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Archive for the ‘Hormone Physician’ Category

Platelet rich plasma and thicker hair | Health Wellness – NorthFulton.com

Everyone would like to have thicker hair. Well, almost everyone -- but our focus today is not on those rare unicorns whose complaint is that their hair is just too thick, too luxurious and too lustrous. This article is for the rest of us who would like to have more or thicker hair or at least stop losing what we have.

A number of treatment options have been the staple considerations for normal male and female pattern hair loss for years. For men, finasteride, minoxidil and hair transplantation have long been the most effective interventions. Womens treatment options used to be even more limited, with minoxidil alone being the main option for female pattern hair loss. However, a growing body of research supports that hormone replacement and/or platelet rich plasma injections could be the miracle grow for failing follicles!

First, a note about hormone replacement therapy: A physician named Dr. Glaser published an article in the British Journal of Dermatology in 2012 which made an observation that has unfortunately gained little attention likely because it runs counter to how people usually think about hair loss and testosterone. Dr. Glaser surveyed 285 women who had been on subcutaneous testosterone therapy for more than a year for the treatment of androgen deficiency and 63% of the women who had reported hair thinning prior to treatment reported hair thickening after treatment began. This finding has received little attention, but a 63% response rate deserves further investigation.

Several patients in my own clinic who complained of thinning hair, went on androgen replacement prescribed by their endocrinologist or ob-gyn for other reasons. These patients hair became markedly thicker and more voluminous on testosterone. Although Premier Dermatology does not offer hormone replacement therapy (HRT), androgen levels are one of the laboratory tests that we order as part of our screening panel for causes of hair loss. If we have a female hair loss patient with low androgen levels (either low or low normal), we offer referral to a physician who performs HRT for discussion of risks and benefits of a trial of androgen replacement therapy for hair loss. Results that we have seen have paralleled the 63% response rate that Dr. Glaser published.

Second and just as exciting, Platelet Rich Plasma, also known as PRP, is an option that is fast becoming an important treatment strategy for treating hair loss in both men and women, be it for common hair thinning or for certain alopecia syndromes. PRP is a blood product derived from a patients own blood. The process involves the following: A fraction of blood (up to 22ml in our practice) is drawn from the individual patient into a syringe (depends on the extent of hair loss). This is a relatively small amount compared to blood donation. The blood then is spun in a centrifuge to separate its components (White & Red Blood Cells, Platelet Rich Plasma and Platelet Poor Plasma). The Platelet Rich Plasma (PRP) is collected into a syringe. The PRP is then injected into a treatment area (the scalp for hair loss).

The basis behind PRP is that growth factors and other proteins within platelets promote healing and induce tissue regeneration and rejuvenation. Platelets contain growth factors and biologically active molecules that are normally released when platelets are outside of blood vessels such as when a person gets a cut and starts to bleed into surrounding tissue. Injecting PRP into the subdermal fat induces platelet degranulation (release of platelet contents) which causes tissue exposure to platelet growth factors. In plain terms, PRP delivers growth factors to stimulate hair follicles.

To achieve best results, PRP is performed in a series of treatments. Typically, two to three treatments are performed once per month initially. It is often recommended that treatments take place every 6 months after the initial series of treatments to continue hair regeneration and maintain or enhance results.

PRP has numerous other applications in dermatology the most common of which is as an adjunct to microneedling for skin rejuvenation or treatment of acne scars. However, PRPs greatest potential may be as a treatment to help grow or maintain hair.

At Premier Dermatology and Mohs Surgery of Atlanta, we are committed to offering scientifically-backed, effective and state of the art treatments. Kathryn Filipek, PA-C has extensive cosmetic, surgical and medical dermatology experience and is responsible for the hair loss branch of our practice. If you are interested in exploring PRP and hair loss options, call today to make an appointment with Ms. Filipek. It is our privilege to take care of you and your familys skin, vein, and hair care needs.https://premierdermatologyatlanta.com/

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Quarantine weight gain: 5 reasons that have nothing to do with food – CNET

There are many reasons you can gain weight that have nothing to do with food.

Sometimes weight gain is easy to figure out. If you've changed your eating habits, added more dessert or processed foods, or have been spending more time on the couch than usual, you can typically blame those reasons if you gain a few pounds. But sometimes figuring out why you gained weight is trickier than that.

And while we're living in unprecedented times, whenstress levels are high and activity levels are lower due to quarantine and gym shutdowns, it's normal to gain weight and it's nothing to be ashamed of. But sometimes weight gain is more complicated than that. Weight gain is often caused by more than just the calories you eat and exercise (or lack thereof). The "calories in, calories out" approach is pretty dated when it comes to weight loss, so it makes sense that gaining weight is more complex than that too.

If you've gained weight and are having a hard time pinpointing the cause, keep reading below for five reasons that could be to blame.

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If you're a woman and are dealing with unexplained weight gain, one of the first things you should check out are your hormones. Your hormones regulate so many important processes in your body, including your metabolism.

Hormone issues are pretty complicated though, so you typically need to get lab work done to really understand what's going on. "There are five key hormones that can affect weight and when any of these happen individually or in combination it can trigger fat storage and weight gain," according to Alisa Vitti, a functional nutritionist, hormone health expert and founder of hormone health care companyFLO Living.

Those five hormone issues are:

Several medical conditions that involve hormones can also be to blame for unexpected weight gain.

"When you have a diagnosed condition like PCOS, fibroids, endometriosis, ovarian cysts, PMS -- it means that your body's hormones are not functioning optimally. You could have excess estrogen, you could have elevated cortisol or insulin insufficiency all creating scenarios by which both your cycle as a whole becomes dysfunctional and weight becomes a problem," Vitti says.

"The weight is the symptom of the hormonal imbalance and truly taking care of the hormonal issue is the best way to resolve weight discrepancy," she adds. How you balance hormones depends on your personal situation and health care provider, but generally, it involves lifestyle changes like diet and exercise, and some doctors can prescribe you other things to help like hormone therapy.

Now that you know that hormones are an important part of the weight gain puzzle, you should know how stress can play a role. One of the ways it works? Stress affects hormones, which as we've seen can affect weight, not to mention your sleep too.

"Prolonged low-grade chronic stress is a huge factor for women especially," Vitti says. "Managing invisible domestic work, managing children, working full time, taking care of elderly parents, remembering every detail and managing one's own emotional reaction to current stressful events takes a huge toll on women's adrenals." Your adrenal glands produce the hormones that help regulate your metabolism, blood pressure and immune system, among other things.

The stress of living through a pandemic can cause weight gain.

Stress, and the habits that can result from stress, are part of a bigger picture that Vitti says can all add up to weight gain and inflammation. "Skipping meals, relying on coffee, being depleted of micronutrients from not eating nutrient-dense meals, overexercising, not getting enough sleep, being woken up in the night on a regular basis, working the night shift, being exposed to xenoestrogens in conventional cleaning or beauty products, pesticides in foods, sugar-- [they] can all disrupt these hormones and create a biochemical environment where inflammation and weight gain occur," Vitti says.

"So it's important to understand that because the old model of calorie restriction and increased exercise will absolutely not address all of these underlying factors."

Certain medications can cause weight gain as a side effect.

A common culprit behind unexplained weight gain is medication. Whether you're taking something every day or in the short term, many medications have weight gain as a side effect.

If you're dealing with weight gain and suspect it could be due to a medication you are taking, talk to your doctor to see if there's anything you can do to mitigate the side effects like adjust your dose or maybe switch to a different medication. Some examples of medications that can cause weight gain are antidepressants, diabetes medications and blood pressure medications.

It may be a hard truth to accept but people do usually gain some weight as they age. This happens because as you get older your basal metabolic rate, or the amount of calories your body needs, begins to decline -- and so does muscle mass.

This means you can eat the same and exercise the same at 50 as you did at 30 years old, but not have the same amount of muscle or be able to maintain the same weight. In order to combat this, it's important to adjust your food intake and fitness routine accordingly. For example, focusing on adequate protein intake and strength training can be helpful for maintaining healthy muscle mass as you age.

Failing to get adequate sleep can show up on the scale.

Missing out on quality sleep is one reason why weight gain can creep up on you. When you'resleep deprived, you're probably not that motivated to eat healthy, cook or exercise in the first place. And when you're not getting enough sleep, you're more likely to crave unhealthy foodsand eat more because you feel so exhausted.

Lack of sleep can throw off your hormones, leading to the issues Vitti mentioned above, and it can mess up your appetite signals, which also explains the tendency to overeat when you're tired.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Quarantine weight gain: 5 reasons that have nothing to do with food - CNET

Cleveland Clinic: Four ways to boost your immune health – WKYC.com

Amid the pandemic, staying healthy is a top priority for most.

CLEVELAND As the state of Ohio continues it's fight against thecoronavirus pandemic, staying healthy seems to be a top priority for everyone.

But outside of washing your hands, not touching your face and proper social distancing, how can you increase your health and overall wellness? The Cleveland Clinic recommends boosting your immune system.

You diet can have a huge impact on your immune Health.

I believe in the power of immune-boosting foods, says Dr. Darling. Choosing whole, unprocessed foods does wonders for overall health, says Preventive medicine physician and wellness expert Sandra Darling.

She suggests adding foods like garlic, prebiotics, vitamin C-rich foods, and antioxidants to your diet to give your system a boost.

Listen, we know it's hard, but living under constant stress is detrimental to the body. Too much stress "cause causes the body to produce too much cortisol, the stress hormone. Over time, elevated cortisol lowers your resistance to fighting off infection and contributes to poor sleep and higher blood pressure," according to the clinic. Dr. Darling suggests making sure you get enough sleep, exercise and try meditation.

A little bit of positivity goes a long way. "Research shows that positive thoughts reduce stress and inflammation and increase resilience to infection while negative emotions can make you more susceptible to the common cold and flu," according to the Clinic.

If you've done all that you can when it comes to taking care of your immune system health, the Clinic recommends trying supplements and or essential oils.

The Clinic also recommends making sure you're taking time for yourself to rest in recharge. There's a lot going on in the world, you can't pour from an empty cup--so fill yours up!

For more information on the Clinic tips and resources, click here.

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Cleveland Clinic: Four ways to boost your immune health - WKYC.com

Dr. Jessica Shepherd Talks Family Planning During COVID And Getting The Most Out Of Your Gyno Visits – MadameNoire

Source: Jackie Shepherd / drjessicashepherd.com

Youll be hardpressed to find any area of life that hasnt changed since the onset of COVID-19. And that includes, pregnancy. With the pandemic looming on, with no end in sightparticularly for the United Stateswomen are thinking seriously about family planning, contraception and delaying having children.

Which means birth control.

We spoke to Dr. Jessica Shepherd, practicing OB/GYN and womens health expert at the University of Illinois, about the options available to women these days, specifically the hormone-free IUD called the Paragard, what Black women can do to advocate for a safer, healthier pregnancy and delivery, and what we can do to get the most out of our gynecological visits.

MadameNoire:Have your patients expressed concerns about getting pregnant or giving birth in the midst of this pandemic?

Dr. Jessica Shepherd: I think thats a very valid concern that patients have and should discuss with their doctors. Most pregnancies are unplannedif you want to call it that. But for those who are planning and have those questions, it could require a visit.

MN: In addition to the pandemic, Black women face additional concerns during pregnancy and labor. Do your patients speak to you about these concerns?

Dr. Shepherd: Oh yeah, I think thats the overwhelming topicmore than just this year. But this year has really made it a discussion topic. The increased maternal mortality rate is a public health issue. Its all intertwined but Im glad its being discussed more so we can be very open with our intent on how we plan to fix that.

MN: How is childbirth different because of COVID?

Dr. Shepherd: The process is different in the sense that we cant have more than one person in the delivery room. Many times, if someone is COVID positive, prior to delivery, we have to keep them isolated. And also postpartum if mom is COVID positive, they have to determine the babys status before theyll allow mom to be with baby.

Most hospitals now are testing patients with rapid testing or if they have a c-section or planned induction date, theyll try and test them about a good 48 hours prior to their admission to the hospital. So these protocols are not always easy to implement because deliveries happen any and every time. But its really for the safety of everybody.

Also using PPE wear during delivery, making sure physicians wear eye protection, face shield and the N-95 masks because some people cant get tested before they start the delivery process if theyre already in labor.

The best way to be preventative is to assume that everyones positive.

MN: What do you advice do you offer expectant mothers? Its a public health issue but its not their fault so is there anything you can advise to ensure that theyre able to have a safe pregnancy and delivery?

Dr. Shepherd: There are a few things that Id highlight. If I could name three specific goals that a woman could do it would be:

Not like people dont go prepared but now that we know that this is something to be focused on, its important to go with concise questions. And find a way to document or record the information that you get. If you need to have that information for later, you have access to it. And you can also share that information with someone else so that they know what they heard was exactly as they heard it.

Have a family member, a confidant, a family member, or friend come to visits with them, if thats possible. Because of the pandemic, thats less likely but there are telehealth appointments that can be done. There are consults that can be done with family members around. What we see now because of COVID is bringing people into delivery rooms or appointments via FaceTime so thats a great way that you can have more than one ear open to the information thats being delivered. So you can ensure that more than one person heard it. And that helps to reiterate the messaging.

A lot of times when we give patients information, it can be misconstrued or misunderstood. So one of the ways of navigating through that is having someone there that can reiterate the message and also make sure that it stays prioritized.

Outside of race of the pandemic, I always encourage patients who feel that the relationship they have with their physiciansometimes its not always a physician problem or a patient problem. Sometimes its a communication problem. The communication can be a little off. So thats when you can ask for a second opinion or a different provider or going to another specialist. And you really want to make sure that youre paying attention because one of the things we dont advocate for or dont advise is changing care late in the pregnancy. Thats not helpful to anyone because theres so much time and information that was missed.

And sometimes it can be difficult to determine what needs to be done when you have such a time sensitive process.

Source: Bryan Bedder / Getty

MN: For those people who are trying to avoid getting pregnant during this time, how do you ensure that you dont have a toxic reaction to the birth control that you choose?

Dr. Shepherd: I think one of the things is discussing with your physician prior to having contraceptive counseling is for patients to know whats in what theyre getting.

Now, the great thing about the Paragard is there is no hormone. Its a 100% hormone free. So youre less likely to see what we hear patients referring to when they talk about side effects of contraception. Usually, theyre referring to a hormonal side effect rather than something else. Its usually due to the active ingredient. And the Paragard only has a couple of active ingredients, so if there is an issue we would know what caused it.

MN: Can you tell us more about the Paragard? How is it were able to have birth control with no hormones?

Dr. Shepherd: The Paragard is one of those forms of contraception thats been around for a very long time. Its an IUD. The IUD has been around decades. Its been so longstanding because its reliable. Its hormone free and maintenance is very low. So, once its inserted, its completely reversible. It works for a maximum of two years.

MN: Would you say that women should avoid adding any types of additional hormones to their bodies?

Dr. Shepherd: No, I wouldnt say that. I think when you look at the world of contraception and whats available to womenwhat has been developed over the decades, I think there is absolute need for all forms of contraception, whether they have hormones or not. The availability and the flexibility within our options and choices as women which is the most important.

When you look at how many women are allowed to have that freedom, that should be the take home message.

Yeah, there are going to be a lot of women who dont respond to hormonal birth control but there are millions of women who use contraception, it doesnt matter what kind. And thats the beautiful part about where we are today because prior to contraceptives being developed, women had no options. Like, none. Weve come a long way and I wouldnt label it as something that is not good to have.

MN: What about affordability of birth control?

Dr. Shepherd: When you think about affordability, I usually go to my mainstay of Planned Parenthood. But when you think about contraceptive counseling, people have insurance. They have insurance plans. The most important distinction of whether they go to Planned Parenthood or whether they go to the doctors office is about what am I looking for? What are my expectations? What have I experienced in the past? And using that as a guideline to narrow down your choices of birth control and what looks best for that person. Its a very individual decision.

Most people come in after theyve had an uh oh moment and realize they need to be on birth control. But its really a conversation that should start early in age. Not that they should start at that time but that they have the information. When you have young women who at least know whats available so they can make better decisions for themselves.

MN: When can you do a telehealth appointment and when should you go into your gynecologists office?

Dr. Shepherd:I think thats been something thats changed over the last five months. The telehealth visits can really accomplish more than one would think. I know a lot of people are freaked out like, What?! How are you going to do an exam? Its not so much of the exam but the foundationwith any medical disciplinethe basis of the relationship starts in the information room.

That requires a lot of information that needs to be extracted from the patient, starting the discussion. When you look at it from that perspective, you can start the discussion and determine if its something thats urgent and the patient needs to come in right away or two weeks out or maybe they can get their question resolved right then.

In my practice, the top three things I saw patients for on telehealth were abnormal uterine bleeding, contraceptive counseling, and IUDS. So we would do the initial consultation and then bring them in for the insertion.

I saw an increase in IUD patients over this time because people were thinking about things that were longstanding so the features of the IUDS really made a stand out appearance because it has such low maintenance

MN: How can women make sure they get the most out of their gynecological visits? Too often we go into those appointments anxious or scared and then we end up leaving without giving or receiving the information we wanted.

Dr. Shepherd: One of the best features is to come prepared. We all have it in our heads, right and then you get there and then you have some anxiety and then you leave and youre like, I literally forgot to ask A, B, and C. So writing it down is sometimes the best and easiest advice to take.

Now, I would say the challenge is when patients have the expectation that the questions they bring are all going to be answered. That sometimes can fail.

The relationship between a physician and patient should be one thats ongoing. So the expectation of going and getting twenty questions answered versus we can look at those questions and say lets tackle the most important ones that are impacting you right now and then lets do a follow up visit and get to the rest of those questions. Sometimes its a part B and part C type of visit.

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Dr. Jessica Shepherd Talks Family Planning During COVID And Getting The Most Out Of Your Gyno Visits - MadameNoire

How Covid Sends Some Bodies to War With Themselves – The New York Times

Janelle Ayres, a physiologist specializing in infectious diseases at the Salk Institute for Biological Studies, describes this concept as a disease tolerance mechanism the ability, sometimes hard-wired, sometimes induced by environmental factors, to survive infections without falling ill. Our traditional view has been: To survive an infection, you have to kill it, she told me. We have a very disease-centric approach to biology. But infection doesnt always equate to disease. Many of the most frightening pathogens tuberculosis, cholera, polio and now the coronavirus dont cause illness in everyone they infect. Some people experience these infections with few if any symptoms. Their immune systems evidently handle the invasion with the perfect balance of aggression, restraint and repair or tolerance to stave off disease. The drugs of the future, Ayres hopes, will enable these native tolerance mechanisms that help some shrug off, with few ill effects, the diseases that sicken and kill others.

The Covid-19 pandemic has already prompted many physicians to bend in this direction. So few tools exist to reliably eliminate the virus from our bodies that they have, out of necessity, turned to the idea of prodding the immune system in various ways. They have shifted their focus in a manner that Ayres has long argued is necessary: from eradicating the pathogen to helping the patient survive the pathogen. They are, in a way, pinning their hopes on innate tolerance mechanisms.

Dozens of trials are currently underway that focus on the immune system. These involve everything from cheap, over-the-counter pain medication to expensive antibodies manufactured in living cells. The drugs they are testing include anakinra, used by Navarro-Milln; leronlimab, a drug with anti-inflammatory properties originally developed to treat H.I.V.; and drugs that block IL-6 (full disclosure: My wife works for Genentech, owned by Roche, which manufactures tocilizumab, one of the IL-6 blockers). One study in Britain is testing high doses of a stomach-friendly formulation of the nonsteroidal anti-inflammatory ibuprofen, better known in the United States as Advil. (Dont try this at home.) Researchers are even looking into low-dose X-ray radiation as a way to calm the immune system, a method that was used in the early 20th century to treat pneumonia but has since fallen out of use.

Theres an intriguing trial on an old drug originally developed to treat gout, a painful inflammatory condition of the joints, called colchicine. The drug, which was recently shown to offer protection against heart attacks, targets the very pathway called NLRP3 inflammasome that some scientists believe is naturally dampened in bats. Unlike biologics, which are given intravenously, colchicine can be taken in pill form. And while biologics can cost hundreds of dollars per dose, colchicine is dirt cheap. We think that in the setting of this viral infection, NLRP3 gets activated aberrantly, says Priscilla Hsue, a professor of medicine at U.C.S.F. and one of the physicians overseeing the trials. And that leads to downstream badness. The drug, its hoped, will prevent the immune system from ever getting to the point where it becomes overly activated. The study aims to start treatment early by sending pills to the homes of patients who have tested positive for Covid-19. The thought is, If we can intervene early with an anti-inflammatory agent, we can have an impact on slowing down progression and keeping patients off ventilators, Hsue says.

It remains to be seen which, if any, drug will work best, and what might be the unforeseen consequences of suppressing the immune system in the midst of its battle with the coronavirus. Some trials are already showing failures. Despite promising results from early, weak studies, two of the strongest trials to date on the IL-6 blockers tocilizumab and sarilumab suggest no benefit. (The pharmaceutical companies running the studies, Roche and Regeneron, are continuing with other trials testing their IL-6 blockers.)

Or maybe the studies would have produced better results had they been designed differently. Thomas Yadegar, who thinks tocilizumab can be a lifesaver, if used in the right way, surmises that one study didnt employ stringent-enough criteria for choosing its study patients. Navarro-Milln thinks the trials tried to treat patients too late in the course of the disease. She likened these efforts to trying to cure Stage 4 metastatic cancer probably doomed from the start.

Other researchers also raise this issue of timing when doctors should administer drugs to curb immune responses in a more general sense. Suppressing the immune system too soon after infection could be counterproductive because it might squelch the initial antiviral response and allow the coronavirus to proliferate, says Dawn Wahezi, a pediatric rheumatologist at Childrens Hospital at Montefiore. Yet treating too late may make it impossible to quell the eventual immune overreaction. Knowing when is the right time I think thats one of the key components, Wahezi told me. Theres a very delicate window where immunomodulators can help.

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How Covid Sends Some Bodies to War With Themselves - The New York Times

Amid COVID-19, people with diabetes struggle to get insulin – Los Angeles Times

For Adam Winney, a 26-year old with Type 1 diabetes, grocery shopping during the early days of a pandemic was an infuriating task. Everything was sold out, except for the one type of food he couldnt eat.

The only things left were carbs, carbs, carbs, the Van Nuys resident said. Ive never been more furious than back in March.

For the record:

1:54 PM, Aug. 11, 2020A previous version of this story said an insulin pump delivers insulin to the pancreas of a person with Type 1 diabetes. The pump actually infuses the insulin under the skin so it can be absorbed into the bloodstream.

Winneys disease has deprived his body of insulin, a hormone thats needed to turn the sugar in carbohydrates into energy. Without it, his blood sugar can spike to dangerous levels, eventually leading to serious health problems like cardiovascular disease, nerve damage and kidney failure.

But the insulin pens he relies on to keep his body in balance cost him upwards of $1,000 a month, since his health insurance doesnt cover the medication. After the coronavirus outbreak cost him his job as a receptionist at a hair salon, that expense was beyond his reach. He went six weeks without the long-acting insulin he usually takes every day.

I was fighting nausea every morning, he said, a sign that his body was susceptible to diabetic ketoacidosis, a state of dangerously high blood sugar levels that has landed him in the hospital before. Your body just falls apart.

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COVID-19 presents a unique set of challenges to the roughly 34 million Americans like Winney who are living with diabetes.

The Centers for Disease Control and Prevention says people with Type 1 diabetes are probably more susceptible to a severe case of COVID-19. Those with Type 2 diabetes the more common form that begins when people lose their sensitivity to insulin are definitely at increased risk of severe COVID-19, according to the CDC.

For instance, a study of more than 7,300 COVID-19 patients in China found that those with Type 2 diabetes needed more medical care and were nearly 50% more likely to die than patients without diabetes. The risk of death was especially high for people who had trouble controlling their blood sugar, researchers reported. Another study of more than 1,200 COVID-19 patients in the U.S. found that the mortality rate for those with diabetes or high blood sugar was 29%, compared with 6% for those without diabetes.

The extent to which you control your diabetes is a risk factor, said Dr. Daniel Drucker, a senior scientist at the Lunenfeld-Tanenbaum Research Institute at the University of Toronto. Theres a lot we can do about that, by making sure that your diabetes is optimally controlled.

Insulin is essential for keeping blood sugar in check, but the pricey medicine is harder to get if a job disappears, along with the health insurance that came with it.

The cost of insulin varies from patient to patient. It depends on the type of insulin they need some take effect within 15 minutes; others last more than a day as well as the dose. Some insurance plans pick up more of the tab than others.

The financial strain brought on by the pandemic has forced Royce Jonathan Miller of Yuba City to consider rationing the insulin he takes for Type 1 diabetes. He has kept his job as an optician at Walmart, but since his father-in-law lost his job at a maintenance company that closed operations due to the pandemic, Miller has become the sole provider for the four people in his household.

Brandi DaVeiga programs the insulin pump that helps her control her Type 1 diabetes.

(Christina House / Los Angeles Times)

Miller has an insulin pump, which uses a tube to infuse a small amount of insulin under the skin so it can be absorbed into the bloodstream. He is supposed to change out the pieces that connect to his body every three days. Lately, hes been wondering if thats absolutely necessary.

Im starting to think, I can stretch that up for two cycles, every six days, and hopefully it doesnt get infected, Miller said. But I do realize that if I am to make myself sick and wind up in the hospital, that will be a bigger burden.

A nationwide survey of 5,000 people with diabetes conducted for the American Diabetes Assn. found that one in four have rationed supplies to cut the cost of their diabetes care since the start of the pandemic.

Now is not the time to let up on helping these individuals manage their disease, because it may in fact be helpful in preventing them from getting severe COVID-19, Drucker said.

People with Type 2 diabetes may face even greater hardship in affording their insulin, said Dr. Francisco Prieto, a family health physician in Sacramento.

Not everyone who has Type 2 has to take insulin, Prieto said. Those who do are typically folks who either have the most severe cases of diabetes or have failed all the previous oral and injectable treatments. That means they may need to take even more insulin on a daily basis than Type 1 patients, he said.

Since 2019, 11 states have set limits on the amount insurance companies can set as co-payments for insulin. Each of those states has enacted price caps ranging from $25 to $100 per month since the coronavirus outbreak took off in March.

California may soon join the list. In February, Assemblyman Adrin Nazarian (D-North Hollywood) introduced a bill that would cap insulin co-pays at $50 for a 30-day supply, or $100 per month. It passed in June by a 64-4-11 vote, but the Senate Health Committee has not scheduled a hearing that would allow the bill to move forward.

Winney said a price cap would give him some peace of mind. These days he relies on free samples provided by one of his doctors, but that generosity may not last.

I see that as an incentive to finally change insurance, he said.

Brandi DaVeiga, who has Type 1 diabetes, at home in Lakewood.

(Christina House / Los Angeles Times)

Ensuring an affordable supply of insulin would help people with diabetes manage their disease better, said Brandi DaVeiga, a stay-at-home mom in Lakewood with Type 1 diabetes. She has good coverage now through her husbands health insurance plan, but when she was between plans three years ago, she began skipping insulin doses to make her supply last longer. On several occasions, her blood sugar levels rose dangerously high, and she ended up in the emergency room.

Its really stressful, she said of managing diabetes during a pandemic. And that doesnt help your blood sugar.

The fact that people with diabetes are rationing their insulin when they need it most points to larger problems with healthcare access in this country, Drucker said.

COVID-19 is reminding us of the importance of doing everything we can in our vulnerable, at-risk populations, he said. Lets do everything we can to optimize their health because that may, in turn, reduce their risk of having a bad outcome with this virus.

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Amid COVID-19, people with diabetes struggle to get insulin - Los Angeles Times

4 of the best ways to treat diabetes and lower blood sugar – Insider – INSIDER

No matter what type of diabetes you have, the goal of diabetes treatment is to control blood sugars and keep them within the healthy range.

Type 1 diabetes must be treated with insulin, since the pancreas does not produce insulin naturally. People with type 2 or gestational diabetes don't always need insulin treatment, and will often focus on lifestyle changes and oral medications that encourage insulin production or decrease insulin resistance.

With proper access to healthcare, diabetes is highly treatable, says Katherine Araque, MD, an endocrinologist and director of endocrinology of the Pacific Neuroscience Institute at Providence Saint John's Health Center in Santa Monica, California.

Here are the four main ways you can treat and manage your diabetes.

Insulin is a hormone produced in the pancreas in healthy individuals. It helps facilitate the process of converting blood sugar into fuel, so that glucose doesn't build up in the blood.

In people with type 1 diabetes, the pancreas cannot produce insulin, so they need synthetic insulin. This can happen in two ways:

People with type 2 diabetes are treated with insulin when they are unable to control their blood glucose levels with lifestyle changes and medication. Overall, roughly 24% of people with diabetes are treated with insulin, according to a 2018 study published in Diabetes Care.

If you need insulin, your doctor will provide specific guidance on how much you need and when you should take it.

Although people with type 1 diabetes will need insulin, they may also be prescribed medication if they have some remaining pancreas function. The medication can encourage insulin production in the body.

People with type 2 diabetes are prescribed medication when they can't control their blood sugars through diet and exercise. Oftentimes, people with type 2 diabetes use more than one medication to control their condition.

However, medications are usually not recommended for pregnant people with gestational diabetes.

Common medications used to treat diabetes include:

Metformin is the most common medication used to treat type 2 diabetes. It's sometimes used to treat type 1 diabetes in people who still have some insulin production, along with insulin.

Metformin helps control blood sugar by making it easier for the body to absorb glucose. It's usually taken twice a day, with meals. Even when used alone, metformin can reduce A1C levels by 1.5% on average, which is enough to drop blood sugar levels from diabetes to prediabetes.

Sulfonylureas are a class of drugs that encourage the pancreas to release more insulin. They're used to treat type 2 diabetes. They are often taken once or twice a day before meals.

Sulfonylureas have a similar efficacy to metformin, and can be used alongside it.

TZDs make it easier for the body to use insulin; they reduce insulin resistance. They can be used to treat type 2 diabetes. They are taken 1 to 2 times per day.

After a year of taking TZDs, people with type 2 diabetes reduced their A1C levels by 1.4%, according to a 2019 study published in Vascular Health Risk Management.

Exercise is important for people with all types of diabetes. "Exercise helps at multiple levels: it increases base metabolic rate, fights insulin resistance, and helps with weight loss," says Araque.

Exercise helps muscles burn glucose and reduces insulin resistance. When you exercise, your muscles burn more glucose, removing it from the bloodstream and helping to lower blood sugar levels.

For example, a 2017 study published in Biomedical Research followed 120 obese teens, who did two hours of aerobic exercise twice a day for six days a week. After five weeks, their average fasting blood sugar was reduced by 0.84 nanomoles per liter (nmol/L) for males and 1.04 nmol/L for females. The researchers described this as "an extremely significant difference."

The Center for Disease Control and Prevention (CDC) recommends that people with diabetes get the normally recommended amount of exercise: 150 minutes of exercise each week, including two days of strength workouts that incorporate major muscle groups. The American Diabetes Association recommends starting with small changes, like walking daily.

Any exercise will help, but some may be especially beneficial. For example, a 2019 study published in Diabetologia found that afternoon exercise decreased blood sugars more than morning exercise.

Overall, you should work with your doctor to identify an exercise program that will benefit you, Araque says.

Healthy eating is critical for people with diabetes. As food breaks down, it releases glucose into your blood. Some foods, including processed sugars and carbohydrates, raise blood sugars more than other foods, like proteins or leafy vegetables.

In particular, people with diabetes need to be aware of how many carbs they eat per day. They should also create an eating plan that includes the following:

For example, the DASH diet and Mediterranean diet which both emphasize healthy fats, lean protein, protein and vegetables have been proven to help people with type 1 and type 2 diabetes control blood sugar.

Read more about the best ways to eat if you have diabetes:

Diabetes is a chronic but manageable condition, Araque says. People with diabetes should work with their doctor, nutritionist, and an exercise professional to design a program that meets their needs.

"The most important message is if they follow these recommendations they can get this under control and decrease risk for complications," Araque says. "Patients should have hope."

Originally posted here:
4 of the best ways to treat diabetes and lower blood sugar - Insider - INSIDER

Edited Transcript of ONTX.OQ earnings conference call or presentation 12-Aug-20 8:30pm GMT – Yahoo Finance

Newtown Aug 13, 2020 (Thomson StreetEvents) -- Edited Transcript of Onconova Therapeutics Inc earnings conference call or presentation Wednesday, August 12, 2020 at 8:30:00pm GMT

* Abraham N. Oler

Onconova Therapeutics, Inc. - Senior VP of Corporate Development & General Counsel

Onconova Therapeutics, Inc. - CFO

Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development

* Steven M. Fruchtman

Onconova Therapeutics, Inc. - CEO, President & Director

Laidlaw & Company (UK) Ltd., Research Division - MD of Healthcare Research & Senior Biotechnology Analyst

H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst

Good afternoon, and welcome to Onconova Therapeutics corporate update and 2Q 2020 financial results conference Call. (Operator Instructions) As a reminder, this call may be recorded. At this time, I would like to turn the call over to Avi Oler, Senior Vice President of Corporate Development and General Counsel.

Abraham N. Oler, Onconova Therapeutics, Inc. - Senior VP of Corporate Development & General Counsel [2]

Thank you, operator. Good afternoon, and welcome to Onconova's second quarter 2020 corporate update and financial results conference call. Earlier this afternoon, we issued a press release outlining our financial results and business progress during the quarter. If you have not seen this press release, it is available on the Investor Relations page of our website at http://www.onconova.com. On today's call, Dr. Steve Fruchtman, President and CEO, will discuss the company's recent highlights and anticipated clinical and business milestones. After Steve completes his opening remarks, Mark Guerin, our Chief Financial Officer, will review second quarter financial results. Following Mark's report, we will move to the Q&A portion of the call, which will be joined by Dr. Rick Woodman, our Chief Medical Officer. Lastly, Steve will come back with some final comments and a review of our upcoming milestones.

Before we begin, I remind everyone that statements made today during this conference call will include forward-looking statements under the safe harbor provisions of the Private Securities Litigation Reform Act of 1995, which involve risk and uncertainties that can cause actual results to differ materially. Forward-looking statements speak only as of the date they are made, as the underlying facts and circumstances may change. Except as required by law, Onconova disclaims any obligation to update these forward-looking statements to reflect future information, events or circumstances. Please see the forward-looking statements disclaimer in the press release issued this afternoon and the risk factors in the company's current and future filings with the SEC.

With that, it is now my pleasure to turn the call over to Steve.

Thank you, Avi. Good afternoon, everyone, and thank you for joining today's call. First, as the COVID pandemic continues to evolve in the U.S. and abroad, we wish all safety and good health to you and your love ones. We remain committed to executing our goals with INSPIRE and beyond. We remain focused on INSPIRE data readout and we'll speak more about the COVID pandemic shortly. Onconova has had a productive second quarter and exited the quarter carrying a significant momentum into the second half of 2020. As previously indicated, our pivotal Phase III INSPIRE trial recently achieved required number of survival events to allow for data analysis, and we anticipate top line data readout by the end of September. COVID has made access to hospitals and clinics more difficult, so data verification of key dates such as survival and the most recent clinical encounters are more difficult to verify, but verify, we must and we shall. Following top line data readout, we expect to present more detailed data at a major medical meeting later this year. The meeting to be identified based on time lines. Of note, most, if not all, major medical meetings are now virtual. To shorten the time lines for our anticipated new drug application or NDA submission to the FDA, we have already begun NDA preparation prior to data readout. We are working also with regulatory consultancy experts on our NDA document for the U.S. FDA for both the clinical and manufacturing modules of the NDA as well as on the marketing authorization application, or MAA, document for the European Medicines Agency. We anticipate that this initial work will put us in a position to expedite our health authority applications when data becomes available. As part of this process, our clinical team under Rick Woodman's leadership is preparing for a pediatric investigational plan, or PIP, an important component of the MAA. We are also advancing our plans to be ready for commercialization, including the recent announcement of the election of a commercial expert, Ms. Terri Shoemaker, to our Board of Directors. Terri carry was instrumental in the successful commercialization of azacitidine, the most commonly used hypomethyl agent in the world for high-risk MDS.

As you recall, INSPIRE is an open-label, randomized, controlled, international study designed to determine the efficacy, safety and tolerability of single agent intravenous rigosertib in the treatment of patients with second-line, high-risk MDS. Patients in this study are less than 82 years of age and have progressed or relapsed or failed to respond to previous treatment with the standard of care, a hypomethylating agent, also called an HMA. The study randomized patients to receive either rigosertib with best support of care or the physician's choice of therapy with support of care. The primary endpoint of this study is overall survival of all randomized patients in the intent-to-treat population. There is a second opportunity for an FDA approval, which is the sequential analysis of the overall survival of the very high-risk MDS subs as defined by the revised International Prognostic Scoring System. Should intravenous rigosertib demonstrate a survival advantage compared to physician's choice of therapy on the INSPIRE trial in a statistically significant manner, we believe rigosertib could be a major advance for high-risk, second-line MDS patients with a novel mechanism of action. Hopefully, broader and additional novel indications will follow.

Beyond our progress with INSPIRE, a highlight of the quarter was the initiation of an investigator-initiated Phase I/II trial of oral rigosertib plus the immune checkpoint inhibitor, nivolumab, in advanced metastatic KRAS positive lung adenocarcinoma. Over half of non-small cell lung cancers are classified at lung adenocarcinoma. And of these, the largest subset has a KRAS mutation as the predominant genetic driver. Given their utility in multiple cancer setting, checkpoint inhibitors are among the world's top-selling pharmaceutical products. And continue to obtain FDA approval for broader indications. In our view, this makes our novel combination approach with rigosertib a potentially meaningful option to pursue in lung cancer. We hope this will offer patients who have progressed on first-line therapy, a second-line approach. We are also initiating studies in other RAF pathway-driven cancers as part of our investigator-initiated development program.

Onconova has also recently featured pipeline developments in multiple venues. At the European Hematology Association's virtual conference in June, we announced updated aggregated baseline genomic data for HMA failure patients screened and entered into the INSPIRE trial. Briefly, the presentation show that RAF pathway mutations in these higher-risk MDS patients were observed more frequently in patients who progressed on HMA therapy as defined by the international working group's definition of progression compared to those who failed to respond to HMA therapy. In fact, in this study, patients with mutations of the RAF pathway had a higher likelihood of progression on hypomethylating agents than those with TP53 mutations, a well-recognized genomic abnormality predicting for progression in a number of cancers. We believe this is informative to the potential role of RAF targeting agents such as rigosertib. And to our knowledge, this mutational analysis is among the largest such databases to be collected. Patients on the rigosertib and physician's choice arms will have repeat analysis of their genomic status performed as part of the INSPIRE trial.

Following the close of the second quarter, Onconova also announced a publication of Phase I data with the combination of oral rigosertib plus azacitidine and higher-risk MDS and AML in the journal, Leukemia Research. A key strategy emerging in the treatment of MDS is the identification of safe and effective combination, particularly those involving oral agents. We anticipate meeting with the FDA in conjunction with the pivotal data readout from the INSPIRE trial for alignment with the agency on a registration trial for the combination of oral rigosertib plus azacytidine and HMA-naive, high-risk MDS. We look forward to these interactions with the agency. In the journal, Molecular Cell, we also announced the publication of additional preclinical data, supporting rigosertib's mechanism of action as a RAS-targeted anticancer therapy. Onconova believes this data sheds light on the ability of rigosertib to modulate the RAS pathway.

We also disclosed that we have embarked on early preclinical work exploring legal service potential in COVID-19. The background for this is as follows: these preclinical studies follow a presentation at ASH in 2019, suggesting the ability of rigosertib to upregulate viral defense pathways such as interferon. It is hypothesized that the immune system may play a role in the pathogenesis of MDS and immune modulation has been studied in MDS. More recent preclinical studies conducted with rigosertib demonstrated impressive inhibition of SARS-CoV-2 replication in vero cells when compared to controls, and provide the company with optimism that further research in humans infected with SARS-CoV-2 is warranted. In late July, Onconova announced that it has applied to the National Institute of Allergy and Infectious Diseases, or NIAID; and also to BARDA, the Biomed Advanced Research and Development Authority, to seek funding and to participate in therapeutic trials under the NIH umbrella to conduct human studies with rigosertib. We caution that our work in COVID-19 is very early, and the need for therapeutics and effective vaccines is evolving rapidly as the pandemic continues in various geographies across the globe. Hence, we cannot predict what the outcome of our efforts will be. We hope to provide greater clarity sometime during the second half of this year. In addition to the U.S., we have the rights to rigosertib in Europe and China and other key markets around the world. Beyond rigosertib, ON 13300 (sic) [ON 123300] is our first-in-class inhibitor of CDK4/6 and ARK5. We believe ON 123300 has the potential to treat numerous cancers, including refractory metastatic breast cancer, where CDK4/6 inhibitors are already commercially available. CDK inhibitors have emerged as promising products and compounds targeting very large cancer indications such as hormone receptor positive metastatic breast cancer. Due to its unique targeting of ARK5 as well as CDK4 and 6, we believe ON123300 could overcome many of the existing product's limitations, potentially making it suitable for certain cancers that may not be responsible -- responsive, sorry, to the current generation of CDK4/6 inhibitors. If successful, we believe this product candidate could address this very large market opportunity. We maintain global rights for ON 123300 outside of China. Our partner in China for this compound is HanX Biopharmaceuticals. HanX funded the Chinese IND-enabling studies. The Chinese IND was approved in January 2020 by the Chinese health authorities. We anticipate a Phase I study may begin in China in the second half of 2020. We also intend for the Chinese IND-enabling studies to comply with FDA regulations. To the U.S., we plan to file a U.S. IND in the fourth quarter of 2020.

And now I'd like to turn the call over to Mark Guerin, our Chief Financial Officer, for a discussion of our financial results for second quarter 2020. Mark?

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Mark Patrick Guerin, Onconova Therapeutics, Inc. - CFO [4]

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Thanks, Steve, and good afternoon, everyone. First, as a reminder, early this month, Onconova received a letter from NASDAQ stock market stating that it had regained compliance with the minimum bid price requirement of the NASDAQ listing rule 555-082 because its common stock had a minimum closing price of at least $1 per share for a minimum of 10 consecutive business days.

Our cash and cash equivalents as of June 30, 2020, totaled $27.2 million compared to $22.7 million as of December 31, 2019. Common stock warrant exercises since our financing transactions in November and December 2019 have added $9.8 million to our balance sheet since January 1, 2020. And as of August 12, 2020, we have 183,568,267 common shares outstanding. Additionally, of the almost -- of the warrants outstanding as of June 30, 2020, over 80% of them were in the money as of August 12. Based on our current projections, we expect that our cash and equivalents will be sufficient to fund ongoing trials and operations into the fourth quarter of 2021. Our net loss was $7.4 million for the quarter ended June 30, 2020, compared to $3.6 million for the comparable period in 2019. Research and development expenses were $4.8 million for the quarter ended June 30, 2020, and $3.9 million for the comparable period in 2019. General and administrative expenses were $2.6 million for the quarter ended June 30, 2020, and $1.8 million for the comparable period in 2019. Our operating cash burn in the second quarter of 2020 was approximately $5.4 million. This completes my financial review.

I'll now turn the call back to Steve.

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [5]

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Thank you so much, Mark. With that, we'd like to open the call for questions. After the questions and answers, I'll finish with some closing comments. Operator, please open the Q&A session.

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Questions and Answers

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Operator [1]

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(Operator Instructions) Our first question comes from the line of Joe Pantginis from H.C. Wainwright.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [2]

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First, I'd like to ask about your initial comments about the data verification process for the study. What do you think are the real rate-limiting steps now, either COVID related or unrelated? And then secondly, with that, I think this is more of a what-if question, do you have any visibility now with regard to any potential patients lost due to COVID that might impact the statistics? And have you had any discussions with the FDA about this and they have put out a recent public guidance a couple of months ago about being a little more amenable to adjusting statistical plans due to COVID.

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [3]

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Joe, thanks for that question, and I'll ask Rick to please provide the answers.

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Richard Charles Woodman, Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development [4]

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Thank you, Steve, and thank you, Joe. So all along, the biggest challenge that we observed with our study related to COVID was access to documents and -- at the sites. And this is not necessarily physically being able to get to sites, but even having remote monitoring opportunities. We have been able to overcome almost all of those difficulties and challenges. Now we are still in database lock, and so we are continuing to clean data and monitor and source data verify. But to date, it's gone very well. And I think it's in part, the understanding by the sites regarding where we are in the life cycle of the study and the importance of this data to the outcome of the study and to this disease. We have not lost any patients due to COVID at this time. The commonest challenge we see is that patients are -- have symptoms suggestive of COVID and then undergo testing and then report to us the results, negative or positive.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [5]

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Got it. And as things continually get more exciting for you guys coming into the data, I guess I'll ask the question at this point, again, and I know I do ask this a lot about what you feel is outstanding with regard to the oral study ahead of your upcoming FDA meeting?

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [6]

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Well, I think the primary challenges are related to the unique adaptive design we're proposing to the FDA and that will require some discussion between us and the agency. I think that the timing of INSPIRE, if positive, could very much support their interest in an adaptive study design that has an expedient execution and conduct with oral rigosertib.

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Joseph Pantginis, H.C. Wainwright & Co, LLC, Research Division - MD of Equity Research & Senior Healthcare Analyst [7]

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Good luck for this major thing coming up for you guys. Real exciting.

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Richard Charles Woodman, Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development [8]

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Thank you.

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [9]

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Thank you, Joe.

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Operator [10]

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Our next question comes from the line of Naureen Quibria from Maxim Group.

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Naureen Quibria, Maxim Group LLC, Research Division - Senior Equity Research Associate [11]

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Steven, congrats on the quarter. So I guess I want to start off with the KRAS study that's going on right now, obviously. So I was just wondering, it's an open-label study, do you have any idea if we'll have any updates this year on that? And then what kind of response rates would you -- would give you some confidence in terms of you feel there's activity in this tumor type? I know it's a long ways away, but I'm curious about that as well.

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [12]

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So thank you. And I just want to point out that this is a Phase I study, and I'll ask Rick to give -- offer the more details that we may have.

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Richard Charles Woodman, Onconova Therapeutics, Inc. - Chief Medical Officer and Senior VP of Research & Development [13]

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Thank you, Steve. So we're in the early phases of enrollment with this study. I think, obviously, with these studies, data can become available sooner than anticipated. Or conversely, take much longer than anticipated depending upon dosing and development DLTs. Because this is a Phase I study, Steve mentioned safety, DLT determination and determination of a recommended Phase II dose for the combination is the priority. I think like all Phase I studies, we are always excited about responses, but that is not what's going to determine the success of the study or the ability to proceed with other studies. It will be dosing and safety.

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Naureen Quibria, Maxim Group LLC, Research Division - Senior Equity Research Associate [14]

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Sure. That's helpful, actually. And then in terms of moving oral or looking at oral rigosertib in COVID, and you mentioned that you'd applied for a grant. I was just wondering what's the turnaround time for that. And, a, when will you know anything? And then in terms of the economics, is this just -- would it be sufficient for IND-enabling studies or actually for a clinical trial?

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Steven M. Fruchtman, Onconova Therapeutics, Inc. - CEO, President & Director [15]

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So I'll take that and thank you. So you mentioned oral rigosertib. So why we believe rigosertib should be studied in COVID disease is because we have oral and intravenous rigosertib. So as you know, there's different levels of disease with COVID infections, some relatively mild and some pent demand to pulmonary [cell]. So based on the inhibition of SARS-CoV-2 in cell culture systems. As you mentioned, we've applied for funding through the NIH federal mechanism of studying COVID disease. Early in the disease, ideally, it would be with oral rigosertib to see if it would prevent progression to pulmonary insufficiency for patients who have already reached, unfortunately, the stage of pulmonary insufficiency, requiring ventilatory support, that would be a group of patients who could be studied with intravenous rigosertib. Because the global pandemic is changing rapidly, it is unclear to us how NIH and the federal funding agencies will make decisions regarding both therapeutics and vaccines. We believe as long as the pandemic continues to rage, there is a great need for the development of additional efficacious therapeutics. So thus, we believe, based on the preclinical studies, we would like to participate in any clinical trials that the NIH may be considering for therapeutics. But clearly, the NIH is appropriately focused on the development of vaccines, and thus, it's unclear to us where NIH stands on the issue in question of the role of therapeutics during the pandemic and the role of vaccines. Any information we have going forward, we will be happy to share that with the investment community.

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Operator [16]

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Our next question comes from the line of Ahu Demir from NOBLE Capital.

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Ahu Demir, NOBLE Capital Markets, Inc., Research Division - Biotechnology Research Analyst [17]

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View post:
Edited Transcript of ONTX.OQ earnings conference call or presentation 12-Aug-20 8:30pm GMT - Yahoo Finance

How long does it take to build muscle? – CNET

Building muscle is a slow but worthwhile process.

Many people start workout routines to look toned or lean. Lifting weights can help you achieve those goals, but it's important to start a new workout plan with the right expectations.

Building muscle takes much longer than most people realize. It's a slow -- almost excruciatingly slow -- process that can feel discouraging when you don't see the muscle definition you want.

Here you'll learn how long it takes to build muscle and what factors influence your ability to get stronger, leaner and fitter from weight training.

Our Health & Wellness newsletter puts the best products, updates and advice in your inbox.

Each muscle is made up of muscle fibers, which are cylindrical cells. Weight training breaks them down and recovery helps them grow.

Building muscle involves the repair of microtraumas in your muscle fibers. Here's a breakdown of this extremely complex process:

1. Each muscle is made up of thousands of tiny muscle fibers.

2. When you lift weights (or do body weight exercises), your muscles endure tiny injuries throughout their fibers.

3. Then, when you rest your muscles, your body begins repairing your damaged muscle cells.

4. The repair process involves fusing torn muscle fibers back together, as well as laying down new proteins within each muscle cell.

5. Your muscles become bigger and stronger as a result of the repair process.

Keep in mind that the above is a tremendously simplified version of what actually happens in your body after a weight training workout. In reality, the process includes more than just your muscles -- your nervous system, circulatory system and endocrine system all contribute to muscle repair and growth.

Building muscle is super hard. If it was easy, we'd all be ripped.

There's no one muscle-building timeline, because several factors affect your ability to build muscle mass, including:

Your protein intake: While all macronutrients have their roles, protein is king when it comes to building muscle. Your muscles need adequate protein to repair themselves after the stress of weight training. Without enough protein, muscle growth stagnates.

Your calorie intake: If you don't eat enough calories on a daily basis, you won't build muscle even if you eat a lot of protein. To build muscle, your body must create new tissue, and it can't create something from nothing. Extra fuel from extra calories expedites muscle recovery and growth. This is one reason many people never reach their muscle growth goals -- they aren't willing to deal with the extra body fat that comes along with a muscle-building phase.

Your sleep schedule: Lifting weights while sleep-deprived isn't a smart strategy. You might see some gains, but you definitely can't optimize muscle growth when you don't give your body a fighting chance to recover.

Your lifting routine: If you're trying to build muscle, you should know about two key strength training concepts: frequency and volume. Frequency refers to how often you train a muscle or muscle group, while volume refers to the total load you stress a muscle with.

For example, if you perform three sets of 10 reps on squats using 100 pounds, your total volume is 3,000 pounds. More volume and higher frequency typically equate to more muscle, unless you reach the point of overtraining.

Your training age: The more advanced you are, the less muscle growth you'll see (yeah, that sounds backward). Everyone has a maximum genetic potential for muscle growth, and the closer you get to yours, the harder it gets to build more muscle.

Your actual age: Like a lot of things, building muscle gets harder as you get older. Sarcopenia, or loss of muscle mass and function, is actually a big problem in older adults. That's one reason why it's so important to stay active as you get older.

Other major factors include your genetic potential for building muscle (which is impossible to quantify without lab testing, and even then, kind of wishy-washy) and your testosterone levels -- which is why men typically have more muscle than women. Other hormones, including human growth hormone and insulin growth factor also play a role in muscle growth.

All that said, the muscle-building process starts the moment you challenge your muscles to do something. True beginners might see muscle growth within six weeks of starting a resistance training program, and advanced lifters may see results within six to eight weeks of switching up their usual strength training regimen.

Regardless of fitness level, building muscle takes several weeks, even when your diet, sleep and training regimen are all dialed in to optimize muscle growth.

Cardio that involves high-volume weight training can help you build muscle.

This depends on your definition of cardio and your training age. Most people won't build much muscle from traditional cardio, such as walking or jogging, and people who've been training for a long time definitely won't build new muscle through traditional cardio. It doesn't recruit your muscles in a way that sends a muscle-building signal to your body.

However, cardio that involves high-intensity exercises like plyometrics (think jump squats) or high-volume weight training can help you build muscle to an extent. Sprinting hills, hiking, skiing and other outdoor cardio can also contribute a small amount to muscle mass, especially for beginners. People with a long training history may not see as much success with cardio.

Although cardio can improve your overall fitness and help build muscle in select scenarios, strength training remains the best way to build muscle mass.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

See original here:
How long does it take to build muscle? - CNET

Global Endocrine Testing Market: Industry Analysis and Forecast (2019-2026) By Test, Technology, End Use and Region. – Good Night, Good Hockey

Global Endocrine Testing Market was valued US$ XX Bn in 2018 and is expected to reach XX Bn by 2026, at a CAGR of 8.00% during a forecast period.

REQUEST FOR FREE SAMPLE REPORT:https://www.maximizemarketresearch.com/request-sample/33711

The endocrine system plays a vital role in reproduction, growth and sexual development, retorts to injury and stress, body energy level, bone and muscle strength, and also internal balance of the body.

The report study has analyzed revenue impact of covid-19 pandemic on the sales revenue of market leaders, market followers and disrupters in the report and same is reflected in our analysis.

The growing incidence of hormonal imbalances in individuals is one of the key drivers in the global endocrine testing market. Changing lifestyles, growing stress, and unhealthy food habits result in obesity and disturbed hormonal changes, these are some of the driving factors under the growth in global endocrine testing market.

The software has been designed to accomplish the workflow in the laboratories, like new mobile apps have been developed so that patient can be reminded about his appointment or test, and he will be able to contact a physician. These advancements in technology are projected to propel the global endocrine testing market growth over the forecast period.On the other hand, the high cost of technology is projected to be the key restrain for the growth of the global endocrine testing market. Furthermore, an increase in the investment in research and technology is measured as a major opportunity for the growth of the global endocrine testing market.

The thyroid-stimulating hormone (TSH) test is expected to share significant growth in the global endocrine testing market. The significant growth in the market is attributed to the growing incidences of TSH-related disorders, and rising awareness regarding the correlation between variations in the thyroid hormone level and cardiovascular disorders. Furthermore, the Insulin test is expected to grow at a XX % rate of CAGR during the forecast period. The considerable rise in the diabetic population and the rising awareness about diagnosis are expected to contribute towards the demand for an insulin test.

The tandem mass spectrometry is estimated to hold a dominant position in the global endocrine testing market followed by sensor technology segment. The growing use of tandem mass spectrometry in combination with liquid chromatography, which also helps in overcoming challenges associated with traditional techniques are expected to increase the demand for tandem mass spectrometry. On the other hand, sensor technology is projected to grow at a XX % rate of CAGR during the forecast period owing to the increasing use of biosensors in glucose monitoring for diabetes which is used on routine basis by the individuals to monitor their blood sugar level.

Geographically, North America region is estimated to contribute a significant share in the global endocrine testing market. Growing incidence of several types of endocrine diseases, rapid adoption of novel testing techniques supported by regulatory infrastructure and positive recompense scenario are some of the prominent factors behind the growth in the global endocrine testing market.

The objective of the report is to present a comprehensive assessment of the market and contains thoughtful insights, facts, historical data, industry-validated market data and projections with a suitable set of assumptions and methodology. The report also helps in understanding dynamics, structure by analyzing the market segments and, project the global endocrine testing market. The report also provides a clear representation of competitive analysis of key players by product, price, financial position, product portfolio, growth strategies, and regional presence in the global endocrine testing market. The report also provides PEST analysis, PORTERs analysis, SWOT analysis to address the question of shareholders in arranging the efforts and investment in the near future to a particular market segment.Scope of the Report for Global Endocrine Testing Market

Global Endocrine Testing Market, By Test

Follicle stimulating hormone (FSH) Human Chorionic Gonadotropin (hCG) Thyroid Stimulating Hormone (TSH) Dehydroepiandrosterone sulphate (DHEAS) Prolactin Progesterone Insulin Cortisol Testosterone Estradiol (E2) Luteinizing Hormone (LH)Global Endocrine Testing Market, By Technology

Immunoassay Clinical Chemistry Monoclonal and Polyclonal Antibody Sensor technology Tandem Mass SpectroscopyGlobal Endocrine Testing Market, By End User

Hospitals Physician Offices Health Care Centers Commercial LaboratoriesGlobal Endocrine Testing Market, By Region

North America Europe Asia Pacific Middle East & Africa South AmericaKey players operating in Global Endocrine Testing Market

Thermo Fisher Scientific, Inc. Quest Technology Biomedical Technologies. Sysmex Corporation Abbott Laboratories AB Sciex Pte. Ltd. Agilent Technologies Siemens Healthcare Ortho Clinical Technology BioMerieux SA Bio-Rad Laboratories DiaSorin S.p.A F. Hoffmann-La Roche Ltd. Laboratory Corporation of America Holdings

Browse Full Report with Facts and Figures Report at:https://www.maximizemarketresearch.com/market-report/global-endocrine-testing-market/33711/

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A Guide to Your Gut Type and What This Means for Your Diet – One Green Planet

Ive written lots of articles about probiotics, microbiota, and the health of your gut, especially in relation to things like heartburn, mental well-being, and simple overall health. As Im currently nine months pregnant, Ive been dealing with quite a few unpleasant gut changes, which led me down a fascinating road of gut types. Who knew that there were actually differenttypes of gut that present physically, mentally, and emotionally!

Each human body is individual and therefore requires individual attention and this goes for your gut too. While probiotics, a plant-based diet, and a physically active lifestyle are all great places to start when boosting your gut health, discovering the exact type of issues going on within your gut will help to tailor the food you eat, the type of exercise you take part in, and what type of supplements may help to alleviate any digestive discomfort.

Lets take a little explorative session into the digestive system, the microbiome, the different types of gut, and how we can care for ourselves as individuals!

When you talk about the gut, youre actually referring to an incredibly complicated system that extends between your mouth all the way to your rectum. This system is the main source of nutrient absorption and storage, its how we energize, and how we get nourishment. Alright, so what makes up your digestive system?

The digestive system includes your mouth, esophagus, stomach, small intestine, large intestine (also called your colon), pancreas, liver, gallbladder, rectum, and anus. As you can tell, the digestive system isnt just located in your mid-section generally where you feel most digestive discomfort such as bloating, gas, or upset stomach but its an entire body, top to bottom, network.

On top of that, your gut or digestive system is riddled with good and bad bacteria called microbiota that make up the microbiome, yet another incredibly complicated ecosystem within your body. Yet, this microbiome has been found to play an integral role in not only your digestive health but also your mental health, the efficacy of nutrient absorption, energy level pretty much your overall bodily health.

Each part of the digestive system has an important part to play! Lets take a look at how your food is processed through this amazing network. Digestion begins in the mouth as your salivary glands get active when you see and smell food. Your saliva then mixes with the food to begin to break it down into a form your body can absorb and use.

Next, your esophagus receives food from your mouth [and] a series of muscular contractions within the esophagus called peristalsis delivers food to your stomach. Finally, weve made it to the stomach! This hollow organ holds food while it is being mixed with stomach enzymes [and strong acid] [that will] continue the process of breaking down food into a usable form.

From there, this new conglomeration of enzyme, acid, and nutrients moves into the small intestine where the work really starts! Your small intestine is a 22-foot long muscular tube made of three segments the duodenum, jejunum, and ileum where your food is further broken down using enzymes released by the pancreas and bile from the liver, as well as peristalsis, which aids the food to move through and mix with digestive juices from the pancreas and liver. The first segment of your small intestine the duodenum is responsible for the continuous breaking-down process, while the lower sections the jejunum and ileum are responsible for absorption of nutrients into the bloodstream.

The resulting semi-solid mixture water, bile, enzymes, and mucus passes into the colon (of the large intestine). The colon is a 6-foot long muscular tube that connects the small intestine to the rectum and its primary goal is to separate the necessary from the waste. While the colon may be shorter than the small intestine, its made up of more parts including the cecum, the ascending (right) colon, the transverse (across) colon, the descending (left) colon, and the sigmoid colon, which connects to the rectum. Once all the nutrients and water have been removed from the mixture, youre left with waste matter, which is stored in the sigmoid (S-shaped) colon until a mass movement empties it into the rectum once or twice a day.

While we dont reallywantto talk about waste, its important to note that theres a lot more going on there than meets the eye. Your waste or stool is mostly food debris and bacteria. Its the bacteria that you want to focus on. These good bacteria perform several useful functions, such as synthesizing various vitamins, processing waste products, and food particles, and protecting against harmful bacteria.

I covered, very briefly, the difference between microbiota referring to the collection of microbes that live in and on the human body and microbiome referring to the complete set of genes within these microbes. One is talking about the entirety and the other refers to the individual or more detailed version of the former. In another of my gut-related articles Understanding the Gut-Hormone Connection I break down the microbiome:

Themicrobiomeis very similar to a mini-ecosystem in which microscopic organisms thrive. These microscopic organisms, also called microorganisms, create a symbiotic environment called themicrobiome and they includebacteria, pathogens infections agents, archaea prokaryote microorganisms, which lack a nucleus, and eukaryotic microbes microorganisms that have a nucleus. Your microbiome is built from yourpersonal environment and lifestyle, such as geography, health status, stress, diet, age, gender, and everything you touch, therefore every humans microbiome isspecial and uniqueto them.

When it comes to the health of your gut or digestive system there are lots of factors that play an important role including exercise, stress, and medication. Yet, one of the most influential factors is your diet. The effects of diet are probably what you would expect.

A diet thats loaded with highly processed and ultra-processed foods which include refined carbs, sugars, hydrogenated oils, and trans fats is severely detrimental to your gut health, while a diet rich in whole, plant-based foods is linked to a healthy gut. This isnt just hearsay, there have been multiple studies conducted at different institutions and within different parameters that come to similar conclusions such as this study published in the European Cardiology Review or this multi-institutional study entitled The Effects of Vegetarian and Vegan Diets on Gut Microbiota.

So, what is it about a plant-based diet that improves gut health? A lot of it has to do with the fact that plant-based diets are naturally anti-inflammatory, yet the other large part is due to the fact that plants are rich in a variety of gut-sustaining nutrients such as dietary fiber, antioxidants, healthy fats, and a diverse range of all the vitamins and minerals. For instance, dietary fiber is known to promote the growth of beneficial bacteria that reduce inflammation and cardiovascular disease risk, as well as increases short-chain fatty acids linked to improved immunity and improved intestinal function.

While fiber is important, its also about incorporating a balanced intake of the proper amount of vitamins, minerals, and macronutrients, while excluding the toxic ingredients of processed foods and high amounts of added sugar. All of these play a factor in your gut health!

Alright, now that we know as much as we can about gut health in as short a period as possible, that is! its probably a good idea to take stock of your own gut health. Digestive issues are a pervasive issue in the states. Per the Centers for Disease Control and Prevention, 22.4 million people were diagnosed with a digestive disorder or disease by their physician, while 8.3 million people were separately diagnosed in the emergency room.And this doesnt account for physician or emergency room visits for less severe digestive disorders such as painful gas, diarrhea or constipation, excessive bloating, or upset stomachs.

Most likely, everyone reading this article has one or two gripes about their digestive system! Where do you start? Figure out what type of gut youve got and learn how to properly care for it so you can balance out that microbiome and avoid products and foods that may cause disrupt.

Candida is a genus of yeasts that is typically found in small amounts in the mouth and intestines and on the skin. Its actually quite normal to have small amounts of candida throughout your life, yet when that amount begins to grow uncontrollably, it can cause an infection known as candidiasis, which happens to be the most common cause of fungal infections in humans.

This condition can manifest in weight gain, phlegmy coughs and sniffles, and a white coating on the tongue.Those with a candida gut generally desire foods rich in sugar, dairy, and wheat and are generally incredibly worrisome, anxious, and obsessive.

If youre looking to heal yourself, its recommended to eat a lot of soups, stews, and warm starchy veggies, such as this Chickpea Miso Noodle Soup or these Cinnamon Turmeric Sweet Potatoes fermented foods, such as these Potato Kimchi Pancakes or this Homemade Raw Sauerkraut and incorporate a good probiotic such as this Garden of Life Whole Food Probiotic Supplement, this Florastor Daily Probiotic Supplement, or this Hyperbiotics PRO-15 Probiotic. On the other hand, make sure to avoid dairy, sugar, refined grains, raw foods, and yeast.

A gastric gut is directly linked to your lifestyle, self-care routine, and a slow-moving digest system. In particular, it means that youre overworking and overexerting yourself. This mixture overworking and a slow-moving digestive system leads to habits that cause poor digestion such as not chewing properly, overeating, and taking antacids.

This condition manifests with issues such as gas, bloating, and acid reflux, as well as habits such as eating your food too fast. If youve got this gut type, you most likely are a fiery, passionate, and reactive personality type as well!

If youre looking to heal, try to eat several small meals and stop before youre full, load up on bitter veggies, herbs, and citrus, drink mineral water, [and] supplement with digestive enzymes, such as this Pure Vegan Digestive Enzyme Complex, these Mary RuthsVegan Digestive Food Enzymes, or this Garden of Life Organic Chewable Enzyme Supplement. On the other hand, youll want to avoid alcohol, caffeine, fried foods, and spicy foods. Try a few of these plant-based recipes that are rich in bitter veggies, herbs, and citrus: 10-Minute Seitan Beef and Broccoli, Braised Kale, Cilantro Lime Tacos, Alkaline Green Juice, or this Avocado Grapefruit Jicama Salad.

You may think that a gastric and stressed gut are the same thing and while they may have similarities, theyre actually quite different! A stressed gut is caused by the constant circulation of stress hormones, which diverts blood flow away from your gut and impairs the growth of good bacteria and digestive enzyme production.

The condition usually manifests in adrenal fatigue, which causes sleep issues, decreased libido, and trouble focusing. These folks tend to consume too much coffee and/or too much alcohol and generally have a type-A workaholic personality.

If youre looking to heal, incorporate salty, dark-colored foods, such as this Vietnamese Purple Yam Soup or these Homemade Dark Chocolates supplement with B vitamins, and look into getting some adaptogens into your life such as these Natures Way Astragalus Root Capsules, these Pure Mountain BotanicalsHoly Basil Capsules, or this NaturaLife LabsOrganic Maca Root Black, Red, Yellow.

Make sure to avoid alcohol, caffeine, refined grains, and sugar.

One of the main culprits behind an immune gut is food sensitivities most commonly, gluten and dairy. Unfortunately, there are a few factors that are somewhat unavoidable that can cause an immune gut including longtime use of antibiotics, birth control pills, and steroids.

An immune gut is treatable, but at its worst results in autoimmune disorders and inflammatory bowel diseases. Those with this type of gut generally have a habit of going for the antibiotics on a regular basis and are usually perfectionists, insecure, and detail-oriented personality types.

If youre looking to heal an immune gut, its a bit more complicated than other types. First off, youll want to pair up with your doctor, nutritionist, or dietitian in order to work out an elimination diet in order to find out exactly what youre sensitive too. Next, its recommended to focus on reestablishing the health of your gut through supplemental digestive enzymes, soil-based (SBO) probiotics, and L-glutamine. Also, think about incorporating healthy fats on a daily basis think avocado, nuts, seeds, and coconut oil! On the other hand, steer clear of alcohol, dairy, raw foods, and packaged foods.

Find the perfect probiotic and digestive enzyme for your body using the following guide articles 10 Vegan Digestive Enzyme Supplements and Vegan Probiotics: How To Get Them From Supplements and Food

And then try out some of these healthy fat-filled recipes: Garden Green Soup, Peach, Raspberry and Coconut Yogurt Chia Pudding, Brussels Sprouts Salad with Macadamias and Apple, Avocado Pesto Pasta, or this Super Quick Chocolate Porridge.

Last, but not least, the toxic gut!

This type of gut is actually caused by the Standard American Diet basically, eating processed or fast food. As mentioned earlier, processed and ultra-processed foods are incredibly detrimental to your gut microbiome, so much so that eating too many are referred to as toxic. By eating processed foods, youre actually eating unhealthy fat, sugar, and chemicals.

This condition manifests in an inflammatory chain reaction from our liver to our intestines, leading to symptoms ranging from gallstones to rosacea to neurological distress. People who suffer from toxic gut generally are impatient, frequently frustrated, and quick to anger personality types. If youre looking to heal a toxic gut, incorporate an abundance of raw, green, and/or sour foods, drink dandelionormilk thistle tea, [and]get more sleep. On the other hand, avoid alcohol, non-organic produce, fried foods, nut butter, [and] oils.

Try some of these recipes that are rich in raw, green, and sour foods: Raw Cranberry Coconut Energy Bars, Carrot Ginger Soup With Curried Raisin Relish, Spinach Potato Soup, Thai Tempeh Collard Greens Wraps, Fizzy Pink Grapefruit Lemonade, or these Super-Easy Refrigerator Dill Pickles.

Learning everything you can about gut health is an excellent step towards a better functioning body! From boosting energy to smoothing out digestion to absorbing more nutrients and even conquering mental health issues, starting with the gut is a great idea!

Homemade Probiotic Cashew Yogurt/One Green Planet

Reducing your meat intake and eating more plant-based foods is known to help withchronic inflammation,heart health,mental wellbeing,fitness goals,nutritional needs,allergies,gut health,andmore! Dairy consumption also has been linked to many health problems, includingacne,hormonal imbalance,cancer,prostate cancerand has manyside effects.

For those of you interested in eating more plant-based, we highly recommend downloading theFood Monster App with over 15,000 delicious recipes it is the largest plant-based recipe resource to help reduce your environmental footprint, save animals and get healthy! And, while you are at it, we encourage you to also learn about theenvironmentalandhealth benefitsof aplant-based diet.

Here are some great resources to get you started:

For more Animal, Earth, Life, Vegan Food, Health, and Recipe content published daily, subscribe to theOne Green Planet Newsletter! Lastly, being publicly-funded gives us a greater chance to continue providing you with high-quality content. Please considersupporting usby donating!

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A Guide to Your Gut Type and What This Means for Your Diet - One Green Planet

Social Isolation is Raising New Mental Health Risks in Older Adults – The National Interest

Physical pain is unpleasant, yet its vital for survival because its a warning that your body is in danger. It tells you to take your hand off a hot burner or to see a doctor about discomfort in your chest. Pain reminds us all that we need to take care of ourselves.

Feeling lonely is the social equivalent to feeling physical pain. It even triggers the same pathways in the brain that are involved in processing emotional responses to physical pain.

Just like feeling physical pain, feeling lonely and disconnected from others is also a signal that we need to take care of ourselves by seeking the safety and comfort of companionship. But what happens when we are unable to find companionship and the loneliness persists?

As scholars at the Center for Healthy Aging at Penn State, we study the impact of stress on the aging body and brain, including how it can worsen cognitive decline and risk for dementia. The social isolation older adults are experiencing now amid the coronavirus pandemic is raising new mental health risks, but there are things people can do to protect themselves.

The health consequences of loneliness

The COVID-19 pandemic has put many older adults social lives on hold, leaving them at greater risk for loneliness. They know they face a higher risk of developing severe symptoms from COVID-19, so many are staying home. Restaurant closures and limits on visitors to assisted living centers have made it harder to see family and friends.

But even prior to the pandemic, public health experts were concerned about the prevalence and health impacts of loneliness in the U.S. Loneliness affects between 19% and 43% of adults ages 60 and older, and many adults ages 50 and over are at risk of poor health from prolonged loneliness.

Research has shown that prolonged loneliness is associated with increased risk for premature death, similar to smoking, alcohol consumption and obesity. Other health consequences are also associated with loneliness, including elevated risk for heart disease and stroke, and it is associated with increased physician visits and emergency room visits.

Loneliness can affect brain health and mental sharpness

Older adults who are socially isolated or feel lonely also tend to perform worse on tests of thinking abilities, especially when required to process information rapidly. And those who feel lonely show more rapid decline in performance on these same tests over several years of follow-up testing.

It is thought that loneliness may contribute to cognitive decline through multiple pathways, including physical inactivity, symptoms of depression, poor sleep and increased blood pressure and inflammation.

Loneliness has also been found to increase the risk of developing dementia by as much as 20%. In fact, loneliness has an influence similar to other more well-established dementia risk factors such as diabetes, hypertension, physical inactivity and hearing loss.

Although the underlying neural mechanisms are not fully understood, loneliness has been linked with the two key brain changes that occur in Alzheimers disease: the buildup of beta-amyloid and tau proteins in the brain. Other indicators of psychological distress, such as repetitive negative thinking, have also be linked with the buildup of beta-amyloid and tau in the brain. Theories suggest that loneliness and other psychological stressors act to chronically trigger the biological stress response, which in turn appears to increase beta-amyloid and tau accumulation in the brain.

How loneliness can contribute to disease

The evidence suggests that prolonged feelings of loneliness are detrimental to health. So, how do those feelings get converted into disease?

Feeling lonely and socially isolated can contribute to unhealthy behaviors such as getting too little exercise, drinking too much alcohol and smoking.

Loneliness is also an important social stressor that can activate the bodys stress responses. When prolonged, that response can lead to increased inflammation and reduced immunity, particularly in older adults. Inflammation is the bodys response to fight off infection or heal an injury, but when it continues unchecked it can have a harmful impact on health. Stress hormones play an important role in making sure that inflammation doesnt get out of control. But, under chronic stress, the body becomes less sensitive to the effects of the stress hormones, leading to increased inflammation and eventually disease.

In healthy older people, loneliness is related to a stress hormone pattern similar to that of people who are under chronic stress. This altered pattern in the stress response explained why people who were lonelier had poorer attention, reasoning and memory ability.

Social activity can buffer against the decline

Maintaining high quality relationships may be a key for protecting brain health from the negative impacts of loneliness.

Older adults who feel more satisfied in their relationships have a 23% lower risk of dementia, while those who feel their relationships are supportive have a 55% lower risk of dementia, compared to those who feel dissatisfied or unsupported in their relationships.

Maintaining social activity also buffers against decline in thinking abilities, even for those who live alone or who have signs of beta-amyloid accumulation in their brain. One reason for these benefits to brain health is that maintaining strong social ties and cultivating satisfying relationships may help people to cope better with stress; people who feel better able to cope with difficulties or bounce back after a stressful event show less buildup of tau protein in their brains.

This is good news because, with the importance of social distancing for controlling the COVID-19 pandemic, how people manage their feelings and relationships is likely more important for brain health than the fact that they are spending time physically apart.

[Get our best science, health and technology stories. Sign up for The Conversations science newsletter.]

Strategies for coping with loneliness

Loneliness is a common and normal human experience. An important first step is to recognize this and accept that what you are feeling is part of being human.

Rather than focusing on whats not possible at the moment, try to refocus your attention on what you can do to stay connected and make a plan to take action. This could include planning to reach out to friends or family, or trying new activities at home that you normally wouldnt have time for, such as online classes or book clubs.

During times of high stress, self-care is essential. Following recommendations to maintain regular exercise and sleep routines, healthy eating and continuing to engage in enjoyable activities will help to manage stress and maintain mental and physical health.

Karra Harrington, Postdoctoral Research Fellow, Clinical Psychologist, Pennsylvania State University

Martin J. Sliwinski, Professor of Human Development and Family Studies, Director of the Center for Healthy Aging, Pennsylvania State University

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

Image: Reuters

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Social Isolation is Raising New Mental Health Risks in Older Adults - The National Interest

The best types of medicine for nausea and which is right for you – Insider – INSIDER

There are many different reasons why you may experience nausea. Sometimes it is due to an underlying medical condition. Other times, nausea may occur as a result of motion sickness or eating too much.

In many of these cases, taking anti-nausea medication can help relieve your symptoms quickly. But which medicine you should take depends on what's causing your nausea.

The most common causes of nausea include:

If you know you're going to be nauseous in advance, you can prevent it by taking medication beforehand. So, for example, if you know you're prone to get nausea on airplanes, you should take medication approximately half an hour before your flight takes off.

Here are the most common types of anti-nausea medicine for motion sickness:

Motion sickness medications work best when taken before the activity that may cause motion sickness, Devine says, so it won't help as much to take it after you feel nauseous.

Nausea caused by acid reflux is best resolved by treating the acid reflux itself, Devine says. The two major classes of medication to treat acid reflux are:

These are prescription medications, but some of them are available over-the-counter at lower strength doses. You should contact your doctor if you experience symptoms of acid reflux, like heartburn and nausea, that persist for seven days even with over-the-counter treatment.

Nausea during pregnancy typically subsides in the second trimester, though there are some people who experience it for longer, or who may have an extreme version, known as hyperemesis gravidarum.

Pyridoxine (Vitamin B6) is a common over-the-counter anti-nausea medication deemed safe during pregnancy, Devine says. However, the kind of anti-nausea medication or treatment best suited for a pregnant person depends on the severity of their nausea and other individual factors.

Some anti-nausea medications may impact fetal development, so if you think you may need anti-nausea medication, it's important to discuss options with your obstetrician first.

If you experience severe, recurrent episodes of nausea without a clear underlying cause your doctor may prescribe medications that act on histamine, dopamine, or serotonin receptors in the brain.

These prescription medications can help treat acute episodes of nausea or prevent future episodes. Examples include:

Common side effects of anti-nausea medication include:

Most medications to treat nausea are safe, Devine says, but there are cases where anti-nausea medication may not be a good idea. Some common anti-nausea medications, like those acting on dopamine and serotonin receptors, can affect electrical rhythms of the heart.

These medications are typically not recommended for people with a history of heart conditions or those on other medications with potential side effects of heart rhythm abnormalities.

Talk with your doctor about the best anti-nausea medication for your symptoms. Together, you can develop a treatment plan to prevent and treat your nausea.

"No one should have to suffer with frequent nausea and vomiting," Devine says. "In the overwhelming majority of cases, nausea can be well managed with a combination of lifestyle, dietary, and medication therapies."

For more information, learn about the best home remedies for nausea.

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The best types of medicine for nausea and which is right for you - Insider - INSIDER

Can Taking a Vitamin D Supplement Help You Lose Weight? – Everyday Health

When looking into the connection between vitamin D and weight loss, researchers often use supplements in their studies, rather than tracking a subjects sun exposure or food.

Thats because pills are standardized and can be given in high doses to quickly up a study participants vitamin D level. For example, a study published in July 2018 in the International Journal of Preventive Medicine gave subjects who were overweight or had obesity 50,000 IU of vitamin D (an amount well above the recommended limit of 4,000 IU per day, or 28,000 IU per week, per the NIH) each week for six weeks. Researchers found in this small study that the subjects weight, BMI, waist circumference, and hip circumference all decreased significantly, and their vitamin D levels increased significantly, after taking this high vitamin D supplement regime. However, thats not a safe amount of vitamin D to take for weight loss (or any other reason) in the real world.

Although scientists havent done much research on eating vitamin D-rich foods and weight loss, theyre definitely still worth consuming. What we know is that foods high in D tend to be healthy anyways salmon, mackerel, mushrooms, vitamin D-fortified milk, which are part of a healthier diet, versus processed foods so consuming these would likely help with weight loss, says Agarwal.

And while researchers dont typically track sun exposure, getting a little sun the old-fashioned way isnt a bad idea, but its important to not overdose on sun, which can up your risk of skin cancer, according to Harvard Health Publishing.

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Can Taking a Vitamin D Supplement Help You Lose Weight? - Everyday Health

6 natural home remedies to get rid of nausea – Insider – INSIDER

Nausea refers to feelings of queasiness often with the urge to vomit. Symptoms of nausea include sweating, a rush of saliva in the mouth, fatigue, and loss of appetite.

While it's often associated with acid reflux and over-eating, nausea can also occur during pregnancy, with motion sickness, or as a side effect of other medical disorders or common illnesses.

There are many anti-nausea medications that can help with severe or persistent nausea. But if your nausea is mild or occasional, there are also a number of effective home remedies that can help relieve your symptoms naturally.

Ginger is an effective remedy for nausea, says Daniel Devine, MD, internal medicine doctor and geriatrician at Devine Concierge Medicine, a primary care practice in Philadelphia.

That's because ginger has anti-inflammatory properties, which can support digestion, and its compounds are also thought to speed up the process of stomach contents moving into the small intestine, which can reduce symptoms of nausea.

A 2014 analysis of six different studies published in the Journal of the American Board of Family Medicine examining the use of ginger in pregnancy found that taking about one gram of ginger once a day for at least five days decreased symptoms of nausea and vomiting in early pregnancy. Studies have also found that ginger can be effective in managing nausea and vomiting symptoms for chemotherapy patients.

Ginger can be taken as a supplement, sold as capsules. You can also add pieces of whole, fresh ginger to your tea, or include it as a spice or seasoning in your food.

Peppermint has long been regarded as a traditional remedy for nausea, though the scientific evidence on its efficacy is not as robust as it is for ginger, Devine says. Still, many people swear by its calming properties.

The main ingredient in peppermint, menthol, is thought to relax the stomach, which can alleviate cramping and nausea.

One small study from 2014 published in the Journal of Perianesthesia Nursing suggested that even the scent of peppermint oil can alleviate nausea, but more research is needed to determine whether it is an effective remedy.

However, if you experience both nausea and vomiting, peppermint may not be very effective, since it is primarily used to treat nausea and not episodes of vomiting.

If you want to give peppermint a try, you can buy it as a tea or diffuse peppermint essential oil for aromatherapy by adding two to three drops of peppermint oil to a diffuser filled with water.

Eating too much can cause nausea, Devine says. That's because when you eat too much, it stretches the stomach, resulting in bloating, heartburn, and excessive digestive movement all of which can lead to nausea.

Eating small, frequent meals and consuming a bland diet without strong flavors can be helpful in reducing episodes of nausea, Devine says. Bland foods are easy to digest and can help settle your stomach.

Bland foods that can help with nausea include:

If you're feeling queasy, you should avoid spicy food and acidic beverages like soda, juice, or alcohol all of which can exacerbate nausea symptoms. You may even want to consider trying the BRAT diet when you feel nauseous.

It may be hard to eat or drink anything when you have nausea including water. But according to Devine, dehydration will only make your nausea worse.

This can be especially important if you're experiencing nausea as a result of extreme heat or humidity. In fact, nausea and vomiting are some of the main symptoms of heat exhaustion and heatstroke.

Overheating causes your blood vessels to dilate as your body tries to cool itself down and this change in blood pressure can manifest as nausea or dizziness. But if you drink lots of water and stay hydrated, it will help you cool down and return to a normal body temperature.

If drinking water is a challenge for you with nausea, you should take small sips throughout the day or try a soothing beverage like warm peppermint tea.

For more information, read about how much water you should be drinking each day to stay hydrated.

When you feel queasy, you might be tempted to lay down, but this actually isn't the best idea. Lying flat while nauseous could lead to vomiting, Devine says.

"It is important to use gravity to your advantage and keep your head inclined above your stomach," Devine says.

By staying upright, gravity helps keep your stomach contents down. Sitting down in an upright position or lying down with your head propped up on a couple pillows is the best choice if you're hoping to relieve nausea.

Acupressure is an alternative medicine practice of applying pressure to certain points on the body, known as meridians. The idea is that by putting pressure on these places, you send a message to the body to turn on its self-healing mechanisms, which may alleviate pain or nausea.

A 2006 review of more than 40 trials published in the journal Autonomic Neuroscience found that acupressure can reduce some symptoms of nausea.

One of the main pressure points for nausea is called the Pericardium 6, or Neiguan, located near your wrist. This pressure point is thought to alleviate nausea because the meridian pathway of this point travels up the arm, into the chest and upper abdomen, near the stomach.

Here's how to locate P6 and use this pressure point:

If nausea is associated with frequent episodes of vomiting, chest pain, or comes with dark stools or dark vomit, you should reach out to your doctor, Devine says. And if nausea persists for more than a couple days, or if the symptoms are quickly worsening, that could also be a sign that something more serious is going on.

For example, conditions like pancreatitis, bowel obstructions, or even a heart attack can cause nausea and will require medical attention.

Some people are also more prone to nausea due to certain conditions. These include:

Nausea can feel uncomfortable, but it is generally very manageable with the right approach. If you can't get rid of nausea with these natural home remedies, check in with your doctor, who can work with you to develop a treatment plan.

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6 natural home remedies to get rid of nausea - Insider - INSIDER

Sparano Shares Progress Made in the Molecular Guided Management of Breast Cancer – OncLive

The advent of gene expression assays has provided predictive insight into chemotherapy benefit that can be combined with prognostic information yielded by gene expression profiling to better target patients with breast cancer who are at higher clinical risk for the use of adjuvant chemotherapy, according to Joseph A. Sparano, MD.

The notion of precision medicine in breast cancer is not a new concept; it dates back to the 1970s when we began using ER and PR protein expression initially by ligand-binding assay and then by immunohistochemistry to identify patients who would benefit from adjuvant endocrine therapy, said Sparano, a professor of medicine and womens health at Albert Einstein College of Medicine, in a presentation during the 19th AnnualInternational Congress on the Future of Breast Cancer West, a virtual program by Physician Education Resource (PER).1

We then entered the second generation using gene amplification for HER2/neu via FISH testing to identify women who could benefit from adjuvant trastuzumab (Herceptin), an anti-HER2based therapy, added Sparano. Fifteen years into the third generation [we use] gene expression profiles to guide the use of adjuvant chemotherapy and endocrine therapy. We're currently pretty far into the fourth generation of assays in terms of mutational profiling, which can identify individuals who could benefit from targeted therapies.

In his presentation, Sparano, who is also an associate chairman in the Department of Oncology at Montefiore Medical Center, provided insight into advances made with gene expression profiles, the clinical utility of available assays, as well as future directions in this area.

Gene expression profiles first emerged in the breast cancer paradigm about 15 years ago based on unsupervised analyses, which indicated that breast cancer was a heterogenous disease, that there were distinct subtypes, and that prognosis could vary by subtype, according to Sparano. The unsupervised work resulted in the PAM50 assay (Prosigna), which can be used to identify the distinct breast cancer subtypes that exist.

The next generation of gene expression assays were based on supervised analyses, which evaluated genes associated with a better or worse prognosis. This research led to the development of various prognostic assays, which included the 21-Gene recurrence score assay (Oncotype DX) and the 70-Gene signature test (MammaPrint), among others.

One important point is that theres a lack of concordance in the prognostic classification provided by these assays, said Sparano.

Prospective Validation

The first trial to show that a gene expression assay could provide independent prognostic information was the B14 trial, which included archival samples from a total of 668 patients with estrogen receptor (ER)positive, node-negative breast cancer who had received treatment with tamoxifen for 5 years.

Fifty-one percent of patients fell into the low-risk group, which was defined as a recurrence score (RS) of less than 18, 22% of patients were in the intermediate-risk group (RS of 18-30), and 27% were in the high-risk group (RS of 31 or greater). The 10-year risk of distant recurrence was 7%, 14%, and 31%, respectively, for each of these groups.2

Further data revealed a statistically significant association for RS that was independent of age and tumor size, said Sparano. As such, RS was not a surrogate marker for these other factors; it provided independent prognostic information.

Results from another study, referred to as B20, went on to demonstrate prediction of benefit with these assays.3 A total of 651 patients with ER-positive, node-negative breast cancer were randomized to receive tamoxifen or tamoxifen plus chemotherapy. For the entire cohort you see approximately a 4% improvement in distant relapse-free survival for patients who received chemotherapy, noted Sparano. However, there was a very large benefit for patients who had a RS of 31 or higher; the absolute benefit was in the range of about 25% in the group with the highest RS, suggesting that one can identify, using this assay, a subpopulation of patients who are deriving all of the benefit from chemotherapy.

The prospective TAILORx trial included women with hormone receptorpositive, HER2-negative, and axillary node-negative breast cancer and they were randomized to treatment based on their RS.

Of the 10,273 women enrolled on the trial, 1629 who had a low RS of 0 to 10, were assigned to receive endocrine therapy alone (arm A). Women with a high RS of 26 to 100 were assigned to endocrine therapy plus chemotherapy (arm D). Those in the midrange who had a RS of 11 to 25 were randomized to receive either endocrine therapy plus chemotherapy in the standard arm (arm C), versus endocrine therapy alone in the experimental arm (arm B).

The study had a noninferiority design with invasive disease-free survival (iDFS) as the primary end point, and full information is expected after 835 iDFS events were reported.

We modified the mid-range group for several reasons. The TAILORx population excluded HER2-positive disease and we know that the 21-gene assay includes a HER2 module that drives the RS up and is associated with a higher score, but we know that most HER2-positive tumors have a higher RS, explained Sparano.5 As such, if you use the assay in a HER2-negative population, youll have a different RS distribution.

Additionally, the RS assay is used selectively in practice in situations where there is therapeutic equipoise, which is typically intermediate-grade tumors that are 1 cm to 2 cm; this results in more tumors having a score in the mid-range group, according to Sparano. The trial really needed to be designed to address that group, he said.

Moreover, the RS range was adjusted to preserve prediction in the highest-risk group and minimize the potential for undertreatment in the low-risk group, Sparano added.

Initial data from the low-risk group showed that at 5 years, the rate of freedom from recurrence of breast cancer at a distant site was 99.3% (95% CI, 98.7%-99.6%).4 This information was subsequently integrated into the American Joint Committee on Cancers Cancer Staging Manual, noted Sparano.

After a median of 7.5 years, results from the intent-to-treat population (arms B and C) were released and showed that the primary end point for iDFS was met (HR, 1.08; 95% CI, 0.94-1.24; P = .26), demonstrating noninferiority of endocrine therapy compared with the standard.6 Endocrine therapy alone was also found to be noninferior to chemoendocrine therapy with regard to freedom of recurrence of breast cancer at a distant site (HR, 1.10; 95% CI, 0.85-1.41; P = .48).

Investigators then examined whether any patients with a mid-range score were still deriving benefit from the chemotherapy. No benefit was observed with regard to increasing tumor size or grade, but statistically significant chemotherapy treatment interactions were observed between age, RS, and chemotherapy benefit. Patients who had a higher RS and a higher clinical risk within this younger group seemed to derive benefit, explained Sparano.

At 9 years, in those with a RS of 16-20, a 1.6% absolute benefit from chemotherapy was observed versus a 6.5% absolute benefit in those with RS ranging from 21 to 25, added Sparano.

An exploratory analysis looking at the impact of age and menopausal status on chemotherapy benefit in patients with a RS ranging from 16 to 25 showed that there was no benefit in older women with an increasing score. However, curves began to separate for younger women with a RS of less than 25, noted Sparano.

When examining absolute differences in 9-year distant recurrence rates by chemotherapy use in women 50 years or younger with RS of 16 to 25 stratified by RS and clinical risk, investigators noted that the estimated absolute benefit of chemotherapy in women with a RS of 16 to 20 who were not stratified by clinical risk was +1.6%. The estimated absolute chemotherapy benefit stratified by clinical risk was -0.2% in those with low clinical risk (n = 671) and a RS between 16 and 20 and +6.5% in those with high clinical risk (n = 215).7

When looking at the impact of age on chemotherapy benefit, investigators observed that women who were closer to menopause, aged 46 to 50 years, experienced the greatest benefit. Interestingly, younger women really had no benefit, suggesting that some of the effect that was seen with chemotherapy in these younger patients who had higher RS might have been due to a castration effect, explained Sparano.

At 9 years, a 3% distant recurrence with endocrine therapy alone was observed in patients with an RS of 0 to 10 (arm A). An overall 5% distant recurrence rate was reported in those with an RS between 11 and 25 (arms B and C). Between arms B and C, a less than 1% difference was observed for all end points. In those with a RS between 26 and 100 (Arm D), a 13% distant recurrence was observed, despite chemotherapy plus endocrine treatment.

MINDACT

The MINDACT trial included 6,693 patients who were assigned to a clinical risk or a genomic risk. Patients who had discordance in their clinical and genomic risks were randomized to receive either no chemotherapy or chemotherapy.8 The primary end point of the trial was distant metastasis-free survival at 5 years for those with high clinical risk and low genomic risk without chemotherapy.

No effect with chemotherapy was observed in older women, but there was a 5% benefit from chemotherapy in younger women, which is very similar to what we saw in TAILORx, said Sparano.

The phase 3 Plan B trial used the Oncotype DX Recurrence Score to define a genomically low-risk subset of patients with clinically high-risk pN0-1 early breast cancer for adjuvant treatment with endocrine therapy alone. A total of 3198 patients were enrolled on the trial and chemotherapy was omitted in 86.1% of eligible patients with a RS of 11 or less.

At a median follow-up of 5 years, DFS in the patients treated with endocrine therapy alone who had a RS of 11 of less was 94% versus 94% in those with an RS between 12 and 25 and 84% in those with an RS of greater than 25 (P < .001). In patients who received chemotherapy, the 5-year overall survival was 99% versus 97% versus 93%, respectively (P < .001).

This provided a limited amount of level 1 evidence supporting the use of the Oncotype assay in patients with low-volume disease, noted Sparano.

Future Directions

With all of the data yielded thus far, it is clear that gene expression assays provide prognostic information, that the 21-gene assay offers predictive information, and that the 70-gene assay provides prognostic information, according to Sparano.

Its important to remember that these assays are not interchangeable, and theres a lack of concordance in risk classification which needs to be considered when deciding which assay to use and what to do with the information yielded, concluded Sparano. Future plans involve integration of the clinical and gene expression profile information to recalibrate existing tools in an effort to provide more refined information regarding prognosis as well as an estimation of chemotherapy benefit.

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Sparano Shares Progress Made in the Molecular Guided Management of Breast Cancer - OncLive

Hair Loss in Women Guide: Causes and Treatment for Thinning Hair and Alopecia – GoodHousekeeping.com

If youve noticed patchy or thinning spots on your scalp or a surplus of hair strands on your hairbrush or in the shower, you're not alone. More than half of all women will experience noticeable hair loss, according to the Cleveland Clinic. In order to put a stop to shedding, though, you have to figure out the root of the problem. Hair loss is not a diagnosis, says Yolanda Lenzy, M.D., M.P.H.,board-certified dermatologist and licensed cosmetologist in Chicopee, Massachusetts. Hair loss is a symptom. Once you get a specific diagnosis, then you can know the causes associated with that diagnosis.

For starters, know that the term alopecia refers to all kinds of hair loss. There are two main types of alopecia, and then a variety of forms of hair loss within those two categories. In cases of non-scarring or temporary hair loss, the missing hair will eventually grow back. With scarring or permanent hair loss, permanent damage is done to the hair follicles so they wont grow back. With scarring hair loss, the goal is not for it to grow back, but to stop the progression, says Dr. Lenzy. Below, are seven different kinds of alopecia knowing which one youre suffering from will help determine the proper treatment.

When people talk about male or female pattern hair loss typically a receding hair line in men or thinning at the crown in women thats androgenetic alopecia. Its the most common form of hair loss among all people. In fact, research shows that more than 50% of women will develop androgenetic alopecia by the age of 80. It can come from either side of the family in men or women, skip a generation, and start earlier in the next generation that the one before it, says dermatologist Carolyn Goh, M.D., Health Sciences Assistant Clinical Professor at the David Geffen School of Medicine and Director of the Hair and Scalp Disorder Clinic at UCLA. However, some people have pattern hair loss without a family history of it. While some women start showing signs of androgenetic alopecia in their teenage years, others wont experience it until their 50s or 60s. When nearing menopause, the decrease of estrogen means you have unopposed testosterone, says Dr. Lenzy. That elevated testosterone can convert to a hormone called dihydrotestosterone (DHT), which contributes to the thinning of the hair follicles the follicles actually get smaller in this particular form of hair loss.

Telogen effluvium is just a fancy name for excessive hair shedding an annoyance that many people will experience at some point in their life. A common cause is stress, usually meaning major life stressors or physical stressors like surgery, medication (including over the counter ones and supplements), weight loss, or a death in the family, to name a few, says Dr. Goh. It usually starts three to six months after a stressor and then lasts for three to six months. Hypothyroidism and iron deficiency can also trigger telogen effluvium. The beautiful thing about it is 70% of your hair strands are still in the anagen or growing phase, adds Dr. Lenzy. Because the hair follicles work in a cycle, you wont go bald.

This type of hair loss affects about 2% of people and usually appears as round smooth circles anywhere on the head without any redness, itching, or pain. Alopecia areata is thought to be caused by an autoimmune process, says Dr. Lenzy. The bodys immune system makes some mistakes and produces T cells that attack hair follicles.

Thinning and bald patches at the temples or where hair is frequently pulled tight can indicate traction alopecia. This very common form of hair loss is caused by haircare and hairstyle practices practices which place excessive tension or weight on the follicles like braids, ponytails, hair extensions, or locs.

Central centrifugal cicatricial alopecia tends to start on the top of the head with breakage and thinning, and often with some tenderness of the scalp, says Dr. Goh. It gradually spreads outward and can cause permanent hair loss. CCCA is especially common among Black women. Some recent studies have found that about 25% of people with this form of hair loss have a genetic mutation in one of the proteins thats responsible for the formation of the hair follicle, says Dr. Lenzy. On top of that, she notes that the same haircare practices that create tension and cause traction alopecia also contribute to CCCA.

Lichen planopilaris can result in patchy spots of hair loss as well as redness, itching, burning, or pain in the scalp. Its a form of alopecia thats found more commonly among caucasian women. LPP is thought to be autoimmune-related and but research is still being done to figure out the exact cause. Theres some research that shows individuals with this form of hair loss have decreased activity of a very essential enzyme called PPAR-gamma, says Dr. Lenzy. PPAR-gamma is responsible for how our scalps metabolize lipids on the scalp so when individuals dont have that active, they can develop LPP. One particular form of LPP called frontal fibrosing alopecia (FFA) is becoming increasingly common in postmenopausal women, according to Dr. Goh. In FFA, the hairline recedes gradually from the front and sides and sometimes the back of the scalp, she says. Eyebrows are often lost and sometimes eyelashes and other body hair.

Lupus of the scalp is another form of scarring alopecia thats autoimmune, says Dr. Lenzy. Its common, especially in women of color. It shows up as red, scaly, thick lesions that dont usually hurt or itch.

Holger ScheibeGetty Images

Trichorrhexis nodosa is the official name for hair breakage. It takes place mid-shaft while hair loss occurs at the scalp. For instance, if you see little hairs on the floor of different lengths, thats a sign of breakage, says Dr. Lenzy. But with shedding, the hair is coming out from the root so you will see long strands the entire length of your hair. Hair color, excessive heat during styling, and chemical straighteners can all dry out hair strands, making them more likely to break. If your haircare practices are the culprit, youll see breakage throughout your hair. However, isolated breakage in one spot can be a sign of alopecia areata or CCCA.

The cause of your particular form of hair loss will point you toward the right treatment. For stress-related telogen effluvium, time is usually the best solution as hair should grow back six to nine months after the excessive shedding occurs. However, if your telogen effluvium is caused by an underlying health issue such as a thyroid problem or low iron levels, your hair should grow back after you address the underlying problem.

Topical minoxidil (Rogaine) is the only FDA-approved treatment for hair loss in women, says Dr. Goh. Its technically approved for androgenetic alopecia, but its used for many types of hair loss, and its available over the counter. A common reason people dont try minoxidil is because they have heard you have to keep using it forever, says Dr. Goh. While it is true that minoxidil only works while you use it, it is also true of all treatments for hair loss as long as the underlying hair loss is chronic. It can become a routine like brushing your teeth. Finasteride (Propecia) is FDA-approved for male pattern androgenetic alopecia and is quite effective, especially when combined with minoxidil. Its often prescribed off-label for women, but can cause birth defects so its usually used in women after child-bearing age, notes Dr. Goh. Spironolactone is another medication often used for women with female pattern hair loss that can cause birth defects so women are advised to use proper contraception while taking it.

If you have one of the forms of scarring alopecia that is inflammatory, such as CCCA, we often use antibiotics to decrease inflammation around the hair follicle, says Dr. Lenzy. Topical or injection cortisones can also be helpful in reducing inflammation in CCCA as well as in alopecia areata. There are a lot of new treatments on the horizon that are currently being studied in clinical trials for extensive forms of alopecia areata, adds Dr. Lenzy. Some of the treatments that are coming down the pike, we currently use off-label even though theyre not yet approved. In general, many of the treatments for hair loss are experimental because theres just not a lot of FDA-approved treatments. But those of us who specialize in hair loss, we have a lot of effective therapies that we use.

Be cautious about vitamins, supplements, and shampoos that claim to help hair loss, advises Dr. Goh. None of these have been studied thoroughly and they often cost a lot of money. Theres also little regulation of these products by the FDA so theres no guarantee that they are both safe and effective.

In particular, you should steer clear of supplements that contain large amounts of biotin as there is little proof that it is helpful in people who have normal biotin levels which is most people. About two years ago, the FDA issued a warning that mega doses of biotin can alter many of your lab results, including your thyroid function tasks and cardiac enzymes, says Dr. Lenzy. People think just because something is natural or a vitamin then it cant be harmful, but that couldnt be farther from the truth. If you happen to take a multivitamin that contains a smaller amount of biotin, stop taking it two to three days before having any bloodwork conducted to ensure that your results are accurate.

While other purported natural treatments like castor oil might be benign, Dr. Lenzy doesnt recommend them because they may not be effective. If you have a form of scarring alopecia, the most important thing is for you to get an early diagnosis, she says. This is permanent hair loss so if you spend six months to a year trying castor oil, youre losing precious follicles that whole time that you wont be able to get back. She says the best thing you can do is get a proper diagnosis from a doctor: These are actual medical conditions just like high blood pressure or diabetes. I see so many people suffering and trying different things and if they had only come in sooner, their result would be so much better.

Yulia ReznikovGetty Images

Everyones shedding pattern is a little different so theres no standard amount of hair loss that warrants a call to your dermatologist. Some people shed very little and some people shed a lot at baseline, says Dr. Goh. We say losing 100 to 200 hairs per day can be normal and people usually shed more on a shampoo day than a non-shampoo day. She points out that many people stop washing their hair when they see it falling out, but you should continue to wash your hair every 1 to 2 days to keep your scalp healthy to promote hair growth. Keep in mind that a receding hair line and thinning hair can both occur without visible shedding. I would recommend seeing a doctor if there are clearly visible bald spots, itching or burning of the scalp, or the hair loss has been going on for longer than six months, says Dr. Goh. Also, if there is a significant family history of hair loss, it may be a good idea to come in sooner than later.

The key is to find the right doctor. Seek out a board-certified dermatologist who specializes in hair loss and will be aware of newer treatments currently being studied. Keep track of any other symptoms like fatigue or joint pain, says Dr. Goh, as those pieces of the puzzle may help your physician identify underlying conditions. Along those same lines, dont be afraid to get a second opinion. Ive had people whove seen me after three or four opinions and they were told nothing could be done because they had a form a scarring alopecia, says Dr. Lenzy. But theres always something that can be done. If you do nothing, in five years you may have 25% or 50% of the hair you have now, but with treatment you may be able to slow the hair loss process down substantially. The goal in some conditions is not to get the hair to grow back, emphasizes Dr. Lenzy. The goal is stabilization and help is available.

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Being Hemp Launches Proprietary Nano CBD Products Specifically Formulated to Target Womens Health, Wellness and Beauty Needs-NK#137011 – New Kerala

SAN DIEGO: Being HempTM, the makers of THC-free CBD products formulated doctors to specifically address women's unique health, wellness and beauty needs, launched a line of products designed to deliver pure, powerful results for female consumers - an anti-aging skin care system, five condition-specific tinctures, and the first-ever apple cider vinegar gummies featuring high-absorption Nano CBD.

There is a big difference between marketing existing CBD products to women and creating physician-formulated products that meet women's specific needs, said Liz Gagnon, Director of Communications for Being Hemp. As we looked at the landscape of CBD products, we found that women are looking for CBD products that speak directly to their concerns and that they can trust to work as advertised. We're confident that Being Hemp products will deliver the pure, powerful results that women expect and deserve.

Product Launch Summary

Being Hemp Apple Cider Vinegar Nano CBD Gummies The first of their kind, these watermelon-flavored apple cider vinegar (ACV) gummies support overall health and well-being, offering 350mg of ACV and 25mg of Nano CBD per gummie - more than twice the CBD of most other gummies. ACV is commonly used as a natural appetite suppressant and is known for various healthful properties, including antimicrobial and antioxidant effects. Evidence suggests it may offer additional health benefits, such as aiding weight loss, reducing cholesterol, lowering blood sugar levels, and improving the symptoms of diabetes.

The Being Hemp Anti-Aging Skin Care System This doctor-formulated, three-product system utilizes the most advanced dermatological science plus proven natural ingredients to achieve timeless results for women of every age and skin type. All three clean label products are hypoallergenic, sulfate-free, and synthetic fragrance-free, and include superior-absorbing Nano CBD to restore cellular balance and reduce puffiness, as well as Hyaluronic Acid to hydrate and reduce lines and wrinkles.

Beautiful Age-Defying Serum, a light, silky cream to leave skin looking youthful and healthy with real and lasting benefits that start at the cellular level to fuel regeneration and visibly defy the signs of aging. The serum features Collagen to dramatically improve skin elasticity; Saw Palmetto to trigger enzyme production; and, Vitamins A and B support to cell rejuvenation.Beautiful Day Creme, a superior moisturizer that protects skin from the damage caused by sun exposure and airborne free radicals without leaving an oily residue or clogging pores. Formulated to give make-up incredible staying power, it features Vitamin E and Rose Hip Oil to improve elasticity and minimize the signs of aging, as well as Titanium Oxide to naturally protects against harmful UVA and UVB rays.Beautiful Night Creme, a skin-pampering formulation to reverse daytime damage. Made with a relaxing lavender scent and a hint of vanilla, it features Vitamin A to fuel cell regeneration and Rosehip Oil to improve elasticity and minimize the signs of aging.All three products are packaged in an innovative, airless pump jar that protects product purity and integrity while providing 1-finger dispensing convenience.

Being Hemp Tinctures These five, condition-specific, gluten-free formulations deliver 50 mg of Nano CBD per 1ml serving. Each includes Omega 3-6-9, Vitamins C and D, Zinc and Theanine, a Green Tea extract.

Restful, a sleep formula with Melatonin and Lavender;Immune, an immune booster with Turmeric and Elderberry;Serene, a stress and anxiety formula with Bacopa and Limonene;Centered, a PMS/mood formula with Ashwagandha and Evening Primrose; andHarmony, a hormone balance formula with St. John's Wort and Black Cohosh Root.

All Being Hemp products are crafted in GMP-certified facilities to ensure consistency, safety, quality control and reliability for every batch. The company uses only the most reputable third-party testing labs to verify all product ingredients and potencies for every batch. The Certificate of Analysis (COA) for any Being Hemp product can be viewed online.

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Being Hemp Launches Proprietary Nano CBD Products Specifically Formulated to Target Womens Health, Wellness and Beauty Needs-NK#137011 - New Kerala

HGH and Hysterectomy: How Does Hormone Therapy Help? Read more / Skip – eTurboNews | Trends | Travel News

Arguably, one of the most life-altering medical procedures that a woman can undergo is a hysterectomy. For those who are not familiar with hysterectomies, they are surgical procedures that entail removing a womans uterus and, in some cases, other reproductive organs. When this happens, her menstrual cycles will stop, and she will lose the ability to get pregnant. According to a study published by the Centers for Disease Control and Prevention (CDC), an estimated 600,000 hysterectomies are performed in America every year, with the average woman getting one around the age of 42.

The success rate for hysterectomies is quite high for women who undergo them to combat specific health problems, some of which include fibroids, pelvic pain, endometriosis, and a prolapsed uterus. Hysterectomies are also sometimes recommended to women diagnosed with cancer of the uterus or cervix.

When it comes to hysterectomies, the end of a womans menstrual cycles and an inability to get pregnant represents only a part of what she can expect after surgery. Before detailing the additional side effects that a woman is likely to encounter, lets take a moment to go over the three types of hysterectomies that a physician might recommend depending on the health condition their patient is facing:

Partial hysterectomy This surgical procedure entails removing a womans uterus while leaving her cervix intact.

Standard hysterectomy This surgical procedure entails removing both the uterus and cervix.

Total hysterectomy This surgical procedure involves removing the uterus and cervix. Additionally, the surgeon will also remove one or both ovaries as well as the fallopian tubes.

Regardless of the type of hysterectomy procedure a woman undergoes, she will likely encounter an array of short-term side effects afterward. Some of these short-term side effects can include the following:

Although short-term side effects will typically resolve themselves, women who undergo a total hysterectomy may encounter long-term side effects that sometimes require additional medical treatment. A few of these long-term side effects, which are also commonly associated with menopause, include the following:

Many women who undergo a hysterectomy often find themselves struggling with hormonal deficiencies. And this is especially true following a total hysterectomy. According to Science Daily, an online aggregator of science-related press releases, total hysterectomies can increase the risk of early menopause in younger women by nearly two-fold. In short, this means that women who undergo these types of hysterectomies, in addition to hot flashes, insomnia, night sweats, vaginal dryness, and low libido, may experience hormonal imbalances as well. In fact, some women who undergo a hysterectomy that includes the removal of one or both ovaries experience a sharp decline in estrogen and progesterone production. This decline is triggered by a severe drop in human growth hormone production, which, unfortunately, is yet another side effect of undergoing a hysterectomy for many women.

To combat many of the side effects that follow a hysterectomy, many women turn to human growth hormone (HGH) replacement therapy. This form of therapy, administered by injection, provides the same level of symptom relief to women following a hysterectomy that it does to menopausal women. Considering that low growth hormone levels often lead to low estrogen and progesterone levels, it makes sense that many physicians are recommending growth hormone replacement therapy alongside traditional treatments consisting of estrogen and progesterone replacement therapies. Some physicians are even recommending growth hormone replacement therapies over estrogen and progesterone since they are less likely to result in complications.

For reference, a study published by the National Cancer Institute found that estrogen replacement therapies can increase a womans chances of developing blood clots, gallstones, or suffering a stroke. Further, when combined with progesterone or another bioidentical hormone, such as progesterone, can increase the risk of developing breast cancer.

When it comes to hormone replacement therapy involving the use of growth hormones to combat the side effects of a hysterectomy, the long and short of it is that these treatments help return a womans growth hormone levels to a healthy and normal state. In response, her estrogen and progesterone levels return to a normal and healthy state as well. Once her growth hormones, estrogen, and progesterone levels are normalized, the side effects that follow a hysterectomy, such as night sweats, low libido, hot flashes, and low bone density, for example, will start to subside. Further, her chances of developing breast or uterine cancer will also decrease. Some of the more commonly prescribed HGH-based medications that physicians prescribe to women following a total hysterectomy include the following:

If youre thinking about starting HGH-based replacement therapy to relieve side effects following your hysterectomy, youre probably interested in knowing how long it will take to see results. If so, you will be happy to know that, for most women, these treatments begin to work almost immediately. However, long-term improvement of symptoms can take anywhere from 3 to 6 months.

In summary, even though human growth hormone replacement therapy is a relatively new approach to combating side effects brought on by a hysterectomy, there is evidence that proves it is just as effective as estrogen hormone replacement therapy. More than that, it is significantly safer by comparison, according to most physicians.

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HGH and Hysterectomy: How Does Hormone Therapy Help? Read more / Skip - eTurboNews | Trends | Travel News

Withdrawal bleeding – what is a withdrawal bleed? – cosmopolitan.com

Periods are just one of the amazing functions of the female body. And while we're all probably familiar with what a period is, you might not know quite so much about a withdrawal bleed (AKA a period you have while taking hormonal contraception)? So, whether you've had a withdrawal bleed before, or you're considering starting on birth control, here's everything a doctor wants you to know about withdrawal bleeding.

A withdrawal bleed is essentially the period that you have while you're on hormonal birth control. But how does it work? Here are the basics:

"Many types of contraception work by altering your bodys hormones, preventing your ovaries from releasing an egg each month," explains Dr Samantha Wild, a GP and Primary Care Physician at Bupa Health Clinics. A lot of these hormonal birth controls, like the pill, patches and vaginal rings, work on a 21-day cycle, giving you a week off taking hormones which is when you have the withdrawal bleed. And there's a purpose to this intermittent bleeding. "A 'withdrawal bleed' happens as a result of this drop in hormones when you have the week off, and the body releases some of the blood and mucus from the lining of the uterus," Dr Wild explains.

For all intents and purposes, you might think a withdrawal bleed is the same as a period - it looks the same, anyway. But it's not. "Withdrawal bleeding isnt the same as a regular period. This is because the hormones from the contraception affect your endometrium the lining of your uterus preventing it from thickening, so theres less discharge," notes the doctor.

"Similarly, the hormones also prevent you from ovulating, meaning there is no egg for your body to get rid of. As such, withdrawal bleeds are typically lighter and have less pronounced symptoms to a standard period, Dr Wild adds.

It's not just the pill that can cause withdrawal bleeding. Other kinds of hormonal contraception usually contain the same hormones and have the same effect - they're just inputted into the body in a different way.

"Contraceptive patches work in the same way as the pill and contain the same hormones, oestrogen and progestogen, and the same goes for the contraceptive vaginal ring which is inserted in the vagina," Dr Wild explains. "But pills, patches and vaginal rings are the only types of contraception which may cause withdrawal bleeding. You wont experience one when using the coil," she advises.

This is because, on the copper coil (IUD), you still get your normal monthly period. "The IUD doesnt contain any hormones. Your regular period may be heavier, longer or more painful especially in the first 3-6 months after it is put in," says the doctor. "The Intrauterine System (IUS) wont cause a withdrawal bleed either. This is a small plastic T-shaped device that releases the hormone progestogen into the womb to stop you getting pregnant. It can make your periods lighter, shorter or stop altogether. These arent withdrawal bleeds though, as the progestogen is provided constantly so theres a no break in the cycle." So there you have it.

As with 'normal' periods, withdrawal bleeds vary from person to person, and everyone's cycle is different. However, they will usually average at just under a week. "Withdrawal bleeding happens when you are having one week with no hormones," explains Dr Wild, "but the bleed will usually last for less than a week as it can take a couple of days to start after the hormones have stopped going into your system."

"You might still experience some symptoms similar to those you get around your 'normal' menstruation, but they are usually less severe," says Dr Wild. So, hopefully, even if you've still got cramps they won't be as tough as usual.

Plus, hormonal contraception like the pill is actually often prescribed as a treatment for PMS because the symptoms are milder, Dr Wild adds, so if you're struggling with PMS then switching to hormonal contraception with a withdrawal bleed could actually be a good option. But, of course, speak to your doctor first.

Ashley Armitage / Refinery29 for Getty ImagesGetty Images

Although pill packets are usually designed to give you a break (and therefore a withdrawal bleed) once a month, you actually don't need to take one. "It's not medically necessary to have a withdrawal bleed every month," Dr Wild explains. "Early pill regimes were designed like this to mimic a natural menstrual cycle, but it's safe to take them for longer before having a break."

Taking pill packets back to back without having a break will mean your withdrawal bleeds become less frequent. And if you do still experience symptoms during your withdrawal bleeds, then you most likely won't have any of these symptoms while taking packets without a break.

However, Dr Wild advises speaking to your GP before you make any changes to how you take your pill, as you'll need to make sure it's right for you.

The short answer is yes. "A withdrawal bleed is still a sign that you're not pregnant," says Dr Wild. And on the flip side, "if you don't bleed when you expect to then you should do a pregnancy test, if there is a chance that you could be pregnant."

However, some people don't have withdrawal bleeds, adds Dr Wild, and if you're not having a pill break then you won't have one either - so you won't be able to use bleeding/not bleeding as an indication. Other first signs of pregnancy include "breast tenderness, nausea or fatigue," says Dr Wild, but if you suspect you could be pregnant then still take a test.

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Withdrawal bleeding - what is a withdrawal bleed? - cosmopolitan.com

Can Toxic Chemicals Trigger Sleep Trouble? – Everyday Health

Around menopause, many women have at least occasional difficulties when it comes to sleep. Experts often attribute this to changing hormones or to the stress and anxiety that may accompany midlife.

A new study adds another potential factor to the mix: endocrine-disrupting environmental chemicals (EDCs), especially phthalates.

Related:11 Natural Insomnia Aids That Will Give You Sweet Dreams

This study is important because endocrine-disrupting chemicals are everywhere, says Stephanie Faubion, MD, a womens health physician at the Mayo Clinic in Jacksonville, Florida, and the medical director for the North American Menopause Society (NAMS). It provides additional evidence of potential sex differences in endocrine disrupting chemical exposure (in this case, phthalates) and impact on health.

The study was published on July 29, 2020, in the NAMS journal Menopause.

RELATED:10 Ways to Beat Menopausal Belly Fat

Researchers at the University of Illinois used information from the Midlife Womens Health Study. This major clinical trial was conducted between 2006 and 2015 with women ages 45 to 54 in the Baltimore region, to assess risk factors for hot flashes in women not taking hormone therapy. Because the women were tracked closely for so many years, others researchers have subsequently mined its health data to shed light on other issues surrounding menopause.

For this study, data from 760 premenopausal and perimenopausal women were assessed. Questions the women had answered about sleep, among other things, were matched with concentrations of chemical phthalates in their urine.

The scientists focused on phthalates because a previous study had suggested increased exposure to the chemicals significantly increases a womans risk of hot flashes. Animal studies have also shown its influence on hormones associated with sleep.

Related: Fight Menopausal Sleep Problems With Light Therapy, Study Suggests

The results confirmed that the frequency of sleep disruptions in midlife women is associated with higher concentrations of phthalates in the body.

The relationship proved to be complex, however, and may be affected by other factors, especially smoking. Because smoking is known to impact both sleep and hormones, women with the same levels of chemicals who were former smokers reported different effects on their sleep than nonsmokers. This suggests that smoking history influences the relationship between phthalates and self-reported frequency of disrupted sleep, the authors write.

Still, anything that sheds light on possible reasons for sleep disturbances will be welcomed by many midlife women.

Up to 60 percent of women in their menopause transition report sleep issues, the study authors note. They also point out that women who have trouble falling asleep are at increased risk of developing depression.

Because this was an observational study and not a randomized clinical trial, and because of the confounding influence of smoking, additional study is needed investigating the complex relationship between endocrine disrupting chemicals, hormones, and sleep, mood, and menopause symptoms, Dr. Faubion says.

She also notes that other factors known to impact sleep were not measured in the study, including caffeine intake and stress, which may have influenced the results.

Whats more, the underlying mechanisms by which EDC exposure impacts sleep in midlife women still need to be uncovered, the researchers write.

RELATED: Why Sleep Is an Important Womens Health Issue

Even before that research is done, though, experts say its smart for all women, including those in midlife, to minimize phthalate exposure as much as possible. The chemicals appear to concentrate more in women than men, the study authors note.

Phthalates are common EDCs that are used in a wide array of industrial products to increase their performance, explains Nneka Leiba, MPH, vice president of healthy living science at the nonprofit Environmental Working Group in Washington, DC.

RELATED: 10 Toxic Household Items You Should Throw Away Now

They can be found in plastics and food packaging, Leiba says. A key way midlife women come into contact with them is through skin-care products.

Phthalates are used as ingredients in personal care products, including skin-care products, perfumes, and colognes, she says. And since they are typically part of any products fragrance mixtures, you are also likely to encounter them in anything with an aroma, from candles to detergents to trash bags, she says.

Black women may be at higher risks than white women for exposure to these chemicals. EWGs research indicates that Black women use more personal care products than other demographics, and there are fewer productsmarketed specifically to Black womenthat are free from chemicals, Leiba says.

RELATED: What Are 'Natural' Skin-Care Products, and Are They Actually Better for You?

Due to their pervasiveness, it isnt possible to avoid phthalates completely. Even limiting your exposure would mean knowing which products theyre hiding in, something that is difficult because manufacturers are not required to label these ingredients, Leiba says.

Given that phthalates are often used in fragrances, Leiba suggests avoiding products that bear the catch-all label of fragrance. Instead choose products that disclose specific fragrance ingredients. You can even contact a manufacturer to ask about their use of phthalates in your favorite products, she advises.

EWGsSkin Deep database identifies many skin-care options without these and other ingredients of concern.

For any product, if you come across a brand labeled phthalate-free, choose it to help lower your risk of EDCs, advises the medical organization the Endocrine Society.

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Can Toxic Chemicals Trigger Sleep Trouble? - Everyday Health

‘It’s like they’re testing it on us’: Portland protesters say tear gas has caused irregularities with their periods – OPB News

Federal officers deploy gas to disperse crowds of protesters near the Mark O. Hatfield federal courthouse in Portland, Ore., July 20, 2020.

Jonathan Levinson / OPB

After more than 50 days of nightly protests against racism and police violence, demonstrators in Portland are intimately familiar with the immediate effects of tear gas: blurry eyes, burning skin, choking, coughing, crying, retching.

But some protesters believe the gas is doing more than causing red eyes and seething skin. OPB interviewed 26 protesters, ranging in age from 17 to 43, who said they believe regular exposure to tear gas has caused irregularities within their menstrual cycle.

Related: 60+ days of tear gas leaves behind 'a stew of pollutants'

The experiences range. Some protesters reported getting their period multiple times in a single month. Others reported debilitating cramps at least one that ended in a hospital visit and blood clots the size of half a fist. Trans protesters who had stopped menstruating since taking testosterone said they have seen their cycles restart.

There are two common threads between the experiences of the 26 protesters: All said what they were experiencing was abnormal for their bodies. And all believed the tear gas, which law enforcement has been using against demonstrators for two months, was at fault.

Related: 60-plus days of tear gas leaves lingering questions about environmental impacts

There has been little scientific research into whether tear gas can affect a persons hormones and experts warn against extrapolating a solid medical conclusion from anecdotal evidence. But while the science remains thin, the troubling stories have mounted as the release of the chemical has become a near-nightly occurrence.

Lindsey Smith, a 26-year-old preschool teacher who has been live-tweeting the protests since mid-June, said shes noticed a pattern: If she inhales a significant amount of gas in the night, shell have her period the next morning. She said this has happened at least three times in two months even though the hormonal birth control shes on makes it so shes only supposed to menstruate four times a year.

On July 12, after another night that saw federal officers blanket the crowd with tear gas, Smith tweeted to ask if anyone else was menstruating after being exposed to the gas. She received nearly 30 responses from protesters with their accounts of irregular periods: cramping within hours of exposure, periods that stretched for nearly a month, or arrived weeks early.

She was also met with some trolls.

When I posted that, there were a lot of alt-right people screenshot-ing it and reposting it and a lot of them are saying, Good, I hope after this youre sterile, she said. That was the first time that the thought occurred to me: I dont know what this is going to do. And I dont think anyone really knows long-term.

Within the small body of research that does exist on tear gas, the question of what effect it could have on a persons reproductive health, if any, has been left unanswered.

Sven Eric Jordt, an associate professor at the Duke University School of Medicine who has extensively studied tear gas agents, said its possible the gas impacts hormones. He pointed to a 2010 study that showed burning the agent in CS gas, a common type of tear gas, could generate chemicals potentially toxic enough to affect hormonal homeostasis. Researchers in Chile raised concerns tear gas might cause miscarriages in 2011, leading the government to temporarily ban its use. In Bahrain, Physicians for Human Rights documented accounts of pregnancy loss among civilians gassed during anti-government protests.

But no one can say with certainty if theres a link.

Theres really no data on this. Its entirely possible that some of these chemicals that if you inhale them at high levels can have effects, Jordt said. But its really hard to say.

Intense stress could be another culprit. Rising levels of cortisol, the bodys primary stress hormone, are known to upend normal menstrual cycles, And the policing tactics common among local and federal officers including tear gas, impact munitions, and flash bangs could all be fairly described as cortisol-inducing. Not to mention the new unusual rituals that could potentially alter someones usual menstrual cycle: bedtimes pushed to the early morning, a diet of snacks and energy drinks, nightly sprints away from gas and police.

But some protesters in Portland are convinced that stress alone cant explain their experiences.

While many nights are traumatic, protesters are not breathing lungfuls of the chemical every single evening. And some report its only in the aftermath of these hazy nights, during which theyve inhaled for minutes without a mask, that they notice the irregularities.

Alissa Azar, 29, has been protesting downtown at least five nights a week since the demonstrations began. She said shes been caught in the thick of a cloud of gas six times. On two of these occasions, her period started immediately after. The other four times, it started within a few days.

Obviously were experiencing a significant amount of stress right now physically, mentally, emotionally. It would be naive to believe that doesnt have an effect. However, I definitely think theres a correlation between menstruation and tear gas, she said. The timing has been too spot-on.

She said the periods are different than what she expects. Each one lasts for four or five days. The cramps are more like the contractions she had when she gave birth, inducing nausea and severe back pain. A dozen other protesters interviewed had similar accounts of cramps that felt like sharp rocks being cradled in their stomachs.

Were not paranoid. This isnt a coincidence. Somethings going on, Azar said. Within 15 minutes of a gas attack, myself and others will have to take a break from how bad the cramps are.

For some, the experience goes beyond physical pain. Five transgender individuals taking testosterone, which typically stops menstruation after a matter of months, told OPB theyd seen their cramps and bleeding return after attending demonstrations.

These protesters say these unexpected periods were accompanied by a sense of gender dysphoria, the clinical term for the discomfort and distress people feel when their bodies dont align with their gender.

Its definitely a back and forth feeling. Im still pretty early in my transition, and Ive waited a really long time to be able to do this, said Lester Lou Wrecksie, a nonbinary transmasculine person who has been taking testosterone since September.

Wrecksie, 43, said on most nights they stay in the back of protests, largely out of the way of gas. But on June 21, they got knocked down and ended up getting caught in the chemical for longer than usual. Two days later, Wrecksie said their cycle returned for the first time in half a year.

Its unsettling to be like, I can go out into the air with chemicals and have it basically undo part of what Im trying to do for myself, they said.

A few protesters said they were concerned enough with the period irregularities that they scheduled a call with the local Planned Parenthood. Paula Bednarek, the medical director for Planned Parenthood Columbia Willamette, said clinicians had not noticed an uptick in patients reporting unusual menstruation since the protests began.

But enough reports linking period irregularities and tear gas have cropped up nationwide in the last few months that another branch of Planned Parenthood has taken note. An epidemiologist with Planned Parenthood North Central States, which supports reproductive health in Iowa, Minnesota, Nebraska, North Dakota, and South Dakota, crafted a research proposal after putting out a call for reports from protesters whod spontaneously menstruated after being tear-gassed. A handful of online outlets have also done write-ups this summer questioning a possible connection between the chemical and periods.

Dr. Rohini Haar, a medical expert for Physician for Human Rights, said while these experiences should be acknowledged, she believed there is danger in overreporting a potential link without the hard scientific evidence to back it up.

Haar, an expert in crowd control weapons who has studied the health consequences of tear gas up close among Palestinian refugees, said shed only started hearing these anecdotal reports of tear gas affecting menstruation a few weeks ago. She worried these new accounts could genderize protests and lead to a narrative that protesting is only safe for people without ovaries.

This may be an issue, but its certainly not enough of an issue to intimidate people away from protesting especially women, she said. Its not the situation where you should tell your teenager, This definitely injures your reproductive tract, you are not allowed to go. There is no evidence to say that.

Dr. Jordt said he thought it would be worth trying to find out. He suggested a local or state health department in Oregon should initiate a study, taking health data from protesters and residents and following up with them over the long term.

Jordt estimates there are currently five or six of these sorts of studies that look at long-term effects of tear gas on people who have been exposed repeatedly, most coming from the Middle East during the Arab Spring. But he said governments in these countries often hampered the efforts of the doctors leading these studies, making it difficult to follow up with civilians over long periods of time.

One of the most comprehensive studies within the United States was conducted on recruits for the U.S. Army in 2014. Researchers found recruits exposed to CS gas as part of a training exercise were at a higher risk for developing respiratory illnesses, including influenza, pneumonia and bronchitis.

They were exposed to the gas just once.

Jordt pointed to two reasons why learning the long-term health effects of repeated exposure to tear gas has yet to become a top concern of health experts in the United States: The first is that its rarely used at the levels the country has seen this summer. While its been used en masse on protesters before in Ferguson, Missouri, in 2014, during the Occupy Wall Street movement in 2011, during the Vietnam War protests in the 60s and 70s he said the chemical hasnt been pervasive enough to become a top priority among health experts.

Nor is it top of the list for law enforcement agencies. Jordt said theres a strong belief among law enforcement that teargas is their safest option for controlling crowds. He suspects they will not be the ones leading the charge for a deeper study.

The lack of concrete studies has left some protesters feeling like guinea pigs, scouring Google for answers on whats happening to their bodies with no satisfying results.

We dont know the long term effects of this, said Elisa Blackman, 24, who said she got her period five times between June 2 and July 5. She tried to search for an explanation, but the hits she got on the internet focused on effects you could expect in the minutes after being gassed, not weeks or years.

Its like theyre testing it on us.

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Sea Moss: Add To Your Diet For Natural Weight Loss, Better Immunity and Energy – Broadcast Cover

The most up to date shrouded weapon in your wellbeing stockpile may simply be the kelp you ventured over to get into the sea the last time you were at the sea shore. Ocean greenery has been around since the seas previously lapped the shore, yet its getting a charge out of a flood in notoriety, on account of its incredible invulnerable boosting supplements. Ocean greenery is plentiful in common minerals, high in iron and cancer prevention agents that make it an inside and out insusceptibility promoter and weight reduction help, which is the reason organizations are gathering it from sea shores as far away as Ireland and the Caribbean, and purchasers are adding it to everything from smoothies to acai bowls and rice and beans.

It is difficult to distinguish one specific plant that has all the nutrients and minerals your body needs, however ocean greenery approaches. It contains over 90% of the supplements your body needs and can be utilized as a characteristic medication to treat or lessen influenza like side effects. This is the reason the little ocean plant is regularly called Natures Multi-Vitamin.

Ocean Moss, otherwise called Irish Moss, is a kelp, is a large scale green growth. It is sold in packs that look simply like the clear yellow ocean growth youd discover appearing on sea shores along the Atlantic seaboard and the Caribbean. Ocean greenery originates from both natural gathering and man-made pools, and where its developed influences the organization of the plant and its medical advantages. Crucial Vegan accepts that wildcrafted ocean greenery from the sea is better, so they just collect their ocean greenery from the Caribbean, explicitly Jamaica.

Under two centuries prior, ocean greenery was utilized as a wellbeing treatment of tuberculosis and pneumonia. Its likewise been utilized as a food to sustain individuals who worked in potato fields since it was a modest wellspring of supplements. Since it was utilized by helpless ranchers, the kelp was thought of as a poverty food, and overlooked by wellbeing searchers, because of the negative affiliation. Dr. Sebi, the notable botanist with the clique like after, took ocean greenery back to the consideration of his adherents and prescribed it to his patients to treat ceaseless diseases. Presently standard, ocean greenery is accessible at wellbeing markets and online through organizations that develop it in sea pools and reap it to sell.

Creator and veggie lover botanist Paul Otote clarified the medical advantages of ocean greenery and why this kelp is viewed as a powerhouse food. The Beet recorded his six motivations to eat ocean greenery, so you can completely comprehend why this supplement thick food is valuable for generally speaking wellbeing.

1. Ocean Moss Contains Iron and Can Help You Have More Energy.

Ocean greenery is loaded with iron, which many plant-based eaters need since its generally found in creature nourishments like meat, poultry, and fish. Ocean greenery contains around 9 milligrams of iron for every 100 grams, which implies ocean greenery has multiple times more iron than chicken. At the point when youre feeling exhausted or low vitality, it might be on the grounds that your iron levels are low, since iron enables your body to make red platelets to move oxygen from your lungs to your cells. On head of taking a sound iron enhancement, take a stab at including ocean greenery in a gel structure to your smoothies and check whether you start to see the distinction in your vitality. In the event that you have ever been determined to have mellow weakness, ocean greenery could work to enable your body to get the iron you need.

2. Ocean Moss Contains More Tha 90% of Nutrients Our Bodies Need.

The small winding yellow ocean growth is amazingly supplement thick, its practically similar to natures multi-nutrient. Otote clarifies that sea moss has 92 of the 110 minerals the body is made from, and he considers it the powerhouse. Sea greenery contains beta-carotene, nutrient B, nutrient C, and sulfur just as minerals like magnesium, manganese, calcium, phosphorus, and zinc. All these add to solid cell working in the body.

3. Ocean Moss Promotes Healthy Weight Loss.

Ocean Moss contains elevated levels of iodine, a mineral found in a constrained measure of nourishments. Our bodies need this mineral with some restraint to create thyroid hormones. These hormones control the bodys metabolism and many other important functions. The body also needs thyroid hormones for proper bone and brain development during pregnancy and infancy, as per an examination by the National Institute of Health. The key is to get the perfect sum, in any case, and not all that much.

Ocean Moss contains the indispensable thyroid hormone precurses that are significant for solid thyroid capacity and your bodys digestion. So if your thyroid isnt working appropriately they can be valuable and help in weight reduction. In any case, before you use ocean greenery to support thyroid hormones or as a weight reduction supplement, check with your primary care physician since you would prefer not to over-do these hormone forerunners either. Control is the most significant thing with thyroid capacity.

4. Ocean Moss Can Help You Build Strong, Lean Muscles.

The ocean growth is wealthy in protein with 6 grams of protein for each 100 grams of ocean greenery. In particular, it contains an amino corrosive called taurine, which enables the body to consume fat and assemble muscle. Taurine has the ability to make the body burn fat instead of carbs during cardio, Otote says.

5. Ocean Moss Strengthens the Immune System and Helps to Prevent Sickness.

Ocean Moss likewise enables the body to retaliate against regular maturing and irritation, in what could be classified the antis: Anti-provocative, hostile to maturing, against bacterial, and against viral. Its utilized as a treatment to help forestall and soothe cold and influenza like side effects, in powdered structure. It can be used to prevent colds but also help you heal and recover from sickness, Otote says. Ocean greenery contains potassium chloride, which enables the body to lessen irritation and individuals take it to bring down their danger of contaminations as a result of its positive effect on the invulnerable framework. Otote summarizes it as a no-lose added substance: Sea moss when youre ill is a win, and sea moss when youre healthy is a win, its a win-win.

Ocean greenery can be taken in a gel fluid structure to add to your smoothies, acai bowl, or even applied legitimately to your skin or hair as a lighting up treatment. The kelp can likewise be utilized as a preparing subsite for eggs, which makes is a simple method to get minerals into your eating routine through heating so use ocean greenery when you heat treats, cakes, and biscuits. You can likewise utilize it as a roux or a thickening gel in grains like rice or quinoa, farro, or when making beans.

Greg Mulligan is a well-known author and publisher. He published few article on his career. His secret ambition on arriving in Paris was to become a successful writer. Mulligan is winning multiple awards for his excellent writing, In addition to his regular contributions to English journals and articles. Presently he is working on Broadcast Cover.

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Magnesium: Why you need this mineral for better sleep, mood and more – CNET

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Most of us have a cabinet full of supplements that at some point, get neglected. Whether it's because you fell out of your routine or you forgot why you even started it in the first place, there's one that most Americans could benefit from adding back into their regimen: magnesium.

Studies show that the majority of the population is at risk for magnesium deficiency due to a variety of lifestyle factors, including a diet high in processed food. Certain illnesses or health conditions, including Type 2 diabetes or alcohol dependency, can make you susceptible to low magnesium levels, too. A 2013-2016 analysis from the National Health and Nutrition Examination Survey found that 48% of Americans don't get adequate magnesium in their diets.

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Magnesium supplements have become popular in the wellness space recently, and many experts are recommending them for helping with sleep, stress, anxiety and more. But do these claims hold up? Below, I give an overview of the science on magnesium, and I also talked to registered dietitian Amy Gorin to find out more on why magnesium is important and how to know if a supplement may be right for you.

Magnesium requirements vary based on a person's age, gender and other health factors (like pregnancy), but the average recommendation is around 300mg per day.

"Magnesium is important for so many aspects of health. The mineral is involved in more than 300 enzymatic reactions in the body. It's important for bone health, helping to keep your blood sugar levels stable, helping your muscles and nerves to properly function, and keeping your blood pressure at healthy levels," Gorin says.

Magnesium levels also affect your brain and your mood, which is why low levels of magnesium are associated with mood disorders, although more research needs to be done to determine just how important it is for your emotional or mental health.

If you've ever asked a health expert about the best supplements for stress, chances are magnesium is on the list. Why? First of all, according to Gorin, magnesium helps the brain cope with stressors. "Research has shown that magnesium supplementation may affect the brain functions that help lower stress and anxiety," Gorin says.

It works by helping your body kick into the "rest and digest" state, or by activating your parasympathetic nervous system. When you are stressed, your body is likely in the sympathetic nervous system for prolonged periods, which over time can make you feel run down and tired. Studies also showed that magnesium intake helped improve heart-rate variability (HRV) scores, which are representative of how well your body can adapt to stress.

Likewise, magnesium can help you sleep better, since the mineral can have a calming effect on your body. Magnesium helps regulatethe hormone melatonin, which is involved with controlling your circadian rhythm. Your circadian rhythm regulates many things in your body, including when you feel tired and how well you sleep.

Many activities and habits can throw off your circadian rhythm, including exposing your eyes to blue light at night. If you are trying to optimize your circadian rhythm, or are trying to get better sleep with melatonin supplements, you should check that your magnesium levels are optimal since they work together to help you get better rest.

A 2017 study reviewed the connection between magnesium and exercise performance, and found that the more active you are, the more your body needs magnesium. Some claim that it can help you recover faster from workouts, but the evidence on magnesium specifically for workout recovery is limited.

We do know that your muscles need adequate magnesium to function well and avoid cramping, so it makes sense that optimal magnesium levels can facilitate better recovery from workouts.

Grains and seeds contain naturally occurring magnesium.

Vitamin D is crucial for your overall well-being and especially for your immune system health. But even if you think you're getting enough vitamin D through supplementation or sun exposure, you could still be low if your magnesium levels are not optimal.

According to the American Osteopathic Association, low magnesium levels can make vitamin D ineffective. That means that even though you are taking in vitamin D from food, supplements or sunlight exposure, your body can't use it or benefit from it unless you have sufficient magnesium levels.

Magnesium is found naturally in food, like leafy vegetables, whole grains, nuts, seeds and milk, but it's usually in smaller amounts and it can be difficult to get the full 300 mg or more that is needed per day. Plus, scientistspredict that only about 30% to 50% of the magnesium that you take in is actually absorbed in the body. For these reasons, many people turn to a supplement to ensure they are meeting their daily needs.

There are several different types of magnesium supplements that can help specific issues.

If you walk into a vitamin or health food store and look for magnesium supplements, you will likely find several different types. You can get magnesium supplements in powder form (like the popular Natural Vitality Calm supplement) that can be dissolved in water or you can take the mineral in a capsule or tablet.

But not all magnesium supplements are the same, which is why it's important to not only seek a health professional's guidance on which supplement may be best for you, but also understand that different forms of magnesium can have different side effects. For example, magnesium carbonate is one form of magnesium that, if you overdo it, you can end up with stomach upset and diarrhea.

Popular forms of magnesium that are available in supplements:

Magnesium glycinate:"This is a common form of magnesium in supplement form. You might also see it used in heartburn treatments," Gorin says. Magnesium glycinate is often recommended by experts since it's absorbed well in the body and tends to cause less stomach discomfort or upset.

Magnesium oxide: "This form of magnesium can be used as an antacid for heartburn relief, as a short-term laxative, or as a dietary supplement when you're not taking in enough magnesium from food," Gorin says.

Magnesium citrate: "This form of magnesium is sometimes used as a stool softener or laxative," Gorin says.

Magnesium L-threonate:"This is a specific type of magnesium that's been proven to have cognitive benefits. It was discovered by MIT researchers, and you can get it in supplement form. Research suggests that it may help improve brain plasticity, which may have positive effects on memory, learning and cognition," Gorin says.

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The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Why urgency is needed when managing stable heart failure patients such as Bernard – New Zealand Doctor Online

References

1. Ahmed A. Am J Cardiol 2007;99:54953.

2. Taylor JC et al, 2016. Australian Family Physician; 45 (11): 823-827.

3. Calvert MJ et al. Eur J Heart Fail 2005;7:24351.

4. Moser DK et al. Heart Lung 2010;39:37885.

5. Cowie MR et al. ESC Heart Failure 2014;1:11045.

6. Chandra A et al. JAMA Cardiol. 2018 Jun; 3(6): 498505.

7. Desai AS et al. Eur Heart J 2015; 36: 1990-1997.

8. Okumura N et al. Circulation 2016; 133: 22542262

9. McMurray JJ et al. N Eng J Med 2014; 371(11): 993-1004.

10. ENTRESTO New Zealand Data Sheet.

11. Pharmaceutical Schedule Pharmac http://www.pharmac.govt.nz.

Abbreviations

ACEi Angiotensin Converting Enzyme inhibitor, NYHA New York Heart Association, ARB Angiotensin Receptor Blocker, HF Heart Failure, LVEF Left Ventricular Ejection Fraction, ECHO - Echocardiogram, HFrEF Heart Failure with reduced Ejection Fraction, BNP - B-type natriuretic peptide, NT-proBNP - N-terminal (NT)-pro hormone BNP, eGFR - estimated Glomerular Filtration Rate

Minimum Prescribing Information

PRESCRIPTION MEDICINE. Entresto 24mg/26mg, 49mg/51mg, 97mg/103mg (sacubitril/valsartan) film coated tablets. Consult full Data Sheet before prescribing, available from http://www.medsafe.govt.nz. Entresto is fully funded under Special Authority Criteria, please refer to http://www.pharmac.health.nz.

Indication: Treatment of chronic heart failure (NYHA Class II-IV) with reduced ejection fraction. Contraindications: Hypersensitivity to sacubitril, valsartan, or excipients. ACE inhibitors (ACEi). Do not administer within 36 hours of switching from or to an ACEi. Angioedema related to previous ACEi or ARB therapy. Use with aliskiren in Type 2 diabetes (T2D). Severe hepatic impairment, biliary cirrhosis and cholestasis. Pregnancy. Precautions: Caution switching from ACEi or while co-administering with aliskiren in T2D (see Contraindications). Should not be co-administered with an ARB. May cause symptomatic hypotension, especially in those 75 years old, renal disease and systolic BP <112 mmHg or patients with an activated RAAS. Initiation not recommended in systolic BP <100 mmHg. Monitor BP when initiating therapy or during dose titration. If hypotension occurs, dose adjustment of diuretics, antihypertensives, and consider treatment of other causes of hypotension. If hypotension persists, consider dose reduction or temporary interruption. Correct sodium and/or volume depletion before starting treatment. May be associated with decreased renal function; assess renal function before initiation and during treatment. Monitor serum creatinine, and down-titrate or interrupt if a clinically significant decrease in renal function develops. May increase urea and creatinine levels in patients with renal artery stenosis. Not recommended with end-stage renal disease. Should not be initiated and consider discontinuation if the serum potassium level is >5.4 mmol/L. Monitor serum potassium periodically and treat appropriately, especially in patients with risk factors, dosage reduction or interruption may be required. Caution with medications known to raise potassium levels. If clinically significant hyperkalaemia occurs, consider adjusting the dose of concomitant medications. If angioedema occurs, immediately discontinue, and provide appropriate therapy and monitoring until complete and sustained resolution; black patients or patients with a prior history of angioedema may be at higher risk. Caution in NYHA Class IV or in moderate hepatic impairment or with AST/ALT >2X ULN. Use in lactation not recommended. Use contraception during treatment and for 1 week after last dose. Interactions: Aliskiren in T2D, ACEi/ARB. Caution with statins, sildenafil, lithium, potassium-sparing diuretics including mineralocorticoid antagonists, potassium supplements, or salt substitutes containing potassium, NSAIDs including selective COX-2 Inhibitors, frusemide, inhibitors of OATP1B1/B3, OAT3 or MPR2 and metformin. Dosage: Target dose one tablet of 97 mg/103 mg twice daily. Starting dose one tablet of 49 mg/51 mg twice daily. Starting dose one tablet of 24 mg/26 mg taken twice daily recommended for ACEi/ARB naive patients, those with severe renal impairment, moderate hepatic impairment, and in those 75 years old. Double every 2-4 weeks to the target dose. Adverse effects: Very common ( 10%): Hyperkalaemia, hypotension, renal impairment. Common (1 to 10%): Cough, dizziness, renal failure, diarrhoea, hypokalaemia, fatigue, headache, syncope, nausea, asthenia, orthostatic hypotension, vertigo. Uncommon (0.1 to 1%): Angioedema, dizziness postural. Unknown: Hypersensitivity (including rash, pruritus, and anaphylaxis).

Novartis New Zealand Limited, Auckland. Ph 0800 652 422 Registered Trademark

NZ-00758 June 2020, TAPS NA12043, BGA200605

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