making sure you are hydrated and have adequate fibre in your diet, which would mean having vegetables at every meal, is an absolute requirement for a healthy bowel.

If you add to the problem, by smoking, and drinking alcohol and coffee in excess amounts, then it will be even harder to solve the problem.

Look at your habits and lifestyle traits and make positive changes.

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Constipation: How to relieve constipation - Express

Unlike Type 1 or Type 2 diabetes, Type 3 diabetes isnt an official clinical diagnosis. Its not an established medical

Unlike Type 1 or Type 2 diabetes, Type 3 diabetes isnt an official clinical diagnosis. Its not an established medical term at least not yet, points out Guojun Bu, chair of the department of neuroscience at Mayo Clinic in Jacksonville, Florida. But experts say the concept is still a useful one that speaks to the link between insulin resistance in the brain and dementia caused by the progressive brain disorder Alzheimers disease.

Insulin, a hormone produced by the pancreas, regulates glucose levels in the blood. With insulin resistance, the cells dont respond well to the hormone. That can lead to higher blood-sugar levels and the development of Type 2 diabetes (and before that, prediabetes, a precursor to the chronic condition). Research shows that, even short of a person developing diabetes, insulin resistance can impact the body and brain and lead to a range of health complications.

The concept of Type 3 diabetes comes from the idea that insulin resistance is linked, in many cases, to Alzheimers dementia, making it yet another form of diabetes. Of course, the term is also an oversimplification, says Dr. Gary Small, a professor of psychiatry at the UCLA Semel Institute and author of The Small Guide to Alzheimers Disease, since the association isnt completely understood.

Where it breaks down is that its not a 100% link not all patients who have Alzheimers disease have insulin resistance, and not all people who have insulin resistance have Alzheimers disease, Small explains. Now one could argue it could be a subtype of Alzheimers disease where theres that link.

[See: 9 Habits That May Reduce Your Risk for Developing Alzheimers.]

Insulin Resistance Isnt Limited to Diabetes

Today, more than 30 million people in the U.S. have diabetes, according to the Centers for Disease Control and Prevention. And many more people have insulin resistance which isnt routinely tested for.

Even though insulin resistance is associated with diabetes, its much more common than diabetes, says Suzanne Craft, a professor of gerontology and geriatric medicine and director of the Alzheimers Disease Research Center at the Wake Forest School of Medicine in Winston-Salem, North Carolina. It can lead to diabetes, but it can also cause a host of other complications Alzheimers disease being one of those. Those who have insulin resistance, particularly at mid-life, are at greater risk for developing Alzheimers disease, Craft says.

There is a lot of literature supporting the association between insulin resistance and various types of dementias that disproportionately affect older patients, particularly Alzheimers disease, echoes Dr. Samoon Ahmad, a professor of psychiatry at the NYU Grossman School of Medicine and founder of the Integrative Center for Wellness in New York City. Insulin resistance in Alzheimers is a growing area of focus. As noted in a 2018 review article in the Frontiers in Neuroscience, The epidemiological connection between diabetes, obesity, and dementia represents an important public health challenge but also an opportunity to further understand these conditions. The key intersection among the three diseases is insulin resistance.

The association also applies to conditions that are related to insulin resistance, including Type 2 diabetes and obesity, notes Christian Pike, a professor in the Leonard Davis School of Gerontology at the University of Southern California.

Researchers arent exactly sure why insulin resistance is associated with higher rates of Alzheimers disease and related forms of dementia. But theres no shortage of theories and possible mechanisms that have been suggested to explain the relationship. And, generally speaking, its well-known that insulin plays an important role in brain function.

Insulin basically transports glucose from the bloodstream into cells, Small says. So that makes sense if your insulin transport system getting those nutrients to brain cells is not functioning properly, that the brain is not being fed its main energy source as well.

Insulin has a number of important roles to play in healthy brain function, Craft notes. Accordingly, she says, there are several pathways through which insulin resistance could increase the risk for Alzheimers disease. For one thing the hormone helps brain cells form connections. It helps the brain repair itself from injury and generate new brain cells, Craft says. It plays a very important role in memory.

So dysfunction in regards to how insulin is used or isnt can have a meaningful impact on cognitive function. Insulin resistance, by definition, is the brain not responding normally to insulin, Craft explains. So by depriving the brain of all of these various functions of insulin, insulin resistance creates an environment in the brain that makes it vulnerable to developing the kind of injury thats associated with Alzheimers disease.

Given the important role of insulin, it could be used as a possible treatment for mild cognitive impairment and Alzheimers disease, as noted in a 2018 research review published in the Journal of Neurology. Insulin delivered through a nasal spray, for instance, has been shown to improve recall of story details or story recall in patients with Alzheimers or mild cognitive impairment.

Ultimately, insulin may be delivered as a means to improve or at least stabilize cognition in people with Alzheimer and other dementias. In limited studies, intranasal insulin delivery has been shown to lead to some cognitive benefits in dementia patients, Pike points out.

Theres evidence that the Alzheimers brain may be less sensitive to insulin, which is critical for memory formation and maintenance, Bu adds. But more research is needed to explore the possibilities for managing or treating Alzheimers with insulin.

In the meantime, whats already well established is that preventing insulin resistance can protect a persons overall health including brain health.

[See: 10 Myths About Diabetes.]

Preventing Insulin Resistance Through Lifestyle Changes

Factors out of ones control namely genetics, having a family history of insulin resistance or diabetes can predispose a person, or raise ones risk of developing insulin resistance. But lifestyle still plays an outsized role in preventing it.

Lifestyle changes are among the most effective ways of preventing or delaying Alzheimers disease, too. And they are recommendations weve all heard before, Craft says.

Those include:

Getting regular exercise.

Consuming a healthy, balanced diet.

Maintaining a healthy weight.

If a person did all of those things, the rate of insulin resistance would be dramatically reduced, Craft says.

What we dont understand is why some people have a greater tendency to develop insulin resistance than others, even when their diets and levels of exercise are more or less than the same, Ahmad says. Genetics is likely one answer, but there may be other factors we are not aware of, and these may complicate the association between Alzheimers risk and diet.

Even so, the role of lifestyle remains important. While some individuals are at a significantly higher risk of developing either diabetes or Alzheimers because of genetic factors, getting regular exercise and eating healthy will certainly lower ones risk of developing Type 2 diabetes and could lower ones risk of developing Alzheimers disease, Ahmad adds.

Federal physical activity guidelines suggest getting at least 150 minutes of moderate intensity exercise, like brisk walking, weekly. Shifting to a sustainable, well-rounded, balanced eating pattern rather than say an extreme diet is also encouraged.

While most people like to hear about fad diets that produce unrealistic or unsustainable results, the best way to plan ones meal is to avoid excessive amounts of alcohol and processed foods particularly those high in saturated fats and sugars and to try to eat foods that are as close to their whole or natural states as possible, Ahmad says. This means a diet that is rich in whole grains, lean proteins, and fruits and vegetables, particularly raw fruits and vegetables.

From improving heart health to brain health and staying disease-free in general for as long as possible data strongly suggests turning away from a traditional Western diet thats heavily processed and high in saturated fat and sugar. This type of eating pattern has been linked with a higher risk of Alzheimers disease.

[See: Best Foods for Brain Health.]

The kind of diet that protects the brain is generally a Mediterranean-style diet that includes fresh fruits and vegetables, legumes, healthy fats from omega-3s which are anti-inflammatory, Small says. You can get omega-3 fats from fish and nuts. He notes that the fruits and veggies provide antioxidants and may fight against wear and tear from oxidative stress that causes damage to neurons over the years. A diet that limits refined sugars and processed foods will lower risk for Type 2 diabetes as well as Alzheimers dementia.

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Type 3 Diabetes? The Link Between Insulin Resistance and Alzheimer?s originally appeared on usnews.com

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Type 3 Diabetes? The Link Between Insulin Resistance and Alzheimer's - WTOP

It is possible to feel good and be resilient in times of stress, including the stressful time of menopause transition. The body changes of menopause can be detrimental to individual women, her community and the workplace. With Mothers Day on May 10 and Womens Health Week from May 10-16, addressing the impact of menopause is good for all in West Michigan.

When a woman crosses into menopause, her health is essentially as good as it is going to get. Menopause symptoms which include hot flashes, low sec drive and mood changes affect the quality of life for 80% of women, according to a 2015 study.

Menopause body changes lead to a dramatic increase in risk for obesity, heart attack, diabetes and depression. Because of this, hot flashes can be used to signal it is time to assess risk factors and make decisions about a womans health goals, lifestyle choices and treatment options. For example, estrogen is safer than many people think. Estrogen use early in menopause can reduce the risk for cardiovascular disease without increasing risk for breast cancer and while improving quality of life or a plant-based diet could reduce risk of heart attack.

The symptoms of perimenopause and menopause also can impact the bottom line for businesses. Scientific review of insurance claim data shows women with untreated symptoms of menopause hot flashes, night sweats had 57% fewer days of productive work, were more likely to miss days at work and have more medical office and ER visits with increased medical costs of $1,346 per patient per year, according to a 2015 study. Health care visits for women with symptoms totaled more than $340 million in direct cost, and the total cost of lost work was $28 million.

Experts say these symptoms and the related health consequences lead women to be more likely to leave the workforce or have their careers affected just at the time of potential upswing or promotion. Companies would benefit from increased attention to the benefits of addressing employee health needs around the menopause transition.

Menopause also affects our community by its effect on a womans sense of self, her work life and her family life. It is time to expand the conversation and better care for our community. Menopause happens to all women, either naturally around age 52 or prematurely as a result of cancer treatment or removal of the ovaries due to surgery for cancer or benign conditions such as fibroids or endometriosis.

Women benefit when they are empowered with knowledge about symptoms and treatment options, including targeted lifestyle choices, hormone or other medication, or therapies such as acupuncture. Women whose symptoms are treated spend less time going to the doctor, more time engaged in activities and less prone to chronic illness. West Michigan-based True Womens Health, a midlife, menopause and sexual health wellness clinic, aims to equip women with the right tools and resources to support optimal health for each patient through the good and the bad times.

With Mothers Day and Womens Health Week in mind, it is crucial to continue healthy aging year-round. As a patient of mine who survived breast cancer and works as a supervisor on a factory floor said, The SEEDS (Seven Essential Elements of Daily Success) and medication you prescribed saved me. I am back and happy with my new normal.

She and others like her have proven to me that all women deserve choices on how to cope with their menopause journey, which is the ultimate goal for our True Womens Health patients. When this happens, the whole community will benefit.

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Continuing healthy aging through motherhood and beyond - grbj.com

As the rumblings of a pandemic began to be felt at the beginning of the year, scientists at Penn started work to develop a vaccine and assess 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.

The more scientists and clinicians observe about the virus, the more avenues of investigation emerge, aiming to shed light on questions such as what happens once the virus enters the body, what treatments might be of benefit, and how society should take action to keep transmission low.

To dig into what scientists around campus are asking and learning, Penn Today spoke with several who have pivoted their research to focus on COVID-19. Their work, while in its early days, is in many cases already finding applications in the fight against this ferocious virus, and may well shape the next steps to defeat it.

Another respiratory infection, influenza, has been a focus of research led by Andrew Vaughan of the School of Veterinary Medicine. But Vaughan didnt hesitate to begin studies of the novel coronavirus once its eventual impact became apparent.

Its not a stretch for our lab, he says. All the projects in our lab focus on repair and regeneration of the lungs after injury. The majority of my studies are to some degree agnostic about what is causing the injury.

Earlier work by his group, for example, showed that a lung cell transplant could boost healing in mice affected by a severe bout with flu. 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 the Perelman School of Medicine (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, those that are particularly essential for continuing oxygen exchange deep in the lungs, to alter or block ACE2 gene expression to try to prevent viral entry.

These alveolar type-two cells seem to be particularly susceptible to injury in both influenza and perhaps even more so in COVID-19, says Vaughan. In a perfect world, you might be able to take these genetically edited type-two cells and use them as a cellular therapy. I dont know that this is going to happen in time to impact this pandemic, but even if the pathogen the next time around is slightly different, we may still be able to employ these types of regenerative responses to help the lung recover better from injury.

In a separate project, Vaughan is partnering with Penn Vets Montserrat Anguera 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, says Vaughan. I immediately texted her and said, I think theres something to that.

Normally women inactivate one of their X chromosomes, but some genes can escape this inactivation. This means its possible women may have higher ACE2 expression than men. Somewhat counterintuitively, scientists have actually found that higher ACE2 levels actually reduce lung injury, even though ACE2 is also what the virus depends on to enter cells.

Hormone expression levels are, of course, another factor that may influence sex differences in disease. Together, 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 with Susan Weiss and others, says Vaughan.

Individual differences in how people respond to infection may be influenced by their unique genomic sequences. Penn Integrates Knowledge Professor Sarah Tishkoff of PSOM and the School of Arts & Sciences, 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. As in Vaughan and Angueras work, ACE2 is a focus.

This gene is very important for general health, Tishkoff says. Women have two copies, men have one; it plays a role in regulating blood pressure; its in the kidneys; its in the gut. We want to understand the role that variation at this gene may play in risk for COVID-19, severity of disease in people with underlying health conditions, and differences in the prevalence of disease in men and women.

Using genomic data from 2,500 Africans collected for another project, Tishkoffs team is looking for patterns of genetic diversity. Early findings suggest that natural selection may have acted upon on version of the ACE2 gene, making it more common in some African populations with with high exposure to animal viruses.

Shes also collaborating with Anurag Vermaand Giorgio Sirugo of Penn Medicine to analyze genetic variation in samples from the Penn Medicine Biobank, looking in particular at people of African descent. Were seeing disturbing health disparities with COVID, with African Americans at higher risk for serious illness, says Tishkoff. This disparity mostlikelyhas to do with inequities in access to health care and socioeconomic factors, but were also looking to see if genomic variation may be playing a role.

Looking ahead, Tishkoff hopes to partner with Daniel Rader and others through the Center for Global Genomics and Health Equity to work with the West Philadelphia community. Wed like to do testing to understand the prevalence of infection and identify environmental and genetic risk factors for disease, she says.

The immune reaction to SARS-CoV-2 is a double-edged sword. The immune system is what eliminates the virus, says E. John Wherry of 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.

Wherry and PSOMs Michael Betts 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. Theyre doing so by working with clinicians at the Hospital of the University of Pennsylvania (HUP) and, soon, at Penn 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.

Its one of the beautiful things about Penn. Everyone is working as a team, being selfless, being present, and bringing all their expertise to bear on this crisis. E. John Wherry, Perelman School of Medicine

We are observing a huge amount of heterogeneity across these patient samples, says Betts. But were also identifying some relatively unifying characteristics, indicating there are mechanisms that everyone uniformly uses to fight off this infection.

This variety across patients strongly suggests that the treatments that work for one patient may not for another, Wherry and Betts note. For that reason, they are speaking daily with their colleagues on the front lines of COVID-19 care, relaying what theyre finding out in the lab to adjust and personalize care in the clinic.

Its one of the beautiful things about Penn, says Wherry. Everyone is working as a team, being selfless, being present, and bringing all their expertise to bear on this crisis.

Plenty of recent scientific attention has been paid to the role of the gut microbiome in health. But the medical schools Ronald Collman and Frederic Bushman 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.

There are two reasons were interested in studying this, Collman says. First is that 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, Collman and Bushman are analyzing the microbiome of both the upper (nose and throat) and lower (lung) portions of the respiratory tract of COVID-19 patients. These samples are being used by other groups, such as those developing diagnostic tests, while Collman and Bushmans labs work to identify the types and quantities of organisms that compose the microbiome to find patterns in how they correlate with disease.

Were hoping that if we can find that the response to the virus is different in people with different upper respiratory tract microbiomes, then we could manipulate the microbiome, using particular antibiotics, for example, to make it more likely that patients would have a mild form of the disease.

Absent a vaccine, researchers are looking to existing drugssome already approved by the U.S. Food and Drug Administration for other maladiesto help patients recover once infected. Throughout his career, Ronald Harty of Penn Vet has worked to develop antivirals for other infections, such as Ebola, Marburg, and Lassa Fever.

Our antivirals are sometime referred to as host-oriented inhibitors because theyre designed to target the interaction between host and viral proteins, says Harty. Though many of the biological details of how SARS-CoV-2 interacts with the human body are distinct from the other diseases 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, says 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.

Harty 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, such as Penns Weiss.

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. Hartys lab will be examining the potential interactions between the viral structural proteins and human proteins responsible for maintaining these cellular barriers.

Another faculty member is assessing whether a drug developed for a very different conditionin this case, pulmonary arterial hypertension (PAH)could serve coronavirus patients. Henry Daniell of the School of Dental Medicine recently 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. Daniell is now working with Kenneth Margulies from Penn Medicine 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, says 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 United States, biologist Joshua Plotkin of the School of Arts & Sciences began to raise alarms about Philadelphias St. Patricks Day parade, which had been scheduled to be held March 15, potentially drawing thousands to downtown streets. He had good reason to be concerned: His studies of the 1918 flu pandemic had explored disease incidence and spread, and it was hard to avoid noticing the role of the Liberty Loan parade down Broad Street in triggering a rampant spread of flu a century ago.

Now, with work conducted with two graduate students from Princeton University, Dylan Morris and Fernando Rossine, along with Princeton faculty member Simon Levin, Plotkin has mathematically sound advice for policymakers hoping to effectively stem the spread of a pandemic. In a preprint on arXiv.org, they share optimal, near-optimal, and robust strategies for how to time interventions such as social distancing.

This boils down to knowing what is the best way, of all the infinite possibilities, to intervene using public health measure, says Plotkin. Thats a problem we can solve with math, my colleagues Dylan and Fernando realized.

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, says 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.

Unsurprisingly, timing is key. Attempting the optimal intervention would be disastrous, in practice, because of inevitable errors in timing. Intervening too early is pretty bad, because you get a bigger second peak, he says. But intervening too late is even worse. The key lesson is that a robust intervention is more important than an optimal one.

Plotkin and his colleagues are hoping to share the findings widely, including with local decision makers, to help them navigate a likely second wave of COVID-19.

Montserrat Anguera is an associate professor of biomedical sciences at the University of Pennsylvania School of Veterinary Medicine.

Michael Betts is a professor of microbiology at the University of Pennsylvania Perelman School of Medicine.

Frederic Bushman is the William Maul Measey Professor in Microbiology at the University of Pennsylvania Perelman School of Medicine.

Ronald Collman is a professor of Medicine at the University of Pennsylvania Perelman School of Medicine.

Henry Daniell is vice-chair and W.D. Miller Professor in the Department of Basic and Translational Sciences in the University of Pennsylvania School of Dental Medicine.

Ronald Harty is a professor of pathobiology and microbiology at the University of Pennsylvania School of Veterinary Medicine.

Kenneth Margulies is a professor of medicine and physiology and research and fellowship director of the Heart Failure and Transplant Program at the University of Pennsylvania Perelman School of Medicine.

Joshua Plotkin is the Walter H. and Leonore C. Annenberg Professor of the Natural Sciences in the Department of Biology at the University of Pennsylvania School of Arts & Sciences. He has secondary appointments in the Department of Mathematics and in the School of Engineering and Applied Sciences Department of Computer and Information Science.

Sarah Tishkoff is the David and Lyn Silfen University Professor with appointments in the Perelman School of Medicines Department of Genetics and the School of Arts and Sciences Department of Biology. A Penn Integrates Knowledge Professor, she is also director of the Penn Center for Global Genomics and Health Equity.

Andrew Vaughan is an assistant professor of biomedical sciences at the University of Pennsylvania School of Veterinary Medicine.

E. John Wherry is chair of the Department of Systems Pharmacology and Translational Therapeutics, director of the Institute for Immunology, and the Richard and Barbara Schiffrin Presidents Distinguished Professor at the University of Pennsylvania Perelman School of Medicine.

Homepage image: Researchers around the University are taking a variety of approaches to study the novel coronavirus (particles of which are shown in purple), informed by past expertise and newly formed collaborations. (Image: National Institutes of Health)

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Coming together to solve the many scientific mysteries of COVID-19 - Penn: Office of University Communications

Release Date: May 5, 2020

BUFFALO, N.Y. Mary Wilson, wife of the late Buffalo Bills owner Ralph Wilson and a strong advocate of Western New York for the past 29 years, will be awarded the Chancellor Charles P. Norton Medal, UBs highest honor.

Jean Wactawski-Wende, SUNY Distinguished Professor in the Department of Epidemiology and Environmental Health and dean of the School of Public Health and Health Professions, and an internationally recognized researcher on womens health issues, will receive the UB Presidents Medal in recognition of extraordinary service to the university.

In addition, SUNY honorary doctorates are being presented to UB alumna Donnica L. Moore, president of the Sapphire Womens Health Group, and Richard A. Schatz, research director of cardiovascular interventions at the Scripps Heart, Lung and Vascular Center.

Wactawski-Wende will receive the Presidents Medal during the School of Public Health and Health Professions virtual commencement ceremony on May 16; the other award recipients will receive their honors at a later date.

Chancellor Charles P. Norton Medal

The Chancellor Charles P. Norton Medal is presented annually in public recognition of a person who has, in Nortons words, performed some great thing which is identified with Buffalo a great civic or political act, a great book, a great work of art, a great scientific achievement or any other thing which, in itself, is truly great and ennobling, and which dignifies the performer and Buffalo in the eyes of the world.

Announcing this years Norton Medal recipient, Jeremy M. Jacobs, chair of the UB Council, said that Mary Wilson a life trustee of the Ralph C. Wilson, Jr. Foundation richly deserves the honor for her longstanding commitment to the region.

This year, we were absolutely unanimous in our decision to honor Mary Wilson, he said. In her leadership of the Wilson Foundation, Mary is making an enduring and unprecedented impact on Buffalo and all of Western New York, which will be felt for many generations to come. Her dedication and work align perfectly with the spirit of the Norton Medal.

Wilson has been devoted to Western New York since she first arrived in the area for the Bills home opener in 1990.

She has spent many years developing her Western New York Girls in Sports program, which biannually brings more than 200 9- to 12-year-old girls together to take part in various sports taught by young athletes from local universities and sports clubs.

The program, now ensured to run in perpetuity, is organized by the United Way of Buffalo and Erie County through an endowment from the Ralph C. Wilson, Jr. Foundation.

She has also supported organizations benefiting communities in Buffalo, Erie County and Southeast Michigan, among them Hospice of Western New York, WNY Womens Foundation, Food Bank of Western New York, Albright-Knox Art Gallery, Girl Scouts of Western New York, the SPCA serving Erie County, the Buffalo Philharmonic Orchestra, the Alzheimers Association Greater Michigan Chapter, The Helm (formerly Services for Older Citizens), the Detroit Symphony Orchestra, the Detroit Historical Society and the Detroit Institute of Arts, to name a few.

UB Presidents Medal

The UB Presidents Medal, first presented in 1990, recognizes outstanding scholarly or artistic achievements, humanitarian acts, contributions of time or treasure, exemplary leadership or any other major contribution to the development of the University at Buffalo and the quality of life in the UB community.

President Satish K. Tripathi described recipient Jean Wactawski-Wende as a world-renowned epidemiologist who has brought great prominence to UB through her scholarly pursuits and academic excellence in the area of womens health.

A dedicated member of our university community for more than 30 years, Dr. Wactawski-Wende has made seminal contributions that have significantly impacted health care practice and disease prevention for women in the U.S. and around the world, he said.

Thanks to her tremendous leadership, she has further elevated the reputation of UB. Our university community, along with the many communities we serve, have been profoundly enriched by Dr. Wactawski-Wendes scholarship, teaching and service, and it is an honor to present the Presidents Medal to such a truly deserving recipient.

Of particular note is Wactawski-Wendes leadership role in the Womens Health Initiative (WHI), the largest longitudinal study of womens health in the United States. In 1993, she was part of the team that spearheaded UBs successful bid to become one of the federally funded studys 16 original vanguard clinical centers. Since the inception of the WHI, UB has received more than $30 million in funding from the National Institutes of Health to investigate health issues impacting postmenopausal women.

Among the WHIs major discoveries was the groundbreaking finding that intake of combined estrogen plus progestin was associated with an increased risk of heart disease, stroke and invasive breast cancer. That research, on which Wactawski-Wende served as a co-principal investigator, changed the use of hormone therapy in older women worldwide, potentially saving countless lives.

Through UBs current $6.2 million award extension of the WHI, she has overseen the continuation of research into many diseases associated with aging, such as cardiovascular disease, cancer, osteoporosis, stroke and dementia. She is also administering new studies that focus on frailty and predictors of healthy aging.

For those of us who know and have worked closely with Dr. Wactawski-Wende, we readily recognize the magnitude and excellence of her contributions to academic medicine, said Michael E. Cain, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences at UB.

She is an eminent and distinguished scholar and leader whose work, professional service, and stature in her discipline and research field are outstanding and continue to grow.

SUNY Honorary Doctorates

An internationally recognized womens health expert and advocate, Donnica L. Moore is president of Sapphire Womens Health Group, a multimedia firm that educates women about the benefits of a healthy lifestyle.

A pioneering physician, Moore utilizes public speaking and multiple media platforms including her own website and podcast to share impactful health information in laypersons terms.

She will receive a SUNY Honorary Doctorate in Science.

Dr. Moores significant accomplishments associated with women's health set an inspiring example for our university community and reflect the values of both UB and the SUNY system, Tripathi said.

Breaking barriers to educate women about an array of health-related topics, she has demonstrated a sustained and dedicated commitment to the well-being of women around the globe. One of UBs most distinguished alumni, Dr. Moore in utilizing accessible platforms to create broad access to sound, peer-reviewed medical information is enhancing lives in communities near and far.

Moore is a 1986 alumna of the Jacobs School of Medicine and Biomedical Sciences at UB, and underwent residency training in obstetrics and gynecology at Temple University, followed by a year of family medicine training at Memorial Hospital of Burlington, New Jersey.

She has appeared more than 800 times on such programs as The Oprah Winfrey Show, The Anderson Cooper Show and Good Morning America.

Richard A. Schatz is co-creator of the first coronary stent approved by the Food and Drug Administration for restenosis.

Known as the Palmaz-Schatz stent, this life-saving device has been used to treat coronary artery disease in nearly 100 million patients worldwide since its approval in 1994. It is considered one of the top 10 medical device patents of the past 50 years.

He will receive a SUNY Honorary Doctorate in Science.

Dr. Schatz is widely known as the father of modern interventional cardiology for good reason, Tripathi said. Every day, his groundbreaking work is realized in operating rooms across the country and beyond. The stent he co-created spurred a revolution in the treatment of coronary artery disease and, 30 years later, it has had an immeasurable impact on health care.

By contributing to society through his biomedical innovations and inventions, Dr. Schatz has improved the lives of tens of millions of people while embodying the ideals of our university community and our university system.

A New York native, Schatz is the research director of cardiovascular interventions at the Scripps Clinic and director of gene and stem cell therapy. He is an elected fellow of the American College of Cardiology. In 2019, he received the Fritz J. And Dolores H. Russ Prize, which recognizes biomedical engineering achievements that have significantly improved the human condition. He is also the recipient of the Barton Haynes Lifetime Scholar Award from Duke University Medical Center.

Schatz attended UB in the early 1970s before gaining early admission to Duke Medical School, then completed his cardiology training at Brooke Army Medical Center.

Throughout his career, he has maintained a strong affinity for UB, crediting the universitys faculty and curriculum for inspiring him to pursue a career in medicine.

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Mary Wilson to receive UB's Norton Medal - UB News Center

The latest lifestyle, fashion and travel trends

Missing your monthly facial?

Londons salons might be shut, but some of the citys savviest skin specialists have boxed up their bestselling treatments ready to pop in the post; allowing for a little me time before you FaceTime.

Mid-hibernation hydration

Contents of the Pfeffer Sal Essential Product Pack

The Pfeffer Sal clinic in Fitzrovia has earned its place in every London beauty editors little black book for its brand agnostic product recommendations and holistic-meets-high-tech approach. In order to keep their loyal clients GFH (glowing from home), the clinic has released six DIY facials, the best of which has to be the Essential product pack, based on the salons signature treatment. Included in the delivery are four full size products, among them an enzyme peel, a hydrating mask and Pfeffer Sals new own-brand Essential Serum a star blend containing four key actives that hydrate, stimulate collagen and elastin, and boost the skins regeneration. A virtual one-to-one with a therapist, normally 50, is also included, to ensure you peel and pamper like a pro.

Our top tip: Book the guided facial in the evening and leave the mask on to work its magic overnight

Pfeffer Sals Essential At-Home Product Pack, 250. Shop it here

The socially distanced detox

Antioxidant probiotic skin supplement from the Beauty Chef, included in the Skinwork Detox Facial in a Box

Thought this makeup-free WFH life was set to be a holiday for your skin but instead find yourself suffering with blackheads and breakouts? Youre not alone. The global pandemic-induced raising of stress levels increases production of the hormone cortisol, which in turn triggers overproduction of sebum. More sebum means more spots - but dont panic. LA import Skinwork, based in the Alex Eagle store in Soho, has a Detox Facial in a Box thats a one-way ticket to zit-free Zooming. Book a 30-minute skin coaching session with one of their team wholl take you through a thorough cleanse and detoxifying mask, finishing with a powerful vitamin C serum that treats pigmentation and brightens skin. Alongside the two full-size products the kit contains a headband, cleansing mitt and an antioxidant probiotic skin supplement from the Beauty Chef to get you glowing inside and out.

Skinwork Facial kits start at 100; The Detox Facial kit is priced at 165. Shop it here

The planet-loving pamper

Evolve Beauty's facial in a box

If you like your skincare vegan, organic, natural and cruelty-free, the Get Up And Glow Facial In A Box from British brand Evolve Beauty could be the one for you. The company makes all its products by hand and in small batches at its Hertfordshire wind-poweredecostudio, using the most effective natural superfoods. The box, made using recycled packaging, contains five travel size products: a Gentle Cleansing Melt, a Miracle Mask, a Hyaluronic Serum, Hyaluronic Eye Complex and a Daily Renew Facial Cream, alongside a towel headband and a step-by-step guide on how to apply your goodies. Best for normal to dry skin types, this is aDIYfacial both your skin and the planet will thank you for.

Evolve Beautys Get Up And Glow Facial In A Box, 50. Shop it here

How to do an at-home facial, according to a skincare pro

The post-lockdown reveal peel

Feel like youve aged a year in the last two months? Our current hermit-like existence offers the perfect opportunity to try a temporary redness-inducing chemical peel. Brilliant for brightening, peels also treat fine lines, wrinkles and hyperpigmentation while deeply hydrating and restoring the skins barrier. Facialist Kate Kerr, whos normally based out of the agua Spa at the Sea Containers Hotel, has an intensive Peel in a Box treatment on offer which uses high dose retinol to stimulate skin renewal and collagen production to even skin tone and smooth its texture. Not for the faint of heart, the three-day process forces the skin into an active peeling phase; best approached before a socially distanced weekend indoors. Given the intensity of the products, its suited to those already using a 0.5 per cent or 1.0 per cent retinol every night, and a preliminary telephone consultation with one of the Kate Kerr team is a must.

Kate Kerrs Home Peel Box costs 295 and contains enough for three courses of peel. Shop it here.

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Facials in a box: the step-by-step salon skincare you can order to your door - Evening Standard

Ajay Rampal, CEO, IFFCO Poultry Image Credit: Supplied

With a vision for excellence and quality, IFFCO established in 1975 is an international group based in the UAE, which manufactures and markets a well-integrated range of mass-market food products, related derivatives, intermediates, and services. With a portfolio of over 80 brands, IFFCO has firmly established itself as one of the main and most diversified groups in the Middle East.

IFFCO acquired Al Khazna Farm in April 2008, a farm where the best chicken breeds are selected, raised and fed on a 100 per cent vegetarian diet, with zero antibiotic residue and hormone-free production, ensuring the delivery of safe, nutritious, and high-quality fresh chicken.

Today, Al Khazna is one of the leading brands in the market under the fresh chicken category. Al Khazna prides itself in being a pioneer in processes and new product development.

Keeping consumer requirements in mind, Al Khazna offers whole chicken, portions and pre-cut parts to cater to every need.

While commenting on the current trends in the poultry industry, Ajay Rampal, CEO, IFFCO Poultry, says, With the current global situation, we see a change in the buying behaviour of consumers. A trend which is fast catching on is online shopping for groceries and fresh produce. Keeping this in view, we have tied up with a number of online operators, besides being present on retailers webstores.

The fresh and high-quality chicken products are also daily transported to various retail outlets, hotels, catering companies, government sectors and many more locations across the UAE in its temperature-monitored vehicles. Al Khazna is certified with HACCP, ISO22000-2018, FSSC 22000-2018, Halal and ESMA certificates.

At Al Khazna, we commit to deliver the highest quality meat from farm to fork on the same day to ensure that our consumers enjoy the exquisite taste with high nutritional value, explains Rampal.

In a unique initiative, Al Khazna has associated with Dubai Cares this Ramadan to support the cause of child education. We strongly believe that education is the basic right of every child, says Rampal, adding, With every kilo of Al Khazna product that a consumer buys, we contribute towards this cause. This platform not only gives us but also our consumers an opportunity to share and support this noble initiative.

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IFFCO: Delivering the highest quality poultry for all your cooking needs - Gulf News

For Avilez, the difficult adjustment is not just the result of the time she spent in prison and detention, but that she's back in her aunts house trying to live her life authentically in close quarters with some family members who haven't seen her since she transitioned to female.

"My aunt still calls me mijo. It's kind of hard for her, and I understand that. I'll have to sit down and talk with her about that later," Avilez said. "But, I want to be able to wear my makeup. I don't have to be scared no more."

Avilez lost an initial bid for asylum, but she has appealed. While she awaits her next immigration court hearing, she said she's eager to get her life started again. She wants to get a cellphone, so that she can call the friends she made in detention.

She also wants to get her job back. Avilez said she used to work in the medical field as a service technician, helping people who use wheelchairs and providing assistance to the elderly across Monterey County.

"I'm happy I'm free. [Though] I don't feel completely free because I'm wearing an ankle monitor ... I can't go out, she said.

Since Avilez left ICE custody, she has not had access to hormone treatment. But attorney Hector Vega of the San Francisco Public Defender's Office, who represents Avilez in her immigration case, said social workers in his office have found a clinic in Monterey County that can provide her the medication, free of charge.

In her first act of independence since being released from detention, Avilez bought a pink T-shirt with a single parentheses in the middle and colons dotting either side, creating the image of both a sad and happy face.

"Is it a happy face? Avilez asked. You decide if it's happy or not."

Continued here:
Released From ICE Detention Into a Pandemic: For One Woman, Returning Home Is Complex - KQED

Beauty, business, relax, repeat: Its all in a days work for British Beauty Council CEO Millie Kendall, MBE.

Subtle TweaksI totally rate Dr. Jules Nabet for tweakments. He is based at Omniya in Knightsbridge. He is a hormone specialist as well and really understands a womans face. Dr. Alexis Granite at Mallucci London is pretty incredible, too. I have watched her work and she is extremely light-handed if you want subtlety.

Freeze Frame My favorite facial would be with Su-Man Hsu at the W Hotel. She is Taiwanese, a former dancer and lives near me. She has really become a friend. Su-Man has the most unique massage techniqueit is like your face wakes up after having been asleep for years. I can top up my facials with a Bioeffect rejuvenating facial at Apogii in Notting Hill. They also have a cryo clinic and its a double-chambered one. Call me a sucker, but three minutes at minus 110 degrees Celsius can do wonders for your body. Plus, it is large enough so you can take some friends in with you for moral support.

Charlotte Tilbury, of course, the darling of British Beauty; Pat McGrath Labs, the mother of British Beauty; Aromatherapy Associates is simply my favorite bath and body brand. Deep Relax is divine and the most recognizable, but equally unique, scent.

Destination: RelaxationMy favorite massage is a deeply relaxing Aromatherapy Associates full body with Rika at the Mandarin Oriental Hotel. The spa is just so chic.

One-Stop Shop For workouts, I have a personal trainer, but I love the Reformer Pilates classes at Frame. I go to the one near our offices on Berners Street. There is a Hershesons hair salon above it, so you can get your hair done afterwardsand you can also choose from one of the many amazing additional services, like DryBy nails, SumanBrows, Ministry of Waxing, etc. It is literally a mecca. Then, around the corner is Nicola Clarke for John Frieda; Nic has been coloring my hair forever and I visit there on a very regular basis for a top-up of blond.

Gut CheckIf you want nutritional support or a colonic, see Kaori Murphy at the Hale Clinic. She is amazing at getting your gut health on track. She is extremely strict with you, but gentle, too. I saw her for months at one pointevery Friday morning I had to go see her. She honestly changed my life.

Arabellas Votary skin-care range is so loved by makeup artistsprobably because her oils are really light and wearable; The frankincense line from Neals Yard Remedies is amazing, and their farm and manufacturing facility are spectacular; Sam McKnights Cool Girl Barely There Texture Mist makes you look and feel like Kate Moss; I love anything from The Body Shop the original renegade brand; Theres a new British hair-care brand based on Ayurveda called Chmpo, which is the Indian word for shampoo.

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National Treasures: Millie Kendall Recommends the Best Beauty Buys London Has to Offer - NewBeauty Magazine

publication date: May. 1, 2020

Howard A. Skip Burris III, MD, FACP, FASCO

President, American Society of Clinical Oncology

President, Clinical Operations and Chief Medical Officer

Sarah Cannon, the Cancer Institute of HCA Healthcare

Associate, Tennessee Oncology

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.

The COVID-19 pandemic will change the structure and economics of clinical care and clinical trials in cancer, said Howard Skip Burris, president of clinical operations and chief medical officer of Sarah Cannon, the Cancer Institute of HCA Healthcare.

The pandemic is going to create an opportunity to look at how oncology should be reimbursed and how a practice is not disadvantaged when theyre able to function electronically in some areas, said Burris, who is this years president of the American Society of Clinical Oncology. And then I think bigger picture, this pandemic will help us set some health care priorities for the population.

Im hopeful that after we get through the storm, there will be a real assessment and look at the data as you alluded to about the need to continue with appropriate cancer screening programs, mammography, colonoscopy, and appropriate CT scans.

And hopefully, we wont see too big of a disadvantage coming from procedures being delayed. The information during this time will help confirm what we thought for yearsthat early detection of cancer really leads to better outcomes. These few months here, I think, are going to greatly shape how we approach health care over the next few years.

Burris spoke with Paul Goldberg, editor and publisher of The Cancer Letter.

Paul Goldberg:

First of all, how are you?

Skip Burris:

Im doing well. We are staying fairly busy in continuing to care for our patients. Nashville had a lot of cases, but we have had a fairly low number of hospitalizations and an even lower number of deaths. So, weve been a little bit of an outlier as a state.

Nashville had a lot of cases early, but the hospitals have been relatively quiet in comparison to other states. The major hospitals here have been running inpatient COVID-positive numbers in the twenties, with a handful of patients in the intensive care unit.

PG:

How about your practice? How about Sarah Cannon?

SB:

Our major practices are Tennessee Oncology and Florida Cancer Specialists, where we have the bulk of the patients on clinical trials. We also have research programs in Kansas City, Oklahoma City and Denver.

We have about a dozen COVID-19 positive patients across the practices, and have been fortunate that none have been critically ill. A few staff have been infected, exposed outside of our clinics, but again, nobody critically ill.

The Nashville clinic, where I practice, is relatively quiet, but we are continuing treatment. Surveillance visits have been moved out a few months, and were continuing to keep an eye on that timing. The benign hematology has also been moved out. The oral therapies are being handled with telemedicine and shipping the drugs to the patients.

The clinics across our network are steadily functioning, but not overly busy, including chemotherapy rooms. With the lower volume, we are able to successfully implement social distancing measures as well as all the safety precautions of masks, gloves, and hand washing.

PG:

What about the financial impact? Are you seeing any?

SB:

There is an impact, but its a little early to do any calculations. The absolute visits are going to be dropping. We are starting to pick up the telemedicine visits, but its probably 50/50 on patients being comfortable with that approach versus simply wanting to push out their visit. The treatments have remained fairly steady in terms of those patients that are on intravenous treatments.

I think the financial impact is not going to be quite as devastating as we had first anticipated. The missed visits will never be made up.

Its a little bit like the movies and the restaurant businesspeople are not going to have two dinners at the same place in the same night, or see two movies at the same timepatients are not going to come for two visits to our clinics in a week either. So, I think the financial impact is going to be substantial, but not catastrophic.

I do think it is different for large practices versus the smaller practices. I worry about some of the smaller practices, with a handful of physicians, and their ability to have staying power through this pandemic, as they may not have the ability to handle the decrease in volume.

PG:

What about impact on clinical trials, especially drug company trials? Weve certainly written a lot about NCI trials, but drug company trials, I think havent been really gauged yet. What impact do you think this will have on approvals?

SB:

Its an interesting question. We have seen big pharma that are conducting global trials pause studies and put a hold on accrual. I think a part of that is making sure that they can get the data.

Also, it was easier to not make site-specific selections and just put a large trial on hold. So, weve seen most of the big pharma react that way.

We have seen a substantial drop in enrollment for phase II/III studies, resulting from at least a third of the clinical trial menu being put on pause.

The other part about the phase II/III side of the businesses is, in many of those scenarios, patients have an option. We have had so many approvals recently. Patients may have an off-study option that might require fewer visits or less travel. I suspect that is impacting accrual as well.

All of those will be detrimental in terms of slowing down trial completion, slowing down approvals.

On the other hand, on the phase I end of the spectrum, where I think the majority of the patients are seeking an investigational treatment and/or a treatment to match their mutation, we have not seen quite the level of decline.

And in particular, we have seen the smaller biotechs continue forward. Many of their phase I trials are at only a handful of sites, making any decisions site-specific.

As you said at the beginning, in terms of approvals, certainly many of the phase II/III studies are going to be slowed substantially. It is also important to note that some of the big academic centers, typically accruing many patients, are in cities hit the hardest by COVID-19, such as New York City, Boston and some of the cities in Europe, which is impacting trials.

PG:

You would think that some patients would have to be censored out, because with time to progression, the radiographic metrics, you would pretty much have missed the opportunity to gauge it; right?

SB:

Correct. I think its going to be complex within the phase II/III trials. I was reading The Cancer Letter with Matt Ongs interview with Don Berry [The Cancer Letter, April 24, 2020], thinking about how individuals will need to come in and really think about how we pool that data and analyze it. But youre exactly right.

The NCI has been great in encouraging taking deviations related to COVID-19 needed to keep the patient on study. We have made a number of operational adjustments including remote data monitoring, shipping pills to keep people on oral therapies, and implementing telemedicine visits.

Certainly, in the phase II/III area, with time to progression studies, there will be an impact, and there will be some complexities in how we analyze that data.

PG:

How are academic cancer centers affected?

SB:

Probably a lot depends on where they are located geographically. In talking to our colleagues at centers in New York, Boston and New Haven, we know many of those centers have had to stop clinical trial accrual. We are seeing the same thing in much of the East Coast and parts of the West Coast.

Also, there is a tertiary referral travel population. We have seen, at all of our centers, patients being much more hesitant to travel for treatment. I think it will substantially impact analyzing the data from those centers and getting those trial programs up and running.

Some of the academic medical centers have had a higher volume of COVID-19 positive patients. I know Ive had some patients that have gone back and forth to MD Anderson, where they are now encouraging patients to stay there in Houston, and not travel for their safety.

This recommendation gets into socioeconomic issues about who can do this relocation and who cannot.

PG:

What impact do you think it will have financially on the academic cancer centers?

SB:

I think you have to look at an academic medical center as part of a larger hospital. We can break this into different bucketssmall community practices will be hit differently than larger community practices that have more synergies.

Larger practices may have better staying power, and, of course the CARES program allows the hospitals to help in some ways. There are some waivers with regard to Stark concerns, and then the ability for some of these practices to participate in the PPP programs for loans and for advanced Medicare payments.

When you think about the hospitals right now, they are essentially doing emergency room care, which has dropped, COVID-19 care thats ongoing, and then cancer care that needs to be done.

The other services generating revenues have slowed down because many of the procedures, such as orthopedics and cardiovascular can be pushed out a few months. We have seen across the country health systems and hospital systems beginning to furlough individuals and take other actions with regard to employment.

I think that this environment is going to be tough for the academic medical centers. Hospitals have multiple sources of revenue, and many of these sources have really been scaled back as patients choose to defer coming in or there are simply not the resources for routine health care.

PG:

So, there is redistribution, but is it a net loss?

SB:

It will be interesting to see how some of that care comes back. While patients will never make up that cancer visit, the patients who need a hip replacement will schedule their surgery.

The individuals who need a valve replacement will get their cardiac procedure. I think in other specialties there will be a backlog, and it will be interesting as we go through the summer and the fall to see how that is handled. There is some short-term pressure in terms of just how much routine health care has paused or slowed down.

It has been interesting to see the articles talking about all the patients who used to come into the emergency room or the urgent care centers for aches and pains, and how much that has dropped. And then we are going to wonder going forward, will patients be more hesitant to utilize the health care system? Will they think once or twice before coming in?

As you have alluded to, we also have the economic side: we are seeing the unemployment numbers go up, which may have short-term impact as well. We have many Americans, unfortunately, uninsured or with less health insurance than they have had in the past.

PG:

What about the impact on community hospitals and for-profit hospitals?

SB:

Sarah Cannons parent company is HCA Healthcare, and they have committed to not laying off anyone through this crisis. HCA Healthcare is a large company, with the financial strength to support pandemic pay programs that will aid employees.

County hospitals or rural community hospitals are impacted on a different level. They already were under economic pressures. I suspect we may see some consolidation and closures of hospitals in rural settings or in places that are geographically disadvantaged.

That issue is going to be a stressor to the system. We already were trying to figure out how to do rural health care before the pandemic, and this crisis has certainly exacerbated the challenge.

Hospitals that do not have a large system to help alleviate some of the stress are going to be struggling to get through the near term.

PG:

I was just looking at what seems to be happening in the adjuvant care. There seems to be a shift to neo-adjuvantbecause of COVID. Is there data to support this in terms of safety and efficacy?

SB:

That is a great question, and I say that because I have asked the same question. In certain settings, such as HER2 positive breast cancer, there are a number of patients who would likely benefit from neoadjuvant therapy, as well as some triple-negative or locally advanced tumors.

There are likely other subsets of breast cancer and other diseases where neoadjuvant therapy makes sense. But by and large, you are correct, that during this COVID-19 crisis, many think it is better to put patients through chemotherapy versus surgery. And that has been greatly debated.

CMS came out with guidelines that put cancer surgery in the Tier Three category, and that seems reasonable. Our motto at Sarah Cannon has been that we are going to stay safe and stay the course.

We have seen a number of surgeries put off, but I do not think I have ever said to a patient with invasive cancer that their surgery is elective. Some are more urgent than others.

The system has made a quick shift to thinking that neoadjuvant therapy is the safest thing to do or the best thing to do, but there is not a lot of data to back that up in many settings. We have never really had clinical trials that showed that hormonal therapy was a great neoadjuvant treatment for the hormone-positive breast cancer. It is a real judgment call to put patients through chemotherapy, with myelosuppression and more in this setting.

There were some broad-based recommendations made from several societies that I found interesting, without a lot of data to back them up.

PG:

Will we learn from this, or will this be one of those societal experiments that we will never know the impact of?

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Skip Burris: These few months are going to shape health care in the coming years - The Cancer Letter

The world lost another brilliant actor, Irrfan Khan, on April 29, 2020. He was admitted to Mumbais Kokilben hospital intensive care unit, with a colon infection, the day prior. His condition deteriorated quickly and took a turn for the worse. He was 53 years old at the time of his death.

In 2018, he was diagnosed with a neuroendocrine tumor. This is a type of cancer that begins in specialized cells called neuroendocrine cells. These cells have similar traits to those of hormone-producing cells and nerve cells. Neuroendocrine tumors are rare and normally form in the appendix, pancreas, small intestine, rectum, or lungs.

Khan was born in Jaipur, Rajasthan, India, on Jan. 7, 1967. His full name at birth is Sahabzade Irrfan Ali Khan. He was an amazing cricket player. Khan was selected for the CK Nayudu Tournament. However, due to a lack of funds, he was unable to attend.

He decided to focus his attention on acting. The beloved actor earned himself a scholarship to the National School of Acting located in New Delhi, in 1984. His acting career started out in Bollywood where he was in Haasil, Maqbool, and the Namesake to name a few movies.

Khan showed the world how adaptive he was when he took on his various roles. His exquisite style showed the world a man who could be charming, clever, and at times maniacal and dangerous. During his decades-long career, he won his way into many fans hearts.

His rise to international fame came with his role in the movie Slumdog Millionaire. This movie won seven BAFTAs and eight Academy Awards. Khan also had memorable roles in other movies such as, Jurassic World, Life of Pi, and The Amazing Spiderman.

Many people went to social media to voice how Khan had touched them with his acting. He has left behind his beloved wife Supta, and their sons Ayaan and Babil.

By Sheena RobertsonEdited by Jeanette Vietti

Sources:

IMDB: Irrfan KhanMayo Clinic: Neuroendocrine tumorsIndian Express: Irrfan Khan (1967-2020): An actor whose brilliance made everything betterYahoo: Slumdog Millionaire and Life of Pi star Irrfan Khan dies at 53MSN: Irrfan Khan, Life of Pi, and Slumdog Millionaire Star Dies at 53The Daily Beast: Irrfan Khan, Life of Pi and Slumdog Millionaire Star, Dies at Age 53

Top and Featured Image Courtesy of Herry Lawfords Flickr Page Creative Commons LicenseInline Image by Bollywood Hungama Courtesy of Wikimedia Commons Creative Commons License

death, khan, Slumdog Millionaire, spot

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Irrfan Khan, International Superstar, Passed Away at the Age of 53 - Guardian Liberty Voice

By its very definition, medicine saves lives by treating or preventing diseases. But now, some in the media are distorting its meaning to include abortion the ending of anothers life.

On April 28, The New York Times published a piece examining, Abortion by Telemedicine. In the story, health and science writer Pam Belluck cited several women who obtained abortions through TelAbortion, a telemedicine program that provides video consultations with abortion providers so that pregnant women can take abortion pills on their own without having to visit an actual clinic. Both TelAbortion and Belluck recognized the pills that cause abortion as medications.

One of the women interviewed for the piece, Ashley Dale, allowed the Times to sit in on her video consultation.

The doctor explained that two medicines that would be mailed to Ms. Dale would halt her pregnancy and cause a miscarriage, Belluck described.

Bellucks wording mirrored the abortion industrys embrace of euphemistic language surrounding abortion. But theres a difference: Medicine saves human lives; abortion ends them. Miscarriage isnt a choice; abortion is.

In order to distinguish from surgical abortion, many in the media refer to medication abortion as an abortion administered by pill. But only recently havemajor outlets begun using phrases such as abortion medication to call abortion itself a type of medicine.

Belluck described what happens in this particular type of abortion.

[D]octers explain that most women do not experience discomfort from mifepristone, which blocks a hormone necessary for pregnancy to develop, she wrote. Cramping and bleeding, resembling a heavy period, occur after the expulsion of fetal tissue caused by the second drug, misoprostol, which is taken up to 48 hours later.

Thats not how all doctors describe it. Dr. Anthony Levatino, an obstetrician-gynecologist who once performed more than 1,200 abortions, partnered with pro-life group Live Action in 2016 todetail abortion procedures. Medical abortion, he said, consists of two steps.

At the abortion clinic or doctors office, the woman takes pills which contain Mifepristone, or RU-486, he began. RU-486 blocks the hormone progesterone and causes the lining of the mothers uterus to break down, cutting off blood and nourishment to the baby.

In the second step, the woman takes Misoprostol, or Cytotec, a day or two later. Taken together, RU-486 and Misoprostol cause severe cramping, contractions, and often heavy bleeding to force the dead baby out of the womans uterus, he added.

If the abortion takes place at nine weeks, he said, her baby will be almost an inch long and she might even be able to distinguish his or her fingers and toes.

Even so, theNew York Timespiece regularly referred to these abortion pills as medication. One photo caption showed Ashley Dale taking medications that were mailed to her.

At one point, Belluck described how one woman went on an engagement photo shoot with her fianc after taking the first medication and then took the second medication that evening.

She continued to use the phrase medication and even the two-medication regimen in her piece.

Abortion through medication, first approved by the F.D.A. in 2000, is increasingly becoming womens preferred method, she wrote.

Or is it? Several of the women appeared to choose abortion because they felt like it was their only choice.

Dale, the first woman Belluck mentioned in her piece, said she would love to have another baby, but circumstances involving an estranged boyfriend had made the choice clear.

Another woman, Lee, decided to terminate the pregnancy because she had recently cut ties with her boyfriend after he was arrested on drug charges.

And Leigh, who self-identified as pro-life, turned to abortion because she has depression, which became so severe after she had a baby two years ago that she sometimes felt suicidal, wrote Belluck.

In a follow-up call after her abortion, Leigh said she felt compelled to abort no matter how much I hate myself, Belluck reported. Even now, when she sees another baby, she asks herself, Did I make the wrong choice?

I wanted to keep my baby, but I just couldnt, she added.

Abortion and medicine are opposing terms; not interchangeable ones. Medicine promotes the welfare of human beings and saves lives every day. Abortion destroys a life that, from the moment of conception,contains a unique set of DNA. Instead of being a disease to fight, the unborn child is a patient to protect.

But heres one thing that even themedia can agree on: An unborn babys heart often begins beating before a mother even knows shes pregnant. Abortion stops it.

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Dear Media: Abortion Is Not Medicine - Townhall

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Hormone Replacement Therapy in New Jersey | HealthGAINS

Ashley Dale was grateful she could end her pregnancy at home.

As her 3-year-old daughter played nearby, she spoke by video from her living room in Hawaii with Dr. Bliss Kaneshiro, an obstetrician-gynecologist, who was a 200-mile plane ride away in Honolulu. The doctor explained that two medicines that would be mailed to Ms. Dale would halt her pregnancy and cause a miscarriage.

Does it sound like what you want to do in terms of terminating the pregnancy? Dr. Kaneshiro asked gently. Ms. Dale, who said she would love to have another baby, had wrestled with the decision, but circumstances involving an estranged boyfriend had made the choice clear: It does, she replied.

Now, the coronavirus pandemic is catapulting demand for telemedicine abortion to a new level, with much of the nation under strict stay-at-home advisories and as several states, including Arkansas, Oklahoma and Texas, have sought to suspend access to surgical abortions during the crisis.

The telemedicine program that Ms. Dale participated in has been allowed to operate as a research study for several years under a special arrangement with the Food and Drug Administration. It allows women seeking abortions to have video consultations with certified doctors and then receive abortion pills by mail to take on their own.

Over the past year, the program, called TelAbortion, has expanded from serving five states to serving 13, adding two of those Illinois and Maryland as the coronavirus crisis exploded. Not including those new states, about twice as many women had abortions through the program in March and April as in January and February.

To accommodate women during the pandemic, TelAbortion is working to expand to new states as fast as possible, said Dr. Elizabeth Raymond, senior medical associate at Gynuity Health Projects, which runs the program. It is also hearing from more women in neighboring states seeking to cross state lines so TelAbortion can serve them.

As of April 22, TelAbortion had mailed a total of 841 packages containing abortion pills and confirmed 611 completed abortions, Dr. Raymond said. Another 216 participants were either still in the follow-up process or have not been in contact to confirm their results. The programs growth is significant enough that Republican senators recently introduced a bill to ban telemedicine abortion.

The F.D.A., which has allowed TelAbortion to continue operating during the Trump administration, declined to answer questions from The New York Times about the program.

The F.D.A. rules, however, do not specify that providers must see patients in person, so some clinics have begun allowing women to come in for video consultations with certified doctors based elsewhere. TelAbortion goes further, offering telemedicine consultations to women at home (or anywhere), mailing them pills and following up after women take them.

In interviews, seven women who terminated pregnancies through TelAbortion described the conflicting emotions and intricate logistics that can accompany a decision to have an abortion, and their reasons for choosing to do it through telemedicine.

Ms. Dale, a single mother, was about to start a job at a storage center when she became pregnant last year. She would have had to fly to Honolulu, incurring expenses for travel and child care.

The alternative would be to wait for a doctor to come to my island in three weeks, Ms. Dale, 35, told Dr. Kaneshiro during her consultation, which she allowed a Times reporter to observe. By then, she would be too pregnant for a medication abortion.

But many TelAbortion patients live near clinics. Shiloh Kirby, 24, of Denver, who said she had become pregnant after being raped at a party, chose TelAbortion for convenience and privacy. She conducted her video consultation while sitting in her car in the parking lot of the hardware store where she worked.

Dawn, 30, a divorced mother of two who asked to be identified only by her first name, was terrified that the debilitating postpartum depression she experienced after her childrens births would return if she continued her pregnancy. And she worried protesters at her local Planned Parenthood in Salem, Ore., might recognize her.

I just dont want to deal with that ridicule, she said.

Based on state laws governing telemedicine and abortion, Dr. Raymond estimated TelAbortion might be legal in slightly over half of the states, including some conservative ones. It now serves Colorado, Georgia, Hawaii, Illinois, Iowa, Maine, Maryland, Minnesota, Montana, New Mexico, New York, Oregon and Washington.

The doctors (and nurses or midwives in some states) who do TelAbortions video consultations must be licensed in states where medication is mailed, but do not have to practice there. Likewise, patients do not have to live in the states that TelAbortion serves; they just have to be in one of them during the videoconference and provide an address there that of a friend, relative, even a motel or post office to which pills can be shipped.

We have had patients who cross state lines in order to receive TelAbortions, Dr. Raymond said. More are expected to do so during the pandemic. This month, a woman from Texas drove 10 hours in snowy weather to New Mexico, where she stayed in a motel for her videoconference and to receive the pills.

The organization that provides TelAbortion services in Georgia, carafem, has expanded recently to Maryland and Illinois, and it is running digital ads that are expected to reach women in some nearby states like Missouri and Ohio, which have more abortion restrictions, said Melissa Grant, carafems chief operations officer.

In May, shortly after Georgias governor signed one of the countrys strictest abortion laws (which is now being challenged in court), Lee, 37, who lives near Atlanta, discovered she was seven weeks pregnant.

Lee, who asked to be identified only by a shortened version of her first name, said the pregnancy had shocked her because she took birth control pills regularly. She decided to terminate the pregnancy because she had recently cut ties with her boyfriend after he was arrested on drug charges, she said.

She kept her decision from her family members, who she said were strongly against abortion. And she feared protesters would castigate her if she visited an abortion clinic.

No one goes through life saying, Im going to grow up and get an abortion, Lee said. So youre already struggling with that and then to have someone tell you that youre going to hell or that youre killing babies, its horrible.

She found carafem, and videoconferenced in her office at lunchtime with a doctor in another state.

During such consultations, doctors explain that most women do not experience discomfort from mifepristone, which blocks a hormone necessary for pregnancy to develop. Cramping and bleeding, resembling a heavy period, occur after the expulsion of fetal tissue caused by the second drug, misoprostol, which is taken up to 48 hours later. After several hours, bleeding dwindles but might continue for two weeks. In rare cases, women can develop fevers, infections or extensive bleeding requiring medical attention.

Lee received a package marked only with her name and address; it contained the pills, tea bags, peppermints, maxipads, prescription ibuprofen and nausea medication.

Just everything you could need, she said. It was so comforting.

TelAbortion reports that of the 611 completed abortions documented through April 22, most were accomplished with only the pills and without complications. In 26 cases, aspiration was performed to finish the termination.

Dr. Raymond said 46 women went to emergency rooms or urgent care centers with issues that appear just as likely to have occurred if the women had followed the common practice of visiting abortion clinics for consultations, taking the first medication there and the second at home. Two women went before receiving the pills and two before taking them, either because of morning sickness or because they thought they were miscarrying. Fifteen ended up needing no medical treatment. Some were given medicine for pain or nausea.

Three were hospitalized, all successfully treated: two women had excessive bleeding, and another had a seizure after an aspiration, Dr. Raymond said.

Eleven women decided not to have abortions and did not take the pills they were sent. Another woman continued her pregnancy after the medication failed, as did another after vomiting the mifepristone. Sixteen women have undergone two telabortions, Dr. Raymond said.

Of the women The Times interviewed, only Dawn, who said she has anxiety, called the 24-hour TelAbortion line for emotional support.

It was after I took the pills, Dawn said. I felt like my body, my hormones essentially crashed. And because I suffer from mental health issues, just everything was just kind of out of whack and I started really panicking bad. I called the nurse and she just sat on the phone with me.

TelAbortion typically charges $200 to $375 for consultations and pills. Women must also pay for an ultrasound and lab tests, obtained from any provider. During the coronavirus pandemic, TelAbortion may waive its requirement for an ultrasound to gauge the gestational age of the pregnancy if women are unable to visit a doctor to obtain one, Dr. Raymond said.

In some states, some or all of the costs are covered by private insurance or Medicaid. For women facing financial hardship, like Ms. Kirby in Denver, the program taps abortion grant networks.

Some patients said the teleconsultations helped them navigate the complex feelings that abortion can evoke.

Leigh, a 28-year-old construction inspector in Denver, who asked to be identified only by her middle name, said she considered herself totally pro-life.

But, she said, she also has depression, which became so severe after she had a baby two years ago that she sometimes felt suicidal. Doctors, she said, didnt trust me alone with my baby.

Last March, after discovering she was pregnant and consulting her fianc, she called Planned Parenthood. I said, I dont want to be this person, but I need to abort this pregnancy, Leigh said.

She chose the TelAbortion option. After taking the first medication, she attended a previously scheduled photo shoot for engagement pictures with her fianc, then took the second medication that evening.

Conducting her follow-up call from a field on a job site, Leigh told the doctor, Kristina Tocce, medical director of Planned Parenthood of the Rocky Mountains, that she felt compelled to abort no matter how much I hate myself.

When she sees a baby now, she says she still sometimes wonders, Did I make the wrong choice?

I wanted to keep my baby, but I just couldnt, she said.

During Ms. Dales videoconference in Hawaii, Dr. Kaneshiro spoke calmly.

It is pretty normal to pass some blood clots that maybe are even the size of a quarter, she said.

Im prepared because I actually had a miscarriage last year at four months along, Ms. Dale replied.

This will not be that bad I mean, at this stage of pregnancy, the actual embryo is smaller than the size of a grain of rice, Dr. Kaneshiro said. Its very unlikely to see anything thats recognizable as a pregnancy.

OK, thats good, said Ms. Dale, then eight and a half weeks pregnant.

It doesnt affect future pregnancies, so it doesnt have any long-term effects, Dr. Kaneshiro said.

OK, that was one of my questions, thank you, Ms. Dale said.

Mommy, mommy! called her daughter, Sophia, bouncing into the living room from a bedroom filled with Legos and a pop-up castle.

Shes beautiful, Dr. Kaneshiro said.

Ms. Dales consultation and lab tests were covered by Hawaii public assistance. The pills, which cost her $135, arrived by certified mail. She placed them on a table near two pregnancy ultrasound photos.

OK, this is happening, Ms. Dale said she told herself. Im doing this.

Her reasons partly involved disagreements with her estranged boyfriend, the father of Sophia, now 4. Their strained relationship made Ms. Dale believe she would have to raise their second child alone.

Ive got a beautiful daughter and Id really love to have another one, she said. But its just not feasible for my sanity, and I feel like Id basically be guaranteeing us to live in poverty.

On the back of an ultrasound picture, she wrote: Never forget why you had to make the hard decision to let this baby go. She swallowed the pill.

She had Sophia stay at her mothers house and took the other tablets, which she said felt like chalk in her mouth. To distract from seven hours of cramping and heavy bleeding, she watched back-to-back Matrix movies.

Its not like it was easy, she reflected later, but at the same time its pretty clearly the right choice.

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Abortion by Telemedicine: A Growing Option as Access to Clinics Wanes - The New York Times

The novel coronavirus tends to affect men more severely than it does women. Though nobody can yet explain the oddity, researchers are hot on the case.

It's possible that the sex hormones estrogen and testosterone play a role, according to previous research on respiratory illnesses. Or perhaps it's because the X chromosome (which women have two of, but men have only one) has a larger number of immune-related genes, giving women a more robust immune system to fight off the coronavirus, SARS-CoV-2. Or, maybe the virus is hiding in the testes, which has abundant expression of ACE2 receptors, the portal that allows SARS-CoV-2 into cells.

Uncovering the real reason is, of course, imperative because it could help improve patient "outcomes during an active public health crisis," according to an editorial published April 10 in the Western Journal of Emergency Medicine (WJEM).

Related: When will a COVID-19 vaccine be ready?

Since the first known COVID-19 case was reported in China late last year, countless studies have shown that the disease tends to be more severe and deadly in men than in women.

For instance, in an analysis of 5,700 COVID-19 patients hospitalized in New York City, just over 60% were men, according to an April 22 study published in the journal JAMA. What's more, "mortality rates were higher for male compared with female patients at every 10-year age interval older than 20 years," the researchers wrote in the study.

Furthermore, of the 373 patients who ended up in intensive care units, 66.5% were men, the JAMA study reported.

Related: 13 Coronavirus myths busted by science

Results are similar in other studies. When the WJEM editorial was published in early April, the authors noted that between 51% and 66.7% of hospitalized patients in Wuhan, China, were male; 58% in Italy were male; and 70% of all COVID-related deaths worldwide were male. In one large study of more than 44,600 people with COVID-19 in China, 2.8% of men died versus just 1.7% of women.

These COVID-19 sex differences are not unexpected. Other coronavirus outbreaks, including outbreaks of SARS in 2003 and the Middle East respiratory syndrome (MERS) in 2012, had higher fatality rates in men than in women, according to the WJEM editorial. For example, a 2016 study found that men had a 40 percent higher odds of dying of MERS than women did.

Even the comically labeled "man flu" is so named because men tend to have a weaker immune response to respiratory viruses that cause flu and the common cold. As a result, men tend to get more severe symptoms from these viruses than women do, a 2017 review in BMJ found. That review pinned these results on the differences in "sex dependent hormones" in men and women.

A mouse experiment offers clues about this hormonal mystery; when scientists infected both male and female mice of different ages with SARS, the male mice were more susceptible to the infection than females of the same age, according to a 2017 study, which was published in The Journal of Immunology. However, when the female mice had their estrogen-producing ovaries removed or were treated with an estrogen-receptor blocker, they died at higher rates than those with working ovaries and normal estrogen.

"These data indicate that sex hormones produced in female [mice] may help to defend against coronaviruses like SARS and SARS-CoV-2," Akiko Iwasaki, a professor of immunobiology at Yale University School of Medicine, who was not involved in the study, told Live Science.

Related: Is 6 feet enough space for social distancing?

To learn more, scientists at Cedars-Sinai Medical Center in Los Angeles and the Renaissance School of Medicine at Stony Brook University in New York are testing estrogen or another sex hormone called progesterone on small groups of people who have COVID-19, Live Science previously reported.

There's another way to look at the COVID-19 sex difference; perhaps the X chromosome is protective because it has more immune-related genes than the Y chromosome does. This may also explain why women are more likely than men to have autoimmune diseases, the authors of the WJEM editorial noted.

The second X chromosome is usually silenced in women, but almost 10% of those genes can be activated, Veena Taneja, who studies differences in male and female immune systems at the Mayo Clinic, told NPR. "Many of those genes are actually immune-response genes," she said. This could give women a "double-dose" of protection, Taneja said, although research is needed to see whether these genes factor into protection against COVID-19.

New research offers yet another idea; men seem to clear SARS-CoV-2 from their bodies more slowly than women do. To explain that possibility, researchers have suggested the virus may have found a hiding place in men: the testes.

In the research, published on the preprint medRxiv database, 68 people confirmed to have COVID-19 in Mumbai, India, were tested with nasal swabs until they tested negative for the virus. At the end of the experiment, scientists found that women cleared the virus from their bodies in an average of 4 days, compared with men's average of 6 days. The same test in three different Mumbai households found similar results.

Related: 13 Coronavirus myths busted by science

"Our collaborative study found that men have more difficulty clearing coronavirus following infection, which could explain their more serious problems with COVID-19 disease," study lead researcher Dr. Aditi Shastri, assistant professor of medicine at the Albert Einstein College of Medicine in New York City and a clinical oncologist at the Montefiore Einstein Center for Cancer Care, said in a statement.

Previous research has shown that SARS-CoV-2 invades certain human cells by plugging into these cells' ACE2 receptors. So, the researchers consulted a database, and found that the testes have high levels of ACE2 expression. In contrast, ACE2 could not be detected in the ovaries, the female equivalent of the testes.

However, the research did not actually look in the testes to see if SARS-CoV-2 is hanging out there, so "it does not tell us whether the virus infects testes or whether it is a reservoir of virus," said Iwasaki, who was not involved in the research.

Other research has suggested that smoking may play a role, as smoking is related to higher expression of ACE2 receptors. But while more men than women smoke in China, that's not true in other countries, which likely puts a kibosh on smoking to explain the sex difference.

"What we saw in Wuhan [with the sex difference] has been replicated in every country around the world where we have accurate reporting," Sabra Klein, a researcher at the Johns Hopkins Center for Women's Health, Sex, and Gender Differences, told NPR. "In countries like Spain, where the percentages of males and females who report smoking is not significantly different, we still are seeing this profound male bias in severity of COVID-19."

Other explanations: Women are simply less likely to engage in health-related risks and are better at washing their hands, studies find, and perhaps that's behind the gender disparity

Sex differences aren't the only factor at play, however. Other groups more vulnerable to COVID-19 include the elderly and people with diabetes, high blood pressure and obesity, Live Science previously reported.

Originally published onLive Science.

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Why are more men dying from COVID-19? - Livescience.com

The relationship between exercise and your menstrual cycle is more important than you think. Here, personal trainer Lucy Fry explains how to adapt your training to match your hormones.

Youre determined to go for a run. You really will today. Then you feel that nagging backache telling you your period is on its way. Though a brisk 30-minute walk or some gentle cycling would probably help your mood, this just isnt the time to be pushing yourself. The trainers go back under the bed. But in 10 days time it will be a different story.

As a personal trainer, Ive discovered through menstrual bleeding, hot sweats and lots of hormonal tears just how much my menstrual cycle matters. This is something I speak to every female client about; explaining how tracking and respecting their hormones is one of the most important things they can do for their overall fitness.

Exercising in a way that specifically encourages hormonal balance will improve your mood, reduce PMS, enhance bone, brain and cardiovascular health and make you fitter, agrees Dr Valeria Acampora from The Marion Gluck Clinic, a specialist hormone centre in London.

Ive gone from being totally uninterested in the relationship between hormones and fitness to becoming borderline evangelical. I know that when I exercise in a way thats mindful of my menstrual cycle, things feel good. When I dont, well there was the weightlifting class I walked out of because my PMS tears made it hard to see the barbell. I also once dropped a dumbbell on my foot because I was distracted by cramps. So, do as I say and not as I did.

As we know, everyone is individual and cycle lengths vary, but take day one of your period as the starting point and follow my guide to timing your workouts for the healthiest impact.

Day 1-5: Dont stop moving

So your period has started. This marks the start of the follicular/ pre-ovulatory phase of the menstrual cycle, which lasts all the way up to ovulation at the mid-point of your cycle. In the Middle Ages, the onset of a period was referred to as flowering. I know floral isnt exactly how many of us feel on the first day (more drained, weepy and sore), but its not so ludicrous: energy and vitality are around the corner. Your oestrogen, testosterone and progesterone may be low at this point, but oestrogen and testosterone will rise again within hours of menstruating.

A few women feel fine on day one, but many feel they want to curl up and die, says Nike global master trainer Joslyn Thompson Rule, who recommends that all her clients track their cycleswith apps such as Moody Month.

The more information about yourself that you are able to gather, the better equipped you are to make optimal decisions around your training at any given time of the month.

Even if youre feeling ropey, you should still get moving, says Dr Acampora. Im constantly fighting the notion that its best to stay in bed and take painkillers during this first couple of days, she says. In fact, doing short bursts of moderate exercise is the best thing you can do, particularly if youre suffering from cramps. Endorphins peak around 20 minutes into exercise and are natural, effective painkillers.

A short burst of exercise is the best thing you can do, endorphins are natural, effective painkillers

Choose an exercise you enjoy. Whether you opt to power walk, cycle or lift weights, just be aware that you might feel a little shaky or weak. Its probably not the time to try one of those shouty military classes and it certainly isnt the time to get competitive. Not only are you likely to feel washed out if youre bleeding heavily, but research also suggests physical performance is impaired by menstruation, mainly because we have less energy. (Tennis star Heather Watson said recently that she had nightmares about getting her period during Wimbledon.)

You should also think about your ligaments, as exercise while youre bleeding can have a more powerful effect on this connective tissue. Its best to avoid high-impact workouts like jumping or sprinting.

And what about yoga? Some yogis, especially for the more vigorous styles like Ashtanga, say that women having their periods shouldnt be on the mat. Others say you should avoid inversions like shoulder stands, but theres little evidence to back this up. Its probably best to stick to more restorative yoga like Iyengar and Yin, rather than Bikram-style heated classes, so you can breathe easily through every pose.

Wearing a Be You Period Cramp Relief Patch, which is infused with menthol and eucalyptus oil, will relax your muscles and help reduce the pain of cramps while you work out (6.99 for five, beyouonline.co.uk).

Underwear brand Dear Kate has created knickers with a leak-resistant outer layer and a lining that holds the same amount as two tampons especially for exercising on your period (from 28, fashercise.com).

Day 6-14: Go hard and high-intensity

This is the time in your cycle when you feel like you can move mountains. Some women start to feel fabulous around day three while for others its more like day seven, but somewhere during this secondary phase youll notice increased power in your body and more clarity in your mind.

Your oestrogen levels have been rising slowly and by the end of the first week you should feel a definite shift upwards in energy, says Thompson Rule. There are practical benefits, too. This increase in oestrogen means that muscle repair happens faster, so your body is prepped hormonally to train harder at a higher intensity and with a faster recovery time, she says. This is thought to be down to an increase in collagen metabolism, a process that helps your wounds to heal, at this point in the menstrual cycle. Youll also be physically stronger a recent study in The Journal Of Physiology noted that ovulating women showed an 11% increase in strength in their handgrip as well as in their quadriceps (the front thigh muscles).

So, you feel like a superhero, strong and fast to heal. But theres more. All that testosterone your body is now producing enhances confidence, assertiveness and libido, making this the ideal time to try that scary trapeze class youve been putting off, go rock-climbing or even learn to tango. Try to book in the big challenges for this phase in your cycle a 10k race, triathlon, marathon or any ambitious mountain climbs. Heavy weightlifting should feel great now too, as should any kind of high-intensity interval training.

All the testosterone your body is producing enhances confidence, assertiveness and libido

But, sadly, youre not actually a superhero particularly around ovulation (days 12-16) when, despite all that extra handgrip ability, you might also do yourself a mischief. Women feel at their strongest and most resilient during ovulation, but are possibly more prone to injury at this point due to high oestrogen levels, says Stephanie Moore, a nutritional therapist and hormonal health expert.

Even though you wont be saving cities while wearing a cape, you are still entitled to rewards. Lots of carbohydrate-based rewards, because this is a time when your body is optimised to turn carbs into muscle energy. The oestrogen dominance in this phase translates to better insulin sensitivity, which drives glycogen stores in the muscles, says Moore. Translation? Pass the pizza after your training, of course.

Give yourself an extra boost with a turmeric and ginger-infused drink like DRGN, which is packed with vitamins, electrolytes and an amino acid to keep you energised (5.56 for three cans, drgndrink.com).

A couple of squares of 85% cacao chocolate helps with stress management and relaxes muscles after training, says Moore. Try Vivanis dark chocolate creamy and not too bitter (2.65, planetorganic.com).

Day 15-23: Keep it steady and stress-free

Now begins the second half of your cycle, otherwise known as the luteal phase, starting after ovulation and continuing right through until you get your period again.

Progesterone starts increasing now, while testosterone and oestrogen decrease, which means youre likely to feel fatigued. But wait get off the sofa and into your running shoes, says Dr Acampora. You may not feel like it, but this is the time for running or swimming or cycling and gentle yoga isnt enough, she says. You need to move intensely enough to create the physiological changes inside your body that boost your energy. Doing what we call steady-state exercise, like 30 minutes of even-paced swimming or jogging, causes the numbers of organisms called mitochondria (that live in the muscle cells) to go up, explains Dr Acampora. These organisms are the ones that give us energy, so having more can

lessen the feeling of tiredness.

Probably best to cap activity at 30 minutes, however. Firstly, body temperature tends to run higher post-ovulation (it dips just before and then goes up and stays up for

a good few days after one of your ovaries has released an egg). Science suggests that this can make it harder to sustain endurance training and high-level cardio workouts, so its best to save the more intense stuff for the week before. For you more seriousrunners or cyclists: if theres a week to avoid those super sweaty, anaerobic sessions where you maintain a tough pace for a certain uncomfortable length of time, this is it.

Body temperature tends to run higher post-ovulation, making cardio workouts harder

Another reason not to overdo it here, and the reason you shouldnt be hitting it hard every time you exercise, relates to cortisol. Cortisol is an anti-inflammatory hormone released when you are under stress, often referred to as natures built-in alarm system. Its great in a crisis as it helps fuel the all-important fight or flight response but heavy training isnt actually a crisis, is it?

While regular exercise of varied intensities can help with stress, regulating our cortisol production, if you do too much exercise you can actually increase cortisol levels and feel worse, says Dr Acampora. Id never advise pushing too hard, too often. To achieve the optimal hormonal balance you have to exercise at least three times a week, ideally four, but if you do it at high intensity 6-7 times a week youll increase cortisol too much. Unless youre an athlete, keep intense workouts to a minimum now or youll risk reduced immunity, insomnia and injury.

The Cloud performance trainers from On Running are stylish, lightweight and feel more like slippers than serious workout wear they make getting out and getting moving even easier (120, on-running.com).

Make sure you arent overdoing it, plan your workouts around your week and stay on track with the help of a beautiful Daily Greatness 12-week training journal (29.95, dailygreatness.co.uk).

Day 23 onwards: Wind down your workouts

Oh dear, its time for PMS, which can start anywhere from five to 10 days before your period is due and includes all sorts of symptoms, ranging from the uncomfortable to the downright debilitating. Youre probably familiar with many of them breast tenderness, bloating, feeling unusually irritated or upset, headaches, fatigue and skin issues.

Do yourself a favour right now and eat more good fats, says Moore. The higher progesterone levels during the luteal phase make your body better at burning fat. That said, women are more prone to a reduction in serotonin levels, which can drive carb cravings. So eat the avocado, but cut back on the toast.

And what about the exercise? Definitely do still go to the gym, but for less time, says Dr Acampora, advising not much more than 30 minutes of low intensity exercise to help with pre-menstrual symptoms. Youre aiming to produce endorphins again, which reduce pain and boost our mood.

A recent study suggested that regular exercise had similar effects to some antidepressants when it came to dealing with depression and can also make the same positive structural changes in the brain as medication.

I have had some fairly embarrassing encounters in kickboxing classes thanks to PMS

One thing that isnt so great for your mood though, is feeling like an idiot. Stay away from complicated moves at this time of the month, since lowered oestrogen and testosterone can reduce your coordination. I have had some fairly embarrassing encounters in kickboxing classes thanks to PMS (lets just say the other persons face wasnt very happy when I missed the pads) and majorly wiped out of a headstand in yoga, taking down at least three others in the process. The rest of the class found it hilarious but, quite honestly, I just felt sore and out of control.

Headstands and boxing aside, its certainly good to keep moving through PMS, even if youre feeling that rather special blend of melancholic and irate that comes upon us at this time of the month. Need some more motivation? Enter irisin. Irisin is a hormone thats produced by the skeletal muscle cells only when you exercise, and its job is to protect bone health and brain health, says Dr Acampora. Its also an incredible fat-fighter, since irisin activates some genes that transform white fat (the lazy kind) into brown fat, which continues to burn energy and therefore helps people to lose unwanted fat even after exercising. So its gentle, aerobic irisin-producing exercise that is recommended at this stage of your cycle.

Moore recommends a teaspoon of pure MCT (medium chain triglyceride) oil a day. Its full of healthy fats that boost energy and control blood sugar levels (from 18.99 for 500ml, hollandandbarrett.com).

I often tune in to The V Word podcast; when youre low on motivation and energy, listening to two badass gynaecologists talk vaginas and womanhood is empowering.

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Exercise and periods: How to workout according to your hormones - Stylist Magazine

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Routine cancer care, from screening and diagnostic tests in suspected casesto treatment of known cases with surgery and chemotherapy, has been substantially disrupted as a result of the COVID-19 pandemic, warns an expert from a leading UK charity, Cancer Research UK (CRUK).

Sara Hiom, CRUK's director of cancer intelligence, early diagnosis, and clinical engagement, says this is taking its toll on patients and healthcare workers alike.

She suspects that there are thousands of cancer cases going undiagnosed or untreated because of a lack of healthcare staff, fears over infection risk, and patients with signs and symptoms not coming forward.

Writing in a blog post published by CRUK on April 21, Hiom says this is causing "huge anxiety" to patients and having a psychological impact on physicians unable to "offer the comfort and reassurance they'd like."

The issue has been building since the COVID-19 pandemic hit the UK.

Earlier this month, consultant oncologist Karol Sikora, MD, PhD, warned that patients in certain areas of the country were not receiving chemotherapy and operations were being put on hold. Sikora, who is chief medical officer at Rutherford Health, which runs several oncology centers, told The Guardian newspaper on April 4 that treatment had become "inconsistent," with some hospitals having put "blanket bans on cancer treatment."

"Not everyone needs to rush ahead with cancer treatment, but others need to continue despite this to get the best long-term cure," he said.

In her post, Hiom details how the COVID-19 pandemic has affected many aspects of cancer care in the UK right along the care pathway.

Alongside screening services being officially "paused" in Scotland, Wales, and Northern Ireland, she says they are "effectively paused" in England because invitations to screen are not being sent out.

This means that around 200,000 people are no longer being screened for colorectal, breast, and cervical cancer across the UK every week.

She warns that as a consequence "there will be a significant number of early cancers left undetected before these programs can be reintroduced," particularly in the early stages "when treatment is more effective."

The issue of cancer screening being halted was recently discussed on Medscape by Yale pathologist Benjamin Mazer, MD. He argues that the pandemic offers "a natural experiment like no other" and wonders if the break in screening will result in more advanced cancer being diagnosed, and whether that will affect outcomes.

In her blog, Hiom also reports that patients are not presenting with signs and symptoms indicative of cancer. The drop in numbers of people visiting their physician with symptoms affects "the whole diagnostic pathway." Urgent referrals for cancer havedropped by around 75% in England since the pandemic started.

Additionally, physicians are reluctant to send their patients to the local hospital in case they contract COVID-19, and many diagnostic tests such as endoscopy, bronchoscopy, guided biopsies, and computed tomography, are not taking place to protect patients and staff.

Hiom estimates that, as a result, 2300 cancer cases are going undiagnosed across the UK, a figure that "will be stacking up over time."

Patients already diagnosed with cancer have been hit hard by the pandemic.

Despite national guidelines saying that urgent and essential cancer treatment must continue, those waiting in particular for surgery have had, in some hospitals, their appointments canceled or delayed by 3 months or more.

"We've been hearing that patients requiring major surgery aren't able to have it as either there are no recovery beds with ventilation, no [intensive care unit] beds if surgery were to go wrong, or because the surgery is just too risky for patients and staff," Hiom writes.

"Unfortunately, these issues are heavily affecting those who might benefit from surgery the most, as many 'curative' operations are complex," she continues.

There are also cases of chemotherapy and palliative care being affected by the COVID-19 pandemic, with either fear over the risks of infection or a lack of staff preventing high-priority treatment.

Comments on the CRUK post from patients with cancer and relatives show the anxiety that has resulted.

Patricia Matthewman said her son was diagnosed with cancer on March 17 and was told he needed chemotherapy "ASAP."

However, 2 weeks later he was told his treatment was postponed "until further notice."

"How are we supposed to live with this," she writes. "He is 47 years old with a wife and 2 children. I am terrified."

Another woman, who has secondary breast cancer, said all her appointments with her oncologists have been canceled and her personal physician called her to make sure she has an advance do not resuscitate order.

She writes that she is "literally being left to die."

Some oncologists have tried to "mitigate some of this disruption," Hiom writes. For example, some are using hormone therapy or radical radiotherapy instead of surgery for some cancers.

One oncologist who has adapted his practice in response to the pandemic is Clive Peedell, MD, from the James Cook University Hospital, Middlesbrough, UK, and cofounder of the National Health Action Party. In a series of posts on Twitter, he explains that he has switched to teleconsultations for routine and treatment follow-up, but still has in-clinic visits for most of his new patients and those he is worried about.

"To be fair, this could be a good new way to do a lot of my work in future," he says.

However, Peedell acknowledged that it has been "a new tough new world for oncologists" in terms of treatment decisions.

"We lack the data to accurately guide us and we are taking a pragmatic approach based on national and international expert consensus opinion," he added.

Peedell notes that he is giving less chemotherapy and has stopped adjuvant chemotherapy for patients with lung cancer after surgery, which will reduce the cure rate "by at least 5% in these patients."

On a more positive noted, Peedell adds: "Interestingly, I'm actually giving more lung cancer radiotherapy than ever before, because the surgeons are operating much less due to #COVID19 risks, and we can use stereotactic radiotherapy to treat early stage lung cancer as a very good alternative to surgery."

No funding or conflicts of interest declared.

Cancer Research UK. How coronavirus is impacting cancer services in the UK. Published online April 21, 2020. Blog

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Cancer Diagnosis and Treatment Upended by COVID-19, Says CRUK - Medscape

Although losing weight at any age has considerable health benefits, it turns out that dropping a few pounds after age 50 might be especially good for you.

Losing weight after 50 is doable, and it comes with some big health perks.

Image Credit: kali9/E+/GettyImages

Hormonal and metabolic changes that commonly take place after 50 make it easier to pack on weight, Kristine Gedroic, MD, medical director of the Gedroic Medical Institute, tells LIVESTRONG.com. But while weight gain after 50 might be common, it can also be dangerous: Putting on pounds at this age, Dr. Gedroic says, increases the risk of diseases like stroke and diabetes.

But while weight gain might be risky, weight loss is possible and worth it if your weight has crept into the unhealthy range. Here are a few of the most notable benefits.

Did you know that keeping a food diary is one of the most effective ways to manage your weight? Download the MyPlate app to easily track calories, stay focused and achieve your goals!

Obesity at 50 was associated with an increased risk of dementia in a study published February 2018 in the journal Alzheimer's & Dementia (although, curiously, obesity at 60 or 70 was not).

While researchers aren't clear exactly why this is, Dr. Gedroic says the gut microbiome, which can become imbalanced as we age, might be a potential link.

"Research has shown that we have a natural tendency toward an imbalanced gut, including more bad bacteria in our gut, as we grow older," she says. "An imbalance in the gut microbiome can affect brain health and has even been tied to neurodegenerative disease."

Indeed, one January 2019 study published in Scientific Reports analyzed the fecal samples of participants in a memory care clinic and found that the samples that came from patients with dementia had a higher prevalence of bad bacteria.

Eating more fruits, vegetables and high-fiber foods can contribute to weight loss, balance the gut, and lead to a healthier brain in the process, Dr. Gedroic says.

Hot flashes, which occur as a side effect of menopause and are most common in women over 50, are notoriously uncomfortable and carrying extra weight can make them even more so.

"Hormones like estrogen are stored in fat tissue, so it makes sense that the more fat a woman has, the more estrogen in her body and the more pronounced her menopausal symptoms can become," Dr. Gedroic says.

In fact, one study from the December 2017 issue of BMC Women's Health found that women with obesity were "significantly" more likely to have moderate to severe menopausal symptoms as well as have them more often, including hot flashes.

Dropping to a healthy weight can help ease joint pain.

Image Credit: dragana991/iStock/GettyImages

Osteoarthritis, or OA, is one of the most common side effects of aging, according to the Harvard T.H. Chan School of Public Health.

With OA, the cartilage that cushions and protects the bones wears down over time, causing the bones to rub together and joints to become swollen, stiff and painful. Carrying extra weight exacerbates osteoarthritis, causing more pressure on the joint and, often, more pain.

Arthritis and damaged cartilage aren't conditions that can be reversed. But, according to the Cleveland Clinic, losing weight can put less pressure on the joints and reduce symptoms, making it easier and less painful to walk around.

Cancers that are hormone-dependent can show up in women over 50 due to weight gain since hormones like estrogen are stored in fat, Dr. Gedroic says.

"The more fat you're carrying, the higher your hormone levels," she says. "This is why obesity in women has been linked to a higher risk of hormone-receptor-positive breast cancer, and why women who lose weight particularly after the age of 50 dramatically reduce their risk of the disease."

Not surprisingly, a study published December 2019 in the Journal of the National Cancer Institute found that women who lost weight in their 50s had a lower risk of breast cancer than women whose weight stayed the same even if the women who lost weight ended up gaining some of it back.

What's also important to note, Dr. Gedroic says, is that obesity is also associated with a poorly functioning liver. The liver is critical to filtering out harmful chemicals like environmental pollutants and cancer-causing toxins. With cancer rates already higher due to age, having a poorly functioning liver due to obesity "increases the risk of many diseases, including cancer," she says.

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4 Surprising Benefits of Losing Weight After 50 - LIVESTRONG.COM

Surgery, puberty blockers, and hormone replacement therapy will soon be banned for trans-identified youth under the age of 18 in the UK. The UKs Trade Minister Liz Truss offered this statement to the Times: Grown adults should be able to make decisions, to have agency to live life as they see fit. But before the age of 18, when people are still developing their decision-making capabilities, they should be protected from making decisions that are irreversible about their bodies that they could possibly regret in the future.

This development may come as no surprise to those who have paid attention to the intense scrutiny on medical transition among minors by people who view it as causing irreversible change to kids who may someday regret their choice.

In the last few years, there has been a huge statistical rise in young people identifying as transgender. According to The Childrens Gender Service at the Tavistock in Britain, there were just 77 trans children at their clinic in 2010. By 2019, there were 2,950 patients with 3,000 more on the waiting list to be treated.

We can attribute the unprecedented spike in children seeking to medicalize their gender to both the increase in acceptance and knowledge of transgenderism as well as the constantly-expanding definition of what transgender is by activists. It has continuously become an umbrella that encompasses far more than just the individuals who experience gender dysphoria, which used to be the primary factor in decisions made by psychologists and surgeons to determine if an individual should undergo transition.

As a trans woman myself, Ive always been concerned with the reality that tweens and teens were given the choice to permanently sterilize themselves through hormone replacement therapy, which is an effect male-to-female transsexuals experience. While there are many success stories from trans people who made the leap very young, such as famed pop singer Kim Petras, it seems to be that there are just as many stories of regret.

The voices of young people who have now de-transitioned are also becoming more and more available thanks to social media platforms like Youtube, where new stories are going viral on a consistent basis. It is unconscionable to disregard these stories as invalid while only signal-boosting the success stories.

One of the most fascinating interviews Ive done on my YouTube channel is with a teen de-transitioner who described every regret and trauma that critics of underage transitioning fear for them. You can check it out below.

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UK moves to ban children transitioning Surgery, puberty blockers, and hormone replacement therapy will soon be - The Post Millennial

While she has been given the green light to start treatment, not everyone has been so lucky.

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Associate Professor Peter Illingworth, medical director of IVF Australia, wrote to patients warning that while the fertility provider was "aiming to accommodate everyone who contacts us ... we will not compromise the care IVF Australia can offer you, by taking on too many patients at once".

Those patients whose had already had a cycle postponed due to the COVID-19 epidemic, were "short of time by being aged 40 or above, had a low ovarian egg number or had already completed three full cycles with IVF Australia" would be prioritised, the email said.

Dr Anne Clark, medical director of Sydney IVF clinic Fertility First, Sydney, said it would not be a simple case of booking a procedure when the ban lifts on Tuesday, as many clinics were operating on a skeleton staff and some patients had stopped their hormone treatment.

"Many women and couples have had to delay treatment when their time to have a child is already very limited," Dr Clark said.

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"For many women, their cycles will be out of synchronisation."

Professor Luk Rombauts, vice president of the Fertility Society of Australia, said families seeking IVF treatment had "often been trying for two or three years with lots of mishaps along the way" before seeking treatment.

"They don't rock up on our doorstop with a new problem ... By the time we see them, they're new to us, but they've already had a significant journey behind them, including a couple of miscarriages, perhaps," he said.

"So for them to be told ... they would have to postpone or delay their treatment for an indefinite period of time because no one knew whether this was going to be six months or a year that was understandably very devastating and very hard for us to communicate to our patients."

Professor Rombauts said it made sense to restore IVF services early in the elective surgery restart, as patients with fertility problems were "otherwise generally healthy, and they're quite young".

"So, if some of them were to accidentally somehow get infected, the implications of that is probably less than for older people who need a colonoscopy," he said.

Fertility industry guidelines were being distributed, outlining best practice for the use of personal protective equipment and COVID-19 testing of patients deemed at risk.

"Testing patients when they come in is probably one of the best ways we can minimise the risk of infection," Professor Rombauts said.

Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.

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Fertility patients eager to restart IVF treatment when ban lifts - Sydney Morning Herald

Study on the Global Endometriosis Treatment Market

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Segment by RegionsNorth AmericaEuropeChinaJapanSoutheast AsiaIndia

Segment by TypeHormonal ContraceptivesGonadotropin-releasing Hormone (Gn-RH) AgonistsProgestin TherapyAromatase Inhibitors

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Weekly Update: Global Coronavirus Impact and Implications on Endometriosis Treatment Market Projection By Top key Players, Share, Size, Demand,...

Our hands are at the frontline of our personal battle against Covid-19.

Weve all learnt to wash them regularly, for extended periods of time, and to slather them in hand sanitiser when needed. But for many, the flip side of all this attention is flaky or dry skin, exacerbated by the fact that we are spending more time indoors, with the air conditioning on.

We are seeing more dermatitis of the hands than usual, as the alcohol in hand sanitisers as well as the act of washing hands more frequently are both drying out the skin

Dr Mariam Khalfan Al Suwaidi

With Covid-19 requiring frequent handwashing and sanitising, and with most people staying at home, as well the onset of summer and Ramadan, we should be taking more care of our skin, says Dr Mariam Khalfan Al Suwaidi, consultant dermatologist and head of Healthpoints department of dermatology.

"At Healthpoint, we are seeing more dermatitis of the hands than usual, as the alcohol in hand sanitisers as well as the act of washing hands more frequently are both drying out the skin. Some sanitisers and soaps contain chemicals and perfumes that irritate the skin, and cause contact dermatitis, she adds.

After washing your hands for the prescribed minimum of 20 seconds, ensure they are completely dry and then make a habit of applying some moisturiser. Al Suwaidi recommends a skincare, rather than cosmetics, range with as few perfumes, chemicals and potential irritants possible.

Using moisturiser will not neutralise your handwashing efforts, or leave you more vulnerable to infections, notes Dr Rutsnei Schmitz Junior, a dermatologist at Medcare Women and Children Hospital. He also recommends that you moisturise immediately after washing your hands, using a pea-sized amount of lotion that you rub into both hands.

Use moisturisers with mineral oil or petrolatum they are the ones that you squeeze out of a tube, not the ones that you pump out of a bottle. Choose fragrance-free and dye-free moisturisers, as these are less irritating to your skin.

If you suspect that you are suffering from more than your run-of-the-mill dryness, Al Suwaidi recommends consulting with a dermatologist; she is currently seeing patients through video calls to maintain social distancing. If you have a flare-up indicating dermatitis, with symptoms such as red, cracked, itchy or burning skin, it should be evaluated by a dermatologist to ensure it is not accompanied by a bacterial infection.

Heightened anxiety and stress levels, as well as disrupted sleeping patterns, may also be having an adverse affect on your skin, suggests Dr Fiona Cowie, an aesthetician at Dermalase Clinic in Dubai.

It is important for our skin that we stick to a regular sleep pattern otherwise our bodies release more cortisol which is the stress hormone. Cortisol can cause flare ups of acne, eczema and psoriasis. Exercising regularly at home will help to reduce cortisol as well as reducing stress and anxiety, leading to clearer skin.

If you are suffering from perpetually itchy skin, Cowie suggests acquiring a humidifier. Also, avoid long hot showers, which can further dehydrate your skin and take shorter, lukewarm showers instead. And do not become over-reliant on the hand sanitiser. Its alcohol content is far more likely to dry out your skin, so rely on good old fashioned soap and water instead.

Avoid washing in excessively hot water, as this can strip the natural protective oils from your skin. Make sure you use a moisturising soap, soaps that have glycerin and lanolin in them are excellent moisturisers, suggests Cowie. Try to avoid bar soaps, and use liquid soaps instead as these have a lower pH and are less drying to skin. And try to pat hands dry rather than using rough towels to avoid disrupting the natural skin barrier.

A good tip is to leave a moisturiser next to every sink and get into the habit of applying it after every hand wash. Using gloves as much as possible for household chores will also help to protect your hands. Finally, if you suffer with a skin condition that has become worse during lockdown, try to avoid foods with a high glycemic index, such as cereals, rice and white bread, and replace them with foods that are rich in antioxidants to boost your overall health.

As the weather heats up, you should also be doing your best to stay hydrated, especially if you are fasting, as this will have an impact on the skin all over your body.

As a special treat, why not try a DIY hand mask, says Galina Antoniuk, director of Anantara Dubai Spa. Hand masks are a skin conditioning, nourishing treatment, improving the appearance of the skin and are usually used after exfoliation, which removes dead skin and improves circulation.

"Note that hand masks can be prepared at home. Add 2/3 cup of sugar to a jar or container of your choice (whatever sugar you have in the pantry is fine). Add 1/4 cup of either coconut oil or olive oil. Apply to hands and rub together. Rinse and apply hand cream.

Updated: April 27, 2020 08:39 AM

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Dry hands from constant washing? Here are some tips on how to counter the flaky problem - The National

According to some of the more dramatic pandemic predictions, as many as 150 million Americans will come down with COVID-19 before a vaccine becomes widely available. While avoiding it altogether is the ideal scenario, as the virus continues to spread, for many, infection is inevitable.

Given that unfortunate reality, building up a personal defense system against an invisible enemy is paramount, according to the experts.

In March, Banner Health published a blog post: How You Can Boost Your Immune System, with the message: A strong immune system is the ultimate defense against illness, whether its COVID-19, seasonal flu, or something else. The posts advice is largely mundane: Get eight hours of sleep, eat nutritious foods, exercise, hydrate, and do what you can to reduce stress in an incredibly stressful time.

Most people understand that adopting healthier habits is a good idea, but can these habits really boost your immune system so that a coronavirus infection looks more like, say, a common cold? Jessica Lancaster, an immunologist researcher at the Mayo Clinic, thinks its a distinct possibility.

If you had two people with the same virus exposure and very similar genetic makeup, Lancaster said, and if one had been better overall sleeping, eating well, and exercising that person would most likely be much better off than the person who is not caring for themselves as well.

The microscopic novel coronavirus typically enters the body through the nose, she said. From there, it begins a deliberate and dangerous process of multiplying and penetrating deeper down the respiratory tract and into the bloodstream. A spry immune system bolstered by exercise, healthy food, and plenty of sleep will harass the virus before it wreaks the kind of havoc that requires hospitalization, ICU admission, or a ventilator.

Essentially, the immune system is a collection of cells, surveilling our body for unwelcome visitors: viruses, bacteria, various toxins, and cancer. When something isnt right, alarm bells go off and the immune system springs into action to make things right.

Jessica Lancaster, immunologist at the Mayo Clinic

YouTube/Mayo Clinic

Our immune systems ability to react to alarm bells and fight off foreign intruders depends on a multitude of factors. Among them are our age, where we live, what we do for work, and three biggies: good sleep, low stress, and healthy eating. These things have a profound effect on two major contributors to our immune systems sharpness: chronic inflammation and cortisol levels.

In the case of COVID-19, the virus hijacks lung cells and eventually damages them to where they become inflamed. But when there is chronic inflammation in people, such as those with preexisting conditions like heart disease or lung disease, the immune cells are worn out or lulled to sleep.

In these cases, Lancaster said, [immune cells] are kind of used to hearing these signals over and over again. When they have to actually respond to something, they're already exhausted.

For example, if you are regularly exposed to toxic chemicals that cause inflammation, like cigarette smoke, you can have a boy that cried wolf situation, where the body gets jaded to these constant warning signs of trouble and is slower to respond.

For someone with COVID-19, any kind of delayed immune response can be catastrophic.

When you have something that is quite aggressive like coronavirus, which can strike really quickly if you have a lagging immune response, that can be devastating because by the time everything is mobilized, its too late. There's too much damage to the lungs, Lancaster said.

One simple way to avoid inflammation is to avoid overeating. If you eat too many calories, it can be hard for your body to regulate its blood sugar. And that leads to inflammation, Lancaster said, adding that this kind of blood sugar-induced inflammation tends to affect the kidneys, liver, and pancreas.

When it comes to supplements, Lancaster is ambivalent. But she admitted that when she gets sick herself, she takes zinc lozenges. She cited some inconclusive evidence that Vitamin C may have some antiviral properties or may be simply reducing inflammation across the body.

Cortisol is another of the bodys loud alarm bells. It is our primary stress hormone, and according to Lancaster, it can cause drastic changes to the way that your cells can function on a genetic level. A burst of cortisol here or there can help you spring into action to avoid a threat, but too much, too often can leave your body stuck in an uncomfortable, unhealthy kind of overdrive.

Lab research shows that immune cells can't fight viruses as well when they are injected with cortisol. In 2018, researchers at the University of Kent found cortisol levels to be a critical factor at play in leukemia cases, showing that the stress hormone hinders the immune systems ability to incapacitate intruders before they really get destructive.

Reading, meditating, and especially exercising may lower cortisol levels in people.

Exercising has the added benefit of helping you get your eight hours of sleep, all of which helps reduce inflammation and regulate stress hormones.Last week, a cardiovascular researcher at the University of Virginia released findings suggesting that an antioxidant that is naturally released during exercise can significantly reduce the risk of suffering fromacute respiratory distress syndrome, a severe problem that occurs in 20 to 42 percent of hospitalized COVID-19 patients. Exercise, the research found, boosts production of an antioxidant known as extracellular superoxide dismutase, or EcSOD, which "hunts" atomic free radicals that can harm the body's cells.

Beth Jacobs

University of Arizona

"We cannot live in isolation forever, said Zhen Yan of the University of Virginia School of Medicine in an April 15 University of Virginia news release. "Regular exercise has far more health benefits than we know. The protection against this severe respiratory disease condition is just one of the many examples.

Beth Jacobs, a nutritional epidemiologist at the University of Arizona, is wary about making any promises about how any type of immune boosting can influence ones chances of coming down with a bad case of the virus.

"We know essentially nothing about COVID19 yet," she said in a recent interview.

In lieu of more specific knowledge about the virus, she echoes Lancasters sentiments about the importance of healthy habits. When it comes to immunity, she said, it is all about the three interlocked concepts, which are diet, physical activity, and sleep.

Essentially, [sleep] is the time when you're repairing what's happened during the day, Jacobs said. It allows you to heal up to take on the next day.

While science has yet to uncover the inner workings of sleep, Jacob says we can infer its value from its incredible cost. Our ancient ancestors risked being eaten while they laid motionless for hours a day for it, she pointed out.

She urges persistence and patience in developing new, healthy habits, stressing that we are still at the very beginning of the pandemic. Try new recipes and get outside, Jacobs urged.

Use the time to go outside and walk," she said. "And if you've never walked before, just take a 10-minute walk, and then a 15-minute walk next week. Just keep going."

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Boosting the Immune System Really Does Help With COVID-19, Experts Say - Phoenix New Times

In the United States, across the countries various medical clinics are actively involved in the advertising activities for hormone treatment. Many people believe that hormonal treatment as a source of youth. Medical clinics marketing and selling hormonal treatment as an alternative therapy to make individuals feel and look younger. Though, the further research and investigation of CBS News found that the particular claim regarding hormonal treatment is not right and may be harmful to the patient life.

In 2018, Cindy Kinder-Binge, a woman of 60 years had admitted to a hospital-based in New Albany, Indiana, for the high blood pressure and excess heart rate related issues. She had registered with the four times heart rates, which are very high as compared to the normal one. Prior to this incidence, she had undergone an emergency situation with the palpitations. Cindy Kinder-Binge was treated by a nurse practitioner at 25 Again clinic. In this clinic, she had been prescribed hormone of thyroid for the menopausal symptoms such as hot flashes, irregular periods, night sweats, mood changes, and weight gain and slowed metabolism despite having normal thyroid blood levels. CBS News found that there are many more clinics throughout the country which are prescribing testosterone and thyroid hormones to individuals with standard levels.

According to the Cardiologist, hormonal therapy was the major cause of abnormal heart rates in the case of Cindy Kinder-Binge. Doctor Leighann Decker, who is currently working as an ultrasound technician and previously employed with OB-GYN in Owensboro, Kentucky stated that she had also given prescription of testosteroneto the many patients who had normal level testosterone. She also stated that many medical practitioners are involved in hormonal therapy as there is a huge profit in practice. Some research studies suggest that the adoption of hormonal therapy, such as thyroid and testosterone, may lead to an increased risk of stroke or heart attack.

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Hormone Therapy May Lead To The Heart Rates Abnormalities And Possibilities Of Stroke - TheLoop21

Accessing NHS fertility treatment involves a tremendous amount of patience at a period in your life when you have least time to spare. It was 14 months after my first tearful appointment with my GP that I lay on an operating table at Manchesters Saint Marys hospital last year, squeezing the anaesthetists hand as he put me under heavy sedation so that a doctor could stick a needle up my vagina to hoover out my eggs. I was 38 and had been told there was a 20% chance IVF would result in me finally becoming a mother.

My clinical commissioning group started a consultation on cutting all funding for fertility treatment

I felt miserable, a failure. Id failed to meet the right man until I was 35 and now my ovaries were failing me too. Coming round from the egg collection, I started blabbering deliriously about a school friend who fell pregnant at 16. We all thought she was nuts to keep the baby. But maybe she had the right idea, I wailed at the nurse, as she handed me a cup of tea and a biscuit.

All of the resulting embryos were frozen so that my body, battered after the hormone injections, could go back to normal. Christmas approached and the clinic began its annual shutdown. More waiting. It wasnt until early March that the doctors allowed me to finally prepare for an embryo transfer and I started taking HRT to override my natural menstrual cycle. It seemed particularly cruel that in order to outsmart my ageing reproductive organs I had to take menopause pills. Still, I thought, it would all be worth it if it worked.

I was supposed to have the transfer the week beginning 23 March. You know what happened next. All fertility treatment was suspended. My embryos would stay in the freezer. For how long? Nobody knows. Ive had a lot of time to brood during lockdown. Sure, being pregnant during a global pandemic wouldnt be much fun, but what if coronavirus takes away my one-in-five shot at motherhood? Where I live, women under 40 are entitled to two NHS-funded IVF cycles (one fewer than recommended by Nice, the national body that advises clinicians). It is not clear whether I will get my second if the clinic does not reopen before I turn 40 next year.

Now I hear Saint Marys the first ever NHS IVF clinic and my local centre may close for ever in April 2021 after hospital bosses said they could not afford a 10m refurbishment. Reproductive medicine is not, it seems, a priority, even when it comes with world-class research in tow. I knew the hospital had seen better days. The day I went for egg collection it had been raining and there were buckets and what looked like incontinence pads catching the drips from the ceiling. Im glad the lift was working that day: I discovered later that for a while staff had had to practise carrying a loaded stretcher downstairs in case they had to evacuate a patient who fell ill under sedation in the weeks before the lift engineer arrived.

It now feels inevitable that IVF will be rationed even further, particularly at a time when the NHS is under so much pressure. Can it afford to help create new life as well as sustain those already in existence? Last year my local clinical commissioning group started a consultation on cutting all funding for fertility treatment, which it said would save almost 700,000 a year. Five other CCGs have already stopped paying for any IVF cycles, according to the Fertility Network. Its a classic postcode lottery: if our house were half a mile away we would get three cycles on the NHS.

The NHS is currently buckling under the strain of coronavirus, and I know Im part of a long line of patients waiting for deferred operations or specialist appointments, many far more urgent than mine. When the worst of the pandemic has passed, a huge backlog awaits not to mention an almighty budgetary black hole, which will surely exacerbate the decline in publicly funded fertility treatment.

I also know that some people may have no sympathy for people like me. We should have procreated at least a decade earlier, maybe even two, like my high-school chum. Having a child is not a human right, particularly on our overpopulated planet.

Perhaps you have your own children, conceived the traditional way. But what if you, like me, were infertile? Would you have sought out NHS treatment to have your precious offspring? Should fertility assistance be yet another luxury available only for the rich? I dont have the answers. I just feel sad.

Continue reading here:
Coronavirus has slashed my chances of IVF treatment - The Guardian