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New Clinic Fills Need for LGBT-focused Care Hospitals & Health Networks The clinic, now in its fourth month, offers specialized primary care services for the LGBT community, including hormone therapy and monitoring, HIV care, and referrals for specialty services. It also provides support for family members, health ...

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New Clinic Fills Need for LGBT-focused Care - Hospitals & Health Networks

This article is authored by the Mayo Clinic Center for Individualized Medicine. The mission of the Center is to discover and integrate the latest in genomic, molecular and clinical sciences into personalized care for patients.

A picture is worth a thousand words. While that saying may be true, for the more than 50 percent of all women who have dense breast tissue, a picture from traditional, 2-D mammography may not tell the full story about whether they have breast cancer.

Breast density is like the wolf in sheeps clothing. Both tumors and dense breast tissue appear white on a mammogram. A traditional 2-D mammogram may not distinguish between the two. Thats why mammograms find as few as 40 percent of cancers in women with dense breasts, says Deborah Rhodes, M.D., a Mayo Clinic Breast Clinic physician.

If tumors are obscured by dense tissue on a mammogram, the tumor may go undetected for a year or longer during which time the tumor will grow which is a significant problem when you consider how closely survival from breast cancer is linked to tumor size at diagnosis. If we discover a tumor when it is less than 1 centimeter, that patient has over a 90 percent chance of surviving. If we could reliably find tumors in dense tissue when they are small, more lives could be saved," adds Dr. Rhodes.

In addition to dense breast tissue masking tumors on a mammogram, research has shown that women with dense breast tissue have a higher risk of developing breast cancer. Many states have now passed legislation mandating that women found to have dense breasts on a mammogram be provided with information about the impact of breast density on breast cancer detection and risk.

Because both Minnesota and Arizona have this legislation, and because national guidelines on breast cancer screening differ, Mayo Clinic breast specialists developed consensus guidelines for breast cancer screening in women with dense breasts.

Bringing dense breast tissue into focus - 3-D mammograms and molecular breast imaging (MBI)

In order to provide the best screening to detect breast cancer, Mayo Clinic physicians recommend that women with dense breasts initially have a 3-D mammogram and be given the option to have further screening with molecular breast imaging (MBI).

Dense breast tissue what you should know

Women with dense breast tissue have a higher proportion of dense tissue compared to fatty tissue in their breasts. You can find out whether you have dense breast tissue by talking with your physician and reading your mammogram report.

Factors that lead to women having dense breasts include:

Adjusting the lens researchers work to refine screening tools

Mayo Clinic Center for Individualized Medicine has supported development of molecular breast imaging as an individualized approach to cancer screening and will continue to support research that refines this technology in order to provide patients with dense breast tissue the best care.

Our goal is to identify the best tool to screen for and diagnose cancer at its earliest stages, when it is more treatable. By finding the best individualized care for women with dense breasts, I think we can greatly reduce the number of breast cancers diagnosed when they are already advanced - cancers that were not visible on an x-ray. We have already demonstrated that MBI can detect many cancers including advanced cancers that were not seen on traditional 2-D mammography. Our future research will continue to evaluate the effectiveness of 3-D mammograms and MBI. While this research is ongoing and important, MBI is available now as a tool for women who seek additional screening because they have dense breasts, says Dr. Rhodes.

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3-D Mammograms And Molecular Breast Imaging Personalized ... - HuffPost

Conventional weight loss strategies are leaving people frustrated and unsuccessful in an era of processed foods, chemicals, and hormone disruptions. A new approach at Balanced Body Health Center, LLC is having patients shed 15-20 lbs of fat per month by adapting the body's ability to process these stresses.

St. Louis, MO (PRWEB) June 04, 2017

Sadly, our allopathic, insurance-based medical model for health care hasn't found a sustainable way to rid itself of Diabetes, weight gain, and the toll obesity has on our health. Instead, people are getting sicker, more inflamed, and more dependent on medications. A St. Louis clinic has taken upon itself to break this mold and offer a simple solution for people to live more vibrant and happy livesand get leaner in the process!

Functional Nutritionist, Dr. De Geer, explains 95% of diets don't work. Most people try to research weight loss strategies on their own and there's the infamous yo-yo effect where a person loses weight only to regain it later. A myth that consistently fails to explain the overweight epidemic is: weight problems are merely a consequence of taking in too many calories and not burning enough. A physician's typical advice regarding this issue is: "eat less and exercise more." This limited approach fails to touch upon hormones, toxins, food choices, inflammation, stress, and gut health.

Learn more at http://www.drdegeer.com/weight-loss-program/

At Balanced Body Health Center, LLC patients are educated on these factors and follow guidelines that result in 15-20 lbs of fat loss per month on average. Here, a person initially meets with a physician to casually discuss health and weight loss goals and to uncover metabolic roadblocks they may be facing. Most people live a lifestyle that promotes fat storage while shutting down pathways to access this later for energy.

Dr. De Geer explains fat cells accumulate hormones and toxins. "The more fat we have, the more hormonal problems and toxin-related issues we can face." Fat cells are also prime targets for hormone-disrupting chemicals that can increase the number and size of fat cells.

Another common condition gaining media attention is leaky gut. With leaky gut, the digestive tract lining breaks down, stimulating the release of inflammatory molecules. This downregulates the breakdown of fat cells and stimulates the production of more fat cells. These two mechanisms lead to an inability to lose weight. Also, those who are obese tend to have a less diverse collection of gut bacteria than those who maintain a healthy weight.

Balanced Body Health Center, LLC takes an innovative approach at removing toxins, controlling inflammation and completely transforming patients' lives. For an effective strategy on how lose weight, visit http://www.drdegeer.com/weight-loss-program/ or call (314) 541-8188 to schedule a consultation.

For the original version on PRWeb visit: http://www.prweb.com/releases/2017/06/prweb14386878.htm

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St. Louis Clinic Introduces Weight Loss Breakthrough - Benzinga

Contributor: Jame Abraham, MD

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Its not unusual for a patient to ask if men can get breast cancer, and the answer to the question is yes. In 2017, about 2,470 new cases of invasive breast cancer will be diagnosed, and about 460 men will die from breast cancer, according to the American Cancer Society.

But breast cancer is about 100 times less common among men than among women. For men, the lifetime risk of getting breast cancer is about 1 in 1,000. The number of breast cancer cases in males relative to the population has been fairly stable over the last 30 years.

The most common symptoms of male breast cancer are:

There are myriad risk factors that increase the odds of a man developing breast cancer, but many men will develop the disease without experiencing any of these. Many risk factors are similar for men and women, including age, family history and genetic mutations.

One risk factor that increases the risk of breast cancer for both men and women is aging. In general, the risk of breast cancer goes up as a man ages, with an average age of diagnosis of 68.

Family history is important, too, as breast cancer risk is higher if other members of the family have had the disease. About 20 percent of men with breast cancer have a family history of it.

Genetic mutations, such as the BRCA2 gene, increase the risk of breast cancer for anyone, with a lifetime risk of 6 in 100. BRCA1 mutations, in particular, can increase the risk for breast cancer in men; the risk is about 1 in 100. Other important mutations are the CHEK2 and PTEN genes, which may be responsible for some breast cancers in men.

Theres a congenital condition called Klinefelter syndrome that affects 1 in 1,000 men. In normal men, the cells have a single X chromosome with a Y chromosome, while womens cells have two X chromosomes. Men with Klinfelter syndrome have cells with a Y chromosome, plus at least two X chromosomes. These men also have smaller-than-usual testicles, and theyre often infertile because theyre unable to produce functioning sperm cells. Compared with other men, they have lower levels of the male hormone androgen and more of the famale hormone estrogen. For this reason, they often develop swelling of the breast tissue, called gynecomastia. Some studies have shown that among men with this syndrome, the risk of getting breast cancer was about 1 percent, or 1 in 100.

Having been exposed to radiation in the past is also a risk factor for breast cancer in men. A man who had radiation to the chest for lymphoma or any other conditions has an increased risk of developing breast cancer.

Heavy alcohol consumption and liver disease increase the risk of breast cancer in men. Other risk factors include estrogen therapy or other hormonal therapy for prostate cancer, obesity, testicular condition such as undescended testis and some occupations, such as steel mill workers.

In general, the way male breast cancer is managed is similar to tactics used with female breast cancer. The disease could be diagnosed via a clinical examination, mammogram or ultrasound and, if an abnormality is found, the man will be considered for a biopsy of the lesion.

Definite treatment will include surgerythat may include removal of the breast, lump and lymph node surgery, and possibly chemotherapy and anti-estrogen therapy.

Overall prognosis depends upon the stage and other features of breast cancer.

Male breast cancer survivors face many challenges, since its a rare condition. Most of the data related to male breast cancer is derived from female breast cancer. We have only very limited data about specific treatment, prognosis and outcome of male breast cancer.

Its important for men with breast cancer to take care of themselves. This includes being compliant with their cancer treatment and having appropriate follow up.

Adopting a healthy lifestyle that includes eating healthy, exercising and avoiding tobacco and alcohol is imperative. Its a good idea to look for clinical trials; unfortunately, however, many breast cancer trials exclude men. My hope for patients is that this will change in the future.

This post is based on one of a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.

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Male Breast Cancer: Less Common Than For Women, But Still Serious - Health Essentials from Cleveland Clinic (blog)

Thursday, June 01, 2017 11:40 a.m. CDT

By Lisa Rapaport

(Reuters Health) - Women who dont have access to reproductive health clinics can safely use telemedicine services to consult with a doctor and get drugs to terminate their pregnancy without surgery, suggests a study of Irish women.

About one quarter of the worlds population lives in countries with highly restrictive abortion laws and where women may resort to unsafe methods to end pregnancies. This results in an estimated 43,000 deaths every year, researchers write in The BMJ.

The current study focused on 1,000 women who used an online telemedicine service to get medical abortions in the Republic of Ireland and Northern Ireland, where abortions are illegal in most circumstances.

About 95 percent of the women reported successfully terminating their pregnancies without surgical intervention using medication they received in the mail after providing their medical details and consulting with a trained helpdesk team on how to use the drug. No deaths were reported, and less than 3 percent of the women had complications that required treatment like antibiotics or blood transfusions.

The results provide the best evidence to date that medication abortion conducted entirely outside the formal healthcare setting using online telemedicine can be highly effective and safe, said lead study author Dr. Abigail Aiken, a researcher at the University of Texas at Austin.

All of the women in the study got abortion pills through Women on Web (WoW), a nonprofit organization that provides access to medical abortions early in pregnancy for women who live in countries where access to safe abortion is limited.

While Women on Web only provides medication abortion through online telemedicine in countries where abortion is restricted, the findings of our study suggest that this model may be much more widely applicable, Aiken said by email. As long as a woman does not have a contraindication to medication abortion (there are a few of these, but they are rare) and her pregnancy is at a gestational age appropriate for the approved use of the medications in her country, medication abortion using a reputable online telemedicine service may be an appropriate option if she needs or prefers it.

Surgical abortions require in-person clinic visits, but many abortions are now done with medication and a growing number of women are getting pills by consulting with doctors online even when they live in places where abortion is legal.

In the U.S., medication abortions are typically performed before 10 weeks of pregnancy with two drugs mifepristone and misoprostol that can be self-administered at home. Healthcare providers can use telemedicine to interview patients and assess potential safety issues by reviewing lab test results and ultrasounds before prescribing medication.

In a typical two-step medical abortion regimen, women first take mifepristone. This pill works by blocking the hormone progesterone, which causes the lining of the uterus to break down and makes it impossible for the pregnancy to continue. Then, a day or two later, women take misoprostol, which causes the uterus to empty.

Women may be advised to have a clinic visit afterwards to confirm that the pregnancy was successfully terminated. In rare cases when ultrasound or a blood test shows the medical abortion didnt succeed, women require surgical abortions.

In the study, 93 women, or about 9 percent, experienced a symptom that they were told required medical attention, and most of the women followed advice to visit a clinician in person.

One limitation of the study is its reliance on women to accurately recall and report any side effects or problems, the authors note.

Still, women should be reassured by the results, said Dr. Wendy Norman, a researcher at the University of British Columbia in Vancouver who co-wrote an accompanying editorial.

When a woman has access to see a clinician in person to obtain a medical abortion, that is the preferred method, Norman told Reuters Health by email. In areas where medical abortion providers are not available, or areas where abortion is legally restricted, access to a qualified clinician via telemedicine provides a reasonable alternative to discuss the current pregnancy in the context of a woman's general health and health history, consider available options for her pregnancy, and to provide management of a medical abortion from start to finish if desired.

SOURCE: http://bit.ly/2rY2FQL and http://bit.ly/2qEP9xs The BMJ, online May 16, 2017.

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Online access to abortion pill may be safe alternative to clinics - KFGO

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Hair loss: What is female-pattern baldness? BBC News Hayley Jennings, who set up the Yorkshire Hair Loss Clinic, said the majority of her clients were women - especially mothers - in their 30s and 40s with female pattern hair loss. "This effects one ... Dihydrotestosterone (DHT) is the main hormone ... and more »

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Hair loss: What is female-pattern baldness? - BBC News

Breast cancer is thought of as a womens disease, with less than 1 percent of breast cancers affecting men, according to breastcancer.org. Because of that, there is a lack of awareness about the disease in males, which leads to late diagnoses and lower chances of survival.

As part of Mens Health Month in June, learn the facts about male breast cancer and what can be done to treat it.

Everyone has breast tissue

Male bodies dont make as much of the hormone that stimulates breast growth as female bodies, but men still have breast tissue and can even develop medium or large breasts, according to breastcancer.org.

Usually these breasts are just mounds of fat, the website says. But sometimes men can develop real breast gland tissue because they take certain medicines or have abnormal hormone levels.

While testosterone in men and estrogen in women controls their sex characteristics, those hormones are found in both sexes.

Most people think of estrogen as an exclusively female hormone, but men also produce it though normally in small quantities, the Mayo Clinic says. However, male estrogen levels that are too high or are out of balance with testosterone levels can cause gynecomastia."

Gynecomastia happens when males have swollen breast tissue which, on its own, is not a serious problem but, because both the condition and breast cancer are related to more breast tissue, one could be a sign of the other.

Male breast cancer is usually advanced

Although breast cancer in men is uncommon, its usually diagnosed late, meaning the cancer is more advanced.

Overall survival is shorter in men, possibly because they tend to be older and have more comorbid conditions, according to research in medical journal the BMJ.

Having comorbid conditions means a person has more than one disease or condition at a time. Men may also have advanced stages of breast cancer because they ignore symptoms.

Men carry a higher mortality than women do, primarily because awareness among men is less and they are less likely to assume a lump is breast cancer, which can cause a delay in seeking treatment, the National Breast Cancer Foundation says.

Men can check for symptoms, at home

Men with a family history of breast cancer are at a higher risk of developing it, but all men should tell their doctor if they have any of these symptoms:

Before going to the doctor, men can perform a self-check, something they should do every month. That may sound like a lot, but it takes less than 30 seconds and is simple, involving looking for changes on or around the nipple and feeling in the area for lumps or discharge. Detailed instructions are available from multiple online resources.

Men can treat and beat breast cancer

If a biopsy confirms a man has cancer cells in his breast, medical tests will determine the stage. As with other cancers, a lower stage means the cancer has not progressed as far.

Treatment options could include surgery, chemotherapy, hormone therapy, radiation therapy and targeted therapy, according to the National Cancer Institute.

Men's and womens breast cancer survival rates are the same, so the stage is more important. For example, if men visit the doctor early, and the breast cancer is caught and treated at stage 0 or 1, there is a 100 percent survival rate, according to the American Cancer Society. That rate drops for every subsequent stage until stage 4, which has a 20 percent survival rate.

The best thing a man with a family history or symptoms of breast cancer can do is visit his doctor right away for diagnosis and treatment.

Sinclair Broadcasting is committed to the health and well-being of our viewers, which is why were introducing Sinclair Cares. Every month well bring you information about the Cause of the Month, including topical information, education, awareness and prevention.

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Here Are The Facts About Male Breast Cancer - KUTV 2News

A federal judge in Minnesota dealt a devastating blow to parental rights last week. Senior U.S. District Judge Paul Magnuson dismissed a lawsuit brought by a mother who accused school officials, healthcare providers, and doctors of violating her parental rights by assisting her son with gender transition without the mothers consent.

Anmarie Calgaros case made international headlines last year when she sued her teenage son known only as EKJ for undergoing a sex change through hormonal therapy without her permission, as well as numerous state agencies for the role they played in helping him to transition from male to female. Calgaros lawsuit claimed that she was neither consulted nor informed about the transition, thereby stripping her of her constitutionally protected parental rights.

The U.S. Constitution says that parental rights are fundamental rights, that cant be terminated without due process, said Calgaros attorney, Erick Kaardal of the Thomas More Society.

At particular issue in Calgaros lawsuit was a Minnesota law that allows minors to undergo medical care and procedures without parental consent. According to Calgaros suit, Park Nicollet and Fairview Health Services began providing hormone therapy to her son in November without consulting Calgaro or even informing her about it. Calgaro also argued that St. Louis County violated her parental rights by providing government assistance in the form of medical payments to cover the costs of the childs transition.

Calgaro indicates she is fighting for parents to be included in their minors medical decisions.

"I'm also taking this action for the benefit of all parents and families, who may be facing the same violation of their rights so that they and others in the future may be spared from the same tragic events," she opined.

Sadly, some media outlets portrayed Calgaro less as a champion of parental rights and more as an anti-LGBTQ activist, even quoting critics who took issue with Calgaros and her attorneys repeated references to her son as male, which of course squares with reality, but not with her sons desire to be acknowledged as female.

For Calgaro, however, the case is not about her son's transgenderism, but with his ability to obtain medical treatment without her knowledge or consent, particularly potentially harmful treatment. At a press conference, Calgaro told reporters that "The transitioning thing isn't even the issue, the issue is that he's able to make these [medical] decisions."

In fact, scientists suggest that it is psychologically harmful for adolescents to undergo hormonal therapy in the name of transgenderism, as most children outgrow gender confusion.

"Children are a special case when addressing transgender issues. Only a minority of children who experience cross-gender identification will continue to do so into adolescence or adulthood, a study in The New Atlantis reads.

There is little scientific evidence for the therapeutic value of interventions that delay puberty or modify the secondary sex characteristics of adolescents, although some children may have improved psychological well-being if they are encouraged and supported in their cross-gender identification," it continues. "There is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender."

The study argues that enabling acceptance of transgenderism through medical intervention is particularly harmful. An area of particular concern involves medical interventions for gender-nonconforming youth. They are increasingly receiving therapies that affirm their felt genders, and even hormone treatments or surgical modifications at young ages, the authors observe.

Calgaros lawsuit also focused on the absence of an official legal process in the state for the emancipation of minors, and this absence served to create considerable confusion and inconsistencies in Calgaros case. Some of the agencies involved considered the teenage boy to be emancipated from his mother based on the grounds that he no longer lived with Calgaro and was not financially supported by her. EKJ reportedly moved out of his mothers home in 2015 to move in with his father so that he could attend a better school and has not returned since. He eventually moved in with friends until he finally began living on his own.

EKJ also filled out an emancipation form with the help of a homosexual advocacy group without Calgaros knowledge. In the lawsuit, Calgaro notes that the emancipation form was riddled with falsehoods. For example, the form claimed that Calgaro failed to report her teen son as a runaway and made no attempt to bring him home, thereby concluding that she wished to have no contact with him, all of which Calgaro denies.

The Minneapolis Star Tribune reports that an attorney with the Mid-Minnesota Legal Aid clinic then provided EJK with a letter that concluded the teen was legally emancipated under Minnesota law.

Meanwhile, Calgaros attorney noted at a news conference last year that Calgaro was never given notice that her child was seeking emancipation and the emancipation determination was reached without a hearing or court order.

"If there had been a court order of emancipation, then Anmarie would have received notice and an opportunity to be heard," said Kaardal.

Once it was determined that EKJ was emancipated, the school then refused to provide Calgaro her sons medical records, and the Department of Human Services refused to provide her information about her sons hormonal therapy, Life Site News reports.

Yet, while these particular agencies accepted EKJs emancipation determination, the St. Louis County District Court had rejected the teens application for a name change because of the lack of any adjudication relative to emancipation, underscoring the flimsy legal grounds on which the defendants case stood.

Calgaro turned to the federal court to intervene, and asked the court to stop the teens hormone treatment and award her financial damages.

But Judge Magnuson determined on Tuesday that Calgaros claims were meritless.

Magnuson admitted that the boy was not legally emancipated, and that Calgaro's parental right "remain[ed] intact." However, he decided that the defendants could not be held liable because they did not act under color of state law. Without evidence that the school and agencies violated a law or a policy or custom, Calgaro had no claim, he determined.

Magnuson revealed his flagrant disregard for parental rights by going so far as to question whether those include access to school records.

Furthermore, Kaardal asserts that Judge Magnusons decision has done little to clarify the states emancipation issue.

On the legislative front, people on the left and on the right believed that emancipation procedures in Minnesota should be put in statutes and codified, Kaardal said. But until then, its confusing and the courts decision hasnt cleared up that confusion.

NBC News notes the potential impact that a decision on the states emancipation process could have on abortion in Minnesota, since current statute mandates that a non-emancipated minor cannot access an abortion until 48 hours after parental notification has taken place.

Predictably, EJKs attorneys welcomed the judges decision, saying it shows the resilience of transgender youth and the importance of access to appropriate health care.

The law protects all young people, including transgender young people, and we are pleased that this outcome supports her access to essential health care and other critical service, said Asaf Orr, a staff attorney for the National Center for Lesbian Rights Transgender Youth Project in San Francisco.

According to theMinneapolis Star Tribune, Kaardal and Calgaro are considering an appeal.

Anmarie Calgaro is living a parents worst nightmare," Kaardalsaid. "Her minor child has been piloted by third parties through a life-changing, permanent body altering process by organizations that have no legal authority over him, and that have denied his own mother access.

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Judge Dismisses Mother's Lawsuit Over Her Son's Transition to a "Girl" - The New American

"I thought it was, what's the right word, ill-conceived, shall we say? And merciless as well. Particularly in the way it treats the poor and the disabled in our society."

Crist chats with James Keane, Metros fundraising and events manager.Kate BradshawAs we wrote about last year, Metro Wellness is a nonprofit that offers specialized care and advocacy for the region's LGBT residents everything from HIV tests to hormone replacement therapy for gender transition to counseling for gay and trans youth. It's headquartered on the western edge of St. Petersburg's Kenwood neighborhood in an area where new apartment buildings seem to be going up by the month.

They're in the middle of a massive expansion officials with the organization say will better equip them to meet the needs of the community. And with any luck, event and retail space they plan on renting out will boost their revenue.

July of 2018 their target for cutting the proverbial ribbon is a long way off.

But with the looming (though uncertain) repeal and replacement of the Affordable Care Act and a spike in new HIV cases (largely among gay minority men under 30), demand for what they do will probably go up well before then.

On Wednesday morning, former Governor and current Congressman Charlie Crist, D-St. Petersburg, checked out the facility for the first time.

He did his usual thing introducing himself to the dozens of staff members going about their day, making conversation about sports and hometowns.

Crist speaks to Metro's CEO, who was home recovering from knee surgery, as Priya Rajkumar looks on.Kate Bradshaw

He was there to show his support for Metro and to find out more about what they do. As a Democrat in Congress, it doesn't seem likely that Crist could do all that much in D.C. in terms of pulling down federal money.

Metro doesn't get much in the way of federal funding anyway, beyond grants and savings on medications it doles out via the 340B Prescription Drug Program. Many of the services they provide are free, and they take insurance when it's applicable.

But if millions of people lose their health care under the Republicans' Affordable Health Care Act, that could put a huge burden on health nonprofits like Metro.

The health care act is going to be pretty crucial for us in terms of our ability to move forward as an organization, said Priya Rajkumar, Metro's chief operating officer, as she and her colleagues gave Crist the grand tour.

Needless to say, Crist wasn't a fan of the GOP plan, either.

I thought it was, what's the right word, ill-conceived, shall we say? And merciless as well. Particularly in the way it treats the poor and the disabled in our society. I think it's on its way to nowhere. I hope, he told Metro CEO Lorraine Langlois, who was at home recovering from a knee surgery at the time of the tour, during a phone call in which he congratulated her on Metro's success.

Notably, the tour took place the day before Pride Month starts. In June, St. Petersburg hosts the biggest Pride festival in the state. Metro has long been something of a hub during the event, as an adjacent parking lot served the parade's staging area for years. This year, the event's parade portion will take place in downtown St. Pete and the former staging area now belongs to a developer. There was controversy over the move, especially since Kenwood and the Grand Central District, where the parade has taken place for over a decade, make up the city's first gay-friendly area.

Perhaps the downtown move is a sign of how mainstream Pride has become, and how welcoming St. Pete is. Even so, given the political climate and the ideological bent that's helping shape federal and state health care policy, the need for services that cater to the LGBT community like the ones Metro provides isn't going anywhere.

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As specter of GOP healthcare overhaul looms, Crist tours expanding LGBT clinic in St. Pete - Creative Loafing Tampa

It was Aubrey Reinhardts last year at Texas Tech University. So when things started getting serious with her boyfriend, she decided it was time to look into birth control.

Reinhardt knew that abortion foes had been trying to strip Planned Parenthood of every penny it receives from government sources. But until that moment two years ago, Reinhardt recalled, she didnt appreciate what that could mean for a person like her who just needed somewhere to go for affordable contraception without feeling she was being judged.

Planned Parenthood had to close its two health centers in Lubbock, where Reinhardt was studying, so she turned to the campus clinic. But the doctor there told her she might have a blood clotting problem, and said Reinhardt would need to get approvals from three other doctors and a hormone specialist before she would prescribe contraception.

Reinhardt, now a 22-year-old law student in Dallas, was stunned. None of her previous physicians had suggested she might have such a problem. Could the doctor be using it as an excuse? She could feel herself tearing up.

Why are you crying? she recalled the doctor asking. Are you really in that big of a hurry to become sexually active?

Humiliated, Reinhardt hurried out of the office.

In the annals of the abortion wars, the call to defund Planned Parenthood has become one of the most potent and contentious rallying cries. The organization is the largest single provider of abortions in the country and has used its political clout to protect access to the procedure.

Now with President Trump in the White House and Republicans in control of Congress and statehouses across the nation, those seeking to curtail public funding for Planned Parenthood see opportunities to achieve their long-sought goal and they see Texas as a model to follow. But as Reinhardts experience shows, the effects of a successful defunding campaign can be far more extensive and potentially damaging than intended.

In 2011, Texas lawmakers slashed funding for family planning clinics rather than allow any of the money to go to Planned Parenthood. Because of the cuts, a quarter of the states clinics closed, making it harder for women of limited means to get a range of other basic health services, including contraception, breast and cervical cancer screenings, and testing for sexually transmitted infections.

Lawmakers have since attempted to repair the damage by directing more money to facilities not tied to abortion providers. But there isnt always a facility that can readily fill the void when women are denied access to Planned Parenthood, which serves about 2.4 million patients nationally each year.

Federally funded community health centers, which provide a range of low-cost primary care to poor families, are stretched thin. And family planning is not routinely offered at 40% of these facilities, according to a study by the Guttmacher Institute, which advocates for reproductive rights, including abortion.

After Reinhardts upsetting visit to the campus clinic, she called one such center in Lubbock. The soonest she could get an appointment was in April. It was January. She then tried facilities operated by Christian nonprofits. They didnt offer contraception.

So she called what was left of Planned Parenthood. They could see her right away, but their nearest locations were in El Paso and Fort Worth, both four-hour drives away.

Over spring vacation, Reinhardt drove to Fort Worth and received an implant that prevents pregnancies for up to four years. But she wondered, What about the mother that has two children, that works two jobs, that cant take off two days to drive four hours away to a clinic and come back?

It is already illegal to use federal dollars for abortions, except in cases of rape, incest or when the mothers life is in danger. And Planned Parenthood says about half of its health centers dont offer the procedure.

But the groups opponents argue that giving Planned Parenthood public funds for non-abortion-related care allows it to spend more of its private funds on abortions. In 2016, the group received $554.6 million from government sources, about 40% of its budget.

The Republican bill to replace Obamacare, which narrowly cleared the House on May 4, would prevent Planned Parenthood from receiving reimbursements from Medicaid for a year.

That would be a big hit. Medicaid, the federal-state program that insures more than 70 million poor Americans, accounts for the majority of Planned Parenthoods public funding, according to Congressional Budget Office estimates. Federal Title X family planning grants make up most of the rest.

The House bill, the American Health Care Act, faces an uncertain future in the Senate. And states have faced pushback from federal officials and the courts when they try to withhold federal money from Planned Parenthood themselves.

Texas, however, has found roundabout ways to chip away at the groups funding.

Texas Republicans scored their first big win in 2011 when the Legislature reduced the two-year budget for the states Family Planning Program to $38 million from $111 million. It also approved a new way to allocate the funds that prioritized community health centers and county health departments over specialized family planning clinics like those affiliated with Planned Parenthood.

The argument was that women would be better served if they had their reproductive health needs addressed at facilities that could provide more comprehensive care; critics contend it was a way to squeeze out Planned Parenthood.

Texas also wanted to exclude Planned Parenthood from a separate Medicaid-funded program that offered family planning coverage for certain women who didnt qualify for full healthcare benefits. But the Obama administration wouldnt allow that because of a federal law guaranteeing Medicaid clients their choice of providers.

The Legislatures solution: Forgo federal funding that had paid for 90% of the program and set up an entirely state-financed version called the Texas Womens Health Program. That effort, launched in 2013, does not contract with clinics affiliated with abortion providers.

Texas actions have provided a road map for other states to follow. In May, Planned Parenthood announced it was closing four of its 12 clinics in Iowa after lawmakers there decided to set up a state-run family planning program that can legally exclude the group.

Planned Parenthood wasnt the only organization hurt by such decisions. By 2013, 82 Texas clinics a third of them Planned Parenthood affiliates had closed or stopped offering family planning services, said Kari White of the Texas Policy Evaluation Project, which studied the defunding effort. None of the clinics performed abortions.

Of those that remained open, researchers found, many had to reduce hours or begin charging for services previously offered for free.

Even when there were other clinics nearby where women could use their state benefits, White said, women would often find that they did not stock the more expensive, long-acting birth control methods available at Planned Parenthood. So women switched to less effective methods, and a few years later, some had become pregnant.

State officials take issue with some of the conclusions because they are based on a study that sampled only patients enrolled in the Texas Womens Health Program expanded and rebranded last year as Healthy Texas Women and not those who received family planning care through other programs.

Now that Trump is in the White House, the state is applying to get its Medicaid funding back for Healthy Texas Women. Since 2013, the Legislature has also committed more than $150 million in additional state funds to rebuilding the network of family planning providers and improving care for poor women more than making up for the clinic closures, according to officials.

Although participation in the states womens health programs plunged from around 359,000 in 2011 to 201,000 two years later, state figures show, the number of clients enrolled has increased since then and in 2015 was approaching 364,000.

"Texas is committed to women's health, Republican state Sen. Jane Nelson, who heads the Senate Finance Committee, said in an email. The number of providers has tripled, and we are making sure that women throughout the state can access these vital services."

Kelly Hart, a spokeswoman for Planned Parenthood of Greater Texas, acknowledged the states efforts to improve family planning. But she said a question lingers: Can [those efforts] be as good as the citizens of this state deserve if you deny a major player in womens healthcare a seat in your program?

Planned Parenthood has 34 health centers left in Texas, four of which perform abortions.

Community health centers will try to fill the gap, but many will need to hire and train staff, reconfigure space and purchase equipment, said Jose Camacho, who heads an association of such facilities in Texas.

In the meantime, women who rely on publicly funded healthcare are still having trouble finding providers who will accept new patients and can see them in a timely manner, Planned Parenthood clinicians say. That can be critical for some patients.

Four years ago, Dayna Farris-Fisher, a mother of three from Plano, discovered a lump in her breast. She didnt have insurance, because her husband had been laid off. None of the low-cost clinics she tried could see her for at least four months.

In a panic, she called Planned Parenthood. Vivian Bigelow, a nurse practitioner at the groups local health center, saw her the next day.

But if a patient like Farris-Fisher, now 50, walked into her exam room today, Bigelow said, she would have to refer her somewhere else. The breast and cervical cancer screening program that paid for the diagnostic testing no longer accepts claims from Planned Parenthood, another casualty of the states defunding efforts.

That terrifies Farris-Fisher. In the five weeks that it took to confirm a diagnosis and begin treatment, her tumor doubled in size.

If I had had to wait for one of those other clinics, she said, I literally am convinced that I would be dead.

alexandra.zavis@latimes.com

Twitter: @alexzavis

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Link:
'Defund Planned Parenthood' has gained momentum. Texas shows the effects can go far beyond just clinics - Los Angeles Times

Dani Castro had developed a UTI, but was afraid to go to the doctor due to her track record of bad experiences. She collapsed and became unresponsive, so a friend drove her to the ER. (Content warning.)

I was hospitalized, and my gender marker was listed as male, she said. I had to push back and say something. They changed it, but before I was discharged the medical provider did a pelvic exam.

During the pelvic exam, the physician moved his fingers around inside of her vagina and told her he was impressed with the results of her surgery. Dani didnt have the energy or resources to file a lawsuit and dealt with the inappropriate, traumatizing eventthrough therapy, family and friends.

Today, Castro is a project director at the University of California, San Francisco Center of Excellence for Transgender Health. The UCSF center serves to offer comprehensive care to the trans community, and offers guidelines and resources for primary care providers treating transgender and gender non-binary people.

Castro says shes spoken to folks who have had disrespectful doctors and traumatizing experiences in the emergency room, and during the far more frequent routine visits. Often, Castro says, physicians just use trans patients to answer questions theyre curious about.

Madeline Deutsch, director of UCSF Transgender Care said that specific exams should only happen if its necessary, relevant and based on evidence. In her professional opinion, asking someone for a genital exam because, oh, well theyre taking hormones, maybe they have testicular cancermaybe first make sure theres evidence. Such a relationship between hormones and cancer has not been shown.

Patients already need to travel all over the country for gender-affirming surgery, and the waiting list could be over a year. Despite broader coverage for transgender services under the Affordable Care Act, some state health insurance plans still exclude them, and who knows what will happen with the outcome of the Affordable Care Act vote. Its no surprise that simply receiving preventative care is an ordeal for trans and gender non-binary folks.

Most of us dont go for prevention, said Castro. We go when its an emergency.

The situation is miserable. In 2015, 28,000 transgender people from all fifty states took the National Center for Transgender Equalitys United States Transgender Survey, the largest of its kind. A third had a discriminatory experience at the doctors office. A quarter of the respondents did not see a doctor when they needed to because of fear of being mistreated as a transgender person. A National LGBTQ Task Force survey of 6,450 transgender and gender non-binary people from 2011 documents cases of patients concealing their identities from their doctor, and what appears to be a general lack of sensitivityin the medical fieldwhen dealing with trans issues, including using the incorrect gender pronouns and even mocking patients. Around 20 percent of the participants of that study were flat-out denied care.

Theyre afraid to go to the doctor because of discrimination, and data shows that the fear is justified, said Deutsch. When patients arrive, theyre finding doctors who arent properly trained on how to care for them.

One 2011 survey completed by 132 American and Canadian medical school deans found that undergraduates received a median of just five hours of training in lesbian, gay, bisexual and transgender-related content. Of those schools, 44 had zero hours of LGBT content in their clinical studies.

As a result, trans folks might face what some have dubbed trans broken arm syndrome, where doctors blame whatever health ailment simply on the patient being trans. Malcolm Maune, who works for Trans Lifeline, a hotline staffed by transgender people for struggling transgender people, has lupus and has frequent interactions with doctors he trusts. But hes gone to new doctors whove assumed his troubles simply stem from taking testosterone. They think thats optional, somehow, he said. Theyll just attribute all kinds of things to it that have nothing to do with it.

Sure, a few studies have shown that some men receiving testosterone for other ailments have an increased risk of heart disease. But several studies comparing transgender men with cisgender women specifically havent found an increase in cardiovascular problems. And Maunes doctors ensure he has the same amount of testosterone as any cisgendered manand cisgendered men are more likely to suffer heart attacks younger, regardless! If people assigned male at birth are happy living with that heart disease risk, then Im happy being trans living with that heart disease risk, please and thank you very much.

Not all transgender or gender non-binary folks take hormones, but it is an important way for many trans people to match their physical appearance with their identity. And for them, hormone therapy isnt optional.

Uninformed medical advice could have devastating consequences. Taking someone off of their hormones is a good way to precipitate a suicide attempt, said Maune, adding that somewhere around 40 percent of trans people attempt suicide during their lifetime. This is a matter of life and death.

Somehow, even the endocrinologists who specialize in hormones arent knowledgeable in sex hormone treatment, Joshua Safer, Medical Director of the Transgender Center at Boston University, told me. Given the increasing number of folks who identify as transgender, possibly 1 in 137 teenagers, according to a recent New York Times report, It would be hard to have an endocrine practice without seeing some [trans people], he said. A 2017 study found that of 411 practicing endocrinologists, 80 percent had treated a transgender patient, but 80 percent never received training on how to care for them.

The Endocrine Society has a set of guidelines on treating transgender patients for endocrinologists, said Safer, but theyre not up-to-date. Today, they are literally called Endocrine Treatment of Transsexual Patients, transexual being a term no longer considered to be an umbrella term for transgender people. Theyre in serious need of being revised, said Safer. Weve been working at the revisions and are sorry theyve taken us until 2017.

These oversights lead to glaring omissions in even the most basic care, like advice on maintaining a healthy lifestyle. Trans folks already suffer from higher rates of diet pill use and eating disorders than other patients. Hormone therapy can lead to weight gain or weight loss, according to UCSF Transgender Care, which could exacerbate these issues. And yet, the folks undergoing hormone treatment that I talked to have had little dietary or nutrition advice from their doctors.

When my friend Mattie White chose to start taking hormones, she had questions. How should she eat? Should she alter her behavior or lifestyle? I would even ask, Are there any vitamins I should make sure I get enough of, things I should avoid? My doctors would just say, Take whatever you want. I asked my doctor if I should eat less protein so I dont have too much muscle mass. They said, If you want to, you can eat less. I want a more specific answer than that! This ambivalenceseems to be a repeating theme.

Sadly, much of the missing guidance is supplemented through message boards and testimonials shared online, like the common tip to decrease muscle mass by avoiding protein altogether. One person I spoke with, Sarah Garland, told me that she had found this posted on blogs, Reddits r/asktransgender board, or the Susans Place forum. I know that is not healthy, said Garland, but some people do it out of desperation.

Deutsch says its unacceptable that trans folks are not provided the same kind of health advice and basic care that many take for granted. I see fear and hesitation from medical providers on providing gender-affirming care, then walk around the clinic and see the curveballs other patients throw providers, she said. They take care of patients with far more complicated and rare situations that involve more complex and costly treatment that may have more side effects of risk.

Deutsch commented that yes, there is a lack of research studying transgender people specifically. But many providers are already treating patients who take hormones, and some of the ailments theyre blaming on hormones are just common ailments that people always have that doctors already know how to treat. High blood pressure is high blood pressure and high cholesterol is high cholesterol, said Deutsch.

If medical providers are unsure about how to treat a patient, there are guidelines that can help them not be shitty about it.

The Center of Excellence for Transgender Health offers some incredibly detailed guidelines that are readily available for a minimal amount of searching consistent with the degree of searching providers do on a daily basis for other uncommon symptoms, said Deutsch. These include ailments reasonlessly blamed on hormones like cardiovascular disease and testicular cancer.

Possibly most importantly, these guidelines provide instructions on how to perform an appropriate physical exam in a way that wont drive a patient away from seeing a doctor again. Things can get better.

Trans Lifeline is a hotline staffed by and for transgender people, with experts ready to chat to folks in distress or in need of support. Its numbers are (877) 565-8860 for the US and (877) 330-6366 in Canada.

Follow this link:
How American Healthcare Is Failing Transgender Patients - Gizmodo

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CNN Library

(CNN) -- Here's a look at the use of performance-enhancing drugs in sports.

Facts: "Doping" by professional athletes has been acknowledged as a problem since at least the 1960s.

The issue gained prominence as a result of the Bay Area Laboratory Co-Operative (BALCO) investigation, tell-alls by former professional athletes, a 2007 report on drugs in professional baseball and a scandal involving Russia's 2014 Olympic team.

About Performance-Enhancing Drugs: There are several types of performance-enhancing drugs, including anabolic steroids, stimulants, human growth hormone and diuretics.

Anabolic steroids are natural and synthetic substances which help build muscle mass, enabling athletes to train harder and recover quickly from strenuous workouts.

Tetrahydrogestrinone, also known as THG or the Clear, is a powerful steroid purportedly used by such high profile athletes as track star Marion Jones and baseball player Barry Bonds.

Stimulants, including amphetamines, impact the central nervous system, increasing alertness and decreasing appetite.

Human growth hormone (HGH) is taken for improved endurance and strength.

Androstenedione is a supplement that was sold over-the-counter until the FDA took action in 2004. It is banned by the NFL, Olympics, NCAA and MLB. The supplement is an anabolic steroid precursor, meaning that the body converts it into testosterone.

Timeline: 1967 - The International Olympic Committee (IOC) establishes a Medical Commission in response to an increase in the usage of performance enhancing substances.

1981 - After American discus thrower Ben Plucknett tests positive for steroids, he is banned from participating in future events by the International Amateur Athletics Federation (IAAF) and he is stripped of his world record.

1987 - The National Football League (NFL) begins testing players for steroids.

1988 - Congress passes the Anti-Drug Abuse Act, which makes possession and distribution of anabolic steroids for non-medical purposes a crime.

1990 - Congress strengthens the 1988 law by classifying anabolic steroids as a controlled substance.

1999 - The World Anti-Doping Agency (WADA) is established.

2000 - The US Anti-Doping Agency (USADA) is established.

2002 - Federal authorities launch an investigation into BALCO, a California lab that is suspected of selling performance enhancing drugs to elite athletes. (See BALCO Fast Facts for more details).

2003 - Major League Baseball begins testing players for steroids.

February 2005 - Retired baseball star Jose Canseco publishes an autobiography, "Juiced: Wild Times, Rampant 'Roids, Smash Hits and How Baseball Got Big." In the book, Canseco recounts his own steroid use and implicates other players.

March 2005 - Six former and current Major League Baseball players testify before the House Government Reform Committee about drugs in baseball. They include Mark McGwire, Sammy Sosa and Canseco.

March 2006 - MLB Commissioner Bud Selig announces an investigation of steroid use among pro baseball players. Former US Sen. George Mitchell will lead the investigation.

August 22, 2006 - The USADA bans sprinter Justin Gatlin for eight years after he tests positive for banned substances a second time. Gatlin is also forced to forfeit his 100-meter world record.

May 2007 - 1996 Tour de France winner Bjarne Riis admits using performance-enhancing drugs to win his title. Race organizers tell him to return his yellow first-place jersey.

September 20, 2007 - Cyclist Floyd Landis is stripped of his 2006 Tour de France title and he is banned for two years after a positive test for synthetic testosterone.

December 13, 2007 - The Mitchell Report is released. MLB players named in the steroid report include Barry Bonds, Roger Clemens and Andy Pettitte.

February 2008 - Former New York Mets clubhouse employee Kirk Radomski is sentenced to five years probation after pleading guilty to distributing steroids.

February 2009 - Alex Rodriguez admits to using performance-enhancing drugs while playing for the Texas Rangers.

January 2010 - Mark McGwire admits to using steroids during his career.

February 2012 - Three-time Tour de France winner Alberto Contador is stripped of his 2010 title for doping.

June 2012 - The USADA confirms that it is opening proceedings against Lance Armstrong and five former teammates. Armstrong denies the charges. (For more details about Armstrong's case, see our Lance Armstrong Fast Facts).

August 2012 - American cyclist Tyler Hamilton is stripped of his gold medal from the 2004 Olympics after he admits to doping.

January 2013 - MLB announces it will begin random testing for HGH.

July 2013 - Ryan Braun of the Milwaukee Brewers is suspended without pay for the rest of the 2013 season for violating the league's drug policy.

August 2013 - MLB suspends Kansas City Royals player Miguel Tejada for 105 games for amphetamine use.

August 2014 - Anthony Bosch, the founder of a Miami anti-aging clinic, surrenders to the Drug Enforcement Administration. He later pleads guilty to a charge of distributing steroids to athletes. His sentence is four years in federal prison.

September 2014 - The NFL and NFL Players Association reach an agreement regarding the league's performance-enhancing drug policy. The agreement calls for HGH testing and an overhaul of the drug program.

January 2015 - Kenya's Rita Jeptoo, a three-time Boston Marathon champion, is banned from competition for two years for doping.

September 2015 - The DEA announces that 90 people have been arrested and 16 underground steroid labs have been shut down in a sweeping drug bust called Operation Cyber Juice.

November 9, 2015 - A WADA report details evidence of doping in Russian athletics and a "deeply rooted culture of cheating at all levels." Russia is provisionally suspended as a member of the IAAF in response to the doping allegations.

March 2016 - At a press conference, tennis player Maria Sharapova admits to failing a drug test at the Australian Open. She is initially suspended for two years, but the ban is later reduced to 15 months.

July 18, 2016 - A WADA report alleges Russia ran a state-sponsored doping program during the 2014 Sochi Winter Olympics. On December 9, 2016, WADA releases an update to the report concluding that a"systematic and centralized cover-up" benefited more than 1,000 Russian athletes across 30 sports.

August 4, 2016 - The IOC announces that 271 athletes from the 389-member Russian Olympic team have been cleared to participate in the Games. The rest of the team - 118 athletes - are banned in the wake of the doping scandal.

August 7, 2016 - A swimmer from the Chinese Olympic team tests positive for a banned substance called hydrochlorothiazide, a blood pressure drug that doubles as a diuretic.

August 11, 2016 - John Anzrah, a sprint coach for the Kenyan Olympic team, is sent home after allegedly posing as an athlete to take a drug test. He is the second Kenyan running coach to face allegations that he tried to help athletes cheat on doping tests. Michael Rotich, the team's track and field manager, reportedly tried to bribe undercover journalists posing as coaches, offering to pay them in exchange for advance warning about drug tests.

August 24, 2016 - The International Weightlifting Federation reports that 15 Olympic weightlifters, including three Chinese gold medalists, have tested positive for illegal growth hormones and other banned substances in doping retests.

January 25, 2017 - The IOC rules that Usain Bolt's 2008 gold medal in the 4x100m relay no longer counts after one of his teammates tests positive for methylhexaneamine, a banned substance.

TM & 2017 Cable News Network, Inc., a Time Warner Company. All rights reserved.

Originally posted here:
Performance Enhancing Drugs in Sports Fast Facts - KRTV Great Falls News

Woman's heartache at miscarrying twins

BelfastTelegraph.co.uk

A woman has told the heartbreaking story of her miscarriage and how she lost twins a fortnight apart.

http://www.belfasttelegraph.co.uk/news/northern-ireland/womans-heartache-at-miscarrying-twins-35760376.html

http://www.belfasttelegraph.co.uk/news/northern-ireland/article35760375.ece/f3af3/AUTOCROP/h342/2017-05-27_new_31501562_I1.JPG

A woman has told the heartbreaking story of her miscarriage and how she lost twins a fortnight apart.

Karen Irvine told of the devastating moment she realised she was losing her baby and - after suffering severe pain - she later learned she had been expecting twins.

"I was sitting at work when I realised I was losing my baby," Karen said. "The year was 2003, I was 41 years old and had undergone fertility treatment following years of trying to conceive.

"Only a week prior, I had been ecstatic with the news that I was five weeks pregnant and no way could I keep it a secret until week 12, as custom dictates. I told everyone immediately.

"This actually made things easier for me later, as I couldn't have hidden my grief, it was too painful.

"After one night in hospital and following a procedure the next day to remove the remaining 'products of conception', I was discharged.

"I went to bed and stayed there, weeping for the loss of our much-wanted baby and sinking into a deep depression."

However, over the next two weeks Karen began to experience abdominal pain which her GP said was her "womb shrinking back to the normal size".

But as the pain increased she sought advice from her local family planning clinic.

"On conducting a urine test the clinic said my pregnancy hormone levels oddly had increased rather than decreasing," she said.

"At home that evening I was in unbearable pain.

"At the Early Pregnancy Unit of the Royal Victoria Hospital doctors and consultants did not know what was wrong with me. One suggested appendicitis."

As an investigatory laparoscopy was about to be performed, and as Karen was going under the anaesthetic, someone mentioned an ectopic pregnancy. "I became inconsolable, begging the surgeon, if so, to move the baby into my womb," she said.

"Of course, I knew later that this is not possible and that my baby would already be dead.

"The following morning my surgeon sat at the end of my bed and said that I was lucky to be alive; I did not feel lucky, as my fallopian tube had burst and the remains of it and my foetus had been removed.

"My husband and I had lost twins two weeks apart, one from in the womb and the other in a fallopian tube. This was known as a 'heterotrophic' pregnancy."

The twins were named Tonii and Kyrie and had their names placed in the Book of Remembrance in St Anne's Cathedral.

After seven months Karen returned to work but as she struggled to come to terms with the loss she said the Mariposa Trust - a support charity providing support to thousands each week globally, who have suffered the loss of a baby at any stage of pregnancy, at birth or in infancy - helped her feel less alone.

Karen has urged people to attend the trust's Saying Goodbye service at St Anne's Cathedral tomorrow at 3.30pm.

Belfast Telegraph

Excerpt from:
Woman's heartache at miscarrying twins - Belfast Telegraph

Contributor: Anna Taylor, MS, RD, LD, CDE

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

If you or someone you care about has recently been diagnosed with breast cancer, there will be questions. These may include: What should I eat?

During any cancer therapy, remember these four diet tips:

If you dont have nutrition-related side effects from your cancer treatment that limit your ability to eat and/or digest food, you can follow a generally healthy diet that includes:

Fruits and vegetables contain antioxidant and anti-estrogen properties. Cruciferous vegetables such as broccoli, cauliflower, kale, cabbage and Brussels sprouts are especially good to include and are rich in phytochemicals.

Whole grains are unprocessed foods that are high in complex carbohydrates, fiber, phytochemicals as well as vitamins and minerals. A study by researchers at Soochow University in Suzhou, China, found that high fiber intakes may have a positive effect by altering hormonal actions of breast cancer and other hormone-dependent cancers.

Some studies, including a study by researchers at the Karolinska Institute in Stockholm, Sweden, have suggested that the type of fat you consume may initiate the development of breast cancer. Limit your intake of saturated fat such as beef, lamb, organ meats, butter, cream, etc. and decrease your intake of foods containing trans fats, which also are called hydrogenated oils. Increase your intake of fatty fish like salmon, tuna, herring, and sardines to two to three times everyweek.

For good protein sources, increase your intake of poultry, fish, and legumes such as beans and lentils.Minimize your intake of cured, pickled and smoked foods. Soy in moderate amounts, which means one to two servings/day of whole soy foods, such as tofu, edamame and soy milk, also can be included. Studies, including research reported in the American Institute for Cancer Research, show that animals metabolize soy differently than humans. Not only is soy safe in moderate amounts, but research shows that soy contains isoflavones, a phytonutrient with anti-cancer properties. Up to threeservings of whole soy foods per day does not increase a breast cancersurvivors risk of recurrence or death.

Drinking alcohol is a known risk factor for breast cancer. A large, observational study of 105,986 women suggested that drinking three glasses of wine or more per week throughout life increases a womans risk of breast cancer by a small but significant percentage. The study saw a 15 percent increased risk of breast cancer when women drank an average of three to six drinks per week, compared to women who did not drink. Try to avoid intake of alcoholic beverages when possible.

Obese women have higher levels of estrogen circulating in their bodies than women who are in their ideal body weight range.

Many studies including a study conducted by researchers from the Iranian Institute for Health Sciences Research in Tehran, Iran, have demonstrated an association between body mass size and breast cancer in post-menopausal women.

Weight reduction should be accomplished through a healthy diet and regular exercise once treatment is completed. Weight loss during treatment is not typically encouraged, as this is often associated with undesired muscle loss, leading to fatigue, a suppressed immune system, and a slower healing process.

Allow your body the nutrients it needs to fight cancer; once treatment is done, consider meeting with a dietitian for individualized recommendations to decrease recurrence risk and support a healthy weight.

Phytonutrients support human health and are found in plant-based foods, including fruits, vegetables, beans, and grains. Below, find common foods that contain important phytochemicals.

If you experience nausea, your nutritionist may recommend that you try to eat more foods that are cool or at room temperature, because they dont have a strong odor. Your nutritionist also may advise you to eatlower-fat foodsince fats take longer to digest.

Dont skip meals entirely if you have nausea, since an empty stomach can make nausea worse. Instead, focus on small bites of food throughout the day. Avoid strong flavors. Feel free to incorporate ginger root into your recipes, as this can help settle a nauseated stomach.

If constipation becomes an issue, your nutritionist may encourage you to eat fiber-rich foods and increase your fluid intake. Low-intensity walking and warm beverages also can help encourage regular bowel movements.

To combat fatigue, choose high-protein snacks and small frequent meals rather than large meals. People often experience more fatigue when they are not eating well, or when they are losing weight during treatment.

If experiencing any side effect that affects your ability to eat regularly, ask your care team if you can meet with a dietitian to review individualized nutrition recommendations.

See the article here:
The Best Foods to Eat When You Have Breast Cancer - Health Essentials from Cleveland Clinic (blog)

Doctors have been adding a new tool to the arsenal of how they restore the sex lives ofmenopausaland post-menopausal women: the humble vibrator.

With the onset of menopause, a decrease in the production of hormones causes vaginal tissue to get thinner and drier. Vaginal muscles can also atrophy, leading to painfulsex a problem for half of all menopausal and post-menopausal women, according to the National Institutes of Health.But the solution might be as simple as a vibrating piece of silicon.

Vibrators that are used internally stimulate pelvic blood flow, which increases vaginal moisture and boosts sexual response, all of which makes sex (with or without a partner) better. Like any muscle, the vagina is best kept healthy with regular exercise its the use it or lose it thing. Deterioration of this muscle becomes more common as middle-age or older women find themselves in situations where they arent sexually active anymore single, divorced, widowed or just not having regular sex with partners.

Therapeutically speaking, frequent vibrator use can prevent and ward off conditions such as painful vaginal dryness and atrophy. And yes, doctors are recommending their use with the caveat that since the vibrator industry isnt regulated, certain cautionary steps should be taken. (In brief:Keep anything you put inside your privates clean, and dont share your toys with friends.)

Dr. Barb DePree, whos been a gynecologist for about 30 years and was recognized by the North American Menopause Society in 2013 as the practitioner of the year for her exceptional contributions to menopause care, has long been prescribing vibrators to her patients. She keeps one handy in the exam room when she explains to her menopausal patients why regular vibrator use will be beneficial to their health, and suggests they try it.

While a few patients might have blushed through the years, all of them have been willing to take it for a spin, DePress told HuffPost. She explains that vibrators that stimulate just the clitoris might be fun, but for intercourse with a partner to resume pain-free, there must be pelvic floor activity.

One of her patients is a 70-year-old woman who reports having sex two or three times a week now without the use of lubricants or estrogen creams. She doesnt always achieve an orgasm, but according to her doctor, is quite pleased with what working with a vibrator for a few months accomplished.

DePree draws this analogy: When your vision started to fail, you didnt give up reading. You went out and bought yourself a pair of readers. Same thing is true about sex.

A survey of more than 2,000 women aged 18 to 60 indicated that 52 percent have used a vibrator.

Another benefit of vibrator use, said DePree, is they can help address the fact that orgasm intensity weakens with age. She said she commonly hears women say, Orgasm takes so much longer, and comes and goes so quickly its hardly worth it. She said, Those are the women who may benefit from introducing a vibrator too.

In a published paper she authored, DePree discussed a 52-year-old post-menopausal patient who sought her help. The woman estimated that at least five years had passed since she last experienced an orgasm. The patient had multiple sclerosis and was taking a selective serotonin reuptake inhibitor. She had tried a vibrator in the past, without success.

As a physician, I knew that she needed a more powerful motor for more intense stimulation. I was able to let her feel the difference and obtain the appropriate vibrator. Imagine her appreciation when she returned after achieving success, DePree said.

Having vibrators to road test in the safety of a doctors office also seems to be a boon. Not every woman feels comfortable going into a sex toy shop for the purchase. Online, the choices are mind-boggling. There are hundreds to choose form, and they can range in price from under $10 to the super-deluxe MotorBunny for $900 and the even higher priced Sybian.

Dr. Mary Jane Minkin, a Yale University obstetrician and gynecologist, brought vibrators out from under the bed a few years ago when she began prescribing them to Yale Cancer Clinics cancer patients, who often struggle with early menopause and need to combat its side effects. The vibrators increased her patients blood flow, and yes, improved their sex lives.

While the American Congress of Obstetricians and Gynecologists, the primary professional organization for ob-gyns, doesnt have an official policy on using vibrators to treat menopause and post-menopausal symptoms, a spokeswoman from the group told HuffPost that the organization doesnt really take issue with it.

And the organization does recommend masturbation to combat painful sex. I believe you could extrapolate that external stimulus, like a vibrator, fits into those categories, said Maggie McEvoy of the ACOG communications staff.

There are, of course, other options to help restore the vaginas elasticity and health for those who are unable or unwilling to go the vibrator route.

Hormone replacement therapy is controversial, but still on the table. Its use to treat symptoms of menopause changed abruptly after a large clinical trial in the U.K.found that the treatment actually posed more health risks, like breast cancer,than benefits for one type of hormone therapy.

But further review of clinical trials and new evidence show that hormone therapy may be a good choice for certain women, depending on their risk factors.Low-dose vaginal preparations of estrogen which come in cream, tablet or ring form can effectively treat vaginal symptoms and some urinary symptoms, while minimizing absorption into the body, says the Mayo Clinic.

There are also vaginal lasers, a relatively new FDA-approved treatment, that work by stimulating collagen production along vaginal walls, helping to build up the tissue again. The MonaLisa Touch and similar laser processes require three treatments (spaced a month apart) and cost about $3,000 that likely wont be covered by your insurance.

On the plus side, there have been18 studies that speak to the MonaLisa Touchs efficacy, all largely positive. One Stanford university study of 30 women found that all of them responded positively to the treatment. They showed highly statistically significant improvement in symptoms including dryness, pain, itching, painful urination and painful intercourse after the first treatment.

The North American Menopause Society gives the process a resounding maybe. It notes that the FDA approval process for devices is less strenuous than the one for new drugs, and these products havent survived the test of time yet. Meaning: They havent been around long enough to know the longer-term results.

The procedure itself doesnt hurt, but does require an annual maintenance treatment.You also shouldnt have laser therapy until youve had a Pap test and a thorough exam by your doctor to ensure that there are no other medical issues such as fibroids causing the pain.

Options are a good thing, right?

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When Your Doctor Prescribes A Vibrator - HuffPost

A test commonly used in breast cancer has been found to also identify which patients with aggressive prostate cancer will benefit from hormonal therapy, according to a study led by scientists at UC San Francisco and the University of Michigan.

While hormone therapy has been used successfully to treat many prostate cancer patients, until now, researchers have been unable to predict which patients would benefit from early initiation of this therapy following surgery. The study, conducted by a team of researchers at 11 medical centers nationwide and in Canada, demonstrates the first new way to select the best treatment for specific patients.

In the study, which appears today in the journalJAMA Oncology, the researchers divided prostate tumors into three subtypes based on genetic patterns. Their results reveal that starting hormone treatment after surgery prevents the spread of the tumor in only one of the three types, known as luminal B, a particularly aggressive form that affects about one-third of those with the disease.

Hormone therapy carries significant side effects, so knowing which patients are likely to benefit from it can focus treatment on the right patients at the appropriate time, while sparing the others of increased risk of fatigue, sexual dysfunction, osteoporosis, diabetes and other conditions.

If confirmed, patients with the luminal B subtype could be selected for early initiation of hormone therapy, which would allow for treatment intensification for patients most likely to benefit from it, saidFelix Feng, a radiation oncologist with UCSF Health and a senior author of the study.

Weve clearly shown that there are different molecular subtypes of prostate cancer and that a test widely used in breast cancer can also potentially be used to help individualize therapy for prostate cancer patients as well. said Feng,a UCSF associate professor of Radiation Oncology, Urology, and Medicine, who specializes in the treatment of high-risk, aggressive prostate cancers. He is also a member of the UCSF Helen Diller Family Comprehensive Cancer Center.

The hormone treatment is known as androgen-deprivation therapy, or ADT. Just as estrogen has been found to promote breast cancer growth, male sex hormones called androgens notably testosterone stimulate prostate cancer. As in breast cancer treatment, depriving cancer of the critical sex hormone can starve some prostate tumors.

The test, called PAM50, has been used for over a decade to identify which breast cancers are the best candidates for hormone treatment. But no such screen has been available for prostate cancer, Feng said. The new research shows that PAM50 can also distinguish between the three prostate cancer subtypes.

Ultimately, our goal is to find the right treatment for the right patient at the right time, said Feng. Using the PAM50 test may allow us to take the first step towards this goal, in the setting of hormone therapy for prostate cancer patients treated with surgery.

Fengs co-senior author on the research paper, Daniel Spratt, a radiation oncologist at the University of Michigan, commented on the potential of the biomarker to distinguish between the three prostate cancer subtypes: luminal B, luminal A and basal.

Prostate cancer has seen a recent surge of both investigational and commercially available prognostic biomarkers, Spratt said. Luminal and basal subtyping can be added to a very short list of predictive biomarkers in prostate cancer to truly personalize treatment for prostate cancer patients.

The retrospective study focused on 1,567 prostate cancer samples from high-risk patients who had undergone radical prostatectomy. The scientists identified the three distinct gene expression profiles that define the three cancer subtypes and confirmed the finding in another 6,300 prostate cancer samples.

They determined that luminal B disease was the most aggressive, with metastases recurring in about half of the patients over 10 years, compared to about one quarter of the patients with the luminal A or basal subtype.

They found that ADT treatments were more effective with luminal B tumors and may even have worsened prognosis in the other types of tumors a finding that would need to be confirmed with a prospective study and to firmly establish the biomarker finding as a diagnostic tool to guide treatment, said Feng.

Feng and Spratt will co-lead a large, National Cancer Institute-funded prospective clinical trial involving as many as a hundred clinical research sites, using the PAM50 assay to identify patients by their cancer subtype, and then randomly assign them to treatment with radiation and a placebo or radiation and hormone therapy treatment.

Our research published today, while very provocative, needs to be validated in this prospective study, the researchers said. Were hopeful that the biomarkers will prove to be a robust predictor of hormone treatment success, so we can increase survival of even the most aggressive cases and at the same time limit hormone treatment to those patients most likely to benefit from it.

In addition to Feng and Spratt, co-authors include first author Shuang G. Zhao, from the Department of Radiation Oncology, University of Michigan, as well as additional researchers from UCSF; the University of Michigan, Ann Arbor, Mich.; GenomeDx Biosciences, Inc., Vancouver, British Columbia; the University of Wisconsin, Madison; Thomas Jefferson University, Philadelphia, Penn.; Cedars-Sinai Medical Center, Los Angeles, Cal.; Cleveland Clinic, Cleveland, Ohio; University of British Columbia, Vancouver, BC; Mayo Clinic, Rochester, Minn.; Johns Hopkins Medical Institutions, Baltimore, Md.; Northwestern University, Chicago, Ill.; and Harvard Medical School, Cambridge, Mass. The full list of authors, institutional citations, and declared conflicts of interest can be found in the full paper.

Funding for the study was provided by the Prostate Cancer Foundation, Evans Foundation, V Foundation for Cancer Research, and A. Alfred Taubman Medical Research Institute.

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Agnes LLOYD-PLATT

This isnt what I came for. Id walked into the acupuncture clinic close to my house - one of those mysterious places that lists ailments in the window to draw people in - in desperation with my painful shoulder, and a few minutes pulse-checking and tongue-inspecting later, I got this: Your metabolism is like a belligerent, ageing dog, unwilling to go for a walk. Im affronted, which seems to spur the Chinese-medicine therapist on: You are a tortoise when you should be a hare. Or at least a rabbit. Right. Im too polite to tell her to stop the animal metaphors, but Im concerned. I do feel sluggish, but then doesnt everyone? Or perhaps everyone doesnt feel like this and I am indeed a tortoise.

The word metabolism is bandied about all the time as women we decide the type of metabolism we have when were teenagers, and this notion sticks. Increasingly, though, its being seen as one of the pillars of preventative medicine - that current health buzz phrase. Its a major shift in perception for doctors and patients alike. Its vital to recognise the warning signs your body is giving you and act to prevent avoidable damage. You can outfox ageing, declares Dr Sara Gottfried, epigenetics expert and author of the New York Times bestseller The Hormone Cure, as well as a new book enticingly titled Younger. Certainly, it feels compelling to ease the gradient and speed of hormonal decline to protect heart and bone health and OK, I admit it, to stave off a middle-age spread rather than tackling it once it appears.

But it occurs to me that I still dont really know what metabolism actually means. The dictionary definition is uninspiring: The chemical processes within a living organism in order to maintain life. I mention it to my psychologist friend Nicole Sihera, who rings later that day. Well, its easier to blame metabolism than take responsibility for ourselves, isnt it? Its called a self-serving bias, she says. Of course, it does feel very unfair when you see someones Instagram account where they spring out of bed at 6am every day, citing the power of positivity and theres not a bloated stomach or podgy arm in sight. Its enough to make me reach for a pain au raisin and blame my metabolism, but I suspect theres more at play.

The fact is, I do feel lethargic in the mornings, even after a good nights sleep, and my weight has crept up by several kilos in the past few years despite no obvious change in my diet. I drink more alcohol than I used to and am probably not as active. My first thought is to have a full fitness analysis to get some truths. I decide to book in with head trainer and sports-medicine specialist Luke Worthington at the Third Space and make a mental note to be as transparent with him as I can.

I walk in to discover that Luke is an Adonis and I am immediately disinclined to reveal anything, especially not my suspected too-high body-fat percentage. I know youd like me to tell you that people can have a fast or a slow metabolism but that isnt the case, he says. The differences between our metabolic rates are marginal, to say the least. In fact, the number of calories we need is highly correlated with lean muscle mass. The higher the muscle mass, the higher the metabolic rate. This is why men can eat more. Its also a main factor in why we put on weight as we age, because our muscle mass declines. Well, that isnt the answer I wanted. I rail at him, giving him anecdote upon anecdote about the girl we all know who has Dairy Milk and lattes for breakfast but is a size eight. Luke listens patiently and says: The very best advice I can give you is to start weight-bearing exercise. The tipping point for muscle decline is 30. By 40 you start to see the visible physical effects unless you put in the work. The benefits to the body are numerous, not least an increased sense of energy and wellbeing.

I undergo a full scan, which enthusiastically spews out all kinds of stats about the state of my body. I am less than wowed. My magic personal metabolic rate is 1,424 calories, the number that my body would need to keep going each day if I just sat still. For comparison purposes, Luke tells me that his gym-bunny colleague, who is a similar age and height but has a higher lean muscle mass than me, has a personal base rate of 1,600. Theres a handful of nuts in it, calorifically speaking. Luke does crack and say there are other factors, which can be implicated in a feeling of sluggishness that we commonly call a slow metabolism, and I pounce on them, disliking myself for my desire for a quick fix. Thyroid function plays a role, as do insulin response and hormone profile, all of which can be affected by age. But if we eat well and exercise regularly, then much of this negative change is avoided, he explains. My next move, then, is to book in for blood tests to see if hormone function is at play.

Its no coincidence the majority of my patients are over 40 and report the same unhappy triumvirate: fatigue, a sluggish digestion and weight gain, says Dr Sohre, a GP-turned-private-wellness doctor from the Omniya clinic in London. The common factor is a changing hormone profile which can have a negative effect on our wellbeing and certainly influences our metabolism. Quite literally we start to feel less energetic. I undertake a sweep of tests to determine the state of my hormones. Testosterone, which women need to feel vital and maintain muscle mass, is often the first to fall, Sohre continues. I ask what metabolism means to her. For me, it means how healthy we feel and how well we process what we eat. Weve all had that heavy feeling after a meal that, for some, can last for days. I believe improving gut health, optimising hormone levels before the crisis of menopause and eating a healthy diet is the key to getting our metabolic processes firing on all cylinders.

While I wait for the results, I throw myself into some gym visits. I spend time on the weight machines because Luke Worthington and Dr Sohre were both unequivocal: muscle equals metabolic oomph. I tell myself Ill reap the rewards of the afterburn the brilliantly fizzy metabolic term for the two-hour period after exercise when the metabolic rate is proven to increase two- to threefold. Exercise increases metabolism, says Dr Thomas Barber, an obesity researcher and associate professor of clinical endocrinology at the University of Warwick, but it doesnt have to be strenuous. Just by walking about, youre boosting your metabolism and improving health. Weve found that the process of simply contracting a muscle releases beneficial hormone signals called myokines, he explains.

Results day, and Dr Sohre draws a circle on a piece of paper, placing the words thyroid, cortisol, insulin, female hormones around the outside. Each of these will impact your wellbeing and all are mutually dependent. So, for example, a waning thyroid will drain the bodys progesterone production, and a body pumping out the stress hormone cortisol will drain the thyroid, she explains. Results bands for blood tests are typically quite broad. If you were being assessed in the NHS, you would be told you are OK. Theres a pause. But Im looking for optimum health and all of your results are in the bottom third of these reference bands. Your thyroid function isnt clinically abnormal but with levels like this at your age I would expect you to feel the cold more than most, accumulate fat on your tummy and be fatigued. Yes, yes and yes. Your results are clearly sub-optimum and only headed in one direction without intervention. Im starting to feel that the grim reaper will lurch out of the supplies cupboard. No one wants the blood results of a septuagenarian, not even a septuagenarian.

Dr Sohre lifts the mood with her can-do attitude and a plan of action that includes a high-strength thyroid-support supplement, which I am to take as religiously as a medicine to see if we can pep it up without recourse to a prescription for something stronger. A well-functioning thyroid means feeling rested on waking, an efficient digestion and the body basically running more sparkily. I resist knocking back the whole bottle right there at her desk. Im also dispensed a bio-identical progesterone hormone to top up my waning supplies to balance my oestrogen, which she promises will make me feel less grumpy, less puffy and more energetic. Lastly, I am prescribed DHEA to bolster my below-average results. Its the mother hormone made in the adrenal glands. It manages the metabolic processes in the body and cascades to make lots of other hormones, and dwindles with age. By 70 we make around 20 per cent of what we make in our twenties, explains Dr Sohre. DHEA production is also hampered by stress because the body diverts attention to pumping out cortisol, so the stressed-out middle aged are hardest hit. DHEA is considered by many to be a panacea for all ageing ills and is available over the counter in many countries but not in Britain. I realise I am clutching the bottle like Gollum with his ring.

I leave Omniya feeling optimistic, reflecting on the decision Ive made to take medication to optimise my wellbeing rather than treat illness. Its quite clear that metabolism is more than just a weight-gain/weight-loss stooge. Its a catch-all for all the biochemical reactions happening in the body and the trick is to set the conditions to help it flourish. So dont question whether yours is fast or slow, ask instead: is it functioning well?

The fast lane Your thyroid is the main driver of your metabolism. Look after it. Natures Plus Ageloss Thyroid Support, 31 for a months supply, at Amazon.co.uk or Omniya.co.uk

Listen to your body If youve slowed down, think about a body MOT with a preventative medicine specialist. Metabolism & Energy consultation with Dr Sohre at Omniya (3a Montpelier Street, SW7), 250

Help your body burn energy efficiently Healthy gut flora have been proven to support metabolic processes from insulin sensitivity to the livers ability to metabolise fat, explains nutritional therapist Kerry Beeson. Optibac Probiotics Extra Strength, 22.99, Optibacprobiotics.co.uk

Cooling the body induces a metabolic kick The latest fad is to lock yourself in a cryo chamber at -90C to burn calories, heal injuries, pump up the endorphins and give your body a turbo boost. I left bouncing around like a teenager. 95 per session, at 111cryo.com

Metabolism is like moving a boulder Getting started is the tricky part, then momentum takes over. For impetus, drink strong green tea, which has thermogenic properties, and take a mood-enlivening supplement: try Higher Nature Drive (18.30, Victoriahealth.com) which provides the co-factors for energy, balanced brain chemistry and get up and go.

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What Is Metabolism? - Vogue.co.uk

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May 12, 2017 Credit: Vetmeduni Vienna

Alpacas, a species of New World camelids, have very thick wool. This requires them to be shorn regularly, just like sheep. But shearing is a source of stress for the animals. This has now been confirmed for the first time by researchers from Vetmeduni Vienna based on an evaluation of clinical, hormonal and behavioural parameters. The scientists were able to show that even the act of restraining the animals in different positions released higher concentrations of the stress hormone cortisol. Shearing the animals on the floor or on a special tilt table also resulted in changed clinical parameters such as heart rate. These values remained at normal levels only when the animals were sheared in a standing position. But shearing animals in the standing position is only possible if the alpacas do not resist being restrained with a risk of injury to themselves or to their handlers. These animals should be restrained on a mattress on the ground or on a tilt table. The study was published in Veterinary Records with organisational and financial support from the Alpaca Association e.V. of Germany and the Austrian Buiatric Association.

Alpacas are members of the camel family and, like llamas, guanacos and vicuas, belong to the New World camelids. Domesticated they are of great importance in South America, especially in Peru, where they have been kept and bred for their wool for thousands of years. In Europe, on the other hand, alpaca breeding is relatively uncommon. But the number of animals and breeders has been growing for years. Just like sheep, alpacas must be shorn regularly to harvest their wool. The procedure is an unusual one for the animals and thus a source of stress. An interdisciplinary team of researchers from Vetmeduni Vienna has now investigated for the first time which shearing position produces the least amount of stress for the animals and therefore represents the least stressful method from the point of view of the animal's wellbeing.

Stress hormone detectable in saliva and faeces

Unlike sheep, which are usually turned onto their backs, alpaca breeders use several different methods of restraint. The animals are either held by assistants in a standing position, restrained on a mattress on the ground or placed on special shearing tables. Previously, there had been no studies as to which method produced the least stress among the animals. "The stress of the animals can be determined based on clinical parameters, by observing the animals' behaviour or through the laboratory analysis of saliva and faeces," explains senior author Susanne Waiblinger of the Institute of Animal Husbandry and Animal Welfare. Saliva and faeces contain cortisol, which is an important stress marker. Saliva cortisol is considered to reflect a short-term stress response, whereas faecal cortisol shows longer-lasting stress responses. Besides measuring stress-induced hormonal levels, the researchers also looked at clinical parameters, such as heart rate, respiratory rate and body temperature, as well as the animals' behaviour.

Clinical parameters nearly unchanged when shearing in standing position

To describe the impact of shearing on the alpacas, the team divided its study into two parts. Part one studied the level of stress caused by each of the restraining methods, as the shearing itself represents a separate stress factor. In part two, the animals were divided into groups and shorn using one of the methods. Animals that were restrained without shearing exhibited no significant changes in terms of the clinical parameters. Both the respiratory rate and heart rate remained at normal levels. "The body temperature was unchanged during this part of the study. But if the animals were restrained and also shorn, the clinical values changed significantly in the animals that were restrained on the floor or on the table. For all restraining methods, however, body temperature remained unchanged. This makes alpacas different from sheep or from the alpaca's relative, the vicua," says first author Thomas Wittek of the University Clinic for Ruminants.

Stress hormone shows that alpacas are only stressed by the restraint

The analysis of the cortisol concentrations in saliva and faeces, on the other hand, showed that the animals were also stressed in the first part of the study despite the almost unchanged clinical parameters. Saliva cortisol levels were clearly higher after just 20 minutes and increased even further within 40 minutes. The cortisol concentrations then remained unchanged, although the higher levels could be demonstrated in faeces even 33 hours later. During restraint and shearing, the cortisol values also increased regardless of the shearing position. When animals were restrained on the ground, however, this led to a more significant increase of hormone levels over time compared to the other two methods. Faecal cortisol levels remained at the same high levels in all three groups.

Animal behaviour just as important for choice of restraining method

"At first glance, it appears difficult to compare or associate the two experiments," says Wittek. "But we can assume that just the sound of the shearing machine and the duration of the restraint cause stress for the animals. This means that you can practically add the values." Merely positioning the animals is a source of stress, which then increases further through the act of shearing. The standing position was tolerated the best by the alpacas in terms of the clinical parameters. Restraining the animals in the standing position, however, only makes sense and is only possible if the alpacas remain calm. If they resist from the beginning, the risk of injury to themselves or to one of the handlers is too great, says first author Wittek. These animals should therefore be restrained on a table. The handlers usually know the behaviour of their animals and can decide in advance which method to use.

Explore further: Can aromatherapy calm competition horses?

More information: T. Wittek et al. Clinical parameters and adrenocortical activity to assess stress responses of alpacas using different methods of restraint either alone or with shearing, Veterinary Record (2017). DOI: 10.1136/vr.104232

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Shearing of alpacas is necessary, but also stressful - Phys.Org

It's the season of longer days, and many forgo a good night's rest to tackle that to-do list. Just because the sun stays up longer, doesn't mean you must.

KING 5 Healthlink and NBC News , KING 6:07 PM. PDT May 11, 2017

As the days grow longer, you might stay up longer and wake earlier, but doctors say getting seven to 9 hours of sleep should be a priority.

Most of us know the importance of a good night's sleep, but research shows that few of us get the recommended seven to nine hours a night.

"It's more of a reminder to make sure that you're not sleep deprived and making sure that you get enough sleep. Make sure that you make sleep a priority," said Dr. Charles Bae, a neurologist at the Cleveland Clinic.

To make sure you're getting quality sleep, it's important to limit exposure to stimulants such as caffeine, energy drinks, and the blue light that comes from tiny screens on our cell phones or tablets. That can interfere with your circadian rhythm or natural sleep-wake cycle.

Baesays not getting enough sleep or being sleep deprived increases a person's likelihood for decreased alertness, especially while driving, a decline in memory and cognitive function, as well as an increased risk for several other health risks.

"Linked to increased risk of diabetes, high blood pressure, also there's connections to increased risk of heart attack and stroke, and that's all from not getting enough sleep," saidBae.

And getting enough sleep is equally important for kids. Sleep triggers the body to release a hormone that promotes healthy growth in children and teens, boosting muscle mass and repairing cells and tissue.

2017 KING-TV

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Make sleep a priority on long summer days - KING5.com

The adrenal glands sit atop the kidneys.

The adrenal glands affect metabolism, blood pressure, the immune system, sex hormones and the body's response to stress. The human body has two adrenal glands. About 1 inch by 2 inches (2.54 centimeters by 5.08 cm), they sit on top of the kidneys.

Along with the parathyroid glands, pituitary gland, thyroid gland, pancreas, ovaries (in females) and testicles (in males), the adrenal glands are part of the endocrine system. This system produces hormones that control just about every function in the body.

"The adrenal gland is an intricate part of the HPA (hypothalamus, pituitary, adrenal) Axis," Dr. Mark Engelman, permanent Clinical Consultant for Cyrex Laboratories, told Live Science. "This intimate physiological relationship is fundamental and critical to our wellbeing."

The hypothalamus acts as the body's thermostat, Engelman said. It senses most of the important physiological elements involved in homeostasis and sends out signals to correct perceived unhealthy variations. It connects directly to the pituitary gland, which essentially picks up the orders from the hypothalamus and sends out signals to various organs and glands, including the adrenals, to carry out these orders. The adrenal glands then produce a wide range of hormones, including estrogen, adrenalin and cortisol.

"One of the primary activities of cortisol is to increase available glucose to the nervous system by breaking down protein and fat to glucose in the liver," Engelman said. "It helps block glucose uptake into tissues other than the central nervous system."

Cortisol also has powerful anti-inflammatory and anti-allergy actions, according to Encyclopedia Britannica. It decreases the activities of the immune system to reduce inflammation conditions. Because of this, it is used to treat dermatitis, insect bites, inflammation from arthritis and ulcerative colitis.

One of the most important functions of the adrenal gland is the fight-or-flight response. When a person is stressed or frightened, the adrenal gland releases a flood of hormones, such as adrenaline and cortisol. These hormones increase the heart rate, elevate blood pressure, boost energy supplies, sharpen concentration and slow down other body processes so the body can run from or fight a threat.

Too much of a stress response is a bad thing, though. Too much exposure to elevated hormones from the adrenal gland can cause anxiety, depression, digestive problems, headaches, heart disease, sleep problems, weight gain and memory and concentration impairment, according to the Mayo Clinic.

There are many dysfunctions and diseases associated with the adrenal gland. One of them is the growth of tumors on the glands. These tumors can be benign or cancerous and can throw off the proper production of hormones. A tumor that causes the gland to create too much hormone is called a functioning tumor, while a tumor that causes too little hormone to be produced is called a nonfunctioning tumor. Approximately 4 to 12 out of 1 million people develop a type of adrenal tumor called adrenocortical carcinoma, according to American Society of Clinical Oncology. Some types of adrenal tumors may be linked to ADHD.

A "trendy" disorder is adrenal fatigue. It currently is not an accepted diagnosis option for the medical community at large. The Mayo Clinic defines adrenal fatigue as "a term applied to a collection of nonspecific symptoms, such as body aches, fatigue, nervousness, sleep disturbances and digestive problems." These symptoms are thought to be caused by a wide range of adrenal problems, such as low hormone production.

Engelman said he thinks the signs and symptoms of adrenal fatigue are not related to the ability of the adrenals to work, but rather decreased stimulation from an over-taxed central nervous system. The entire physiological system is based on the concept of maintaining homeostasis. "I have heard from lecturers and read many theories and controversies about 'adrenal fatigue,'" Engelman said. "The ones that make the most scientific sense to me relate to the down regulation of central nervous system receptors to stress signals. This ultimately decreases downstream stimulatory signaling to the adrenal glands as a brain self-protective mechanism from the damaging effects of long term stress."

Adrenal fatigue is thought to be a lesser form of adrenal insufficiency. Adrenal insufficiency (Addison's disease), a condition widely accepted by medical experts. It occurs when the adrenal gland does not produce enough hormones as a result of an underlying disease. Some symptoms are:

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Being acquainted with what each time in your cycle means and the accompanying symptoms can help you better understand your period.

Lets start by establishing how we count the days. Day 1 is the first full day of flow. The length of your cycle is counted from Day 1 of this cycle and until Day 1 of your next cycle.

Cycles vary widely anything between 24 to 35 days is perfectly normal, but for simplicity sake, we often refer to a 28-day cycle. (This is especially applicable if youre on birth control that works on a 28-day cycle.)

More:These Two Life Events Could Predict Early Menopause

Your cycle has two major phases, follicular and luteal, with a brief but crucial third phase, ovulation, in the middle. When it comes to your menstrual cycle, estrogen and progesterone are the primary hormone drivers. Fun fact: Its what many forms of the birth control pill consist of. These hormones are secreted by the ovary, and are responsible for stimulating the lining of the uterus or womb, called the endometrium, to grow and prepare for a potential pregnancy.

The first phase of your cycle is called the follicular phase. This is because the main event during this phase is the creation of a follicle in the ovary. It is from this follicle that an egg is released, which is known as ovulation. This phase varies in length, but is usually between 12 and 16 days.

During your period in the first few days of your cycle, both estrogen and progesterone are low. Starting around Day 4 to 5, estrogen levels gradually begin to rise and what is called a dominant follicle forms. The dominant follicle prepares the egg for ovulation. Around cycle Day 10, estrogen production increases dramatically and progesterone slowly begins to rise. Estrogen surges around Day 12 to 13, meaning it shoots up, quadrupling levels, but then falls almost all the way back to pre-surge levels.

Twenty-four to 36 hours after estrogen surge, ovulation occurs. The dominant follicle releases an egg and becomes what is called the "corpus luteum." In a 28-day cycle, this is around Day 14.

More: "Period in a Petri Dish" Could Have a Big Impact on Reproductive Research

The last phase of your cycle, which is called the luteal phase referring to the corpus luteum, begins after ovulation. This part of your cycle is less variable in length and should consistently be 13 to 14 days. Both estrogen and progesterone rise sharply 1 or 2 days after ovulation. They peak about a week later around Day 20 to 22 and then if pregnancy does not occur, fall precipitously, resulting in low levels by Day 28. Now that your hormone levels are low, your next period starts, and it all begins again.

As you can see, there are some hormonal highs and lows throughout the month. Considering what is happening with your hormones may help to explain why some days you feel awesome and others not so much. For instance,according to Sarah Jio at Womans Day,during the first week of your cycle when estrogen levels are low, you may have less energy and a lower libido. So prepare for that. Plan for extra sleep if youre tired or extra time with your partner if you notice your libido is low.

Menstrual migraines are a classic example. According to the Mayo Clinic, estrogen and progesterone may affect brain chemicals associated with headaches. Drops in estrogen, which occur both around the time of ovulation as well as premenstrually, can make headaches worse. Birth control pills can control headaches by keeping estrogen levels steady.

Although the exact causes are not known,the Office on Womens Health states that an important cause of PMS is changing levels of hormones. Since PMS symptoms can begin anywhere from 1 to 2 weeks before your period starts, consider what is happening with estrogen and progesterone during that time. They are both rising dramatically and then falling precipitously. No wonder some women just dont feel well during that hormonal roller-coaster ride.

Every woman thinks that its the sudden drop in estrogen from not ovulating that causes the problems. But in reality, its the fluctuation of estrogen along with less progesterone that is behind many of the typical symptoms of perimenopause,says Dr. Steven R. Goldstein, professor of obstetrics and gynecology at NYU Medical Center in New York City.

More: Irregular Periods Explained: 8 Big Reasons Your Period's Gone MIA

Understanding the elaborate hormonal changes that occur throughout the month and in what way they may affect how you feel including your mood, energy and libido to name a few can help you anticipate and prepare for the highs and lows. This way, you can ride the hormonal wave instead of being crushed by it.

By Katie Killoran

Originally published on HelloFlo.

More here:
Here's What Happens to Your Hormone Levels During Your Period - SheKnows.com

According to theMarch of Dimes, each year more than 12,000 newborns are identified as having a condition detected through newborn screening. Newborn screening is the practice of testing every newborn for certain genetic, metabolic, hormonal, and functional conditions. If diagnosed early, many of these conditions can be successfully managed, improving lives and reducing costs. If not diagnosed, or not diagnosed and treated in a timely manner, these conditions can cause severe disability or death.

Through newborn screening, nearly every baby in the United States is tested for genetic disorders shortly after birth. Health care providers collect blood samples from newborns and send them to labs for testing. But a recentreportissued by the U.S. Government Accountability Office found most states have not met federal benchmarks to screen 95 percent of blood samples within seven days of birth by 2017.The report was required as part of a bill signed by President Barack Obama in 2014, in response to aMilwaukee Journal Sentinel investigationthat found infants have died and suffered permanent disabilities because of screening delays by hospitals and state labs.

Further, lab policies and protocols for newborn screening vary widely from state to state. The lack of uniformity in newborn screening means a child who suffers permanent disability in one state might have been diagnosed and treated in another, the investigation found. Each state runs its own program and sets its own standards to detect the disorders.

In an effort to prevent treatable conditions from causing permanent disabilities in children, theAdvisory Committee on Heritable Disorders in Newborns and Childrenin the U.S. Department of Health and Human Services is studying inconsistencies in newborn screening. Disability Scoop reports that the committee seeks to provide guidance to state public health labs on how to better test newborns for genetic disorders. According to Joseph Bocchini, chairman of the committee, every state should look at this issue carefully, making adjustments as appropriate to take every precaution to minimize bad outcomes,

The Mayo Clinic has developed software under a federal grant to improve the accuracy of newborn screening. Since 2004, researchers and labs around the world have built a database of true-positive cases to better predict which babies have a genetic disorder. The software draws on screening results from 30 million babies throughout the world, 19,000 of whom were diagnosed with metabolic disorders. Instead of relying on cutoff values that may be arbitrary or outdated, labs can compare each newborns results with babies who have actually been diagnosed. An algorithm analyzes results from each child tested by a state lab and flags those whose results are similar to babies known to have a disease. The software also can reveal how a labs cutoffs might miss babies.

But many state labs dont use the software. Also Mayo Clinic controls access to it. Dieter Matern, a committee member and co-director of the biochemical genetics laboratory at the Mayo Clinic pressed the committee to move quickly to have states use the software to make newborn screening more uniform throughout the country.

One disorder that newborn screening tests identify is congenital hypothyroidism, a disorder where the childs thyroid doesnt work properly or is absent. Thyroid hormone is crucial in the first three years of life, helping a babys brain, bones and organs develop. Congenital hypothyroidism is considered the most common, preventable cause of intellectual disability. A newborn diagnosed with the condition is immediately started on replacement thyroid hormone, often within the first few days after birth and thereafter develops normally while taking a thyroid hormone pill daily.

When newborn screening levels for congenital hypothyroidism are slightly below a states cutoff, the result is reported as Normal. However, that cutoff varies from state to state, meaning the newborn screening levels for a child born in one state may be flagged as abnormal, triggering further investigation and treatment while a child born a few miles away may be missed due to a lower cutoff level, possibly leading to a preventable disability.

A mother whose two children were born with congenital hypothyroidism recently addressed the committee. One of the children was diagnosed shortly after birth and began treatment immediately. He is a typically-developing four year old. However, his siblings newborn screening levels were not high enough to be flagged in the state where he was born and he did not begin treatment until he was nearly three years old, resulting in significant developmental delays.

Read more from the original source:
Do We Need More Uniformity in Newborn Screening in the US? - The National Law Review