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There is not any specific diet to treat melancholy , but ingesting more of some foods and less or none of others can help some people handle their symptoms.

In this guide, we look at a few foods and nutrients that may be valuable and a few that individuals must avoid.

Many nutrients are available to purchase, but their should be asked by people Because they may occasionally interfere with other medications, Physicians advice before using any supplements.

One factor that may contribute to depression is.

A 2017 research Found that people with moderate-to-severe depressions signs improved when they ate a much more healthful diet for 12 weeks and received nutritional counselling sessions.

The diet centered on whole and fresh foods that are high in Nutrients. It limited sweets, refined foods, and food, including junk food.

Depressive symptoms, including mood and anxiety, improved enough to achieve remission criteria in more than 32 percent of the participants.

The researchers reasoned that people could help manage by fixing their diet, or enhance their symptoms of depression.

Selenium

Some scientists have suggested that raising selenium intake may help improve mood and reduce stress, which might help to make depression more manageable.

Selenium is found in Many Different foods, including:

Entire grainsBrazil nutsa few fishorgan meats, such as liver.

Vitamin D

Vitamin D might help improve the symptoms of depression, according to a 2019 meta-analysis.

Individuals obtain most of their vitamin D through sun exposure, but dietary sources are also important.

Foods that can supply vitamin D comprise :

Fatty fishfortified dairy productsbeef liveregg

Omega-3 fatty acids

The results of some studies have suggested that omega-3 fatty acids might assist with depressive disorders.

On the other hand, the writers of a 2015 review concluded that more studies are required to confirm this.

Eating omega-3 fatty acids may reduce the risk of mood disorders and Brain diseases by preserving and improving brain function.

Good sources of omega-3 fatty acids include:

Cold-water fish, such as salmon, sardines, tuna, and salmonflaxseed, flaxseed oil, and chia seedswalnuts

Antioxidants

Vitamins A (beta carotene), C, and E contain substances called antioxidants.

Antioxidants help eliminate free radicals, which are.

If the body cant remove enough free radicals, oxidative stress may develop. Lots of health problems can result, which may include depression and stress.

The results of a 2012 research Suggested that swallowing the vitamins that provide antioxidants may reduce symptoms of anxiety in people with generalized anxiety disorder.

Fresh, plant based foods, like berries, are great sources of antioxidants. There is that A diet rich in fruits and vegetables, soy, along with other plant products might help reduce the stress-related symptoms of depression.

B vitamins

Vitamins B-12 and B-9 (folate, or folic acid) help protect And maintain the nervous system, including the brain. They may help reduce symptoms and the threat of mood disorders.

Sources of vitamin B-12 include:

Eggsmeatpoultryfishoystersmilkentire grainssome fortified cereals

Foods that contain folate include:

Dark leafy vegetablesfruit and fruit juicesnutslegumesentire grainsdairy productsmeat and poultryseafoodeggs

Zinc assists the body perceive flavor, but additionally, it boosts the immune system and might affect melancholy.

Some research have indicated that zinc levels might be lower in people with depression and that zinc supplementation might assist antidepressants operate more effectively.

Zinc is current in:

Whole grainsoysterssteak, chicken, and porkbeansnuts and pumpkin seeds

Protein

It might also help people, although protein allows the body repair and to raise.

The body uses a protein called tryptophan to create serotonin, thefeel good hormone.

Tryptophan is present in:

Tunaturkeychickpeas

Serotonin Seems to play a role In depression, but the mechanism is complicated, and how it works remains unclear. But may be beneficial.

Probiotics

Foods such as kefir and yogurt can boost the levels of bacteria.

Healthy gut microbiota may reduce the signs and risk of depression, based on some 2016 meta-analysis. The researchers indicated that Lactobacillus and Bifidobacterium might help.

Weight control

This increased danger could possibly be due to the hormonal and immunological changes which happen in people with obesity.

Someone who is overweight or has obesity may desire to seek advice from with a dietitian or their health care provider about ways to manage their own weight.

The Dietary Approaches to Stop Hypertension (DASH) diet, which health authorities recommend, can help reduce blood pressure and improve overall health.

Theres also evidence it may help with weight loss and may reduce the risk of melancholy.

Foods to avoid

The symptoms of depression can aggravate.

Convenience foods, such as fast food and junk foods, can be full of calories and low in nutrients.

Research Have suggested that those who consume a lot of food are more likely to have depression than those who eat mainly fresh produce.

Processed foods, particularly those high in sugars and refined carbs, May contribute to a greater risk of depression. When a person eats carbs that are refined, the bodys energy levels grow rapidly but crash. A rapid low can follow, although an immediate increase may be given by A bar of chocolate.

Its ideal to opt.

Processed oils

Processed and polyunsaturated fats can activate inflammation, and they might also impair brain function and aggravate the symptoms of depression.

Fats to avoid include:

Trans fats, that are present in many processed foodsfats in red and processed meatssafflower and corn oil, which can be saturated in omega-6 fatty acids

At least one study has found that a moderate consumption of caffeinein the form of java , may assist people with depression. The benefits of caffeine could be due to properties that are antioxidants and its stimulant effect.

Coffeeteachocolatesodasenergy beverages

There is some evidence That small amounts of caffeine can reduce improve and stress mood. Some research has found that it might increase feelings of stress, stress, and depression in kids of high school age.

While caffeine may benefit some individuals, Its Best to:

Consume it in moderationavoid products with a high caffeine content, such as energy drinksavoid caffeine after midday

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What Foods Are Good For Helping Depression? - The Health Eaducation

A committee for the US Food and Drug Administration now recommends that the approval of Makena, a drug used to reduce the risk of preterm births, should be withdrawn and some women who have used the medication are sounding the alarm.

The 9-7 vote, which took place at a meeting of the Bone, Reproductive and Urologic Drugs Advisory Committee on Tuesday, came in response to evidence suggesting that the drug was not effective.

The committee serves as an advisory group to the FDA and the voting results are not binding, said Dr. Walid Gellad, director of the Center for Pharmaceutical Policy and Prescribing at the University of Pittsburgh, who was not involved in the committee meeting.

Most of the time the FDA will make a decision that aligns with the committee, but not always, Gellad said.

One study showed FDA will go against the committee about 20% of the time. But the committee did vote that removal of the drug from the market was warranted, which is relevant for supporting any FDA decision about withdrawal, he said.

An FDA spokesperson confirmed in an email on Thursday that the committee voted 13-3 that there is not substantial evidence of effectiveness of Makena in reducing the risk of recurrent preterm birth, based on findings from two trials that were part of a study called PROLONG, published last week in the American Journal of Perinatology.

Nine members of the committee voted to pursue withdrawal of approval for Makena, and seven members voted to leave Makena on the market under accelerated approval and require a new confirmatory trial.

None voted to leave the drug on the market without requiring a new confirmatory trial.

Makena, sold by AMAG Pharmaceuticals, is a progestin hormone that gets delivered to a patient as an injection. In 2011, the FDA approved the medicine to reduce the risk of preterm birth in women who have a history of spontaneous preterm birth under the provisions of accelerated approval regulations.

Accelerated approval is a mechanism for drugs to be approved by FDA before they have proven benefit. They need to address a high need clinical condition for which there are no or few other therapies, like premature birth, and they have to show some effect on a surrogate outcome an outcome that is reasonably expected to be related to clinical benefit, Gellad said.

As a requirement for a drug that is approved through accelerated approval, the company must perform a confirmatory trial to show clinical benefit. In this case, it took eight years, and the confirmatory trial showed no benefit, he said, adding that many of the patients in the trial were not from the United States.

So one argument from the company is that the trial does not represent effectiveness in the US, and because there are no other drugs available, and a prior study showed effectiveness, and its recommended by various OB/GYN groups, that it should stay on the market and be evaluated in another trial, he said. The caveat is that this treatment existed even before accelerated approval because pharmacies could compound or make the therapy themselves so if the drug leaves the market, there is still an option to use the drug.

Current guidelines in the United States recommend the use of progesterone supplementation, such as Makena, in women with prior spontaneous preterm births.

Last week, when the results of the PROLONG study were published, the Society for Maternal-Fetal Medicine released updated clinical guidance for providers to discuss important factors with patients, including uncertainty regarding the benefit of the drug.

Meanwhile, the American College of Obstetricians and Gynecologists released a statement from its Vice President for Practice Activities, Dr. Christopher Zahn, indicating that ACOGs clinical guidance on the use of the medication will remain in effect.

ACOGs guidance is based on a review of the best available literature. As such, we will continue to monitor this topic, evaluate additional literature and any further analyses as published, and address findings as needed in relevant clinical guidance, Zahn said in the statement.

Danielle Boyce, a mother of four and research consultant based in Philadelphia, had significant preterm labor issues with her first two children, including her eldest son, Charlie. He was born preterm at 34 weeks, developed a seizure disorder as a baby and now has Lennox-Gastaut syndrome, severe intellectual disability and autism, Boyce said.

When Boyce became pregnant for a third time at age 42, she was very concerned about having another preterm birth and made the shared decision with her physician to start using Makena. Her third and fourth children came home from the hospital and did not require a NICU stay. They are both healthy and developing normally, Boyce said.

I am glad that I had the opportunity to use Makena while it was still available because it worked for me, Boyce said in an email on Thursday.

Boyce added that she respects the decision the members of the FDA panel made since it was based on evidence presented to them but noted that studies can be flawed.

As someone trained in epidemiology and statistics, as well as someone who has served on FDA panels myself, I can appreciate the difficult decision that the panel had to make given the evidence presented, Boyce said.

I agree that the study design could have been better and the statistical endpoints were not achieved, she said about the evidence. However, this is a rare case where the stakes are so high and the side effect profile is so low that an additional layer of scrutiny is warranted beyond the statistical evidence presented before a decision is made to pull this effective medication from the market.

Boyce said that she would ask the FDA panel to consider ACOGs judgment.

Meanwhile, there also have been calls for the FDA to ban Makena.

Earlier this month, the consumer advocacy nonprofit Public Citizen submitted a petition to request that the FDA immediately withdraw the approval of all medications containing hydroxyprogesterone caproate (Makena).

Meena Aladdin, a health researcher at Public Citizens Health Research Group, testified during the FDA committee on Tuesday, arguing that maintaining approval of Makena in the absence of any clinical benefits being demonstrated by Trial 002 or Trial 003 would make a mockery of the more than 50-year FDA legal standard requiring substantial evidence of a drugs effectiveness.

In response to the FDA vote, AMAG Pharmaceuticals Chief Medical Officer Dr. Julie Krop said in a statement that the company was disappointed.

We are committed to working with the FDA to identify feasible ways to generate additional efficacy data on Makena while retaining current access to the therapy for at-risk pregnant women, Krop said in the statement.

For more than a decade, health care providers have relied on hydroxyprogesterone caproate (Makena) to reduce preterm delivery in high-risk patients, which aligns with recently updated treatment recommendations of the American College of Obstetricians and Gynecologists, as well as the Society for Maternal-Fetal Medicine, she said.

The medication now remains in limbo until the FDA makes a final decision based on its committees new recommendations.

I predict FDA will remove the drug from the market, since the confirmatory trial showed no benefit, and removing the drug does not necessarily completely eliminate the opportunity for some women to receive the therapy, Gellad said. There is an 80% chance I will be right.

Excerpt from:
FDA panel recommends withdrawing approval of drug used to prevent preterm births - FOX 59 Indianapolis

Animal sociability through microbes

Accumulating evidence suggests that the microbiota living in and on animals has important functions in the social architecture of those animals. Sherwin et al. review how the microbiota might facilitate neurodevelopment, help program social behaviors, and facilitate communication in various animal species, including humans. Understanding the complex relationship between microbiota and animal sociability may also identify avenues for treating social disorders in humans.

Science, this issue p. eaar2016

Increasingly, it is recognized that the microbes resident in the gastrointestinal tract can influence brain physiology and behavior. Research has shown that the gastrointestinal microbiota can signal to the brain via a diverse set of pathways, including immune activation, production of microbial metabolites and peptides, activation of the vagus nerve, and production of various neurotransmitters and neuromodulators in the gut itself. Collectively, this bidirectional pathway is known as the microbiota-gut-brain axis. In the absence of a microbiota, germ-free and antibiotic-treated mice exhibit alterations to several central physiological processes such as neurotransmitter turnover, neuroinflammation, neurogenesis, and neuronal morphology. Perhaps as a result of these neurological alterations, the behavior of rodents lacking a microbiotaespecially social behavioris remarkably different from that of rodents colonized with bacteria. Conversely, supplementation of animals with certain beneficial live bacteria (e.g., Bifidobacterium and Lactobacillus) can lead to notable improvements in social behavior both in early life and in adulthood. Collectively, these results suggest that microbial signals are important for healthy neurodevelopment and programming of social behaviors in the brain. Although research on the functional and ecological implications of the gut microbiota in natural populations is growing, from an evolutionary perspective it remains unclear why and when relationships between microbes and the social brain arose. We propose that a trans-species analysis may aid in our understanding of human sociability.

Sociability comprises a complex range of interactive behaviors that can be cooperative, neutral, or antagonistic. Across the animal kingdom, the level of sociability an animal displays is variable; some are highly social (e.g., primates, termites, and honey bees), living within cooperative communities, whereas others have a mostly solitary existence (e.g., bears). Consequently, although studies on germ-free and antibiotic-treated animals have yielded insights into how the microbiota may influence social behaviors, they are perhaps too reductionist to fully appreciate the complex relationship between symbiotic bacteria in the gastrointestinal tract and host sociability when considering a broader zoological perspective. Some social interactions have evolved to facilitate horizontal transmission of microbiota. Observations across both invertebrate and vertebrate species suggest that factors such as diet and immunity generate selection pressures that drive the relationship between microbiota and social behavior. Although microbiota may influence behaviors endogenously through regulation of the gut-brain axis, some animal species may have evolved to use symbiotic bacteria exogenously to mediate communication between members of the same species. Hyenas, for example, produce an odorous paste from their scent glands that contains fermentative bacteria that is suggested to facilitate social cohesion among conspecifics. This complex relationship between animals and microbiota raises the hypothesis that microbes may have influenced the evolution of the social brain and behavior as a means to propagate their own genetic material.

Understanding the factors that affect the development and programming of social behaviors across the animal kingdom is important not only in terms of rethinking the evolution of brain physiology and behavior, but also in terms of providing greater insight into disorders of the social brain in humans [including autism spectrum disorders (ASDs), social phobia, and schizophrenia]. Evidence for a link between the microbiota and these conditions is growing, and preclinical and emerging clinical data raise the hypothesis that targeting the microbiota through dietary or live biotherapeutic interventions can improve the associated behavioral symptoms in such neurodevelopmental disorders. Larger clinical trials are required to confirm the efficacy of such interventions before they are recognized as a first-line treatment for neurodevelopmental disorders. Although such connections between gut bacteria and neurodevelopmental disorders are currently an intriguing area of research, any role for the microbiota in the evolution of social behaviors in animals does not supersede other contributing factors. Rather, it adds an additional perspective on how these complex behaviors arose.

The bidirectional pathway between the gut microbiota and the central nervous system, the microbiota-gut-brain axis, influences various complex aspects of social behavior across the animal kingdom. Some animals have evolved their own unique relationship with their gut microbiota that may assist them in interacting with conspecifics. The relationship between the gut microbiota and social behavior may help to explain social deficits observed in conditions such as autism spectrum disorders (ASDs) and could potentially lead to the development of new therapies for such conditions.

Sociability can facilitate mutually beneficial outcomes such as division of labor, cooperative care, and increased immunity, but sociability can also promote negative outcomes, including aggression and coercion. Accumulating evidence suggests that symbiotic microorganisms, specifically the microbiota that reside within the gastrointestinal system, may influence neurodevelopment and programming of social behaviors across diverse animal species. This relationship between host and microbes hints that host-microbiota interactions may have influenced the evolution of social behaviors. Indeed, the gastrointestinal microbiota is used by certain species as a means to facilitate communication among conspecifics. Further understanding of how microbiota influence the brain in nature may be helpful for elucidating the causal mechanisms underlying sociability and for generating new therapeutic strategies for social disorders in humans, such as autism spectrum disorders (ASDs).

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Microbiota and the social brain - Science Magazine

My first diagnosis was stage IIIC breast cancer, which is as close as you can get to stage IV without actually being stage IV, which is terminal. At that point, IIIC, youre still considered curable.

My oncologist told me that I had triple-negative breast cancer, which can be more aggressive and more difficult to treat than other forms of breast cancer. (Triple-negative breast cancer doesnt respond to some common breast-cancer treatments, such as hormone therapy.)

I went through chemotherapy and then had a double mastectomy in May of 2018. The lump was in one breast, but I felt like I would always worry that wed missed something if I hadnt had both removed. I have three sonsnow 12, 13, and 16and every step of the way, Ive wanted to do whatever I could to heal myself and be here for them.

I made the most of my (bald) 44th birthday.

The mastectomy was followed by a second round of chemotherapy, which was followed by radiation. And then my oncologist said, Youve done all the treatment thats reasonable at this point. Now you need to go back to your normal life and watch for any symptoms. Well check you out every three to six months.

After recovering from the radiation, I went back to work the first week in December. I worked for a month and then was diagnosed with stage IV cancer the first week of January.

The cancer had metastasized to my liver and lungs. I did even more chemotherapy, but a follow-up scan showed that the tumor in my liver had doubled in size in the three months since my last scan. Following treatment, some tumors will shrink or disappear. The 14-centimeter tumor in my liver didnt react that way; its there, not getting smaller. There really isnt much room left in my liver. For now, my best-case scenario is that the cancer doesnt spread further.

It was really hard to tell my kids. Ive always wanted to be really honest with them. I was honest about what I had and that it was serious. Theyre old enough that they can do their own research. There was no point in trying to mislead them from the beginning. Also, I tried to be lighthearted.

I want my sons to know and remember how much I love them. Im glad that theyre at a point where theyll remember me. And my husband can remind them.

My eldest son has thanked me a couple of times for handling things so well. He feels like the fact that Im not complaining a lot or acting down or sad or depressed has been really helpful. I really try to stay positive and make the most out of all the moments that I still do have with them.

It was hard for them to see me go bald again. Having my hair grow back was a big milestone for my kids. My youngest, especially, was so excited when my hair started to grow back. He would measure it and rub my headhe really celebrated me starting to look more normal again.

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This Mom Has Terminal Breast Cancer, But Shes Still Fighting for Her Kids - Glamour

If you tend to wake up feeling like all you need is "just one more hour" of sleep, youre probably pretty stoked about "falling back" an hour this Halloweekend, marking the end of Daylight Saving Time. After all, when you change your clocks (or, let your iPhone do it for you) to switch back to standard time, you're gifted with an extra hour of sleep basically the best thing since the advent of the snooze button, right?

Well, according to experts, while you may gain that extra hour this weekend, the end of DST can actually have some pretty negative effects on your sleep and overall health.

In fact, although around 70 countries currently participate in DST, several are now pushing to scrap the practice altogether, citing general unpopularity and public health concerns. (One scary example? Scientists found that the pedestrian risk for being struck and killed by a car at 6 p.m. in November, when DST ends, is 11 times higher than the risk at 6 p.m. in April, when DST begins.)

Because at least for now DST isnt going anywhere in the U.S., its important to know what lies ahead. Here, experts weigh in on how Daylight Saving Time affects your health and mood and how you can squash symptoms related to the transition.

RELATED: We Tried 4 Products Designed to Help You Sleep Better

Youve probably already guessed this one, but the reason your sleep suffers as a result of the time change comes down to light (or lack thereof), says Clifford Segil, DO, a neurologist at Providence Saint John's Health Center.

"We get used to going to sleep a few hours after it gets dark, which is disrupted when all of sudden it's dark earlier than we are used to, Dr. Segil says. "Its hard for many people to continue to fall asleep at the same time or to maintain good sleep for the same amount of time as they did before a time change."

Someone whos regularly logging plenty of sleep will be able to adapt more easily to the shift. However, it can feel like the last straw if you are already dealing with not-so-great sleep habits, says Caroline Rasmussen, a meditation teacher, herbalist, and founder of brain health company, Antara.

The fix: Light cues can help your body's internal clock adjust more quickly to the time change, Dr. Segil says. If you wake up and its still dark, try to mimic morning light by turning on a nearby light or salt lamp, Dr. Segil says. He adds that the type of light isn't as important as the duration of time spent in the light and the volume of light the more the better. The same goes for when nighttime darkness begins to creep in; turn on a lamp at your desk if you can so your system knows it's not time for bed.

Maintaining a consistent sleep schedule aiming to hit the hay and wake up at the same time each day can also shorten the time it takes to feel back to normal after a time change, Dr. Segil adds.

As a result of poor sleep, your mood, productivity level, and concentration may all suffer, Dr. Segil says. Beyond feeling irritable and sluggish, theres a more serious mental health risk at play, too.

A 2016 study published in Epidemiology showed that depression diagnoses have a tendency to spike as people make the transition out of DST and into standard time. The studys authors noted that they believe the shift is related to the "psychological distress associated with the sudden advancement of sunsetwhich marks the coming of winter and a long period of short days."

This could be related to a larger condition that affects people during the winter months Seasonal Affective Disorder (aka SAD). People who experience SAD notice an increase in depressive symptoms in early fall or winter that experts say is linked to decreased exposure to light.

"The change in light information created by the time change directly influences the level of stress hormones in the body," Rasmussen says. If you already have chronically elevated cortisol levels, the time change can have an even more noticeable, negative impact on mood, she adds.

RELATED: 8 Signs You Might Have Seasonal Affective Disorder

The fix: If you think you have SAD, seek help from a mental health expert, who may recommend medication or light therapy; a 2009 study showed using a light box daily for 20 to 40 minutes resulted in significant and immediate mood improvement in people with SAD.

If its an overall feeling of irritability or stress you're experiencing, you may also want to consider adding in relaxing habits, like sipping tea. Not only is the act soothing, but Rasmussen says tea also contains L-theanine, an amino acid that can help keep stress at bay. On the supplement home front, consider popping an adaptogen, like tulsi or ashwagandha, which can help ease anxiety.

"Adaptogens help balance the stress response system for example by restoring the normal sensitivity of our cortisol receptors so that the adrenals aren't forced to pump out overly high levels of the hormone to achieve the same physiological effect," Rasmussen says.

Surprisingly, the time change and subsequent disruption of our circadian patterns can also have downstream effects on everything from our levels of inflammation to our eating habits, Rasmussen says.

"The brain is programmed for a 24-hour day, and when our internal clocks are disrupted, it leads to a domino effect, disrupting many bodily functions, including your appetite, body temperature, bowel function, and even heart and lung function," explains David Cutler, M.D., a California-based family medicine physician. Because these functions are all controlled by the brains internal clock, the end of DST can take your body on a bit of a roller coaster, he adds.

Translation: If you notice you're way hungrier than usual or that your digestion is out of wack DST may actually be partially to blame.

The fix: While there are some health factors out of your control, it never hurts to help your body along by taking care of it with diet and exercise. Aim to stick to your regular workout schedule at least 150 minutes per week of moderate-intensity aerobic activity per week or 75 minutes of vigorous aerobic activity and save protein-heavy meals (which involve more digestion and may disrupt your sleep) for earlier in the day, Rasmussen says.

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How the End of Daylight Saving Time Can Affect Your Health - Yahoo Lifestyle

I used to think that the brain was the most wonderful organ in my body. Then I realized who was telling me this.

Emo Philips, American Comedian

A research letter in JAMA Cardiology captures the same idea, substituting cardiologist for brain and physician for organ in my body.

Researchers begin by noting that new medications for diabetes also modify the course of heart disease; and that there are increasing numbers of patients with new-onset Type 2 diabetes. They then look at new-onset cases of Type 2 diabetes by state comparing them to the available supply of cardiologists, endocrinologists (physicians caring specifically for diabetes among other hormone-related conditions), and nephrologists (physicians who care for kidney disease). Low and behold, with three times more cardiologists than either endocrinologists or nephrologists, who is well-positioned to participate in diabetes care given their numbers and distribution relative to diabetes cases? Yes, cardiologists.

In addition to their sheer numbers, cardiologists bring other values to the table. Cardiologists see more patients with diabetes than endocrinologists; cardiologists are more frequently consulted in the hospital for issues involving patients with diabetes increasing the teachable moments. And finally, diabetes is becoming less glucocentric and more about global risk reduction. Frankly, who knows more about reducing risk, cardiologists just ask them.

All right, I must confess, I have a conflict of interest here. As a vascular surgeon, I have watched cardiologists claim that they can care for vascular disease, the area I trained in for six years because they are good with wires and balloons and they fix coronary arteries that are very small and important, so the big arteries that I care for are easy. Arteries are arteries after all unless, of course, you are a vascular surgeon that, for some bizarre reason, feels that you should fix a coronary artery with a balloon and stent; then, those arteries are different.

There is an invited commentary from a primary care physician; more specifically, an individual specializes in general internal medicine. He points out that patients often require coordinated, collaborative care, and there is a push to create a medical home, business-speak for having one consistent primary care physician. To extend that medical home metaphor, he points out that other specialists, part of the medical neighborhood, have much to offer, but that the decision to involve the neighbors, like cardiology, nephrology, or endocrinology involved should be made by the patient and their immediate real and medical family.

Collaboration and communication are not easy, even in this day of smartphones and text. It is challenging to coordinate a discussion about a patient using text messaging.; If you think that a physician has a time advantage when calling another physician, then you havent witnessed the dance of competing office staff trying to eliminate any waiting time for their doc - someone has to wait on the line. As a result, coordinating care often means prolonging decisions, increasing patient wait times, and in some instances, anxiety. Who is best qualified to coordinate the neighborhood? I agree with the commentator, the generalist has the best view, seeing more than the heart disease or glucose management.

Why are cardiologists so interested in expanding their lane? Why are they not content, supporting the hard work of primary-care physicians? As we move deeper into team medicine, not everyone can be the quarterback coordinating the play; even that gifted receiver, the one in this instance caring for your heart.

Source: Implications of Specialist Density for Diabetes Care in the United States JAMA Cardiology DOI: 10.1001/jamacardio.2019.3796

Optimizing the Physician Workforce for Care of Patients with Type 2 Diabetes JAMA Cardiology DOI: 10.1001/jamacardio.2019.3827

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If Diabetes Leads to Heart Disease, Should Cardiologists Care For Diabetes? - American Council on Science and Health

Posted: Oct 28, 2019 / 05:26 PM GMT-0600 / Updated: Oct 29, 2019 / 11:47 AM GMT-0600

Everyone wants to lose weight and keep it off, but even with exercise and diet, that can be hard. Dr. Kristen Kells, DC, BSc, Chiropractic Physician.

Dr. Kells started her successful weight loss center in Colorado. She explained how her patients saw results, hit their target weight and were able to keep the weight off! Kells herself struggled with weight resistance.

Dr. Kells and her team specialize in weight loss resistance treatment. Triggers that can keep you from losing the weight are symptoms such as brain fog, hormone disregulation, fatigue, belly fat and craving carbs. There are many factors that can contribute to this and everyones body is different so the approaches are client specific.

Kristin DeHerrera, a client of Dr. Kells weight loss program over the last 3 months has already lost an astonishing 45lbs. She says it works because you dont need to do anything too special outside your daily life to make things work. I like the real life aspect of it That I just have to take whats out there and make it work.

If you are struggling to keep the weight off and feel that you have tried every trick in the book, call (385) 217-6368 for a free consultation or visit drkellsweightloss.com.

This story includes sponsored content.

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Why this program can help you lose weight and keep it off for life - ABC 4

IOWA CITY A growing percentage of younger women are getting breast cancer with rates among 20-somethings increasing the fastest, according to new University of Iowa-led research.

Although the overall number of affected women in that age range remains well below other age groups, the rate of 20 to 29-year-olds diagnosed with stage 1 to stage 3 breast cancer increased about 2 percentage points a year during the 15-year study period, according to research published in the September issue of the Journal of the National Cancer Institute Cancer Spectrum.

Breast cancer rates for women in their 30s and 40s also increased from 2000 to 2015, although not as fast, inching up about .3 percentage points a year.

The study looked not only at incidence rates but survival rates and found that, in addition to seeing the largest annual percentage increase, the diagnosed 20-somethings had lower 10-year survival rates than their 30-to-40-year-old peers.

Reasons for the worse outcomes could be multifold and include that younger women often experience diagnosis and care delays in part because breast-cancer screening is less common among that age group.

Physicians might be less suspicious of malignancy in younger patients even when they show up in clinic with a breast lump, according to researchers.

Detecting cancerous growth in younger women also can be more challenging due to their dense breast tissue, according to the studys lead author, UI professor of epidemiology Paul Romitti.

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Romitti said the findings could have important clinical and self-care implications encouraging increased education and self-checks at a younger age.

Try to avoid care delays with these women, Romitti said. Be aware that because theyre traditionally not screened to make sure that when patients report a lump in their breast, its checked.

Brooke McKinnon of Coralville said shes glad her physician did, when last December she went in for her annual gynecology appointment. At age 27, the UI graduate and Hawkeye rowing athletic trainer hadnt yet had a mammogram.

But during her appointment, the doctor felt a lump and given that McKinnons mother not even two years before had been diagnosed with breast cancer the physician encouraged her to get a full work-up, while trying to calm her nerves.

Shes like, You know, young women get cysts in their breasts sometimes. She said, Dont get yourself worked up, but lets just get it checked out, McKinnon said.

That guarded reassurance did infiltrate McKinnons thinking as she waited four long weeks between that original appointment and when they could get her in for more imaging and tests.

I kind of convinced myself that Im too young to have breast cancer and this is not cancer and Ill be fine, she recalled.

But ultrasound and biopsy results revealed McKinnon despite her young age did have cancer grade 1B invasive ductal carcinoma. She got the call on a Monday morning and by that afternoon she had an appointment with the breast surgeon.

They mapped out a plan for a lumpectomy and more tests, and just after Christmas she learned her cancer hadnt spread and therefore was considered stage 1.

That was the best news you could get, she said.

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McKinnon still endured chemotherapy and continues to undergo hormone therapy in that her cancer cells grew in response to estrogen and progesterone.

Being premenopausal complicates treatment for younger patients, especially those such as McKinnon who havent had children but want to.

Having my own kid is very important to me, so I did IVF (in vitro fertilization) before even starting chemotherapy, she said.

When McKinnon was diagnosed, she was engaged with a wedding date planned for the coming summer. They managed one embryo from the IVF, and she took a drug to protect her ovaries during her cancer treatment in hopes shell be able to conceive without IVF in the future.

After her follow-up radiation, McKinnon today is cancer free and has a good prognosis not to mention a wedding still on the books for June.

Learning that her age group is getting breast cancer at a faster clip than others, she said, was shocking.

Its unsettling, she said.

The UI research in addition to assessing incidence and survival rates by age range looked at different types of breast cancers and variations by race and ethnicity.

Survival rates were lower among those who identified as non-Hispanic blacks and Hispanics, compared with non-Hispanic whites and Asian/Pacific Islanders.

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Some of those differences could be tied to variations in access to health care, according to Romitti, who is continuing his research by focusing on Iowa women in hopes of identifying life factors that might contribute to incidence and survival rates.

But based on what this initial research has found, his colleague and co-author at Wake Forest School of Medicine, Alexandra Thomas, stressed physicians should reject assumptions that younger women with lumps in their breasts dont have cancer.

We want physicians to be alerted to the rising cancer incidence among this population, Thomas said.

Comments: (319) 339-3158; vanessa.miller@thegazette.com

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More women are getting breast cancer in their 20s, University of Iowa research shows - The Gazette

When Kimberly Zieselman was 41, she got hold of her medical records from Massachusetts General Hospital. What she found was shocking.

The words "male pseudo hermaphrodite" were written on her chart.

Zieselman discovered she was born with XY chromosomes. Until that moment, she had no idea she was born intersex, an umbrella term used to describe people born with male and female anatomical characteristics.

As a teenager, Zieselman came to discover, doctors had performed surgery on her reproductive organs in an effort to conform her anatomy to fit one mold a move that had serious psychological ramifications for her later on in life, she said, and that was done without her complete, informed consent.

Like, Zieselman, many intersex adults who underwent procedures as babies have dealt with painful consequences later in life. Now 53, Zieselman has become a part of a growing movement within the intersex community speaking out against surgeries performed on intersex babies. Unless surgery is medically necessary, activists say, doctors should not interfere. Some activists are lobbying their state governments to pass legislation to ban surgeries that are medically unnecessary such legislation has already been proposed in California and Connecticut.

In the medical community, though, many say the issue should not be legislated, and that medical decision-making for children should remain parents responsibility after consulting with medical professionals.

A 2000 study in the American Journal of Human Biology found that 1.7 percent of babies are born intersex. There are many variations of intersex that manifest as differences in external genitals, internal reproductive organs and sex chromosomes. Another term used is DSD, which stands for Differences of Sex Development.

In Zieselmans case, she has Complete Androgen Insensitivity Syndrome, or CAIS. She was born with external female anatomy and internal testes. This means her body doesnt respond to testosterone and instead converts it to estrogen. In 1982, when Zieselman was 15, doctors removed her testes and told her and her parents that it was a partial hysterectomy, when, in fact, she never had a uterus or ovaries. All she knew was that she would never menstruate or be able to get pregnant.

My parents were told I was born with partially formed reproductive organs, Zieselman said.

She felt betrayed.

I realized I had been lied to by the medical community, by doctors who had been involved in this surgery and diagnosis. The truth was hidden even from my parents, she said.

Zieselman believes her doctors thought they were doing what was in her best interest at the time. But she disagrees.

The procedure, she said, meant having to take hormone replacements for the rest of her life. She maintains that had doctors not removed her gonads, she wouldnt have to take estrogen supplements. The psychological toll of learning the truth about her surgery was also devastating.

Its that feeling of being told youre not good enough. That there is something wrong with your body, that it is something to be shameful of and something to hide. And the fact that youre lied to. It was so shameful that the doctors didnt even tell your parents the whole story, she said.

Learning she is intersex was a turning point for Zieselman. The married mother of two who lives outside of Boston is now the executive director of InterACT, an advocacy group for intersex youth. Shes also publishing a memoir next spring, titled "XOXY."

Activists and medical professionals alike acknowledge that in rare, severe cases involving the reproductive organs like when there is no passage for urine, or when the bladder is on the outside of the body surgery is imperative.

Activists say that the types of surgeries that they condemn are not medical emergencies. Its common for infants with atypical genitalia to undergo procedures within the first year of their lives to make their anatomy look more traditionally male or female. Some baby girls undergo clitoral reduction, a cosmetic surgery, solely for appearance reasons. In 2013, the U.N. Human Rights Council deemed these procedures cruel.

But Jack Elder, chief of pediatric urology at Massachusetts General Hospital, said the term "medically necessary" can be interpreted differently, and he thinks legislation gets in between the physician and patient.

How can somebody else, an outside group, a legislative body, decide what is medically necessary or unnecessary when we're dealing with genital ambiguity? Elder said.

Elder says he and his colleagues dont dictate what parents should do. Instead, he encourages parents of his patients to educate themselves on the pros and cons of having their infant undergo surgery.

We're just trying to help parents and provide some guidance. They might say, What do you think I should do?" he said. "You've got to make a decision at some point, because when they hit puberty, its going to create issues, and the surgery is a lot more involved.

As the debate around these surgeries grows fiercer, pediatric urologists have found themselves being increasingly questioned about their practices surrounding surgeries on intersex babies. WGBH News reached out to three other hospitals in and around Boston and pediatric urologists declined, two of which cited the sensitive nature of the topic.

In March 2018, the Societies for Pediatric Urology and the American Urological Association issued a joint statement on pediatric decision-making. They said they believe medical decision-making for children should remain parents' responsibility after consulting with medical professionals and should not be legislated. The statement also said that children should be involved in these decisions.

In Nov. 2018, the Massachusetts Medical Societys Committee on LGBTQ Matters submitted a report to MMS, recommending hospitals create teams designed to assess the needs of intersex babies and proposing that MMS advocate for a delay of surgery.

Parents who have just welcomed a newborn can find themselves overwhelmed with a multidisciplinary team made up of pediatric urologists, endocrinologists and pediatric gynecologists and social workers.

A Boston-area mother, who asked not to be named to protect the identity of her child, has a daughter with an intersex condition who was treated at a different Boston hospital three years ago. Within a couple days of their daughters birth, she and her husband met with a team of 15 people.

[It] is very overwhelming, and everyone is telling you different things: She doesnt have a uterus, there are testes," she remembered. "They started talking about her vagina hole size and talking about intercourse for her one day. It was hard to talk about my daughters sexual health when she was just born.

She and her husband felt some pressure to have their daughters gonads removed. They connected with an intersex support group in search of advice.

We heard adults telling us that they felt violated, that they had to have multiple surgeries. We were shocked at the horror stories we heard, she said.

When she called their daughters pediatric urologist with their decision not to have their daughters testes removed, she said he was visibly unhappy with their decision. He abruptly ended the meeting.

In the beginning when we made the decision, we were still skeptical. Like, is this real? We were nervous that we only talked with people who were unhappy and rightfully so. But the more we talk about it, the more we feel really strongly against surgeries, she said.

Their daughter could develop secondary male characteristics once she hits puberty, but this is a possibility her parents have accepted. They believe their daughter should decide what she wants to do with her body when shes older.

Dina Matos, executive director of the CARES Foundation, an organization based in New Jersey that offers support for people with Congenital Adrenal Hyperplasia the most common DSD said the organization is not for or against genital reconstructive surgery and that their role is to educate parents and patients.

We always encourage people to get more than one opinion. The one thing we highlight most importantly, is if they decide that surgery is indicated with their child, that they seek out an expert," Matos said. "It really takes the surgeon with significant experience, and we really only refer to three or four surgeons in the country right now.

Meredith Nierman/WGBH News

For some, surgery is never an option. Tatenda Ngwaru, an intersex activist from Zimbabwe, recently moved to the suburbs of Boston.

Some people tried to burn down my father's house and kill all of us. And this was done just because of me, because I have a big mouth, Ngwaru said.

When Ngwaru was born, doctors mistook her enlarged clitoris for a penis. She was raised as a boy for the first 10 years of her life, until doctors discovered she had ovaries. It was what she calls an aha moment she never felt like a boy. But in her small town, going from son to daughter was out of the question.

It had always been treated as an abomination, as bad. Back then they used to say we're the ones who will give bad luck to the community, Ngwaru said.

Her parents, stunned by this news, didnt want her to be bullied, so they urged her to continue wearing a boys uniform throughout high school. It was agonizing.

I remember sleeping at night sometimes and thinking, Couldn't morning just come so that we can get it over with? Or maybe morning shouldn't come at all, because I didn't want to deal with daylight and having to be out and pretending and hiding something. There's nothing as painful as an untold story that you have to hide inside, she said.

Ngwaru waited until she was at college in a different part of Zimbabwe to live as a woman and started Zimbabwes first intersex advocacy organization. But trouble soon followed. She was attacked, her office was raided and her family was threatened.

So she fled for the U.S., seeking asylum from gender persecution. And she thought things would be different here.

I thought, they are promoting transgender lives on their TV shows. Clearly, they must know about intersex. I had a rude awakening. Nobody seemed to know what intersex is. And in America what was most shocking for me are the surgeries that had been done on infants, she said.

Zieselman said she wants attitudes to shift in the way they recently have for transgender people.

With transgender children, what the standard of practice has become is to do reversible procedures first and provide a lot of psycho-social support to the child and family, so no irreversible decisions are made too quickly until the child is really sure about what they want," she said. "Why arent we using the same standard of practice for intersex children?

Massachusetts voters may someday see a push for legislation banning medically unnecessary surgeries on infants. Zieselman said she is in discussion with state lawmakers about proposing a bill "to protect intersex children."

All humans have bodily differences, and if theres nothing making them sick or interfering with their health, then theres no reason to modify them," she said. "Intersex people can grow up without surgery and be happy and healthy.

Correction: A previous version of this story misspelled Kimberly Zieselman's name.

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Medically Necessary Or 'Cruel'? Inside The Battle Over Surgery On Intersex Babies - wgbh.org

(MENAFN - Arab Times) Gynecomastia is a problem that occurs in some men in whichbreast tissue develops. It is often caused by some type of disruption to theendocrine system. This is the system of the body which consists of glands thatsecrete various hormones, so any thing that upsets the homeostatic balance ofparticular sex hormones can result in gynecomastia.

There are some cases where a man may not have extra breasttissue because of hormonal problems but rather from having too much fat thataccumulates behind the areolae of the chest. This condition is sometimesdistinguished from gynecomastia and is called lipomastia or adipomastia.

Interestingly gynecomastia is not uncommon in newborn maleinfants and is found in from 60 to 90% of newborn baby boys, but thecondition usually goes away on its own. It can occur in about 1/3 of menbetween 25 and 45 and it becomes more prevalent with age.

How steroids causehormonal problems

One of the major factors associated with the development ofgynecomastia in men is the use of anabolic steroids, causing as many as 25% of allcases in men. Steroid abuse has long been a problem in the sports world,and the concern is that there are unpleasant side effects with these drugs.

The steroids often alter the balance of estrogen andandrogen hormones in people. A man usually has a lot of the androgen hormoneslike testosterone and very little estrogen, but the steroids affect theconcentrations. This hormonal imbalance is believed to be the main causativefactor of gynecomastia in men.

Not all of the steroid drugs necessarily cause breastdevelopment, but those that do often do so because they can cause a change inhormone levels. The synthetic steroid mimics the effect of naturally producedtestosterone. Testosterone is the hormone most associated with muscledevelopment in boys at puberty, and it can lead to increased muscle mass asboys mature during adolescence. Unfortunately the body tends to convert theartificial testosterone found in anabolic steroids into estrogen after a whilewhich then leads to breast tissue development.

What can be doneabout gynecomastia ?

The most permanent solution to the problem of gynecomastiais to have breast reduction surgery as is done at such places as theVera Clinicin Turkey. A surgeon canremove the excess breast tissue from the chest area to create a more masculineappearance. A man does have to be healthy enough to undergo surgery though, sothis is something to keep in mind and why consulting with a physician is a goodfirst step in looking for treatment options.

For some men, the breast cancer drug Tamoxifen has provedhelpful in treating their gynecomastia condition. If a man has breast tissuebecause of being overweight, the first step should be to try to lose weight bystarting an exercise program and following a healthy diet. In the end this canonly benefit you even if you later decide on breast reduction surgery.

MENAFN3010201900960000ID1099198024

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Early detection is the best defense to managing breast health.

October is Breast Cancer Awareness Month and a good reminder to schedule your mammogram, perform a self-check in the shower or ask your doctor about your risk factors.

Its important for every woman to know what shes up against regarding breast cancer, says Jessica Bensenhaver, M.D., director of the breast cancer program at Henry Ford Cancer Institute, but the most important things you can do are to be a self-advocate and attend your annual screening.

Breast cancer is one of the most frequently diagnosed cancers in women in the United States. Overall, one in eight women will be diagnosed with breast cancer in her lifetime. However, risk increases with age. According to Dr. Bensenhaver, at age 30, 1 in 217 women are likely to get breast cancer. At age 40, the figure is 1 in 67.

Since breast cancer is treatable at any age when discovered early, routine screenings should be an important part of every womans health plan.

Although most women with breast cancer have no family history of the disease, those with an immediate family member on either parents side should notify their doctor.

Age and family history are among the risk factors women cant control. Others include:

BRCA1 and BRCA2 gene mutations that mean an eight out of 10 chance of getting breast cancer at some point in your life

Race/ethnicity. According to Dr. Bensenhaver, Caucasian women are traditionally more likely to get breast cancer than African Americans. However, if youre younger than 45, African American women are at a higher risk

Breast density. In addition to increasing your risk of breast cancer, having dense breast tissue can make diagnosis of a lump or tumor through standard mammography more challenging. In Michigan, women must legally be notified if their breasts are dense. Sometimes it is recommended that women with dense breasts undergo additional screening methods, like ultrasound or screening tomosynthesis, also known as 3D mammograms

In addition to scheduling regular screenings, women should be familiar with their breasts and see a doctor immediately if they feel a lump, experience persistent pain or observe changes in skin color or texture.

Since worrying about breast cancer can weigh heavily on the mind, the Henry Ford Cancer Institute encourages women to be proactive about their breast health. Dr. Bensenhaver said to lower your overall risk of breast cancer:

Numerous studies have shown that obesity can increase your risk for many types of cancer, including breast cancer. According to the National Cancer Institute, postmenopausal women who are obese have a 20 to 40% increased risk of developing breast cancer.

Consuming one alcoholic drink per day increases your chances of getting breast cancer by at least 5 percent, according to the American Cancer Institute for Cancer Research. Two to three drinks per day raises your risk by 20%.

Although no one knows why, studies show that women who breastfeed have a lower risk of breast cancer. Even just a couple of months of breastfeeding can lower your risk.

In 2002, researchers discovered a connection between Hormone Replacement Therapy (HRT) and increased breast cancer risk. Although HRT can ease postmenopausal symptoms, talk to your doctor about the possible risks and avoid it if possible.

To take the private, at-home assessment, simply visit HenryFord.com/BreastCancerRisk to answer questions about your current health status and fitness levels as well as your family history. The assessment will generate a personalized report that you can download and share with your doctor.

Talking to your doctor is a critical part of the process. Your physician can answer your questions and help you navigate through massive amounts of information available about breast cancer health online. As you try to determine how to reduce your controllable risks, your doctor can cut through all the what ifs to provide compassionate care and straightforward information.

Despite their best efforts, the fact is that some women will face a breast cancer diagnosis. The Henry Ford Cancer Institute has one of the nations leading breast cancer programs, featuring specially trained breast radiologists who read all mammograms and imaging results.

Henry Ford also has the most advanced technologies available to detect and diagnose breast cancer and offers mammography locations throughout southeast and south central Michigan, with day, evening and weekend hours available. Visit HenryFord.com/Mammography for locations and to schedule your mammogram.

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Don't wait: Schedule your breast cancer screening at Henry Ford Cancer Institute - Dearborn Press and Guide

LOS ANGELES, Oct 23 (Reuters) - One toke for the road could end up being a total bummer for drivers who smoke pot, with several companies in the United States preparing to market cannabis breathalyzers as legalized marijuana spreads across the country.

Law enforcement agencies will require breathalyzers to detect marijuana as they are "faced with the necessity of stopping more and more motor vehicles being operated under the influence of THC," said Brett Meade, a retired police chief and a senior program manager for Washington-based non-profit group the Police Foundation.

Nearly a dozen U.S. states allow recreational marijuana consumption and 33 states permit pot for medical use. But all states prohibit driving under the influence of marijuana.

Oakland, California-based Hound Labs is one of the companies developing a breathalyzer to detect THC - the component in marijuana that gets people high - and plans to market it in 2020.

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Legal recreational marijuana sold in California

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Customers buy recreational marijuana at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Marijuana is displayed for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

A customer browses marijuana products for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Customers queue for recreational marijuana outside the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

A customer browses screens displaying recreational marijuana products for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

A woman holds marijuana for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Marijuana edibles are displayed for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Eron Silverstein, 51, (R) shops for marijuana at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Marijuana products are displayed for sale at the MedMen store in West Hollywood, California U.S. January 2, 2018. REUTERS/Lucy Nicholson

Customers purchase marijuana at Harborside, one of California's largest and oldest dispensary dispensaries of medical marijuana, on the first day of legalized recreational marijuana sales in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

People wait in line at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana sales in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

A customer waits at the counter to purchase marijuana as others wait in line at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

Andrew DeAngelo (L) and his brother Steve DeAngelo (R), co-founders of Harborside, one of California's largest and oldest dispensaries of medical marijuana, celebrate after a ceremonial ribbon cutting on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

An employee hugs a customer as others wait in line at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

An employee finds marijuana for a customer at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

Employees wait behind the counter at Harborside, one of California's largest and oldest dispensaries of medical marijuana, as a large clock counts down to the store's official opening at 6am on the first day of legalized recreational marijuana in Oakland, California, U.S. January 1, 2018. REUTERS/Elijah Nouvelage

Different strains of marijuana are seen for sale at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

A couple poses behind a cardboard Instagram frame while waiting in line at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

Employees prepare to open at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

Steve DeAngelo (C) makes the first legal recreational marijuana sale to Henry Wykowski at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana sales in Oakland, California, U.S. January 1, 2018. REUTERS/Elijah Nouvelage

Michael Sherman purchases marijuana at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana sales in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

A customer peers at different marijuana strains in a glass case at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

Marijuana is seen for sale at Harborside, one of California's largest and oldest dispensaries of medical marijuana, on the first day of legalized recreational marijuana sales in Oakland, California, U.S., January 1, 2018. REUTERS/Elijah Nouvelage

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Construction companies could be a big part of its market, said Hound Labs Chief Executive Officer Mike Lynn.

"Nobody wants a crane operator 50 stories up to be smoking a joint," he told Reuters.

Lynn, a physician, said pregnancy tests, which can detect minute quantities of hormone, inspired him to tackle the challenge of measuring THC on users' breath.

Separately, Cannabix Technologies Inc based in the Vancouver suburb of Burnaby is testing a pair of devices at different price points.

Its THC Breath Analyzer could be cheap enough at a few hundred dollars per unit to potentially allow parents interested in testing their teenager before turning over the keys to the family car, said Cannabix CEO Rav Mlait.

The U.S. court system would need to consider how to treat evidence from THC breathalyzers.

Assuming a motorist who tested positive with a THC breathalyzer was impaired behind the wheel could be "problematic," said Stanford University law professor Robert MacCoun.

Unlike with alcohol, scientific research has not yet established firm correlations between the amount of marijuana people consume and how impaired they become, MacCoun said in an email.

Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, expressed similar concerns.

But he welcomed breathalyzers as an improvement over existing tests used by police and employers, such as urine analysis that is unable to determine whether marijuana was used recently with the potential for impairment, or days or weeks in the past. Breathalyzers are likely to only detect a user who consumed cannabis within the last few hours.

"A test like that would frankly make sense," Armentano said. "Just like we wouldn't allow employees to have a couple drinks and show up to work." (Additional reporting by Jane Ross in Newark, California; editing by Bill Tarrant and Bill Berkrot)

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That last toke for the road could be a downer with pot breathalyzers coming - AOL

Conley recently created a GoFundMe page to help cover his future medical bills. Despite this, he said he feels uncomfortable putting his personal life on public display, especially since he hasn't yet come out to his grandmother.

But accessing affordable, supportive health care, he said, has been a challenge. He has rescheduled the surgery twice due to insurance confusion and financial stress.

Because of N.C. State Health Plan's policy, the $9,000 estimated cost of the surgery, and potentially all future trans-related health care, will fall on Conley. He said he has saved his own money, but it will not be enough without crowdsourcing.

He also said it has been difficult to find trans-positive health care providers and surgeons.

This is just one example of how transgender people are left out of the discourse, Ezra Wright, a member of UNCs Sexuality and Gender Alliance said.

There is minimal representation and few doctors that perform gender affirmation surgery, they said.

Anne Stephens, a clinical medicine physician at Campus Health, said she understands that LGBTQ+ healthcare should not have a singular approach.

There is a range of ways individuals may choose to transition and express their gender, she said. Changes may be social factors like name and clothing style, or more medical-based changes with male or female hormone medication. The medical side of student transitions is what she and her colleagues aim to help with.

Conley said that pursuing gender confirmation surgery is the right choice for him. However, medical transitions mark a small piece of the deeper LGBTQ+ identity.

The idea that as a transgender person you need to be transitioning is not true, Wright said. It has nothing to do with validity.

They said that the story of gender does not end with surgery that surgery is not the core of the transgender experience.

Its like gender, Wright said. Transitioning is treated as binary its not.

The transgender and LGBTQ+ experience, Conley said, is somewhat shaped by cultural exceptions and the media. He said that it is extremely important that support for the transgender community be genuine.

There are a lot of people at this University that I have found to be my best supporters, he said. But Im not sure that this University as a whole is cognizant of the struggles that trans people face."

Conley said that there is a prevalence of token queer people or token people of color in the media and University public relations.

In terms of University treatment of trans individuals, he said, a motto that they should go by is 'representation, not exploitation.'

He said acknowledging the successes, not just the dangers and violence, in the LGBTQ+ community is a necessary shift in mindset. He said the resilience of the transgender community is shown through the presence of transgender people in academia, healthcare, the arts and other industries.

Why should someone have to die in order for people to care? he said. The ultimate act of resistance is still being alive.

Conley said he is still discovering his own identity and his advocacy work.

I don't want my narrative to be pigeonholed into being a single-story narrative," he said. There is not a before or an after to my transition, as I am learning.

Conley is often afraid that his identity defines him and his body.

Sometimes when I look in the mirror, I still see a stranger," he said. "I will always be living in a state of transition."

Conleys view of top surgery is not cosmetic.

It's one step closer to becoming someone I recognize to be myself, he said. And quite honestly, it will be a life-saving procedure like any other surgery someone may have.

@alliemkelly

university@dailytarheel.com

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When N.C. healthcare wouldn't cover his top surgery, Owen Conley turned to GoFundMe - The Daily Tar Heel

Texas government officials are parroting right-wing media misinformation about trans youth, including during an appearance on Fox News, as the state is attempting to launch a child abuse investigation into a custody battle over a transgender child whose parents disagree about affirming her gender identity. Anti-trans figures have consistently portrayed the affirmation of trans youth as child abuse.

Right-wing media outlets have dubiously framed the custody battle as a debate over medical intervention -- despite the fact that the child would not be undergoing any such procedures in the near future. They have also pushed misinformation about medical interventions that are widely supported by medical professionals, inaccurately calling them chemical castration -- a false claim which has also been repeated by the Texas attorney general office.

The custody battle is between Anne Georgulas and Jeffrey Younger, two divorced Texas parents of a trans child who goes by Luna and uses female pronouns. Three mental health professionals have diagnosed Luna with gender dysphoria, and Georgulas has accepted her as trans. However, Younger has rejected Lunas gender identity, insisting she is not trans and referring to her by her former name (commonly referred to as a deadname). According to court documents, Younger has engaged in increasingly aggressive behavior, including physical force, toward Georgulas and emotionally abusive behavior toward the child. He has also launched an online campaign, fundraiser, and petition all using the name Luna formerly used.

On October 24, a judge ruled that the parents would share joint custody of Luna despite a jury ruling that Georgulas should have sole custody earlier this week. The judges decision came after major outcry from right-wing media figures and Texas elected officials, including Rep. Dan Crenshaw (R-TX) and Sen. Ted Cruz (R-TX).

Right-wing media led an extensive misinformation campaign about the custody battle, which Texas government officials relied on to justify launching an investigation.

Abbott announced on October 23 that the Texas Office of the Attorney General and Department of Family and Protective Services are looking into the custody case. Government officials in the state usedthat misinformation to justifythe potential investigation. Following the announcement, Texas Assistant Attorney General Jeffrey Mateer sent a letter and issued a press release requesting that the state Department of Family and Protective Services conduct a thorough investigation into possible child abuse to protect the boy in question [from] permanent and potentially irreversible harm by his mother.

Mateer is an allied attorney with the extreme anti-LGBTQ group Alliance Defending Freedom; at least four other ADF allied attorneys worked in the Texas attorney generals office in 2018. In 2017, Mateers federal judicial nomination was withdrawn after some of his extreme anti-LGBTQ comments were uncovered. Notably, Mateer claimed that the existence of trans youth proves that Satans plan is working, and he advocated for the harmful and debunked practice of conversion therapy.

On October 24, Texas Lt. Gov. Dan Patrick went on Fox News The Ingraham Angle, a friendly show for anti-LGBTQ viewpoints, and claimed that at seven, you can't make that decision that will change their life forever -- that you cannot come back, particularly if you go through the full treatment into their teen years. During the segment, Ingraham also called gender-affirming carechild abuse. In another segment from Foxs The Daily Briefing with Dana Perino on October 25, Patrick suggested the legislature would explore the issue in its next session.

The language in Mateers comments and Patricks interviews comes directly from right-wing media, which have taken the custody battle and falsely reframed it to be about supposedly irreversible medical procedures. In fact, therapists have not recommended any medical interventions for Luna, but rather would allow her to dress and otherwise identify as a girl. The Washington Post has noted:

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Right-wing media built the Texas government investigation into custody battle over trans child - Media Matters for America

Pain in cancer may come from compressing or infiltrating nearby body parts, from treatments and diagnostic procedures or from skin, nerve, and the other changes caused by a hormone imbalance or immune response.

The report, states that opioids will continue to dominate as a breakthrough cancer pain treatment, mostly due to available generics and physician familiarity.

Access Report Details at: https://www.themarketreports.com/report/global-cancer-pain-market-research-report

The global Cancer Pain market is valued at xx million US$ in 2018 is expected to reach xx million US$ by the end of 2025, growing at a CAGR of xx% during 2019-2025.

This report focuses on Cancer Pain volume and value at global level, regional level and company level. From a global perspective, this report represents overall Cancer Pain market size by analyzing historical data and future prospect. Regionally, this report focuses on several key regions: North America, Europe, China and Japan.

Key companies profiled in Cancer Pain Market report are Biodelivery Science, Prostrakan Group, Teva Pharmaceuticals, Eli-Lilly, Grunenthal Group, Gw Pharmaceuticals, JohnsonJohnson, Meda Pharmaceuticals, Orexo, Sanofi, Wex Pharmaceuticalsand more in term of company basic information, Product Introduction, Application, Specification, Production, Revenue, Price and Gross Margin (2014-2019), etc.

Purchase this Premium Report at: https://www.themarketreports.com/report/buy-now/1417222

Table of Content

1 Cancer Pain Market Overview

2 Global Cancer Pain Market Competition by Manufacturers

3 Global Cancer Pain Production Market Share by Regions

4 Global Cancer Pain Consumption by Regions

5 Global Cancer PainProduction, Revenue, Price Trend by Type

6 Global Cancer Pain Market Analysis by Applications

7 Company Profiles and Key Figures in Cancer Pain Business

8 Cancer Pain Manufacturing Cost Analysis

9 Marketing Channel, Distributors and Customers

10 Market Dynamics

11 Global Cancer Pain Market Forecast

12 Research Findings and Conclusion

13 Methodology and Data Source

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Global Cancer Pain Market Report to Share Key Aspects of the Industry with the details of Influence Factors - Market Research Reporting

My daughter teaches at a school where a major theme for the students this year is doing acts of kindness.

This prompted me to wonder about the health ramifications of being kind. Its not unusual for some of my older patients to feel withdrawn, and I speculate that if they could engage in sustainable acts of kindness (such as volunteering), maybe their mental health and physical health would improve.

When we hold an elevator door open for someone, hand a dollar to a homeless person or let someone go ahead of us in a line, we notice that we tend to feel good. Aside from the benefit to the recipient when were kind, might there be health benefits to the giver, as well?

In order to answer this question, first we have to look at what happens in the brain when a good deed is performed.

An act of kindness results in the release of several brain chemicals: oxytocin, dopamine, serotonin and endorphins.

Oxytocin is known as the love hormone. It plays a role in social bonding and helps mothers when giving birth and breastfeeding. It also causes the release of nitric oxide in the body, which dilates blood vessels. This results in lowering blood pressure, which, in turn, leads to lower risk of heart attack and stroke.

Dopamine is the neuro-transmitter that is most credited with causing the helpers high. It has a major role in the brains pleasure and reward system.

Serotonin is the neuro-transmitter that regulates mood and happiness. Most prescription anti-depressants work by increasing serotonin levels in the brain.

Endorphins, another kind of neuro-transmitter, interact with opiate receptors to reduce the perception of pain and can lead to feelings of euphoria. Prolonged exercise and consuming chocolate are familiar ways of increasing endorphins.

Performing acts of kindness regularly provides other health benefits. It reduces cortisol, the stress hormone, thereby lowering anxiety.

In a study of 3,000 patients aged 57 to 85, volunteering was the activity most strongly linked to lowering inflammation in the body as measured by C-reactive protein (CRP), a substance made in the liver. High CRP can increase the risk of stroke, heart attack and mortality. In particular, active volunteers aged 70 to 85 had lower CRP levels than those aged 58 to 69 who were not active as volunteers. If thats not enough, there have been several studies that show volunteering leads to longer lifespan.

A study from Pennsylvania State University published in November 2015 in the American Journal of Public Health studied 753 kindergartners to determine the link between social competence and future wellness. Each child was scored on a scale that included items like cooperates with peers without prompting and is helpful to others.

Follow-up was done when these students were approximately 25 years old. The children who scored the highest in social competency in kindergarten predictably had significantly higher college graduation rates and stable employment, and fewer crime, binge-drinking and mental-health problems as adults. By fostering kind behavior in children, we are giving them a greater chance for success later in life.

So how much kindness do you need to do to acquire long-lasting emotional and health benefits?

A lot.

A single act of kindness results in maybe a two-minute high, so to obtain real benefits, performing acts of kindness needs to be repetitive or sustained like by volunteering. Performing a single act of kindness would be like saying you did your exercise quota for the entire day by walking half a block.

An example: After a colleague of mine lost his wife, I was surprised to see him back at work the next day. Being a physician afforded him many opportunities to demonstrate kindness, a natural way for him to cope with his despair. I imagine social-service professionals and those who work as caregivers, educators and clergy have similar chances.

There are many acts of kindness that can become habits. These may include things like tutoring, making charitable donations, expressing gratitude to others, or reading to children or grandchildren.

Caring about one another can lead us to act compassionately. And when acts of kindness become a ritual, the positive effect on our own health can become a surprising side benefit. What will be your next act of kindness?

See the article here:
Acts of kindness are good for your health - The Jewish News of Northern California

LOS ANGELES (Reuters) - One toke for the road could end up being a total bummer for drivers who smoke pot, with several companies in the United States preparing to market cannabis breathalyzers as legalized marijuana spreads across the country.

Law enforcement agencies will require breathalyzers to detect marijuana as they are faced with the necessity of stopping more and more motor vehicles being operated under the influence of THC, said Brett Meade, a retired police chief and a senior program manager for Washington-based non-profit group the Police Foundation.

Nearly a dozen U.S. states allow recreational marijuana consumption and 33 states permit pot for medical use. But all states prohibit driving under the influence of marijuana.

Oakland, California-based Hound Labs is one of the companies developing a breathalyzer to detect THC - the component in marijuana that gets people high - and plans to market it in 2020.

Construction companies could be a big part of its market, said Hound Labs Chief Executive Officer Mike Lynn.

Nobody wants a crane operator 50 stories up to be smoking a joint, he told Reuters.

Lynn, a physician, said pregnancy tests, which can detect minute quantities of hormone, inspired him to tackle the challenge of measuring THC on users breath.

Separately, Cannabix Technologies Inc based in the Vancouver suburb of Burnaby is testing a pair of devices at different price points.

Its THC Breath Analyzer could be cheap enough at a few hundred dollars per unit to potentially allow parents interested in testing their teenager before turning over the keys to the family car, said Cannabix CEO Rav Mlait.

The U.S. court system would need to consider how to treat evidence from THC breathalyzers.

Assuming a motorist who tested positive with a THC breathalyzer was impaired behind the wheel could be problematic, said Stanford University law professor Robert MacCoun.

Unlike with alcohol, scientific research has not yet established firm correlations between the amount of marijuana people consume and how impaired they become, MacCoun said in an email.

Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, expressed similar concerns.

But he welcomed breathalyzers as an improvement over existing tests used by police and employers, such as urine analysis that is unable to determine whether marijuana was used recently with the potential for impairment, or days or weeks in the past. Breathalyzers are likely to only detect a user who consumed cannabis within the last few hours.

A test like that would frankly make sense, Armentano said. Just like we wouldnt allow employees to have a couple drinks and show up to work.

Additional reporting by Jane Ross in Newark, California; editing by Bill Tarrant and Bill Berkrot

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That last toke for the road could be a downer with pot breathalyzers coming - Reuters

Jerusalem Linda Gradstein has a strong family history of breast cancer. Her mother survived breast cancer in her 60s but died a decade later from leukemia. Her maternal grandmother died of the disease in her 50s and her fathers father died of it in his 60s.

So when Gradsteins physician suggested she get tested for the BRCA1 & 2 mutations that greatly raise the risk of developing breast and ovarian cancers especially in Ashkenazi women, the 57-year-old Jerusalem resident readily agreed.

When the test came back negative I felt quite relieved, as if I didnt have to deal with this now, Gradstein, a journalist, told The Jewish Week.

Even so, Gradstein is aware that she may harbor another type of breast cancer-inducing gene mutation.

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Its scary because I feel I have no control over it. I try not to think about it too much, she acknowledged.

Hoping to lower her risk, Gradstein eats healthily and exercises regularly, especially because being overweight is a risk factor for breast cancer. She also continues to get mammograms, may retest for the BRCA1 & 2 mutations (the test has improved over time), and is considering undergoing testing for other gene mutations.

Gradstein is one of the many women who have tested negative for the BRCA1 & 2 mutations but are still considered to be at higher than average risk of developing breast cancer.

About her family history of breast cancer, Linda Gradstein says, Its scary because I have no control over it. Courtesy of Linda Gradstein

Just 5 to 10 percent of breast cancers are thought to be hereditary, caused by mutated genes inherited from a parent. But these low odds are of little comfort to families where multiple relatives have been diagnosed, especially prior to the onset of menopause.

BRCA1 and 2 mutations account for an estimated 20 to 25 percent of hereditary breast cancers and about 5 to 10 percent of all breast cancers.

Li-Fraumeni and Cowden syndromes raise the risk of developing several types of cancer, including breast cancer. Additionally, more than 150 other genetic mutations have been associated with a slightly higher breast cancer risk, according to a report by the American Cancer Society.

A mutated gene can be inherited from a persons father or mother.

Physicians advise high-risk BRCA-negative women to undergo frequent breast exams that combine a physical exam by a breast specialist with mammograms and/or ultrasounds. Some also advise an MRI, in between mammograms.

Otherwise, you have almost a year with no imaging, said Dr. Tal Hadar, a breast surgeon at Shaare Zedek Medical Center, who advises many of her patients at risk for hereditary breast cancer to alternate mammograms with MRIs every six months, along with a clinical exam.

A trained breast specialist may be able to detect breast lumps and spot irregular discharge from the nipples that imaging technology can miss.

Professor Tamar Peretz, who heads Hadassahs Sharett Institute of Oncology, Center for Malignant Breast Diseases, emphasized that not every woman who has a mutated gene will develop breast cancer.

We cannot say or define exactly why one woman with a mutated gene develops cancer and her sister with the same genomic profile does not. This is part of our research, Peretz said.

Hadassahs Professor Tamar Peretz says a healthy lifestyle can reduce the likelihood of developing breast cancer. Hadassahinternational.org

But there is data suggesting that a healthy lifestyle can reduce the likelihood of developing breast cancer.

Factors such as hormone exposure, environmental exposures, diet, exercise and other genes can affect cancer risk, both in people with inherited genetic mutations that increase cancer risk and people who do not have a mutation.

Based on a womans estimated risk and her personal preferences, her physician may recommend comprehensive panel testing (testing for a number of gene mutations) to determine whether she has a non-BRCA mutation that could raise her breast cancer risk.

Although limited testing for just a handful of so-called Ashkenazi mutations, including BRCA1 & 2, was once the norm, some cancer specialists now advise their patients to opt for full sequence testing, with searches for those mutations plus many others.

We know if a woman is Ashkenazi and tested [negative] only for the mutations most common in Ashkenazi Jews, there is still a 4-to-5 percent probability she is carrying another mutation in the BRCA gene, Peretz said. And among the BRCA-negatives, there are several gene mutations in other genes that have already been identified.

Before opting for genetic testing a woman should sit with a genetic counselor not only to gauge her risk based on everything from family history to whether she breastfed her children, but to discuss the implications of discovering a non-BRCA mutation.

While the risks of having certain mutations (such as PALB2, CHEK2, ATM, BARD1, PTEN, TP53, NF1, CDH1, NBN, and STK11) are well-established, there are many other mutations whose level of risk is not currently known.

There are instances when the tests come back with variants of uncertain significance, which means that there is a mutation but its potential impact on health is unknown at this time, said Dr. Ephrat Levy-Lahad, the director of the Medical Genetics Institute at Shaare Zedek Medical Center in Jerusalem.

While scientists may one day learn more about the mutations implications, right now geneticists cannot say how much risk the mutation carries. Not everyone is comfortable living with that uncertainty.

When a mutations implications are known, knowing you are carrying that variation may lead to more positive outcomes, according to Hadar.

Speaking at a medical gathering, Hadar noted that patients at Shaare Zedeks Noga clinic for women who are BRCA1 & 2 positive are usually diagnosed earlier [than patients who are not BRCA-positive] because they are aware of the danger and have a better prognosis. They have more frequent screenings and may decide to have a preventative double mastectomy to prevent cancer from developing.

Being BRCA1 & 2 negative has only boosted Gradsteins desire to learn as much as possible about her cancer risk.

I feel like if we have the opportunity to have more information, why wouldnt we want to have it, in the hopes of early detection? she said.

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BRCA-negative Women Explore Their Options - Jewish Week

For years, speed skater Katherine Adamek struggled with chronic professional self-doubt, despite having won two Olympic medals. The anxiety and insecurity were bleeding over from the ice into her personal life. A hip injury forced her into retirement in 2013.

After three years, though, Adamek was craving a comeback, but I wanted to do things differently this time, she says, building my confidence and learning how to be present for my teammates, how to enjoy my successes and learn from my mistakes instead ruminating and judging myself for them. She reached out to an Olympic sports psychologist with whom shed previously trained, who agreed to help, with one caveat: Adamek needed to start using a meditation app.

Between grueling workouts, Adamek interspersed three-minute guided meditations, building to 10- and 20-minute sessions. Within a few weeks, negative emotions passed more easily. I noticed changes in my relationships with my family, friends and teammates. I could enter a strength training session feeling confident, even if my last workout wasnt great. Adamek set a new American record at her first World Cup Circuit back from retirement in 2016.

Related: The Best Free Meditation Appsand One You Should Pay For

In the early 90s, when Phil Jackson (Nickname: The Zen Master) introduced mindfulness to the Chicago Bulls, the concept of athletes using meditation to tune into their bodies and minds and live in the moment was novel. But as meditation has moved mainstream among the American publicmore than tripling from 2012 to 2017, per the U.S. Centers for Disease Control and Preventionmore and more athletes have embraced the technique.

Kobe Bryant, who learned to meditate when Jackson began coaching the Los Angeles Lakers, has said 15 minutes of daily morning meditation act like an anchor for his day, leaving him calm, set and ready for whatever may come my way. Pete Carroll, head coach of the Seattle Seahawks and an ardent believer in mindfulness, hired a sport psychologist to teach meditation, deep breathing and visualization to his athletes as a means of calming their minds during stressful plays and helping them enter the zonethe mental state of peak performance where an athlete can seemingly do no wrong. And Nike has partnered with the Headspace meditation app, offering subscribers features like mindful guided runs as part of a holistic athlete experience.

Orthopedic surgeon Mark Schickendantz, MD, director of Cleveland Clinic Sports Health and head team physician of the Cleveland Indians Major League Baseball team (yes, they employ a mindfulness coach), says meditation doesnt make players run faster or hit the ball with more force. It allows athletes to grow more grounded and centered, he explains and that mental stillness translates into them being able to tune out noise from the crowd, or not let a strike out wreck their performance for the rest of the game.

Schickendantz says it can do the same for everyday folks watching from the bleachers. Think about the stressors that come into our lives and catch us off guard; we tend to react mindlessly, yelling at the person who cut us off in traffic, for example. With practice, meditation and other mindfulness techniques help you respond to stress in a calmer, more present manner.

Practice gratitude. It can reduce depression and anxiety, lower your risk of disease and flood the brain with feel-good chemicals like serotonin. Work gratitude into your daily routine by reaching out to say thanks to someone who means a lot to you.

You dont need a candlelit yoga studio or an NBA locker room; just find a quiet, comfortable place where you can sit upright and be comfortable. Choose something to focus on; your breath, a mantra, an object. Feel your feet on the floor, connecting to the earth, and take three deep cleansing breaths, inhaling through your nose and out through your mouth, Schickendantz says.

Outside thoughts, like your looming To Do list, are bound to arise. Not only is that perfectly OK its the point of meditating. Mind-wandering isnt bad, he assures. Dont judge it. Just recognize it, label itWhoops, my mind is wandering and bring yourself back to the meditation. This continual re-centering is what builds mindfulness muscles, helping you better filter out stress and distractions and respond to life in a calmer, less-judgmental manner.

Creating a formal daily practice can maximize your benefits, but Journal of Clinical Psychology research found that meditating for five minutes a day, five days a week was enough to slash stress, elevate happiness and enhance the sense of connection subjects felt with others. Try grabbing it throughout the day, encourages Schickendantz, who practices while stuck in traffic. Do it while standing in line at the coffee shopinstead of automatically grabbling your phone [and mindlessly scrolling,] just stand there and be with yourself. (These are sometimes called micro-meditations.)

Related:The Four Sacred SecretsAuthors Share Their Favorite 6-Step Meditation for Beginners

Thanks to modern-day addictions like smartphones and social media, along with the tendency to over-analyze our words and actions, many of us neglect to tune into our thoughts and emotions, causing us to miss out on everyday moments, big or small, and disconnecting us from our bodies, says ChristianSlomka, Community Manager for the Calm meditation app. For athletes, losing focus can mean the difference between a huge win or loss; for you, the stakes range from sad (your little one feels ignored when you appear to choose your tablet over her) to sick (constant rumination triggers the bodys stress response, which is linked with an exhaustive laundry list of illnesses) to devastating (a texting-while-driving car accident).

Schickendantz says relief comes by treating pain just like an unwelcome thought: You identify it, label itTheres that pain againand let it go, accepting it as something that just happens to be a part of your life right now. Its not easy, he acknowledges but it can work. In a recent study by the Hospital for Special Surgery in New York, meditation and mindful breathing helped patients manage chronic pain, sometimes lessening the need for opioid medication. Other research showed a single 10-minute meditation session could feasibly replace painkillers, boosting pain tolerance and reducing pain-related anxiety.

Whether youre an injured Olympian coping with an injury or a parent attempting to keep cool during a toddler temper tantrum, meditation can help you respond to life in a calm, mindful, less judgmental way. The practice also elicits multiple calm-inducing health effects, such as decreased heart rate and blood pressure, and reduced stress hormone production.

Celebrity interviews, recipes and health tips delivered to yourinbox.

The National Sleep Foundation says people who meditate fall asleep faster, sleep longer and catch higher quality zzzs.

Pre-meditation, Id bring work home with me and it would affect my interactions with my husband, Adamek described. After six weeks of using the Vision Pursue meditation app (cofounded by 10-year NFL veteran Jon McGraw), I brought less stress home with me and could be present, asking him about his dayand really listening. Back on the ice post-retirement, her new mindful skills helped her tune into teammates having bad days, encouraging them to open up. Today, as owner of a coaching company called Fix Your Mindset, Adamek helps athletes and organizations reach their next level via mental toughness skills including, of course, meditation.

Try a mealtime meditation with this easy exercise.

Original post:
5 Benefits of Meditation: Why Athletes Meditate and You Should, Too - Parade

During the week, online newspaper, TheCable published an expose on the rot and other shady deals that take place at police stations.

Although they zeroed in on a particular police station in Lagos, however, what they exposed is what is happing at the various other police stations dotted across the length and breadth of this country.

In the story, captioned: UNDERCOVER INVESTIGATION (I): Bribery, bail for sale Lagos police station where innocent civilians are held and criminals are recycled, TheCable wrote in their intro to the piece: Investigative journalist FISAYO SOYOMBO spent two weeks in detention five days in a Police cell and eight as an inmate in Ikoyi Prison to track corruption in Nigerias criminal justice system, beginning from the moment of arrest by the Police to the point of release from prison.

To experience the workings of the system in its raw state, Soyombo adopting the pseudonym Ojo Olajumoke feigned an offence for which he was arrested and detained in police custody; arraigned in court and eventually remanded in Prisonhe uncovers how the Police pervert the course of justice in their quest for ill-gotten money.

TheCable then goes on to give a vivid account of what transpires at the Pedro Police Station and even Ikoyi Prison through the first-hand experience of their undercover reporter.

In one instance, Ojo Olajumoke wrote: The complainant was already registering the case with a policewoman by the time we returned, and soon after they were haggling over the fees. Chigozie Odo, the policewoman, had rejected his offer of N500. After some five minutes of talking, he handed her a N1, 000 note.

Odo stripped me of my shirt, singlet, belt, wristwatch, shoes and cash. Look at his hair; na you gangan be Ruggedy Baba, she said as she unlocked the cell and bundled me in.

This report was only published during the week, but sadly, I can point out that this has been the pattern for decades; because I have also personally experienced it.

In my own case, it was not an attempt to expose the rot through fine investigative reporting, but rather I was a forced participant because a then military governor wanted to deal with my then medium, The Guardian.

I have actually written the story before in a piece I titled How Champions League landed me in Kirikiri Prison, which I wrote to commemorate the 25th year that I and three other colleagues, Bayo Oguntimehin, Taiwo Akerele and Ben Akparanta (now late) were hounded into detention for about 16 days, first at Alausa Police Station and then Motor Traffic Division (MTD), both in Ikeja, Lagos, before ending up in Kirikiri Medium Prisons, just because the then governor Col, Raji Rasaki (rtd) had some bones to pick with the flagship over The Guardians critical position on some of his actions as governor of Lagos.

Our ordeal began on May 29, 1991 when the then governor made his move leading to the closure of The Guardian by the state government.

At both Alausa and MTD, we witnessed first-hand how the police who claim to be our friends interact with those who come to the station to either lodge complaints or are brought in for allegedly committing and offence.

They (police officers) were mostly unfriendly towards such people and more often than not were ready to either bend the law or dish out favours following the receipt of some form of gratification.

For instance, on the first night of our detention after our management had spoken to the officers on duty, we were not immediately shoved into the detention cells with other suspects.

Instead, we were kept outside until about midnight before we were told we had to be put into the cell because it was against the law to allow suspects spend a whole night outside the holding bay.

But of course, before sending us into the cell, they (police) had spoken to the president to ensure that we (journalists) were not given the traditional welcoming which is often a severe beating.

And just like Ojo Olajumoke wrote, I still recall having to remove my belt, watch and other valuables on me and when I jokingly asked what would happen should my trousers not stay up without a belt, I was told if that be the case, then I would have to hold my sokoto because I could not enter the cell with a belt so that I dont use it to commit suicide or as a weapon!

Those in the holding cells were a sorry sight to behold with many of them complaining that they had been thrown in on trumped up charges and would only regain their freedoms as soon as they settled.

Many of them were brought in for wandering, which was then an offence that the police exploited very well in apprehending people.

Although it is often said lightening does not strike twice, however, I have been an exception; and six years after my Kirikiri trip, I was again a forced guest of the police, after I and my two other co-tenants were arrested for armed robbery and gun running.

Incidentally, I had just arrived in the country from Egypt, where I had gone to cover the FIFA U17 World Cup when this fresh incident occurred.

This time we were lodged at the Adeniji Adele Police Station, while we battled to extradite ourselves from the case, which if not properly handled could see me face the death penalty.

Sadly, during the course of our investigation, we were told by our fellow detainees, that we had actually been setup by one of our fellow tenants, who was the only one not with us in detention.

We were told that he (the tenant) had come to the police that he could make money for them by writing a petition that he knew of some armed robbery suspects who once caught would be ready to cough up money in order to free themselves and it was this money that they (the tenant and police) would share.

Unfortunately in the end, the police doubled crossed him on the grounds that the money they made was not as much as he had claimed they would make.

Both stories were subsequently written, but here more than two decades after, we are reading the same story all over a clear indication that absolutely nothing had changed!

And this sadly is one of the biggest problems we face in this country failure to tackle issues head on in order to improve as a nation.

Instead we will all complain about poor governance and yet still vote for the same people that are the hindrance to the nation having decent governance.

At the end of the day, the path to a decent society lies with us as a people, who must then decide once and for all that enough is enough and we are now ready for real change and not just mouth change.

Unless this happens, I can bet that two decades down the line another Ojo Olajumoke will write another expose on virtually the same issue.

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When the hair falls off - New Telegraph Newspaper

By Alex Dobuzinskis

LOS ANGELES (Reuters) One toke for the road could end up being a total bummer for drivers who smoke pot, with several companies in the United States preparing to market cannabis breathalyzers as legalized marijuana spreads across the country.

Law enforcement agencies will require breathalyzers to detect marijuana as they are faced with the necessity of stopping more and more motor vehicles being operated under the influence of THC, said Brett Meade, a retired police chief and a senior program manager for Washington-based non-profit group the Police Foundation.

Nearly a dozen U.S. states allow recreational marijuana consumption and 33 states permit pot for medical use. But all states prohibit driving under the influence of marijuana.

Oakland, California-based Hound Labs is one of the companies developing a breathalyzer to detect THC the component in marijuana that gets people high and plans to market it in 2020.

Construction companies could be a big part of its market, said Hound Labs Chief Executive Officer Mike Lynn.

Nobody wants a crane operator 50 stories up to be smoking a joint, he told Reuters.

Lynn, a physician, said pregnancy tests, which can detect minute quantities of hormone, inspired him to tackle the challenge of measuring THC on users breath.

Separately, Cannabix Technologies Inc based in the Vancouver suburb of Burnaby is testing a pair of devices at different price points.

Its THC Breath Analyzer could be cheap enough at a few hundred dollars per unit to potentially allow parents interested in testing their teenager before turning over the keys to the family car, said Cannabix CEO Rav Mlait.

The U.S. court system would need to consider how to treat evidence from THC breathalyzers.

Assuming a motorist who tested positive with a THC breathalyzer was impaired behind the wheel could be problematic, said Stanford University law professor Robert MacCoun.

Unlike with alcohol, scientific research has not yet established firm correlations between the amount of marijuana people consume and how impaired they become, MacCoun said in an email.

Paul Armentano, deputy director of the National Organization for the Reform of Marijuana Laws, expressed similar concerns.

But he welcomed breathalyzers as an improvement over existing tests used by police and employers, such as urine analysis that is unable to determine whether marijuana was used recently with the potential for impairment, or days or weeks in the past. Breathalyzers are likely to only detect a user who consumed cannabis within the last few hours.

A test like that would frankly make sense, Armentano said. Just like we wouldnt allow employees to have a couple drinks and show up to work.

(Additional reporting by Jane Ross in Newark, California; editing by Bill Tarrant and Bill Berkrot)

See the original post:
That last toke for the road could be a downer with pot breathalyzers coming - Physician's Weekly

When you think of any sort of preconception or fertility treatment, such as hormone testing or in vitro fertilization (IVF), chances are you envision going into either your OB-GYN's office or a fertility clinic and encountering lots of doctors and a slew of needles. But just as services like grocery delivery and transportation are becoming increasingly app-based and tech-savvy, so too are fertility tests and treatments.

As the industry strives to increase access and convenience for patients with at-home options, it's important to remember that there's no one-size-fits-all in fertility treatments, says Chantae Sullivan-Pyke, M.D., a reproductive endocrinologist at Kofinas Fertility Group in New York City. Therefore you'll do well to consult a health care provider about whether an at-home treatment, test, or tracking system is right for you.

So just how much can (and should) really be DIY when it comes to bettering your odds of getting pregnant? We took a look at three of the latest at-home fertility products and services that aim to allow you to take matters of your fertility into your own handsand hometo weigh the pros and cons.

New Hope Fertility in New York City has an exclusive service called At-Home IVF, which is meant to cut out the stressful commute to and from a doctor's office. The kit includes an instruction card, color-coded individual packets with oral and vaginal medications that are numbered by day, a nasal spray which is used on days 12 and 13, and an ovulation testing kit with test strips. Day 14 is the only day that isn't "at-home," as it's when a patient will go into the clinic for egg retrieval.

The pros: "There is no need to go the the physician's office for monitoring, for bloodwork, or for ultrasounds," says Zaher Merhi, MD, FACOG, the director of IVF research and development in IVF technologies at New York'sNew Hope Fertility Clinic. "The woman will only go to the office on the day of the procedure, the egg retrieval. This translates into a tremendous advantage for the woman. She will have much less stress, no concerns about making and keeping appointments at the doctor's office, for women who already have a child there is no need to get a babysitter, and no worries about losing time from work."

The cons: A high chance of human error. Dr. Merhi has acknowledged previously it's a possibility, but the clinic has a built-in contingency plan. Of course, the patient needs to be hyper-vigilant and very motivated to adhere to the correct protocols, he told the New York Post. If an error occurs during the process, the clinic might offer a discount on future treatment and future monitoring would be done in the office versus at home.

The cost: The At-Home IVF kit costs $850. But compared to the cost of conventional IVF at New Hope Fertility which totals approximately $4,000 according to Dr. Merhi, trying the DIY method means a savings of $3,200.

New Hope isn't the only business selling more convenient, in-home kits. Modern Fertility is a hormonal testing kit that allows you to gain insight into the hormones that effect fertility with a finger prick. The blood sample is collected at home, then the test is shipped back to the company. They then provide customers with a report analyzing their hormone levels.

The pros: Knowledge is power. "I actually tried Modern Fertility at 38, a few months before getting married, and it was a 'fertility saver,'" says Ann Murray-Dunning, 40, an expectant mom from San Francisco. "I didn't realize how low my AMH was for my age (.6), and that this meant that my egg reserve was very low for my age. Due to this new knowledge, I sped up the timeline, if you will, and we turned to the pregnancy journey soon after. After some difficulties likely given my low AMH, I am now 18 weeks naturally pregnant with a healthy girl."

Murray-Dunning says she's so confident that all women should do tests like Modern Fertility that she bought a kit for her younger sister. "I talk to her about my challenges and suggested she do what I did earliertest early, so that she has the power of more time and planning," she notes.

The cons: Due to the nature of their profession, doctors are natural skeptics of any at-home hormone testing. "There are a number of at-home hormone tests. Some are reliable and some are not, but all should be confirmed and interpreted with a medical provider if someone is concerned about an underlying medical condition or if someone is struggling with fertility," says Emily Jungheim, MD, MSCI, a board certified reproductive endocrinologist and fertility expert at the Women & Infants Center in St. Louis, Missouri. "That's why we recommend using at-home hormone tests in conjunction with your doctor's care rather than in lieu of it."

The cost: Modern Fertility costs $159. Similar tests include EverlyWell (which costs $159 and looks at the hormones that influence normal ovarian function) and Proov (which costs $39.99 and zeros in on the ebb and flow of your progesterone levels).

Before trying intrauterine insemination (IUI), people hoping to conceive might be drawn to at-home conception aids. Take The Mosie Kit, an insemination syringe kit that was designed for women by women for home insemination and is geared to helping couples with unexplained infertility, the LGBTQ community, women suffering from vaginismus, endometriosis and tilted uterus, male factor issues (low motility, sperm count, and performance anxiety), as well as single mothers by choice.

The pros: "You can do almost anything from home nowadays with DIY kits, and the same goes with slinging sperm," says Aimee D. Eyvazzadeh, MD, MPH. "There are a lot of times when doing this is helpful, but the most helpful is when sex hurts. Then, you can take it into your own hands! I help about four to five patients a year get pregnant in this way, and The Mosie is actually something I've been doing with my patients for over 10 years! And it works."

The cons: A potential lack of information or misinformation. Dr. Eyvazzadeh says The Mosie works even better when patients are shown how to do it by their health care provider so they aren't "missing anything big picture."

Sheeva Talebian, MD, a board-certified reproductive endocrinologist at CCRM Fertility New York, agrees, emphasizing that couples who are turning to these aids because they're struggling with fertility concerns should work with a physician who can provide a comprehensive fertility evaluation. If male factor issues (determined by a semen analysis) are at play, an in-office intrauterine insemination (IUI) may be more effective than an at-home device, she says.

Dr. Eyvazzadeh is also concerned about false claims that other products (like one called The Stork OTC) advertise in regard to "higher pregnancy rates than are truly possible."

"To tell someone that it really increases their chances isn't fair or telling them the truth," Dr. Eyvazzadeh notes. "At-home inseminations aren't as successful as they describe on their website. I wish!"

The cost: The Mosie's two-pack insemination syringe kit costs $89.

The rest is here:
At-Home Fertility Tests and Treatments: Understanding the Pros and Cons - Yahoo Lifestyle

CHARLESTON When Julia Shalhoup was getting ready to retire, she wasnt sure what she was going to do with her new freedom.

A breast cancer diagnosis just three days after her retirement answered that question.

I had so many doctors appointments. Thats all I did, she said.

At the time of her diagnosis, Shalhoup hadnt gone in for a mammogram in several years, she said.

This was despite a standing order for a mammogram.

It was not Shalhoups first experience with cancer.

Shalhoup, who was diagnosed with ulcerative colitis in 1991, found herself in the hospital in 1994 due to severe anemia caused by the disease.

A couple weeks later during a checkup of the colitis, they found an ovarian tumor.

It was totally encapsulated, but it was ovarian cancer, stage 1 and malignant. Had I not had the colitis, they wouldnt have found the ovarian cancer most likely, she said.

When I was diagnosed with the ovarian cancer I think I was in shock. I knew I wasnt feeling well, but I thought the symptoms were on account of the colitis. I was working raising kids and practicing (law).

By the time the cancer was removed, it had grown to the size of a grapefruit.

It was just a tough surgery, and recovery was tough, she said.

At first, Shalhoup was good about faithfully getting her recommended mammograms.

Once you tell physician youve had ovarian cancer, youre top of the list for other cancers, she said.

At a point, however, she felt too busy with her law practice and began to put it off.

I was remiss, she said. It was on my to-do list.

The breast cancer diagnosis in spring 2019 therefore came by accident.

As she was shutting down her divorce law practice that she had devoted nearly 20 years to, she sought treatment for an ulcer.

The physician ordered a scan of her abdominal area. Luckily, the scan included her chest and doctors identified the cancer.

She was fortunate. The cancer was identified at an early stage.

I felt good. You could barely feel the lump, she said.

Still, it was a shocker for the family.

At first, youre a little shocked, said Nick Shalhoup, her husband. I handle things pretty well and so does Julie, but I just felt bad. Especially right after she retired and then days later she gets the diagnosis. You think youre going to enjoy your free time and then you have to deal with this.

She did not require chemotherapy and instead went through a lumpectomy and 16 radiation sessions at the WVU Cancer Institute.

I was great up until the last week. I had a very significant exhaustion period. It felt like I had narcolepsy. Im a reader and I would open a book and start to read and fall asleep. The doctor assured me that was normal, Julia Shalhoup said.

Following treatment, she was prescribed Arimidex, a commonly prescribed therapy for post-menopausal women who have had hormone-receptor positive breast cancer to prevent recurrence.

Theres some pretty serious side effects that can affect the rest of your life and have nothing to do with the cancer, she said. For her, those come from the Arimidex.

Now, she deals with the side effects of that medication, which are hard to bear.

Ive been taking it for almost six weeks and I have at least four or five of the symptoms that are pretty difficult to take, she said.

These include back pain, hot flashes that she describes as more of an internal heat than what she experienced during menopause, and weakness and pain in the extremities.

I truly believe shes handled this very well. Obviously, she has her moments. Everyone would. Worst part has been the Arimidex. It has so many side effects, Nick Shalhoup said.

Julia Shalhoup said she shares her story not for sympathy, but to remind women of the importance of getting the recommended screenings.

I just feel hopeful that if I talk to enough people, theyll feel compelled to do mammograms, she said.

Finding the cancer at an early stage not only improves personal outcomes, but can give your family the information they need to make their own medical decisions.

Shalhoup said waiting for results of her daughters BRCA genetic testing was the hardest part of the process.

That was probably the most difficult two weeks of my life, just worrying about whether she had the genetic marker, she said. She did not have the marker.

Im telling everybody. Im telling everybody Im fine. The sympathy I dont need. I need to make sure that you reach out to every woman you know and say, You need to get this test. Theyre not painful anymore, she said. They used to be painful, but theyre not painful anymore.

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'You need to get this test': Julia Shalhoup stresses importance of mammograms after her own breast cancer experience - WV News

Hypothyroidism is an opposite of hyperthyroidism; one condition may also lead to another. In these conditions, thyroid glands do not function as per the body need and thus, the condition erupts. Lets first understand about the condition.

Hypothyroidism is a condition in which thyroid glands do not produce enough thyroid hormone which means its underactive. Thyroid glands are in the front of the neck with two lobes at each side of the windpipe. These hormones are responsible for regulating bodys metabolism and therefore, any affect on its production can hurt the metabolic function. Thyroid hormone is regulated by thyroid-stimulation hormone which is produced by pituitary gland.

The thyroid gland produced two hormones TS3 and TS4. The symptoms of the condition include fatigue, intolerance towards cold, and muscle and joint pain. Other symptoms could be weight gain, constipation, dry skin and decreased sweating, high cholesterol and insomnia. In some extreme cases, there could be respiratory infections, depression and loss of libido.

Because the condition impacts the metabolism, processing sugar and carbs from processed food could get difficult for the body. Sugary food can also cause increase in inflammation in body further aggravating the condition. Also, sugar can only give short term energy boost. However, controlling your sugar intake can help in long-term regulation of sugar. It may help your skin condition and stress levels that can come with the condition. It could be difficult, but you start with processed food and additional sugar.

Vitamin B12 levels get decreased during hypothyroidism causing fatigue and tiredness. It also impacts vitamin B1 levels in body. Taking these supplements may help refurbish the deteriorating levels of vitamin B in body. Include more of peas, cheese, milk, sesame seeds and eggs in your diet. If in case you are planning to take supplements, make sure you discuss with your doctor once.

Ashwagandha is a herb that can be beneficial for health in many ways. It is called an adaptogenic herb that can prove to be magical in balancing the thyroid hormones. This herb is used to strengthen the immunity and thus, relieving stress and boosting stamina which are common during hypothyroidism. This supplement can be sued twice a day, or you may discuss it with your physician in case you are sceptical about the dose. As its natural, it will not have any side-effects.

Flaxseeds are a rich source of omega-3 fatty acids. This can be beneficial for hypothyroidism. Alpha-linolenic acid is the type of omega-3 fatty acid present in flaxseeds. This has proven benefits in regulating the production of thyroid hormones. They have phytoestrogenic properties that support sex hormones which in turn can regulate thyroid hormones. Magnesium and vitamin B12 present in flaxseeds help body fight symptoms of hypothyroidism. However, make sure you dont consume it in excess for it may have a reverse reaction. Limit it to a couple of spoons a day.

Coconut oil contains medium-chain fatty acids which are easier to break by the body. Ingredients that are easier to digest are important when the metabolic function of the body is affected. It helps in boosting metabolism, one of the biggest ill-effect of hypothyroid. It also helps in keeping your body temperature in control to help keep your intolerance towards cold at bay.

Ginger is full of benefitsit has potassium, magnesium and polyphenols. It has anti-inflammatory properties as well that will help relieve hypothyroidism symptoms. Ginger tea could be the best way to consume ginger to absorb most of its goodness.

Published : October 24, 2019 2:32 pm

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Here are how you can treat hypothyroidism at home - TheHealthSite

ANKARA, TURKEY - NOVEMBER 14: A woman takes a pill on November 14, 2018 in Ankara, Turkey. (Photo ... [+] by Dogukan Keskinkilic/Anadolu Agency/Getty Images)

If you have high blood pressure, remembering to take your medication is so important.

In fact, the time of day when you take your medicine could influence your risk for complications such as heart attack and stroke, which is ultimately related to how well you manage your blood pressure.

The bodys natural rhythm, known as the circadian rhythm also affects how we respond to specific medications, the result of a complex interplay between your medication and cortisol, the chief hormone responsible for this rhythm.

Now, a new study recommends that you take your blood pressure medicine at bedtimeto lower your blood pressure during the night and early morninghelping to prevent elevation of blood pressure that normally occurs as you awaken.

The research was published earlier this week in the European Heart Journal.

There is a growing body of evidence which indicates that not only genetics, but the time of day you take a medicine may influence how effective it is for treating a particular condition.

The current study looking at this phenomenon represents the largest study to date of patients with high blood pressure, and included more than 19,000 persons (from 40 ambulatory blood pressure monitoring clinics in Spain) on medications to treat high blood pressure.

For the study, the patients were randomly assigned to one of 2 groups: one group took their pills in the morning, and the other group took them at bedtime. The investigators monitored the patients for over 6 years tracking their blood pressure.

Blood pressure normally drops as we fall asleep, reaching its lowest between midnight and 3-4 am. It gradually rises as we awaken thanks to release of cortisol from the adrenal glands. Those who do not experience a drop in blood pressure during sleep may, in fact, be at higher risk for heart attack and stroke.

The study found that those who took their medication at bedtime had a significantly lower average blood pressure both at night and during the day, dipping more at night compared to those who took their medication during the morning or daytime.

Study participants who took their medicine at night were 43% less likely to experience any cardiovascular event (heart attack, stroke, heart failure) compared with those who took it in the morning. Those who took their medicine in the nighttime also had a 49% lower risk for stroke, 34% lower risk for heart attack, and 42% lower risk for developing heart failure.

Overall, there was a 45% reduction in cardiovascular risk from any cause (composite score of risk of heart attack, stroke, coronary artery bypass grafting [CABG] or cardiac stent placement, heart failure) in those who took blood pressure medication at bedtime. There was also a 56 % reduction in risk from cardiovascular disease overall.

The results of the study, demonstrating an impressive reduction in risk for heart attacks and strokes, argue for taking blood pressure medicine at bedtime. While previous research has also shown reduction in cardiovascular effects with night time administration of blood pressure medication, this is the largest study to date.

That said, more research is still necessary to better understand if the effect seen in patients taking a specific class of medication in this study also applies to different classes of blood pressure medications. (Study participants took a variety of blood pressure medications including ACE inhibitors, ARBs, ACEI- ARB combination, diuretics, calcium channel blockers, beta-blockers.)

Additional research is also necessary for different ethnicities, as well as those who work various late or overnight shifts to see if taking blood pressure medications in the late evening before bed has the same effect on reducing stroke and heart attacks

While blood pressure has multiple genetic determinants, lifestyle choices also have a significant impact. To reduce blood pressure, its best to reduce alcohol intake, quit smoking, lose weight, reduce stress, exercise more, reduce salt intake, practice yoga or Tai chi, and embrace deep abdominal or diaphragmatic breathing and meditation.

Health care providers recommend that patients try to adhere to a schedule and take their medications at the same time every day. Interestingly, current guidelines dont provide any specific recommendation regarding timing for blood pressure medications, with many people choosing to take them in the morning.

If you take blood pressure medicine, your health care provider has indicated on your prescription when to take it. Its best to consult with your provider and inquire why they have prescribed to take in the morning or before going to bed.

One issue is whether taking blood pressure medicine at night time is the best clinical approach for all patients. Age is certainly one determinant as well as fall risk, since a lower blood pressure at night and early morning can place patients at higher risk for falls, especially in a dark room when attempting to use the bathroom.

Timing of blood pressure medicine is very patient-specific, said Satjit Bhusri, M.D., FACC, Assistant Professor of Cardiology, Lenox Hill Hospital, Northwell Health. There are many factors, including compliance, labile blood pressure, and other medications being administered at the same time.

In conjunction with your healthcare provider, the desire to change the timing of blood pressure medication ultimately involves the ability to lower cardiovascular risk. To achieve lower blood pressure while asleep, its vital that patients take their medicine at the same time every night.

The key here is routines, said Bhusri.An even routine has shown that patients are more compliant with taking their medications more regularly and not forgetting.

While a nighttime approach may achieve a lower mean blood pressure while asleep, helping to reduce cardiovascular risk, is compliance or consistency also playing a role?

The key play here is compliance of medication, offered Bhusri.Not missing a dosewe know one thing worse than an elevated blood pressure is swings in blood pressure due to periodic non-compliance.

If further trials continue to demonstrate reductions in cardiovascular risk with the night time approach, the issue is whether all patients should take their meds at bedtime.

This recommendation is a personalized one that should involve a joint physician-patient interchange, concluded Bhusri.

The Skinny on Blood Pressure

It turns out that your blood pressure begins to rise as you wake up in the morning, elevates through midday, but then actually reaches its lowest point of the day between midnight and 3-4 am.

That said, persons with

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Day Or NightWhen Is The Best Time To Take Your Blood Pressure Medicine? - Forbes