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Archive for the ‘Hormone Physician’ Category

5 things to know about Polycystic Ovary Syndrome – StarNewsOnline.com

By Stephanie Bowens| StarNews Correspondent

Polycystic Ovary Syndrome is one of the most common, yet treatable, causes of infertility in women. PCOS affects 1 in 10 women of childbearing age, according to the Office On Womens Health, and women who have the condition experience hormonal imbalance and metabolism problems that may affect their appearance and overall health.

Dr. Nicholas Bodenheimer, DO, an obstetrician-gynecologist withNovant Health OB/GYN Bolivia, said hes treated many women who have PCOS. He said the condition is typically characterized by hyperandrogenism, or elevated levels of androgens, such as testosterone, irregular or no menstrual periods and polycystic ovaries revealed on an ultrasound. Bodenheimer said despite the name, you dont have to have polycystic ovaries or small cysts on yourovaries to be diagnosed with PCOS. He recommends women discuss their concerns with a gynecologist.

1. Imbalances of hormones, including insulin and testosterone, play key role in PCOS symptoms.

The exact cause of PCOS is unknown. However, PCOS is associated with insulin resistance, obesity and high levels of androgens.

Androgens, often called male hormones, are hormones, such as testosterone, that are important for normal male sexual development, but women also make small amounts of androgens. Androgens control development of male traits, and women with PCOS have more androgens than normal.

Normally, in healthy women testosterone is largely bound by a protein called sex hormone binding globulin, leaving just a very small amount of freely circulating bioactive free testosterone. However, insulin resistance can disrupt this, and Bodenheimer said many women with PCOS have insulin resistance. Insulin resistance can cause a low level of sex hormone bind globulins, Bodenheimer said. So, if you have a low level of that you have an increase of testosterone in the body which can lead to hyperandrogenism.

Insulin resistance refers to when the bodys cells do not respond normally to insulin, a vital hormone that regulates blood sugar (glucose) in the body.

2. Irregular menstrual cycles are common symptoms of PCOS.

Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle.

Bodenheimer said PCOS symptoms that often bring patients in to see him include excessive facial hair growth, absence of a menstrual period, irregular menstrual bleeding, or unsuccessfully trying to get pregnant for over a year. We see a lot of different types of clinical manifestations from PCOS, but probably the most common we see are menstrual disorders, Bodenheimer said. That can range from irregular menstrual periods to heavy menstrual periods to someone who is not having any menstrual periods. If we see women who are anovulatory, meaning they arent having regular menstrual cycles, that can lead to infertility.

Bodenheimer said usually in a 28-day cycle around cycle day 14 a woman ovulates so an egg is released. If someone is not ovulating, the egg is not released, he said. Thats how that leads to infertility.

Bodenheimer said there are various treatment options for infertility caused by PCOS.

3. PCOS often causes abnormal hair growth.

Bodenheimer said, for women with PCOS, increased levels of testosterone in the body can lead to excessive hair growth on their arms and face as well as acne. According to OWH, the excessive hair growth is called hirsutism and affects up to 70 percent of women with PCOS, causing them to have too much hair on the face, chin, or parts of the body where men usually have hair, and acne can appear on the face, chest, and upper back.

According to the OWH, other symptoms of PCOS include thinning hair, hair loss on the scalp or male-pattern baldness, weight gain or difficulty losing weight and darkening of skin, particularly along neck creases, in the groin, and underneath breasts.

4. Research has linked PCOS to other health problems, such as hypertension and sleep apnea.

According to OWH, studies have found links between PCOS and diabetes, high blood pressure and unhealthy cholesterol, sleep apnea, depression and anxiety and endometrial cancer. OWH indicates more than half of women with PCOS will have diabetes or prediabetes before age 40, and women with PCOS are at higher risk for high blood pressure compared with women of the same age without PCOS.

Problems with ovulation, obesity, insulin resistance, and diabetes, which are all common issues in women with PCOS, increase the risk of developing endometrial cancer, according to OWH.

Additionally, Bodenheimer said, For women with PCOS who do get pregnant we see increased risk of gestational diabetes as well as hypertensive disorders such as preeclampsia.

5. PCOS treatment focuses on managing symptoms.

Bodenheimer said treatment for PCOS focuses on treating and managing patients symptoms. When developing a treatment plan, the physician typically considers the patients symptoms, their plans for having children, and the patients risk of long-term health problems such as diabetes and heart disease.

If patients desire future fertility and are planning to become pregnant, then we see if they are ovulating or not, and we can usually do that by checking lab work, he said. If we are treating someone with PCOS who is not ovulating, we can treat them with medicine to help them ovulate, he said.

But Bodenheimer said one of the risks of using fertility drugs include pregnancy with multiples, such as twins.

If they are not desiring fertility in the immediate future, then we try things like birth control pills to help regulate those menstrual periods, Bodenheimer said.

He said he also sometimes discusses lifestyle modifications, including diet and weight loss. Some studies show losing five to 10 percent of their current body weight may induce spontaneous ovulation again, he said.

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5 things to know about Polycystic Ovary Syndrome - StarNewsOnline.com

Metabolic Renewal Review: Pros, Cons, and Effectiveness – Healthline

Metabolic Renewal is a weight loss program designed specifically for women.

The program aims to boost your metabolism by modifying your diet and exercise routine based on your specific hormone type. Yet, the science behind these claims is suspect.

Despite several downsides, it has become popular among those looking to enhance their energy levels, curb cravings, and promote overall health.

This article examines the pros and cons of Metabolic Renewal to determine whether you should give it a try.

BOTTOM LINE: While Metabolic Renewal may promote short-term weight loss, many aspects of the plan arent backed by evidence. Additionally, its difficult to sustain long term and may lead to weight regain once you resume a normal diet.

Metabolic Renewal was designed by Dr. Jade Teta, an integrative physician who specializes in natural health and fitness. The program is intended to optimize womens metabolism using Dr. Tetas 4 M framework Mindset, Movement, Meals, and Metabolics.

The idea that seven distinct hormone types exist is central to the program, as well as that determining your specific hormone type may enhance your metabolism.

Metabolic Renewal offers a 12-week meal plan with recipes tailored to your hormone type.

It also includes access to a collection of 15-minute workouts, along with guidebooks on balancing hormone levels and eliminating belly fat.

Metabolic Renewal is a weight loss program that claims to optimize womens metabolism based on hormone type.

The first step of Metabolic Renewal is to determine your hormone type using their online quiz, which collects information about your age, menstrual cycle, medical history, and health goals.

A guide called The Hormone-Balancing Roadmap provides detailed information on how to follow the plan depending on your hormone type.

Meal plans are based on what Dr. Teta calls the 3-2-1 Diet, which provides three meals per day, two of which contain only protein and vegetables and one of which offers a small portion of starch.

The program includes a detailed meal plan with recipes, but youre permitted to create your own meals based on the 3-2-1 Diets principles, adding snacks as needed.

Metabolic Renewal also includes a 12-week workout plan thats divided into 4 phases. Throughout the program, youre required to exercise for 15 minutes 3 times per week using the plans Intelligent Workouts, which claim to combine resistance and cardio training.

On your days off, youre encouraged to walk for a set amount of time thats determined by your hormone type. Doing so is said to help maintain any changes to your metabolism.

Furthermore, Metabolic Renewal offers a private online community for its customers.

Metabolic Renewal provides a custom meal plan and exercise regimen based on your supposed hormone type.

Metabolic Renewal doesnt eliminate any foods outright but encourages a low carb, high protein diet. Fruits, grains, fats, and oils can all be enjoyed in moderation.

While no foods are banned, you should limit processed foods and items high in carbs and sugar.

Metabolic Renewal doesnt eliminate any foods outright but encourages you to restrict your intake of processed and high carb foods. Instead, youre meant to emphasize vegetables and high quality proteins.

Although Metabolic Renewal hasnt been studied specifically, it may offer several health benefits.

Several aspects of the program may aid short-term weight loss.

For starters, Metabolic Renewal encourages a diet rich in unprocessed whole foods, including meat, fish, poultry, and vegetables.

These foods are not only often lower in calories than processed foods but also rich in important nutrients like vitamins, minerals, and antioxidants.

Additionally, some research links a lower intake of processed foods to a decreased risk of obesity (1).

Metabolic Renewal is also low in carbs, with most meals consisting of vegetables and a source of protein. Some studies show that low carb diets promote short-term weight loss and fat loss (2, 3).

Whats more, increasing your protein intake may keep you feeling full for longer, which likewise supports weight loss (4).

Metabolic Renewal doesnt require you to count calories, measure your food, or track macronutrients. It also offers several ways to customize your meal plan, making it a good fit for those who prefer more flexibility.

In fact, you can easily swap in other recipes from the meal plan or create your own meals using the basic principles of the diet.

Plus, it offers options for paleo, keto, vegan, and vegetarian diets.

Although no studies have examined Metabolic Renewal, its very flexible and may promote weight loss at least in the short term.

Although Metabolic Renewal may offer some benefits, theres no evidence to support many aspects of the plan.

The idea that there are seven specific female hormone types isnt backed by science.

In fact, most of the benefits of this program are likely due to its diet and lifestyle changes not optimizing female metabolism.

The programs quick, 15-minute workouts that take place 3 times per week are said to maximize efficiency without stressing your metabolism.

While this idea may appeal to some people, it may be unsuitable for those who are more physically active or prefer certain workouts, such as cardio or weightlifting.

Metabolic Renewal retails for $67, which includes either online access or the printed program and set of DVDs.

This price tag is higher than many other programs, so its an important consideration for those on a tight budget.

Keep in mind that Metabolic Renewal is a short-term program designed to be followed for 12 weeks.

Although many short-term diets lead to rapid weight loss, youre likely to regain weight after you resume a normal diet. Thats partly because brief dietary changes dont often translate to long-term lifestyle habits (5).

Several core elements of Metabolic Renewal are scientifically suspect, including the concept of specific hormone types. Furthermore, the diet is expensive and may lead to weight regain.

Metabolic Renewal provides a 12-week meal plan, although you can still create your own meals using the basic principles of the diet.

Here is a sample 3-day meal plan for Metabolic Renewal.

The sample menu above details some of the meals that you can enjoy on Metabolic Renewal, including breakfast smoothies and dishes packed with veggies and protein.

Metabolic Renewal is a program intended to optimize womens metabolism by making changes to their diet and exercise routine.

Although the diet is very flexible and may lead to short-term weight loss, many aspects are rooted in unfounded health claims. Furthermore, its short-term nature makes weight regain likely once you resume a normal diet.

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Metabolic Renewal Review: Pros, Cons, and Effectiveness - Healthline

Fasting is one of the easiest ways to strengthen immunity – The Garden Island

We are always living in a state of survival. This might be any type of chronic illness, virus or maybe a lifestyle related disease. Whatever it is, fasting can help with many health issues and in addition can help with strengthening your immune system. I think if you try it you will be surprised by the benefits that you see, even if you are practicing time-restricted feeding (TRF) eating within the same time window each day, for example have a 12 hour period in which you eat, and the other 12 hours of the day in which you eat nothing. This will lead to more conscious eating habits as well.

Studies have shows how especially after a 72 hour water only fast the immune system strengthens and even the metabolism slightly increases. I dont suggest that length of fast for everyone, however you still can practice fasting for improving your health.

I love the fasting lifestyle for so many reasons, including:

Improving immunity

Efficiently cleaning up dead cells

Improving digestion

Reducing the risk of many types of cancer

Slowing down the aging process

Its an easy way to lose fat

It helps regulate your hormones

Its convenient

You can save time from cooking and shopping

Its easy to do, no matter which diet you choose to follow

And its all under your control

Heres a few suggestions if you would like to try it:

If you want to try longer than 18 to 20 hours then make sure that you listen to your body. If you experience any dizziness, diarrhea, headaches or stomach pain then its time to stop, break your fast, and try again next time.

If you are taking medication then you must let your physician know before you practice fasting.

Identify your goals why would you like to practice fasting? For example, are you doing it to heal your diabetes, or just to lose a few pounds, or maybe for some more serious health problems? You need to know what type of fasting schedule is the best for you.

Women can be much more sensitive to fasting, although it is great for balancing hormones. So its very important, especially for women, to break the fast with a low carbohydrate, high protein, and moderate fat meal. This can help not to raise insulin (the fat storage and blood sugar regulating hormone) so quickly.

During the fast you generally dont need any supplements. However, it depends on the length of your fast. If you are fasting for longer than 20 hours you may need to supplement with salt, potassium chloride, and magnesium. When you are doing fasting the body uses glycogen (sugar) for energy which, depending on your bodys state, can take 20 to 36 hours. Each gram of glycogen in the cell holds about 3 grams of water, so when you deplete your glycogen storage you also lose electrolytes too. Thats why you may feel low energy, brain fog and a little dizzy too.

Probably you now understand that I am really a fan of water only fasting. This can be done daily, for example a daily 14 hour fast and then 10 hours in which to eat your meals. Or it can be done as prolonged fasting. You just need to be sure that you know why youre doing it and what you want to achieve so you can make your own fasting schedule.

Fasting is free so just try it out, and if you dont like it then change your schedule. Just pay attention your body, it will tell you whats best.

Resources:

Intermittent fasting: Surprising update

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808902/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478699/

Fasting for 72 hours can reset your entire immune system (The Source)

Fasting triggers stem cell regeneration of damaged, old immune system

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4102383/

Ayda Ersoy, nutritionist (Dip.C.N., Dip.S.N.), master trainer (CPT ACE, NCSF, CanfitPro), registered yoga teacher, founder, Health Angel Nutrition, Fitness and Wellness, founder, SMS (Stability, Mobility Strength) Intuitive Training System.

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Fasting is one of the easiest ways to strengthen immunity - The Garden Island

Cancer Hormone Therapy Market : Industry Overview, Trends and Growth Opportunities Forecasted Till 2024 – The Think Curiouser

Hormones are natural substances made by our glands in our body and the network of glands that make hormones is termed as endocrine systems. These hormones are carried through bloodstream and act as a messenger between one part to another part of our body. Hormone therapy is one of the major modalities of medical treatment for cancers which involves manipulation of the endocrine systems through exogenous administration of steroid hormones or drugs inhibiting or interrupting activities of specific hormones.

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Surgical removal of certain endocrine organs for instance oophorectomy can also be employed as a part of hormone therapy. In hormone therapy physician generally start with hormone receptor test that let caregivers to measure amount of cancer proteins or hormone receptors within a cancer tissue. By estimating the amount of hormones such as estrogen or progesterone the test either can be positive or negative. A positive test indicates growth of cancer cells with the help of hormones.

In such cases physician divert the hormone therapy by blocking the interaction of hormones with the hormone receptor. Alternatively, in case of negative hormone receptor test which signifies null effect of hormones in growth and development of cancer cells other effective treatments can be rendered to cure cancer.

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A hormone therapy can be rendered either before or after a primary treatment. In case it is rendered before the primary treatment it is medically termed as neoadjuvant treatment which kills. Neoadjuvant treatments help to kill cancer cells and contribute to the effectiveness of the primary therapy. If hormone therapy is given after the primary cancer treatment, it is called adjuvant treatment. Adjuvant therapy is given to improve the chance of a cure.

Now a day hormone therapy is widely used in treating breast and prostate cancer. In breast cancer the female hormone estrogen are primarily responsible for stimulating the growth and development of breast cancer cell in majority of cases. Recently in 2014, aromatase inhibitors such as Arimidex and Femara have been approved for treating breast cancers through hormone therapy. Apart from these FDA approved Zoladex Lupron can also be used in curing breast cancers through hormone therapy. In case of prostate cancer a variety of medications can be used as hormone therapy.

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Male hormones, such as testosterone, stimulate prostate cancer to grow. Hormone therapy is given to help stop hormone production and to block the activity of the male hormones. Some of the antiandrogens used as inhibitors of prostate cancer cell growth encompass flutamide, enzalutamide, bicalutamide, and nilutamide among others. some of the other cancers to which hormone therapy is gaining acceptance now a day include womb cancer, kidney cancer, ovarian cancer among others.

Major drivers to global cancer hormone therapy include rising incidences of cancer across globe. Statistically according to WHO cancer accounts for 8.2 million deaths in 2012 and it is estimated that annual cancer cases is expected to rise from 14 million in 2012 to 22 million by 2022. Rising awareness among physician and patients towards alternative cancer therapy processes such as target therapy, immunotherapy or hormone therapy is likely to uplift the market in forthcoming years.

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Side-effects associated with hormone therapy are major restraints to growth and acceptance of therapy. Some of the common side-effects associated with hormone therapy for cancer include nausea, vaginal spotting, irregular menstrual periods, skin rashes, loss of appetite, vaginal dryness, impotence and male breast enlargement among others.

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Getting a good nights sleep in troubled times – Patch.com

This post was contributed by a community member. The views expressed here are the author's own.

On Sunday, November 1st, at 2 am, clocks will be turned one hour back for Daylight Savings Time, so when the clock reads 10 am on Sunday morning, your brain and body will insist that it is really 11 am.

"Gaining' an hour in the fall is much easier for our bodies than 'losing' an hour in the spring," says Dr. Praveen Rudraraju, medical director of the Center for Sleep Medicine at Northern Westchester Hospital. "For many, sleep has become more elusive in these uncertain times.

"Sleep specialists are seeing an unprecedented numbers of patients suffering from insomnia and other sleep disturbances due to the pandemic, which presents a unique set of multiple stressors," he adds. "There's no quick fix for the anxiety that's keeping people awake as they worry about their jobs, income, the health and safety of loved ones, social isolation and an uncertain future. There is actually a hormonal basis for this kind of insomnia. Anxiety triggers the production of stimulating chemicals in the body that keep people awake.

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To get the most out of sleep, Dr. Rudraraju says that both the quality and quantity are important. Most adults need seven to eight hours of sleep in order to feel refreshed and alert. Sleeping less than five hours a night can raise the risk of cardiovascular disease by 40 percent, while chronic insomnia quadruples the risk of stroke. Numerous studies have linked poor-quality sleep to weight gain. Ghrelin, a hormone linked to hunger, increases when people sleep poorly.

Dr. Rudraraju advises people to practice good sleep hygiene:

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If you often wake up groggy, have trouble falling asleep or staying asleep, feel sleepy all day long or snore, you may need a sleep study to assess the possibility of a sleep disorder. An at-home sleep study can find out if you do have a sleep issue, but an in-hospital sleep study can diagnose whether it is caused by an underlying medical condition.

One of the most common disorders is sleep apnea, typically characterized by loud snoring and feelings of constant tiredness. The condition interrupts a person's breathing hundreds of

times a night, depriving the brain and heart of oxygen. Untreated sleep apnea increases the risk of high blood pressure, heart attack, stroke, obesity, diabetes and mental illness. It also puts people at increased risk of heart failure, arrhythmias or irregular heartbeats, and increases the risk of driving accidents.

For more information or to make an appointment for a sleep center study, visit nwh.northwell.edu/sleep-center or call 914-666-1114.

About Northern Westchester Hospital

Northern Westchester Hospital (NWH), a member of Northwell Health, provides quality, patient-centered care that is close to home through a unique combination of medical expertise, leading-edge technology, and a commitment to humanity. Over 650 highly-skilled physicians, state-of-the-art technology and professional staff of caregivers are all in place to ensure that you and your family receive treatment in a caring, respectful and nurturing environment. NWH has established extensive internal quality measurements that surpass the standards defined by the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality Alliance (HQA) National Hospital Quality Measures. Our high-quality standards help to ensure that the treatment you receive at NWH is among the best in the nation. For more information, please visit http://www.nwhc.net and connect with us on Facebook.

About Northwell Health

Northwell Health is New York State's largest health care provider and private employer, with 23 hospitals, nearly 800 outpatient facilities and more than 14,200 affiliated physicians. We care for over two million people annually in the New York metro area and beyond, thanks to philanthropic support from our communities. Our 72,000 employees 17,000-plus nurses and 4,500 employed doctors, including members of Northwell Health Physician Partners are working to change health care for the better. We're making breakthroughs in medicine at the Feinstein Institutes for Medical Research. We're training the next generation of medical professionals at the visionary Donald and Barbara Zucker School of Medicine at Hofstra/Northwell and the Hofstra Northwell School of Nursing and Physician Assistant Studies. For information on our more than 100 medical specialties, visit Northwell.edu and follow us @NorthwellHealth on Facebook, Twitter, Instagram and LinkedIn.

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Can You Really Overdose on Black Licorice? Here’s The Science on The Hidden Dangers – ScienceAlert

Black licorice may look and taste like an innocent treat, but this candy has a dark side. On Sept. 23, 2020, it was reported that black licorice was the culprit in the death of a 54-year-old man in Massachusetts.

How could this be? Overdosing on licorice sounds more like a twisted tale than a plausible fact.

I have a longstanding interest in how chemicals in our food and the environment affect our body and mind. When something seemingly harmless like licorice is implicated in a death, we are reminded of the famous proclamation by Swiss physician Paracelsus, the Father of Toxicology: "All things are poison, and nothing is without poison; the dosage alone makes it so a thing is not a poison."

I am a professor in the department of pharmacology and toxicology and author of the book Pleased to Meet Me: Genes, Germs, and the Curious Forces That Make Us Who We Are.

The unfortunate man who recently succumbed to excessive black licorice consumption is not alone. There are a smattering of similar case reports in medical journals, in which patients experience hypertension crisis, muscle breakdown or even death.

Adverse reactions are most frequently seen in people over the age of 40 who are eating far more black licorice than the average person. In addition, they are usually consuming the product for prolonged periods of time.

In the most recent case, the Massachusetts man had been eating a bag and a half of black licorice every day for three weeks.

Licorice is a flowering plant native to parts of Europe and Asia. Its scientific name, Glycyrrhiza, is derived from the Greek words "glykos" (sweet) and "rhiza" (root). The aromatic and sweet extract from its root has long been used as an herbal remedy for a wide variety of health maladies, from heartburn and stomach issues to sore throats and cough.

However, there is insufficient evidence to support that licorice is effective in treating any medical condition.

Glycyrrhizin (also called glycyrrhizic acid) is the chemical in black licorice that gives the candy its signature flavor, but it also leads to its toxic effects.

Glycyrrhizin mimics the hormone aldosterone, which is made by the adrenal glands when the body needs to retain sodium and excrete potassium. Sodium and potassium work together as a kind of cellular battery that drives communication between nerves and the contraction of muscles. Too much glycyrrhizin upsets the balance of these electrolytes, which can raise blood pressure and disturb the heart's rhythm.

Other symptoms of excessive licorice intake include swelling, muscle pain, numbness and headache. Examination of the man who died from consuming too much licorice revealed that he had dangerously low levels of potassium, consistent with glycyrrhizin toxicity.

It should be noted that a number of licorice-based foods do not contain real licorice, but use a flavoring substitute called anise oil, which does not pose the dangers discussed here. In addition, despite its name, red licorice rarely contains licorice extract. Instead, red licorice is infused with chemicals that impart its cherry or strawberry flavor.

Products that contain real licorice are usually labeled as such, and list licorice extract or glycyrrhizic acid among the ingredients. Be advised that some products, such as black jelly beans or Good & Plenty, are mixtures of different candies that contain both anise oil and licorice extract.

Licorice is produced from the Glycyrrhiza glabra plant. (Franz Eugen Khler/Khler's Medizinal-Pflanzen/Wikimedia)

Glycyrrhizin has the distinct licorice flavor and is 50 times sweeter than sugar and has been used in other types of candy, soft drinks, tea, Belgian beers, throat lozenges and tobacco.

This can make it challenging to keep track of how much glycyrrhizin has been consumed, and a combination of these products could trigger adverse effects.

Some people take dietary or health supplements that already contain licorice, which increases the risk of toxic effects from eating black licorice candy. Certain medications such as hydrochlorothiazide are diuretics that cause increased urination, which can lower potassium levels in the body.

Glycyrrhizin also lowers potassium levels, further disrupting the balance of electrolytes, which can produce muscle cramps and irregular heart rhythms.

People with certain preexisting conditions are more susceptible to black licorice overdose.

For example, patients who already have low potassium levels (hypokalemia), high blood pressure or heart arrhythmia are likely to have greater sensitivity to the effects of excessive licorice. Those with liver or kidney deficiencies will also retain glycyrrhizin in their bloodstream for longer times, increasing their risk of experiencing its adverse effects.

If you're a fan of black licorice, there is no need to ban it from your pantry. Eaten in small quantities from time to time, licorice poses no significant threat to otherwise healthy adults and children. But it is advisable to monitor your intake.

With Halloween approaching, be sure to remind your kids that candy is a 'sometimes food', especially the black licorice. The FDA has issued warnings about the rare but serious effects of too much black licorice, advising that people avoid eating more than two ounces of black licorice a day for two weeks or longer.

The agency states that if you have been eating a lot of black licorice and experience an irregular heart rhythm or muscle weakness, stop eating it immediately and contact your health care provider.

Some scientists have further cautioned against the routine use of licorice in the form of a dietary supplement or tea for its alleged health benefits.

A review article from 2012 warned that "the daily consumption of licorice is never justified because its benefits are minor compared to the adverse outcomes of chronic consumption."

Bill Sullivan, Professor of Pharmacology & Toxicology; author of Pleased to Meet Me: Genes, Germs, and the Curious Forces That Make Us Who We Are, Indiana University.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Can You Really Overdose on Black Licorice? Here's The Science on The Hidden Dangers - ScienceAlert

Qualigen Therapeutics Receives Positive Pre-IND Response from FDA for the Clinical Development of AS1411 as a Treatment for COVID-19 – PRNewswire

CARLSBAD, Calif., Oct. 28, 2020 /PRNewswire/ --Qualigen Therapeutics, Inc. (Nasdaq: QLGN) today announced receipt of written feedback to its Type B Pre-IND (Pre-Investigational New Drug application) meeting request from the U.S. Food and Drug Administration (FDA) that is in general agreement with the Company's planned clinical development of AS1411, a nucleolin-targeting DNA aptamer drug candidate, for the treatment of COVID-19.

The FDA's response solidifies Qualigen's intention to reprioritize its clinical development program and to first advance AS1411 into clinical trials (for treatment of COVID-19) in the first half of calendar 2021, to be followed next by seeking to advance ALAN into clinical trials against acute myeloid leukemia. ALAN is AS1411 attached to a gold nanoparticle.

"We are delighted with the FDA's thoughtful and thorough response to our Pre-IND meeting request which provides a pathway for us to move forward with filing the IND application and initiation of a clinical trial in the first half of calendar 2021," stated Michael Poirier, President, Chief Executive Officer and Chairman of Qualigen. "We are in agreement with the FDA's additional recommendations and believe their responses provided the clarity needed to move forward to get AS1411 into clinical trials for the treatment of hospitalized patients with COVID-19.In addition, we look forward to further investigating the potential use of AS1411 as a broader spectrum antiviral therapeutic."

In its Pre-IND meeting request, the Company requested regulatory guidance on its planned randomized, multicenter study to evaluate the safety and efficacy of AS1411 in hospitalized patients with COVID-19. The FDA's recommendation is to commence with a Phase 2a proof-of-concept study to evaluate safety and initial efficacy in determining the appropriate dose with outcomes assessed at Day 28. The Company and the FDA agree that a Phase 1 clinical trial is not needed here, because in a previous clinical trial against cancer AS1411 has already been shown to meet Phase 1 safety requirements.

"There continues to be a need for novel treatments for COVID-19," stated Paula Bates, PhD, Professor of Medicine at the University of Louisville, who co-invented the technology. "We know that nucleolin plays an important role in the infectivity of viruses and were able to demonstrate in our AS1411 preclinical studies, the aptamer was effective against the SARS-CoV-2 virus at doses indicated to be safe in humans by previous research. As a result, we believe AS1411 has the potential to be a promising therapeutic for COVID-19, as well as for other viral infections."

Extensive preclinical research conducted at the University of Louisville has demonstrated that AS1411 has potent anti-viral activity against SARS-CoV-2 infection, the novel coronavirus responsible for COVID-19. Qualigen has held an exclusive license to AS1411 since 2018, and in June 2020 Qualigen entered into an exclusive license agreement for the University of Louisville's pending U.S. patent for the use of AS1411 for inhibiting or treating COVID-19.

About Qualigen Therapeutics, Inc.Qualigen Therapeutics, Inc. is a biotechnology company focused on developing novel therapeutics for the treatment of cancer and infectious diseases, as well as maintaining and expanding its core FDA-approved FastPack System, which has been used successfully in diagnostics for almost 20 years. The Company's cancer therapeutics pipeline includes ALAN (AS1411-GNP), RAS-F and STARS. ALAN (AS1411-GNP) is a DNA coated gold nanoparticle cancer drug candidate that has the potential to target various types of cancer with minimal side effects. The foundational aptamer of ALAN, AS1411, is also being studied for use in treating or even preventing viral-based infectious diseases, including COVID-19. RAS-F is a family of RAS oncogene protein-protein interaction inhibitor small molecules for preventing mutated RAS genes' proteins from binding to their effector proteins; preventing this binding could stop tumor growth, especially in pancreatic, colorectal and lung cancers. STARS is a DNA/RNA-based treatment device candidate for removal from circulating blood of precisely targeted tumor-produced and viral compounds. Because Qualigen's therapeutic candidates are still in the development stage, Qualigen's only products that are currently commercially available are FastPack System diagnostic instruments and test kits, used in physician offices, clinics and small hospitals around the world. The FastPack System menu includes rapid point-of-care diagnostic tests for cancer, men's health, hormone function, vitamin D status and antibodies against SARS-CoV-2. Qualigen's facility in Carlsbad, California is FDA and ISO Certified and its FastPack product line is sold worldwide by its commercial partner Sekisui Diagnostics, LLC. For more information on Qualigen Therapeutics, Inc., please visit https://www.qualigeninc.com/.

Forward-Looking StatementsThis news release contains forward-looking statements by the Company that involve risks and uncertainties and reflect the Company's judgment as of the date of this release. These statements include those related to the timing of the filing and (if any) acceptance of an IND application for AS1411 as a therapy against COVID-19 and the timing of the related clinical trials (if any), and the possible effectiveness of AS1411 against COVID-19 or other viral infections. Actual events or results may differ from the Company's expectations. For example, there can be no assurance that clinical trials will be approved to begin by or will proceed as contemplated by any projected timeline; that the Company will successfully develop any drugs or therapeutic devices; that preclinical or clinical development of the Company's drugs or therapeutic devices will be successful; that future clinical trial data will be favorable or that such trials will confirm any improvements over other products or lack negative impacts; that any drugs or therapeutic devices will receive required regulatory approvals or that they will be commercially successful; that patents will issue on the Company's owned and in-licensed patent applications; that such patents, if any, and the Company's current owned and in-licensed patents would prevent competition; that the Company will be able to procure or earn sufficient working capital to complete the development, testing and launch of the Company's prospective therapeutic products; that the Company will be able to maintain or expand market demand and/or market share for the Company's diagnostic products generally, particularly in view of COVID-19-related deferral of patients' physician-office visits and FastPack reimbursement pricing challenges; that adoption and placement of FastPack PRO System instruments (which are the only FastPackinstruments on which the Company's SARS-CoV-2 IgGtest kits can be run) will be widespread; that the Company will be able to manufacture the FastPack PRO System instruments and SARS-CoV-2 IgGtest kits successfully; that any commercialization of the FastPack PRO System instruments and SARS-CoV-2 IgGtest kits will be profitable; or that the FDA will ultimately approve an Emergency Use Authorization for the Company's SARS-CoV-2 IgG test. The Company's stock price could be harmed if any of the events or trends contemplated by the forward-looking statements fails to occur or is delayed or if any actual future event otherwise differs from expectations. Additional information concerning these and other risk factors affecting the Company's business (including events beyond the Company's control, such as epidemics and resulting changes) can be found in the Company's prior filings with the Securities and Exchange Commission, available atwww.sec.gov. The Company disclaims any intent or obligation to update these forward-looking statements beyond the date of this news release, except as required by law. This caution is made under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995.

SOURCE Qualigen, Inc.

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Qualigen Therapeutics Receives Positive Pre-IND Response from FDA for the Clinical Development of AS1411 as a Treatment for COVID-19 - PRNewswire

Screening the key to breast cancer prevention, treatment – newsoforange.com

Its not often that breast cancer is overshadowed by another health crisis, but such is life in pandemic times. But what should never take a backseat where breast cancer is concerned is the importance of screening and prevention.

Screening for breast cancer is really important because, while it is quite common and can be deadly, when caught early it is much more treatable and less deadly, said Christy Bridges, a physicians assistant with the Orange County Health Department in Hillsborough. The idea for doing a screening is your looking at someone who doesnt have any symptoms and looking for a concern or a problem. Because you would only screen if you could do something about it. Breast cancer is a cancer we can do something about by screening.

The most-commonly used tool for breast cancer screening is the mammogram. It is recommend women of average risk for breast cancer start discussing screening with their care provider at age 40. Between ages 40 and 50 theres not a strong base of evidence showing any real benefit in undergoing a mammogram. After reaching age 50 the evidence is more clear that breast cancer screening with mammogram is effective. The recommendation of screening every two years with a mammogram starts at age 50.

Health care providers will order a mammogram for a patient. Many health care facilities, like UNC Healthcare, do mammogram screenings at multiple locations. The patient goes in for the mammogram and is given the results through a letter, or if there is a determination that additional follow up is needed, then that can be done either at the time of the screening or at a follow up appointment.

Its often believed that family history is a big factor in the likelihood of being diagnosed with breast cancer. But this is not necessarily so, said Bridges.

Most women who are diagnosed with breast cancer do not have a family history. For women who have a family history of breast cancer, we want to discuss that and its good for us to know that so we can determine if they would benefit from a specific, like targeted testing to determine if they have a genetic marker that makes them more of a risk. But the vast number of women who are diagnosed with breast cancer dont have a genetic history. While it is a risk factor, its not the only one.

As far as types of cancer, breast cancer is the most common of new cancer cases in North Carolina, according to 2017 statistics from the Centers for Disease Control, making it more common than lung and colon cancers. It is less deadly than lung cancer, but it still is the second-leading cause of cancer deaths in the state.

While there may not be much difference in the number of breast cancer cases, minorities often face a higher mortality rate.

What we unfortunately see sometimes is that breast cancer is diagnosed at a later stage in African American or Latino women, Bridges said. If youre diagnosed at a later stage, or a more advanced stage of breast cancer, that decreases your likelihood of surviving it. Women-of-color should take any breast cancer concerns seriously and take any opportunity for screening.

Surgery and surgery with radiation is the most common treatment for breast cancer, if it is caught early enough and before it has spread beyond the breast. If the cancer is a more spread, then chemotherapy can be used. Other treatments include hormonal therapy and targeted therapy. Although there are many layers of treatment for breast cancer, the message health professionals want to make clear is the earlier cancer is diagnosed, the easier the treatment tends to be.

For some risk factors, like age and family history, little can be done to decrease the the chance of a cancer diagnosis. But there are steps that can be taken to cut down on other risk factors.

Things you do have control over that are risk factors for breast cancer that someone can alter or change include not being physically active, Bridges said. Increasing your physical activity is protective from breast cancer. Being overweight is a risk factor. Keeping your weight to a healthy level is protective. Alcohol can be a risk factor. Hormonal therapy, like post-menopausal hormone replacement therapy that can be useful in certain instances, can also have some risks. Thats worth a discussion with your care provider.

One of the biggest risk factors is for women who are not connected with a health care provider, or are underinsured. One program that the Orange County Health Department participates in is the Breast and Cervical Cancer Control Program, or the BCCCP, which is a federal and state program with funding to help screen women for breast and cervical cancer who are underinsured or uninsured. The Orange County Health Department participates in the program to help women who may not have a health care provider or be connected to care.

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Screening the key to breast cancer prevention, treatment - newsoforange.com

How social stigma and delayed diagnosis affect Indian women with breast cancer – The News Minute

The American Cancer Society recommends that all women over the age of 40 years should undergo regular breast screening and practice breast self-examination.

Over the years, breast cancer has become the nemesis of Indian women, overtaking cervical cancer to establish its dominance as the most common cancer in Indian women. The sheer number of cases is so huge that even with both sexes combined, breast cancer ranks as the number one among all cancers in terms of numbers. So, what causes it? Factors are numerous such as: 1) Prolonged exposure to oestrogen during reproductive phase of life which can be due to early menarche, late menopause, delayed child birth or lack of children etc; 2) Obesity; 3) Increased breast density; 4) Genetic mutations; 5) Familial mutations; and 6) Exposure to ionizing radiation.

Breast lumps, like most cancers, are silent killers. They sneak up stealthily on unsuspecting patients with painless, hard masses which are noticed accidentally only after they become big enough to be palpable. Diagnosis is further delayed by societal taboos and denial mentality of patients. Studies have shown that a number of factors such as educational status, religion, marital status and socio-economic status contribute to a delay in diagnosis of breast cancer in Indian women. Lack of education and low socio-economic status, contribute to avoidance of breast cancer screening and even if a mass is identified, these women are reluctant to seek medical help as they prioritize needs of family over theirs and fear the economic burden of medical treatment and loss of income as they would have to discontinue their jobs. Divorced and widowed women, especially in the older age group, often find themselves living alone without a support system. This results in a delay in seeking remedial therapy for any breast mass, even if they identify it at an early stage.

Another variable causing delay in diagnosis of breast cancer is the rampant use of alternative medicine. Many patients report to a doctor after having tried alternative therapies for resolution of mass. If the mass is malignant, the therapies dont work, causing tumor progression and often present as a metastatic disease. Indian women most commonly present as Stage IIb and above, unlike their western counterparts who undergo rigorous screening which helps in detecting small non-palpable tumours. In advanced disease, there maybe skin ulcers, nipple erosion, nipple inversion, bloody nipple discharge, bone pain, breathing difficulty, etc. It is high time that we educate our women, starting with our family members, about the value for routine screening of breast cancer and to ensure that they seek medical help at the earliest, if a mass is detected. Catching it early gives us the best shot at curing the disease completely.

The American Cancer Society recommends that all women over the age of 40 years should undergo regular breast screening and practice breast self-examination which is a series of simple steps that women can perform on themselves on a monthly basis to identify suspicious lumps. If a lump is identified, it is not a cause for panic. It is advisable to contact a family doctor or an oncologist, as most breast lumps, especially in younger age groups, are benign or harmless. The oncologist will examine the patient and advise a mammogram and needle evaluation of the breast lump, either as a Fine Needle Aspiration Cytology (FNAC) or Trucut biopsy, which yields more tissue. If malignancy is confirmed in the specimen, then further staging workup is done in the form of Ultrasound Abdomen, Chest X-ray, PET CT scan, etc. based on physicians judgment.

Treatment for breast cancer consists of the following modalities: Surgery, Radiation, Chemotherapy and Hormonal therapy, used in combination based on stage, tumour type, age and general condition of patient. Each of these treatment modalities can be further tailored for each patient. For patients who wish to preserve the breast, it is possible to so in early breast cancer by breast conservation techniques; similarly, chemotherapy drugs and regimens vary based on tumour types and its hormonal receptor markers. Radiation therapy has evolved over the years to become extremely precise, allowing patients to be treated with limited adverse events.

Once treatment is complete, patients have to be close follow up for a number of years. Some patients who have hormone receptor markers positive in their tumour tissue are advised to take hormonal therapy for 5-10 years.

In conclusion, breast cancer is not the death sentence it once was. Advanced treatment options have ensured that patients presenting at any stage can enjoy a long and healthy life. In the words of Cayla Mills, You never know how strong you are until being strong is the only choice you have. Help is at hand.

(Dr M Banu Priyaa is the Clinical Lead and Consultant Radiation Oncologist at Kauvery Cancer Institute, Chennai)

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How social stigma and delayed diagnosis affect Indian women with breast cancer - The News Minute

Eating healthier can reduce the risk of cancer – Rome Sentinel

My very good friend Joanne recently revealed that she is starting radiation treatment for a very recent diagnosis of breast cancer. She found her lump and immediately contacted her physician. From then to now has been a whirlwind of activity. The area of concern started with an itch, but it really concerned her. Maybe it was imagination, she thought. She persisted, even when the mammogram wasnt seeing it. In this case her lump was positional undetectable when standing, but detectable when she leaned forward. It was tiny about half a centimeter (2.54 centimeters - 1 inch).

Joanne marked her area with a sharpie so radiographers would know. Her tumor is hormone (estrogen) driven. Ironically enough, Joanne always monitored her diet and instinctively avoided foods that promote hormones.

She eats much more healthy than I do. And she has no known family history. Her first treatment was Monday right before Breast Cancer Awareness Month October. The statistics are shocking 1 out of 8 women will suffer breast cancer. I wrote several columns on prevention in the past, and my information is meant to educate my readers. But I know it can strike anyone even those who eat a great diet and have a healthy lifestyle.

For those who are interested, there are foods and lifestyle practices that actually promote cancer, and then there are foods and lifestyle practices that can help prevent it. Lets review food and lifestyle practices that can PROMOTE cancer: High fat foods, nitrites (found in cured meat), eating the burnt part of charcoal grilled foods (acrolein), belly fat (look in a mirror), high levels of caffeine, cigarette smoking and second-hand smoke, heating foods in Styrofoam and plastic wraps, supplements containing boron and excessive use of soy, and even eating the same foods over and over. There is evidence that soy, mushrooms, broccoli and cauliflower, citrus fruits, flax seeds and fiber increase hormone production.

Then there are those that can PREVENT cancer: Eating more plant-based proteins (beans, legumes), drinking more water, a wide variety of fruits and vegetables especially those with deep colors (beets, winter squash, carrots), including fish at least weekly, eating low fat foods, eating more whole foods (a baked potato instead of French fries), using whole grains (rye or pumpernickel instead of plain white bread), eating a wide variety of foods (limits overexposure), staying physically active and achieving and maintaining a healthy weight range.

Joanne stresses the importance of self-detection. That, my dear readers, is just one more thing that we need to do on a regular basis. But it is so important. I have a monthly note on my Calendar in my iPhone to remind me to self-examine on the first of the month. Get familiar with what is normal and then pay attention to any changes. Johns Hopkins Medical Center states, Forty percent of diagnosed breast cancer are detected by women who feel a lump. Its also important to do a monthly visual inspection, too. You can Google how to perform the self-exam, which is recommended to do while in the shower.

As far as diet changes Plan at least one plant based dinner weekly beans and greenspasta and tomato sauce?? Thats easier on your pocketbook, too. Use baby carrots, apples, grapes, cut-up green peppers as snacks instead of chips and dip. Substitute flavored herbal teas for coffee and soda. Carry a water bottle around to have ready access to a healthier no calorie beverage. Use whole foods more in your meal preparation. It only takes 4 minutes to nuke a whole potato. Lets make surviving the easier option. Continue with PINK POWER!! And Im praying for my friend.

Jeannie Wolcott, RD, CDN, is a retired registered dietitian, licensed Zumba (R) instructor for adults and kids, and a coordinator of Old Forestport Days.

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Eating healthier can reduce the risk of cancer - Rome Sentinel

Cancer, naturopathy and emotional roots – TT Newsday

FeaturesKieran Khan6 Hrs AgoLicensed naturopathic physician Dr Anna Maria Pouchet says people don't realise how seemingly little things impact them and make them susceptible to cancer. Photo courtesy Dr Anna Maria Pouchet

The key approach to dealing with cancer will always be with prevention," explained Dr Anna-Maria Pouchet, a licensed naturopathic physician with the Hope and Wellness Clinic, "and it starts with the things that many women and men overlook in their everyday life. They dont realise how seemingly little things impact them and make them susceptible to cancer.

Turmeric is a natural herb that can be used in the fight against cancer. Image taken from cdn-prod.medicalnewstoday.com

We need to be more aware how our cell phones, the lotions containing parabens, nail polishes, birth control tablets, laundry detergent, fabric softeners, bleach, and even the plastic bottles we drink from every day are impacting on our life as much as the antibiotics and pesticides in our foods are too.

The cancer-environment connection

Pouchet's view of the world we live in is echoed by dozens of documentaries and hundreds of research papers. Human beings are destroying the planet in a way that it is also in turn destroying us.

We are aware of the oestrogen hormone, but what people fail to recognise is that the amount of hormones produced in our bodies is so minimal but we absorb additives to our beauty products and our food, (and) in particular oral contraceptives, that contain milligrams of synthetic hormones milligrams when our bodies dont even need these amounts, she pointed out.

The result is that our kidneys and liver are overburdened by the detoxification of all (these) toxic chemicals, including excess hormones, and eventually we become nutrient-depleted by the process of eliminating and begin to store many of these in our fatty tissue which for women often means in the breasts and other areas like the hips, butt and thighs.

"Toxins also cause damage to our DNA and as a result our cells are not able to regulate and eventually mutate and become malignant, she elaborated.

Pouchet focuses on helping the body to function in the right way with proper diet, nutrition, detoxification, and supplementation, as needed.

Our hormonal balances are dependent on having proper functioning of our liver, kidney and a good gut flora so that we process and eliminate toxins. To achieve that you want to ensure you have sufficient intake of fibre and basic nutrients such as zinc, B vitamins, magnesium, etc.

"I highly recommend flaxseed or chia seeds daily along with lots of water. When it comes to water you also want to filter your water as best as you can. Flaxseed contains Omega-3 fatty acids and is especially important, in that it binds to excess oestrogen in the GI tract and gets it out the body.

Oral contraceptives contain synthetic hormones. Image taken from flushinghospital.org

According to LiveStrong.com, lignan by-products are known to bind to the oestrogen receptors found in body tissues, shifting oestrogen production to weaker forms which do not enhance cancer cell growth. The lignans found in flax may also inhibit aromatase, an enzyme which produces oestrogen.

Pouchet also advises everyone to invest in their health with good quality daily vitamin and mineral supplements to avoid nutritional deficiencies, even if they think they eat well.

And what if you are diagnosed?

Depending on the stage of the cancer and the size of the tumour as well as the course of treatment chosen, there is a lot that you can do for yourself to help you beat cancer.

Pouchet says, Research shows that there are herbs that work with the chemotherapy synergistically, which help to protect your healthy cells while they go through the process. There are also natural herbs that fight cancer and should be used for prevention of tumours, like turmeric, green tea, aloes, ginger, for example.

People living with cancer also struggle to get the daily intake of nutrients needed to fight the disease. Pouchet suggested supplementing as needed, and avoiding sugar, refined carbohydrates and, as far as possible, to turn to steamed cruciferous vegetables and probiotics to fuel and feed the gut lining, which is damaged by chemotherapy.

The emotional connection

In addition to diet and exercise, there is one key area Ikeen to learn Pouchet insights on cancer and its emotional roots. There are areas of research that link the onset of cancer to emotional disturbances or upheavals in peoples lives.

Pouchet agrees.

There is absolutely a connection. Many natural oncologists point out that cancer starts with the collapse of the nervous system or the sympathetic and parasympathetic systems in our bodies. The autonomic nervous system regulates many bodily functions, and they have links to every organ, especially our digestion.

According to licensed naturopathic physician Dr Anna Maria Pouchet, flaxseed contains Omega-3 fatty acids and binds to excess oestrogen in the GI tract and gets it out the body. Image taken from cdn-prod.medicalnewstoday.com

"From my own work I have seen patients that point out that there was a divorce or some form of recent conflict in their lives prior to their diagnosis. Negative emotions are involved in the breaking down of how the body protects itself and can create openings for the emergence of cancer, she said.

Given the emotional disturbances brought on by the covid19 pandemic, keeping positive eating habits and healthy exercise regimens should be an area of focus for everyone.

Though covid19 dominates our headlines, lifestyle diseases are still the leading causes of preventable death in TT.

Dr Anna Maria Pouchet is a licensed as a naturopathic physician by the State of Washington who practises in Trinidad. Education and medical training was at Bastyr University, which is one of four accredited naturopathic programmes in the US and internationally recognised as a pioneer in the natural sciences. Always consult a medical doctor or nutritionist before starting major diet changes.

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Cancer, naturopathy and emotional roots - TT Newsday

Tolaney Touches on HER2+ -Low Breast Cancer Testing, Possibilities, and Challenges – OncLive

While antibody-drug conjugates (ADCs), such as fam-trastuzumab deruxtecan-nxki (Enhertu), may have shown efficacy in patients with HER2-low breast cancer in initial studies, according to Sara M.Tolaney, MD, MPH, investigators still need better methods for identifying this disease subtype to guide treatment decisions.

What we're learning is that we really need to improve our ability to detect very low levels of HER2 expression, said Tolaney. Testing will need to change so that we can potentially address all patients who are able to benefit from these therapies.

In an interview with OncLive, Tolaney, associate director of the Susan F. Smith Center for Womens Cancers; director of Clinical Trials, Breast Oncology;andsenior physician at Dana-Farber Cancer Institute, as well as anassistant professor of medicine at Harvard Medical School, discussed the challenges in treating patients with heterogenous HER2 expression and what treatments could potentially improve outcomes for this subgroup.

Tolaney: Some challenges that we face surround the patients who have heterogeneous expression for HER2. For example, it's not that the entire tumor is strongly HER2-positive. We've learned from a couple trials, 1 of them being the KRISTINE trial, and another that is exploring heterogeneity in the preoperative setting, that having heterogeneous HER2 expression can impact the efficacy of ado-trastuzumab emtansine [T-DM1; Kadcyla].

The other challenge is: What about patients who, for example, lose HER2 expression after preoperative therapy? Many of us are uncertain with what to do with those patients who have residual disease, but at the time of surgery are no longer HER2-positive. We did see some data from the KATHERINE study, which showed that even those patients who had HER2-negative disease at the time of surgery, despite being HER2-positive prior to preoperative therapy, still benefited from adjuvant T-DM1, which was quite interesting. There are all of these complexities that come up when caring for patients, but again, we're quite fortunate to have so many nice treatment options in this setting.

HER2-low is defined as tumors with a little bit of HER2 expression but aren't quite HER2-positive. What that means is that if a patient, for example, has a tumor that is 1+ by immunohistochemistry [IHC], we would consider them HER2-lowpositive. If they're HER2 2+ by IHC and is not amplified via fluorescence in situ hybridization [FISH], we would also consider them HER2-lowpositive.

We've seen from various datasets that about 55% of all breast cancers are actually HER2-low, which is a significant proportion of our patients with breast cancer. We do know that the prevalence is different by hormone receptor [HR] expression. [About 60% of] HR-positive tumors are more commonly HER2-lowpositive, as opposed to triple-negative breast cancers where only about one-third of those cases will end up being HER2-lowpositive. The prevalence is different based on breast cancer subtype.

We've seen some initial attempts looking to see if trastuzumab [Herceptin] would have any benefit in patients with a little bit of HER2 expression. We have seen data from a randomized phase 3 trial where, in fact, there was no benefit from trastuzumab added to chemotherapy in the early breast cancer setting for patients with HER2-lowpositive [disease].

What we have seen now is that some of the new ADCs do have activity in these tumors. For example, trastuzumab deruxtecan was explored in patients who were HER2-lowpositive. We saw that the objective response rates [ORRs] were almost 40% in this population; this response was similar for patients who had HER2 1+ disease compared with HER2 2+ disease; these data suggest very impressive efficacy in this subgroup.

Many of us have been a little bit perplexed about why some drugs work for HER2-lowpositive disease and others don't. For example, [when using] trastuzumab deruxtecan, we're seeing an almost 40% ORR, but we did not see significant responses with T-DM1 in subsets of HER2-lowpositive patients. Why is this? We truthfully don't have the answer, but it may be that you're delivering more chemotherapy with trastuzumab deruxtecan than you are with T-DM1. Perhaps that's why you need just a bit of HER2 expression to get that binding of the ADC and get the drug into the cancer cell.

We have also seen this with other novel ADCs, such as [vic-]trastuzumab duocarmazine [SYD985], where we've also seen ORRs between 25% and 30% in HER2-lowpositive disease. Again, this is very promising and there are lots of other drugs in development that are being studied in this setting, such as new bispecific antibodies. Were going to see many more [treatments] come in this space. There is even a registration trial ongoing with trastuzumab deruxtecan compared with standard chemotherapy for HER2-lowpositive patients.

Right now, testing for these breast cancers is really quite rudimentary and is via IHC. If a patient is HER2 1+, they would be HER2low-positive and if they are HER2 2+ but not FISH-amplified, they would be HER2low-positive. We need to see if there are better tests that can be done to detect very low levels of HER2 expression, because there may be some patients who have tumors [that dont show any positivity but have] low levels of expression that just don't quite meet criteria to be HER2 1+ that may benefit from some of these novel ADCs.

Right now, I'm very excited about the ongoing registration study for trastuzumab deruxtecan compared with physicians choice for patients who have received 1 or 2 prior chemotherapies for metastatic HER2-lowpositive breast cancer. Seeing ORRs that are near 40%, at least in the early single-arm studies, makes us quite excited about the potential to get this level of activity. This would be a nice opportunity for patients to get more personalized treatment that could improve their outcomes.

We've seen a lot of very interesting data come out about approaches to take for patients who have early-stage, HER2-positive disease. Prior to 2 or 3 years ago, we were predominantly treating patients in the adjuvant setting with HER2-directed therapy, but we have since learned that it's quite critical to give the majority of our patients preoperative therapy because we can adapt postoperative treatment to improve outcomes.

Data have evolved over the last year, and we've learned that giving adjuvant ado-trastuzumab emtansine [T-DM1; Kadcyla] can improve outcomes for patients with residual disease after neoadjuvant HER2-directed therapy.

Also, we can augment outcomes for patients by adding an additional biologic therapy, such as pertuzumab [Perjeta], to our patients who are getting chemotherapy and trastuzumab [Herceptin]. We certainly have a lot of tools added to our toolbox, but we've been trying to refine that even further. That's what the focus of a lot of the more recent developments have been on. Now that we have all of these very effective biologic therapies, can we potentially de-escalate therapy for patients who may be at lower risk? Can we potentially escalate therapy for those who may be of a higher clinical risk?

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Tolaney Touches on HER2+ -Low Breast Cancer Testing, Possibilities, and Challenges - OncLive

Living with Advanced Hormone-Sensitive Prostate Cancer and Treatment with Abiraterone and Androgen Deprivation Therapy: The Patient, Nursing and…

This article is co-authored by a patient with metastatic hormone-sensitive prostate cancer who is receiving abiraterone and androgen deprivation therapy treatment in Manchester, UK. The patient relates his personal experiences struggling with the diagnosis, his experience with treatment and the physical, emotional and psychosexual impact on his life. After his diagnosis, the patient has become an outspoken advocate and fundraiser for prostate cancer awareness and wants to ensure that novel treatments with proven efficacy and tolerability, such as abiraterone, are available for all men in his condition. The specialist nursing and physician perspectives, provided by healthcare professionals based in London who are not directly involved in this patient's care, were written in response to the challenges and concerns highlighted by this patient. The role of the specialist nurse as a key healthcare professional in the cancer patient journey, particularly in managing the complex physical and emotional side effects of treatment, is highlighted in this perspective piece. The physician reviews the current difficulties of establishing an effective screening programme in prostate cancer, the common side effects of hormone treatment and the significant progress and challenges in novel drug development and prescription in metastatic hormone-sensitive prostate cancer. While written primarily from the perspective of a patient and healthcare professionals in England, many messages in this commentary would resonate with patients and professionals involved in the care of prostate cancer worldwide.

Oncology and therapy. 2020 Oct 09 [Epub ahead of print]

Tony Collier, Shievon Smith, Michelle Greenwood, Kenrick Ng

Prostate Cancer UK, 53 Tooley Street, London, SE1 2QN, UK., St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK., St Bartholomew's Hospital, Barts Health NHS Trust, London, EC1A 7BE, UK. .

PubMed http://www.ncbi.nlm.nih.gov/pubmed/33037517

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Living with Advanced Hormone-Sensitive Prostate Cancer and Treatment with Abiraterone and Androgen Deprivation Therapy: The Patient, Nursing and...

Schedule Your Breast Cancer Screening this Month – raccoonvalleyradio.com

Though COVID-19 has stopped many things this year, it hasnt stopped other life-threatening illnesses during Breast Cancer Awareness Month.

Some may be putting off an annual wellness visit or other medical procedures because they dont want to be in a medical center during the pandemic, but American Cancer Society Senior Community Development Manager Kim Durst says breast cancer and other diseases shouldnt be ignored, So if you are concerned because maybe you found a lump or its that time for you to go in and get your testing done, reach out to your healthcare provider. They are taking the precautions at the doctors offices, hospitals, and clinics where you wear your mask, use your hand sanitizer, and they are finding ways now to get people in for their checkups.

The Centers for Disease Control and Prevention states that additional ways to lower your risk of breast cancer include keeping a healthy weight and exercising regularly, limiting alcohol consumption, and asking your physician about the risk of taking hormone replacement therapy or birth control pills.

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Schedule Your Breast Cancer Screening this Month - raccoonvalleyradio.com

PROfound Trial With Olaparib Shows Feasibility of Personalizing Care in mCRPC – OncLive

Olaparib (Lynparza) significantly improved overall survival (OS) versus enzalutamide (Xtandi) or abiraterone acetate (Zytiga) in patients with metastatic castration-resistant prostate cancer (mCRPC) who harbor BRCA1, BRCA2, and/or ATM aberrations, according to results from the final OS analysis of the pivotal phase 3 PROfound trial (NCT02987543).1

In the trial, patients with mCRPC who progressed on previous treatment with a new hormonal agent and harbored BRCA1, BRCA2, or ATM aberrations (n = 245; cohort A) or other alterations in the homologous recombination repair (HRR) pathway (n = 142; cohort B) were randomized 2:1 to receive either olaparib or enzalutamide or abiraterone acetate.

Final OS data from cohorts A and B were presented during the 2020 ESMO Virtual Scientific Program. Results showed that the median OS in cohort A was significantly longer with olaparib than with physicians choice (HR 0.69; 95% CI 0.50-0.97; P = .0175).1In cohort B, the median OS was 14.1 months with olaparib versus 11.5 months with the control (HR, 0.96; 95% CI, 0.63-1.49).

What is exciting about this particular trial is that it showed the feasibility of personalizing care and using precision medicine strategies to preselect patients to maximize the chance of benefit for those who are candidates for these treatments, said Maha H.A. Hussain, MD, FACP, FASCO.We can also help patients avoid unnecessary exposure to ineffective treatments.

Previously published data showed that olaparib resulted in a 66% reduction in the risk of disease progression or death compared with abiraterone or enzalutamide (HR, 0.34; 95% CI, 0.25-0.47;P<.0001).2 Based on these results, the FDA approved olaparib in May 2020 for the treatment of adult patients with deleterious or suspected deleterious germline or somatic HRR genemutated mCRPC who have progressed following prior treatment with enzalutamide or abiraterone.

In an interview with OncLive, Hussain, the Genevieve E. Teuton Professor of Medicine in the Department of Medicine of the Division of Hematology Oncology and the deputy director at the Robert H. Lurie Comprehensive Cancer Center of the Northwestern University Feinberg School of Medicine, further discussed the updated findings from the PROfound trial, its clinical significance in the treatment of patients with mCRPC paradigm, and the promise of precision medicine.

Hussain: PROfound is a randomized phase 3 clinical trial. It is one of the first precision medicine clinical trials to complete; patients were preselected based on specific genomic alterations and then randomized accordingly. Patients with mutations in the HRR genes or DNA damage repair genes were assigned to 2 different cohorts. The primary cohort was [comprised of] patients who had BRCA1/2 or ATM mutations, while cohort 2 included [those who harbored] other genes that are involved in the HRR pathway. Patients were randomized 2:1 to olaparib or standard of care per physicians choice of either abiraterone and prednisone or enzalutamide. The primary end point [of the trial] was radiographic progression-free survival (rPFS), which is a meaningful clinical end point, while OS was one of the several key secondary end points [examined].

Data from the Stand Up to Cancer highlighted the fact that over 20% of patients with mCRPC have significant mutations in the DNA repair pathway or the HRR genes. That [research] underscored the fact that this is a clinically relevant pathway to go after. At the time that [the PROfound trial was being designed] we saw evidence of benefit [with this approach] in other tumors [such as] breast and ovarian cancers, and then subsequently, in pancreatic cancer.

The specific pathway relevance is that both normal cells and cancer cells need to repair themselves when there is damage; the HRR pathway is involved in that repair process. However, are alterations or mutations [are present], the cells are not able to repair themselves and they fall back into a different pathway, which is the PARP pathway. Basically, PARP agents tend to inhibit that enzyme so that the [cancer] cells cannot repair themselves.

[Earlier data from the trial were previously published] this past summer. Johann de Bono, MB, ChB, PhD, of The Institute of Cancer Research was the first author on the publication in the New England Journal of Medicine, which highlighted [data regarding] the primary end point of rPFS. In this particular presentation delivered at the 2020 ESMO Virtual Congress, [investigators] reported OS [data from] cohorts A and B.

We saw that the benefit [with olaparib is] not only in terms of rPFS; the benefit translated into a median OS benefit of over 4 months between the arms, despite crossover from the control arm to the olaparib arm at time of progression. Additionally, the risk of death was reduced by 31%, which is very clinically significant. In [the cohort of patients who harbored the] other 12 genes, other than BRCA1/2 and ATM, we saw a trend in OS improvement but it was not statistically significant. The trend was about a little bit over 2 months of a difference. When adjusting for crossover, the trend improved although it was still not statistically significant. However, several patients in cohort B experienced clinical benefits from treatment. The primary benefit [with olaparib] still seems to be driven by BRCA primarily.

No; the overall safety was very much consistent with what was known about olaparib. The most common adverse effects observed included anemia, nausea, and fatigue. Most of these were low-grade events, aside from the anemia. Many of these patients were heavily pretreated; while they might have previously received abiraterone or enzalutamide, they would have also received chemotherapy and other potential anticancer treatment and be fairly advanced in the course of their disease. The findings, overall, are really not surprising and the safety profile very much consistent with what has been observed with the agent in other tumors.

We have reached a major benchmark in the management of this disease. Ever since the original observations regarding androgen deprivation [therapy] in prostate cancer and subsequent treatments, and certainly since the time I entered the field in the early 1990s, prostate cancer management has been more of a one-size-fits-all approach. In fact, when we give chemotherapy and hormone treatment we don't preselect [patients].

We still have [a lot of work to do]. Patients with metastatic castration-resistant disease continue to die from prostate cancer; they also suffer from pain and other factors involved with this disease. This [research] highlights the feasibility of performing precision medicine trials. It also shows us that meaningful clinical benefits could be achieved in these patients. I would hope that our partners across the spectrum will invest further in conducting more clinical trials.

The observation that we've seen with olaparib also opens up the door for potential combination clinical trials, both in castration-resistant disease and potentially in earlier stages of disease, where we might get a better return on investment from a clinical perspective.

Genomic profile evaluation for patients is critical moving forward, not only for the purpose of treatment for the patient. Conducting or counseling the patient regarding germline testing and tumor genomics evaluation in preparation for future treatment is also very critical. Obviously, genetic testing is associated with genetic counseling, [which may allow patients] and potential blood relatives [to get ahead of the game].

Tissue-based genomic evaluation will open the door for the patient to explore different treatments, and [certain] genomic alterations might qualify them for different clinical trials opportunities. [This work] underscores the hope for patients that their cancer can be managed better with genomically targeted treatments, specifically, in this case, the PARP inhibitor. [Now we can build on] these observations in terms of different treatment strategies and combinations.

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PROfound Trial With Olaparib Shows Feasibility of Personalizing Care in mCRPC - OncLive

Jennifer Wong, RPA-C with Advanced Dermatology PC, Offers Tips on Reducing the Hyperpigmentation of Melasma – PR Web

Jennifer Wong, RPA-C

ASTORIA, N.Y. (PRWEB) October 14, 2020

Blame it on the hormones? Well, maybe. In some cases, notes Jennifer Wong, a certified registered physicians assistant specializing in dermatology with Advanced Dermatology PC, the dark skin patches called melasma occur at the same time a woman experiences hormonal changes. But were still learning about the nature of the connection.

In this country, as many as six million people a year ninety percent of them women experience darkened patches of facial skin, usually brown or gray, the result of overproduction of the skin pigment melanin.

In particular, says Wong, women with darker skin tones are more susceptible because their skin has more active melanocytes the skin cells that produce melanin. Genetics also seems to play a role: having a family member with melasma increases the possibility of developing it yourself.

And, of course, there is the role of the sun. The sun triggers our melanocytes, observes Wong. With melasma, very little exposure may cause the discoloration. Unlike age spots, melasma is not due to cumulative sun, and actually often occurs in young women. In some cases, even the light of our computer or cell screens can contribute to melasma.

Melasma usually appears on the center forehead, over the brows, on the bridge of the nose, on the chin, and on the upper lip. All places that get sun exposure, observes Wong. In some cases, melasma occurs on other frequently exposed areas like our forearms.

When melasma co-occurs alongside hormonal changes due to pregnancy, birth control pills, or hormone replacement, it can spontaneously resolve when hormones return to previous levels, for example after the pregnancy or if medications are discontinued. But in other cases, notes Wong, melasma persists. While it is medically harmless, its appearance on ones face can be distressing. Fortunately, we have a number of options to lighten melasma.

With that in mind, Wong makes the following suggestions:

5 Tips on Treating Melasma:

1. First, get a clear diagnosis: Its important, says Wong, to rule out any skin condition that requires medical treatment. A skin specialist can do an examination and, if needed, a biopsy. Once you have a clear diagnosis, you can work with your provider on a treatment plan.

2. Skin lighteners can help: In particular, notes Wong, topical use of hydroquinone or HQ can be effective. HQ comes in varying strengths, including less concentrated over-the-counter formulations, as well as combined with other topicals, such as the retinoid tretinoin and a corticosteroid, in a so-called triple cream. Other topical lighteners include azelaic acid and kojic acid. Your skin-care specialist can help guide your choices.

3. Choose OTC products with care: An alarming number of OTC skin lighteners contain mercury, advises Wong, a neurological toxin that can also injure the children and partners that people come into close contact with. Your skin specialists guidance can be especially helpful because some products do not clearly identify ingredients, using different terms for mercury, including calomel, cinnabaris, hydrargyri oxydum rubrum, or quicksilver. In addition to hidden mercury, weve also seen products with unlisted steroids, which can cause skin damage.

4. Outpatient procedures can help, too: Lasers, explains Wong, can penetrate down to melanocytes to block melanin production, while chemical peels can remove hyperpigmented surface skin. Again, your skin specialist can explain outcomes, time involved, and side effects to help customize a treatment plan that is the best fit.

5. Throw shade on the chance of reoccurrence: The sun activates our skins production of melanin, notes Wong. Melasma can be triggered by minimal exposure, regardless of season or weather, so patients will want to be vigilant about protecting themselves from the sun every day, all year. A broad-spectrum SPF 30 mineral sunscreen with zinc oxide or titanium dioxide can help physically block rays. Patients will also benefit from protective clothing, including a wide-brimmed hat and sunglasses.

Fortunately, Wong concludes, patients can take action now to reduce the appearance of melasma, as research continues to connect the dots between hormones and other factors.

Bio: Jennifer M. Wong, RPA-C Physician Assistant. Ms. Wong has comprehensive experience in medical and cosmetic dermatology for all ages.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. http://www.advanceddermatologypc.com

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Jennifer Wong, RPA-C with Advanced Dermatology PC, Offers Tips on Reducing the Hyperpigmentation of Melasma - PR Web

Nutrafol Pioneers Hair Wellness Industry with New Study that Reveals it Safely and Effectively Improves Hair Growth in Menopausal Women – PRNewswire

NEW YORK, Oct. 12, 2020 /PRNewswire/ --Nutrafol, the award-winning hair wellness supplement backed by top physicians, celebrities and hairstylists alike, announces the positive results from its new clinical trial, an industry-first study presented on hair growth in menopausal women. The 6-month double-blind, randomized, placebo-controlled study assesses the safety and efficacy of Nutrafol's Women's Balance formulation in improving hair growth and quality in perimenopausal, menopausal and postmenopausal subjects with self-perceived thinning hair. This milestone establishes Nutrafol as the only hair supplement brand to present research specifically for menopausal women and continues to solidify Nutrafol as an innovator and trusted leader in hair science.

Forty percent of women experience hair loss by age 40, and that number continues to increase as women age.1 Nutrafol created Women's Balance - which first launched in 2019 - in response to the complex hormonal needs of women who are going through or have gone through menopause. It is the only hair wellness supplement clinically formulated to address the root causes of hair thinning in perimenopausal and menopausal women. Featuring a patented Synergen Complex Plus, it includes clinically effective natural ingredients like saw palmetto, ashwagandha and maca, known to support hormone health before, during and after menopause.

"There is unfortunately a lack of research for the physical and emotional effects that menopause has on women," said Dr. Sophia Kogan, Nutrafol's co-founder and Chief Medical Advisor. "At Nutrafol, our mission is to empower women to take control of their hair health, and hormones. After years of research, rigorous clinical testing and the accumulation of unsurpassed data, we have a proven and effective option with our Women's Balance formulation."

To assess the safety and efficacy of Women's Balance for perimenopausal, menopausal and postmenopausal women, Nutrafol conducted a 6-month randomized, double-blind, placebo-controlled trial. Results were significant for objective measures of hair growth, including terminal, vellus and total hair counts. There was a progressive increase in hair counts for Nutrafol subjects compared to placebo at three and six months. Additionally, daily administration of Nutrafol resulted in significantly less shedding compared to placebo. This was accompanied by significant visible clinical improvement in hair growth and quality in the active group, as assessed by a blinded physician investigator. Conclusively, the study verified that the daily intake of a novel supplement with bio-optimized phytoactive ingredients to specifically address multiple underlying factors that compromise hair growth was safe and effective in improving hair growth and quality in women going through menopausal transition. The Primary Investigator of the study was Dr. Glynis Ablon, MD, FAAD and founder of the Ablon Skin Institute & Research Center, an independent clinical research site specializing in dermatology clinical trials.

"Menopause is a disruptive time for women between the hormonal shifts and changes in their bodies that are out of their control," said Dr. Glynis Ablon MD, Primary Investigator on the clinical study. "Nutrafol has pioneered a new way of thinking about the science of hair wellness as it relates to menopause. With safety and efficacy at the forefront of everything the brand does, the published data supports the clinical effectiveness of the Women's Balance formulation for menopausal women. This provides physicians with a solution for their patients, and gives menopausal women the opportunity to take control of their menopausal transition and beyond."

To learn more about Nutrafol and Women's Balance, please visit http://www.Nutrafol.com or speak with your Healthcare Provider.

About NutrafolNutrafol pioneered the hair wellness category with its integrative approach to hair health, using a first-of-its-kind patented formulation of clinically effective, natural, medical-grade ingredients to support whole body wellness from within. In multiple clinical studies, Nutrafol has been shown to improve hair growth in both men and women by multi-targeting root causes of thinning hair, including stress, hormones, environment and nutrition. Nutrafol's team of doctors and researchers continue to seek out scientific advancements at the forefront of genetics, anti-aging medicine, phytoactive and biotechnology to remain on the cutting-edge of hair health innovation. Nutrafol has been adopted by over 2,700 Healthcare Providers across the U.S. for its trusted, reliable results and has received numerous prestigious accolades.

1American Academy of Dermatology

PR ContactBehrman Communications / Gianna Cesa[emailprotected] 212.986.7000

SOURCE Nutrafol

http://www.nutrafol.com

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Nutrafol Pioneers Hair Wellness Industry with New Study that Reveals it Safely and Effectively Improves Hair Growth in Menopausal Women - PRNewswire

Q+A: Katherine Crew, MD, on the Many Advances in Breast Cancer and What’s to Come – Columbia University Irving Medical Center

Katherine Crew, MD, is a physician-scientist whose work in breast cancer risk, prevention, and screening has helped move the needle in breast cancer research. Dr. Crew is a member of the Cancer Population Science research program at the Herbert Irving Comprehensive Cancer Center, associate professor of medicine and of epidemiology at Columbia University Irving Medical Center, and a medical oncologist at NewYork-Presbyterian Hospital.

Weve made a lot of strides in the past few decades and part of that is because we are detecting breast cancer a lot earlier with improved screening and due to our improvements in treating breast cancer, says Dr. Crew. There are always more improvements to make along the way but overall survival for breast cancer, since the 1980s, has improved by about 40%, and its due to all of those efforts, including increased advocacy and increased awareness of this disease.

Where are we now in treating breast cancer?Through epidemiological studies, we have a better understanding of the main risk factors for breast cancer, whether it be age and reproductive factors that influence exposure to the hormone, estrogen, and were learning a lot more about genetic risk for breast cancer.

Back in the mid-1990s it was all about BRCA1 and BRCA2 mutations but now, in the past several years, were testing for multiple genes that can predispose to breast cancer as well as other cancers. And with next generation sequencing, were able to sequence the whole genome much more cheaply and much more quickly. This has led to an increase in our understanding about genetic susceptibility to breast cancer in particular.

Once a person knows about her genetic risk factors or that they are predisposed to breast cancer, what then?We know if a woman has a genetic predisposition, she has the option for enhanced screening, with not just mammography, but more sensitive screening tests like breast MRI. If she has a high penetrance gene she may opt for prophylactic mastectomy. Certainly when Angelina Jolie wrote her Op-Ed in The New York Times about getting a bilateral mastectomy after she found out she had a BRCA1 mutation that really helped to increase awareness.

Now that were finding these more moderate risk genes it has becoming harder to know where to draw the line. We dont want women to do unnecessary surgery or to do unnecessary procedures because that may be potentially harmful. I think were still learning what to do with that information. Knowing more about a persons genetic risk has definitely helped to make breast cancer risk much more personalized and we are always trying to provide the right intervention for the right level of risk, per individual.

There are many types of breast cancer. Can you give us the lay of the land of the main subtypes?The different subtypes of breast cancer all behave differently and we treat them differently. The most common is the estrogen receptor positive breast cancer, which counts for about 70% of all breast cancers and we know that these types of breast cancers respond very well to anti-estrogen therapy. More recently weve been using a class of drugs called aromatase inhibitors in post-menopausal women. In many ways thats been one of the most effective targeted treatments that weve had for breast cancer we can see up to a 50% to 65% relative risk reduction in breast cancer relapse with these drugs.

There is HER2-positive breast cancer and recently, theres been an explosion of new drugs for treating this subtype. Within just the past few years, at least four or five additional drugs have been approved for HER2-positive breast cancer. Although it is a more aggressive form of breast cancer, it is also a type of breast cancer that responds well and is very sensitive in general to chemotherapy and targeted therapy. Even in patients who have metastatic disease, women are living longersometimes for more than five yearswith advanced breast cancer.

The most challenging type of breast cancer to treat is triple negative breast cancer, meaning that it is negative for the two hormone receptors estrogen and progesteroneand also negative for the HER2 receptor. We cant treat it with anti-estrogen therapy and we cant treat it with any HER2 targeted therapies. In this case the main treatment option is chemotherapy, which has its own set of side effects associated with it.

Is this a focused area of research right now?Yes, its an area very ripe for new discovery and research. Recently there was drug approval for immunotherapy for triple negative breast cancer, particularly in combination with chemotherapy. Immunotherapy is a very new type of therapy thats gotten a lot of attention in the press and in the oncology world.

Tell us how immunotherapy could impact breast cancer.Currently, immunotherapy is approved in patients with metastatic triple negative breast cancer but there are a lot of clinical trials that are looking to expand the use of this medication for other breast cancer subtypes. Typically in cancer in general we test these new drugs in patients with advanced cancer who have fewer treatment options and in those cases we may only prolong their survival by a few months. Its much more exciting when we can then take these drugs, if theyre found to be safe in patients with early stage disease, to see if we can improve cure rates. There are ongoing trials testing immunotherapy in patients with early-stage breast cancer, especially if they have high risk disease, to see if we can prevent a relapse and therefore cure them.

What are the other exciting areas of breast cancer research right now?A big trend within oncology and within breast cancer in particular is the de-escalation of therapy. Can we spare some patients from unnecessary treatment? We dont want to over treat breast cancer. We want to treat the high-risk patients but the ones with a more favorable breast cancer, we want to spare them some of the side effects of chemotherapy, for example.

One major breakthrough is as we understand the biology of these tumors a little bit better, we can better classify patients. There are different molecular tumor tests we can use now, including Oncotype Dx, MammaPrint, breast cancer index all of these new tumor tests gives us the opportunity to personalize a womans breast cancer care. Based upon a womans tumor biology, we can assess who needs chemotherapy, who may benefit from extended hormonal therapy, who can do well with just five years of anti-estrogen therapy, and then we can spare them from a lot of the side effects that weve seen from some of these drugs. I think that de-escalation of care has helped cut costs and certainly reduces long-term side effects in our breast cancer patients. We dont want to keep adding on expensive treatments on patients who dont necessarily need it.

You run the High-Risk Prevention Clinic. Whats new in prevention?Similar to the breast cancer treatment field, in the preventive setting you have to look at this not as a one-size-fits-all for women. We can now better refine what a womans risk is and give individualized guidelines for them. Prevention is getting more complex. We dont just test for BRCA1 and BRCA2 genes; there are multi-gene panels that we can test for. Now theres a lot of interest in polygenic risk scores (PGS), so rather than looking at one gene we can look at a bunch of genetic variants sometimes hundreds of genetic variations and come up with a risk score based upon those hundreds of variants. Based upon that score, we place women on a spectrum of risk and then use that to make recommendations about screening, lifestyle modifications, preventive surgeries, and even medications. For example, anti-estrogen drugs have also been shown to be effective in the prevention setting.

How has screening for breast cancer evolved or changed?There are major advances on the screening front as well. For a long time we mainly only had 2D digital mammography and now we have 3D mammography, or tomosynthesis. Rather than just having two views of the breast you can have serial slices of the breast and that can help to increase the sensitivity of the mammogram, particularly in women who have dense breast tissue because having dense tissue can lower the sensitivity of the mammogram for early detection.

There is actually a lot of controversy around screening. Just as we know there are more than one type of breast cancer and more than one level of risk, were trying to adopt less of this sort of one-size-fits-all for breast cancer screening. For instance, not all women need to get yearly mammograms, maybe just higher risk women with dense breast tissue could get enhanced screening with either ultrasound or MRI. But for the majority of women who are not high risk, perhaps we can think about cutting back on mammography screenings. Current guidelines are that if you are average risk you can wait until youre 50 to get mammograms every two years, rather than yearly. Maybe less frequent screenings can also reduce some of the harms of screenings, like increased biopsies.

What does the future hold for breast cancer research and treatment?All of the new drugs and targeted therapies have definitely incrementally advanced the field.

The most exciting is this idea of precision medicine, both for prevention and for treatment, and using genetic information to assess breast cancer risk, having the genetic information of the tumor tissue to assess the aggressiveness of the cancer and being able to tailor treatments specific for individual patients is what we are working towards. I think that more than anything else having that genetic information tailoring our carehas really put more tools in our tool box in terms of what we can offer patients.

-Interview by Melanie A. Farmer

Related:Five Questions with Dr. Eileen Connolly: 'Less is More' Adage Signifies Shift in Breast Cancer Radiotherapy

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Q+A: Katherine Crew, MD, on the Many Advances in Breast Cancer and What's to Come - Columbia University Irving Medical Center

What you need to know about breast cancer and screenings – The Denver Channel

This article is the part of a monthly series of stories focused on cancer issues. Denver7 is proud to partner with the American Cancer Society, Cancer Support Community, Colorado Cancer Coalition and Sarah Cannon Cancer Institute at HealthONE to bring you these stories, tips and resources.

DENVER -- This year, the American Cancer Society estimates that 4,530 women in Colorado will be diagnosed with breast cancer in 2020 and 640 women will die from the disease.

Breast cancer screening is important and can detect the disease when symptoms appear, or before there are any signs. The following American Cancer Society guidelines are for women at average risk:

For more information on screening and risk factors, visit https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html

If a patient had to reschedule their screening in the midst of the pandemic or are due for their screening, they should talk to their healthcare team. Providers can discuss balancing the risks and benefits of being screened now or postponing for a later date, considering personal and family history, other risk factors, and the timing of the last screening test.

Signs and SymptomsIts important to know how breasts normally feel and to be aware of any changes. A common symptom is a new lump or mass, but other things to be aware of include:

If you notice any changes, contact your doctor. For details visit https://www.cancer.org/cancer/breast-cancer/about/breast-cancer-signs-and-symptoms.html

Mammogram Q&AI'm pregnant or breast-feeding and due for a test. Should I wait?

I have a breast implant. Can I still get a mammogram?

What else should I know?

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What you need to know about breast cancer and screenings - The Denver Channel

6 science-backed health benefits of ginger and how to add it to your diet – Business Insider India

Ginger is a plant that has been used to treat ailments for thousands of years. Not only is ginger a delicious addition to cooking because of its spicy and unique flavor, but it's also great for your health.

Here are six health benefits of ginger and how to add it to your diet.

A small 2017 study tested the antioxidant effects of ginger in cancer patients receiving chemotherapy. Those who received a daily ginger extract had higher levels of antioxidants and lower levels of oxidative stress than the placebo group.

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Typically, inflammation goes away once your body repairs itself. But, when you're experiencing oxidative stress, it can cause chronic inflammation. This causes your body to damage healthy cells, tissues, and organs. Chronic inflammation may lead to diseases like heart attacks or chronic pain like arthritis.

Ginger contains a compound called gingerol. Gingerol is known for improving gastric motility the passage of food through the body and suppressing muscle spasms. This can help settle the stomach and reduce symptoms of nausea and vomiting.

Ginger is also a safe and effective herbal remedy for pregnant women with morning sickness. A small 2009 study tested the effectiveness of ginger capsules on pregnant women experiencing nausea and vomiting. Pregnant women who took four 250mg ginger capsules daily for four days experienced less nausea and less vomiting than women who received a placebo.

In a 2015 study, scientists reviewed previous research looking at the effects of ginger on menstrual pains and concluded that 750 to 2000mg of ginger powder can help relieve pain during the first three to four days of the menstrual cycle.

There is also some evidence to suggest ginger can help control blood sugar levels in people with diabetes by increasing glucose uptake in muscle cells without insulin.

Ginger stimulates digestive enzymes responsible for moving food through the body more quickly, which prevents gas. "[It] helps the body break down gas and get rid of gas more effectively," Ankewe says.

According to Anekwe, you can easily incorporate ginger into your diet by:

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Why Am I So Tired In The Afternoon? 13 Reasons Why – Parade

Youre powering through your day like a boss. A Zoom meeting here, a report thereyup, youre feeling unstoppable. Nothing can bring you down. That is, until its 4 p.m., and all of a sudden, you want to take a nap. You wonder where your energy has disappeared to as you slog through email after email, wishing that quitting time wasnt a whole hour away.

If youve experienced this phenomenon, youre far from alone.Several studies have confirmed the so-called afternoon slump, including one from The National Sleep Foundation that pointed a sharp drop in circadian rhythm that plummets between 2 and 5 p.m. every day.

Tiredness is a fact of life, no matter what time of day it is. Max Kerr DDS, D-ABDSM, a dental sleep expert with Sleep Better Austin, emphasizes that its extremely common for people to feel tired, even if it goes beyond the afternoon slump.

First, give yourself a break, he says. Life is tough. We have a million commitments and not enough time. Relax and take care of yourself. You have to make your health a priority, because no one else will.

Dr. Kerr adds that although its normal to feel tired, you dont have to keep pushing through that afternoon fatigue when there are options available to you. He advises, Seek out a sleep coach, ask your primary care physician for a Home Sleep Test, get your blood tested, and give yourself the gift of purposeful movement. Conquering fatigue can open up life and joy in a most profound way as well as positively impact everyone around you.

It can also help to know why you face afternoon tiredness each and every day. Here, three medical experts address the question: Why am I always so tired in the afternoon? Here are 13 possible reasons why.

Dr. Ilene Ruhoy, MD & PhD, and Gut Council Member for the probiotics company Jetson, believes that our energy states greatly depend upon our hormone levels, such as glucocorticoids, leptin, melatonin, and more, she says. These hormones can be impacted by our sleep and eating habits.

Dr. Ruhoy explains, In the mid-afternoon, levels of these hormones are low. However, the absolute levels and the control of secretory rhythms can be influenced by meal and sleep patterns. Sleep fragmentation, poor sleep hygiene, and sleep deprivation all contribute to the feeling of fatigue in the mid-afternoon when hormones are low.

If you suffer from depression, you know how hard it can be to get out of bed some mornings. Pushing yourself through the day can naturally make you feel depression-related fatigue in the afternoon. The insomnia you experience from depression can also cause you to lag mid-day.

Dr. Abe Malkin, M.D. M.B.A. of Concierge MD LA says, Studies have shown that 75% of people suffering from depression show symptoms of insomnia while the other 25% suffer from hypersomnia, which is excessive daytime sleepiness.

Many of us simply forget to drink water throughout the day if we dont make it a priority. All those meetings and phone calls can push hydration way down on your to-do list, but if you want to beat that afternoon slump, drinking up is key.

Water is the main component of our bodys structure, Dr. Kerr notes. When we are habitually dehydrated, it can affect the normal functioning of our body. The harder our body has to work for its normal functioning, the more energy is needed. The less efficient we are, the more tired and fatigued we become.

In other words, regularly sipping that H2O might even make you more productive.

Related: Can You Drink Too Much Water?

Dr. Ruhoy details, Excessive food consumption, sugar and processed food intake, and poor eating habits, such as eating too many meals, doing stressful eating, or doing hurried eating, contribute to fatigue. Minimize or eliminate sugar and processed foods. These foods contain substances that promote inflammation and can disrupt the hormonal balances that impair our rhythms.

She says that in simpler terms, the post-sugar crash is a real thing. You may want to rethink that 2 p.m. doughnut if you want to stay energized through the afternoon.

In addition to what youre eating, it also comes down to when youre eating. Lunch in the middle of the day could be contributing to your lethargy, and you may need to tweak your mealtimes.

Leptin levels, the hormone that suppresses hunger, is low at noon and lowest at approximately 4 p.m. of our 24-hour cycle. Meals in the morning and early evening, over time, will help the daytime fatigue. Studies have shown fasting improves energy state and it may be that it is not truly fasting at all but rather a more natural meal pattern, Dr. Ruhoy states.

If youre someone who feels anxious as soon as your alarm goes off, its no wonder that you feel depleted in the afternoon.

Dr. Malkin says, A chronic anxiety sufferer will still feel exhausted even after a full nights rest because of constant fear when there is no real danger. It is best to schedule an appointment with your doctor to help pinpoint the issue and get treatment to help combat the anxiety.

Related: What Is Social Anxiety?

Our body uses sugar for energy, Dr. Kerr says. The carbohydrates that we eat are converted to glycogen and transported throughout our body in our blood. Insulin will move the sugar from our blood to the cells that need it. If our insulin metabolism is off, which can be caused by diabetes, then our blood sugar can be too low or too high. This can impact the sugar available to our nervous system in order for it to function appropriately. When this happens, we will become very fatigued and sometimes very disoriented. Insulin metabolism is negatively impacted by poor diet and poor sleep.

Heres some major motivation to get your sweat on: exercise just might eliminate your afternoon slump altogether. Exercising regularly can help combat fatigue, Dr. Ruhoy says. Exercise promotes mitochondrial efficacy and it does not require triathlons or climbing Mount Everest. Daily movement helps maintain systemic blood flow and natural levels of adrenal and hypothalamic hormones throughout the day.

Book a morning spin class, sneak in a lunchtime run, or do some calming-yet-calorie-burning yoga at the end of the day.

Related: Best Workout Apps 2020

Dr. Ruhoy explains that sunlight is a huge component of setting proper circadian rhythm, the biological process that regulates our sleep-wake cycles. That means that your body is craving a noon walk in the sunshineor even better, get out to walk in the sun as soon as you wake up.

She says, We often focus on sleep, which is important to be sure, but part of that cycle includes wake, which is one reason why regular meal patterns can be crucial. But getting outdoors each day is important to simulate that rhythm. It does not have to be a sunny day as all that is needed is natural light.

If youre a coffee-drinker, youre likely already aware that if you guzzle a few cups in the morning, it could result in an afternoon crash fueled by a lack of java. And according to Dr. Malkin, the pandemic has been marked by an increase in caffeine all around.

The standard morning cup of coffee became morning, afternoon, and evening joe to help us stay up for Netflix binges and try to function during a Zoom call the next day, he says. Im all for a shot of espresso, but in moderation. When taken in excess, [caffeine] will quickly give you the ultimate jolt but remember what goes up must come down.

To pace yourself, he says that a good rule of thumb is to drink a glass of water equal to your cup of coffee or other caffeinated beverage.

When you find yourself with a few free minutes during the day, were guessing that youre scrolling through social media. Although this can provide an entertaining, or even mindless, diversion, it could result in exhaustion later. Too much screen time isnt good for anyone, Dr. Malkin says. Our brains are actively working to absorb all the images, but lets not forget that the brain is the bodys command center. It gives out all the instructions for when its time to eat, sleep, or work. This is our personal computer which also needs time to reboot just like an athletes body after a rigorous workout.

There are some health conditions that can lead to overall fatigue, the afternoon slump included, and one of those disorders is narcolepsy.

Dr. Kerr says, Narcolepsy is a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep. People with narcolepsy often find it difficult to stay awake for long periods of time, regardless of the circumstances. Narcolepsy can cause serious disruptions in your daily routine.

If you suspect that you may have narcolepsy, its a good idea to schedule an appointment with your doctor.

Stress is a natural, albeit less-than-desirable, part of everyones lives. And needless to say, for many reasons, stress has become even more rampant during the pandemic. When youre stressed out, it can definitely take its toll on your daily energy level.

Celebrity interviews, recipes and health tips delivered to yourinbox.

Dr. Ruhoy shares, Emotional, physical, and mental stress can wear us down and make us less motivated to accomplish tasks or engage in social activities, and over time, the effects of stress can fatigue our cells. Stress has real physiologic effects that can ultimately cause fatigue.

Next up, find out if weighted blanket really help with insomnia.

Excerpt from:
Why Am I So Tired In The Afternoon? 13 Reasons Why - Parade

A tiny particle collider yields new evidence for a type of ‘quasiparticles’ called anyons – Massive Science

The president has had a life-threatening, infectious disease for over a week, and he and his doctors havent been very transparent about the timeline and course of his affliction. In lieu of detailed disclosures, reporters have to piece together his condition based on the treatments hes been receiving.

Trump was started off on an experimental therapeutic an antibody cocktail and then advanced to another remdesivir. The other biomolecules coursing through Donald Trump's system (and this week's headlines) are corticosteroids, called dexamethasone.

You may have heard of cytokine storms, where the body's immune response to severe COVID-19 bombards healthy cells, making the illness worse. Trump has been given dexamethasone, an immuno-supressant that doctors prescribe to temper that effect. Unlike the other experimental treatments, dexamethasone is common and somewhat easy to access. However, it is rarely administered to a patient with a case as (self-)reportedly mild as Donald Trumps. In an interview with New York Magazine's Intelligencer, the co-author of a recent study testing dexamethasone elaborates:

That lack of evidence is concerning as Trump heads into a critical point in the course of his illness. COVID-19 is known for being a bit of a roller coaster, with intermittent fevers, mysterious symptoms, and rapid declines. Abraar Karan, a physician with experience treating patients with COVID-19, told Monique Brouillette at Scientific American that some people have turned corners and left the hospital, only to come back feeling much sicker, with even worse oxygen levels and possibly other harm to the bodys organs.

It is theoretically possible that the early steroid treatment may ward off a dangerous auto-inflammatory reaction. But beyond the inherent risks of immuno-supression, corticosteroids may also cause behavioral side effects in the President. Trump's cognitive and behavioral state has been a point of concern for years. Potent steroids such as dexamethasone are known to increase appetite, decrease restful sleep, and bring about heightened "maniacal" energy states.

As the nation enters the weekend, Speaker of the House Nancy Pelosi is rolling out a 25th amendment commission, Trump is boasting a miraculous recovery with a Fox News doctor, and the rest of us continue to wait and learn how biology will run its course. For better or worse, the side effects our president experiences may prove to have historical consequences. To my knowledge, roid rage has never been a factor in nuclear geopolitics.

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A tiny particle collider yields new evidence for a type of 'quasiparticles' called anyons - Massive Science

Senate Bill May Give More Authority to the FDA for Drug Recall – Med News 365

Beta blockers are often prescribed for high blood pressure, especially if the patient has suffered a heart attack. A new study shows they may not be as effective as once thought.

The study was done in Italy at the University of Bologna. According to researchers, it appears that these beta blockers may not be as effective in women patients as they are in men. Data indicated that women had a higher rate of heart failure than men when they had angina or a heart attack.

The study had 14,000 participants from 12 different countries in Europe. Each one had a diagnosis of high blood pressure, but none of them had a heart disease diagnosis. According to the research, women may have an almost five percent higher risk for having heart failure after a heart attack when taking beta blockers. For those who didnt take the medications, the rate of heart failure was about the same for both men and women.

Researchers dont know the cause for this possible difference. One theory is in the interaction between the beta blockers and hormone replacement therapy. It is obvious that more research focused on women is needed. According to doctors and scientists, research often leads to blanket statements that may not hold true for both men and women.

Women present differently with heart issues than men. They also have a unique physiology from men, which leads to the idea that they may react differently to the same medications as men. Other researchers say that beta blockers pose a risk for anyone, whether the patient is a man or woman.

Beta blockers do their work by blocking the transmission of the hormone epinephrine, which is better recognized as adrenaline. These medications slow down your heart rate as well as the force with which it beats. The result is that your blood pressure is also lowered.

The medications have a secondary job which is to open up the veins and arteries for better blood flow. Not all beta blockers work the same. Some focus on the heart rate while others also impact the blood flow. Some popular brand names of beta blockers include Sectral, Corgard, Zebeta, Toprol XL, Tenormin and Inderal.

Beta blockers arent usually the first line of defense against high blood pressure. Diuretics are often prescribed first. Beta blockers may be prescribed if other medications arent effective and with other drugs designed to lower blood pressure.

Doctors may prescribe these medications for angina, heart attacks, irregular heart rhythm, and migraines. They are often given with other medications.

Beta blockers arent usually recommended for people with asthma because it may trigger an attack. It is also not the first choice for people with diabetes because it can mask signs of low blood sugar.

Until more research is done, it is important to discuss medications like beta blockers with your physician and to tell them everything about your medical history to ensure it is the right choice for your health condition.

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Senate Bill May Give More Authority to the FDA for Drug Recall - Med News 365

Akron Dish: For first time, B&K drive-in staying open through winter in Cuyahoga Falls – Akron Beacon Journal

Katie Byard| For the Akron Beacon Journal

Weve got big news about this little root beer stand that has persevered.

For this first time in its 67 years, the B&K Root Beer drive-in in Cuyahoga Falls, a neighborhood staple, will stay open all year. Previously each year since 1953 the stand closed in the fall.

Loyal customers who in years past have stocked up on pints and quarts of coney dog sauce for the winter are rejoicing.

Weve weathered the storm. Alot of these smaller businesses have not made it," through the COVID-19 pandemic, said Scott Reynolds, who, along with his wife, Christy, owns the old school place at 737 Munroe Falls Ave.

The Reynolds purchased the business in 2015, becoming independent operators of the B&K that years ago was part of the long disbanded B&K drive-in chain.

This has been our best year ever, Reynolds said, noting he wants to keep the momentum going. Weve been very fortunate with all our loyal customers and new ones that discovered the places coney (Spanish) dogs, kraut dogs, hamburgers that are made fresh upon ordering, soft-serve ice cream and more.

I can walk here if the weather gets too bad, said customer Larry Dean, 79, who became a regular about four months ago, after moving nearby to the stand, tucked in a neighborhood.

Last week, Dean, a retired warehouse and inventory manager, drove to the B&K to pick up lunch for himself and his wife. He got his regular order: one coney dog ($2.40), one kraut dog ($2.40), a hamburger ($2.80) and fries ($1.65 for a small order; $2.25 for a large).

Americans are craving more comfort foods during the pandemic, food industry officials say, and the B&K offers familiar eats.

Familiar but upgraded Reynolds says.

Since taking over in 2015, Reynolds, 45, and his wife have kept the vintage vibe freshening up the familiar orange and brown paint while making changes.

The stand now serves one-third pound burgers (larger than before the Reynolds took over) that are formed with the hamburger press that Christy Reynolds grandmother used.

Buns are from Lakemore's Ideal Bakery.

They stand up to our burgers, Scott Reynoldssaid.

Hamburgers previously only offered on Tuesdays are now on the daily menu.

Also joining the daily menu is soft-serve ice cream. One flavor is offered each week.

I am happy to report I have added the B&K to my list of fave area burger places. I brought a couple of cheeseburgers home (including one with grilled onions) for my hubby and me to eat. The stands burgers are straightforward and filling. And, yes, I enjoyed the bun that melded nicely with the cheese and meat, but did hold up.

We also enjoyed a kraut dog (a hotdog topped with homemade sauerkraut that has a sweet flavor), a coneydog (topped with homemade coney sauce) and french fries.

Sides including french fries, tater tots, onion rings, mozzarella cheese sticks are now deep fried. Previously, they were cooked using an air method without grease. Reynolds said customers wanted that classic fried taste.

The stands side of sauerkraut balls isfrom Akron-based Ascot Foods, with roots in the formerBunny B Sauerkraut Balls & Ice Co.

It was rough for the first few years after the couple bought the stand in 2015, Reynolds said.

He noted the business finances were stretched with the purchase of new equipment, including new freezers and refrigerators.

We didnt really know what we were doing at first, he said.

Reynolds, a maintenance supervisor at the Ford Motor Co. plant in Brook Park, and his wife, Christy, a nurse, were looking for an investment when Christy spotted an advertisement saying the stand was for sale.

The idea of running a family business appealed to them. Their children Scott, a fireman;Brian; and Madison, a college student, all work at the stand.

Brians availability to work full-time at the stand now is helping to drive the decision to stay open all year.

The stand is one of three independently operated B&Ks in the area.

Initially the stands were part of the B&Kchain, which began in Michigan City, Ind., in the 1940s. B&Kstands for Bergerson & Kenefick.

Sheila Trombka, a part-time cook at the Cuyahoga Falls stand, is a daughter of Al and Cathy Emich, who acquired the stand in 1958 and sold it in 1996 toVic and Dixie Davis, who sold the stand to Scott and Christy Reynolds in 2015.

Trombka has worked at the stand for virtually her whole life. She learned to wash root beer mugs when she was 5 years old and when she was 9, she ran the register. By the time she was 11,she was a carhop. Now her sons, James, 22, and Jonathan, 18, work part-time there.

She showed us the ropes. We love her to death, Scott Reynolds said.

I came with the building, Trombka said.

About B&K in Cuyahoga Falls

Address: 737 Munroe Falls Ave.

Hours: 11 a.m. to 8:30 pm. Tuesday through Saturday - now, all year.

Phone: 330-922-3355

See the stands Facebook page for specials.

New downtown eatery

Evelyns Coffee & BnhMi has opened at11 E. Exchange St., inthe space behind the Goodwill blue boutique on Main Street in downtown Akron.

The space previously housed coffee shops, including Wholly Joe.

So what is a bnh mi?

Bnh mi is the Vietnamese word for bread, and also in this case refers to the popular Vietnamese baguette sandwich (think sub sandwich on crusty, light bread), typically featuring a meat and pickled vegetables.

French colonists introduced the baguette to Vietnam, but the Vietnamese have made the sandwich their own, creating many versions.

At Evelyns, I enjoyed a chicken bnh that included pickled carrots, cucumber and cilantro ($5.50). You can also get a beef or meatball bnhmi.

Eveylyns also offers kimbap, a Korean dishof seasoned rice with fish cakes, carrots, egg and spinach rolled in seaweed. Other offerings include smoothies, papaya salad and a Vietnamese salad made with shredded cabbage, chicken, carrots and onion. It comes with a sweet and tangy dressing.

The shop offers Vietnamese iced coffee (made with sweetened condensed milk), along with a variety of other coffee drinks.

Vinh Nguyen, a local physician, opened the place this summer, taking advantage of the Start Downtown program operated by the nonprofit Downtown Akron Partnership. The program provides six months of support, including rent subsidies, in the 42-bock Special Improvement District in downtown Akron.

Evelyns is open from 8 a.m. to 4 p.m. Monday through Friday and 9 a.m. to 4 p.m. Saturday.

Phone is 330-849-5080.

See Evelyns web page --https://www.evelynscoffee.comfor more information and to order online.

West Side Bakery's Apple Week

This week is Apple Week at the West Side Bakery in Akron, celebrating 25 years in business this year.

Barb Talevich, who owns the bakery with her husband, Steve, said she expects to go through some fiveor six bushels of Golden Delicious apples from Bauman Orchards in Rittman to make a variety of apple treats.

Available now: Apple cobbler, apple hand pies, caramel apples, apple cobbler tea bread, apple coffee cake, cinnamon apple cheesecake and apple-frangipane galette (an apple tart featuring an almond pastry cream).

Apple fritters will be available this Friday and Saturday.

Its the only time of the year these fried treats are available.

Talevich happily reported that the bakerys employment roster is now back up to more than 20 full- and part-time workers.

For a time during the ongoing pandemic, she and and her husband were the only workers, and the shop was only open on Saturdays.

The shop, at 2303 W. Market St., is now open from 8 a.m. to 5 p.m. Monday through Saturday pickup only. Phone is 330-836-4101.

ThaiSoul Fusion Grill relocates

ThaiSoul Fusion Grill has moved to 992 Kenmore Boulevard in Akrons Kenmore neighborhood.

Thats the space that previously housed Lil Bit Cafe, which closed earlier this year. It apparently was not able to withstand the negative financial impact of the ongoing pandemic.

Well have more soon on ThaiSoul Fusion Grill, which, as its name suggests,offers Thai eats, as well as soul food.

Owners are Tawon and Patricia Burton. They most recently operated the eatery in Stark County, after running it out of space on Romig Roadnear the site of the former Rolling Acres Mall.

Phone is 330-937-8846. Online ordering is athttps://www.thaisoulfusiongrill.com.

The restaurant is only open for pickup at this time.

Wise Guys' clambake

Wise Guys Lounge & Grill in Akrons North Hill will offer a clambake from 3 to 9 p.m. Friday and Saturday.

Cost is $55 for clams, mussels, crab legs, potato, a half check, corn and clam chowder.

Add lobster for $10.

Guys, known for its wide selectionof wine, is at 1008 N. Main St. Phone is 330-922-3006.

Harvest Mart at Lock 3

Harvest Mart featuring food and non-edible items will debut at Lock 3 park off Main Street in downtown Akron on Saturday.

Itll run from 1 to 5 p.m. Saturday, and from 1 to 5 p.m. Oct. 24.

See the Harvest Mart at Lock 3 Facebook page for more information.

Akron'sJ Hudson, an experienced organizer of markets, is coordinating the event.

Hormone-free chicken, turkey, pork, lamb and beef, as well as pumpkins, gourds, apples, late-summer produce and more,will be available.

Cast your vote for favorite burger

You can vote for your favorite burger among two choices at Bob's Hamburg in Akron.

In its "Keeping Burgers Great 2020" election, you vote by buying the quarter pound burger with Swiss cheese and jalapenos or the burger with American cheese, ketchup, onions and mustard. A portion of each saleeach burger costs $6.35 will go to Akron Children's Hospital.

Voting continues through Nov 2. The winner will be revealed Election Day, Nov.3.

Bob's is at 1351 East Ave., near Interstate 76.

Last call at Louie's

As reported by Beacon Journal staff writer Alan Ashworth last week, Louie's Bar & Grille at 739 E. Glenwood Ave. in Akron's North Hill is closing this month. The 28-year-old Louie's, known for its burgers, cited COVID-19 restrictions in its decision to close.

Last day for customers is Saturday.

Thanks for the memories.

Send your local food news to Katie Byard at msakron@sbcglobal.net.

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Akron Dish: For first time, B&K drive-in staying open through winter in Cuyahoga Falls - Akron Beacon Journal

What Was That? Coronavirus, Chaos and Democracy By Michael Fine PART 1 – GoLocalProv

Monday, October 12, 2020

Dr. Michael Fine, Author

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Justice Brett Kavanaugh

The full audiobook can be downloaded here.

"Boys and girls like beer"

-- Brett Kavanaugh, Associate Justice, US Supreme Court

Every morning at 5 AM, three or four white minivans leave from a parking lot on Cowden Street in Central Falls, Rhode Island for factories all across southern New England. Each minivan is densely packed with 10 to 15 mostly undocumented immigrants who live two or three or five people to a room in the ramshackle wooden frame triple-deckers that are crammed into every available square foot in this old mill city. The people in the minivans are from all over the world - from Guatemala, Honduras and El Salvador, from Cape Verde, the Dominican Republic, Colombia; and Puerto Rico refugees from Hurricanes Maria and Dorian who cant find other jobs here. The vans are run by labor contractors who find and supply unskilled labor to the low-wage employers who need bodies for the hot, dirty, smelly and dangerous jobs no one else wants, in the factories, construction sites, meat-packing plants and fish-houses of Southern New England. The vans charge each worker $5 to $10 a day. The work pays minimum wage - $10.50 an hour in Rhode Island, $12.00 an hour in Massachusetts, $11.00 an hour in Connecticut. Theres lots of wage theft on these jobs sometimes workers only get paid for eight hours when they work 12 or 14, or get told the labor contractors havent been paid yet and then never get paid, or are paid piece work using a scale that means they earn $5 or $6 dollars an hour, when they were promised $20 an hour but youd have to produce at an impossible pace to generate that much income.

Yes, we drank beer. My friends and I. Boys and girls. Yes, we drank beer. I liked beer. Still like beer. We drank beer, said Judge Brett Kavanaugh during his testimony to the US Senate Judiciary Committee confirmation hearing.

This testimony provided a unique lens on American culture and mores. A preening conservative President, pandering to his base, chose an undistinguished juror to sit on the U.S. Supreme Court. The opposition party, powerless to stop Kavanaughs confirmation, used accusations about the nominees behavior in high school as the bulwark of their objections to his nomination.

By the time Judge Kavanaugh testified, the process of Supreme Court nomination and confirmation had already been defiled. The nomination to the Supreme Court of Judge Merrick Garland two years earlier had been blocked by the Senate Majority leader, just because he had the power to do that. This occurred just six years after a President had forced through health care insurance reform, because he had the power to do that. Health care insurance reform was unanimously opposed by a minority party, even though the reform itself was based on the ideas of that minority party, which objected only because it was in their perceived political interest to resist the reform, the hell with what the country wanted and needed.

Any pretense of government of, by and for the people, and of governing for the good of the nation had fallen by the wayside years ago. The U.S. Government has long been controlled by special interests, the consequence of the over-centralization of capital, itself a consequence of changes in banking and securities regulations that had been sought by the banking and securities industries themselves. The notion of a common good, of Americans as one people with liberty and justice for all was replaced by narcissism, consumer capitalism, and greed. Brett Kavanaugh is a shallow self-satisfied man - the pure product of a culture without compass or meaning. He now sits on our highest court, appointed for life. I worked hard, he said. I played basketball. I got into Yale and Yale Law School. I got ahead. And yes, I like beer.

These are the values we brought with us into a pandemic.

The nomination and confirmation of Brett Kavanaugh posed a simple question. In the words of another time - have we no sense of decency or responsibility to ourselves as a people?

The story of SARS-CoV-2 and of Covid-19 makes the answer to that question clear. We let loose a pandemic in the US that will cost at least 250,000 lives because we have lost our sense of dignity, our discipline, our courage and our pride.

Almost all the deaths from Covid-19 were preventable. Any fingers to be pointed must be pointed directly at us at ourselves, our culture and our politics. No one did this to us. We did this to ourselves.

Sometime in September or October of 2019, a bat, a pangolin or some other wild animal in China coughed, sneezed, or cried out, perhaps in pain from being caught or slaughtered, or just breathed near a human being. Out of that animal came a virus or more likely a thousand or more viral particles from the family of viruses called Coronavirus - that hung in the air for a moment. Then a human being nearby inhaled. The virus entered the nasal passages and perhaps the lungs of that person, an event likely happens millions or even billions of times a day.

The transfer of viral particles from animals and other human beings is a common, even trivial, event in the human experience. Those particles are always in the air we breathe and they are what our nasal passages, our lungs, our respiratory secretions and our immune systems work to protect us against almost always effectively. Most of the billions of viral particles we inhale or introduce into the body by touching eyes, nose or mouth have no significant impact on the health of individuals. Many viral particles that infect other species plant viruses, insect viruses, frog and toad viruses and bird viruses - have cellular architecture that is slightly different from the cellular architecture of human cells, so most of those viruses are unable to attach to human cells or cause infection. Most of those viral particles are quickly destroyed by the immune system. Most are just dust.

But the virus that entered a human body in the fall of 2019 was different. That virus, which likely evolved in another mammal, had a mechanism that allowed it to attach to specific proteins in certain human cells, cells that line the nose, are present in the lungs and heart and in small numbers in the gastrointestinal system, proteins that are called ACE2 receptors. ACE2 receptors are the proteins that allow the attachment of a hormone called angiotensin converting enzyme, a hormone that helps regulate blood pressure, among other functions.

The virus attached to human cells. It entered those cells and inserted itself into the genetic material of those cells, which is what viruses do. The virus then caused those cells to make copies of itself. Those copies destroyed the cell and were released into the bloodstream where they found and attached themselves to the ACE2 receptors of other cells and entered those cells and their genetic material. Those cells began making still more copies of the virus billions and billions of copies.

That human being had become infected. And then that human began to cough, or sneeze, or breathe or speak, so that the virus entered the air and infected other people nearby. And those people coughed and sneezed and infected other people. The newly infected people infected others, over and over again, until at least sixteen million people who have been tested and counted, as I am writing this, but very likely many more than that likely a hundred to two hundred million people - people who have had the virus but havent been tested or counted have become infected. Which is not many, really, when you consider that none of us has seen this virus before so have no immunity to it. And that there are seven billion of us. Likely all seven billion human beings are susceptible to this new virus and will become infected with it before long since none of us were immune to it in the fall of 2019.

Seven billion humans. 200 million people is about three percent of seven billion, so many more people will become infected before this pandemic is over.

I thought Id sit out the Coronavirus outbreak in the US as an observer. Im a fiction writer turned doctor turned fiction writer again. I worked as a family physician and then started doing public health in my late fifties. I was Director of the Rhode Island Department of Health 2011-2015 a period that included the Ebola epidemic of 2014-2015. Along the way Ive had the privilege of knowing three CDC directors, three Surgeons General (one of whom I helped train to be a state health officer, in 2015) and about 100 city and state health directors, a number of whom are close and dear personal friends with whom I talk frequently. I know CDC and its culture. Many friends and colleagues work there. And I also know government and how it works at the federal, state and city levels. Or doesnt.

When reports began to come out of China of hospitals overwhelmed, of a doctor who had been silenced and then died of the disease, of health workers getting sick and dying in large numbers, of people dying in the streets of Wuhan, I was writing in the morning, and working in the afternoons seeing patients two half days a week, and trying to develop new programs to reduce cost and improve access to health services in Central Falls, Rhode Island, the smallest, poorest and most densely populated city in the state. I consulted a little with the mayors of Central Falls and Pawtucket, Rhode Island, a neighboring city, but had turned my attention to writing fiction, an old first love. I worried a little about this new virus but I assumed that the Chinese CDC and WHO would get in front of it and get it stopped before it spread too far.

I didnt expect to find myself in the middle of one of the worst outbreaks of Coronavirus in the nation.

I also didnt expect the public health apparatus of the world and nation to so dismally fail. Or that the failure would reveal again what my 2018 book Health Care Revolt was written to reveal originally that we have a medical services market, a pharmaceutical products market and a health care insurance market but that we dont have a health-care system in the United States, a system that provides the same set of essential services to all Americans. Our medical, pharmaceutical and health care insurance markets are focused on profit, as markets should be, and not public health. These markets, and the profit focus of American society, have produced a culture in which the rich get richer and the poor are kicked to the side of the road.

Again. The poor get kicked to the side of the road. We have decades of data showing how the market focus of American health care has made our population sicker and poorer, worsened income inequality in the US and has disadvantaged the poor and people of color. You would have thought wed learned something from all our studies, and used what we learned to do a better job with Covid-19. Instead, we failed again, and failed so profoundly that we locked up our society for at least a year, and perhaps for as long as half a generation.

Still, because of my role with a community health center and with the two cities, I paid close attention to the stories and the data coming out of China in late 2019 and by January of 2020 was able to brief the mayors and my colleagues about what we were learning: This new Coronavirus is in the family of viruses that cause the common cold. This one likely evolved in bats and crossed over to human beings in the fall of 2019 in Wuhan China. It was related to the coronaviruses that cause SARS and MERS but this virus appeared to be harder to contain. In most people this new Coronavirus causes mild disease runny nose, fever, cough, loss of taste and smell, and sometimes nausea, vomiting, and diarrhea. But the new Coronavirus spreads quickly and can cause a very serious lung infection in some people, something called Adult Respiratory Distress Syndrome, which is much worse than a simple pneumonia and can be fatal in about one-third of the people who get significantly ill. The case fatality rate - the ratio of the number of people who get the disease to the number of people who die of it - was reported to be 3 percent, so that of a hundred people who would get the disease likely three would die, which made this Coronavirus 30 times more lethal than influenza but 20 times less lethal than Ebola, a virus that kills 50-75 percent of the people who get it.

Eventually wed learn the case fatality rate is more likely 0.4 percent or less, or about four times that of seasonal influenza. Even so thats a scary number, because every human being, in theory is susceptible to the Coronavirus, which means all of us could get sick at about the same time. In theory, a city of 100,000 might have 10,000 people in the hospital in the span of a few weeks, about ten times the usual number. And 3000, we thought then, would likely die. By comparison, about 5 percent of us are susceptible to seasonal flu each year. Even so, it kills 30,000 to 60,000 Americans every year. This means in that city of 100,000 people, likely 5000 people get the flu, and 500 people are hospitalized for it, and 5 die.

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What Was That? Coronavirus, Chaos and Democracy By Michael Fine PART 1 - GoLocalProv

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