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Archive for the ‘Hormone Clinic’ Category

Breast Reconstruction Surgery: Options, Benefits and Barriers – Michigan Medicine

A breast cancer diagnosis rearranges priorities quickly for a woman. Along with possible treatments, such as hormone therapy, chemotherapy and radiation, most women also undergo surgical treatment which could include lumpectomy or mastectomy.

Once a successful course of treatment that includes a mastectomy ends, then what? For some women, part of recovery includes restoring a part of themselves that was removed.

Despite demonstrated psychosocial benefits breast reconstruction surgery can provide, some women either arent aware of all of the options available to them, or that they are candidates for reconstruction at all.

Jessica Hsu, M.D., Ph.D., a plastic surgeon at Michigan Medicine, says awareness is critical for women to make informed choices about how to proceed after cancer treatment.

Its a very personal decision. The important thing is to just have a conversation about all of the options, Hsu says.

Michigan Medicine has an integrated breast care clinic, and every woman diagnosed with breast cancer is offered a plastic surgery consultation. Once a patient decides to pursue breast reconstruction after total mastectomy, theyll likely be offered one of two main procedures offered at the clinic: Implant-based breast reconstruction or natural (also called autologous) tissue breast reconstruction.

Implant-based breast reconstruction uses implants that contain either silicone or saline, has a shorter recovery period and is the more common of the two procedures. Complications with the implants can arise, however, particularly in the case of women requiring radiation as part of their cancer treatment.

Natural tissue breast reconstruction involves moving tissue from another part of the bodymost often the patients abdomenand using that tissue flap to reconstruct a breast mound. Its a procedure that Paige Myers, M.D., a plastic surgeon at Michigan Medicine, specializes in performing. Myers is trained in microvascular surgery, which is required to reconnect the blood supply from the donor tissue to the reconstruction site in some cases.

Breast reconstruction using natural tissue is generally a more involved surgery with a longer recovery time, with a higher immediate complication rate. The upside is that it offers women more natural looking breasts, with tissue that changes along with their bodies and fewer future surgeries over time.

The benefits of autologous breast reconstruction surgery in people who are candidates for both tend to be more longevity of the reconstruction. The patients require fewer revisions down the road. Its your own tissue, so it ages with you naturally, Myers says.

Of course, one option is to not have reconstruction surgery to recreate breast mounds. As with all of the options, its a personal choice, and another one for women to consider.

Theres been a lot written on the flat and fabulous crowd and thats a form of breast reconstruction, Hsu says. They often still do have cosmetic concerns about their skin and we get involved in those cases.

Some women may not be interested in more surgery after undergoing a mastectomy. Hsu sees reconstruction as part of the treatment and recovery process, and points to the confidence women gain after reconstruction.

A lot of people think that the purpose of surgery is to restore function only, and they forget the other part, which is form, Hsu says. To help a woman have symmetric breasts after breast cancer surgery so they feel good in their clothing or in a swimsuit, and feel more like a woman with breast mounds, is really importantand really important to me.

Myers has seen examples of the powerful effects that breast reconstruction can have on a womans mental wellbeing. A happy patient once shared a photo of her son trying to breastfeed from a reconstructed breast after her surgery. To both mother and son, things seemed familiar in a way that was comforting.

According to Myers, so much of the breast cancer journey involves loss of control, and empowering women to determine what their bodies look like after mastectomy is another benefit.

Cancer diagnosis, therapy and everything that ensues takes so much away from patients, Myers says. To be in control of their own course of care, and what they feel is best for them, is another huge benefit.

Many barriers keep women from seeking a consultation or pursuing breast reconstruction surgery. Information overload is an issue for women who are already receiving a breast cancer diagnosis and the ensuing treatment.

Hsus typical consultations last about an hour. Women leave armed with pamphlets and are followed up closely to see if they have additional questions. Its a thorough process, but Hsu thinks theres room to improve the way information is delivered.

Our patients range from younger than 20 to people in their 70s and 80s, so its important to have resources that work for different age groups and different levels of technical comfort, Hsu says. There is an active effort at Michigan Medicine, led by Edwin Wilkins, M.D., to improve patient education resources and decision aids for breast reconstruction.

Myers understands that reconstruction takes a mental back seat to treatment.

When first faced with a cancer diagnosis, women are flooded with emotions and an onslaught of information, Myers says. Survival is the main thing on their minds, and that should be their priority. They receive all this information and then it seems reconstruction is put on the back burner.

The way the University of Michigan Rogel Cancer Centers multidisciplinary Breast Care Center brings the various treatment teams together helps to keep the options more top of mind for patients. According to Myers, not every health care setting has an integrated approach or structure.

Sometimes patients have trouble simply finding a clinic that can perform the surgeries. In some cases, a provider may not be able to offer an option that works and may not refer women elsewhere.

Women may not have access to a microsurgeon, geographically or otherwise, to perform the autologous reconstruction and, therefore, this can be a huge barrier for patients who arent candidates for implant-based reconstruction, Myers says.

The expense of breast reconstruction surgery may also deter women, especially if they dont think the results will be worth it. Hsu says its important to note that most group insurance providers that cover mastectomies are also required to cover breast reconstruction surgery, and that the coverage is more comprehensive than women might assume.

Coverage includes revision on the other side to achieve symmetry, Hsu says. Patients who are undergoing mastectomy on one side worry they wont be able to match the other side that didnt have cancer so they sometimes dont pursue it.

Hsu stresses that she and the rest of the team are eager to help women navigate questions and barriers, and to walk them through the options so that they ultimately make the decision thats right for them.

If you have questions, Im here, Hsu says. If you want to meet in five years, Im here. If you dont want to do it, thats your choice, and thats fine, too.

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Breast Reconstruction Surgery: Options, Benefits and Barriers - Michigan Medicine

Reduce the risk of breast cancer | News, Sports, Jobs – Maui News

This is National Breast Cancer Awareness Month. Maintaining that focus is important since breast cancer is the most common cancer in women worldwide, regardless of race, contributing more than 25 percent of new cancer cases.

Although more women are surviving, breast cancer has been on the rise for several years, and theres no simple answer as to why. Breast cancer is a complicated disease with a variety of different causes, and many aspects of our lives swing our risk in one direction or another. While some of these are out of our hands, others can be controlled, which is why eating healthy and exercising can help reduce risk.

As to what to drink, water is best, and coffee and tea are also useful because they contain antioxidants that can reduce your risk of cancer. You should eat a diet rich in vegetables and fruits. Foods to stay away from include grilled and red meat and processed foods. Eat them only occasionally.

If theres a history of breast cancer in your family, your risks are higher, and you should be informed on how to reduce it. A good place to start is the Mayo Clinic. Visit and search for reduce breast cancer risk for dozens of articles on that subject.

Youll learn what you likely already know: limit alcohol, dont smoke, control your weight, be physically active, breast-feed and limit hormone therapy. Be vigilant about breast cancer detection. If you notice any changes in your breasts, such as a new lump or skin changes, consult your doctor. Also, ask your doctor when to begin mammograms and other screenings based on your personal history, the clinic advises.

In addition to decreasing your risk of breast cancer, a healthy diet also staves off diabetes, heart disease and stroke. Says the clinic, Women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses on mostly plant-based foods, such as fruits and vegetables, whole grains, legumes and nuts. People who follow the diet choose healthy fats, such as olive oil, over butter and eat fish instead of red meat.

To learn more about other ways you can help fight breast cancer, visit

* Guest editorial from The Kingsport Times-News in Kingsport, Tenn.

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Reduce the risk of breast cancer | News, Sports, Jobs - Maui News

15 Greatest Methods to Enhance Your Libido, In response to Docs – KYR News

Intercourse is without doubt one of the easiest issues on the planet, and probably the most sophisticated. In case your libido is flagging, it isnt as straightforward as flipping a swap again to on. Libido is pushed by plenty of components, says Michael Ingber, MD, a specialist in feminine pelvic medication and urology based mostly in Denville, New Jersey. The sexual response cycle requires a whole lot of issues to occur. That course of might be affected by food plan, way of life, stress and hormone rangessimply to call a couple of variables. In case your want is derailed and also you need to get again on observe, here is the place docs say you need to begin. Learn on to study the most effective methods to extend libido, and to make sure your well being and the well being of others, do not miss these Sure Signs Youve Already Had Coronavirus.


Strolling or performing some sort of motion train every day reduces irritation, boosts intercourse drive and improves the blood movement to the intercourse organs, says Yeral Patel, MD, a purposeful medication doctor in Newport Seaside, California. This small adjustment could make a giant distinction.

Train can also improve the output of pure endorphins, making one really feel calm and horny, says Felice Gersh, MD, an OB/GYN and founder/director of the Integrative Medical Group in Irvine, California. After all, train helps each women and men change into buffand a physique you are feeling horny in goes an extended technique to growing the will for intercourse.

The Rx: Goal to get 30 minutes of train most days of the week, together with at the least two periods of power coaching weekly.


Chocolate incorporates many mood-enhancing and energy-producing chemical compounds, so it is no surprise we affiliate chocolate with friskiness, happiness and sexual cravings and satisfaction, says Anna Cabeca, DO, an OB-GYN and anti-aging doctor and writer of The Hormone Repair. It incorporates theobromine (a temper elevator), caffeine and sugar (a temper elevator and vitality booster) and the endorphin Phenylethylamine (PEA) which produces an vitality enhance.

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The Rx: Attempt a couple of squares (a 1 to 2 oz. serving) of darkish chocolate for dessert.


Persistent stress retains this intercourse drive low, says Myles Spar, MD, MPH, an inner medication doctor and writer of Optimum Maless Well being. The easiest way to repair that is to learn to handle stress in order that the physique just isnt all the time in fight-or-flight mode, feeling like you might be below assault on a regular basis.

The Rx: Day by day habits like journaling, breathwork, mindfulness observe, meditation, mild yoga and even prayer have been proven to considerably decrease the sympathetic nervous system overdrive state and create a way of rest, says Spar. Then intercourse drive will increase, as a result of the mind senses that it is time for copy. It is all evolutionary.


Sleep is necessary. There have been a number of research that present a scarcity of sleep negatively impacts intercourse drive. So ensure youre well-rested otherwise you will not be up for the duty, says Ingber.

The Rx: Specialists advocate seven to 9 hours of sleep nightly for the optimum efficiency of your coronary heart, mind, metabolismand intercourse drive.


Chubby and overweight sufferers have elevated irritation which causes hormone imbalance and thus, could cause low libido and low intercourse drive, says Patel.

The Rx: Keep in a wholesome weight vary with common train and a balanced food plan.


Most processed meals include hormone-altering chemical compounds that may wreak havoc on (amongst different issues) intercourse drive, says Patel.

The Rx: As an alternative of packaged meals, Patel recommends consuming beets and spinach, that are excessive in pure nitrates that assist improve blood movement to the intercourse organs; lycopene-rich meals comparable to citrus and tomatoes, which additionally improve blood movement; and meals excessive in flavonoids, comparable to darkish chocolate, blueberries, strawberries and inexperienced tea. These assist strengthen and heal blood vessels.

RELATED: Im a Doctor and This Vitamin May Reduce Your COVID Risk


Oysters have been acknowledged for hundreds of years as a traditional aphrodisiac, says Cabeca. Oysters include dopamine, a hormone recognized to extend libido. Oysters and most shellfish additionally include arginine, an amino acid that the physique makes use of to make nitric oxide. Nitric oxide will loosen up and develop your blood vessels, very similar to the erectile dysfunction drug Viagra, thereby growing libido. Avocados are excessive in vitamin B6, which helps improve hormone manufacturing and enhance libido for each sexes, she provides.

The Rx: Indulge within the occasional oyster dinner. Avocados might be part of your every day menuon salads, in smoothies, or as a facet dish for lean protein.


Toxins are one other stressor on our our bodies that may affect hormone manufacturing and may bind to hormone receptors, says Stephanie Gray, DNP, MS, founding father of the Integrative Well being and Hormone Clinic in Hiawatha, Iowa. Work to take away poisonous chemical compounds from your own home and out of your private care merchandise.

The Rx: One of many frequent toxins is plastics. Plastic usually incorporates bisphenol A (BPA), an endocrine disruptor that may have damaging results on our reproductive organs and hormones, particularly the breasts in females and prostate in males, says Grey. Some private care merchandise additionally include parabens and phthalates (extra endocrine disruptors), so learn the labels and keep away from merchandise that merely listing added perfume, since this catch-all time period typically means hidden phthalates.


Too usually sufferers see me stating, My physician already checked my hormones and advised me they have been regular when that is not actually the case, says Grey. Possibly that they had an FSH (menopause) marker checked however did not even have intercourse hormone ranges like estradiol, estrone, progesterone, and testosterone checked.

The Rx: Past having the degrees checked, discover a hormone specialist who can correctly interpret your hormone ranges and formulate a recreation plan to enhance them, says Grey. Simply because ranges register within the regular vary does not imply theyre optimum.


Similar to males, testosterone is the principle steroid hormone which causes libido to extend in girls. So consider it or not, we frequently give this to girls whove a low libido, says Ingber. Additionally, hormones like dopamine, oxytocin, and serotonin play a task.

The Rx: Sure prescription drugs, comparable to Addyi and Vyleesi, are prescribed to deal with decreased sexual want in girls, says Ingber. If low testosterone is a reason for a persons low intercourse drive, testosterone substitute remedy (TRT) is on the market.


Ristela (Bonafide) is a brand new pure remedy which is a plant-based mix of french maritime pine bark extract, antioxidants and naturally occurring amino acids. It was proven to extend bodily arousal by 75% after solely two months of taking it, says Ingber.

The Rx: See your healthcare supplier about whether or not a nutraceutical is an efficient choice for you.


Im usually requested about low libido and what choices can be found for ladies whore experiencing a low sexual want with their accomplice, says Lyndsey Harper, MD, founding father of Rosy, an app for ladies with decreased sexual want. My reply is all the time the identical regaining your sexual want is like setting a brand new aim. It requires a dedication and dedication to making an attempt one thing new that could be out of your consolation zone and sticking with it till you attain your aim.

The Rx: One of many evidence-based interventions I like to recommend is studying a romantic or horny brief story earlier than you propose on having intercourse, says Harper. Studying an attractive story can rev up sexual vitality and open up the room for pleasure and pleasure. After you have a optimistic and pleasurable sexual expertise, this in and of itself will assist you regain intimacy and create a bodily connection and appreciation together with your accomplice.


A food plan excessive in inexperienced leafy greens, beets, and citrus fruits and melons is an effective way to boost the manufacturing of nitric oxide, the gasoline signaling agent that causes vascular engorgement of the penis and of the feminine labia minora and clitoris, says Gersh.

The Rx: Are you getting sufficient? The Dietary Pointers for Individuals recommends consuming 2 cups of fruits and a pair of cups of greens each day. (However extra would not damage.)


Antioxidants can vastly assist within the enjoyment of intercourse by growing genital blood movement, reducing body-wide irritation, and enhancing ranges of intercourse hormones, says Gersh. Some dietary supplements can even elevate ranges of nitric oxide, offering its precursor, like beet powder and Vitamin C.

The Rx: For dietary supplements, I might counsel maca as an total finest aphrodisiac, says Gersh. However do not forget a multivitamin, vitamin D and Okay, zinc, magnesium, omega-Three, probiotics, B12, folate and a B advanced.


If there are relationship issues, they should be addressed very first thing, says Gersh. Relationship discord causes large stress, which lowers libido. Stress of every type should be dealt with, and most notably when the stress entails that couple.

The Rx: In case you have conflicts to work out together with your accomplice, counseling and stress-reduction workouts are sensible methods. Attempt meditation or guided imagery to enhance tolerance of one other and of oneself, says Gersh. Have a good time the little beauties of life, and attempt to maintain the bigger points emotionally managed.

As for your self: To get by way of this pandemic at your healthiest, do not miss these 35 Places Youre Most Likely to Catch COVID.

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15 Greatest Methods to Enhance Your Libido, In response to Docs - KYR News

Young women may be likelier to die after heart attacks than men – Live Science

Younger women may be more likely to die in the decade following a heart attack than men of the same age, a new study suggests.

In general, women under age 50 experience fewer heart attacks than men in the same age range. The new study, published Oct. 13 in the European Heart Journal, also reflects this trend; of 2,100 heart attack patients treated at the Brigham and Women's Hospital and Massachusetts General Hospital in Boston between 2000 and 2016, only about 400 were women. The average age of all the patients in the study was 44 years old.

But over the long-term, these young women were more likely to die than young men. The study authors followed the patients for a median of 11 years, and found that women were 1.6 times more likely to die from any cause than men during that time.

Related: 9 new ways to keep your heart healthy

"Notably, the differences in mortality in our study were primarily driven by non-cardiovascular death," meaning deaths not caused by a heart condition, study author Dr. Ersilia DeFilippis, a cardiology fellow at New York Presbyterian-Columbia University Irving Medical Center, told Live Science in an email. Examples of these non-cardiovascular causes of death included cancer and sepsis, a kind of overblown immune response to an infection.

Unfortunately, "there were no clear explanations as to why women had lower survival," DeFilippis noted, though the study revealed a number of factors that may be at play.

"The risk factors for disease of other organs overlap with risk factors for heart disease," Dr. Marysia Tweet, an assistant professor in Cardiovascular Medicine at the Mayo Clinic, who was not involved in the study, told Live Science in an email. "A heart attack and the ramifications of a heart attack may affect the health of other organs. Long-term mortality is likely due to a combination of multiple factors."

For instance, women in the study had higher rates of diabetes than the men, as well as higher rates of diseases such rheumatoid arthritis , where joint pain and inflammation are often triggered by an immune system attack. This persistent inflammation may drive the formation of fatty plaques in blood vessels, which can block arteries and lead to a heart attack, according to a 2012 report in the journal Arteriosclerosis, Thrombosis, and Vascular Biology. That same inflammation may also affect how patients recover.

In addition, the women showed higher rates of depression than men in the study. "Depression impacts adherence to healthy lifestyle recommendations and medications," which could impact women's long-term survival after a heart attack, Tweet wrote in a commentary also published in the European Heart Journal about the research. But it's also possible that the physiological changes that coincide with depression independently worsen outcomes; for instance, elevated levels of stress hormones and inflammatory molecules called cytokines could worsen a patient's prognosis, she wrote.

In general, women are about twice as likely as men to experience stress-induced reduction in blood flow to organs after a heart attack, according to a 2018 report published in the journal Circulation.

Related: Beyond vegetables and exercise: 5 surprising ways to be heart healthy

Beyond these risk factors, women also received different care from men when being treated for their heart attacks.

Women in the study were less likely than men to undergo coronary angiography, an exam in which dye is injected into the blood vessels so doctors can view those vessels and possible blockages on X-ray. They were also less likely to receive coronary revascularization, in which blood flow is restored through surgery or placement of a stent into the obstructed artery. When discharged from the hospital, women were less likely to be given medications like aspirin, beta-blockers, ACE inhibitors and statins, which are often prescribed after a heart attack to protect the organ from further damage.

These differences in medical care may reflect "persistent sex or gender disparities in clinical care and decision-making," or they may reflect clinical differences in how the men and women's heart attacks unfolded, Tweet wrote. For example, more women than men developed a spontaneous tear in an artery in the heart, which would deter doctors from performing an invasive procedure like coronary revascularization.

Women were also less likely to have severe blockages in their coronary arteries as compared with men, which would also reduce the need for coronary revascularization, Dr. Ron Blankstein, a professor of medicine at Harvard Medical School and a preventive cardiologist at Brigham and Women's Hospital, wrote in a statement.

Related: 7 foods your heart will hate

Socioeconomic status may be another critical factor in women's long-term survival rates, the authors wrote. "In our study, we found that women had lower median incomes than men and were more likely to have public insurance," DeFilippis said. "Therefore, there are likely differences in access to care which are playing a role."

Further studies will be needed to tease out how these factors affect women's long-term survival after a heart attack, the authors noted. In the meantime, cardiologists "need to educate women regarding the risks of cardiovascular disease and potential worrisome symptoms," DeFilippis said. In the study, chest pain was the most commonly reported symptom among both men and women, but a higher proportion of women reported symptoms like shortness of breath, heart palpitations and fatigue.

Doctors can improve women's care by recruiting more women into clinical trials, actively including sex-based data in studies of heart attacks and better addressing sex-specific risk factors when educating patients, Tweet wrote in her commentary. For instance, gestational diabetes and preeclampsia severely high blood pressure during pregnancy can place women at higher risk for heart attacks, she wrote. Ovary removal has also been associated with a higher risk of heart attacks, potentially because ovaries produce the sex hormone estrogen, which is thought to protect against heart disease, according to Harvard Health.

Furthermore, some research suggests that women face greater cardiovascular risks from smoking than men do; all these risk factors warrant further study, especially in terms of whether the risk they present outmatches the protective power of estrogen and leaves women more prone to heart attacks, the authors wrote.

Originally published on Live Science.

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Young women may be likelier to die after heart attacks than men - Live Science

Skateboarding the latest accomplishment for Westerville boy with rare genetic disorder – The Columbus Dispatch

Ken Gordon|The Columbus Dispatch

Watching his son Sora crouched low on a skateboard recently, gliding smoothly down a ramp at Adventure Park in Powell, Tristan Chamberlain thought of all the things that doctors had said Sora would never do.

Born in 2015 with Prader-Willi Syndrome, a rare genetic disorder, the outlook for Sora was uncertain. The syndrome affects about 1 in 15,000 children andtypically leaves themwith low muscle tone, abnormal growthand intellectual disabilities, among other issues.

They told us there was a good chance he would have to use a walker for the rest of his life, Chamberlain said. At 3, he was walking on his own. Then they said, `Well, hes walking now, but he wont be able to run and play like normal kids can do.

So then we got him running around, and they said he probably wont be able to do other things like jumping.

He pulled out his phone and showed off a picture of Sora, now 5,jumping off a large climbing rock at a different park.

A skateboarder in his youth he calls Sora"little dude" and uses the term "gnarly" often Chamberlain, 39, introduced Sora to the sport as a way to keep up his son's muscle tone and balance during the COVID-19 pandemic, when hisphysical therapy sessions were temporarily halted.

Chamberlain said skateboarding has helped Sora both physically and socially. And the skate community, he said, has been welcoming.

"His reaction time is a lot better, he can anticipate things," he said. "And the skills he has developed here have translated into other things, like his running is so much better now."

As for the doctors' gloomy predictions, he said he understands why doctors are hesitant to be overly optimistic, not wanting to provide false hope. But he along with his wife, Tomomi Tanaka never bought into the idea that Soras potential was limited, even after more obstacles were added to his path. He was diagnosed with cerebral palsy 18 months ago and also is on the autism spectrum.

Every new parent has this fantasy of what its going to be like to have a child, and sometimes life punches you in the face, TristanChamberlain said. But having a special-needs child has been the most rewarding thing in my entire lifebecause it taught me to quit worrying about things I cant control.

I cant change the fact that my son has a genetic disorder, but I can change myself and be the best dad possible.

For the Chamberlains, that has meant being aggressive advocates for Sora. That philosophy included approving a regimen of human growth hormone for their son, starting at 6 months of age.

The hormone, approved as a treatment for Prader-Willi in 2000, helps build muscle tone and possibly can help improve cognitive function, as well, according to Dr. Kathryn Obrynba, an endocrinologist at Nationwide Childrens Hospital and medical director of the hospitals Prader-Willi Syndrome Clinic.

Prader-Willi patients have a malfunctioning hypothalamus, the part of the brain that regulates essential functions such as hunger, body temperature and pain.

The natural course of this disease is changing every day because parents like Soras have advocated for change and been onboard with therapies like early growth hormone, Obrynba said. What may have been expected of patients 10 years ago is different from what we anticipate or expect now.

The Chamberlains have had Sora in physical therapy, occupational therapy and speech therapy for years. Not long after the physical therapy stopped this spring, Tristan Chamberlain was cleaning out the garage one day when Sora found his old skateboard.

He picked it up and said, `I want to ride it, Chamberlain said.And I thought, `Why the heck not?

The two started in April in the driveway of their Westerville home, learning to balance and stay on the board. By June, Chamberlain began taking Sora to a skatepark.

His wife, though, does not come and watch. Its a 'mom thing. Chamberlain's mother, Stephanie Chamberlain, said she can relate.

I remember the first time I watched Tristan drop in (to a steep ramp), I thought I was going to throw up, she said while watching her son and grandson at Adventure Park recently during a visit from her home in North Carolina.

All padded up and helmeted, Sora skates confidently, though on this day the park was crowded, and Chamberlainseveral times had to spring into action and guide Sora out of another skaters path. After seven runs, Sora got tired and a little cranky. It was time to head home, where he could play with his 3-year-old younger brother, Kai.

Chamberlainsaid Kai, a typically developing child, has been good for Sora, as has been his pre-kindergarten experience at the Westerville school districts Early Learning Center. The Chamberlains moved from German Village two years ago just so Sora could attend.

There, he and other special-needs kids are in a classroom with typical kids. The goal is to normalize special needs, and also perhaps for the typically developing kids to push Sora to try harder.

It is a phenomenal environment, Chamberlain said.

Obrynba said she wasnt aware that Sora wasskateboarding, but she isnt surprised.

Thats awesome, she said. Tristan and Tomomi support Sora amazingly. Im so impressed with what they do.

The Chamberlains also are involved in fundraising campaigns for Prader-Willi Syndrome. Tristan Chamberlain is particularly proud of aninitiative he and a friend are planning, a line of skateboards that will be sold to benefit research.

They are imprinted with a phrase that he says is inspired by the memories of being told what Sora would never do:

Yes, I Will.


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Skateboarding the latest accomplishment for Westerville boy with rare genetic disorder - The Columbus Dispatch

Impact Of Covid-19 On Blood Testing Market Is To Witness Significant Growth Between 2020-2027 With Leading Players Abbott Laboratories, Bio-Rad…

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Impact Of Covid-19 On Blood Testing Market Is To Witness Significant Growth Between 2020-2027 With Leading Players Abbott Laboratories, Bio-Rad...

There is a disconnect between the mind and body – A transgender woman’s journey exposes her to the difficulties experienced by her community – News24

A young Phumelela in Grade 1

Supplied: Phumelela Nkomozake

"My journey started, as [far back] as I could remember, being a young child growing up and always noticing that there is something particular about you or that you really do not find yourself comfortable in your own body.It is feeling in a particular way that there is a disconnect between your mind and your body."

These are the words of 24-year-old Phumelela Nkomazake, a transgender woman from the Eastern Cape whose personal journey towards affirming her gender led her to discover that the journey was more than just about her, and that it was one that the transgender community experiences as a whole.

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Should you freeze your eggs? IVF websites don’t crack the surface – Sydney Morning Herald

IVF clinics vied for patients in this highly competitive environment knowing women considering freezing their eggs scoured clinic websites and social media for guidance, Dr Beilby said.

"There's a lot of money involved in fertility preserving technology, and it's great to know this technology exists to meet the demand," she said.

But clinics had an obligation to provide clear, accurate information alongside their marketing material about what egg freezing entails, the chance of success, and the cost. "That's what we're not seeing," Dr Beilby said.

None of Australia's 21 most prominent fertility clinic websites specified whether the egg-freezing success rates they quoted were based on patients using their own eggs or donated eggs from cohorts of 20-something women.

Only half provided success rates based on a woman's age and fewer than one-third included the cost of the procedure, according to the analysis published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.

One in three clinic websites published a percentage figure for the chance of getting pregnant after egg-freezing, but only one in 10 published the chance of having a baby.

Overall, the researchers rated 43 per cent of the clinics as "poor" and 57 per cent as "moderate" on an American matrix designed specifically to assess the quality of information on egg freezing.

Co-author Dr Karin Hammarberg said women need to be properly informed of these high costs, potential health risks and chances of having a baby before they decide to undergo egg freezing.

The chance of having a baby from frozen eggs depends on two numbers: the age of a woman when her eggs are frozen, and the number of eggs she freezes, Dr Hammarberg said.


The quality of a woman's eggs declines the older she gets. The older the woman, the more eggs she'll need to freeze to have a reasonable chance of having a baby.

For a women under 30, the chance of taking home a baby per initiated IVF cycle if she uses her own eggs is 19.7 per cent, the latest official IVF data from the Australian and New Zealand Assisted Reproduction Database shows.

FFor women aged 30 to 34, it is 17.5per cent, dropping to 12.1 per cent for 35- to 39-year-olds, 4.6 per cent for 40- to 44-year-olds and 0.4 per cent for women 45 and over.

Freezing 10 eggs at 35 or younger gives a woman a 69 per cent chance of having a live birth, dropping to 50 per cent for 37-year-olds and 30 per cent for 40-year-olds.

The number of stimulation cycles needed to retrieve enough eggs increases with age. Most women over 35 will need more than one egg retrieval to collect enough eggs to have a reasonable chance of success.

More than half of the women who freeze their eggs when they are in their mid to late 30s will need at least two hormone stimulations to get the number of eggs that gives them an 80 percent chance of having a baby when they use their eggs. Almost all women aged 40 or more will need at least four hormone stimulations for the same chance.

There is also a third number to consider: cost. The egg-freezing process can cost $7000 to $10,000 per egg retrieval plus the additional cost of storing the eggs (approximately $200 to $500 a year).

"Something that may not be obvious is that in order to have a good reasonable chance of having a baby you might need to spend $30,000," Dr Beilby said.

The egg retrieval process also involves health risks, such as ovarian hyper-stimulation syndrome (OHSS), which is associated with the hormone injections required as part of the procedure.

Dr Beilby hoped clinics would use the audit to develop a checklist of information to include on their websites, and where possible publish clinic-specific success rates.

"There is a lot of hope tied up in this, and we need to err on the side of caution to align women's expectations with reality," Dr Beilby said.

Professor Luk Rombauts, President of the Fertility Society of Australia, said a consultation with a fertility specialist - not the internet - was the appropriate setting for a woman to be given the information she needed to make an informed decision about egg freezing.

"Just because it's not on the website doesn't mean patients won't get that information," Professor Rombauts said. "They will get it from their doctor, which is exactly where the information should be coming from. Most importantly, we will take into account a patient's personal circumstances."


Professor Rombauts said the fertility industry had done exceptionally well when it came to transparency in advertising compared to other medical specialities.

It was impossible - particularly for smaller clinics - to provide meaningful success rates when only a very small proportion of women have returned to use their frozen eggs.

"A lot of women who freeze their eggs fortunately never have to use them because they do find a partner," he said. "That doesnt mean we couldn't improve the reporting on our websites."

In Australia, the FSA's Reproductive Technology Accreditation Committee sets standards for ART clinics through an audited Code of Practice, which states their websites "must include but not be limited to: processes, costs, risks and outcomes" but does not specify a minimum level of detail.

"This paper could give [clinics] another useful tool when they're considering what information they could include on their websites," Professor Rombauts said.

Kate Aubusson is Health Editor of The Sydney Morning Herald.

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Should you freeze your eggs? IVF websites don't crack the surface - Sydney Morning Herald

Do You Have Dryness, Vaginal Atrophy or Vaginitis? – Bioidentical Hormone Health

At menopause as hormone levels decline, women start noticing signs of dryness or tightness and sex may become uncomfortable

There are several reasons for this, and a number of conditions that can arise at this time may need to be investigated.

Dealing with dryness

This is most common at menopause and related to the declining oestrogen levels that occur at this time.

This is not serious physically, though can certainly be distressing, and there are a number of lubricants available.

If you have mild to moderate vaginitis, using a lubricant can help relieve pain and discomfort while having sex but they provide short-term symptom relief and can improve vaginal dryness during sex, but theres no evidence to show theyre an effective long-term treatment.

Several types of lubricant are available some are water-based and some aresilicone-based. You may need to try a few before finding one thats suitable or your GP may wish to prescribe a localoestrogen cream, gel or pessary.

If you prefer a natural alternative then 20-1, which is a combination cream with the majority ingredient of progesterone with two natural oestrogens added, can help particularly if internal vaginal application is used.


This is inflammation of the vagina that can cause itching, discomfort and discharge. Itcan be caused by any of the following infections or irritants:

thrush a common yeast infection that affects most women at some point

bacterial vaginosis a bacterial infection where the balance of bacteria inside the vagina is disrupted

trichomoniasis an STI (Sexually Transmitted Infection) caused by a tiny parasite

chemical irritation for example, from perfumed soap, bubble bath, or fabric conditioner, or from spermicide and somesanitary products

washing inside your vagina

chlamydia an STI caused by bacteria

gonorrhoea an STI caused by bacteria

genital herpes an STI caused by the herpes simplex virus.and symptoms include:

Symptoms can include the following

an abnormal vaginal discharge

vaginal irritation or itching

pain when peeing or having sex

light bleeding or spotting

a strong, unpleasant smell, particularly after sex, can be a sign of bacterial vaginosisor trichomoniasis, which can sometimes cause vaginitis.

Time to see your GP orgo to a sexual health clinicif you have any unusual vaginal symptoms, particularly if you have :

vaginal itching or an unpleasant smelling vaginal discharge

havent had a vaginal infection before

had vaginal infections before but now your symptoms are different

had a number of sexual partners, or you have a new sexual partner so you may have a sexually transmitted infection (STI)

finished a course of medication for vaginal thrush, but your symptoms are persisting

Theres no need to see your GP if youve been diagnosed with thrush in the past and your symptoms arethe same.If youre sure you have thrush and youve treated it successfully in the past with over-the-counter medication, you can treat it yourself again.

Treating vaginitis

Treatment for vaginitis depends on whats causing it.Yeast infections, such as vaginal thrush, are usually treated with antifungal medicines, and bacterial infections are usually treated with antibiotics.

Vaginal atrophy

This refers to thethinning of the lining of the vagina after the menopause and the resultingdryness, itching or discomfort (particularly during sex). It can also sometimes be caused by a decrease in oestrogen levels after the menopause.

Your GP may recommend using a local oestrogen and that is usually necessary with atrophy until the condition is more stable.

Unlike combined or other forms of HRT, thisonly restores oestrogen to your vagina rather than to your whole body, reducing the risk of side effects.

You can balance this additional oestrogen with bioidentical progesterone, and once the atrophy is under control you can use a combined bioidentical progesterone and oestrogen cream.

How to help yourself

There are number of self-help measures which can reduce the risk of these problems and help once they are diagnosed.

keep your genital area clean and drytake a warm bath rather than a hot one and useunperfumed soap to clean your genital area anddry yourself thoroughly

avoid douching (spraying water inside your vagina) it may make your vaginitis symptoms worse by removing the healthy bacteria that line the vagina and help keep it free from infection

do not use feminine hygiene products such as sprays, deodorants or powders

use pads rather than tampons if youre using intravaginal creams or pessaries to treat an infectiontampons may soak up the treatment meaning theres less available in the vagina

wear loose-fitting cotton underwearthis may be beneficial if you have external soreness, but it wont prevent you getting vaginitis in the future


Because women are often reluctant to talk about conditions like this, they do often suffer in silence but there really is no need as help is readily available.

Generally, maintaining good hormone balance with healthy levels of progesterone and oestrogen is a helpful measure too.

For any of these condition it is best topractice safe sex by usingcondoms to avoid getting or spreading sexually transmitted infections.

What Are the Symptoms of UTIs?

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Do You Have Dryness, Vaginal Atrophy or Vaginitis? - Bioidentical Hormone Health

The Fight for Reproductive Justice in a Post-Ginsburg World – The Intercept

Oriaku Njoku was outside the U.S. Supreme Court alongside a crowd of activists and advocates for abortion rights as the nine jurists inside heard oral arguments in a case that, depending on its outcome, could destroy access to abortion in Louisiana.

It was a crisp morning in early March, mere days before the coronavirus pandemic would see the country all but completely locked down. Njoku, one of the founders of Access Reproductive Care-Southeast, a nonprofit that provides assistance to individuals seeking abortion care across six states in the Deep South, was rallying outside the court with her sister. There was so much energy, she recalled.

It was nearly four years to the day since the last time Njoku had been in front of the high court. That morning, in early 2016, the court was considering the constitutionality of a set of abortion restrictions in Texas that had shuttered half the states clinics. At the time, there were just eight justices on the bench; Antonin Scalia had died several weeks earlier. In the end, Anthony Kennedy joined the four more liberal justices, including Ruth Bader Ginsburg, to strike down the restrictions, which included a requirement that abortion providers have admitting privileges at a local hospital. The court found no evidence that this was necessary to ensure patient safety.

Now, Njoku was back in the same space rallying for the same cause: The restriction at issue in the Louisiana case was identical to the admitting privileges requirement the court had invalidated in Texas. It was a full-circle moment, where it was almost four years to the day; Im back here again, literally fighting for the same thing, she said. I was like, They have to uphold this precedent.

By then, Kennedy had left the bench and President Donald Trump had installed two new conservative justices, Neil Gorsuch and Brett Kavanaugh, who were appointed precisely because of their hostility to abortion. In the end, the court did strike down the Louisiana law, with Chief Justice John Roberts casting the deciding vote albeit with an opinion suggesting the court would be open to upholding additional restrictions in the future.

When the decision was announced, Njoku realized that it wasnt exactly a game-changing victory. Anti-abortion lawmakers have passed more than 450 abortion restrictions over the last decade, many of which still stand, making access to abortion difficult, if not nearly impossible, for millions of people. This is especially true for people of color, LGBTQ people, poorand low-income people, and people in rural areas, who are routinely hit hardest by restrictions on reproductive care, as well as broader inequalities within the health care system. These inequalities have been widely exposed not only by the pandemic, but also through a summer of civil rights protests that have thrown new light on the countrys continuing legacy of racial oppression.

Judge Amy Coney Barrett, President Donald Trumps nominee to the Supreme Court, at the U.S. Capitol on Oct. 1, 2020, in Washington, D.C.

Photo: Caroline Brehman- Pool/Getty Images

And with Ginsburgs death in September, the fight for reproductive justice faces new threats as Republicans scramble to fill her seat with appeals court jurist Amy Coney Barrett, who in 2006 signed on to a call for Roe v. Wade to be overturned, which described its legacy as barbaric. According to the Center for Reproductive Rights, if that were to happen, 24 states would prohibit abortion altogether.

If Barrett is seated, not only is the future of legal abortion in jeopardy, but also access to the larger health care system; the Supreme Court is slated to hear yet another challenge to the Affordable Care Act on November 10. Yes, this is a huge blow, but it doesnt stop the fact that we still have to do work on the ground, as grassroots organizations, as people who are directly impacted by whatever this administration has done or that prior administrations have done, Njoku said. We have to continue fighting until we get to that future of reproductive justice where were able to access whatever health care that we need without any bias or barrier.

WhileGinsburgs seat is still vacant, the Trump administration has already offered the eight-member court an opportunity to restrict abortion access amid the pandemic.

At issue is how medication abortion is provided to people seeking to terminate a pregnancy in its earliest stages. Available through 10 weeks gestation, medication abortion is a two-drug regimen that has been available in the U.S. for 20 years and used by more than 4 million people. Medication abortion accounts for 60 percent of all early terminations and nearly 40 percent of all abortions, according to the Guttmacher Institute.

It works like this: Patients first take mifepristone, a drug that blocks progesterone, a hormone needed to maintain pregnancy; 24 to 48 hours later, the patient takes a second drug, misoprostol, which creates contractions in the uterus that expel its contents. According to the U.S. Food and Drug Administration, medication abortion is very safe and serious complications are extremely rare. Importantly, medication abortion allows patients the ability to terminate a pregnancy in the privacy of their own home or wherever they choose to be.

Nonetheless, access to medication abortion has been restricted in ways that are medically unnecessary. The needless barriers amid a pandemic place individuals at greater risk of contracting Covid-19, according to a federal lawsuit the American Civil Liberties Union filed against the Trump administration in May on behalf of several doctors organizations and a leading reproductive justice group.

Even as state and federal health officials have implored people to avail themselves of telemedicine, abortion patients have been singled out for disparate treatment.

Medication abortion is constrained by what the FDA calls a Risk Evaluation and Mitigation Strategy, a drug safety program designed to control the administration of certain medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks. Where medication abortion is concerned, the REMS has several elements that are onerous in normal times and two that are particularly problematic amid a pandemic: that patients must be handed mifepristone by a medical provider in a clinical setting and that the clinician must collect a physical signature from the patient at the time the drug is dispensed.

While in-person dispensing is required, patients are still in charge of administering the protocol themselves at a time and place of their choosing. And any complications that may arise such as excessive bleeding wouldnt occur until roughly two days later, after the patient ingests the second drug, misoprostol, which is not subject to the REMS. Of the 20,000 drugs regulated by the FDA, mifepristone is the only one that patients must receive in person at a hospital, clinic, or medical office, yet may self-administer unsupervised, reads the lawsuit.

So, even as state and federal health officials have implored people to avail themselves of telemedicine as much as possible, abortion patients have been singled out for disparate treatment, said Julia Kaye, a staff attorney with the ACLUs Reproductive Freedom Project. When youre forcing patients to make unnecessary, in-person trips to a health center during a pandemic, that imposes Covid-19 risks, and theres simply no justification for it, she said, particularly where the federal government has taken extraordinary action to suspend other kinds of in-person requirements. The government has even suspended in-person requirements for controlled substances, including opioids. And I think its important to note that the Covid-19 risks here are greatest for communities of color who make up a majority of impacted abortion patients and who are suffering severe illness and death from Covid-19 at vastly disproportionate rates, Kaye added.

Indeed, back in April, as ARC-Southeast was working to help patients secure abortion access during the worsening pandemic, Njoku recalls reading about the staggering impact the virus was having on Black people; in Georgia alone, they accounted for 80 percent of those hospitalized with Covid-19. I was like, yall, this is the great unraveling thats happening in our society, she said.

In July, a district judge in Maryland agreed with the medical experts and issued a preliminary nationwide injunction blocking enforcement of the in-person requirements during the pendency of the case. The Trump administration balked and asked the 4th U.S. Circuit Court of Appeals to lift the stay; that request was denied.

But instead of allowing the case to play out, the Trump administration asked the Supreme Court to intervene. Given that surgical methods of abortion remain widely available, the enforcement of longstanding safety requirements for a medication abortion does not constitute a substantial obstacle to abortion access, the administrations petition reads, even if the Covid-19 pandemic has made obtaining any method of abortion in person somewhat riskier.

Attempts to truncate the normal course of litigation by running directly to the Supreme Court and forcing cases onto the so-called shadow docket has become a hallmark of the Trump administration, even though it is a move that is supposed to be reserved for extraordinary circumstances. In deciding these cases, the court often issues an order without the full facts before it, without hearing arguments, and without issuing opinions. It typically offers no explanation for its reasoning, even when dissenting justices voice serious objections, and even when the court is effectively overturning the unanimous decisions of lower courts, David Cole, the ACLUs national legal director, wrote in the Washington Post. In the case of the medication abortion challenge, the court could effectively ensure a higher risk of viral transmission with the stroke of a pen.

After pending on the docket for about six weeks, the Supreme Court finally weighed in on October 8, allowing the stay to remain in effect at least for now. In a short order, the court sent the question of whether the stay should be lifted back to the Maryland court for further consideration, essentially postponing any action until after the November election. Justice Samuel Alito, joined by Clarence Thomas, penned a dissent saying that the court should have granted the administrations request.

Had the court granted that request, Kaye said, it would have sent a chilling signal about what lies ahead with a post-Ginsburg court. And though the courts decision to stay out of this particular abortion fight at this particular moment is certainly a win for patients in the short term, she added, its hardly an indication that the right to abortion is secure.

As the pandemic raged this spring, Dr. Honor MacNaughton worried about her patients. MacNaughton, a plaintiff in the ACLU case, is a family physician working in a safety-net hospital system in the Boston area. Her patients are mostly lower-income and people of color, groups disproportionately impacted by the virus. As our health care system was closing down to in-person visits, and we were trying to do everything we could to limit exposure to the virus, it seemed so wrong to require people to still come, in person, to pick up a medication, she said.

Shed long known that the REMS was problematic and that two decades of data demonstrated the safety of mifepristone for pregnancy termination and miscarriage management. I think from a medical standpoint, theres enough evidence for us to feel really confident that the in-person visit isnt required, she said. Since the Maryland court issued its injunction, providers across the country have, for the first time, been able to provide the medication without that constraint. Being able to provide this care since the injunction has been a ray of hope, MacNaughton said. Its given me a glimpse into what more equitable or stigma-free care could look like.

Kirsten Moore, head of Expanding Medication Abortion Access, which was created in part to push for the REMS to be rescinded, has long known that medication abortion is burdened by unnecessary restrictions. She was formerly head of the Reproductive Health Technologies Project, which was founded in 1988 to help bring medication abortion to the U.S. and later successfully pushed for emergency contraception, also known as the morning-after pill, to be made available over the counter.

When medication abortion was approved by the FDA in 2000, Moore said that advocates assumed the restrictions would be revisited as safety data developed. That has not happened. Were still jumping through the same hoops today that we had to when it was first approved, she said. That doesnt make sense, right?

Yes, Roe v. Wade is a great gift. It made abortion legal, but the reality is that it did not make it accessible.

For both Moore and MacNaughton, the disconnect between science and public policy demonstrates that the REMS is about something else altogether a solution in search of a problem.

Of course, the same could be said about most restrictions on abortion access. Lawmakers often peddle these restrictions, like the hospital admitting privileges requirement, as a way to ensure patient safety, even though the alleged benefits fail to materialize. Forty-four states have passed one or more restrictions on abortion access. Twenty-six states mandate delays for patients seeking care; in South Dakota, the 72-hour waiting period doesnt include weekends or state holidays, so a patient could end up having to wait a week before being seen. Thirty states mandate pre-abortion counseling and many incorporate junk science, including, for example, that abortion leads to a greater risk of breast cancer. Several states require providers to counsel patients that medication abortion can be reversed, even though there is no sound science to back up this claim. Taken together, these restrictions have made abortion all but inaccessible across a wide swath of the country, often forcing women to travel long distances across state lines to receive care.

For those who live in the six states served by ARC-Southeast Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee these struggles are common. Every single one of those states experiences some level of reproductive oppression, whether it comes from the legislature or just ideas of shame, stigma, and fear around abortion, Njoku said. She notes that her clients face obstacles to accessing all kinds of basic health care services. None of the states has had any sort of Medicaid expansion; roughly half of Georgias 159 counties are without an OB-GYN. These are all the things that weve always had to navigate, she said. Yes, Roe v. Wade is a great gift. It made abortion legal, but the reality is that it did not make it accessible.

And since Trump took office, lawmakers in states hostile to abortion rights have taken more direct aim at the heart of Roe and its promise of the right to pre-viability abortion.

Women wearing costumes from The Handmaids Tale protest in front of the Alabama State House after the state Senate passed HB314, whichwould ban nearly all abortions, on May 14, 2019, in Montgomery, Ala.

Photo: Elijah Nouvelage for The Washington Post via Getty Images

In 2019 alone, Georgia, Kentucky, Louisiana, Mississippi, and Ohio all banned abortion beginning at six weeks the point at which fetal cardiac activity can be detected and long before many people even know theyre pregnant. Alabama went a step further, passing a law that would ban nearly all abortion. Missouri passed a law to ban abortion at eight weeks, while both Arkansas and Utah have banned abortion at 18 weeks.

Other states have passed bans that interrogate a persons reason for seeking an abortion and would bar access if its based on the sex or race of the fetus or on a diagnosis of Down syndrome or other fetal abnormality. A district court in Missouri has blocked that states anti-discrimination law banning abortion based on a Down syndrome diagnosis, but on September 24, the states solicitor general told a panel of the 8th U.S. Circuit Court of Appeals that the law should be allowed to go into effect in part because individuals with Down syndrome are on the brink of complete elimination.

Since 1973, in Roe v. Wade, the court has given the right to the individual to decide whether or not they want to choose to become a parent at that point in time, said Helene Krasnoff, vice president of public policy litigation and law at Planned Parenthood Federation of America. These laws literally fly in the face of that, she said. They represent another way in which the Supreme Court can really undermine the protections that we have enjoyed, and that Ruth Bader Ginsburg upheld for so many years, without actually outright overruling Roe.

Currently, there are 17 abortion-related challenges to various state restrictions pending in federal appeals courts or before the Supreme Court.

Nothing about the growing storm around reproductive rights is new to Njoku. A lot of folks have been talking about this post-Roe reality, she said. Thats an actual lived reality in states like Texas and Mississippi and really the states we work in in the Southeast. Weve been preparing for things like this because weve been living in this context.

ARC-Southeast has received nearly 16,500 requests for support since they began operations in the summer of 2016. More than 60 percent of clients are already parents. From July 2019 through June 30, ARC-Southeast provided nearly $450,000 in abortion funding and practical support. As the pandemic has continued, jobs have been lost, and politicians across the country have tried to use the public health crisis as a pretext to further block abortion access, Njoku saidthe organization has provided funding not only for abortion, transportation, and lodging, but also for car repairs, food, and even masks. Njoku has seen patients from Texas, Louisiana, Kentucky, and West Virginia come to her region for care, and ARC-Southeast has helped patients to travel as far away as New Mexico, Colorado, and Maryland to get the care they need.

Njoku has been encouraged not only by the donations coming in to support ARC-Southeasts work, but also with a seeming awakening among many that abortion rights have to be viewed within a larger framework that a right without access means nothing, and that people of color are disproportionately impacted by lack of access to basic health care and the racism built into many of the nations social systems. The future that were fighting for is more than just whether or not abortion is legal, she said.

Theres no doubt that the nomination of Barrett presents a threat to that future. According to an analysis by the Center for Reproductive Rights, Barrett has signaled that she believes the Supreme Court should weigh in on the legality of banning abortion based on a patients reason for seeking it, and has suggested that abortion restrictions should be allowed to take effect while questions about their legality are sorted out in court. In Texas, the restrictions ultimately struck down by the Supreme Court were initially allowed to take effect, leading to widespread clinic closures; many never reopened.

And while the Affordable Care Act for the first time created gender parity in health coverage and opened access to maternity care and no-cost birth control, Barrett has expressed skepticism about the legality of the law. In 2012, she signed a letter opposing the ACAs birth control mandate that called contraception and sterilization gravely immoral and unjust and incorrectly described the morning-after pill as an abortion-inducing drug.

Still, Njoku is steadfast in her determination to press forward. Even in the midst of so much pain and so much trauma, she said, in the midst of all of this, we still have people who are willing to continue doing this fight no matter what.

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The Fight for Reproductive Justice in a Post-Ginsburg World - The Intercept

Life was hell but our GPs didnt believe we had started menopause in our 40s – The Sun

WILDLY fluctuating hormones mean hot flushes and zero desire for sex are often just the tip of the iceberg when it comes to The Change.

The menopause usually occurs between the ages of 45 and 55 but symptoms can start years before periods stop a time of transition known as perimenopause.


Subtle changes in mood or menstrual cycle, trouble sleeping and pain during sex can all be early signs.

Yet for many women, symptoms are mistaken for common illnesses. Ahead of next Sundays World Menopause Awareness Day, we speak to three women who were driven to despair in their forties by their misdiagnosed menopause.

SITTING on her bedroom floor sobbing, Jo Morcom told her husband Paul she wanted it all to stop.

The mother of three had convinced herself her family would be better off without her.


For more than a year Jo, 46, had been back and forth to see her GP, complaining of migraines and terrifying loss of memory.

Looking back, she says: As time went on, I slowly turned into someone I barely recognised.

Yet, despite repeatedly asking if her hormones were to blame, Jo says she was dismissed. She was referred for a brain scan and when that was normal she was told it was just her chronic fatigue syndrome.

Eventually Paul, 51, booked an appointment. This time he went with Jo and they refused to leave the clinic until doctors agreed to give a blood test.

The results confirmed that Jo, who also lives with chronic fatigue syndrome, was undergoing the early stages of menopause.

Experts warn that many women similarly get an inaccurate diagnosis failures that cost the NHS millions of pounds in repeat appointments, while also ruining patients lives.

Dr Louise Newson, a GP and menopause specialist, says a survey of 5,000 women showed one in three had to wait at least three years before getting a diagnosis.

She says: I constantly hear from thousands of menopausal women how they are misdiagnosed with conditions such as fibromyalgia, migraines, depression, cystitis, IBS and chronic fatigue, when no healthcare professional has considered their menopause or perimenopause as the underlying cause of their symptoms.

There is currently no formal menopause training for doctors and nurses, she says a situation that must change.

Diane Danzebrink, a psychotherapist and menopause expert, echoed the call.

She says many women are forced to pay for costly private care, resorting to credit cards and loans to pay for help they should be getting on the NHS.

Ms Danzebrink says: Women are regularly told they are too young to be menopausal and this has to stop.

Doctors need to listen to women, who know their own bodies better than anyone, and stop telling them their symptoms are all in their heads.

"This is costing women their health and wellbeing, sometimes their jobs and relationships. And it costs the NHS a fortune in repeat appointments and referrals.

For Jo mum to daughters Helana, 24, and Cate, 16, and 12-year-old son Stanley the alarm bells started to ring months earlier, while heading to her home in Broxbourne, Herts, following a night out.

She had driven the route dozens of times before but that night she got completely lost.

For Jo, a personal assistant, memory loss was the latest addition to a long list of symptoms that had started to creep in five years previously. Debilitating migraines came first, followed by brain fog, joint pain and chronic fatigue.

Over the course of 13 months and numerous visits to her GP, Jo tried to convince the doc her symptoms were hormone-related.


She says: When I couldnt find my way home that night, I knew there was something terribly wrong. I could have driven that route with my eyes shut.

I knew it so well, which is why it was terrifying.

Jo was 41 when she started to suffer horrendous migraines that floored her for days.

She says: I would get halfway to work then have to turn around and head home because I felt so ill.

My periods were irregular too, so it was in the back of my mind that it could all be linked. Over the following months, Jo made several further appointments with her GP. She was prescribed medication for the migraines and referred for an MRI scan.

Jo says: At no point did anyone ask me about my menstrual cycle and any other symptoms.

The scan checked for brain and pituitary tumours but when it came back normal, I was diagnosed with chronic fatigue syndrome. Each time I tried to bring up the subject of hormones it was dismissed.

I couldnt sleep despite being exhausted, and my body ached all over. I looked and felt unwell.

I started looking at menopausal symptoms online and went back and forth to doctors trying to get them to listen. Time and again, each said I was too young.

Paul and the kids walked on eggshells around me. I knew I was being intolerant but I couldnt stop myself. I detached myself from family and friends, which was so unlike me.

I asked for blood tests to check my hormone levels but I was made to feel like I was time wasting and being dramatic.

Things came to a head the day Paul, a domestic appliance engineer, found Jo sobbing in the corner of their bedroom.

She says: I couldnt cope any longer and started thinking how much easier it would be for everyone if I wasnt around any more. I just wanted it all to stop.

After demanding her blood test, Jo finally had her answer.

My oestrogen and progesterone levels were completely out, she says. I felt angry that I had suffered for so long.

It should not have taken that long to get the right help. I had an idea all along.

I know my body better than anyone.

Since then Jo has switched GPs and she reckons her new doctor is fantastic.

She takes the gel form of HRT and an antidepressant, which has helped her get back on track.

She says: While I am relieved to finally get a diagnosis, things need to change.

Women shouldnt need to put up a fight to get help or be ashamed or embarrassed of the menopause.

Talking openly and honestly about it is so important.

WHEN Maria Rooneys doctor suggested she might be pregnant aged 46, Maria laughed.

The Nottingham social worker and mother of two had booked an appointment after her periods had become increasingly unpredictable.


Shocked at the doctors suggestion, Maria, now 49, agreed to take a pregnancy test.

She says: I knew I couldnt be pregnant because I had the contraceptive implant and had lots of other symptoms.

I was constantly exhausted and extremely short-tempered. Until then I had been a good sleeper, but I laid awake most nights. I went from being a confident and happy person to feeling low and anxious.

She finally saw a doctor in February 2017. Her own mum had gone through early menopause meaning Maria recognised the signs in herself.

Even so, she says: I didnt believe it. I thought menopause happened to women in their fifties and sixties.

When the pregnancy test came back negative, I asked if I might be going through early menopause.

The doctor looked at me like I was being ridiculous. She said I was far too young for that.

Over the following year, Marias symptoms went from bad to worse.

She says: Id forget peoples names and had to leave a job I loved. Still, nobody could give me any answers.

Nobody was listening to me, which was really frustrating. I felt like I was falling apart.

I did my own research and took what I found back to my GP.

After 18 months, I was referred to an NHS menopause clinic and given HRT tablets.

Although Im still adjusting to the medication and trying to get the dosage right, I feel relieved Im on the right path.

When I look back now, I feel angry. I suffered for so long but all I wanted was for someone to listen.

Women need to stick up for themselves and if theres something wrong, they must be listened to.

WEIGHT gain, hot flushes and low moods left Vicki Leaver a nightmare to be around, she says.

Now 41, Vicki ticked almost every box for symptoms of perimenopause yet her GP offered her antidepressants, blaming her unhappiness on lockdown.


The admin assistant, who lives in Perth with son Dylan, 18, and daughters Lily, six, and Jasmine, three, says: As soon as I turned 40, everything went wrong. It felt like an extreme case of PMT, but I was grumpy and snappy every day.

Feeling low and hopeless took over my life but I had no idea why I felt that way. Everyday tasks like dealing with a sink full of dirty dishes or an untidy house became too much.

Dylan took the brunt of my bad moods, which made me feel incredibly guilty. I once spent the entire school run crying.

Id wake in the night dripping in sweat and I struggled to hold a conversation because Id forget certain words.

Her periods changed too. Some months they were short and light. Other times, she would bleed so heavily she couldnt leave the house.

She continues: I made an appointment with my GP and broke down, explaining how I was feeling.

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But I got nowhere. I had blood tests that all came back normal, so I was prescribed the progesterone-only Pill to help with my heavy periods. The doctor suggested I was probably depressed because of lockdown and offered antidepressants.

But it was much more than just low moods and I wanted to get to the root of the problem, so I refused. I looked up perimenopause online and except for UTIs, which are common when hormone levels drop, I ticked almost every box.

Since January, I have talked to four different doctors and in June, I started HRT. Four months on, I feel like a different person. I wouldnt wish the last couple of years on anyone.

On Call with Dr Zoe

WHEN a woman will go through the menopause is largely predetermined before she is even born.

Thats because we are born with all our eggs. When they drop below a certain number, you are deemed to be in menopause. But how can you tell?

The best and first thing to do is speak to your mum. It is the biggest clue you have. If she went through it early, you are more likely to follow suit.

Its not an exact science but a good indication. The earlier you know, the better prepared you can be.

A good friend of mine, Zoe Hardman, recently shared her experience of facing the menopause at just 37 with Fabulous. It was only when her older sister discovered that she was menopausal aged just 34, while trying to get pregnant that they spoke to their mum and discovered that she had been through early menopause.

After openly talking about it she said she received so many messages from other women in similar situations, women who shared the shame they had felt.

No woman should feel any shame about facing menopause, whatever her age.

Its so important we all speak about it, to break the taboo and destigmatise something that is completely natural and happens to every woman.

Shame and stigma can be a barrier to women getting the right support and the right treatment. If you are under the age of 45 and start to notice you are suffering with symptoms you think are linked to menopause, it is really important you speak to your doctor.

Appointments with your GP are a partnership. We might have the knowledge but YOU know how you feel. You know when something is not right.

The important thing is to be straight with us. Dont just come in, describe your symptoms and leave it hanging. If you think you are suffering menopausal symptoms, tell us.

Unfortunately, the signs and symptoms of perimenopause and menopause are very similar to lots of other common conditions that affect women in their late thirties and early forties.

Gut feeling

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Life was hell but our GPs didnt believe we had started menopause in our 40s - The Sun

Stars who have frozen their eggs – Nicki Swift

Olivia Munn opened up about freezing her eggs during an interview for the Anna Faris is Unqualified podcast in 2016, saying that she did it because her friend found out she "had the egg count of a 50-something-year-old woman." Munn decided to visit a doctor herself, and while she was told she has "a lot of eggs," she was also told that she might as well freeze some of them so that she would always have them available.

The star also talked about turning 35, saying that's when "you're high risk." However, "many doctors are quick to discount the belief that age 35 always and instantly draws a line between a healthy pregnancy and a high-risk one," according to Self. Indeed, Sarah J. Kilpatrick, M.D., Ph.D., chair of the department of obstetrics and gynecology at Cedars-Sinai, told Self, "I would never tell someone that just because she's 35 she has to see a high-risk doctor only if there's something in her history or something that happened during her pregnancy that warrants it."

That may be true, but Munn clearly still feels confident in her decision. "I think that every girl should do it. ... [For] one, you don't have to race the clock anymore. You don't have to worry about it," she told the former Mom star and podcast host. "Doomsday is now like 'whatevers day,' because I am prepared."

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Stars who have frozen their eggs - Nicki Swift

Breast Cancer Awareness 2020: Carol Keton Parsons: Testing and support are key – The Salem News

Name: Carol Keton Parsons

Age: 79

Hometown: Born in Manchester-by-the-Sea, grew up and currently lives in Gloucester

Background: Married with three daughters, graduated from Gloucester High School and took psychology courses at North Shore Community College in Danvers, grew up at Hillcrest Nursing Home as her parents owned the facility, is a Daughter of the American Revolution, loves the local museums and library.

Favorite childhood memory: My grandmother lived on Centennial Avenue, and she would make homemade old-fashioned doughnuts. I can still see her standing there making doughnuts.

Experience with breast cancer: When Parsons felt a lump in her breast while taking a shower at the age of 69, she knew something was not right. That same week, she went to a cancer clinic, where an ultrasound confirmed her fear. The doctors diagnosed her with invasive ductal triple-negative breast cancer.

All breast cancer is serious, but they said this was an aggressive kind of cancer where you dont live very long, Parsons said.

A doctor in Gloucester suggested that Parsons pursue chemotherapy, which she ended up doing every other day for three weeks.

After finishing up her chemo treatment, Parsons was given radiation treatment at Massachusetts General Hospital and had a lumpectomy to remove the cancer from her breasts.

The Gloucester resident is now 10 years cancer-free.

What she wants people to know: First, older women should get tested. A lot of women who are my age dont think they can get it, she said.

Secondly, go to the support meetings for those who have breast cancer. For Parsons, the bond with other women who have or had breast cancer is a strong one. When she would see other women in head scarves, she would go up and hug them.

When you have breast cancer, it is like a bond, she said. Everyone hugs everyone.

What Is triple-negative breast cancer?

Triple-negative breast cancer is a kind of breast cancer that does not have any of the receptors that are commonly found in breast cancer.

Think of cancer cells as a house. The front door may have three kinds of locks, called receptors.

One is for the female hormone estrogen.

One is for the female hormone progesterone.

One is a protein called human epidermal growth factor (HER2).

If an individuals cancer has any of these three locks, doctors have a few keys (like hormone therapy or other drugs) they can use to help destroy the cancer cells.

But for those people who have triple-negative breast cancer, it means those three locks arent there. So the keys doctors usually use wont work. But chemotherapy is still an effective option.

Often, patients first need to have the lump removed (a lumpectomy) or the entire breast removed (a mastectomy). Then, they have chemotherapy treatments to target any cancer cells that cant be seen cells remaining in the breast or that may have spread into other parts of the body. Sometimes doctors recommend chemotherapy before surgery to shrink the cancer.

Source: Centers for Disease Control and Prevention

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Breast Cancer Awareness 2020: Carol Keton Parsons: Testing and support are key - The Salem News

Not just a survivor a ‘thriver’ – Record Herald

Girls Night Out is an annual breast cancer education event for women hosted by Fayette County Memorial Hospital (FCMH) and Tanger Outlets Jeffersonville, and recently a previous honoree and breast cancer thriver, Dianna Hawes, shared her story.

Although a local breast cancer fighter or survivor is honored each year, this year the event was unable to occur due to the pandemic. Dianna was honored in 2018. All attendees that year released pink balloons to lift Dianna up in her journey.

Diannas story was shared with the R-H from FCMH as a testimony to the impact Girls Night Out has on its honorees and the relationships and support groups that are built out of the event.

In addition to the impacts the event has on the honorees and relationships between participants, it includes breast cancer education. Participants in the Girls Night Out can visit displays from local businesses and get health education information from FCMH and FCMH partners.

Diannas story:

My name is Dianna Hawes, and I am a breast cancer thriver.

Theres a lot of discussion around being called survivors versus thrivers. I personally prefer the latter. Why? Because cancer has not defined me because cancer is lowercase in my life because cancer was a valley to be crossed and not a mountain range to be abandoned.

But how do I use this aggressive adjective so confidently? Because of the broad support of both friends, family and strangers.

You see, I had made a big decision the day before the 2018 Girls Night Out Breast Cancer event. A decision that was met with great opposition from my husband and close friends.

I had decided that after three chemo treatments, I was done.

It was too much, I said.

I knew God was present in the deepest part of the valleys, but I felt weak and defeated.

In May of 2018, I had my annual mammogram. Having hardly ever gone to a doctor for any reason, I was stopped in my tracks when I was told I needed to return for further testing. Next was the biopsy, and at last, the diagnosis. Triple positive breast cancer rare and aggressive.

A very small tumor probably not in lymph nodes, along my chest wall and couldnt be felt.

Choices had to be made. Lumpectomy or mastectomy? Keep surgeon or get another opinion? Genetic testing or take a big guess?

After genetic testing showed only one possible issue and three second opinions, a lumpectomy it was. I was told I probably would just need radiation afterwards.

But when my best friend greeted me as I awoke from surgery, I knew things had changed. There were cancer cells in my lymph nodes the game changer.

Four types of chemotherapy every three weeks, then six weeks of radiation. So again, another very important choice whether or not to put on my big girl panties and do what needed to be done, or to crawl into the nearest hole and deny the inevitable.

I guess, in hindsight, there wasnt much of a choice. My family and friends seemed to take that away from me, and the treatment began late summer.

I continued to work off and on throughout it all, and I found this to be a source of strength of sorts. My co-workers were amazing in their support.

Sometimes it appeared those around me were fighting harder than I was for myself. Chemo places you in a very wonky place.

People would ask how I was feeling. The only word that made sense was wonky. During the lowest days and nights, I could do nothing but whisper the name of Jesus. But this was enough. His presence was overwhelming, and I pursued the goal.

But after the third treatment and stuff going on in the family, I lost my steam my will. But I had been given the incredible opportunity to be honored at the Girls Night Out event. So I put my big girl panties back on and went. Little did I know, it was a God appointment that He scheduled and planned.

During the event, one stranger after another approached me. Most were thrivers, some of 2 years and others as much as 32 years.

They were not only encouraging me to thrive, they were also offering to drive me to treatments, to provide my family with meals, to share hats with me and more. Strangers yesterday, sister thrivers that day.

You see, I had to keep going. I had to do it for me, for them, for those who would follow me. I had to do more than survive. I HAD TO THRIVE and live life abundantly.

That event was the real game changer, and I will always be grateful for those who chose me to be honored.

Dianna was not the first nor will she be the last to be diagnosed with breast cancer in Fayette County. Breast cancer is the second most prevalent type of cancer seen in Fayette County. Nationwide, one in eight women will be diagnosed with breast cancer in her lifetime.

Likewise, it is the second most prevalent type of cancer that is being treated at the FCMH Cancer Care Clinic even though the clinic has only been open about a year.

The clinic is in collaboration with Adena Health System and Dr. Shylaja Mani, and is now able to provide chemotherapy, immunotherapy and hormone therapy. Residents no longer have to leave the county to receive these vital treatments.

Early detection through regular mammograms is key to fighting breast cancer. The National Breast Cancer Foundation reports that 64 percent of cases are diagnosed at a localized stage meaning there is no sign that cancer has spread outside the breast. When this early diagnosis is made, the five-year survival rate is 99 percent.

In conjunction with the FCMH Womens Wellness Center providers Emily Stephens, CNP and Dr. Loliya Idoniboye and the FCMH radiologist Dr. Michael Barrows, the FCMH team is here to support patients from diagnosis through treatment.

Local breast cancer thriver and 2018 Girls Night Out honoree Dianna Hawes.

Dianna Hawes shares her experiences with breast cancer

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Not just a survivor a 'thriver' - Record Herald

Puma’s Positive Neratinib Data, And Other News: The Good, Bad Ugly Of Biopharma – Seeking Alpha

Puma Biotechnology reports positive Neratinib Phase III data

Puma Biotechnology Inc. (PBYI) reported efficacy data for neratinib from the Phase III ExteNET trial. The study involved patients with HER2-positive, hormone receptor-positive (HR+), early-stage breast cancer. The primary endpoint of the trial was invasive disease-free survival. The key secondary endpoint was overall survival. The drug candidate is already approved in the European Union for patients with HR+ breast cancer who initiated treatment within one year of completing an adjuvant trastuzumab-containing regimen.

ExteNET was a multicenter, randomized, double-blind study. It involved 2,840 patients with HER2-positive eBC who were given neratinib after neoadjuvant and/or adjuvant therapy with chemotherapy and trastuzumab. The patients were classified according to their hormone receptor status. The patients were then randomized to be administered either oral neratinib 240 mg/day or placebo for a year.

The data showed that for the HR+ /< 1-year patient population, the absolute 5-year invasive disease-free survival benefit versus placebo was 5.1 percent. The absolute 8-year overall survival benefit was reported to be 2.1 percent. The 5-year cumulative incidence of CNS metastases was at 0.7 percent in the neratinib arm and 2.1 percent in the placebo arm. For the HR+/ <1 year, no pCR subgroup of patients that were at a high risk of disease recurrence, the absolute 5-year iDFS benefit in the neratinib cohort versus placebo was found to be 7.4 percent.

Professor Arlene Chan, Vice Chair Breast Cancer Research Centre - WA, said, This newly published study provides consistent and durable benefits of neratinib in a subset of HER2-positive early stage breast cancer patients who are considered to be at greater risk of relapse: namely patients with HR+ tumors that did not achieve a pCR after neoadjuvant treatment (no pCR). The benefits demonstrated are meaningful in all endpoints evaluated, including iDFS, OS and CNS recurrence, and thus should help guide future clinical decisions.

The data showed that the most common grade 3 adverse events included diarrhea, vomiting and fatigue.

Puma Biotechnology is a biopharmaceutical company. It is mainly engaged in developing and commercializing products in the cancer segment. The company in-licenses the global development and commercialization rights to PB272, the oral neratinib, as well as to PB272 and PB357. PB272 also goes by the name of intravenous neratinib. The oral version of the drug was approved by the FDA for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, following adjuvant trastuzumab-based therapy in 2017. It is marketed in the United States market under the brand name of NERLYNX in the tablet form.

NERLYNX was given further approval for treating adult patients with advanced or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2-based regimens in the metastatic setting in February 2020. For this indication, the drug had been approved to be used in combination with capecitabine. The drug has been given marketing authorization by the European Commission for specified conditions.

Investment Thesis: The stock has remained steady in the recent past, making it suitable for even conservative long-term portfolios. The latest news and the upcoming catalysts are expected to provide a positive fillip to the stock price.

Y-mAbs Therapeutics Inc. (YMAB) reported that the FDA has delivered a Refusal to File letter with regard to its Biologics License Application for omburtamab for the treatment of pediatric patients with CNS/leptomeningeal metastasis from neuroblastoma. The BLA was submitted in August, 2020.

The letter states that the FDA requires further details pertaining certain parts of the Chemistry, Manufacturing and Control module and the Clinical module. However, the regulator has not requested or required any additional non-clinical data. The company stated that it is confident about addressing all points raised by the FDA. It also believes that it can provide the requested additional CMC information.

Y-mAbs plans to submit supplementary data from Study 101. This data includes tumor response data from patients with evaluable disease among the first 24 patients included in the protocol. The company intends to request a Type A meeting with the FDA. It is also looking to work with the FDA to make appropriate amendments to the BLA. Y-mAbs intends to file the reworked BLA before the end of this year.

Y-mAbs is a late-stage clinical biopharmaceutical company. It is mainly focused on developing and commercializing novel, antibody-based therapeutic products for treating cancer. The company has robust development pipeline with two pivotal-stage drug candidates. Out of these, naxitamab is designed to target tumors which express GD2, while omburtamab targets tumors expressing B7-H3.

Despite this setback, the company also reported a positive news, as its leading bispecific antibody program nivatrotamab for the treatment of neuroblastoma was granted Rare Pediatric Disease Designation and Orphan Drug Designation by the FDA.

Investment Thesis: The stock is currently trading close to its highs. Coupled with the latest setback, it is advisable to watch this stock for further development and some meaningful pullback in the price.

Halozyme Therapeutics Inc. (HALO) announced that it has expanded its collaboration and licensing agreement with Argenx. The collaboration deals with the companys Enhanze technology, and the original agreement was signed in February 2019.

The new terms of the agreement provide for Argenx to have an exclusive access to Halozymes Enhanze drug delivery technology for three more targets. The company now can name up to six targets under this collaboration. Dr. Helen Torley, president and chief executive officer of Halozyme, Argenx has made rapid progress in the clinic with efgartigimod utilizing ENHANZE since signing the original agreement, moving to a Phase 2 study initiation for an indication being developed only as SC, within just fourteen months.

So far, Argenx has named two targets for this program. These are human neonatal Fc receptor FcRn and complement component C2. The company can access Enhanze for its FcRn antagonist efgartigimod, its late-stage development for several severe autoimmune diseases.

Halozyme is a biopharmaceutical company. Its Enhanze technology is designed to make various treatments more efficient and time-effective. The technology is based on its proprietary enzyme, rHuPH20. It is mainly used for effectual delivery of injected drugs and fluids with the aim of reducing overall treatment burden. The company has licensed this technology to a number of major biotech and pharma companies, including Alexion (ALXN), Lilly (LLY), Janssen (JNJ) and Pfizer (PFE), among others. Its revenue stream consists of royalties and milestone payments received from such collaborations.

Investment Thesis: The company has strong potential ahead with its robust collaboration framework. However, the stock is currently trading at highs and may see some correction in the near future, providing an opportunity to build a position.

Thanks for reading. At the Total Pharma Tracker, we do more than follow biotech news. Using our IOMachine, our team of analysts work to be ahead of the curve.

That means that when the catalyst comes that will make or break a stock, weve positioned ourselves for success. And we share that positioning and all the analysis behind it with our members.

Disclosure: I/we have no positions in any stocks mentioned, and no plans to initiate any positions within the next 72 hours. I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

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Puma's Positive Neratinib Data, And Other News: The Good, Bad Ugly Of Biopharma - Seeking Alpha

WingNuts Express opens in Magnolia and more Houston-area news – Community Impact Newspaper

The eatery specializes in double-fried chicken wing dishes served with a variety of sauces, including buffalo, mango habanero and garlic Parmesan, among others. (Courtesy WingNuts Express)

Read the latest business and community news from the Houston area.


WingNuts Express now open on Tamina Road in Magnolia

Magnolia's latest wing eatery, WingNuts Express, opened on Tamina Road on Oct. 3, according to a Facebook post from the restaurant.

Sugar Land-Missouri City

Child Advocates of Fort Bend, partners open clinic for child victims of sexual abuse

Child Advocates of Fort Bend, along with AccessHealth and the Harris Health System, opened a medical clinic dedicated to child victims of sexual abuse Oct. 1, according to a CAFB press release.


ROUNDUP: 8 businesses, restaurants that recently opened in Spring, Klein

Twisted Sisters Nutrition Shack, Fajita Pete's and Cavender's Boot City are just a few of the businesses that have recently opened in the Spring and Klein area.

Wingstop now open on Spring Cypress Road

Wingstop opened a new location at 8675 Spring Cypress Road, Ste. 37B, Spring, on Oct. 8. Known for its 11 different flavors of classic wings, boneless wings and crispy tenders, the new location offers carryout and delivery services from 10:30 a.m.-midnight daily.


A Thousand Oaks Events & Retreats venue opening this month in Cypress

A new wedding and event venue, A Thousand Oaks Events & Retreats, is holding an open house Oct. 22 from 4-8 p.m. at 17011 Steinhagen Road, Cypress, to celebrate its grand opening.

Trattoria Pizza & Pasta offers Italian classics, family recipes on Cypresswood Drive

Elderin Berisha said his primary goal at Trattoria Pizza & Pasta is making customers feel at home.

If you come here on a Friday or a Saturday night, youll see all the customers know us, he said. We know their names; we talk to them; we sit with them. Its like a family. I want to try to make you comfortable when you come here. We know what you order, and we pay attention to the details.

Millennium Physicians opens new medical office in Cypress

Officials with Millennium Physicians announced the opening of a new office offering medical oncology and hematology, rheumatology and infusion services.

Heights-River Oaks-Montrose

Houston leaders react to death of transgender advocate Monica Roberts

Local leaders have joined human rights and LGBTQ organizations across the nation reacting to the loss of one of Houston's leading transgender rights advocates, Monica Roberts, who died this week.

DACAMERA chamber and jazz presenters announce virtual performance schedule

Chamber and jazz performance organizer DACAMERA announced its fall schedule Oct. 6, including a new collaboration with The Menil Collection.

Robot Noodle takes over Blackbird Izakaya spot in the Heights

Robot Noodle, a new restaurant by Delicious Concepts Group, has opened at 1221 W. 11th St., Houston, taking over the former space of Blackbird Izakaya, the group announced Oct. 7.


Pearland's StrongFound Personal Training stays successful pivoting during pandemic

StrongFound Personal Training sets itself apart with its target demographic: those who are 40 years old or older.

Lake Houston-Humble-Kingwood

Millennium Physicians Internal Medicine group opens new Kingwood office

Millennium Physicians Internal Medicine group opened a new office July 15 at 22698 Professional Drive, Ste. 100, Kingwood. Internal medicine physicians Dr. Salvador Recio and Dr. Carmen Perez will be offering a variety of services at this location, including weight-loss assistance, diabetes management, well women exams, allergy testing and hormone pellet replacement.

Kelly Schafler, Emma Whalen, Adriana Rezal, Claire Shoop, Hannah Zedaker, Danica Lloyd, Matt Dulin and Haley Morrison contributed to this report.

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WingNuts Express opens in Magnolia and more Houston-area news - Community Impact Newspaper

Gender clinic offers ‘fairytale’ promises to children over transitioning, court hears –

A transgender clinic offers "fairytale" promises to children because they are unable to give their consent to the sex-change process, the High Court has heard.

The case has been brought by 23-year-old Keira Bell, who began treatment to become a boy at 16 before later "de-transitioning", and "Mrs A", the unnamed mother of a 16-year-old girl who is on the waiting list to change gender.

They claim anyone aged 18 and under should only be prescribed hormone blockers which delay the onset of puberty with court supervision in place. Their legal action is against the Tavistock and Portman NHS Trust, which runs the country's only gender identity clinic for children.

Lawyers representing Keira Bell and "Mrs A" whose child is currently on the waiting list for treatment at the service argue that children going through puberty are "not capable of properly understanding the nature and effects of hormone blockers".

They arguethere is "a very high likelihood"children who start taking hormone blockers will later begin taking cross-sex hormones, which they say cause "irreversible changes".

Ms Bell and "Mrs A" are asking the High Court to rule it unlawful for children who wish to undergo gender reassignment to be prescribed hormone blockers without an order from the court that such treatment is in their "best interests".

At a hearing in London on Wednesday, the pair's barrister, Jeremy Hyam QC, said: "The use of hormone blockers to address gender dysphoria does not have any adequate base to support it."

He said it was "simply a fairytale" to think children of 13 or under can give informed consent to receive hormone blockers to delay puberty, adding that "a child who can't consent to any sexual activitycan't possibly give consent" to this treatment.

"We can't accept there can be an age appropriate discussion of the experiences a child has no experience of. It's just an affront to common sense to think that person is giving consent to that process," Mr Hyam said.

Children cannot properly understand the "lifelong medical, psychological and emotional implications" of taking "experimental" puberty blockers and cross-sex hormones, he told the court.

He said "the effect of hormone blockers on the intensity, duration and outcome of adolescent development is largely unknown", adding: "There is evidence that hormone blockers can have significant side-effects, including loss of fertility and sexual function and decreased bone density."

In written submissions, Mr Hyam said: "That children are not capable of giving informed consent to undergo a type of medical intervention about which the evidence base is poor, the risks and potential side-effects are still largely unknown, and which is likely to set them on a path towards permanent and life-altering physical, psychological, emotional and developmental consequences... is the common sense and obvious position."

The barrister told the courtreferrals to the NHS Gender Identity Development Service (Gids) had risen from 97 in 2009 to 2,590 in 2018, "essentially a 20-fold increase".

In a witness statement before the court, Ms Bell added: "I made a brash decision as a teenager, as a lot of teenagers do, trying to find confidence and happiness, except now the rest of my life will be negatively affected. Transition was a very temporary, superficial fix for a very complex identity issue."

However, Fenella Morris QC, representing the Tavistock and Portman NHS Trust, said the contention that children could not give informed consent to being prescribed hormone blockers was "a radical proposition".

She argued in written submissions that the claimants sought to "impose a blanket exclusion" on children under the age of 18 to be able to consent to medical treatment.

Ms Morris added the majority of children referred to Gids between March 2019 and 2020 were aged over 12, with only 13 of those referred being under the age of 13.

She argued that hormone blockers "had been widely researched and debated for three decades", adding: "It is a safe and reversible treatment with a well-established history."

Ms Morris also said the Tavistock and Portman NHS Trust referred children and young people experiencing gender dysphoria to University College London Hospitals NHS Foundation Trust or Leeds Teaching Hospital NHS Trust.

She told the court: "One cannot make a global statement that any child of any particular age is incapable of understanding these particular matters" as she reiterated "the importance of individual assessment".

She said those two trusts, not the Tavistock and Portman NHS Trust, were "responsible" for prescribing hormone blockers to children with gender dysphoria.

Lawyers representing London Hospitals NHS Foundation Trust and Leeds Teaching Hospital NHS Trust are expected to address the court on Thursday.

The hearing before Dame Victoria Sharp, Mr Justice Lewis and Mrs Justice Lieven is expected to last two days, and it is expected that the court will reserve its judgment to a later date.

The hearing continues.

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Gender clinic offers 'fairytale' promises to children over transitioning, court hears -

Puberty-blocking treatment for children ‘provides time and is reversible’, High Court hears – Sky News

Puberty-blocking treatment for children who are considering swapping gender provides time for deliberation and discussion and is reversible, the High Court has been told.

A 23-year-old woman who began taking puberty blockers when she was a teenager before "detransitioning" and the mother of an autistic girl are suing the UK's only gender identity development service (GIDS) for children.

However lawyers for the Tavistock and Portman NHS Trust, which runs the service, has defended hormone treatment which is given to children as young as 10.

The case has been brought against the country's only gender identity clinic for children by two claimants - the mother of a 16-year-old on the waiting list for treatment and Keira Bell who transitioned to a boy in her teens but has since stopped taking testosterone.

Lawyers representing the pair argue that children going through puberty are "not capable of properly understanding the nature and effects of hormone blockers".

They are asking the High Court to rule it is unlawful for children who wish to undergo gender reassignment to be prescribed hormone blockers without an order from the court that such treatment is in their "best interests".

Fenella Morris QC, representing the Tavistock and Portman NHS Trust which runs the service, said every consent decision involves explaining to each child the consequences of their decision in the future.

She added that it is up to clinicians to make sure they understand and if that child is deemed unable to grasp the consequences, they will not be given the puberty-blockers until that child's "understanding of themselves and the world grows".

The court previously heard that referrals to GIDS had risen from 97 in 2009 to 2,590 in 2018, "essentially a 20-fold increase".

Lawyers for the hospitals which prescribe the treatment told the court how a 10-year-old could begin taking puberty-blockers and go on to "mature and have further life experiences".

At 14 or 15 they could stop taking the treatment to enable them to have eggs harvested in case they decided to have children later, they added.

They went on to say that a child of 10 can "understand their body and the changes of their body" and can have "gender dysphoria which is causing them distress".

The court heard there is no alternative treatment to the hormone blockers.

Keira was 16 when she began taking the puberty-blocking drugs and the following year began taking the cross-sex hormone testosterone, before have a double mastectomy at the age of 20.

She told Sky News that once on hormone blockers "it's hard to get off because you are already on a medical pathway and even at that point you feel that you cannot turn back".

"I was completely convinced the physical transition and medical transition was what I wanted to do.

"I was so distressed at the time and I fit the criteria I thought it would change my life for the better."

She now describes that as a "brash decision".

On Wednesday, Ms Morris QC told the court the contention that children could not give informed consent to being prescribed hormone blockers was "a radical proposition".

She argued in written submissions that the claimants sought to "impose a blanket exclusion" on children under the age of 18 to be able to consent to medical treatment.

Ms Morris added the majority of children referred to GIDS between March 2019 and 2020 were over 12, with only 13 of the children referred being under the age of 13.

The hearing before Dame Victoria Sharp, Mr Justice Lewis and Mrs Justice Lieven is in its second and final day.

It is expected that the court will reserve its judgment to a later date.

Lui Asquith, legal and policy director for the charity Mermaids, which supports transgender children, said: "If this case were successful, it would prevent trans young people from being able to take their own medical advice, heralding a new era of minority discrimination in England and Wales."

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Puberty-blocking treatment for children 'provides time and is reversible', High Court hears - Sky News

Opposing Trial Results on CDK Inhibitors Means Good Science – Medscape

This transcript has been edited for clarity.

Hi. It's Dr Kathy Miller from Indiana University. I just finished a phenomenal science weekend at the European Society for Medical Oncology (ESMO) virtual congress, and I want to share some of the breast cancer data with you.

I remember being taught early in my career that a hallmark of good science, whether it's conducted in a laboratory or in the clinic, is that it forces you to ask more questions than it answers. And if that is the case, we saw some really good science this weekend. I want to review two sets of studies with you that have seemingly similar study designs but came to dramatically different conclusions.

First, let's think about the cyclin-dependent kinase (CDK) inhibitors in the adjuvant setting.

We saw the results of the PALLAS trial that studied over 4000 largely stage II and III patients (about 1000 had stage IIA disease, so lymph nodenegative patients were allowed to enroll) who were randomized to 2 years of palbociclib or not. It was stopped for futility at the second interim analysis. To be clear, the study was not stopped, but the data monitoring committee suggested that all patients still on palbociclib should stop therapy and enter follow-up. Those patients, along with those who had already finished the 2 years of therapy, will be followed for at least the next 10-15 years. But there was no suggestion of benefit in the overall trial results and no suggestion of any clinical subset that might benefit, including a high-risk subset about 59% of patients who would have met the high-risk definition in the monarchE trial.

Now, let's contrast that with the monarchE results. It was a very similar study design, with over 5000 high-risk patients (stage IIA, lymph nodenegative patients were not eligible) randomized to 2 years of abemaciclib or not. There was earlier follow-up of only about 15 months, but it was a positive trial nonetheless, with about a 3%-3.5% improvement in invasive disease-free survival and distant recurrence-free survival.

How could these two drugs that look so similar in the metastatic setting have given such different results in the adjuvant setting? There are quite a number of potential reasons:

It could be pure chance. Any study, no matter how many zeros in the P value, could be simply the play of chance. And that is true for negative and positive studies.

It could be that the study design was wrong. Remember, these are agents that we think of as reversing endocrine resistance and extending the benefit of hormone therapy. And yet we looked at very early results. These are early recurrences, the sort of recurrences we typically think of as being affected by chemotherapy and less affected by hormone therapy. Perhaps the study design was just wrong for palbociclib.

Even though these drugs were designed to inhibit CDK4/6, their relative potency for those two CDK inhibitors, as well as the other activity of those drugs, clearly differ. In a metastatic setting, that did not seem to affect effectiveness, but it clearly affected the toxicity profile. Perhaps in the adjuvant setting, those differences really do drive differences in efficacy.

Perhaps this is an issue of drug exposure. About 40% of patients in the PALLAS trial with palbociclib stopped therapy before completing the full 2 years of treatment, largely driven by protocol-defined toxicity, but not entirely. That compares with only about 16% of patients in the abemaciclib trial.

We also need to think more carefully about the regions of the world where these trials were done. The PALLAS trial was almost entirely done in high-resourced, well-developed countries with well-established medical systems. The monarchE trial had a little bit greater diversity of countries. It included some low-resource countries, so perhaps this represents a difference in the number of patients with very high-risk multiple nodepositive disease who underwent extensive staging. And though some of the patients in the monarchE trial had clinically occult but present metastatic disease, this represents simply treatment of early metastasis.

I have no answers for why these two trials are different. It's going to take a lot more data and a lot more time to understand this. But it sure does make you think, and that is clearly a hallmark of good work. Congratulations to the authors of both of these studies. I look forward to your thoughts.

Kathy D. Miller, MD, is associate director of clinical research and co-director of the breast cancer program at the Melvin and Bren Simon Cancer Center at Indiana University. Her career has combined both laboratory and clinical research in breast cancer.

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New Nonhormonal Hot Flash Treatments on the Way – Medscape

A new group of nonhormonal drugs currently in clinical trials shows strong promise for treating menopausal hot flashes as effectively as hormones, researchers told attendees at the virtual North American Menopause Society (NAMS) 2020 Annual Meeting.

"The [kisspeptin/neurokinin B/dynorphin (KNDy)] neuron manipulation is really exciting and holds great promise for rapid and highly effective amelioration of hot flashes, up to 80%, and improvement in other menopausal symptoms, though we're still looking at the safety in phase 3 trials," reported Susan D. Reed, MD, MPH, director of the Women's Reproductive Health Research Program at the University of Washington in Seattle.

"If we continue to see good safety data, these are going to be the greatest things since sliced bread," Reed told Medscape Medical News in an interview. "I don't think we've seen anything like this in menopause therapeutics in a long time."

While several nonhormonal drugs are already used to treat vasomotor symptoms in menopausal women with and without breast cancer, none are as effective as hormone treatments.

"For now, the SSRIs, SNRIs and GABAergics are the best frontline nonhormonal options with a moderate effect, and clonidine and oxybutynin are effective, but we see more side effects with these," Reed said. She noted the importance of considering patients' mood, sleep, pain, sexual function, weight gain, overactive bladder, blood pressure, and individual quality of life (QOL) goals in tailoring those therapies.

But women still need more nonhormonal options that are at least as effective as hormonal options, Reed said. Some women are unable to take hormonal options because they are at risk for blood clots or breast cancer.

"Then there's preference," she said. "Sometimes people don't like the way they feel when they take hormones, or they just don't want hormones in their body. It's absolutely critical to have these options available for women."

Nanette F. Santoro, MD, a professor of OB/GYN at the University of Colorado Anschutz Medical Campus in Denver, who was not involved in the presentation, told Medscape Medical News that physicians may not always realize the extent to which vasomotor symptoms interfere with women's daily lives.

"They have an eroding effect on QOLthat is not appreciated sometimes," she said. Though hot flashes eventually subside in most women, others may continue to experience them into their 70s, when hormonal therapies can begin causing more harm than benefit.

"It goes under-appreciated that for a proportion of women, hot flashes will never go away, and they're just as bad [as] when they were in their 50s," Santoro said. "They need to be treated, and the non-hormonal treatments do not work for everybody."

Autopsy studies of postmenopausal women revealed that a complex of neurons in the hypothalamus was "massively hypertrophied" and sits right next to the thermoregulatory center of the brain, Reed explained.

The complex produces three types of molecules: kisspeptin (a neuropeptide), neurokinin B (a neuropeptide), and dynorphin (a kappa opioid), collectively referred to as the KNDy. The KNDy neural complex is located in the same place as the majority of hormone receptors in the arcuate nucleus, a collection of nerve cells in the hypothalamus.

The current hypothesis is that the KNDy neurons, which communicate with each other, become hyperactivated and cause hot flashes by spilling over to and triggering the thermoregulatory center next door. NKB (kisspeptin and neurokinin B) agonists activate KNDy neurons and dynorphin agonists inactivate KNDy, so the expectation is that NKB antagonists or dynorphin agonists would stop hot flashes.

Indeed, research published in 2015 showed that women taking agonists experienced fewer hot flashes than women in the placebo group. However, no peripherally restricted agonists are currently in clinical trials, so their future as therapeutics is unclear.

Right now, three different NK antagonists are in the pipeline for reducing vasomotor symptoms: MLE 4901 (pavinetant) and ESN364 (fezolinetant) are both NK3R antagonists, and NT-814 is a dual NK1R/NK3R antagonist. All three of these drugs were originally developed to treat schizophrenia.

Phase 2 clinical trials of pavinetant were discontinued in November 2017 by Millendo Therapeutics because three of 28 women experienced abnormal liver function, which normalized within 90 days. However, the study had shown an 80% decrease in hot flashes in women taking pavinetant compared with a 30% decrease in the placebo group.

Fezolinetant, currently in phase 3 trials with Astellas, showed a dose response effect on reproductive hormones in phase 1 studies and a short half-life (4-6 hours) in women. It also showed no concerning side effects.

"There was, in fact, a decrease in the endometrial thickness, a delayed or impeded ovulation and a prolonged cycle duration," Reed said.

The subsequent phase 2a study showed a reduction of five hot flashes a day (93% decrease) compared with placebo (54% decrease, P <.001) "with an abrupt return to baseline hot flash frequency after cessation," she said. Improvements also occurred in sleep quality, quality of life, disability, and interference of hot flashes in daily life.

The phase 2b study found no difference in effects between once-daily vs twice-daily doses. However, two severe adverse events occurred: a drug-induced liver injury in one woman and cholelithiasis in another, both on the 60-mg, once-daily dose. Additionally, five women on varying doses had transient increases (above 1000 U/L) in creatinine kinase, though apparently without dose response.

A 52-week, three-arm phase 3 trial of fezolinetant is currently under way with a goal of enrolling 1740 participants, and plans to be completed by December 2021. Participants will undergo regular adverse event screening first biweekly, then monthly, with vital signs, blood, and urine monitoring.

Meanwhile, NT-814 from KaNDy Therapeutics, has completed phase 2a and phase 2b trials with phase 3 slated to begin in 2021. Adverse events in phase 1 included sleepiness and headache, and it had a long half-life (about 26 hours) and rapid absorption (an hour).

The phase 2a trial found a reduction of five hot flashes a day compared with placebo, with main side effects again being sleepiness and headache. No events of abnormal liver function occurred. Phase 2b results have not been published.

So far, existing research suggests that KNDy interventions will involve a single daily oral dose that begins taking effect within 3 days and is fully in effect within 1 to 2 weeks. The reduction in hot flashes, about five fewer a day, is more effective than any other currently used nonhormonal medications for vasomotor symptoms. SSRIs and SNRIs tend to result in 1.5-2 fewer hot flashes a day, and gabapentin results in about three fewer per day. It will take longer-term studies, however, and paying attention to liver concerns for the NK3R antagonists to move into clinic.

"We want to keep our eye on the [luteinizing hormone]because if it decreases too much, it could adversely affect sexual function, and this does appear to be a dose-response finding," Reed said. It would also be ideal, she said, to target only the KNDy neurons with NK3 antagonists without effects on the NK3 receptors in the liver.

Oxybutynin is another a nonhormonal agent under investigation for vasomotor symptoms. It's an anticholinergic that resulted in 80% fewer hot flashescompared with 30% with placeboin a 2016 trial, but 52% of women complained of dry mouth. A more recent study similarly found high efficacy a 60%-80% drop in hot flashes compared with 30% with placebo but also side effects of dry mouth, difficulty urinating, and abdominal pain.

Finally, Reed mentioned three other agents under investigation as possible nonhormonal therapeutics, though she has little information about them. They include MT-8554 by Mitsubishi Tanabe, FP-101 by Fervent Pharmaceuticals, and Q-122 by QUE Oncology with Emory University and the University of Queensland.

None of the currently available nonhormonal options provide as high efficacy as hormones, but they do reduce symptoms:

Clonidine is an off-label option some physicians already use as a nonhormonal treatment for vasomotor symptoms, but again, the side effects are problematic: dry mouth, constipation, drowsiness, postural hypotension, and poor sleep.

Paroxetine, at 7.5-10 mg, is the only FDA-approved nonhormonal treatment for vasomotor symptoms, but she listed other off-label options found effective in evidence reviews: gabapentin (100-2400 mg), venlafaxine (37.5-75 mg), citalopram (10 mg), desvenlafaxine (150 mg), and escitalopram (10 mg).

"I want you to take note of the lower doses in all of these products that are efficacious above those doses that might be used for mood," Reed added.

Reed receives royalties from UpToDate and research funding from Bayer. Santoro owns stock in MenoGeniX and serves as a consultant or advisor to Ansh Labs, MenoGeniX, and Ogeda/Astellas.

Follow Medscape on Twitter @Medscape and Journalist Name @tarahaelle.

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‘It’s safe to attend breast screening’ – NW Evening Mail

WOMEN are being assured it is safe to attend breast screening services in South Cumbria.

The risk increases with age, which is why all people between the ages of 50 to 70 who have breasts, due to either naturally occurring oestrogen or oestrogen hormone therapy are invited for screening every three years.

Breast cancer can affect anyone with breasts, so some trans or non-binary people are also eligible for screening talk to your GP or Gender Identity Clinic about this.

Breast screening aims to find breast cancers early. In the meantime, if youre worried about breast cancer symptoms such as a lump or an area of thickened tissue in the breast, or you notice that your breasts look or feel different, do not wait to be offered a screening appointment, talk to your GP.

Georgia Argent, programme lead at University Hospitals of Morecambe Bay NHS Foundation Trust said: Breast screening involves having an X-ray (mammogram) at a special clinic or mobile breast screening unit. You will have the chance to talk about any problems or concerns you have. As you will need to undress to the waist, it may be easier to wear trousers or a skirt rather than a dress.

Usually two X-rays of each breast are taken one from above and one from the side. A plastic plate will be gently but firmly pressed onto your breast so that they can get clear pictures. The X-ray test can spot cancers when theyre too small to see or feel.

The mammogram will be checked for any abnormalities, and the results will be sent to you and your GP within two weeks.

Dr Neil Smith, primary care director and Cancer Research UK GP for Lancashire and South Cumbria Cancer Alliance said: Breast cancer can affect you at any age, so its important to be Breast Aware and check your breasts for lumps or a change in size or shape at least once a month. If you notice anything unusual, please dont wait contact your GP straight away.

In most cases it wont be cancer, but its best to get checked over because early diagnosis saves lives.

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'It's safe to attend breast screening' - NW Evening Mail

Welcome to the Era of the Anti-Hustle – Entrepreneur

October8, 20206 min read

Opinions expressed by Entrepreneur contributors are their own.

Covid-19has taught us that we are more than the AI machines we covet.

We are more than a series of tasks that must be completed on time-blocked calendars.

More than hopping on Zoom calls, Slack pings and Facebook DMs.

We are more than the definition of a hustler. No, we are the whole and holistic fragments that need attending to. We are what fulfills us.

Once lockdown hit, it quickly became apparent that what we thought was important wasnt. We didnt die when we rescheduled meetings and prioritized scared children over clients. The peace we had wished to descend into a life of busyness finally did. And for a minute it seemed like our existence would be a free-for-all. Because that is what humans know how to do.

Work a bazillion hours a day or do nothing at all.

Theres never anything in between.

But life is meant to be lived in the in-between. Thats where it gets good.

We finally got permission to ease up on the grind. Maybe that is why we can now explore new solutions to old problems. But why didnt we listen to our brains that threatened to sizzle and fry before it was the end of the world as we knew it?

The hustle mentality. It was quite good at sucking us in.

Ive been reinventing the hustle since I got sick in 2014 and had to quit working due to long-term Lyme and other coinfections and diseases. Since 2016 Ive gone deep down the rabbit hole and connected with well over 100 coaches, studying what the common keys behind success are.

Well, guess what? The truth is in the middle.

Its in the anti-hustle, or as I like to call it, the sick hustle.

Related:3 Strategies to Help You Create a Meaningful Work-Life Balance in the Midst of Covid-19 Chaos

Its in the way that you prioritize what will keep your business running, but it also centers on what will keepyourunning. After all, without you, there is no business.

These six simple tenets came from my disrupted life. They will allow you to get done what you need without driving yourself into the ground with some cool health benefits, too.

These aspects of our lives might seem like they have nothing to do with work, but they do. When you are pushed so hard to do so much because of the volume you worked to stack in your pipeline, you can resent what you do. That doesnt sound like working in a passion to me.

My research for this article pointed me to this quote by Elena Touroni, Ph.D., a consultant psychologist and co-founder of the Chelsea Psychology Clinic in London: Being always on increases our stress levels and reduces our productivity significantly.

Yep, we are designed this way, to do less.

Related:Switch Off Covid-19 Stress: 5 Ways to Achieve Work-life Balance in the New Normal

If thats not enough, I found more research telling us to slow it down. Dena M. DiNardo, Psy.D., a clinical psychologist in Philadelphia, notes that a constant hustle sets us up for a letdown. It can perpetuate feeling like your skills or knowledge expire shortly after theyre acquired, and like theres always something more we need to be doing to stay relevant.

Then I stumbled upon this mind-blowing truth from George Arabian, CEO of Nvision: You only hear about the success stories and not the casualties of this mentality.

Its true. Society and the self-made community have slapped a big label on what success means and what it doesnt.

Nearly kill yourself, while leaching from every aspect of your life to build your business: win.

Exercise strategic pauses that equal less volume but more gratification while nurturing all parts of your life: lose.

But how have you grown if you are too sick, fatigued, sad and stressed to enjoy the fruits of your labor?

The CDC notes, Working too hard is the opposite of self-care. Just more evidence that whether we want to hear it or not, the hustle is not good for us.

Overworking and stress also contribute to cardiovascular diseases, musculoskeletal issues, diabetes, and an increased risk of stroke and cancer. Keep dumping the high-stress hormone cortisol in your bod, too, and prepare for a chronic illness. The cherry is back and neck pain from muscle tension. This is why healthcare costs for high-stressed people are nearly fifty percent higher than less-stressed people.

There is no better time to ask yourself if what you are doing and how you are doing it is worth it.

Life and work must be sustainable for a business to last. It took a pandemic to force us inside our homes and heads. We can use this time to rearrange our priorities the way we wish we would have from the jump, to plan for and handle the day-to-day without overwhelm.

My trajectory screeched to a halt when I had to reinvent myself. I am grateful and have mused many times that not many people have the chance to start over and change the record, mid-play.

But now every waking individual gets that opportunity. The shot at embracing a new era: the anti-hustle of entrepreneurship. Lets not waste this gift, only to awaken years in the future, wishing we had capitalized on the unbelievable time the entire world rebooted.

Related:3 Tips That Can Help You Read More Books This Year


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Chantix may be the most effective way to quit smoking here’s how it works – Business Insider Australia

Chantix, the brand name version of a drug called varenicline, is a nicotine-free prescription pill used to help people quit smoking gradually. Unlike nicotine replacement therapies,varenicline blocks the brain from getting pleasure due to nicotine.

Smoking is the leading cause of preventable death worldwide. This is likely because its so difficult to quit, thanks to how nicotine affects the brain.

When you smoke, nicotine attaches to receptors located in the brains reward centre. This causes those receptors to release dopamine, a hormone that elicits feelings of pleasure. Once that dopamine rush wears off, you begin to crave nicotine, says Panagis Galiatsatos, MD, the director of the Tobacco Treatment Clinic at Johns Hopkins Medicine.

Chantix helps break this nicotine addiction in two ways:

When smoking becomes an addiction, your brain associates certain smells, locations, or emotions with the action. This makes you want to smoke when youre in certain situations, even if your brain isnt in need of a dopamine rush, says Galiatsatos.

If you smoke on Chantix, not only will it be unsatisfying, but it will also break the association between specific circumstances and the need to smoke.

If you try to smoke [while on Chantix], it wont be successful, says Galiatsatos. Varenicline also keeps [higher] dopamine [levels] in the brain, satisfying pleasure sensors without nicotine, and cuts cravings.

Chantix is available by prescription only and is usually prescribed for 12 weeks. Its important to speak with your healthcare provider to determine the right dosage and plan for you.

There are three proven ways you can use Chantix to quit smoking:

How long quitting takes will depend largely, but not solely, on your smoking habit. Some patients can quit immediately but others need to be on it for longer than 12 weeks. Guidelines are fine but they are not rules, you have to adapt treatment to the patient, Galiatsatos says.

In the United Kingdom, one in four people who quit smoking were using Chantix.

A 2020 report found that experts specializing in tobacco addiction recommended that those who wish to quit smoking take varenicline over all other treatment options. The experts also recommended pairing Chantix with a nicotine patch.

A 2016 review also found that varenicline is the most effective single-use agent for treating tobacco addiction. Two large trial studies compared smokers who took either varenicline, bupropion, or a placebo for 12 weeks. It found that 44% of those in the varenicline group had successfully quit smoking four weeks after they completed their 12-week dose, compared to 30% in the bupropion group and 18% in the placebo.

The study also found that the efficacy of varenicline is improved when paired with bupropion an antidepressant and nicotine replacement therapies such as gum, patches, or lozenges.

While there are side effects to be aware of when taking Chantix, Galiatsatos says that the drug poses no more of a risk than commonly used antidepressants. However, some people, especially those with a history of mental illness, may experience serious adverse side effects, such as:

If you experience any of these symptoms, stop taking Chantix immediately and see your doctor.

Chantix works by delivering a one-two punch to smoking: It blocks nicotine from reaching receptors in the brain, which breaks the pleasure cycle of habitual smoking, and prevents cravings by releasing small amounts of dopamine.

Studies show that Chantix is particularly effective when paired with nicotine replacement therapies such as a nicotine patch. However, those on Chantix should pay close attention to any adverse side effects, especially mood changes, and check-in with your doctor if you experience them.

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Chantix may be the most effective way to quit smoking here's how it works - Business Insider Australia

30 Things Stress Is Doing to Your Body – KYR News

You wouldnt eat a food that shrinks your brain. You wouldnt drive a car that makes you sweat. You wouldnt buy a purse that worsens PMS. So why are we all so cool with stress being just a part of life? It doesnt have to be. And if you reduce stress, you will be better for it. Because the impact stress has on your body is remarkableand hazardous. Read on to discover 30 more things stress is doing to your bodyand to ensure your health and the health of others, dont miss these Sure Signs Youve Already Had Coronavirus.


Your head is more likely to throb when youre stressed, according to the Mayo Clinic, with a tension-type headache or even a migraine. And feeling under pressure is also likely to make your headaches worse.


Stress kicks your body into its fight or flight mode, ramping up the release of certain hormones and preparing you to deal with danger. The result can sometimes be hands that shake like maracas.


Were not kidding. When were stressed, our body releases the hormone cortisol, and in limited doses, it can actually be beneficial. But studiesincluding one at the University of California at Berkeleyhave shown that chronic stress actually decreases the weight and volume of the brain.


Stress can increase the production of stomach acid, leading to that annoying reflux, as acid irritates the esophagus. And if you already suffer from chronic heartburn, stress can make it worse. A study of nearly 13,000 sufferers published in Internal Medicine discovered that nearly half reported stress as the biggest factor that worsened symptoms.


Stress gets us all riled up and causes hyper-arousal, making it difficult to fall asleep, stay asleep and making the quality of our sleep worse.

Recommendation: The National Sleep Foundation suggests a cooling off period before bed time, which allows the brain to wind down. Two hours should do it. Put your work away, turn off the TV and grab a book or listen to music.

Story continues

RELATED: Doing This Just Minutes a Day Helps You Sleep Better


When youre stressed, the muscles responsible for breathing tense up, making it more difficult to catch your breath.

Recommendation: If you begin to feel panicky and short of breath, start by exhaling deeply, emptying your lungs. You can also try breathing through your nose, which automatically slows your breathing.


If it seems like youre more likely to be sick when youre stressed, you may not be imagining it. Studies have shed light on the link between stress and sickness, finding that those living with chronic stress (such as unemployment or caregiving to a dementia patient) had a suppressed immune system that left them more vulnerable to the flu and a host of other illnesses.

RELATED: 20 Reasons Why You Keep Getting Sick


When were under stress, our hearts beat faster to help blood reach our vital organs. Often its harmless, but it may not be for those suffering chronic stress. One study from the European Society of Cardiology found that people with stressful jobsnurses or bus drivers, for examplehad a 48% higher risk of atrial fibrillation, a condition marked by an irregular, often rapid heart beat.


Stress has been shown to cause reproductive problems in both men and women. In one study published in Fertility and Sterility, researchers tested 274 women who were trying to get pregnant and found that those with higher levels of a particular enzyme in their saliva correlated to stress had a 12% more difficult time getting knocked up.


Erectile dysfunction is complicated and can have physical as well as psychological causes. Science, however, has shown over and over that stress tends to make the condition worse by releasing more adrenaline and causing exaggerated contractions of the muscles in the penis, keeping it from filling with blood.


Research has shown that various kinds of stress can wreak havoc on a womans period, making it irregular or disappear altogether. And to make matters worse, the Eunice Kennedy Shriver National Institute of Child Health and Human Development studied 259 women and found that stress can also make PMS pain worse.


And its true in both men and women. The causes, a study shows, can be both physical and psychological. Stress causes hormonal changes in the body, which arent particularly conducive for getting it on. It also makes someone distracted, and when their mind is on something else, sex can take a back seat.

Recommendation: One way to break the no-sex cycle is to get more physical with your partner, according to the Gottman Institute. It simply forces the body to go from stress to relaxation, if you allow this. Kiss your stressed out partner a little bit more and hug them for 20 seconds longer.


Stress gets your heart pumping faster and spikes your blood pressure. Not good. Usually, the response in temporary, a reaction to a particular stressful event. But chronic stress over long periods of time can cause inflammation in the arteries, which could lead to a heart attack down the road.

Recommendation: Try some good ol fashioned exercise. Working out three to five times a week can reduce your stress and will make a difference long-term in lowering your blood pressure, according to the Mayo Clinic.


When youre stressed, your body behaves as if its under attack, and your liver reacts by releasing more glucose into your bloodstream. Ongoing stress can lead to long-term sugar spikes, putting you at risk of type 2 diabetes, say experts.


Your gut has the most nerves in your body, this side of your brain, and stress can adversely affect your entire digestive system. The hormones released when youre stressed can interfere with digestion and harm the microorganisms living in your digestive tract. Cue indigestion, cramps, nausea and a whole host of other GI issues.


That tightening can cause back aches and other ailments.

Recommendation: Next time youre feeling stressed, reach for the walnuts. Researchers have shown that foods containing polyunsaturated fats, like the nuts, may help us deal better with stress.

RELATED: This Can Be the First Sign of COVID, Study Finds


Stress can lead to a dry mouth in several ways, say experts. Anxious people tend to breathe through their mouths, drying out the inside. The acid reflux associated with stress can also have an affect on the salivary glands and keep them from producing as much.


Chronic stress can leave your feeling zapped of energy. It could be the accompanying insomnia, or some theorize that it might have something to do with exhausting your adrenal glandthough a 2016 review of the research debunked that diagnosis.


We sweat more when were stressed and we sweat differently, studies show. Anxiety causes sweat to be produced from the apocrine glands, which secrete a thicker, milkier sweat than our eccrine glands. The downside: sweat from the apocrine glands tends to stink more.


Getting headaches is one thing, but actually altering your genetic code? Yep. Researchers at the University of Copenhagen have found that stress can switch on genes that werent supposed to be switched on. The consequence is that genes that should be turned off are now active and this may disturb cellular development, identity and growth, the researcher said.

RELATED: The Scariest New Symptoms of COVID-19


A study at Johns Hopkins concluded that long-term stress may affect the way that the genes controlling mood and behavior are expressed, leading a stressed-out person to be at a higher risk of depression. Tests on mice found that stress led to an increase in a protein produced by a gene called Fkbp5, which in humans has been linked to depression and bipolar disease.


Are the strains and demands of modern society commonly exceeding human ability? Thats the question asked by the authors of this study of more than 17,000 working adults in Stockholm, Sweden. The scientists found that even mild stress can lead to long-term disability or an inability to work. Those who experienced mild stress were 70% more likely to collect disability benefits.


Watch out. Men who are moderately or highly stressed for a number of years were found to have a 50 percent higher mortality rate, according to the Journal of Aging Research. The good news is that two very stressful situations a year might actually be beneficial, teaching us to cope with adversity. Anything beyond that, however, and it might be an early grave.


There may be something to that cliche about stress eating. Researchers at University College London found that feeling stressed changes what we eat. Those under pressure didnt necessarily eat more, but they did reach for more sweet, fatty foods than usual.

Recommendation: If youre feeling stressed, be more aware of what youre eating and try to curb your consumption of junk foodno matter how much your brain is screaming that you need it. For food solutions, visit


One of those areas of the brain that gets shrunken by stress is the hippocampus, which plays a big part in learning and memory. A 2018 study found that those with higher levels of the stress hormone cortisol did worse on memory tests, especially women.


Research has shown that periods of mild to moderate stress may actually help the brain to better encode memories and improve learning. For example, a college student freaked out about an upcoming midterm may actually retain the material better and ace the test.

RELATED: 38 Ways Youre Treating Your Heart Wrong


In addition to generally suppressing the immune system, stress can lead to the growth of malignant cells, making a cancerous tumor bigger, says one study.


Children of parents with drinking problems face a greater risk of turning to booze after experiencing stressful situations, a University of Gothenburg study found.

Recommendation: If alcohol relaxes you when youre stressed, then you should try to find other ways of calming yourself downrelaxation exercises, for example, the researcher suggests.


Tinnitus, that same kind of annoying ringing you get after, say, sitting through a Metallica concert, might just be induced by stress. One study by the Egypts Minia University found that those suffering from chronic ringing tended to be more stressed. In short, There is a direct correlation between duration of tinnitus and severity of stress.


It doesnt get more serious than that. Severe mental stress can bring on sudden cardiac death, as medical professionals colorfully call it. In particular, suffering through a traumatic event, such as an earthquake or a war strike, can be so stressful that people literally keel over.

Recommendation: Dont worry. No ones ever died of a panic attack. If youre experiencing anxiety, dont miss these tips.

As for yourself: To get through this pandemic at your healthiest, dont miss these 35 Places Youre Most Likely to Catch COVID.

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30 Things Stress Is Doing to Your Body - KYR News

Dexamethasone: 5 Fast Facts You Need to Know –

President Donald Trump, who tested positive for COVID-19 on October 1, is now taking a steroid previously used in a clinical trial for hospitalized patients with the virus in the United Kingdom.

White House physician Sean Conley on October 4 updated reporters at the Walter Reed medical Center, where Trump is seeking medical care, on the presidents current condition. Following several conflicting and concerning reports from aides and doctors over the weekend, Conley offered a more optimistic approach on the 74-year-olds progress including a new prescription for Dexamethasone.

Since we last spoke, the president has continued to improve, Conley said.

Trump was taken to the Maryland military hospital on Friday after experiencing a high fever and receiving supplemental oxygen, the doctor explained. The presidents oxygen levels fell again on Saturday morning, requiring oxygen and a lung scan.

Conley said the scans showed some indications of damage, but assured it was nothing of a major clinical concern.

You can watch the full briefing here.

Trump may be discharged as early as tomorrow, another medical expert added during the briefing.

Heres what you need to know about Dexamethasone and its relation to COVID-19:

According to MayoClinic, Dexamethasone is prescribed to relieve inflamed areas of the body, including symptoms stemming from severe allergies, arthritis, asthma, adrenal problems, kidney problems, immune system disorders and skin conditions, among others.

It works on the immune system to help relieve swelling, redness, itching, and allergic reactions, the Clinic states.

The drug works by lowering the bodys natural defense response, WebMD added.

It is only available via a doctors prescription and comes in tablets, elixirs and solutions, the medical website continued.

GettyA healthcare worker tends to a patient in the Covid-19 Unit at United Memorial Medical Center in Houston, Texas.

The drug was used to treat hospitalized patients with the coronavirus in the United Kingdom during a national clinical trial called, RECOVERY, according to the World Health Organization.

The organization said the trial found the drug to be beneficial for critically ill patients, writing:

According to preliminary findings shared with WHO (and now available as a preprint), for patients on ventilators, the treatment was shown to reduce mortality by about one third, and for patients requiring only oxygen, mortality was cut by about one fifth.

The World Health Organization states on its website that Dexamethasone is fairly low-risk, presenting a favourable benefit-risk profile, particularly in patients with severe forms of pneumonia. Patients with non-severe pneumonia see lower benefits, on the other hand, it continued.

Non-threatening side effects include upset stomach, headache, dizziness, menstrual changes, trouble sleeping, increased appetite, or weight gain, WebMD states. If side effects persist or worse, a doctor should be notified promptly.

Long-term use, such as more than two weeks, could potentially cause more adverse reactions, WHO added, including glaucoma, cataract, fluid retention, hypertension, psychological effects, weight gain, or increased risk of infections and osteoporosis.

To reiterate: All these adverse events are not associated with short term use (with the exception of hyperglycaemia that can worsen diabetes), the organization says on its website.

GettyU.S. President Donald Trump wears a mask as he visits Walter Reed National Military Medical Center in Bethesda, Maryland.

Dean of the Brown University School of Public Health Ashish Jha said earlier this weekend that the drug could be a very clear signal that he has a more severe disease, according to The Los Angeles Times.

The Dean emphasized similar sentiments on October 4, expressing that Trumps long-term lung damage is still up in the air, the newspaper reported.

Trump was also half-way through his five-day course of the anti-viral drug Remdesivir, the Los Angeles Times reported.

Dexamethasone is generally available in most countries through several product manufacturers, WHO says.

One manufacturer has already been prequalified by WHO (Kern Pharma in Spain) while another is under assessment, the organization states on its website.

WHO claims the medication is also generally affordable,with a median price of $0.33 per 4mg/ml injection ampoules (range: US$0.13-$3.5), citing 2016 and 2019 surveys of health facilities in low- and middle-income countries.

READ NEXT: WATCH: Trump Mocks Biden During Debate, I Dont Wear Masks Like Him

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